Linking Research Domain Criteria (RDoC) constructs to developmental psychopathology: The role of self-regulation and emotion knowledge in the development of internalizing and externalizing growth trajectories from ages 3 to 10

Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation

PURPOSE OF REVIEW

Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health.

RECENT FINDINGS

(1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse.

SUMMARY

During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.

Reactive and control processes in the development of internalizing and externalizing problems across early childhood to adolescence

Reactive and control processes - e.g., negative emotionality and immediacy preference - may predict distinct psychopathology trajectories. However, externalizing and internalizing problems change in behavioral manifestation across development and across contexts, thus necessitating the use of different measures and informants across ages. This is the first study that created developmental scales for both internalizing and externalizing problems by putting scores from different informants and measures onto the same scale to examine temperament facets as risk factors. Multidimensional linking allowed us to examine trajectories of internalizing and externalizing problems from ages 2 to 15 years (N = 1,364) using near-annual ratings by mothers, fathers, teachers, other caregivers, and self report. We examined reactive and control processes in early childhood as predictors of the trajectories and as predictors of general versus specific psychopathology in adolescence. Negative emotionality at age 4 predicted general psychopathology and unique externalizing problems at age 15. Wait times on an immediacy preference task at age 4 were negatively associated with age 15 general psychopathology, and positively associated with unique internalizing problems. Findings demonstrate the value of developmental scaling for examining development of psychopathology across a lengthy developmental span and the importance of considering reactive and control processes in development of psychopathology.

Systematic Review and Meta-Analysis: Early Irritability as a Transdiagnostic Neurodevelopmental Vulnerability to Later Mental Health Problems

OBJECTIVE

Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization.

METHOD

Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist.

RESULTS

Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization.

CONCLUSION

Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems.

DIVERSITY & INCLUSION STATEMENT

One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

STUDY PREREGISTRATION INFORMATION

Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/; CRD42020214658.

Cool and hot executive function problems in young children: linking self-regulation processes to emerging clinical symptoms

Self-regulation (SR) difficulties are implicated in a wide range of disorders which develop in childhood, including attention deficit hyperactivity disorder (ADHD), oppositional defiance disorder (ODD), anxiety and depression. However, the integration of the existing research evidence is challenging because of varying terminology and the wide range of tasks used, as well as the heterogeneity and comorbidity within and across diagnostic categories. The current study used the Research Domain Criteria (RDoC) framework to guide the examination of different SR processes in young children showing a wide range of symptomatology. Children (aged 4-8) referred by teachers for moderate-to-high conduct, hyperactivity and/or emotional problems at school (assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales; n = 212), and children in SDQ typical ranges (n = 30) completed computerised cognitive control and decision-making tasks. Parents completed questionnaires to assess ADHD, ODD, anxiety and depression symptoms (n = 191). Compared to children with no teacher-reported difficulties, those with moderate-to-high problems showed poorer visuomotor control and decision-making. A factor analysis revealed that task variables adhered to RDoC dimensions and predicted variance in specific disorders: difficulties in cognitive control predicted ADHD symptoms, low reward-seeking was associated with depression and high reward-seeking was associated with ODD. This study highlights how the assessment of cognitive processes positioned within the RDoC framework can inform our understanding of disorder-specific and transdiagnostic difficulties in SR which are associated with diverse clinical symptoms in children.

Prenatal exposures to phthalates and life events stressors in relation to child behavior at age 4-6: A combined cohort analysis

Prenatal exposures to chemical and psychosocial stressors can impact the developing brain, but few studies have examined their joint effects. We examined associations between prenatal phthalate exposures and child behavior, hypothesizing that prenatal stressful life events (PSLEs) may exacerbate risks. To do so, we harmonized data from three U.S. pregnancy cohorts comprising the ECHO-PATHWAYS consortium. Phthalate metabolites were measured in single mid-pregnancy urine samples. When children were ages 4-6 years, mothers completed the Child Behavior Checklist (CBCL), from which a Total Problems score was calculated. Mothers additionally provided recall on their exposure to 14 PSLEs during pregnancy. Primary models examined problem behaviors in relation to: (1) phthalate mixtures calculated through weighted quantile sums regression with permutation test-derived p-values; and (2) joint exposure to phthalate mixtures and PSLEs (counts) using interaction terms. We subsequently refitted models stratified by child sex. Secondarily, we fit linear and logistic regression models examining individual phthalate metabolites. In our main, fully adjusted models (n = 1536 mother-child dyads), we observed some evidence of weak main effects of phthalate mixtures on problem behaviors in the full cohort and stratified by child sex. Interaction models revealed unexpected relationships whereby greater gestational exposure to PSLEs predicted reduced associations between some phthalates (e.g., the metabolites of di-2-ethylhexyl phthalate, di-n-octyl phthalate, di-iso-nonyl phthalate) and problem behaviors, particularly in males. Few associations were observed in females. Additional research is needed to replicate results and examine potential mechanisms.

Trajectories of cognitive flexibility through kindergarten and first grade: Implications for externalizing and internalizing behavior problems in the second grade

Developmental delays in cognitive flexibility early in elementary school can potentially increase vulnerability for subsequent externalizing and internalizing psychopathology. The first goal of the current study was to identify latent subgroups of children characterized by different developmental trajectories of cognitive flexibility throughout kindergarten and first grade using data from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011 dataset. The second goal was to examine whether identified longitudinal developmental trajectories of cognitive flexibility could be associated with internalizing and externalizing behaviors in the second grade, while accounting for background child (age, gender, and Spanish-speaking) and family (family income and mother's education) covariates. The analytic sample consisted of 15,827 kindergarteners (51.20% male; 48.50% White, 13.5% Black/African American, 24.3% Hispanic/Latino, 7.60% Asian, and 6.1% other), who were approximately 5.62 years old (SD = 4.48 months) at the study's outset. Most children lived in households with medium family income of approximately $50,000-$55,000. Using a growth mixture modeling approach, our analyses identified normative (91.05%; 50.4% male) and delayed (8.95%; 59.4% male) cognitive flexibility groups and demonstrated that delayed developers have higher levels of externalizing and internalizing behaviors in the second grade, even after adjusting for background covariates. Our findings, in conjunction with research on cognitive flexibility training, suggest that caregivers may lower the risk for externalizing and internalizing behaviors in delayed developers by correcting inflexible thinking, encouraging alternative solutions, and providing emotional support when children face challenging problems. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotion regulation as a complex system: A multi-contextual and multi- level approach to understanding emotion expression and cortisol reactivity among Chinese and US preschoolers

Are children from "Eastern" cultures less emotionally expressive and reactive than children from "Western" cultures? To answer this, we used a multi-level and multi-contextual approach to understand variations in emotion displays and cortisol reactivity among preschoolers living in China and the United States. One hundred two preschoolers from China (N = 58; 55% males) and the United States (N = 44, 48% males) completed three (i.e., control, interpersonal-related, and achievement-related) emotion-challenging paradigms over 3 days. Behavioral emotion expressions were coded, and salivary cortisol was sampled 30 minutes before and across 90 minutes post-task. Without considering context, Chinese preschoolers displayed fewer levels of positive and negative emotion expressions relative to their United States counterparts. However, Chinese preschoolers displayed similar levels of expressions as their United States counterparts during an achievement-related challenge that is more salient to their sociocultural emphases and showed higher negative emotion expressions in this challenge, relative to other contexts. Moreover, only the achievement-related challenge elicited increased cortisol levels among Chinese preschoolers, and this was correlated with higher levels of negative expressions. For US preschoolers, no cortisol increase was observed in any challenging paradigms, nor was cortisol associated with emotional expressions. Findings counter prior notions that East Asian children are generally less emotionally expressive. Instead, an achievement-related challenge elicited higher emotion expression and cortisol reactivity among Chinese preschoolers, suggesting that children's emotion expression and biological reactivity may be most responsive to contexts salient to their socio-cultural environments. We discuss the importance of considering cultural contexts when studying emotion regulation. RESEARCH HIGHLIGHTS: Chinese preschoolers displayed lower overall positive and negative expressions relative to their US counterparts without considering situational contexts. Chinese preschoolers displayed similar levels of emotion expressions as their US counterparts during an achievement-related challenge salient to their social-cultural environment. Chinese preschoolers are particularly responsive to achievement-related challenges, relative to other emotion-challenging situations that are less culturally salient. No cortisol increase was observed in any of the emotion-challenging paradigms among US preschoolers. Children's emotion expression and biological reactivity may be most responsive to challenges relevant to their socio-cultural environments.

Childhood externalizing, internalizing and comorbid problems: distinguishing young adults who think about suicide from those who attempt suicide

BACKGROUND

While childhood externalizing, internalizing and comorbid problems have been associated with suicidal risk, little is known about their specific associations with suicidal ideation and attempts. We examined associations between childhood externalizing, internalizing and comorbid problems and suicidal ideation (without attempts) and attempts by early adulthood, in males and females.

METHOD

Participants were from the Quebec Longitudinal Study of Kindergarten Children, a population-based study of kindergarteners in Quebec from 1986 to 1988 and followed-up until 2005. We captured the co-development of teacher-rated externalizing and internalizing problems at age 6-12 using multitrajectories. Using the Diagnostic Interview Schedule administered at age 15 and 22, we identified individuals (1) who never experienced suicidal ideation/attempts, (2) experienced suicidal ideation but never attempted suicide and (3) attempted suicide.

RESULTS

The identified profiles were no/low problems (45%), externalizing (29%), internalizing (11%) and comorbid problems (13%). After adjusting for socioeconomic and familial characteristics, children with externalizing (OR 2.00, CI 1.39-2.88), internalizing (OR 2.34, CI 1.51-3.64) and comorbid (OR 3.29, CI 2.05-5.29) problems were at higher risk of attempting suicide (v. non-suicidal) by age 22 than those with low/no problems. Females with comorbid problems were at higher risk of attempting suicide than females with one problem. Childhood problems were not associated with suicidal ideation. Externalizing (OR 2.01, CI 1.29-3.12) and comorbid problems (OR 2.28, CI 1.29-4.03) distinguished individuals who attempted suicide from those who thought about suicide without attempting.

CONCLUSION

Childhood externalizing problems alone or combined with internalizing problems were associated with suicide attempts, but not ideation (without attempts), suggesting that these problems confer a specific risk for suicide attempts.

Targeting cognitive control to reduce anxiety in very young children: A proof of concept study

OBJECTIVE

Underdeveloped cognitive control (CC)-the capacity to flexibly adjust to changing environments-may predispose some children to early onset anxiety disorders and represents a promising intervention target. The current study established and pilot-tested "Camp Kidpower"-a novel group-based, interactive CC training intervention-and assessed its impacts on behavioral and neurophysiological indices of CC among preschool children with elevated anxiety symptoms.

METHODS

Forty-four anxious children (4-6 years) were enrolled in Camp Kidpower, delivered in four sessions over 10 days. Before and after camp, children's capacity for CC was measured using well-validated, non-trained behavioral tasks and error-related negativity (ERN). Child anxiety symptoms were measured by parent report on the Spence Preschool Anxiety Scale.

RESULTS

Thirty-two children completed the study, as defined by completion of pre- and follow-up assessments and at least three camp sessions. From baseline to after camp, performance on behavioral tests of CC improved, ERN amplitude increased, and anxiety symptoms decreased.

CONCLUSION

Results provide initial evidence that play-based cognitive training targeted to behavioral and brain markers of CC reduces anxiety in preschoolers.

Introduction to the Special Issue: Interplay of Family Factors and Cognitive-Affective Processes in Youth

Substantial research suggests that caregivers and families are powerful socialization agents when it comes to how youth process and regulate cognitive-affective information, which in turn can be a risk or resilience factor for various forms of developmental psychopathology. To this end, Clinical Child and Family Psychology Review features this special journal issue on the "Interplay of Family Factors & Cognitive-Affective Processes in Youth." Featured articles review a wide array of methodologies and highlight numerous forms of cognitive-affective processing and family contextual factors. Multiple themes emerged across the twelve articles, emphasizing the need to examine (1) complex pathways within families, (2) the quality of cognitive-affective processes across individuals, (3) neurodevelopmental pathways linking socialization and cognitive-affective processes, (4) nuanced methods to assess "in-the-moment" cognitive-affective processes, (5) the impact of cultural background on how family factors intersect with youth cognitive-affective processes, and (6) the socialization of positive emotion. These papers showcase the applicability of this significant area of research for future efforts in prevention and intervention with youth at risk for, or already experiencing, some form of psychopathology.

Self-regulation and Psychopathology in Young Children

The current study examined concurrent relationships between children's self-regulation, measured behaviorally and by parent-report, and children's internalizing and externalizing symptoms. The aim was to distinguish which components of self-regulation (attention vs. inhibitory control, "hot" vs. "cool" regulation) best predict dimensional symptomatology and clinical disorders in young children. The participants were 120 children, ages 4-8 years old. Results showed that greater parent-reported attention was associated with fewer internalizing and externalizing symptoms. Behaviorally-measured hot inhibitory control related to fewer internalizing symptoms, whereas parent-reported inhibitory control related to fewer externalizing symptoms. Similar patterns emerged for clinical diagnoses, with parent-rated attention most strongly predicting disorders across domains. Results support prior evidence implicating self-regulatory deficits in externalizing problems, while also demonstrating that components of self-regulation are impaired with internalizing symptoms. Further, different sub-components of self-regulation relate to different dimensions of psychopathology in children. Interventions should target these areas in children at-risk for disorders.

Applying new RDoC dimensions to the development of emotion regulation: Examining the influence of maternal emotion regulation on within-individual change in child emotion regulation

While the Research Domain Criteria (RDoC) acknowledges that environmental and developmental influences represent important elements of the RDoC framework, there is little specificity regarding how and when to systematically examine the impact of these dimensions on domains of function. The primary aims of this paper are to demonstrate the ways in which the RDoC can be expanded to include an explicit emphasis on (a) assessing within-individual change in developmental processes over time and (b) evaluating the extent to which selective and measurable environmental influences drive meaningful change during key developmental periods. We provide data from an ongoing randomized control trial as a proof of concept to highlight how repeated assessments within an experimental intervention design affords the unique opportunity to test the impact of environmental influences on within-individual change. Using preliminary data from 77 mother–child dyads repeatedly assessed across 12 months during the sensitive preschool period, we demonstrate the impact of change in maternal emotion regulation (ER) on within-individual growth in child ER and link that growth to fewer teacher-reported externalizing problems. In line with this Special Issue, findings are discussed within the context of expanding and clarifying the existing RDoC framework to explicitly incorporate environmental and developmental dimensions.

Childhood Antisocial Behavior: A Neurodevelopmental Problem

Early-onset disruptive, aggressive, and antisocial behavior is persistent, can become increasingly serious as children grow older, and is difficult to change. In 2007, our group proposed a theoretical model highlighting the interplay between neurobiological deficits and cognitive and emotional functioning as mediators of the link between genetic influences and early social adversity, on the one hand, and antisocial behavioral problems in childhood, on the other. In this article, we review the post-2007 evidence relevant to this model. We discuss research on genetics/epigenetics, stress/arousal regulation, and emotion and executive functioning in support of the argument that antisocial children, especially those who persist in engaging in antisocial behavior as they grow older, have a range of neuropsychological characteristics that are important in explaining individual differences in the severity and persistence of antisocial behavior. Current clinical practice tends not to acknowledge these individual neuropsychological risks factors or to target them for intervention. We argue that aggressive and disruptive behavior in childhood should be regarded as a neurodevelopmental problem and that intervening at the level of mediating neuropsychological processes represents a promising way forward in tackling these serious behavioral problems. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Latent Profiles of Teacher-Reported Self-Regulation and Assessed Executive Function in Low-Income Community Preschools: Relations With Motor, Social, and School Readiness Outcomes

This study contributes to understandings of early childhood self-regulation and executive function, and their components, through taking a person-centered approach to investigating how these skills cluster together in children aged 4-5years. A sample of children (N=206) from preschools in low socioeconomic communities were assessed through teacher report of self-regulation and three executive function tasks at the commencement of the preschool year. Outcome variables included teacher report of social skills and behavioral problems, and children's school readiness and visual motor integration skills were directly assessed. When the scores from this low-income sample were compared to available norms, over 70% of children scored below the 50th percentile in executive function measures, approximately 20% were below average in self-regulation skills, 48% were delayed in school readiness scores, 36% had above average levels of internalizing problems, and 25% were above average in externalizing problems. A series of four latent profile models each used different measurement approaches and combinations of self-regulation and executive function components. In three of the four models (two which combined self-regulation and executive function measures and one with teacher report of self-regulation only), a high skill and low skill profile were found with 31 to 42% of children in the low profile depending on the model. Children were very similarly classified across all three models. When three executive function scores were modeled alone, a more complex three-profile solution emerged (low, moderate, and high) with 52% in the low profile. Children identified in the low profiles across all models were at greater risk of poorer school readiness, visual motor integration and social skills, and increased behavioral problems. Taken together, the findings suggest that self-regulation and executive function skills tend to cluster together at this age and in this low-income sample. Composite scores of teacher report of self-regulation are somewhat sufficient in identifying children who also have poorer executive function skills and are at risk of poorer motor, social, and school readiness outcomes. These children are an important target group for additional supports prior to school entry.

The Development of Co-Occurrent Anxiety and Externalizing Problems from Early Childhood: a Latent Transition Analysis Approach

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.

Psychopathology and Neurocognition in the Era of the p-Factor: The Current Landscape and the Road Forward

Neurocognitive abilities have frequently been claimed to be involved in the aetiology of psychopathology. Neurocognitive deficits have been reported across many disorders, and theoretical perspectives associate these deficits to the onset and maintenance of the symptomology. Recently, the heterogeneity of symptoms, and comorbidity of disorders, have motivated the development of structural models of psychopathology. Structural models indicate that factors such as internalising, externalising, thought disorder and the p-factor account for a wide variety of symptomology. It is unclear how neurocognitive abilities are best examined within these structures to advance our understanding of psychopathology. In this paper, we use Caspi et al.’s seminal writings as a framework to describe how neurocognitive abilities have been previously associated with categorical disorders and recently associated, and claimed to drive, the factors of psychopathology. We discuss the implications of the p-factor as a substantive construct or statistical artefact, and how this impacts the exploration of neurocognitive abilities and psychopathology. Further, we provide the case for alternative structural approaches, describe an innovative hypothesis of neurocognitive functioning, the multidimensional hypothesis, and explain how this may further our understanding of the heterogeneity of neurocognitive performance and psychopathology at the individual level. Finally, we provide a road forward for the future examination of neurocognitive abilities in psychopathology.

Onset of psychiatric signs and impaired neurocognitive domains in inherited metabolic disorders: A case series

Inherited metabolic disorders (IMDs) can present with psychiatric signs that vary widely from one disease to another. This picture is further complicated by the fact that these features occur at very different illness time points, which may further delay appropriate diagnosis and treatment. In this case series of 62 children and adolescents suffering from IMDs, we clustered psychiatric signs (on the basis of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders classification) as well as impaired cognitive domains (on the basis of the Research Domain Criteriamatrix) according to their mean age of onset (5.7 ± 4 years). We observed consistent patterns of occurrence across disorders. Externalizing symptoms, sleep problems, and cross-domain self-regulation deficits were found to precede the IMD diagnosis. Repetitive thoughts and behaviors as well as emotional dysregulation were found to occur around the disease onset. Finally, late-onset features included dissociative or eating disorders, together with impaired emotion knowledge. Clinicians should specifically look for the co-occurrence of age-specific atypical signs, such as treatment resistance or worsening with psychotropic medication in the earliest stages and symptom fluctuation, confusion, catatonia, or isolated visual hallucinations. We believe that the combined characterizations of psychiatric signs and impaired neurocognitive domains may enable the earliest detection of IMDs and the appropriate care of these particular manifestations.

KEY POINTS

Psychiatric signs are common in inherited metabolic disorders (IMDs) and may occur in the same age-range as other clinical manifestations.Three clusters of psychiatric signs and two clusters of neurocognitive domains can be defined according to their mean age of onset.Warning signs to be used in liaison psychiatry should include age-specific cognitive impairments.

The error-related negativity as a neuromarker of risk or resilience in young children

INTRODUCTION

The error-related negativity (ERN) is a neural response that reflects error monitoring. Contradictorily, an enlarged (more negative) ERN has been cited as both a risk factor and a protective factor, which hinders its utility as a predictive indicator. The aim of the current study was to examine the associations between ERN measured in early childhood with the development of cognitive control (CC), emotion regulation, and internalizing/externalizing symptoms over 1-2 years.

METHODS

When children were ages 5-7, EEG was collected during a Go/No-Go task. A subset of the original participants (n = 30) were selected based on their baseline ERN in an extreme-case design: half with high-amplitude ERN, matched by age and sex with another group with low-amplitude ERN.

RESULTS

At follow-up, children in the High-Amplitude group showed better executive function, less self-reported anxiety and depression, less affect dysregulation, more parent-rated CC, less lability/negativity, and fewer parent-reported externalizing problems. Many results held even when accounting for baseline levels. Further, emotion dysregulation mediated the relationship between the ERN and both anxiety and externalizing problems, while CC mediated the ERN's relationship with externalizing problems only.

CONCLUSIONS

These results can inform identification and intervention efforts for children at risk for psychopathology.

Family Context Assessment in Middle Childhood: A Tool Supporting Social, Educational, and Public Health Interventions

Quality of the family context has an important role in the physical and mental health of children; that is why it is important to have reliable and updated tools. This study aims to design and validate a new tool, the Haezi Etxadi Family Assessment Scale 7-11 (HEFAS 7-11), to assess family context quality in middle childhood. A sample of two cohorts of 772 Spanish families with children aged between 7 and 11 (M = 9.39 years; SD = 1.57; 51.2% girls), participated in the study. Results showed good psychometric properties for the instrument and the confirmatory factor analysis showed a five individual subscales structure: 1. Promotion of Cognitive and Linguistic Development (α = 0.79); 2. Promotion of Socio Emotional Development (α = 0.83); 3. Organization of Physical Environment and Social Context (α = 0.73); 4. Parental Stress & Conflict (α = 0.75); and 5. Parental Profile Fostering Child Development (α = 0.80). The association between HEFAS 7-11 and Trial Making Test was also analyzed to determine the concurrent validity of the instrument. The new scale shows its potential in the fields of research, social and educational, to know those variables that need to be promoted under the approach of positive parenting from a public health perspective.

Advances in early identification of children and adolescents at risk for psychiatric illness

PURPOSE OF REVIEW

Childhood and adolescence are a crucial time window for the early identification of perspectival risk for adult psychopathology. This article reviews current advances in the field.

RECENT FINDINGS

Converging developmentally focused and predictive approaches are rapidly expanding in the field of early identification of children and adolescents at risk for psychiatric illness. Although the former emphasizes early phenotypic trajectories emerging in childhood and adolescence, the latter operate in terms of clinical risk staging. Decisive advances in the field include the metaanalytical evidence of the predictive value of clinical high-risk criteria in childhood-adolescence; the systematization of premorbid manifestations of psychotic vulnerability and bipolar prodromes; the corroboration of certain sets of anomalous subjective experiences as transdiagnostic index of familial genetic risk (i.e., basic symptoms) and early developmental expression of schizophrenia spectrum vulnerability (i.e., self-disorders).

SUMMARY

Childhood phenotypic manifestations of liability to mental disorders are often cooccurrent and undergo a plastic, heterotypic modification along the transition to adolescence. In general, they represent epiphenomenic flags of a broad vulnerability for the subsequent structuration of mental illness. This perspective coheres with the p-factor model of psychopathology and complements the clinical staging model which informs the early detection paradigm of severe mental disorders.

Psychometric Properties of the Emotion Dysregulation Inventory in a Nationally Representative Sample of Youth

Objective: The Emotion Dysregulation Inventory (EDI) is an informant questionnaire developed based on the Patient-Reported Outcomes Measurement Information System (PROMIS®) Scientific Standards and refined through factor analyses and item response theory (IRT) analyses. Although it was developed to improve measurement of emotion dysregulation in youth with autism spectrum disorder, emotion dysregulation has transdiagnostic significance. Therefore, the aim of this study was to evaluate the EDI's psychometric properties and to establish IRT-based scores for a general population of youth.Methods: Data were collected from a sample of 1000 caregivers of 6- to 17-year-old youth matched to the US census on age, gender, race/ethnicity, years of education, and region. Confirmatory factor analyses and IRT analyses using the two-parameter graded response model were performed to evaluate the EDI's structure and psychometric properties.Results: Analyses supported the original two-factor structure of the EDI, reflecting factors for Reactivity and Dysphoria. Simulations of computerized adaptive testing supported use of the same items for a Reactivity short form as those that emerged as most informative in the original autism psychometric analyses. IRT co-calibration with commonly used measures of emotion regulation and irritability in child clinical or community samples indicated the EDI scales provide more information across a wider range of emotion dysregulation. Validity was supported by moderate correlations with measures of related constructs and expected known-group differences.Conclusions: The EDI is an efficient and precise measure of emotion dysregulation for use in general community and clinical samples as well as samples of youth with ASD.

Moderation of the relationship between the error-related negativity and anxiety by age and gender in young children: A preliminary investigation

The error-related negativity (ERN) is a neurophysiologic response to errors that associates with anxiety. Despite the potential relevance of the ERN for understanding mechanisms of early anxiety problems in the developing brain, the relation between ERN and anxious symptoms in young children remains poorly understood. Emerging evidence suggests that ERN-anxiety associations could vary by developmental stage, but this work requires replication and consideration of gender effects, given earlier maturation of the ERN and higher rates of anxiety problems in girls relative to boys. To address this gap, the ERN was collected in 49 preschool- to school-aged children (ages 4-9; 26 girls) sampled across a wide range of anxiety severity. Regression analyses revealed that ERN - anxiety associations depended on age and gender. Specifically, larger (more negative) ERN associated with more anxiety in older girls, whereas smaller ERN associated with more anxiety symptoms in younger girls. No ERN-anxiety association was found in boys. These findings suggest that age and gender moderate the direction of the relation between ERN and anxiety in early childhood and could have important implications for the development of ERN-based risk identification and targeted treatment strategies tailored to individual children.