Evolution of behavior disorders into adolescence

Longitudinal research in child and adolescent psychiatry

An indispensable approach to the study of variations in individual development and of causal mechanisms and processes underlying the course of psychopathology is the longitudinal method. In this introductory review, the strengths and weaknesses of longitudinal research are discussed, and factors hampering progress in this field are outlined. The many advantages of this approach warrant continuing efforts to develop strategies that minimize its drawbacks.

Four-year follow-up of an epidemiological sample

In this 4-year follow-up of behavioral/emotional problems in an epidemiological sample of 1,200 children originally aged 4 to 12 years assessed with the Achenbach Child Behavior Checklist (CBCL), high stability in the level of CBCL total problem scores was found. Stability of problem behavior was equally substantial for ages 4 to 12 and both sexes. Aggressive and other externalizing behaviors showed the highest stability. Even in children as young as 4 to 5 years, aggressive and attentional problems showed considerable stability. The results of the present study were informative with respect to methodology in indicating clearly that employing a mailing survey for obtaining parent reports on behavioral/emotional problems resulted in the selective exclusion of a group of especially problematic children who were recovered when parents were interviewed at home.

Developmental psychiatry: a perspective

A brief historical introduction to developmental psychology puts twentieth century views into perspective. The ideas of continuity, critical periods and predictability are examined. The case for a developmental perspective of human development is argued, and the tenets underlying such a model are suggested. The utility of the study of human development is discussed.

Persistence and change in behavioral/emotional problems reported by parents of children aged 4-14: an epidemiological study

Crucial to our understanding of psychopathology in children is information on the stability and change of behavioral/emotional problems and competencies across time. Existing studies, reviewed in this article, provide only limited answers due to one or more of the following factors: restriction of the sample to a single locality, the use of selected samples, large sample attrition, the use of different assessment instruments at different times, the small number of specific behavioral/emotional problems or the use of very broad categories of functioning. The present study was designed to test the persistence and change of behavioral/emotional problems and competencies as reported by parents of 1,412 children aged 4-14 over a two-year period in a representative sample of the general population. At both points, standardized parents' reports were obtained using the Achenbach Child Behavior Checklist (CBCL). A recovery rate of 80.2% was obtained. Our study is the only one, as far as we known, to present follow-up data separately for ages covering the preschool period to adolescence, making it possible to compare stabilities in the occurence of behavioral/emotional problems across various developmental levels. Over the two-year follow-up period, there was a significant decrease in problem scores. Although possible, it is unlikely that the mental health of children in our sample increased very much. A decrease in problem scores over time has been demonstrated for clinical as well as general population samples in other studies as well. No satisfactory explanations are available for this phenomenon. It is important, however, that studies employing a retest design take account of this phenomenon. Irrespective of changes in the magnitude of group scores over time, stability coefficients can tell us whether individual children tend to preserve their rank orders. The stability coefficients between Time 1 and Time 2 total problem scores ranged from .62 (girls, aged 4-5) to .71 (boys, aged 6-11). No significant differences between stability coefficients for different age-groups and for both sexes could be demonstrated. The changes in scores across time for individual items were consistent with the cross-sectional data of our earlier study (Verhulst et al. Acta Psychiatrica Scandinavica, 1985, 72, suppl. 323). Stability coefficients for social competence scores at both times of assessment were generally somewhat weaker than those found for problem scores.(ABSTRACT TRUNCATED AT 400 WORDS)

Subgrouping conduct disordered adolescents by early risk factors

An analysis aiming to functionally subgroup seriously conduct disordered adolescents identified grade of onset of persistent classroom misconduct as the single most useful and discriminating variable for this purpose. Students whose misconduct began in the early elementary school were characterized by a prominent degree of developmental-educational limitations, whereas those with a later onset were--like the control group--remarkably free of early risk factors.

Constancy and change in the growth of human characteristics

Neither genetic programmes nor social influences necessarily unfold in a constant way, and their interactions are complex. The role of chance events adds a further and sometimes potent uncertainty in prediction equations. Both constancies and changes of ordinal position and/or level occur for most characteristics in normal circumstances but, following significant ecological improvement, personal changes among the disadvantaged can be much larger. Recent research emphasises the inadequacy of considering either genetic or environmental effects during one period of development outside the context of preceding and subsequent influences. It is to long-term consistent influences that importance must be ascribed.

Stress management in childhood

In general, physical and emotional problems are more likely to occur in adults and children who have been exposed to unusual environmental stress. The author reviews the research on children's reactions to environmental and intrafamilial trauma: all youngsters are symptomatic after severe trauma and certain symptoms are characteristic for a given developmental stage. However, some children are able to tolerate submaximal pressure without evident harm. These stress-resistant children are likely to exhibit optimism, ability, and a sense of control over their environment. These attributes can be consciously enhanced when children are taught problem-solving skills. The pediatrician is in an excellent position to prevent emotional morbidity by implementing interventions which would augment children's healthy defenses and enhance their sense of mastery.

Mood quality and intensity in nursery school children as predictors of behavior disorder

Ratings of mood quality and intensity of response, as temperamental attributes of preschool children, were derived from interviews with nursery school children and from direct observations. Findings based on these two attributes signaled emotional distress and identified those children who required referral for clinical disorders within the subsequent five-year period. This study suggests that negative mood and high intensity ratings may be effective indicators of children at risk.