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Hennefield L, Whalen DJ, Tillman R, Barch DM, Luby JL. Preschool-Onset Major Depressive Disorder as a Strong Predictor of Suicidal Ideation and Behaviors Into Preadolescence. J Am Acad Child Adolesc Psychiatry 2024; 63:919-930. [PMID: 38070867 PMCID: PMC11156793 DOI: 10.1016/j.jaac.2023.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/28/2023] [Accepted: 11/30/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Suicidal thoughts and behaviors (STBs) in children are an escalating public health concern. This study focused on 1 understudied candidate risk factor, namely, preschool-onset major depressive disorder (PO-MDD), as a predictor of persistent and emerging STBs from early childhood into preadolescence. METHOD Participants were 137 children 8 to 12 years of age who met criteria for PO-MDD when they were 3 to 6 years of age, and a nondepressed sample of 53 age-, income-, and sex-matched peers. STBs were reported by caregivers (preschool, preadolescence) and children (preadolescence) using age-appropriate diagnostic interviews. RESULTS By preadolescence, children who had PO-MDD were 7.38 times more likely than their peers to have endorsed STBs after early childhood (p < .001; 67.9% vs 22.6%), including 6.71 times more likely to have engaged in suicide behaviors/attempts (p = .012; 21.9% vs 3.8%); they were also 8.98 times more likely to have endorsed STBs over the prior month (p = .005; 26.3% vs 3.8%). Similar findings emerged when limiting the PO-MDD group to children without preschool STBs, and when controlling for externalizing comorbidities, implicating PO-MDD as a unique diagnostic predictive risk factor. However, children who had PO-MDD with STBs were 3.46 times more likely than children who had PO-MDD without STBs to endorse later STBs (p = .018; 83.1% vs 54.2%), indicating substantial continuity of preschool STBs alongside strikingly high rates of emerging STBs into preadolescence. PLAIN LANGUAGE SUMMARY This longitudinal study explores preschool onset major depressive disorder (PO-MDD) as a predictor of having suicidal thoughts or attempting suicide by age 12. 137 children aged 8 to 12 years who met criteria for PO-MDD when they were 3 to 6 years of age and 53 non-depressed peers were included in the study. The study found that preadolescents who had experienced preschool-onset depression were 6.14 times more likely to experience active suicidal thoughts and 8.03 times more likely to have made a suicide attempt by age 12 when compared to preadolescents who did not experience preschool depression. Results suggest that children with preschool-onset depression would likely benefit from increased suicide screening, proactive safety planning and early interventions. CONCLUSION PO-MDD is a strong risk factor for the emergence and persistence of STBs into preadolescence. Children with PO-MDD would likely benefit from increased suicide screening, proactive safety planning, and early interventions.
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Affiliation(s)
| | - Diana J Whalen
- Washington University School of Medicine, St. Louis, Missouri
| | - Rebecca Tillman
- Washington University School of Medicine, St. Louis, Missouri
| | - Deanna M Barch
- Washington University School of Medicine, St. Louis, Missouri; Washington University in St Louis, St. Louis, Missouri
| | - Joan L Luby
- Washington University School of Medicine, St. Louis, Missouri
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Carbonneau R, Vitaro F, Brendgen M, Boivin M, Tremblay RE. Are Children Following High Trajectories of Disruptive Behaviors in Early Childhood More or Less Likely to Follow Concurrent High Trajectories of Internalizing Problems? Behav Sci (Basel) 2024; 14:571. [PMID: 39062394 PMCID: PMC11274135 DOI: 10.3390/bs14070571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
The developmental association between disruptive behaviors (DBs: hyperactivity-impulsivity, non-compliance, physical aggression) and internalizing problems in early childhood is not well understood and has generated competing hypotheses and mixed results. Using a person-centered strategy, the present study aimed to examine concurrent trajectories of DBs and trajectories of internalizing problems from age 1.5 to 5 years in a population-representative sample (N = 2057; 50.7% boys). Six trajectories of DBs and three trajectories of internalizing problems, based on parent reports and obtained via latent growth modeling across five periods of assessment, were used as longitudinal indicators of each type of behaviors. Children following low or moderate trajectories served as the reference class. Compared to children in the reference class, those in trajectory classes characterized by high levels of co-occurring DBs (OR = 6.60) and, to a lesser extent, those in single high DB classes (OR = 2.78) were more likely to follow a high trajectory of internalizing problems simultaneously. These results support a multiple problem hypothesis regarding the association between DBs and internalizing problems, consistent with a developmental perspective that includes a general factor underpinning different psychopathologies. These findings highlight the importance of considering the co-occurrence between DBs and internalizing problems when studying either construct in children.
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Affiliation(s)
- Rene Carbonneau
- Department of Pediatrics, University of Montreal, Montreal, QC H3T 1J7, Canada
- Centre de Recherche Azrieli du CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montréal, QC H3T 1C5, Canada
| | - Frank Vitaro
- Centre de Recherche Azrieli du CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montréal, QC H3T 1C5, Canada
- Department of Psychoeducation, University of Montreal, Montréal, QC H3C 3J7, Canada
| | - Mara Brendgen
- Centre de Recherche Azrieli du CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montréal, QC H3T 1C5, Canada
- Department of Psychology, University of Quebec in Montreal, Montréal, QC H3C 3P8, Canada
| | - Michel Boivin
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montréal, QC H3T 1C5, Canada
- Department of Psychology, Université Laval, Québec City, QC G1V 0A6, Canada
| | - Richard E. Tremblay
- Department of Pediatrics, University of Montreal, Montreal, QC H3T 1J7, Canada
- Centre de Recherche Azrieli du CHU Sainte-Justine, Montréal, QC H3T 1C5, Canada
- Research Unit on Children’s Psychosocial Maladjustment, University of Montreal, Montréal, QC H3T 1C5, Canada
- Department of Psychology, University of Montreal, Montréal, QC H3C 3J7, Canada
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Overgaard KR, Oerbeck B, Friis S, Pripp AH, Aase H, Biele G, Ingeborgrud CB, Polanczyk GV, Zeiner P. Early and repeated screening detects children with persistent attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2024; 33:1807-1815. [PMID: 37624573 PMCID: PMC11211128 DOI: 10.1007/s00787-023-02284-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Preschool screening of attention-deficit/hyperactivity disorder (ADHD) has been found too inaccurate to be clinically useful. This may be due to the known instability of ADHD symptoms from preschool onwards, and the use of a single screening only. We hypothesized that by identifying a group of children with persistent ADHD from preschool to school age and repeating the screening, the clinical usefulness of screening would increase. This study is part of the prospective longitudinal, population-based Norwegian Mother, Father and Child Cohort Study, with a diagnostic parent interview at 3.5 years and follow-up with parent questionnaires at ages 5 and 8 years (n = 707). We identified a group classified with ADHD at all three time points (persistent ADHD). We then used the Child Behavior Checklist ADHD DSM-oriented scale at ages 3.5 and 5 years to investigate the accuracies of single- and two-stage screening at different thresholds to identify children with persistent ADHD. About 30% of the children were classified with ADHD at least once across time (at ages 3.5, 5, and/or 8 years), but only 4% (n = 30) had persistent ADHD. At all thresholds, the two-stage screening identified children with persistent ADHD more accurately than single screening, mainly due to a substantial reduction in false positives. Only a small group of children were classified with persistent ADHD from preschool to school age, underlining that future screening studies should distinguish this group from those with fluctuating symptoms when estimating screening accuracies. We recommend a two-stage screening process to reduce false positives.
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Affiliation(s)
- Kristin Romvig Overgaard
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway
| | - Svein Friis
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Guido Biele
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Guilherme V Polanczyk
- Faculdade de Medicina FMUSP, Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Grieshaber A, Silver J, Bufferd SJ, Dougherty L, Carlson G, Klein DN. Early childhood anxiety disorders: continuity and predictors in adolescence. Eur Child Adolesc Psychiatry 2024; 33:1817-1825. [PMID: 37620672 DOI: 10.1007/s00787-023-02287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7-15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety.
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Affiliation(s)
- Alexander Grieshaber
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA.
| | - Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA
| | - Sara J Bufferd
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Lea Dougherty
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Gabrielle Carlson
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA
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Nolvi S, Paavonen EJ, Korja R, Pelto J, Karukivi M, Tuulari JJ, Karlsson H, Karlsson L. Course of child social-emotional and sleep symptoms, parental distress and pandemic-related stressors during COVID-19. Dev Psychopathol 2024; 36:518-532. [PMID: 36794405 DOI: 10.1017/s0954579422001377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Research on the longitudinal courses of child social-emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children's social-emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020-summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social-emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.
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Affiliation(s)
- Saara Nolvi
- Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku. Medisiina A (307), Kiinamyllynkatu 10, 20014 Turun yliopisto, Turku, Finland
| | - E Juulia Paavonen
- Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riikka Korja
- Department of Psychology and Speech-Language Pathology, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine and Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine & Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jetro J Tuulari
- Turku Collegium for Science, Medicine and Technology; FinnBrain Birth Cohort Study, Turku Brain and Mind Center & Department of Psychiatry, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center & Department of Psychiatry & Center for Population Health Research, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study & Center for Population Health Research, Psychiatry, Paediatrics and Adolescent Medicine, Department of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland
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6
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Alacha HF, Isaac AJ, Gemmell N, Dougherty LR, Olino TM, Bufferd SJ. Comparison of Global and Daily Ratings of Associations between Anxiety and Depressive Behaviors and Impairment in Preschool-Aged Children. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01697-z. [PMID: 38578584 DOI: 10.1007/s10578-024-01697-z] [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] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
Anxiety and depressive difficulties can emerge during early childhood and cause impairment in functioning. Anxiety and depressive behaviors and impairment are typically assessed with global questionnaires that require recall of children's behavior over an extended period which could reduce the accuracy of parent report of children's behavior and functioning. The current study compared parents' report of children's anxiety and depressive behaviors and impairment when evaluated with global measures versus a daily diary measure. Participants (N = 901 parents of 3-5-year-old children) completed global and daily measures of children's behavior and impairment during enrollment to the study. Global measures were completed at baseline and the 14 daily diary measures were completed consecutively for two weeks. Across most measures, daily associations between parent-reported anxiety and depressive behaviors and impairment were stronger compared to associations with global measures. These results suggest that daily measures may better capture links between young children's typical behavior and functioning compared to global measures. In addition, daily assessment might be more effective for measuring mild to moderate yet still impairing behaviors that may be missed on global reports that require longer periods of recall.
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Affiliation(s)
| | | | | | | | | | - Sara J Bufferd
- University of Louisville, Kentucky, USA.
- Department of Psychological & Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA.
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7
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Astudillo Y, Kibrom S, Pereira T, Solomon S, Krishnan S, Samsonov D. Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study. J Hypertens 2024; 42:644-649. [PMID: 38230613 PMCID: PMC10906197 DOI: 10.1097/hjh.0000000000003652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Although anxiety is known to be associated with elevated blood pressure and hypertension in adults, this has not been studied in children. The aim of this study was to determine the association between anxiety and elevated blood pressures in adolescents. METHODS Adolescents, aged 12-18 years old, referred to the nephrology clinic were eligible to participate. Elevated blood pressure was defined as either SBP or DBP measurement above the 95th percentile for age, height, and sex. Participants were evaluated for anxiety using the validated Screen for Child Anxiety Related Disorders questionnaire filled independently by the child (SCARED-C) and parent (SCARED-P) evaluating the child. RESULTS Two hundred adolescents participated in this study. Thirty-one (53%) of SCARED-P-positive participants were found to have elevated blood pressure compared with 27 (19%) of SCARED-P negative, P 0.03. Twenty-five (43%) of SCARED-P positive had elevated DBP compared with 31 (28%) of SCARED-P negative ( P 0.003). In SCARED-P positive, mean DBP (78.4 ± 9.9) was higher compared with SCARED-P negative (74.9 ± 9.2) ( P 0.03). In a subgroup of adolescents (№ 130) not treated with blood pressure medications mean DBP was higher in both SCARED-P (79.0 ± 10.1) and SCARED-C (77.1 ± 10.4) positive groups compared with SCARED-P (73.6 ± 9.3) and SCARED-C (73 ± 8.9) negative, respectively. CONCLUSION Our study demonstrates an association between anxiety and elevated DBP in adolescent children. Screening adolescents for anxiety should be a part of the routine evaluation of adolescent children.
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Affiliation(s)
- Yaritzy Astudillo
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sara Kibrom
- Stanford University School of Medicine, Stanford Children's Health, San Francisco, California, USA
| | - Tanya Pereira
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sonia Solomon
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sankaran Krishnan
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Dmitry Samsonov
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
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Camerota M, Lester BM, Castellanos FX, Carter BS, Check J, Helderman J, Hofheimer JA, McGowan EC, Neal CR, Pastyrnak SL, Smith LM, O'Shea TM, Marsit CJ, Everson TM. Epigenome-wide association study identifies neonatal DNA methylation associated with two-year attention problems in children born very preterm. Transl Psychiatry 2024; 14:126. [PMID: 38418845 PMCID: PMC10902402 DOI: 10.1038/s41398-024-02841-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
Prior research has identified epigenetic predictors of attention problems in school-aged children but has not yet investigated these in young children, or children at elevated risk of attention problems due to preterm birth. The current study evaluated epigenome-wide associations between neonatal DNA methylation and attention problems at age 2 years in children born very preterm. Participants included 441 children from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a multi-site study of infants born < 30 weeks gestational age. DNA methylation was measured from buccal swabs collected at NICU discharge using the Illumina MethylationEPIC Bead Array. Attention problems were assessed at 2 years of adjusted age using the attention problems subscale of the Child Behavior Checklist (CBCL). After adjustment for multiple testing, DNA methylation at 33 CpG sites was associated with child attention problems. Differentially methylated CpG sites were located in genes previously linked to physical and mental health, including several genes associated with ADHD in prior epigenome-wide and genome-wide association studies. Several CpG sites were located in genes previously linked to exposure to prenatal risk factors in the NOVI sample. Neonatal epigenetics measured at NICU discharge could be useful in identifying preterm children at risk for long-term attention problems and related psychiatric disorders, who could benefit from early prevention and intervention efforts.
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Affiliation(s)
- Marie Camerota
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
- Brown Center for the Study of Children at Risk, Alpert Medical School of Brown University and Women and Infants Hospital, Providence, RI, USA.
| | - Barry M Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Brown Center for the Study of Children at Risk, Alpert Medical School of Brown University and Women and Infants Hospital, Providence, RI, USA
- Department of Pediatrics, Alpert Medical School of Brown University and Women and Infants Hospital, Providence, RI, USA
| | - Francisco Xavier Castellanos
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Brian S Carter
- Department of Pediatrics-Neonatology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jennifer Check
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jennifer Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Julie A Hofheimer
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University and Women and Infants Hospital, Providence, RI, USA
| | - Charles R Neal
- Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Steven L Pastyrnak
- Department of Pediatrics, Spectrum Health-Helen DeVos Hospital, Grand Rapids, MI, USA
| | - Lynne M Smith
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Thomas Michael O'Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Todd M Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Keefer A, Perrin J, Singh V, Holingue C, Winchell S, Vasa RA. A pilot, single-arm feasibility study of an integrated cognitive-behavioral treatment for anxiety in young autistic children. J Pediatr Psychol 2024; 49:131-141. [PMID: 38216125 DOI: 10.1093/jpepsy/jsad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE Anxiety is prevalent in young autistic children under 7 years of age. Yet there is a paucity of empirically based interventions for this age group. DINO Strategies for Anxiety and Uncertainty Reduction (DINOSAUR) is an innovative cognitive behavioral intervention that seeks to optimize treatment response in young autistic children by targeting anxiety and the contributing mechanisms of intolerance of uncertainty and parental accommodation using a telehealth delivery model. This pilot, single-arm study examines the preliminary feasibility of DINOSAUR. METHODS Fourteen autistic children ages 4-6 years with average language and cognitive skills and their parents received the intervention. Quantitative and qualitative data pertaining to parent satisfaction and treatment outcomes were collected. RESULTS Attendance, retention, and parent satisfaction ratings offer preliminary support for the feasibility of the treatment model. Change in clinical severity ratings on a semi-structured parent interview of anxiety and parents' qualitative report suggests the potential to benefit young autistic children. CONCLUSIONS Results support future study of the DINOSAUR model in a larger, randomized controlled trial.
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Affiliation(s)
- Amy Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, United States
| | - Jeremy Perrin
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, United States
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, United States
| | - Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Sarah Winchell
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, United States
| | - Roma A Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, United States
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10
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Durbeej N, Ssegonja R, Salari R, Dahlberg A, Fabian H, Sarkadi A. Preschool-level socio-economic deprivation in relation to emotional and behavioural problems among preschool children in Sweden. Scand J Public Health 2024:14034948231218040. [PMID: 38166546 DOI: 10.1177/14034948231218040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
AIMS The aim of this study was to explore the association between preschool-level socio-economic deprivation and emotional and behavioural problems among preschool children in Sweden using a multilevel approach. METHODS In this cross-sectional study, we used data on 2267 children whose parents and preschool teachers had responded to items measuring individual-level socio-economic deprivation and the Strengths and Difficulties Questionnaire (SDQ) for assessment of emotional and behavioural problems. Further, the Socioeconomic Structure Compensation Index (SSCI), collected from Uppsala municipality, was used to assess preschool-level socio-economic deprivation. Unadjusted and adjusted multilevel logistic regression models were used to explore the relations between preschool-level socio-economic deprivation and emotional and behavioural problems. RESULTS In unadjusted models, children who attended preschools classified as highly deprived had elevated odds for emotional symptoms (odds ratio (OR) 1.71) as rated by parents. However, this association did not remain significant after adjusting for individual-level socio-economic deprivation factors. In both unadjusted and adjusted models, children who attended preschools classified as moderately deprived had elevated odds for peer-relationship problems as rated by parents (OR 1.63; adjusted OR 1.48). There were no significant associations between preschool deprivation and emotional and behavioural problems as rated by preschool teachers. CONCLUSIONS Swedish preschools may have a compensatory capacity in addressing children's emotional and behavioural problems, whereas preschool-level deprivation remained significantly associated with peer-relationship problems after controlling for individual-level socio-economic deprivation factors. This implies that peer-relationship problems in deprived preschools need to be addressed in a broader community context.
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Affiliation(s)
- Natalie Durbeej
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Richard Ssegonja
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
- Respiratory, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, Sweden
| | - Raziye Salari
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anton Dahlberg
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Helena Fabian
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
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11
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Gosling CJ, Caparos S, Pinabiaux C, Schwarzer G, Rücker G, Agha SS, Alrouh H, Ambler A, Anderson P, Andiarena A, Arnold LE, Arseneault L, Asherson P, Babinski L, Barbati V, Barkley R, Barros AJD, Barros F, Bates JE, Bell LJ, Berenguer C, van Bergen E, Biederman J, Birmaher B, B⊘e T, Boomsma DI, Brandt VC, Bressan RA, Brocki K, Broughton TR, Bufferd SJ, Bussing R, Cao M, Cartigny A, Casas AM, Caspi A, Castellanos FX, Caye A, Cederkvist L, Collishaw S, Copeland WE, Cote SM, Coventry WL, Debes NMM, Denyer H, Dodge KA, Dogru H, Efron D, Eller J, Abd Elmaksoud M, Ercan ES, Faraone SV, Fenesy M, Fernández MF, Fernández-Somoano A, Findling R, Fombonne E, Fossum IN, Freire C, Friedman NP, Fristad MA, Galera C, Garcia-Argibay M, Garvan CS, González-Safont L, Groenman AP, Guxens M, Halperin JM, Hamadeh RR, Hartman CA, Hill SY, Hinshaw SP, Hipwell A, Hokkanen L, Holz N, Íñiguez C, Jahrami HA, Jansen PW, Jónsdóttir LK, Julvez J, Kaiser A, Keenan K, Klein DN, Klein RG, Kuntsi J, Langfus J, Langley K, Lansford JE, Larsen SA, Larsson H, Law E, Lee SS, Lertxundi N, Li X, Li Y, Lichtenstein P, Liu J, Lundervold AJ, Lundström S, Marks DJ, Martin J, Masi G, Matijasevich A, Melchior M, Moffitt TE, Monninger M, Morrison CL, Mulraney M, Muratori P, Nguyen PT, Nicholson JM, Øie MG, O'Neill S, O'Connor C, Orri M, Pan PM, Pascoe L, Pettit GS, Price J, Rebagliato M, Riaño-Galán I, Rohde LA, Roisman GI, Rosa M, Rosenbaum JF, Salum GA, Sammallahti S, Santos IS, Schiavone NS, Schmid L, Sciberras E, Shaw P, Silk TJ, Simpson JA, Skogli EW, Stepp S, Strandberg-Larsen K, Sudre G, Sunyer J, Tandon M, Thapar A, Thomson P, Thorell LB, Tinchant H, Torrent M, Tovo-Rodrigues L, Tripp G, Ukoumunne O, Van Goozen SHM, Vos M, Wallez S, Wang Y, Westermaier FG, Whalen DJ, Yoncheva Y, Youngstrom EA, Sayal K, Solmi M, Delorme R, Cortese S. Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis. Lancet Psychiatry 2023; 10:922-933. [PMID: 37898142 DOI: 10.1016/s2215-0366(23)00272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND The youngest children in a school class are more likely than the oldest to be diagnosed with ADHD, but this relative age effect is less frequent in older than in younger school-grade children. However, no study has explored the association between relative age and the persistence of ADHD diagnosis at older ages. We aimed to quantify the association between relative age and persistence of ADHD at older ages. METHODS For this meta-analysis, we searched MEDLINE, Embase, CINAHL, PsycINFO, and PubPsych up to April 1, 2022, with terms related to "cohort" and "ADHD" with no date, publication type, or language restrictions. We gathered individual participant data from prospective cohorts that included at least ten children identified with ADHD before age 10 years. ADHD was defined by either a clinical diagnosis or symptoms exceeding clinical cutoffs. Relative age was recorded as the month of birth in relation to the school-entry cutoff date. Study authors were invited to share raw data or to apply a script to analyse data locally and generate anonymised results. Our outcome was ADHD status at a diagnostic reassessment, conducted at least 4 years after the initial assessment and after age 10 years. No information on sex, gender, or ethnicity was collected. We did a two-stage random-effects individual participant data meta-analysis to assess the association of relative age with persistence of ADHD at follow-up. This study was registered with PROSPERO, CRD42020212650. FINDINGS Of 33 119 studies generated by our search, we identified 130 eligible unique studies and were able to gather individual participant data from 57 prospective studies following up 6504 children with ADHD. After exclusion of 16 studies in regions with a flexible school entry system that did not allow confident linkage of birthdate to relative age, the primary analysis included 41 studies in 15 countries following up 4708 children for a period of 4 to 33 years. We found that younger relative age was not statistically significantly associated with ADHD persistence at follow-up (odds ratio 1·02, 95% CI 0·99-1·06; p=0·19). We observed statistically significant heterogeneity in our model (Q=75·82, p=0·0011, I2=45%). Participant-level sensitivity analyses showed similar results in cohorts with a robust relative age effect at baseline and when restricting to cohorts involving children with a clinical diagnosis of ADHD or with a follow-up duration of more than 10 years. INTERPRETATION The diagnosis of ADHD in younger children in a class is no more likely to be disconfirmed over time than that of older children in the class. One interpretation is that the relative age effect decreases the likelihood of children of older relative age receiving a diagnosis of ADHD, and another is that assigning a diagnostic label of ADHD leads to unexplored carryover effects of the initial diagnosis that persist over time. Future studies should be conducted to explore these interpretations further. FUNDING None.
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12
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Chen W, Zhou X, Yin X, Zhao S. A parent-report measure of children's anxiety: psychometric properties of the Macquarie Anxiety Behavioural Scale (MABS) in a Chinese sample of preschool children. BMC Psychol 2023; 11:414. [PMID: 38012807 PMCID: PMC10680268 DOI: 10.1186/s40359-023-01463-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/22/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE The Macquarie Anxiety Behavioural Scale (MABS) is a newly developed scale to assess anxiety in children and teenagers. The present study aimed to evaluate the reliability and validity of the Chinese version of the MABS, as well as the measurement invariance across different age groups in a preschool-aged sample. METHODS A total of 1007 parents with children aged 3-6 years participated in the study. Internal consistency was assessed by calculating Cronbach's alpha, McDonald's omega and average inter-item correlation values. Confirmatory factor analysis (CFA) was conducted to examine the five-factor model. Multi-group CFA was conducted to test the measurement equivalence across different age groups (3- and 4-year-olds and 5- and 6-year-olds). Convergent, divergent, and criterion-related validity were assessed with Pearson correlation coefficients. RESULTS Internal consistency for the MABS total score was good and that of the subscales was acceptable. The CFA results showed that the five-factor structure of the MABS was supported in preschoolers (e.g., CFI = 0.929, TLI = 0.914, RMSEA = 0.050). In addition, scalar invariance of the MABS was supported across different age groups (e.g., ΔCFI = - 0.003, ΔTLI = 0, ΔRMSEA = 0). Furthermore, the MABS showed good convergent and divergent validity as well as criterion-related validity. CONCLUSION The Chinese version of the MABS demonstrated satisfactory psychometric properties and appeared to be a valid and reliable instrument for measuring anxiety in preschool children.
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Affiliation(s)
- Wei Chen
- School of Psychology, Guizhou Normal University, Guiyang, China
- Center for Big Data Research in Psychology, Guizhou Normal University, Guiyang, China
| | - Xingrong Zhou
- School of Psychology, Guizhou Normal University, Guiyang, China
- Center for Big Data Research in Psychology, Guizhou Normal University, Guiyang, China
- Bishan Gaoxin Middle School, Chongqing, China
| | - Xingyu Yin
- School of Psychology, Guizhou Normal University, Guiyang, China
- Center for Big Data Research in Psychology, Guizhou Normal University, Guiyang, China
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Ahadianfard P, Gharraee B, Aghebati A, Asgarabad MH. Effectiveness of unified protocol for trans diagnostic treatment in children with anxiety disorders: A randomized control trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:387. [PMID: 38333174 PMCID: PMC10852158 DOI: 10.4103/jehp.jehp_1578_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/24/2022] [Indexed: 02/10/2024]
Abstract
BACKGROUND The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) is a theory-derived approach that can target the common underlying processes, such as the cognitive, emotional, and behavioral processes in emotional disorders in children aged 8-12 years. This study aimed to investigate UP-C's efficacy in treating children's anxiety disorders compared to cognitive behavior therapy (CBT). MATERIALS AND METHODS In this randomized control trial (RCT), with pre-test, post-test, and follow-up, 34 participants aged 8-12 with anxiety disorders were selected through the restricted randomization method and allocated to intervention (UP-C) or control (CBT) groups by random allocation rule. UP-C group consisted of 15 weekly individual sessions, and CBT included 16 weekly individual sessions. The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) and The Screen for Child Anxiety Related Disorders (SCARED-71) were completed in the pre-test, post-test, and three-month follow-up stages. The data of participants were analyzed using the repeated measure analysis of variance. A P- value under. 05 was regarded as significant. RESULTS Based on the repeated measures ANOVA, UP-C, and CBT significantly reduced anxiety symptoms (P = .002) and emotional suppression (P = .032). Moreover, UP-C and CBT significantly increased emotion regulation (P = .000) and cognitive reappraisal (P = .000). CONCLUSION The individual UP-C can be effective as anxiety-oriented CBT in treating anxiety disorders. Also, in the three months follow-up, the UP-C's effects were more stable and progressive than the CBT.
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Affiliation(s)
- Pantea Ahadianfard
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Banafsheh Gharraee
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Asma Aghebati
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Positive Youth Development Lab, Human Development and Family Sciences, Texas Tech University, Texas, U.S.A
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Wiggins JL, Ureña Rosario A, MacNeill LA, Krogh‐Jespersen S, Briggs‐Gowan M, Smith JD, Wakschlag LS. Prevalence, stability, and predictive utility of the Multidimensional Assessment of Preschoolers Scales clinically optimized irritability score: Pragmatic early assessment of mental disorder risk. Int J Methods Psychiatr Res 2023; 32:e1991. [PMID: 37728118 PMCID: PMC10654826 DOI: 10.1002/mpr.1991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES Characterizing the scope and import of early childhood irritability is essential for real-world actualization of this reliable indicator of transdiagnostic mental health risk. Thus, we utilize pragmatic assessment to establish prevalence, stability, and predictive utility of clinically significant early childhood irritability. METHODS Data included two independent, diverse community samples of preschool age children (N = 1857; N = 1490), with a subset enriched for risk (N = 425) assessed longitudinally from early childhood through preadolescence (∼4-9 years old). A validated, brief (2-item) scale pragmatically assessed clinically significant irritability. In the longitudinal subsample, clinical interviews assessed internalizing/externalizing disorders. RESULTS One in five preschool-age children had clinically significant irritability, which was independently replicated. Irritability was highly stable through preadolescence. Children with versus without clinically significant early childhood irritability had greater odds of early onset, persistent internalizing/externalizing disorders. The pragmatic assessment effectively screened out low-risk children and identified 2/3 of children with early-onset, persistent psychopathology. CONCLUSIONS Clinically significant early childhood irritability prevalence is akin to the pediatric obesity epidemic and may warrant similar universal screening/intervention. Also, irritability's stability demonstrates the common guidance "they'll grow out of it" to be false. Finally, pragmatic irritability assessment has transdiagnostic predictive power and addresses a need for feasible measures to flag risk.
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Affiliation(s)
- Jillian Lee Wiggins
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
| | - Ana Ureña Rosario
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Leigha A. MacNeill
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | - Sheila Krogh‐Jespersen
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Justin D. Smith
- Department of Population Health SciencesUniversity of UtahSalt Lake CityUtahUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
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15
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Cervin M. Developmental signs of ADHD and autism: a prospective investigation in 3623 children. Eur Child Adolesc Psychiatry 2023; 32:1969-1978. [PMID: 35748938 PMCID: PMC10533573 DOI: 10.1007/s00787-022-02024-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/03/2022] [Indexed: 12/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are neurodevelopmental disorders with an early onset. Guidelines recommend a careful evaluation of developmental history when assessing the disorders, but it is unclear how children with ADHD and ASD differ from their peers growing up. In this study, physical, family, psychological, social, and educational information were examined in 3623 ethnically diverse children that were prospectively followed from birth to age 15 as part of the Fragile Families and Child Wellbeing Study. Fifteen-thousand variables were screened, and 506 variables included in the final analyses. Accuracy of the most indicative information to predict ADHD and ASD diagnoses in adolescence was evaluated. Adolescents with ADHD (n = 627) and ASD (n = 91) differed from their peers on a plethora of developmental signs, with signs closely related to the core symptoms of the disorders after age 5 being most indicative of the disorders. Predictive models correctly identified 66% of individuals with ADHD and 81% of those with ASD, but 62-88% of identified cases were false positives. The mean proportion of developmental deviations was 18.7% in the ADHD group, 20.0% in the ASD group, and 15.6% in peers; youth with both ADHD and ASD (n = 50) deviated on 21.8% of all developmental signs and had more pronounced deviations than those with ADHD or ASD alone. ADHD and ASD are characterized by broad and non-specific developmental deviations. Developmental information alone cannot be used to accurately predict diagnostic status in adolescence and false positives are likely if the diagnostic process relies heavily on such information. Developmental deviations are part of normal development and common in children without ADHD and ASD. Etiological heterogeneity and considerable temporal fluctuation in the core characteristics of ADHD and ASD may explain the lack of distinct developmental patterns.
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Affiliation(s)
- Matti Cervin
- Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Sofiavägen 2D, 22241, Lund, Sweden.
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16
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Overgaard KR, Oerbeck B, Friis S, Pripp AH, Aase H, Biele G, Ingeborgrud CB, Polanczyk GV, Zeiner P. Attention-deficit/hyperactivity disorder from preschool to school age: change and stability of parent and teacher reports. Eur Child Adolesc Psychiatry 2023; 32:1947-1955. [PMID: 35737107 PMCID: PMC10533600 DOI: 10.1007/s00787-022-02019-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/01/2022] [Indexed: 11/03/2022]
Abstract
Identifying attention-deficit/hyperactivity disorder (ADHD) in pre-schoolers may improve their development if treated, but it is unclear whether ADHD symptoms from this age are stable enough to merit treatment. We aimed to investigate the stability of parent- and teacher-reported ADHD symptoms and ADHD classified above the diagnostic symptom thresholds, including for hyperactivity-impulsivity (HI), inattention and combined presentations from age 3 to 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. At child age 3 years, parents were interviewed and teachers rated ADHD symptoms. At age 8 years, parents (n = 783) and teachers (n = 335) reported ADHD symptoms by the Child Symptom Inventory-4. We found a significant reduction in the mean number of parent-reported ADHD and HI symptoms from age 3 to 8 years, but otherwise similar mean numbers. Parent-reported ADHD symptoms were moderately correlated between ages, while correlations were low for teachers. A total of 77/108 (71%) of the children classified with parent-reported HI presentation at age 3 years were no longer classified within any ADHD presentation at age 8 years, the only clear trend across time for either informant. There was a low to moderate parent-teacher-agreement in the number of reported symptoms, and very low informant agreement for the classified ADHD presentations. Overall, clinicians should exercise caution in communicating concern about HI symptoms in preschool children. Age 3 years may be too early to apply the ADHD diagnostic symptom criteria, especially if parents and teachers are required to agree.
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Affiliation(s)
- Kristin Romvig Overgaard
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway
| | - Svein Friis
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Guido Biele
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.B. 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Ingeborgrud CB, Oerbeck B, Friis S, Zeiner P, Pripp AH, Aase H, Biele G, Dalsgaard S, Overgaard KR. Anxiety and depression from age 3 to 8 years in children with and without ADHD symptoms. Sci Rep 2023; 13:15376. [PMID: 37717097 PMCID: PMC10505233 DOI: 10.1038/s41598-023-42412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/10/2023] [Indexed: 09/18/2023] Open
Abstract
Childhood anxiety and depressive symptoms may be influenced by symptoms of attention deficit/hyperactivity disorder (ADHD). We investigated whether parent- and teacher-reported anxiety, depressive and ADHD symptoms at age 3 years predicted anxiety disorders and/or depression in children with and without ADHD at age 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. Parents of 3-year-olds were interviewed, and preschool teachers rated symptoms of anxiety disorders, depression and ADHD. At age 8 years (n = 783), Child Symptom Inventory-4 was used to identify children who fulfilled the diagnostic criteria for anxiety disorders and/or depression (hereinafter: Anx/Dep), and ADHD. Univariable and multivariable logistic regression analyses were used. In the univariable analyses, parent-reported anxiety, depressive and ADHD symptoms, and teacher-reported anxiety symptoms at age 3 years all significantly predicted subsequent Anx/Dep. In the multivariable analyses, including co-occurring symptoms at age 3 years and ADHD at 8 years, parent-reported anxiety and depressive symptoms remained significant predictors of subsequent Anx/Dep. At age 3 years, regardless of ADHD symptoms being present, asking parents about anxiety and depressive symptoms, and teachers about anxiety symptoms, may be important to identify children at risk for school-age anxiety disorders and/or depression.
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Affiliation(s)
- Christine Baalsrud Ingeborgrud
- Institute of Clinical Medicine, Division of Mental Health and Addiction, Child and Adolescent Psychiatry Unit, University of Oslo, Pb 1039 Blindern, 0315, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Svein Friis
- Institute of Clinical Medicine, Division of Mental Health and Addiction, Child and Adolescent Psychiatry Unit, University of Oslo, Pb 1039 Blindern, 0315, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Pål Zeiner
- Institute of Clinical Medicine, Division of Mental Health and Addiction, Child and Adolescent Psychiatry Unit, University of Oslo, Pb 1039 Blindern, 0315, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Guido Biele
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Søren Dalsgaard
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Glostrup, Denmark
| | - Kristin Romvig Overgaard
- Institute of Clinical Medicine, Division of Mental Health and Addiction, Child and Adolescent Psychiatry Unit, University of Oslo, Pb 1039 Blindern, 0315, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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18
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Michelini G, Gair K, Tian Y, Miao J, Dougherty LR, Goldstein BL, MacNeill LA, Barch DM, Luby JL, Wakschlag LS, Klein DN, Kotov R. Do general and specific factors of preschool psychopathology predict preadolescent outcomes? A transdiagnostic hierarchical approach. Psychol Med 2023; 53:5405-5414. [PMID: 37795688 PMCID: PMC10482704 DOI: 10.1017/s003329172200246x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 06/16/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Preschool psychiatric symptoms significantly increase the risk for long-term negative outcomes. Transdiagnostic hierarchical approaches that capture general ('p') and specific psychopathology dimensions are promising for understanding risk and predicting outcomes, but their predictive utility in young children is not well established. We delineated a hierarchical structure of preschool psychopathology dimensions and tested their ability to predict psychiatric disorders and functional impairment in preadolescence. METHODS Data for 1253 preschool children (mean age = 4.17, s.d. = 0.81) were drawn from three longitudinal studies using a similar methodology (one community sample, two psychopathology-enriched samples) and followed up into preadolescence, yielding a large and diverse sample. Exploratory factor models derived a hierarchical structure of general and specific factors using symptoms from the Preschool Age Psychiatric Assessment interview. Longitudinal analyses examined the prospective associations of preschool p and specific factors with preadolescent psychiatric disorders and functional impairment. RESULTS A hierarchical dimensional structure with a p factor at the top and up to six specific factors (distress, fear, separation anxiety, social anxiety, inattention-hyperactivity, oppositionality) emerged at preschool age. The p factor predicted all preadolescent disorders (ΔR2 = 0.04-0.15) and functional impairment (ΔR2 = 0.01-0.07) to a significantly greater extent than preschool psychiatric diagnoses and functioning. Specific dimensions provided additional predictive power for the majority of preadolescent outcomes (disorders: ΔR2 = 0.06-0.15; functional impairment: ΔR2 = 0.05-0.12). CONCLUSIONS Both general and specific dimensions of preschool psychopathology are useful for predicting clinical and functional outcomes almost a decade later. These findings highlight the value of transdiagnostic dimensions for predicting prognosis and as potential targets for early intervention and prevention.
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Affiliation(s)
- Giorgia Michelini
- Department of Biological & Experimental Psychology, School of Biological & Behavioural Sciences, Queen Mary University of London, London, UK
- Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Kelly Gair
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Yuan Tian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jiaju Miao
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Lea R. Dougherty
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Brandon L. Goldstein
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Deanna M. Barch
- Departments of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
- Departments of Psychiatry, Washington University, St. Louis, MO, USA
- Departments of Radiology, Washington University, St. Louis, MO, USA
| | - Joan L. Luby
- Departments of Psychiatry, Washington University, St. Louis, MO, USA
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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Vasa RA, Kerns CM, Singh V, McDonald R, Jang YS, Keefer A. Anxiety in autistic preschool children: Phenomenology and a network analysis of correlates. Autism Res 2023; 16:1561-1572. [PMID: 37350221 DOI: 10.1002/aur.2968] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/03/2023] [Indexed: 06/24/2023]
Abstract
Anxiety disorders in autistic children are associated with significant functional impairment. Few studies have examined impairing anxiety presentations in autistic preschool children (i.e., 3-5 years old). This cross-sectional study examined the phenomenology of impairing anxiety and the strongest correlates of anxiety in 75 autistic preschool children. Parents completed a diagnostic interview that assesses two anxiety types, DSM-5 anxiety disorders and impairing distinct anxiety presentations, and measures of anxiety correlates. An exploratory network analysis examined connections between anxiety and its correlates. Forty percent of children had impairing anxiety. Specific phobia followed by 'other social fear,' a type of distinct anxiety, were the most common anxiety types. Child intolerance of uncertainty (IU) was the only correlate that was associated with anxiety in a network analysis framework. Child IU linked anxiety to two other correlates, sensory over-responsivity and somatic symptoms. Findings emphasize the need for early intervention for anxiety and further research on its correlates.
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Affiliation(s)
- Roma A Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Rachel McDonald
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
| | - Yeon Sik Jang
- Department of Psychology, Georgetown University, Washington D.C, USA
| | - Amy Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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20
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Warner EN, Ammerman RT, Glauser TA, Pestian JP, Agasthya G, Strawn JR. Developmental Epidemiology of Pediatric Anxiety Disorders. Child Adolesc Psychiatr Clin N Am 2023; 32:511-530. [PMID: 37201964 DOI: 10.1016/j.chc.2023.02.001] [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: 05/20/2023]
Abstract
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
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Affiliation(s)
- Emily N Warner
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati.
| | - Robert T Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John P Pestian
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Greeshma Agasthya
- Oak Ridge National Laboratory, Computational Sciences and Engineering Division, Advanced Computing for Health Sciences Section
| | - Jeffrey R Strawn
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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21
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Speranza AM, Liotti M, Spoletini I, Fortunato A. Heterotypic and homotypic continuity in psychopathology: a narrative review. Front Psychol 2023; 14:1194249. [PMID: 37397301 PMCID: PMC10307982 DOI: 10.3389/fpsyg.2023.1194249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.
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Affiliation(s)
- Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ilaria Spoletini
- Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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22
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Toseeb U, Vincent J, Oginni OA, Asbury K, Newbury DF. The Development of Mental Health Difficulties in Young People With and Without Developmental Language Disorder: A Gene-Environment Interplay Study Using Polygenic Scores. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1639-1657. [PMID: 37040695 DOI: 10.1044/2023_jslhr-22-00664] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE Young people with developmental language disorder (DLD) have poorer mental health than those without DLD. However, not all young people with DLD are equally affected; some have more mental health difficulties than others. What explains these differences remains unclear. METHOD Data from a community cohort study, the Avon Longitudinal Study of Parents and Children, were analyzed to investigate genetic and environmental influences on the development of mental health difficulties at five time points from childhood (7 years) to adolescence (16 years) in 6,387 young people (8.7% with DLD). Regression and latent class models were fitted to the data. RESULTS Polygenic scores (PGSs), indices of genetic risk, for common psychiatric disorders (major depressive disorder, anxiety disorder, and attention deficit hyperactivity disorder) predicted mental health difficulties in both groups (with and without DLD). The presence of DLD, in some instances, amplified mental health difficulties for those with high genetic risk for common psychiatric disorders. Subgroups of children with similar developmental trajectories of mental health difficulties were identified. Young people with DLD were more likely than those without DLD to follow mental health subgroups characterized by consistently high levels of difficulties during development. PGSs, socioeconomic status, and the early home environment distinguished subgroups with low mental health difficulties from those characterized by high levels of difficulties, but these effects did not differ based on DLD status. CONCLUSIONS These findings suggest that, for the most part, both genetic and environmental risk affect the development of mental health difficulties in a cumulative way for young people with DLD (and those without). Some analysis did, however, suggest that genetic risk for common psychiatric disorders might manifest more strongly in those with DLD compared with those without DLD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22351012.
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Affiliation(s)
- Umar Toseeb
- Department of Education, University of York, United Kingdom
| | - John Vincent
- Department of Education, University of York, United Kingdom
| | - Olakunle A Oginni
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Kathryn Asbury
- Department of Education, University of York, United Kingdom
| | - Dianne F Newbury
- Department of Medical and Biological Sciences, Oxford Brookes University, United Kingdom
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23
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Kohlhoff J, Karlov L, Dadds M, Barnett B, Silove D, Mendoza Diaz A, Eapen V. Preschool Behavioral Problems: Links with Maternal Oxytocin and Caregiving Sensitivity in the Postnatal Period, and Concurrent Maternal Psychopathology and Attachment State-of-Mind. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01529-6. [PMID: 37022532 DOI: 10.1007/s10578-023-01529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/07/2023]
Abstract
This study investigated maternal oxytocin, caregiving sensitivity and mother-to-infant bonding at 3-months postpartum as predictors of child behavior and psychological outcomes in the preschool years, when controlling for concurrent maternal negative emotional symptoms and adult attachment state-of-mind. Forty-five mother-child dyads were assessed at 3-months and 3.5 years postpartum using mix of questionnaires, observational, interview and biological methods. Results showed that lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted emotional reactivity in the child at 3.5 years. When maternal adult attachment state-of-mind and negative emotional symptoms were included, lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted withdrawn child behavior. In addition, unresolved adult attachment and maternal negative emotional symptoms were significantly associated child behavioral disturbance in a range of areas. Findings highlight maternal postnatal oxytocin as a potential indicator of children who may be more likely to show emotional reactivity and withdrawn behavior in the preschool years.
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Affiliation(s)
- Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
- Research Department, Karitane, Sydney, Australia.
- Ingham Institute for Medical Research, Sydney, Australia.
| | - Lisa Karlov
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
| | - Mark Dadds
- School of Psychology, University of Sydney, Sydney, Australia
| | | | - Derrick Silove
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Antonio Mendoza Diaz
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Ingham Institute for Medical Research, Sydney, Australia
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Sydney, Australia
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24
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Scott SR, Millwood SN, Manczak EM. Adipocytokine correlates of childhood and adolescent mental health: A systematic review. Dev Psychobiol 2023; 65:e22379. [PMID: 36946681 DOI: 10.1002/dev.22379] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/13/2022] [Accepted: 01/17/2023] [Indexed: 03/14/2023]
Abstract
The objective of this systematic review was to determine the current state of the literature regarding how adipocytokines associate with mental health symptoms/disorders in youth. Findings summarized in this review suggested that in neurodevelopmental disorders, higher levels of leptin, ghrelin, resistin, and visfatin as well as lower levels of adiponectin, retinol-binding protein 4, and progranulin predicted increased risk for or were conflated with autism spectrum disorder. Adipocytokine correlates of attention-deficit hyperactivity disorder and related symptoms included higher apelin, higher leptin-to-adiponectin ratio, and lower adiponectin. Evidence from studies examining anxiety symptoms evinced mixed results regarding leptin, and one study suggested higher levels of ghrelin. Depressive symptoms correlated with higher leptin and ghrelin. Research examining posttraumatic stress symptoms found higher levels of ghrelin. In research examining broadband symptoms, conflicting results emerged for associations between internalizing symptoms (i.e., symptoms of emotional stress) and leptin in youth. Low levels of adiponectin and high levels of leptin predicted externalizing symptoms. Total symptom difficulties were associated with a higher leptin-to-adiponectin ratio. Our findings suggest that adipocytokines may be an important set of biomarkers to consider as underlying mechanisms contributing to developmental psychopathology.
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Affiliation(s)
- Samantha R Scott
- Biology, Environments, and Mood Studies Lab, Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Summer N Millwood
- Biology, Environments, and Mood Studies Lab, Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Erika M Manczak
- Biology, Environments, and Mood Studies Lab, Department of Psychology, University of Denver, Denver, Colorado, USA
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25
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Son S, Lee H, Jang Y. Continuity and Stability of Child and Adolescent Depressive Symptoms in South Korea: A Meta-analysis of Longitudinal Studies. J Youth Adolesc 2023; 52:598-618. [PMID: 36469180 DOI: 10.1007/s10964-022-01709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Abstract
Many adolescents in South Korea experience risk-level depressive symptoms due to stress caused by personal and environmental changes. Prior studies investigated various characteristics of depressive symptoms. However, it is unclear when the mean level of depression changes with the development of children and adolescents and whether it is stable relative to one another over time. Thus, it is necessary to closely understand the continuity and stability of depressive symptoms across developmental stages in children and adolescents. In this study, continuity refers to the consistency in a group's mean level of depressive symptoms over time; however, stability refers to the consistency in the relative placement of the levels of depressive symptoms of individuals within a group over time. To comprehensively understand previous studies, this meta-analysis compiled data from 95 South Korean longitudinal studies (N = 200,338; 49.7% females) published between 2000 and 2021. Data were analyzed using a three-level random effects model with a 1-year interval for each age group to integrate effect sizes, followed by a generalized additive mixed model integrating age as a continuous variable. The results indicate that the mean-level continuity of depressive symptoms was relatively high and the rank-order stability was low for the children in elementary school (including both upper and lower grades). Additionally, as the adolescents aged, the mean-level continuity of depressive symptoms slightly decreased while stability increased. When entering early adulthood, the continuity and stability of depressive symptoms converged without significant change. As a result of moderating effect, the female-only group indicated a high level of continuity and stability than the male-only or mixed group. The findings highlight that South Korean childhood is a period of relatively high continuity and low stability. Moreover, female students' depressive symptoms fluctuate more than those of males, suggesting the need for providing effective and appropriate help.
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Affiliation(s)
- Sookyoung Son
- Innovation Project Group, Woosuk University, 443, Samnye-ro, Samnye-eup, Wanju-gun, Jeollabuk-do, 55338, Republic of Korea.
| | - Hyunjung Lee
- Department of Education, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Yoona Jang
- Department of Education, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
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26
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Chan N, Fenning RM, Neece CL. Prevalence and Phenomenology of Anxiety in Preschool-Aged Children with Autism Spectrum Disorder. Res Child Adolesc Psychopathol 2023; 51:33-45. [PMID: 36048376 DOI: 10.1007/s10802-022-00964-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 10/14/2022]
Abstract
Individuals with autism spectrum disorder (ASD) are at a higher risk for developing co-occurring anxiety symptoms and diagnosable anxiety disorders compared to children with neurotypical development (NTD). The objective of the current study was to characterize the prevalence and phenomenology of anxiety in preschool-aged children with ASD. Our sample consisted of preschoolers (M = 52.8 months, SD = 10.8 months) with ASD (n = 77, 66% with co-occurring intellectual disability, ID) and NTD (n = 55). We employed multi-method (questionnaire and semi-structured diagnostic interview) and multi-informant (parent- and teacher-report) assessments of anxiety. Children with ASD were significantly more likely to meet criteria for an anxiety disorder than children with NTD. Over 70% of our sample with ASD met DSM-5 criteria for an anxiety disorder, with Specific Phobia and Separation Anxiety Disorder being the most prevalent. A range of specific fears was endorsed in the group with ASD, many of which overlapped with ASD symptoms. Parents, but not teachers, also reported greater anxiety symptoms for children with ASD relative to the comparison sample. Prevalence and phenomenology of anxiety in our sample with ASD generally did not differ between those with and without co-occurring ID, with the exception of higher rates of generalized anxiety in those without ID. Results showed poor concordance between parent questionnaires and a semi-structured diagnostic interview in detecting clinically-elevated anxiety in children with ASD. Implications for clinical practice and research are discussed.
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Affiliation(s)
| | - Rachel M Fenning
- Claremont McKenna College, Claremont, CA, USA.,California State University, Fullerton, Fullerton, CA, USA
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27
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Ehrenberg D, Lohaus A, Konrad K, Lüning L, Heinrichs N. How Anxious are German Preschool Children? Child Psychiatry Hum Dev 2022; 53:992-1003. [PMID: 33966151 PMCID: PMC9470646 DOI: 10.1007/s10578-021-01185-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
The experience of fear is universal and is among the earliest of all forms of psychopathology, if excessively present. To prevent negative developmental outcomes due to early-onset excessive fears in children, it is important to systematically assess these experiences as early as possible. Using the preschool anxiety scale (PAS), we aimed to assess the frequency and structure of anxiety symptoms of 489 preschool-aged children raised in their biological family and 88 raised in foster care (as a high-risk sample) in Germany. While these young children displayed the same types of anxiety most commonly as young children in other countries, the overall occurrence seems to be reported less often by parents in Germany compared to parents from other countries. Anxiety symptoms clustered into five correlated factors (generalized anxiety, social anxiety, obsessive-compulsive disorder (OCD), physical injury fear and separation anxiety). Young children in foster care exhibited more OCD and significantly less social anxiety symptoms indicating early repetitive and social disturbances in children in foster care.
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Affiliation(s)
- Daniela Ehrenberg
- Department of Psychology, Institute of Clinical Psychology, Psychotherapy and Assessment, University of Braunschweig, Humboldtstraße 33, 38106, Braunschweig, Germany.
| | - Arnold Lohaus
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Institute of Molecular Neuroscience and Neuroimaging (INM-11), RWTH Aachen University Hospital and Research Center Jülich, University Hospital Aachen, Juelich, Aachen, Germany
| | - Lorena Lüning
- Department of Psychology, Institute of Clinical Psychology, Psychotherapy and Assessment, University of Braunschweig, Humboldtstraße 33, 38106, Braunschweig, Germany
| | - Nina Heinrichs
- Department of Psychology, Institute of Clinical Psychology, Psychotherapy and Assessment, University of Braunschweig, Humboldtstraße 33, 38106, Braunschweig, Germany
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
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28
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Dippel N, Szota K, Cuijpers P, Christiansen H, Brakemeier EL. Family involvement in psychotherapy for depression in children and adolescents: Systematic review and meta-analysis. Psychol Psychother 2022; 95:656-679. [PMID: 35289047 DOI: 10.1111/papt.12392] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 02/23/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Depressive disorders in children and adolescents have an enormous impact on their general quality of life. There is a clear need to effectively treat depression in this age group. Effects of psychotherapy can be enhanced by involving caregivers. In our systematic review and meta-analysis, we examine for the first time the effects of caregiver involvement in depression-specific interventions for children and adolescents. METHODS We included randomized controlled trials examining the effects of interventions for children and adolescents with depression involving their caregivers or families compared to interventions without including caregivers. Primary outcome was the severity of childhood and adolescent depression. RESULTS Overall, 19 randomized controlled trials could be included (N = 1553) that were highly heterogeneous regarding outcome measures or the extent of caregiver integration. We were able to include k = 17 studies in our meta-analysis and find a small but significant effect for family-involved interventions against active control conditions without family-involvement at post intervention (α = 0.05, d = 0.34; [0.07; 0.60]; p = .01). CONCLUSIONS We detected an overall significant but small effect of family/caregivers' involvement compared to control groups without it. Structured, guideline-based research is urgently needed to identify for which children/adolescents with depression, under what circumstances, and in what form the family should be effectively involved in their psychotherapy.
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Affiliation(s)
- Nele Dippel
- Philipps-University of Marburg, Marburg, Germany
| | | | - Pim Cuijpers
- Vrije-University Amsterdam, Amsterdam, The Netherlands
| | | | - Eva-Lotta Brakemeier
- Philipps-University of Marburg, Marburg, Germany.,University Greifswald, Greifswald, Germany
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29
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Neumann A, Jolicoeur‐Martineau A, Szekely E, Sallis HM, O’Donnel K, Greenwood CM, Levitan R, Meaney MJ, Wazana A, Evans J, Tiemeier H. Combined polygenic risk scores of different psychiatric traits predict general and specific psychopathology in childhood. J Child Psychol Psychiatry 2022; 63:636-645. [PMID: 34389974 PMCID: PMC9291767 DOI: 10.1111/jcpp.13501] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Polygenic risk scores (PRSs) operationalize genetic propensity toward a particular mental disorder and hold promise as early predictors of psychopathology, but before a PRS can be used clinically, explanatory power must be increased and the specificity for a psychiatric domain established. To enable early detection, it is crucial to study these psychometric properties in childhood. We examined whether PRSs associate more with general or with specific psychopathology in school-aged children. Additionally, we tested whether psychiatric PRSs can be combined into a multi-PRS score for improved performance. METHODS We computed 16 PRSs based on GWASs of psychiatric phenotypes, but also neuroticism and cognitive ability, in mostly adult populations. Study participants were 9,247 school-aged children from three population-based cohorts of the DREAM-BIG consortium: ALSPAC (UK), The Generation R Study (Netherlands), and MAVAN (Canada). We associated each PRS with general and specific psychopathology factors, derived from a bifactor model based on self-report and parental, teacher, and observer reports. After fitting each PRS in separate models, we also tested a multi-PRS model, in which all PRSs are entered simultaneously as predictors of the general psychopathology factor. RESULTS Seven PRSs were associated with the general psychopathology factor after multiple testing adjustment, two with specific externalizing and five with specific internalizing psychopathology. PRSs predicted general psychopathology independently of each other, with the exception of depression and depressive symptom PRSs. Most PRSs associated with a specific psychopathology domain, were also associated with general child psychopathology. CONCLUSIONS The results suggest that PRSs based on current GWASs of psychiatric phenotypes tend to be associated with general psychopathology, or both general and specific psychiatric domains, but not with one specific psychopathology domain only. Furthermore, PRSs can be combined to improve predictive ability. PRS users should therefore be conscious of nonspecificity and consider using multiple PRSs simultaneously, when predicting psychiatric disorders.
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Affiliation(s)
- Alexander Neumann
- Department of Child and Adolescent PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
- Lady Davis Institute for Medical ResearchJewish General HospitalMontrealQCCanada
- VIB Center for Molecular NeurologyVIBAntwerpBelgium
- Department of Biomedical SciencesUniversity of AntwerpAntwerpBelgium
| | | | - Eszter Szekely
- Lady Davis Institute for Medical ResearchJewish General HospitalMontrealQCCanada
- Department of PsychiatryMcGill University Faculty of MedicineMontrealQCCanada
| | - Hannah M. Sallis
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Centre for Academic Mental Health, Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
- School of Psychological ScienceUniversity of BristolBristolUK
| | - Kieran O’Donnel
- Department of Psychiatry and Sackler Program for Epigenetics and PsychobiologyMcGill UniversityMontrealQCCanada
- Ludmer Centre for Neuroinformatics and Mental HealthMcGill UniversityMontrealQCCanada
| | - Celia M.T. Greenwood
- Lady Davis Institute for Medical ResearchJewish General HospitalMontrealQCCanada
- Departments of Oncology, Human Genetics, and Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealQCCanada
| | - Robert Levitan
- Centre for Addiction and Mental HealthTorontoONCanada
- Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Michael J. Meaney
- Department of PsychiatryMcGill University Faculty of MedicineMontrealQCCanada
- Douglas Mental Health InstituteMontrealQCCanada
- Singapore Institute for Clinical SciencesSingapore CitySingapore
| | - Ashley Wazana
- Lady Davis Institute for Medical ResearchJewish General HospitalMontrealQCCanada
- Department of PsychiatryMcGill University Faculty of MedicineMontrealQCCanada
- Centre for Child Development and Mental HealthJewish General HospitalMontrealQCCanada
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Henning Tiemeier
- Department of Child and Adolescent PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
- Department of Social and Behavioral SciencesHarvard T. H. Chan School of Public HealthBostonMAUSA
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30
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Steinsbekk S, Ranum B, Wichstrøm L. Prevalence and course of anxiety disorders and symptoms from preschool to adolescence: a 6-wave community study. J Child Psychol Psychiatry 2022; 63:527-534. [PMID: 34318492 DOI: 10.1111/jcpp.13487] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND The rate of various anxiety disorders in early childhood and whether they continue into middle childhood or adolescence is not known. We therefore report on the prevalence and stability of DSM-5-defined anxiety disorders and their symptoms, capturing the period from preschool to adolescence. METHODS By means of interviewer-based clinical interviews, anxiety was measured in a sample of Norwegian children at six measurement points from age 4 to 14 (n = 1,041). To adjust for time-invariant factors, we applied random intercept cross-lagged panel models (RI-CLPMs) capturing within-person changes. RESULTS Nearly 10% (95% CI = 7.29, 12.63) had an anxiety disorder at some timepoint. Specific phobia was the most prevalent disorder in early and middle childhood, whereas generalized anxiety disorder (GAD) increased in prevalence and became the most common anxiety disorder at age 14 (4.51%, 95% CI = 2.78, 6.23). When time-invariant confounding was adjusted for, homotypic continuity in anxiety symptoms typically first emerged in late middle childhood or adolescence. Even so, such within-person analyses revealed a heterotypic path from increased number of early childhood symptoms of specific phobia to increased number of GAD symptoms in middle childhood (B = .41, 95% CI = .06, .75). Increased separation anxiety in middle childhood predicted increased symptoms of GAD in adolescence (B = .38, 95% CI = .14, .62), and vice versa (B = .05, 95% CI = .00, .09). Only minor gender differences were revealed. CONCLUSIONS Anxiety disorders are prevalent in childhood. In early childhood, anxiety symptoms generally do not predict later anxiety symptoms. In middle childhood, however, such symptoms are less likely to vanish, indicating this developmental period to be particularly important for preventive and treatment efforts.
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Affiliation(s)
- Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bror Ranum
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
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31
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Goldstein BL, Mackin DM, Miao J, Perlman G, Watson D, Ormel J, Klein DN, Kotov R. Is personality stable and symptoms fleeting? A longitudinal comparison in adolescence. JOURNAL OF RESEARCH IN PERSONALITY 2022; 97. [PMID: 35241862 PMCID: PMC8887882 DOI: 10.1016/j.jrp.2022.104190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Few investigations have directly compared personality and internalizing symptoms stability within the same sample and have not included personality facets. This study examined rank-order stability and mean-level change of Big Five domains, facets of neuroticism and extraversion, and internalizing symptoms in a sample of 550 adolescent females. Personality and symptoms were assessed every nine months for three years. Three year rank-order stability was higher for personality domains and facets compared to symptoms. Notable exceptions included lower stability of depressivity and positive emotionality facets. Facets and symptoms showed similar mean level change. Overall, we observed modest and variable temporal differences between symptoms and traits; symptoms exhibited high rank-order stability and low mean-level change, but domains and facets were generally more stable.
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Affiliation(s)
- Brandon L. Goldstein
- University of Connecticut Health Center, Department of
Psychiatry. 243 Farmington Ave. Farmington, CT 06030, USA
- Corresponding Author –
| | - Daniel M. Mackin
- Stony Brook University, Department of Psychology. 100
Nicolls Rd. Stony Brook, NY 11794, USA
| | - Jiaju Miao
- Stony Brook Medicine, Department of Psychiatry. 101 Nicolls
Rd. Stony Brook, NY 11794, USA
| | - Greg Perlman
- Stony Brook Medicine, Department of Psychiatry. 101 Nicolls
Rd. Stony Brook, NY 11794, USA
| | - David Watson
- University of Notre Dame, Department of Psychology. 501 N.
Hill Street, South Bend, IN, 46617, USA
| | - Johan Ormel
- University Medical Center Groningen, Department of
Psychiatry. 1 Hanzeplein, 9713 GZ Groningen, Netherlands
| | - Daniel N. Klein
- Stony Brook University, Department of Psychology. 100
Nicolls Rd. Stony Brook, NY 11794, USA
| | - Roman Kotov
- Stony Brook Medicine, Department of Psychiatry. 101 Nicolls
Rd. Stony Brook, NY 11794, USA
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32
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Scott SR, Manczak EM. Metabolic proteins at birth predict early childhood mental health symptoms. Dev Psychobiol 2022; 64:e22248. [PMID: 35191530 DOI: 10.1002/dev.22248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/09/2021] [Accepted: 01/03/2022] [Indexed: 11/09/2022]
Abstract
Child mental health disorders are the leading cause of disability in children and adolescents worldwide. Biological correlates predict psychosocial outcomes throughout human development; however, less is known about metabolic proteins. Drawing from a longitudinal birth cohort study, Born in Bradford (BiB), we examined the role of infant metabolic proteins at birth in predicting early childhood mental health symptoms at 3 and 5 years. We found that higher leptin predicted more prosocial behavior at age 3. Additionally, a higher leptin-to-adiponectin ratio predicted increased total symptom difficulties. At age 5, we found that higher adiponectin predicted a decreased likelihood of being rated by teachers as meeting or exceeding expectations in the domain of "managing feelings and behaviors" and marginally predicted lower competency in "making relationships" on national developmental milestone evaluations. To our knowledge, this is among the first few studies to prospectively predict mental health symptoms from cord blood metabolic proteins, and the first examining this association with a leptin-to-adiponectin ratio. Our results provide support for the possibility that metabolic proteins at birth forecast risk for mental health symptoms in early childhood.
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Affiliation(s)
- Samantha R Scott
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Erika M Manczak
- Department of Psychology, University of Denver, Denver, Colorado, USA
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Galbally M, Watson SJ, van Rossum EFC, Chen W, de Kloet ER, Lewis AJ. The perinatal origins of childhood anxiety disorders and the role of early-life maternal predictors. Psychol Med 2022; 52:506-514. [PMID: 32597740 DOI: 10.1017/s0033291720002147] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD. METHODS Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist. RESULTS Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels. CONCLUSIONS This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD.
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Affiliation(s)
- Megan Galbally
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
- King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart J Watson
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wai Chen
- School of Medicine, University of Notre Dame, Fremantle, Australia
- Graduate School of Education, University of Western Australia, Crawley, Australia
| | - Edo Ronald de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew J Lewis
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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34
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Overgaard KR, Oerbeck B, Friis S, Pripp AH, Aase H, Zeiner P. Predictive validity of attention-deficit/hyperactivity disorder from ages 3 to 5 Years. Eur Child Adolesc Psychiatry 2022; 31:1-10. [PMID: 33677627 PMCID: PMC9343262 DOI: 10.1007/s00787-021-01750-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 02/19/2021] [Indexed: 11/29/2022]
Abstract
We investigated to what extent parent-rated attention-deficit/hyperactivity disorder (ADHD) and impairment at age 3 years predicted elevated ADHD symptoms at age 5 years, and whether teacher-rated ADHD symptoms improved these predictions. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. Parents of 3-year-old children (n = 1195) were interviewed about ADHD and impairment, and teachers rated child ADHD symptoms by the Strengths and Difficulties Questionnaire or the Early Childhood Inventory-4. At 5 years of age, the children (n = 957) were classified as ADHD-positive or -negative using Conners' Parent Rating Scale. Relying solely on parent-rated ADHD or impairment at age 3 years did moderately well in identifying children with persistent elevation of ADHD symptoms, but gave many false positives (positive predictive values (PPVs): .40-.57). A small group of children (n = 20, 13 boys) scored above cut-off on both parent-rated ADHD and impairment, and teacher-rated ADHD symptoms, although adding teacher-rated ADHD symptoms slightly weakened the predictive power for girls. For this small group, PPVs were .76 for boys and .64 for girls. Limiting follow-up to these few children will miss many children at risk for ADHD. Therefore, we recommend close monitoring also of children with parent-reported ADHD symptoms and/or impairment to avoid delay in providing interventions. Clinicians should also be aware that teachers may miss ADHD symptoms in preschool girls.
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Affiliation(s)
- Kristin Romvig Overgaard
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway
| | - Svein Friis
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway ,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway ,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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35
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Isdahl-Troye A, Villar P, Domínguez-Álvarez B, Romero E, Deater-Deckard K. The Development of Co-Occurrent Anxiety and Externalizing Problems from Early Childhood: a Latent Transition Analysis Approach. Res Child Adolesc Psychopathol 2021; 50:505-519. [PMID: 34499292 PMCID: PMC8940780 DOI: 10.1007/s10802-021-00865-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Research into co-occurrent internalizing and externalizing problems during childhood is flourishing. In particular, investigation on the association between anxiety and externalizing problems has yielded mixed findings, focused mainly on the issue of which problem might precede the other, and what role anxiety plays with respect to externalizing problems. Relatively little attention has been paid to the developmental patterns of these behaviors from early childhood, despite the potential of such knowledge to fully delineate etiological models of co-occurrence. This study aimed to examine the longitudinal association of anxiety and externalizing problems in a community sample of preschoolers (ELISA Project; N = 2,341; 48.2% girls), by identifying empirically derived profiles and then describing their change and stability through the use of Latent Transition Analysis. Gender differences were explored. Four different profiles were identified: “typically developing”, “mainly anxious”, “modestly externalizing” and “co-occurrent”. Membership in these profile groups showed high stability over a two-year period. However, children in the “co-occurrent” profile group were the most likely to show changes, predominantly towards “modestly externalizing”. Furthermore, a significant gender difference for transitions towards the “co-occurrent” profile group was found, with girls showing less likelihood of being assigned to such profile. These findings show that it is possible to identify an early persistent course of co-occurrent anxiety and externalizing problems, as well as observe changes in co-occurrence towards a simpler externalizing behavioral expression. Further research should explore predictors of group membership and changes in membership, that are malleable and therefore open to preventative intervention.
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Affiliation(s)
- Aimé Isdahl-Troye
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Paula Villar
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Beatriz Domínguez-Álvarez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Estrella Romero
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Kirby Deater-Deckard
- Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, USA
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36
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Hoyniak CP, Whalen DJ, Barch D, Luby JL. Sleep problems in preschool-onset major depressive disorder: the effect of treatment with parent-child interaction therapy-emotion development. Eur Child Adolesc Psychiatry 2021; 30:1463-1474. [PMID: 32935261 PMCID: PMC8120654 DOI: 10.1007/s00787-020-01641-1] [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] [Received: 04/06/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
In school-aged children, adolescents, and adults, more than 72% of individuals diagnosed with major depression report co-occurring sleep problems, but little is known about sleep problems in the context of preschool-onset major depressive disorder (PO-MDD). The current study examined the prevalence of various sleep problems in a sample of young children diagnosed with PO-MDD and explored how the treatment of depression, using a modification of parent-child interaction therapy focused on emotional development (PCIT-ED), affects sleep problems. Participants included 229 preschoolers (ages 3-6 years) who met criteria for PO-MDD and participated a single-blind, randomized control trial comparing PCIT-ED to a waitlist control condition. Children were randomly assigned to either PCIT-ED (n = 114) or the waitlist condition (n = 115). Children were assessed at baseline, immediately after PCIT-ED, and 3 months after treatment completion for parent-reported sleep problems across the domains of insomnia, hypersomnia, daytime fatigue, and a total sleep problem index. In our sample, 45% of children had at least one subthreshold sleep problem, 38.4% had at least one threshold sleep problem, and 72.5% had at least one sleep problem (either threshold or subthreshold). Treatment with PCIT-ED significantly reduced sleep problems, including insomnia, daytime fatigue, and total sleep problems, compared to a waitlist condition, even when controlling for child depression. This reduction was maintained at a 3-month follow-up. Sleep problems are a prevalent co-occurring condition with PO-MDD. Interventions such as PCIT-ED that also effectively reduce sleep problems may be particularly beneficial for recovery from PO-MDD.Clinical trial registration information: a randomized control trial of PCIT-ED for preschool depression; https://clinicaltrials.gov/NCT02076425 .
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Affiliation(s)
- Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, St. Louis, MO, 63108, USA.
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, St. Louis, MO, 63108, USA
| | - Deanna Barch
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, St. Louis, MO, 63108, USA
- Department of Psychology, Washington University, St. Louis, MO, USA
- Department of Radiology, Washington University, St. Louis, MO, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, St. Louis, MO, 63108, USA
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37
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Brasfield J, Goulding SM, Kancherla V. Duration of breast feeding and attention-deficit/hyperactivity disorder in United States preschool-aged children. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 115:103995. [PMID: 34049210 DOI: 10.1016/j.ridd.2021.103995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/21/2021] [Accepted: 05/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by difficulties sustaining attention and controlling hyperactivity and impulsive behavior. Population-based studies concerning the association between breast-feeding duration and ADHD among preschool-aged children in the United States (U.S.) have been sparse. AIMS To determine whether there is an association between the duration of breast feeding and ADHD in U.S. children aged 2-5 years. METHODS AND PROCEDURES We used nationally representative data from the 2016, 2017, and 2018 National Survey of Children's Health (NSCH) to examine the association between breast-feeding duration and ADHD in U.S. preschool-aged children. Sample characteristics were compared using Rao-Scott chi-square test, and adjusted prevalence odds ratios and 95 % confidence intervals were estimated using unconditional logistic regression. OUTCOMES AND RESULTS Of the 20,453 children eligible for our study, 1.5 % had received a diagnosis of ADHD and 77.5 % were reported to have been fed human milk as infants. Prevalence odds of ADHD were 57 % lower among children fed human milk for 6-12 months compared to children never fed human milk after controlling for potential confounders. Among children with durations of breast feeding lasting less than 6 months or lasting 12 months or longer, prevalence odds of ADHD were not significantly lower than the comparison group, children who were never fed human milk, after controlling for potential confounders. CONCLUSIONS AND IMPLICATIONS We noted an inverse association between breast feeding durations of 6-12 months and parent-reported diagnosis of ADHD in preschool-aged children in the U.S. Future studies should use longitudinal designs to examine ADHD and duration of breast-feeding measures.
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Affiliation(s)
- Joy Brasfield
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Sandra M Goulding
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Vijaya Kancherla
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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38
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Morken IS, Viddal KR, Ranum B, Wichstrøm L. Depression from preschool to adolescence - five faces of stability. J Child Psychol Psychiatry 2021; 62:1000-1009. [PMID: 33242346 DOI: 10.1111/jcpp.13362] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The term 'stability' has different meanings, and its implications for the etiology, prevention, and treatment of depression vary accordingly. Here, we identify five types of stability in childhood depression, many undetermined due to a lack of research or inconsistent findings. METHODS Children and parents (n = 1,042) drawn from two birth cohorts in Trondheim, Norway, were followed biennially from ages 4-14 years. Symptoms of major depressive disorder (MDD) and dysthymia were assessed with the Preschool Age Psychiatric Assessment (only parents) and the Child and Adolescent Psychiatric Assessment (age 8 onwards). RESULTS (a) Stability of form: Most symptoms increased in frequency. The symptoms' importance (according to factor loadings) was stable across childhood but increased from ages 12-14, indicating that MDD became more coherent. (b) Stability at the group level: The number of symptoms of dysthymia increased slightly until age 12, and the number of symptoms of MDD and dysthymia increased sharply between ages 12-14. (c) Stability relative to the group (i.e., 'rank-order') was modest to moderate and increased from ages 12-14. (d) Stability relative to oneself (i.e., intraclass correlations) was stronger than stability relative to the group and increased from age 12-14. (e) Stability of within-person changes: At all ages, decreases or increases in the number of symptoms forecasted similar changes two years later, but more strongly so between ages 12-14. CONCLUSIONS Across childhood, while most symptoms of MDD and dysthymia become more frequent, they are equally important. The transition to adolescence is a particularly vulnerable period: The depression construct becomes more coherent, stability increases, the level of depression increases, and such an increase predicts further escalation. Even so, intervention at any time during childhood may have lasting effects on reducing child and adolescent depression.
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Affiliation(s)
- Ida Sund Morken
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Bror Ranum
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway
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39
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Obsuth I, Murray AL, Di Folco S, Ribeaud D, Eisner M. Patterns of Homotypic and Heterotypic Continuity Between ADHD Symptoms, Externalising and Internalising Problems from Age 7 to 15. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:223-236. [PMID: 31705348 PMCID: PMC6969859 DOI: 10.1007/s10802-019-00592-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
ADHD presents a serious community-health problem through its links to a wide range of negative outcomes. These outcomes are exacerbated when ADHD symptoms co-occur with other mental health problems. Research evidence suggests high rates of co-comorbidity with a range of problems. However, there is a paucity of longitudinal research that examines the predictive links between ADHD symptoms and symptoms of other mental health problems. We examined a cross-lagged autoregressive model in order to assess homotypic and heterotypic continuity between ADHD symptoms, aggressive behavior, non-aggressive behavior problems and anxiety/depression in a community-based sample of 1571 youth (761 female, 810 male) assessed annually from age 7 to 13 and again at age 15. Consistently significant correlations between each pair of problem behaviors provided support for concurrent comorbidity. Furthermore, significant autoregressive pathways provided support for homotypic continuity. Support for heterotypic continuity was limited to ADHD symptoms predicting both aggressive behavior and non-aggressive behavior problems, but not vice versa. Our study highlights the importance of focusing on ADHD symptoms to identify children at risk not only for continued ADHD symptomatology but also a range of externalizing behavior problems including different types of aggression and non-aggressive behavior problems, such as rule-breaking. Identifying these patterns in a community-based sample provides support for the possibility of early identification of risk for a range of problem behaviors.
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Affiliation(s)
- Ingrid Obsuth
- Department of Clinical and Health Psychology, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, Scotland. .,Institute of Criminology, University of Cambridge, Sidgwick Ave, Cambridge, Cambridge, CB3 9DA, UK.
| | - Aja Louise Murray
- Institute of Criminology, University of Cambridge, Sidgwick Ave, Cambridge, Cambridge, CB3 9DA, UK.,Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ, Scotland
| | - Simona Di Folco
- Department of Clinical and Health Psychology, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, Scotland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zürich, Andreasstrasse 15, 8050, Zürich, Switzerland
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Sidgwick Ave, Cambridge, Cambridge, CB3 9DA, UK.,Jacobs Center for Productive Youth Development, University of Zürich, Andreasstrasse 15, 8050, Zürich, Switzerland
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40
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Wade M, Plamondon A, Jenkins JM. A Family Socialization Model of Transdiagnostic Risk for Psychopathology in Preschool Children. Res Child Adolesc Psychopathol 2021; 49:975-988. [PMID: 33687647 DOI: 10.1007/s10802-021-00789-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 12/17/2022]
Abstract
This longitudinal study examined the presence of general (P) and specific internalizing (INT) and externalizing (EXT) psychopathology factors in a community sample of preschool children. We assessed child and contextual correlates of P, INT, and EXT, and tested a model connecting socioeconomic risk to these factors through family socialization processes and child cognitive abilities. Participants were 501 children recruited at birth and followed up at 18 months and 3 years. Child and family functioning were measured using parental reports, observation, and standardized assessments. Both mothers and their partners reported on children's mental health, permitting the estimation of a trifactor model of psychopathology that captured caregivers' shared and unique perspectives with respect to P, INT, and EXT. Results revealed several transdiagnostic correlates of the common-perspective P factor, including family income, maternal education, maternal depression, and maternal responsiveness, as well as marginal associations with sibling negativity and children's language and theory of mind abilities. Several shared and unique correlates of INT and EXT were also observed. Structural equation modelling revealed that the effects of family income and maternal education on P operated indirectly through maternal responsiveness, while the effects of maternal education on INT and EXT operated through maternal reflective capacity, albeit in opposite directions. Together, these results suggest that the effects of socioeconomic disadvantage on general psychopathology are organized in a temporal cascade from distal to proximal risk.
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Affiliation(s)
- Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S1V6, Canada.
| | - Andre Plamondon
- Département Des Fondements Et Pratiques en Éducation, Laval University, Québec, Canada.
| | - Jennifer M Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S1V6, Canada
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41
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Maternal antenatal depression and child mental health: Moderation by genomic risk for attention-deficit/hyperactivity disorder. Dev Psychopathol 2021; 32:1810-1821. [PMID: 33427178 DOI: 10.1017/s0954579420001418] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Maternal antenatal depression strongly influences child mental health but with considerable inter-individual variation that is, in part, linked to genotype. The challenge is to effectively capture the genotypic influence. We outline a novel approach to describe genomic susceptibility to maternal antenatal depression focusing on child emotional/behavioral difficulties. Two cohorts provided measures of maternal depression, child genetic variation, and child mental health symptoms. We constructed a conventional polygenic risk score (PRS) for attention-deficit/hyperactivity disorder (ADHD) (PRSADHD) that significantly moderated the association between maternal antenatal depression and internalizing problems at 60 months (p = 2.94 × 10-4, R2 = .18). We then constructed an interaction PRS (xPRS) based on a subset of those single nucleotide polymorphisms from the PRSADHD that most accounted for the moderation of the association between maternal antenatal depression and child outcome. The interaction between maternal antenatal depression and this xPRS accounted for a larger proportion of the variance in child emotional/behavioral problems than models based on any PRSADHD (p = 5.50 × 10-9, R2 = .27), with similar findings in the replication cohort. The xPRS was significantly enriched for genes involved in neuronal development and synaptic function. Our study illustrates a novel approach to the study of genotypic moderation on the impact of maternal antenatal depression on child mental health and highlights the utility of the xPRS approach. These findings advance our understanding of individual differences in the developmental origins of mental health.
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42
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Whalen DJ, Gilbert KE, Luby JL. Changes in self-reported and observed parenting following a randomized control trial of parent-child interaction therapy for the treatment of preschool depression. J Child Psychol Psychiatry 2021; 62:86-96. [PMID: 32469454 PMCID: PMC7704660 DOI: 10.1111/jcpp.13263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parenting in early childhood exerts substantial influence over children's emotional health and development. Using data from a randomized controlled trial of a novel treatment for early childhood depression, Parent-Child Interaction Therapy Emotion Development (PCIT-ED), we explored two broad dimensions of parenting (behavior and affect) to determine whether any changes could be detected following treatment when compared to those in a waitlist control condition. METHOD 229 caregiver-child dyads, 114 randomly assigned to PCIT-ED for preschool-onset depression, and 115 assigned to a waitlist completed two structured interaction tasks at baseline and post-treatment. Interactions were later coded by observer's blind to diagnostic and treatment status. RESULTS Greater reductions were found in self-reported negative parenting behaviors and observed negative affect and greater increases in self-reported positive parenting behaviors and observed positive affect among the caregivers in the treatment group. Increases in the overall positivity of the observed interactional style of caregivers, but no observed parenting behavior change was found following treatment. Discrepancies between self-reported and observed parenting were greater among caregivers on the waitlist. CONCLUSIONS Following PCIT-ED treatment, caregivers self-reported improvements in parenting practices and declines in punitive practices along with observed increases in positive affect and decreases in negative affect when interacting with their child. Moreover, coherence between self-reported and observed parenting was higher in the treatment group. These findings highlight the efficacy of PCIT-ED in improving parenting behaviors and the need to use multiple methods to assess parenting in treatment studies.
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Affiliation(s)
- Diana J. Whalen
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Kirsten E. Gilbert
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Joan L. Luby
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
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43
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Rivero LMHN, Andrade ALM, Figueredo LZP, Pinheiro BDO, Micheli DD. Evaluation of FunFRIENDS program in prevention of anxiety in Brazilian children: a randomized controlled pilot trial. CIENCIA & SAUDE COLETIVA 2020; 25:4497-4508. [PMID: 33175057 DOI: 10.1590/1413-812320202511.33072018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/15/2019] [Indexed: 11/21/2022] Open
Abstract
This study aimed to evaluate the effects of the FunFRIENDS protocol on anxiety symptoms, internalizing problems and prosocial behavior in 4- to 5-year old children. Participated of this study 43 children with an allocation ratio of 1:1 between groups (Intervention Group [IG], N = 21; Control Group [CG], N = 22) from a public school in the city of Sao Paulo participated in the study. Behaviors were evaluated by using standardized questionnaires (PAS, CBCL, SDQ, SCBE) assessing the behavioral profile of the children at three different periods; baseline (T0), one month (T1) and three months (T2) after the intervention. It was observed a reduction in the intensity of anxiety symptoms in the IG after the intervention but with no significant effect. Overall, there were no significant differences between the IG and the CG in most behaviors on all periods evaluated. On both Intention-to-Treat analyses also it was not detected significant effects of the intervention. This is the first Brazilian study evaluating the effects of FunFRIENDS program and the implications of these findings are discussed and its significance for future research.
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Affiliation(s)
| | - André Luiz Monezi Andrade
- Centro de Ciências da Vida, Pontifícia Universidade Católica de Campinas. Av. John Boyd Dunlop s/n, Jardim Ipaussarama. 13034-685 Campinas SP Brasil.
| | | | | | - Denise De Micheli
- Departamento de Psicobiologia, Universidade Federal de São Paulo. São Paulo SP Brasil
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Vasa RA, Keefer A, McDonald RG, Hunsche MC, Kerns CM. A Scoping Review of Anxiety in Young Children with Autism Spectrum Disorder. Autism Res 2020; 13:2038-2057. [PMID: 32978905 DOI: 10.1002/aur.2395] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/31/2020] [Accepted: 08/27/2020] [Indexed: 12/24/2022]
Abstract
Research on anxiety in children and adolescents with autism spectrum disorder (ASD) has burgeoned in the past 15 years. Most of the research has focused on school-age children, ages 6 to 18 years. Yet, recent studies suggest that anxiety can emerge in young children, under 6 years, with ASD. This scoping review synthesized the literature on anxiety in young children with ASD. Three domains of anxiety research were reviewed: (a) prevalence/severity, phenomenology, and course; (b) correlates; and (c) treatment. Four online databases were searched from the start of the database until March 2020. Keywords pertaining to anxiety, autism, and young children were entered. The search identified 44 articles for inclusion. These studies varied with respect to sample source, informants, and measures to assess anxiety. The overall prevalence of anxiety ranged from 1.6 to 62%. Sixteen of 17 studies found that young children with ASD had higher levels of anxiety compared to various control groups. A variety of DSM anxiety symptoms and disorders were present in young children with the most common symptoms being specific, social, and generalized fears. Correlates of anxiety included sensory over-responsivity, sleep disturbance, aggression/defiance, and attention deficit/hyperactivity disorder. Three cognitive behavioral treatment studies for anxiety and one developmental intervention targeting ASD symptoms showed promise in reducing anxiety. Findings indicate an early emergence of anxiety in some children with ASD. Further research on the measurement, pathophysiology, and treatment of anxiety in early childhood is critical to improving outcomes in children with ASD. LAY SUMMARY: This scoping review synthesizes the literature on anxiety in young children with autism spectrum disorder (ASD). Results indicate that children with ASD have higher levels of anxiety than children without ASD. Potential factors that could be contributing to anxiety include sensory, sleep, and behavioral problems. Preliminary studies show that anxiety can improve with cognitive behavioral treatment. These findings suggest that research on anxiety in young children with ASD should be prioritized to improve mental health outcomes.
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Affiliation(s)
- Roma A Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rachel G McDonald
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Michelle C Hunsche
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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Hirshfeld-Becker DR, Henin A, Rapoport SJ, Wilens TE, Carter AS. Very early family-based intervention for anxiety: two case studies with toddlers. Gen Psychiatr 2019; 32:e100156. [PMID: 31922092 PMCID: PMC6936974 DOI: 10.1136/gpsych-2019-100156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 11/30/2022] Open
Abstract
Anxiety disorders represent the most common category of psychiatric disorder in children and adolescents and contribute to distress, impairment and dysfunction. Anxiety disorders or their temperamental precursors are often evident in early childhood, and anxiety can impair functioning, even during preschool age and in toddlerhood. A growing number of investigators have shown that anxiety in preschoolers can be treated efficaciously using cognitive-behavioural therapy (CBT) administered either by training the parents to apply CBT strategies with their children or through direct intervention with parents and children. To date, most investigators have drawn the line at offering direct CBT to children under the age of 4. However, since toddlers can also present with impairing symptoms, and since behaviour strategies can be applied in older preschoolers with poor language ability successfully, it ought to be possible to apply CBT for anxiety to younger children as well. We therefore present two cases of very young children with impairing anxiety (ages 26 and 35 months) and illustrate the combination of parent-only and parent-child CBT sessions that comprised their treatment. The treatment was well tolerated by parents and children and showed promise for reducing anxiety symptoms and improving coping skills.
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Affiliation(s)
- Dina R Hirshfeld-Becker
- Child CBT Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Aude Henin
- Child CBT Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephanie J Rapoport
- Child CBT Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Timothy E Wilens
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
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Abstract
PURPOSE OF REVIEW We review findings related to predictors, correlates, outcomes, and treatment of preschool depression that have been published in the last 3 years. RECENT FINDINGS Preschool depression displays a chronic course through late adolescence and is associated with temperamental and personality traits, poorer physical health, and negative parenting practices. Preschool depression predicts deficits into adolescence, including social difficulties and blunted neural response to rewards. Depressed preschoolers can experience suicidal ideation and behaviors and display an accurate understanding of the finality of death. A treatment for preschool depression has now been validated that uses the parent-child relationship to enhance emotion development and reduce depressive symptoms. Preschool depression is homotypic with depression that occurs later in life. Future work elucidating mechanisms through which preschool depression develops and informs the sub-groups for which particular treatments may be most effective will have considerable implications for prevention and early intervention.
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Affiliation(s)
- Meghan Rose Donohue
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2500, St. Louis, MO, 63110, USA.
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2500, St. Louis, MO, 63110, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2500, St. Louis, MO, 63110, USA
| | - Laura Hennefield
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2500, St. Louis, MO, 63110, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2500, St. Louis, MO, 63110, USA
- Department of Psychology, Washington University, St. Louis, MO, USA
- Department of Radiology, Washington University, St. Louis, MO, USA
| | - Joan Luby
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2500, St. Louis, MO, 63110, USA
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Leppert KA, Bufferd SJ, Olino TM, Dougherty LR. A Daily Diary Analysis of Preschool Depressive Behaviors: Prospective Associations and Moderators Across 14 Days. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:1547-1558. [PMID: 30911869 PMCID: PMC7755310 DOI: 10.1007/s10802-019-00535-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Depressive disorders can be observed in early childhood and are associated with significant concurrent and prospective impairment; however, little is known about day-to-day variations in common depressive behaviors in children. This study examined the day-to-day variability of two common depressive behaviors in preschool-aged children, sadness and irritability, and factors associated with the daily occurrence of these behaviors. Participants included 291 parents of preschool-aged children, and parents completed a 14-day daily diary. Results indicated that sleep quality did not prospectively predict next-day sadness or irritability the following day. We observed between-person stability, but within-person variability, in children's sadness and irritability across 14 days. We observed greater between-person stability and greater within-person variability in sadness and irritability for males and for children with fewer baseline psychiatric symptoms and lower baseline impairment. Findings provide a developmental perspective on normative patterns of sadness and irritability in young children and can inform prevention and individualized intervention efforts to reduce negative sequelae in at-risk preschoolers.
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Affiliation(s)
- Katherine A Leppert
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - Sara J Bufferd
- Department of Psychology, California State University, San Marcos, San Marcos, CA, 92096, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA.
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Jobs I, Müller JM, Skorozhenina O, Romer G. Homo- and Heterotypic Trajectories in a Preschool to Primary-School Clinical Sample: A Prospective Study Related to Maternal Psychopathology. Front Psychiatry 2019; 10:153. [PMID: 30967803 PMCID: PMC6440442 DOI: 10.3389/fpsyt.2019.00153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Most longitudinal or follow-up mental health studies describe developmental pathways using dimensional measures of psychopathology, but seldom using pathways described by clinical disorders. Objective: We aim to describe diagnostic pathways by homotypic (within the disorder continuity) and heterotypic development (between the disorder continuity), with maternal psychopathology as moderator for both trajectories. Methods: Clinically referred children (0-7 years; N = 83) were assessed at preschool age and at primary-school age through a clinical interview. We built a disorder cluster of emotional disorders (ED; F32, F40, F42, F43, F93.0, F93.1, F93.2, F93.8, F95), behavioral disorders (BD; F68.8, F90, F91, F91.3, F93.3, F93.9, F94), and specific early onset disorders (SEO; F50, F51, F70, F98.0, F98.1, F98.2, F98.8, F98.9). We describe the prevalence, comorbidity, and clinical trajectories of various types of homotypic and heterotypic development. Results: We observed a high rate of comorbidity throughout the study (62.6% at admission and 67.5% at follow-up) and in general, a high continuity of mental health problems from preschool to primary-school age children (69.9% of the sample showed continuity), with 50.6% of the sample showing homotypic and 44.6% showing heterotypic development. Hierarchical multiple regression analyses suggest that heterotypic development may be influenced by maternal psychopathology. Conclusion: Currently, evidence-based mental health guidelines for preschool populations are designed and evaluated assuming a homotypic development. However, our findings indicate that treatment interventions and outcome measures should also be designed and evaluated for heterotypic development especially in case of increased maternal psychopathology.
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Affiliation(s)
- Isabell Jobs
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Jörg Michael Müller
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
- Health Psychology and Applied Diagnostics, University of Wuppertal, Münster, Germany
| | - Olena Skorozhenina
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
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Finsaas MC, Kessel EM, Dougherty LR, Bufferd SJ, Danzig AP, Davila J, Carlson GA, Klein DN. Early Childhood Psychopathology Prospectively Predicts Social Functioning in Early Adolescence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 49:353-364. [PMID: 30307751 DOI: 10.1080/15374416.2018.1504298] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psychopathology in school-age children predicts impairment later in development. However, the long-term psychosocial consequences of early childhood psychopathology are less well known. The current study is the first to prospectively examine how a range of diagnoses and symptoms in early childhood predict psychosocial functioning across specific domains during early adolescence 6-9 years later. A community sample (N = 595; 44.9% female; 88.7% White, 12.6% Hispanic) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. Diagnoses and dimensional scores for depressive, anxiety, attention-deficit/hyperactivity (ADHD), and oppositional defiant disorders (ODD) were examined. When children were 12 years old, children and parents completed the UCLA Life Stress Interview for Children, a semistructured interview assessing functioning in multiple domains (academic, behavior, close friends, broader peers, maternal relationship, paternal relationship). Having a diagnosis in early childhood predicted greater impairment in all domains in early adolescence, except paternal relationship. Externalizing disorders predicted impairment in more domains than internalizing disorders. Most of the associations between early childhood psychopathology and poorer functioning in adolescence persisted after taking into account adolescent psychopathology. Moreover, the majority of bivariate associations with depressive, ODD, and ADHD symptoms, but not anxiety symptoms, persisted in a subsample of children who did not meet criteria for a diagnosis in early childhood. Early childhood psychopathology has long-lasting deleterious effects on several domains of psychosocial functioning, often beyond the effects of continuing or recurring adolescent psychopathology. Findings thereby highlight the validity and clinical significance of early psychopathology.
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Affiliation(s)
| | | | - Lea R Dougherty
- Department of Psychology, University of Maryland College Park
| | - Sara J Bufferd
- Department of Psychology, California State University San Marcos
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50
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Gaffrey MS, Tillman R, Barch D, Luby JL. Continuity and stability of preschool depression from childhood through adolescence and following the onset of puberty. Compr Psychiatry 2018; 86:39-46. [PMID: 30077052 PMCID: PMC6842566 DOI: 10.1016/j.comppsych.2018.07.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/16/2018] [Accepted: 07/21/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND A growing body of research now supports the validity, clinical significance, and long-term negative impact of depression occurring during the preschool period. However, the prospective continuity of depressive symptoms and risk for major depressive disorder (MDD) from childhood through adolescence for preschoolers experiencing this highly impairing disorder remains unexplored. Such information is likely to be critical for understanding the developmental continuity of preschool depression and whether it continues to be a salient risk factor for an MDD diagnosis following the transition into adolescence and the onset of biological changes associated with it (i.e., puberty). METHODS Subjects were participants in the Preschool Depression Study conducted at the Early Emotional Development Program at Washington University School of Medicine in St. Louis. Subjects and their parents completed baseline assessments that included comprehensive measures of psychopathology and development at baseline and up to 9 follow-up assessments between 2003 and 2017. N = 279 subjects had diagnostic and clinical data available for the preschool period and the early pubertal and/or later pubertal periods and were included in the analyses. There were N = 275 subjects assessed during the early pubertal period and N = 184 subjects assessed during the later pubertal period. RESULTS Preschool depression was a highly salient predictor of prepubertal and mid-to-post pubertal MDD. Across all modeled time points children with a history of preschool depression continued to demonstrate elevated levels of depressive symptoms from childhood through adolescence, suggesting a heightened trajectory of depressive symptoms relative to their same age peers. CONCLUSION Findings from the current study suggest that children with a history of preschool depression follow a trajectory of depression severity elevated relative to their same age peers from childhood through adolescence but with a similar shape over time. They also support the homotypic continuity of preschool depression into adolescence and the onset of puberty.
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Affiliation(s)
- Michael S. Gaffrey
- Washington University, Department of Psychiatry, Saint Louis, Missouri, Duke University,Washington University, Department of Psychology and Neuroscience, Durham, North Carolina
| | - Rebecca Tillman
- Washington University, Department of Psychiatry, Saint Louis, Missouri, Duke University
| | - Deanna Barch
- Washington University, Department of Psychiatry, Saint Louis, Missouri, Duke University,Washington University, Department of Psychological and Brain Sciences, Saint Louis, Missouri, Duke University
| | - Joan L. Luby
- Washington University, Department of Psychiatry, Saint Louis, Missouri, Duke University
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