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Dugré JR, Potvin S. Investigating the impact of lumping heterogenous conduct problems: aggression and rule-breaking rely on distinct spontaneous brain activity. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02557-w. [PMID: 39143190 DOI: 10.1007/s00787-024-02557-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024]
Abstract
Accumulating evidence suggests that aggression and rule-breaking may have distinct origins. However, grouping these heterogeneous behaviors into a single dimension labelled Conduct Problems (CP) has become the norm rather than the exception. Yet, the neurobiological features that differentiate aggression and rule-breaking remain largely unexplored. Using a large sample of children and adolescents (n = 1360, 6-18 years old), we examined the common and specific brain activity between CP, aggression, and rule-breaking behaviors. Analyses were conducted using fMRI resting-state data from a 10-minute session to explore the correlations between low frequency fluctuations and both broad and fine-grained CP dimensions. The broad CP dimension was associated with deficits in the precentral gyrus, superior temporal gyrus, and tempo-parietal junction. However, only the superior temporal gyrus was shared between aggression and rule-breaking. Activity of the precentral gyrus was mainly associated with rule-breaking, and the temporo-parietal cortex with aggression. More importantly, voxel-wise analyses on fine-grained dimensions revealed additional specific effects that were initially obscured when using a broad CP dimension. Finally, we showed that the findings specific to aggression and rule-breaking may be related to distinct brain networks and mental functions, especially ventral attention/sensorimotor processes and default mode network/social cognitions, respectively. The current study highlights that aggression and rule-breaking may be related to distinct local and distributed neurobiological markers. Overall, using fine-grained dimensions may provide a clearer picture of the role of neurobiological correlates in CP and their invariance across measurement levels. We advocate for adopting a more thorough examination of the lumping/splitting effect across neuroimaging studies on CP.
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Affiliation(s)
- Jules Roger Dugré
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom.
| | - Stéphane Potvin
- Department of Psychiatry and Addiction, Faculty of medicine, University of Montreal, Montreal, Canada.
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, 7331, Hochelaga, Montreal, H1N 3V2, Canada.
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2
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Engelbrektsson J, Salomonsson S, Högström J, Sorjonen K, Sundell K, Forster M. Parent Training via Internet or in Group for Disruptive Behaviors: A Randomized Clinical Noninferiority Trial. J Am Acad Child Adolesc Psychiatry 2023; 62:987-997. [PMID: 36863414 DOI: 10.1016/j.jaac.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 01/01/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To evaluate if an internet-delivered parent training program is noninferior to its group-delivered counterpart in reducing child disruptive behavior problems (DBP). METHOD This noninferiority randomized clinical trial enrolled families seeking treatment in primary care in Stockholm, Sweden, for DBP in a child 3-11 years of age. Participants were randomized to internet-delivered (iComet) or group-delivered (gComet) parent training. The primary outcome was parent-rated DBP. Assessments were made at baseline and 3, 6, and 12 months. Secondary outcomes included child and parent behaviors and well-being and treatment satisfaction. The noninferiority analysis was determined by a one-sided 95% CI of the mean difference between gComet and iComet using multilevel modeling. RESULTS This trial included 161 children (mean age 8.0); 102 (63%) were boys. In both intention-to-treat and per-protocol analyses, iComet was noninferior to gComet. There were small differences in between-group effect sizes (d = -0.02 to 0.13) on the primary outcome with the upper limit of the one-sided 95% CI below the noninferiority margin at 3-, 6-, and 12-month follow-up. Parents were more satisfied with gComet (d = 0.49, 95% CI [0.26, 0.71]). At 3-month follow-up, there were also significant differences in treatment effect on attention-deficit/hyperactivity disorder symptoms (d = 0.34, 95% CI [0.07, 0.61]) and parenting behavior (d = 0.41, 95% CI [0.17, 0.65]) favoring gComet. At 12-month follow-up, there were no differences in any outcomes. CONCLUSION Internet-delivered parent training was noninferior to group-delivered parent training in reducing child DBP. The results were maintained at 12-month follow-up. This study supports internet-delivered parent training being used as an alternative to group-delivered parent training in clinical settings. CLINICAL TRIAL REGISTRATION INFORMATION Randomized Controlled Trial of Comet via the Internet or in Group Format; https://www. CLINICALTRIALS gov/; NCT03465384.
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Affiliation(s)
| | - Sigrid Salomonsson
- Centre for Psychiatry Research, Karolinska Institutet and Region Stockholm, Sweden
| | - Jens Högström
- Centre for Psychiatry Research, Karolinska Institutet and Region Stockholm, Sweden
| | | | - Knut Sundell
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
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3
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Stepanova E, Langfus JA, Youngstrom EA, Evans SC, Stoddard J, Young AS, Van Eck K, Findling RL. Finding a Needed Diagnostic Home for Children with Impulsive Aggression. Clin Child Fam Psychol Rev 2023; 26:259-271. [PMID: 36609931 DOI: 10.1007/s10567-022-00422-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/09/2023]
Abstract
Aggressive behavior is one of the most common reasons for referrals of youth to mental health treatment. While there are multiple publications describing different types of aggression in children, it remains challenging for clinicians to diagnose and treat aggressive youth, especially those with impulsively aggressive behaviors. The reason for this dilemma is that currently several psychiatric diagnoses include only some of the common symptoms of aggression in their criteria. However, no single diagnosis or diagnostic specifier adequately captures youth with impulsive aggression (IA). Here we review select current diagnostic categories, including behavior and mood disorders, and suggest that they do not provide an adequate description of youth with IA. We also specifically focus on the construct of IA as a distinct entity from other diagnoses and propose a set of initial, provisional diagnostic criteria based on the available evidence that describes youth with IA to use for future evaluation.
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Affiliation(s)
- Ekaterina Stepanova
- Virginia Commonwealth University, 1308 Sherwood Ave, Richmond, VA, 23220, USA.
| | - Joshua A Langfus
- University of North Carolina at Chapel Hill, 235 E Cameron Ave, CB# 3270, Chapel Hill, NC, 27514, USA
| | - Eric A Youngstrom
- University of North Carolina at Chapel Hill, 103 Westchester Pl, Chapel Hill, NC, 27514-5237, USA
| | - Spencer C Evans
- University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA
| | - Joel Stoddard
- University of Colorado Anschutz Medical Campus, Aurora, 13123 East 16Th Ave, Aurora, CO, 80045, USA
| | - Andrea S Young
- Johns Hopkins University, 1800 Orleans Street, Bloomberg 12N, Baltimore, MD, 21287, USA
| | - Kathryn Van Eck
- Johns Hopkins University, 1800 Orleans Street, Bloomberg 12N, Baltimore, MD, 21287, USA
| | - Robert L Findling
- Virginia Commonwealth University, 501 N 2Nd St 4Th Floor, PO Box 980308, Richmond, VA, 23298-0308, USA
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4
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Acar IH, Altundal MN, Kırmızıtaş M, Kırbaşoğlu K. Can you see me at my worst? A latent Profile analysis of students and teachers’ perceptions of student behavior problems. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03888-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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5
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Chen HWB, Gardner ES, Clarkson T, Eaton NR, Wiggins JL, Leibenluft E, Jarcho JM. Bullying Perpetration and Victimization in Youth: Associations with Irritability and Anxiety. Child Psychiatry Hum Dev 2022; 53:1075-1082. [PMID: 34024018 PMCID: PMC8711067 DOI: 10.1007/s10578-021-01192-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
Prior work on has demonstrated that irritability and anxiety are associated with bullying perpetration and victimization, respectively. Even though symptoms of irritability and anxiety often occur concurrently, few studies have tested their interactive effects on perpetration or victimization. The current study recruited 131 youths from a broader program of research that examines the pathophysiology and treatment of pediatric irritability and anxiety. Two moderation tests were performed to examine concurrent irritability and anxiety symptoms and their relation to perpetration and victimization of bullying. More severe anxiety was associated with greater victimization. However, more severe irritability was associated with, not just greater perpetration, but also greater victimization. An irritability-by-anxiety interaction demonstrated that youths with more severe irritability and lower levels of anxiety engaged in more perpetration. Our findings suggest a more nuanced approach to understanding how the commonly comorbid symptoms of irritability and anxiety interact in relation to peer-directed behavior in youths.
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Affiliation(s)
- Hung-Wei Bernie Chen
- Department of Psychological and Brain Sciences, University of Delaware, Wolf Hall Suite 108, 105 The Green, Newark, DE, 19716, USA.
| | | | - Tessa Clarkson
- Department of Psychology, Temple University, Philadelphia, PA
| | | | - Jillian Lee Wiggins
- Department of Psychology, San Diego State University, San Diego, CA,San Diego State University / University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Rockville, MD
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6
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Zik J, Deveney CM, Ellingson JM, Haller SP, Kircanski K, Cardinale EM, Brotman MA, Stoddard J. Understanding Irritability in Relation to Anger, Aggression, and Informant in a Pediatric Clinical Population. J Am Acad Child Adolesc Psychiatry 2022; 61:711-720. [PMID: 34438022 PMCID: PMC8863995 DOI: 10.1016/j.jaac.2021.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/13/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Despite its clinical relevance to pediatric mental health, the relationship of irritability with anger and aggression remains unclear. We aimed to quantify the relationships between well-validated, commonly used measurements of these constructs and informant effects in a clinically relevant population. METHOD A total of 195 children with primary diagnoses of attention-deficit/hyperactivity disorder, disruptive mood dysregulation disorder, or no major disorder and their parents rate irritability, anger, and aggression on measures of each construct. Construct and informant relationships were mapped via multi-trait, multi-method factor analysis. RESULTS Parent- and child-reported irritability and child-reported anger are highly associated (r = 0.89) but have some significant differences. Irritability overlaps with outward expression of anger but diverges from anger in anger suppression and control. Aggression has weaker associations with both irritability (r = 0.56) and anger (r = 0.49). Across measures, informant source explains a substantial portion of response variance. CONCLUSION Irritability, albeit distinct from aggression, is highly associated with anger, with notable overlap in child-reported outward expression of anger, providing empirical support for formulations of clinical irritability as a proneness to express anger outwardly. Diagnostic and clinical intervention work on this facet of anger can likely translate to irritability. Further research on external validation of divergence of these constructs in anger suppression and control may guide future scale revisions. The proportion of response variance attributable to informant may be an under-recognized confound in clinical research and construct measurement.
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Affiliation(s)
- Jodi Zik
- Pediatric Mental Health Institute, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora.
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7
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Sugaya LS, Kircanski K, Stringaris A, Polanczyk GV, Leibenluft E. Validation of an irritability measure in preschoolers in school-based and clinical Brazilian samples. Eur Child Adolesc Psychiatry 2022; 31:577-587. [PMID: 33389159 DOI: 10.1007/s00787-020-01701-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/30/2020] [Indexed: 01/18/2023]
Abstract
The Affective Reactivity Index (ARI) is an irritability measure with good psychometric properties. However, there are no published studies in preschool children, an important population in which to differentiate normative from non-normative irritability. The goal of this study was to validate the ARI in preschoolers. Two samples were included: a school-based sample (N = 487, mean age = 57.80 ± 7.23 months, 52.8% male) and a clinical sample of children with Attention Deficit Hyperactivity Disorder (ADHD; N = 153, mean age = 60.5 ± 7.6 months, 83.7% males). Confirmatory factor analysis assessed ARI unidimensionality. ARI criterion validity was tested through comparison to other scales measuring irritability, related constructs, and other aspects of psychopathology. Test-retest reliability was assessed in the school-based sample. Analyses confirmed a single-factor structure and good internal consistency. The ARI showed stronger correlations with irritability measures than with measures of other constructs. In the clinical sample, ADHD children with comorbid disruptive behavior disorders had higher ARI scores than those without this comorbidity. In the school-based sample, test-retest reliability was moderate. This is the first study to demonstrate ARI validity and reliability in preschoolers. The scale performed well in both school-based and clinical samples. Having a concise and validated irritability measure for preschoolers may facilitate both clinical assessment and research on early irritability.
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Affiliation(s)
- Luisa Shiguemi Sugaya
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bldg. 15K-MSC 2670, Bethesda, MD, 20892-2670, USA. .,Department of Psychiatry, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bldg. 15K-MSC 2670, Bethesda, MD, 20892-2670, USA
| | - Argyris Stringaris
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bldg. 15K-MSC 2670, Bethesda, MD, 20892-2670, USA
| | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bldg. 15K-MSC 2670, Bethesda, MD, 20892-2670, USA
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Ibrahim K, Noble S, He G, Lacadie C, Crowley MJ, McCarthy G, Scheinost D, Sukhodolsky DG. Large-scale functional brain networks of maladaptive childhood aggression identified by connectome-based predictive modeling. Mol Psychiatry 2022; 27:985-999. [PMID: 34690348 PMCID: PMC9035467 DOI: 10.1038/s41380-021-01317-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/07/2021] [Accepted: 09/22/2021] [Indexed: 01/05/2023]
Abstract
Disruptions in frontoparietal networks supporting emotion regulation have been long implicated in maladaptive childhood aggression. However, the association of connectivity between large-scale functional networks with aggressive behavior has not been tested. The present study examined whether the functional organization of the connectome predicts severity of aggression in children. This cross-sectional study included a transdiagnostic sample of 100 children with aggressive behavior (27 females) and 29 healthy controls without aggression or psychiatric disorders (13 females). Severity of aggression was indexed by the total score on the parent-rated Reactive-Proactive Aggression Questionnaire. During fMRI, participants completed a face emotion perception task of fearful and calm faces. Connectome-based predictive modeling with internal cross-validation was conducted to identify brain networks that predicted aggression severity. The replication and generalizability of the aggression predictive model was then tested in an independent sample of children from the Adolescent Brain Cognitive Development (ABCD) study. Connectivity predictive of aggression was identified within and between networks implicated in cognitive control (medial-frontal, frontoparietal), social functioning (default mode, salience), and emotion processing (subcortical, sensorimotor) (r = 0.31, RMSE = 9.05, p = 0.005). Out-of-sample replication (p < 0.002) and generalization (p = 0.007) of findings predicting aggression from the functional connectome was demonstrated in an independent sample of children from the ABCD study (n = 1791; n = 1701). Individual differences in large-scale functional networks contribute to variability in maladaptive aggression in children with psychiatric disorders. Linking these individual differences in the connectome to variation in behavioral phenotypes will advance identification of neural biomarkers of maladaptive childhood aggression to inform targeted treatments.
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Affiliation(s)
- Karim Ibrahim
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
| | - Stephanie Noble
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - George He
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Cheryl Lacadie
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Michael J Crowley
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | | | - Dustin Scheinost
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
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9
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Rosa-Justicia M, Saam MC, Flamarique I, Borràs R, Naaijen J, Dietrich A, Hoekstra PJ, Banaschewski T, Aggensteiner P, Craig MC, Sethi A, Santosh P, Sagar-Ouriaghli I, Arango C, Penzol MJ, Brandeis D, Werhahn JE, Glennon JC, Franke B, Zwiers MP, Buitelaar JK, Schulze UME, Castro-Fornieles J. Subgrouping children and adolescents with disruptive behaviors: symptom profiles and the role of callous-unemotional traits. Eur Child Adolesc Psychiatry 2022; 31:51-66. [PMID: 33147348 DOI: 10.1007/s00787-020-01662-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8-18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous-unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.
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Affiliation(s)
- Mireia Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, CIBERSAM, Barcelona, Spain
| | - Roger Borràs
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael C Craig
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Arjun Sethi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Paramala Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain.
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10
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Breda M, Ardizzone I. Irritability in developmental age: A narrative review of a dimension crossing paediatric psychopathology. Aust N Z J Psychiatry 2021; 55:1039-1048. [PMID: 34015947 DOI: 10.1177/00048674211011245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Irritability is an important theme in paediatric psychiatry considering its high frequency in developmental age, its association with negative outcomes and consequently significant public health impact. Present as main or associated feature of several psychiatric diagnoses, irritability represents a challenge for clinicians who try to understand its origin and role in developmental psychopathology. In this review we try to: (1) get an overview of this dimension and its relationship with each of the main neuropsychiatric disorders in paediatric population and (2) provide a summary of currently available instruments to assess irritability in children and adolescents. METHOD In this narrative review, an overview of irritability in children and adolescents is proposed focusing on selected literature. RESULTS Irritability as feature of many paediatric psychiatric conditions has been evaluated by many authors and included in classifications of paediatric psychiatric diseases. Framework of irritability evolved over time and dimension of irritability has been investigated using different tools and methodologies, both qualitative and quantitative. Metrics of irritability as clinical dimension are important in the diagnostic process of paediatric diseases. CONCLUSION Investigating the presence of irritability in all children with related disorders is mandatory if we consider the risk for functional impairment and affective and behavioural disorders associated with high levels of irritability. Using rigid threshold in developmental age to differentiate physiological from pathological irritability could lead many children having subthreshold levels of irritability to receive no diagnosis and, consequently, no treatment where instead a dimensional approach to irritability could allow to identify prodromal phase and prevent the evolution towards clinical pathological expressions.
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Affiliation(s)
- Maria Breda
- Department of Pediatrics and Pediatric Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - Ignazio Ardizzone
- Department of Pediatrics and Pediatric Neuropsychiatry, Sapienza University of Rome, Rome, Italy
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11
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Doyle CM, Lasch C, Vollman EP, Desjardins CD, Helwig NE, Jacob S, Wolff JJ, Elison JT. Phenoscreening: a developmental approach to research domain criteria-motivated sampling. J Child Psychol Psychiatry 2021; 62:884-894. [PMID: 33137226 PMCID: PMC11221542 DOI: 10.1111/jcpp.13341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To advance early identification efforts, we must detect and characterize neurodevelopmental sequelae of risk among population-based samples early in development. However, variability across the typical-to-atypical continuum and heterogeneity within and across early emerging psychiatric/neurodevelopmental disorders represent fundamental challenges to overcome. Identifying multidimensionally determined profiles of risk, agnostic to DSM categories, via data-driven computational approaches represents an avenue to improve early identification of risk. METHODS Factor mixture modeling (FMM) was used to identify subgroups and characterize phenotypic risk profiles, derived from multiple parent-report measures of typical and atypical behaviors common to autism spectrum disorder, in a community-based sample of 17- to 25-month-old toddlers (n = 1,570). To examine the utility of risk profile classification, a subsample of toddlers (n = 107) was assessed on a distal, independent outcome examining internalizing, externalizing, and dysregulation at approximately 30 months. RESULTS FMM results identified five asymmetrically sized subgroups. The putative high- and moderate-risk groups comprised 6% of the sample. Follow-up analyses corroborated the utility of the risk profile classification; the high-, moderate-, and low-risk groups were differentially stratified (i.e., HR > moderate-risk > LR) on outcome measures and comparison of high- and low-risk groups revealed large effect sizes for internalizing (d = 0.83), externalizing (d = 1.39), and dysregulation (d = 1.19). CONCLUSIONS This data-driven approach yielded five subgroups of toddlers, the utility of which was corroborated by later outcomes. Data-driven approaches, leveraging multiple developmentally appropriate dimensional RDoC constructs, hold promise for future efforts aimed toward early identification of at-risk-phenotypes for a variety of early emerging neurodevelopmental disorders.
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Affiliation(s)
- Colleen M. Doyle
- Institute of Child Development, University of Minnesota, Minneapolis, MN,USA
| | - Carolyn Lasch
- Institute of Child Development, University of Minnesota, Minneapolis, MN,USA
| | - Elayne P. Vollman
- Department of Comparative Human Development, University of Chicago, Chicago, IL, USA
| | | | - Nathaniel E. Helwig
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
- Department of Statistics, University of Minnesota, Minneapolis, MN, USA
| | - Suma Jacob
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Jason J. Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN,USA
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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12
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Helping Clinicians to Detect ODD in Children with ADHD in Clinical Settings. Psychiatr Q 2021; 92:821-832. [PMID: 33130959 DOI: 10.1007/s11126-020-09855-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
The objectives of this study were to provide a basic tool for pediatricians or other physicians to suspect and detect ODD in children with ADHD and to distinguish the symptomatic profile of ODD from ADHD. 101 subjects with ADHD, 83 with both ADHD and ODD and 342 controls aged 8 to 15 years were included in the study. A semi-structured interview was performed for evaluation of psychiatric diagnoses. Both parents and teachers completed DSM-IV Disruptive Behavior Disorders Rating Scale. We found differences among all three diagnostic subsamples in two-by-two analyses for all dimensions (Inattention, Hyperactivity/Impulsivity and ODD) both according to parent and teacher reports (p < 0.03 for all analyses). Based on parental ODD scores, ROC Curve analyses between 'only ADHD' and 'ADHD+ODD' groups showed that AUC was equal 0.80 (95%CI = 0.73-0.86) and the best cutoff point for ODD diagnosis in the ADHD subjects was 0.68. This study demonstrates the presence of a basic tool for detection and suspicion of ODD in children with ADHD for primary care clinicians or pediatricians in clinical settings. Findings also indicate that patients with ODD and ADHD have more severe inattention, hyperactivity/impulsivity and oppositional symptoms than those with only ADHD have.
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Abstract
This study examined risk factors of physical aggression during transition from early to late adolescence using a two-wave longitudinal study. Specifically, we examined if risk factors in early adolescence predict physically aggressive behavior starting in late adolescence and why some adolescents desist physical aggressive behavior while others do not. The study sample consisted of 2289 Norwegian adolescents (1235 girls) who participated in the Young-HUNT1 study (mean age 14.5) and the follow-up study 4 years later, Young-HUNT2 study (mean age 18.4). One in six young adolescents reported engaging in physical fights. Moreover, physical aggression in early adolescence was significantly associated with male gender, attention problems, academic problems, being bullied, drinking alcohol, and smoking. Male gender and heavy drinking during early adolescence increased the risk for newly emerging aggressive behavior in late adolescence, whereas heavy drinking during early adolescence was a predictor for persistent versus desisting aggressive behavior in late adolescence.
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14
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Hagenbeek FA, Roetman PJ, Pool R, Kluft C, Harms AC, van Dongen J, Colins OF, Talens S, van Beijsterveldt CEM, Vandenbosch MMLJZ, de Zeeuw EL, Déjean S, Fanos V, Ehli EA, Davies GE, Hottenga JJ, Hankemeier T, Bartels M, Vermeiren RRJM, Boomsma DI. Urinary Amine and Organic Acid Metabolites Evaluated as Markers for Childhood Aggression: The ACTION Biomarker Study. Front Psychiatry 2020; 11:165. [PMID: 32296350 PMCID: PMC7138132 DOI: 10.3389/fpsyt.2020.00165] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/21/2020] [Indexed: 01/05/2023] Open
Abstract
Biomarkers are of interest as potential diagnostic and predictive instruments in personalized medicine. We present the first urinary metabolomics biomarker study of childhood aggression. We aim to examine the association of urinary metabolites and neurotransmitter ratios involved in key metabolic and neurotransmitter pathways in a large cohort of twins (N = 1,347) and clinic-referred children (N = 183) with an average age of 9.7 years. This study is part of ACTION (Aggression in Children: Unraveling gene-environment interplay to inform Treatment and InterventiON strategies), in which we developed a standardized protocol for large-scale collection of urine samples in children. Our analytical design consisted of three phases: a discovery phase in twins scoring low or high on aggression (N = 783); a replication phase in twin pairs discordant for aggression (N = 378); and a validation phase in clinical cases and matched twin controls (N = 367). In the discovery phase, 6 biomarkers were significantly associated with childhood aggression, of which the association of O-phosphoserine (β = 0.36; SE = 0.09; p = 0.004), and gamma-L-glutamyl-L-alanine (β = 0.32; SE = 0.09; p = 0.01) remained significant after multiple testing. Although non-significant, the directions of effect were congruent between the discovery and replication analyses for six biomarkers and two neurotransmitter ratios and the concentrations of 6 amines differed between low and high aggressive twins. In the validation analyses, the top biomarkers and neurotransmitter ratios, with congruent directions of effect, showed no significant associations with childhood aggression. We find suggestive evidence for associations of childhood aggression with metabolic dysregulation of neurotransmission, oxidative stress, and energy metabolism. Although replication is required, our findings provide starting points to investigate causal and pleiotropic effects of these dysregulations on childhood aggression.
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Affiliation(s)
- Fiona A. Hagenbeek
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Peter J. Roetman
- Curium-LUMC, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - René Pool
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Amy C. Harms
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
- The Netherlands Metabolomics Centre, Leiden, Netherlands
| | - Jenny van Dongen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Olivier F. Colins
- Curium-LUMC, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Department Special Needs Education, Ghent University, Ghent, Belgium
| | | | | | | | - Eveline L. de Zeeuw
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Sébastien Déjean
- Toulouse Mathematics Institute, University of Toulouse, CNRS, Toulouse, France
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari and Neonatal Intensive Care Unit, Cagliari, Italy
| | - Erik A. Ehli
- Avera Institute for Human Genetics, Sioux Falls, SD, United States
| | - Gareth E. Davies
- Avera Institute for Human Genetics, Sioux Falls, SD, United States
| | - Jouke Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden University, Leiden, Netherlands
- The Netherlands Metabolomics Centre, Leiden, Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Robert R. J. M. Vermeiren
- Curium-LUMC, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Dorret I. Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Amsterdam Neuroscience, Amsterdam, Netherlands
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15
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Derks IPM, Bolhuis K, Yalcin Z, Gaillard R, Hillegers MHJ, Larsson H, Lundström S, Lichtenstein P, van Beijsterveldt CEM, Bartels M, Boomsma DI, Tiemeier H, Jansen PW. Testing Bidirectional Associations Between Childhood Aggression and BMI: Results from Three Cohorts. Obesity (Silver Spring) 2019; 27:822-829. [PMID: 30957987 PMCID: PMC6594099 DOI: 10.1002/oby.22419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study examined the prospective, potentially bidirectional association of aggressive behavior with BMI and body composition across childhood in three population-based cohorts. METHODS Repeated measures of aggression and BMI were available from the Generation R Study between ages 6 and 10 years (N = 3,974), the Netherlands Twin Register (NTR) between ages 7 and 10 years (N = 10,328), and the Swedish Twin Study of Child and Adolescent Development (TCHAD) between ages 9 and 14 years (N = 1,462). In all samples, aggression was assessed with the Child Behavior Checklist. Fat mass and fat-free mass were available in the Generation R Study. Associations were examined with cross-lagged modeling. RESULTS Aggressive behavior at baseline was associated with higher BMI at follow-up in the Generation R Study (β = 0.02, 95% CI: 0.00 to 0.04), in NTR (β = 0.04, 95% CI: 0.02 to 0.06), and in TCHAD (β = 0.03, 95% CI: -0.02 to 0.07). Aggressive behavior was prospectively associated with higher fat mass (β = 0.03, 95% CI: 0.01 to 0.05) but not fat-free mass. There was no evidence that BMI or body composition preceded aggressive behavior. CONCLUSIONS More aggressive behavior was prospectively associated with higher BMI and fat mass. This suggests that aggression contributes to the obesity problem, and future research should study whether these behavioral pathways to childhood obesity are modifiable.
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Affiliation(s)
- Ivonne P. M. Derks
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Generation R Study GroupErasmus Medical CenterRotterdamthe Netherlands
| | - Koen Bolhuis
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Generation R Study GroupErasmus Medical CenterRotterdamthe Netherlands
| | - Zeynep Yalcin
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
| | - Romy Gaillard
- Department of PediatricsErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of EpidemiologyErasmus Medical CenterRotterdamthe Netherlands
| | - Manon H. J. Hillegers
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of PsychiatryRudolf Magnus Brain Center, Utrecht University Medical CenterUtrechtthe Netherlands
| | - Henrik Larsson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
- School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Sebastian Lundström
- Center for Ethics, Law and Mental HealthUniversity of GothenborgGothenborgSweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
| | | | - Meike Bartels
- Department of Biological PsychologyVrije UniversityAmsterdamthe Netherlands
| | - Dorret I. Boomsma
- Department of Biological PsychologyVrije UniversityAmsterdamthe Netherlands
| | - Henning Tiemeier
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of Social and Behavioral SciencesHarvard T. H. Chan School of Public Health, Harvard UniversityBostonMassachusettsUSA
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamthe Netherlands
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16
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Deveney CM, Stoddard J, Evans R, Chavez G, Harney M, Wulff R. On Defining Irritability and its Relationship to Affective Traits and Social Interpretations. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019; 144:61-67. [PMID: 31097847 DOI: 10.1016/j.paid.2019.02.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Irritability has gained recognition as a clinically significant trait in youth and adults that when persistent and severe, predicts poor outcomes throughout life. However, its definition, measurement, and relationship to similar constructs remain poorly understood. In a community sample of adults (N=458; 19-74 years; M=40.5), we sought to identify a unitary irritability factor from independently constructed self-reported measures of irritability distinct from the related constructs of aggression, depression, and anxiety, and whether it was associated with face emotion identification deficits and hostile interpretation biases previously established in clinical pediatric samples. The three measures of irritability generated a common factor characterized by a rapid, angry response to provocation. This irritability factor had unique associations with tendencies to judge ambiguous stimuli as reflecting hostility, but not with face emotion identification performance. These findings clarify the nature of irritability and its associations with neurocognitive phenomenon.
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Affiliation(s)
| | | | | | - Goretty Chavez
- Department of Psychology, Wellesley College, Wellesley, MA
| | | | - Rachel Wulff
- Department of Psychology, Wellesley College, Wellesley, MA
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17
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Bolhuis K, Muetzel RL, Stringaris A, Hudziak JJ, Jaddoe VWV, Hillegers MHJ, White T, Kushner SA, Tiemeier H. Structural Brain Connectivity in Childhood Disruptive Behavior Problems: A Multidimensional Approach. Biol Psychiatry 2019; 85:336-344. [PMID: 30119874 DOI: 10.1016/j.biopsych.2018.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Studies of white matter connectivity in children with disruptive behavior have yielded inconsistent results, possibly owing to the trait's heterogeneity, which comprises diverse symptoms like physical aggression, irritability, and delinquency. This study examined associations of global and specific white matter connectivity with childhood disruptive behavior problems, while accounting for their complex multidimensionality. METHODS In a large cross-sectional population-based study of 10-year-old preadolescents (n = 2567), we assessed four previously described empirically derived dimensions of disruptive behavior problems using the Child Behavior Checklist: physical aggression, irritability, disobedient behavior, and delinquent behavior. Global and specific white matter microstructure was assessed by diffusion tensor imaging. RESULTS Global fractional anisotropy and mean diffusivity were not associated with broad measures of disruptive behavior, e.g., Child Behavior Checklist externalizing problems scale. Global fractional anisotropy was negatively associated with delinquent behavior (β = -.123, pfalse discovery rate adjusted = .028) and global mean diffusivity was positively associated with delinquent behavior (β = .205, pfalse discovery rate adjusted < 0.001), suggesting reduced white matter microstructure in preadolescents with higher levels of delinquent behavior. Lower white matter microstructure in the inferior longitudinal fasciculus, superior longitudinal fasciculus, cingulum, and uncinate underlie these associations. Global white matter microstructure was not associated with physical aggression, irritability, or disobedient behavior. CONCLUSIONS Delinquent behavior, a severe manifestation of childhood disruptive behavior, was associated with lower white matter microstructure in tracts connecting frontal and temporal lobes. These brain regions are involved in decision making, reward processing, and emotion regulation. This study demonstrated that incorporating the multidimensional nature of childhood disruptive behavior traits shows promise in advancing the search for elucidating neurobiological correlates of disruptive behavior.
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Affiliation(s)
- Koen Bolhuis
- Department of Child and Adolescent Psychiatry; Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Argyris Stringaris
- Mood Brain & Development Unit, Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland
| | - James J Hudziak
- Department of Psychiatry, Vermont Center for Children, Youth and Families, University of Vermont, Burlington, Vermont
| | - Vincent W V Jaddoe
- Department of Pediatrics, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry; Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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18
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Hendriks AM, Bartels M, Colins OF, Finkenauer C. Childhood aggression: A synthesis of reviews and meta-analyses to reveal patterns and opportunities for prevention and intervention strategies. Neurosci Biobehav Rev 2018; 91:278-291. [PMID: 29580961 DOI: 10.1016/j.neubiorev.2018.03.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 01/27/2023]
Abstract
This study provides a synthesis of meta-analyses and systematic reviews on non-pharmacological treatments for childhood aggression. Treatments referred to universal prevention, selective prevention, indicated prevention, or intervention (Mrazek and Haggerty, 1994). Seventy-two meta-analyses and systematic reviews met the inclusion criteria. We describe their characteristics, effect sizes across types of treatments, and the effects of various moderators. For universal and selective prevention, effects were mostly absent or small; for indicated prevention and interventions, effects were mostly small or medium. Only two moderators had a positive effect on treatment effectiveness, namely pre-test levels of aggression and parental involvement. These results identified similarities between indicated prevention and intervention treatments, on the one hand, and universal prevention and selective prevention, on the other. Our findings suggest that research distinguishing between targets of treatments (i.e., factors associated with childhood aggression vs. present aggressive behaviors) would be promising. Moreover, to further increase effectiveness of treatments for childhood aggression, individual differences warrant scientific attention.
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Affiliation(s)
- A M Hendriks
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van den Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - M Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van den Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - O F Colins
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Endegeesterstraatweg 27, 2342 AK Oegstgeest, The Netherlands.
| | - C Finkenauer
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van den Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Interdisciplinary Social Sciences: Youth Studies, Utrecht University, Faculty of Social and Behavioural Sciences, Martinus J. Langeveld Building, Heidelberglaan 1, 3584 CH Utrecht, The Netherlands.
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19
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Ogundele MO. Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World J Clin Pediatr 2018; 7:9-26. [PMID: 29456928 PMCID: PMC5803568 DOI: 10.5409/wjcp.v7.i1.9] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/30/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023] Open
Abstract
Mental health problems in children and adolescents include several types of emotional and behavioural disorders, including disruptive, depression, anxiety and pervasive developmental (autism) disorders, characterized as either internalizing or externalizing problems. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional, defiant or conduct disorders are the commonest behavioural problems in preschool and school age children. The routine Paediatric clinic or Family Medicine/General Practitioner surgery presents with several desirable characteristics that make them ideal for providing effective mental health services to children and adolescents. DSM-5 and ICD-10 are the universally accepted standard criteria for the classification of mental and behaviour disorders in childhood and adults. The age and gender prevalence estimation of various childhood behavioural disorders are variable and difficult to compare worldwide. A review of relevant published literature was conducted, including published meta-analyses and national guidelines. We searched for articles indexed by Ovid, PubMed, PubMed Medical Central, CINAHL, EMBASE, Database of Abstracts and Reviews, and the Cochrane Database of Systematic reviews and other online sources. The searches were conducted using a combination of search expressions including "childhood", "behaviour", "disorders" or "problems". Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents.
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Affiliation(s)
- Michael O Ogundele
- Department of Community Paediatrics, NHS Fife, Glenwood Health Centre, Glenrothes KY6 1HK, United Kingdom
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