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Evans SC, Burke JD. The Affective Side of Disruptive Behavior: Toward Better Understanding, Assessment, and Treatment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:141-155. [PMID: 38656139 DOI: 10.1080/15374416.2024.2333008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Historically, much of the progress made in youth mental health research can be classified as focusing on externalizing problems, characterized by disruptive behavior (e.g. aggression, defiance), or internalizing problems, characterized by intense negative affect (e.g. depression, anxiety). Until recently, however, less attention has been given to topics that lie somewhere in between these domains, topics that we collectively refer to as the affective side of disruptive behavior. Like the far side of the moon, the affective side of disruptive behavior captures facets of the phenomenon that may be less obvious or commonly overlooked, but are nonetheless critical to understand. This affective side clarifies socially disruptive aspects of traditionally "externalizing" behavior by elucidating proximal causation via intense negative affect (traditionally "internalizing"). Such problems include irritability, frustration, anger, temper loss, emotional outbursts, and reactive aggression. Given a recent explosion of research in these areas, efforts toward integration are now needed. This special issue was developed to help address this need. Beyond the present introductory article, this collection includes 4 empirical articles on developmental psychopathology topics, 4 empirical articles on applied treatment/assessment topics, 1 evidence base update review article on measurement, and 2 future directions review articles concerning outbursts, mood, dispositions, and youth psychopathology more broadly. By deliberatively investigating the affective side of disruptive behavior, we hope these articles will help bring about better understanding, assessment, and treatment of these challenging problems, for the benefit of youth and families.
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Affiliation(s)
| | - Jeffrey D Burke
- Department of Psychological Sciences, University of Connecticut
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Sonuga-Barke EJS. Paradigm 'flipping' to reinvigorate translational science: Outlining a neurodevelopmental science framework from a 'neurodiversity' perspective. J Child Psychol Psychiatry 2023; 64:1405-1408. [PMID: 37706585 DOI: 10.1111/jcpp.13886] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/15/2023]
Abstract
For the most part the science of neuro-developmental conditions, such as autism and ADHD, is conducted within a framework defined by a paradigm that assumes that these expressions of neuro-developmental variation are disorders resulting from brain dysfunction. the translational goal being to identify, then target, the source of such dysfunction to reduce disorder and resolve impairment. By shifting this perspective to one that defines such conditions as divergence in thought and action underpinned by brain atypicality, the neurodiversity paradigm offers a fresh scientific vision shaped by a new translational imperative. It shifts the focus of enquiry to understanding the way environments shape experience to either stifle or promote the well-being and development of neurodivergent people. It also encourages the fullest possible participation of neurodivergent people in the scientific process. Together these two elements provide a platform for a new translational science of neurodevelopment.
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Sonuga-Barke EJS, Becker SP, Bölte S, Castellanos FX, Franke B, Newcorn JH, Nigg JT, Rohde LA, Simonoff E. Annual Research Review: Perspectives on progress in ADHD science - from characterization to cause. J Child Psychol Psychiatry 2023; 64:506-532. [PMID: 36220605 PMCID: PMC10023337 DOI: 10.1111/jcpp.13696] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 12/20/2022]
Abstract
The science of attention-deficit/hyperactivity disorder (ADHD) is motivated by a translational goal - the discovery and exploitation of knowledge about the nature of ADHD to the benefit of those individuals whose lives it affects. Over the past fifty years, scientific research has made enormous strides in characterizing the ADHD condition and in understanding its correlates and causes. However, the translation of these scientific insights into clinical benefits has been limited. In this review, we provide a selective and focused survey of the scientific field of ADHD, providing our personal perspectives on what constitutes the scientific consensus, important new leads to be highlighted, and the key outstanding questions to be addressed going forward. We cover two broad domains - clinical characterization and, risk factors, causal processes and neuro-biological pathways. Part one focuses on the developmental course of ADHD, co-occurring characteristics and conditions, and the functional impact of living with ADHD - including impairment, quality of life, and stigma. In part two, we explore genetic and environmental influences and putative mediating brain processes. In the final section, we reflect on the future of the ADHD construct in the light of cross-cutting scientific themes and recent conceptual reformulations that cast ADHD traits as part of a broader spectrum of neurodivergence.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- School of Academic Psychiatry, Institute of Psychology, Psychiatry & Neuroscience, King’s College London. UK
- Department of Child & Adolescent Psychiatry, Aarhus University, Denmark
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, United States
| | - Sven Bölte
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
- Division of Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Sweden
| | - Francisco Xavier Castellanos
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Joel T. Nigg
- Department of Psychiatry, Oregon Health and Science University, USA
| | - Luis Augusto Rohde
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clinica de Porto Alegre, Federal University of Rio Grande do Sul, Brazil; National Institute of Developmental Psychiatry, Brazil
| | - Emily Simonoff
- School of Academic Psychiatry, Institute of Psychology, Psychiatry & Neuroscience, King’s College London. UK
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Sonuga‐Barke EJS. ‘If it don't fit, don't force it?’
If real‐world, complex clinical decisions are intrinsically categorical can dimensional systems add value? Reflections on Lahey, Tiemeier & Krueger (2022). JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sonuga-Barke EJS, Zubedat S, Daod E, Manor I. Editorial: Each child with ADHD is unique: Treat the whole patient, not just their symptoms. Front Behav Neurosci 2022; 16:1041865. [PMID: 36268468 PMCID: PMC9577492 DOI: 10.3389/fnbeh.2022.1041865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Edmund J. S. Sonuga-Barke
- School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- School of Medicine, Aarhus University, Aarhus, Denmark
| | - Salman Zubedat
- The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- *Correspondence: Salman Zubedat
| | | | - Iris Manor
- Geha MHC, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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Ronald A. Editorial: Transdiagnostic research: transitory or transformative? J Child Psychol Psychiatry 2022; 63:721-723. [PMID: 35665926 DOI: 10.1111/jcpp.13644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Angelica Ronald
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Jaffee SR. Editorial: The times they are a-changin': paradigm shifts in child and adolescent psychology and psychiatry. J Child Psychol Psychiatry 2022; 63:357-359. [PMID: 35312044 DOI: 10.1111/jcpp.13604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
The world is a different place than it was more than 2 years ago, at the start of the COVID-19 pandemic. The times are always changing, but events of the recent past have radically shifted how we work, when and how we interact with each other, and how we understand our history. The papers in the current issue echo this spirit of change, challenging us to fundamentally re-think how we conceptualize psychopathology, where we define boundaries between 'normal' and 'abnormal' (and, who gets to define those boundaries), and whether our current conceptual models are generalizable to ever more diverse groups. These challenges represent healthy and timely critiques of dominant paradigms. Collectively, the authors who contributed to the current Annual Research Review make the case that these new frameworks will have big pay-offs in terms of improving clinical practice and policy.
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Pellicano E, den Houting J. Annual Research Review: Shifting from 'normal science' to neurodiversity in autism science. J Child Psychol Psychiatry 2022; 63:381-396. [PMID: 34730840 PMCID: PMC9298391 DOI: 10.1111/jcpp.13534] [Citation(s) in RCA: 127] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 12/17/2022]
Abstract
Since its initial description, the concept of autism has been firmly rooted within the conventional medical paradigm of child psychiatry. Increasingly, there have been calls from the autistic community and, more recently, nonautistic researchers, to rethink the way in which autism science is framed and conducted. Neurodiversity, where autism is seen as one form of variation within a diversity of minds, has been proposed as a potential alternative paradigm. In this review, we concentrate on three major challenges to the conventional medical paradigm - an overfocus on deficits, an emphasis on the individual as opposed to their broader context and a narrowness of perspective - each of which necessarily constrains what we can know about autism and how we are able to know it. We then outline the ways in which fundamental elements of the neurodiversity paradigm can potentially help researchers respond to the medical model's limitations. We conclude by considering the implications of a shift towards the neurodiversity paradigm for autism science.
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Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of EducationMacquarie UniversitySydneyNSWAustralia
- Cooperative Research Centre for Living with Autism (Autism CRC)BrisbaneQldAustralia
| | - Jacquiline den Houting
- Macquarie School of EducationMacquarie UniversitySydneyNSWAustralia
- Cooperative Research Centre for Living with Autism (Autism CRC)BrisbaneQldAustralia
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Levy Y. ASD-Time for a paradigm shift. Front Psychiatry 2022; 13:956351. [PMID: 35935420 PMCID: PMC9354486 DOI: 10.3389/fpsyt.2022.956351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yonata Levy
- Psychology Department, Hadassah Medical School, Hebrew University, Jerusalem, Israel
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Levy Y. Commentary: Time to reconceptualize ASD? comments on Happe and Frith (2020) and Sonuga-Barke (2020). J Child Psychol Psychiatry 2021; 62:1042-1044. [PMID: 33118612 DOI: 10.1111/jcpp.13345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/19/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
Happe and Frith (2020) list seven changes in the concept of autism that have taken place since the 80s when autism became the focus of clinical concerns and research interests. These dramatic changes, supported by additional research results, have not convinced Sonuga-Barke (2020) that a Kuhnian revolution in psychiatric nosology may be at our front door. This commentary will discuss this conclusion, calling on ASD researchers to re-evaluate the benefits of a paradigm shift in the nosology of ASD.
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Affiliation(s)
- Yonata Levy
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
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Sonuga-Barke E, Thapar A. The neurodiversity concept: is it helpful for clinicians and scientists? Lancet Psychiatry 2021; 8:559-561. [PMID: 33984295 DOI: 10.1016/s2215-0366(21)00167-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Edmund Sonuga-Barke
- School of Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anita Thapar
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.
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Jellett R, Muggleton J. Implications of Applying "Clinically Significant Impairment" to Autism Assessment: Commentary on Six Problems Encountered in Clinical Practice. J Autism Dev Disord 2021; 52:1412-1421. [PMID: 33893595 DOI: 10.1007/s10803-021-04988-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
The addition of 'clinically significant impairment' (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, Author, 2013) to the diagnostic criteria for autism in DSM-5 attempts to establish a threshold for the condition. However, the increased prominence of the neurodiversity paradigm and social model of disability runs counter to the idea that characteristics of autism are fundamentally impairing. Consequently, diagnostic criteria for autism are becoming misaligned with the contemporary views of 'disorder' and 'disability'. In this commentary, we outline six clinical issues that arise from this misalignment during diagnostic assessment for autism, and the tension this creates in making diagnostic decisions. We conclude by considering ways the 'clinically significant impairment' criterion could be changed, and the implications this would have on clinical practice, and the concept of autism.
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Affiliation(s)
- Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Joshua Muggleton
- Clinical Psychologist for NHS Fife, Lynebank Hospital, Halbeath Road, Dunfermline, Fife, KY11 4UW, Scotland.
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