Biomedical subjects

Robert F Ferdinand

Publications and source records attributed to Robert F Ferdinand.

35 records · Page 2Linked to original sources

PubMed2005

Classes of adolescents with disruptive behaviors in a general population sample.

BACKGROUND: To study disruptive behaviors adequately, we need to distinguish between individuals with different types of problems that may have a different etiology. The availability of a taxonomic system that helps in identifying homogeneous groups of individuals, with similar patterns of disruptive behaviors, is crucial to achieve this goal. Therefore, we examine which classes of preadolescents with symptoms of Attention Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) can be identified in the general population. METHODS: Disruptive behaviors of 2,230 10-12 year olds from the Dutch general population were assessed with the Child Behavior Checklist and Youth Self-Report. RESULTS: Latent class analysis revealed three classes of preadolescents: the first characterized by high scores on ADHD, ODD, and CD items; a second by high probabilities of ADHD and ODD symptoms; a third with low scores on all items. CONCLUSIONS: Because classes of preadolescents with symptoms of only one type of disruptive behavior problems could not be identified, it can be questioned how useful separate diagnostic distinctions are in general population studies.

Adolescent↗

PubMed2005

No aggression in a 4-year-old boy with an androgen-producing tumour: case report.

BACKGROUND: The androgen testosterone plays a critical role in many aspects of sexual differentiation. Also, it is thought to induce aggressive behaviours or to play a role in social dominance. CASE PRESENTATION: In this case report a 4-year-old boy is described whose testosterone and dehydroepiandrosterone sulphate (DHEA-S) levels were raised to pubertal levels due to a testosterone producing testis tumour. This provided the unique opportunity to examine the effects of elevated levels of androgens on levels of aggression or on social dominance before the onset of puberty. CONCLUSION: The present case report does not support the hypothesis of a causal relationship between testosterone and aggression or between testosterone and social dominance in young children.

Journal Article↗

PubMed2005

Latent class analysis of anxiety and depressive symptoms in referred adolescents.

BACKGROUND: Comorbidity between anxiety disorders and depressive disorders in adolescents occurs very frequently. The aim of this study was to investigate if anxiety and depression represent distinct disease entities. METHODS: Two thousand thirty two 11- to 18-year-olds, referred to mental health services, were investigated. Self-reported symptoms of anxiety and depression were analyzed with latent class analysis. RESULTS: The numbers of adolescents with severe depression symptoms, but with less severe, or absent, anxiety symptoms, were negligible. Further, two subgroups could be discerned in those with severe anxiety symptoms: one with severe depressive symptoms, and one with mild depressive symptoms. LIMITATIONS: A self-report questionnaire was used, whereas diagnostic interview information regarding DSM-IV disorders was not available. DISCUSSION: It seems less useful to develop treatments, or to conduct studies aimed at etiological mechanisms, that are specifically aimed at depression and not at anxiety. Further, it may be relevant to discern specific subgroups of anxious adolescents, with severe versus mild comorbid depression symptoms.

Adolescent↗

PubMed2005

Cannabis--psychosis pathway independent of other types of psychopathology.

AIMS: To investigate if associations between cannabis use and psychotic symptoms occur independently, or occur as a consequence of previous-other types of-psychopathology. METHODS: A 14-year follow-up study of 1580 initially 4- to 16-year-olds who were drawn randomly from the Dutch general population was conducted. At initial assessment, psychopathology was assessed with the Child Behavior Checklist. Across the 14-year follow-up period, cannabis use and psychotic symptoms were assessed with the Composite International Diagnostic Interview (CIDI). Because cannabis use is generally condoned in The Netherlands, false-negative reports of cannabis use may occur less frequently than in countries with stricter drug policies, which supports the value of the present study. RESULTS: Survival analyses indicated that the association between cannabis use and psychotic symptoms occurred independently of initial CBCL scores. CONCLUSIONS: The link between cannabis use and psychotic symptoms is specific, and does not depend on the earlier presence of other types of psychopathology. This indicates that research aimed at unraveling mechanisms that are responsible for this specific association is useful. Further, given the fact that cannabis use seemed to be a specific risk factor for future psychotic symptoms, prevention aimed against cannabis use may prohibit the onset of psychotic symptoms in vulnerable individuals.

Adolescent↗

PubMed2005

Latent class analysis of anxiety and depressive symptoms of the Youth Self-Report in a general population sample of young adolescents.

This study examined whether distinct groups of young adolescents with mainly anxiety or mainly depression could be identified in a general population sample. Latent class analysis was used on self-report ratings of DSM-IV symptoms of anxiety and depressive disorders, because it was hypothesized that these ratings provide a bigger chance to identify distinct groups than parent ratings of symptoms that are poorly associated with DSM-IV. Results from exploratory and confirmatory latent class analysis showed that only very small numbers of young adolescents had mainly anxiety or mainly depressive symptoms. Instead, a five-group model fitted the data best. These five groups contained young adolescents who either had a high, intermediate, or low probability to have comorbid symptoms of anxiety and depression. It was concluded that symptoms of DSM-IV anxiety and depressive disorders co-occur in young adolescents, and that latent class analysis on items that capture also severe symptoms like suicidal thoughts are needed to derive groups with specific comorbidity patterns in a general population sample.

Anxiety Disorders↗

PubMed2005

Concurrent validity of the DSM-IV scales Affective Problems and Anxiety Problems of the Youth Self-Report.

This study investigated the concurrent validity of the DSM-IV scales Anxiety Problems and Affective Problems of the Youth Self-Report (YSR) in a community sample of Dutch young adolescents aged 10-12 years. We first examined the extent to which the YSR/DSM-IV scales reflect symptoms of DSM-IV anxiety disorders and DSM-IV Major Depressive Disorder, assessed with the Revised Child Anxiety and Depression Scale (RCADS). Second, we examined whether the association between the YSR/DSM-IV scales and the RCADS scales was stronger than the association between the empirically derived YSR narrow-band scales Anxious/Depressed and Withdrawn and the same RCADS scales. Results showed that the YSR/DSM-IV scale Affective Problems had a stronger association with symptoms of DSM-IV Major Depressive Disorder than the YSR narrow-band scales Withdrawn and Anxious/Depressed. However, the YSR/DSM-IV scale Anxiety Problems had a weaker association with symptoms of DSM-IV anxiety disorders, compared to the YSR narrow-band scale Anxious/Depressed. It was concluded that the construction of the DSM-IV scales improved the correspondence with DSM-IV Major Depressive Disorder, but not with DSM-IV anxiety disorders.

Adolescent↗

PubMed2005

Psychopathology in children: improvement of quality of life without psychiatric symptom reduction?

OBJECTIVE: The aim of this study was to assess the association between change in psychopathology and Quality of Life (QoL) across time in children with high levels of psychopathology. METHODS: A referred sample of 126 seven- to 19-year-olds was studied across a 1-year follow-up period. Information concerning QoL and psychopathology was obtained from parents. RESULTS: Overall, 38.1% of children showed neither psychiatric symptom reduction nor QoL improvement, 33.3% of children showed both a clinically significant psychiatric symptom reduction and QoL improvement, and 28.6% of children showed either psychiatric symptom reduction or QoL improvement. In 11.1% of all children, QoL improved, while the level of psychopathology remained high. Age, gender, or psychiatric diagnosis did not predict a poor outcome of persistently high psychopathology scores and poor QoL. CONCLUSION: QoL in children with psychiatric problems may be improved by reducing psychiatric symptoms in a number of children, but it is also possible to improve QoL without psychiatric symptom reduction. This implicates that QoL should become an important aim and treatment outcome measure of psychiatric treatment programs, especially since psychopathology tends to persist.

Adolescent↗

PubMed2005

Phenotypic subtypes in attention deficit hyperactivity disorder in an isolated population.

We address the use of two informants in genetic studies and whether familial aggregation is similar for the three phenotypic subtypes of ADHD. Lifetime ADHD was diagnosed in a Dutch isolated population using parents and teachers as informants, creating two subgroups (one or two informants), then further divided into three phenotypic categories (inattentive, hyperactive/impulsive, combined). Genealogy was collected for all patients. Mean kinship coefficients for the subgroups were calculated. Fifteen of 26 children were linked to a common ancestor within 10 generations. The mean kinship coefficient of patients confirmed by two informants was significantly higher than in patients only scored positive by one informant (p = 0.03). All patients of the inattentive subtype were connected to a common ancestor, which was significantly higher (p = 0.03) than expected. Eighty-one percent of these patients derive of consanguineous marriages, also higher than expected. This means that recessive mutations may be involved in the inattentive subtype. These patients were more closely related than those with the other phenotypes (p<0.01). Our data suggests that using two informants in diagnosing ADHD helps identify a phenotype with a strong genetic component. The inattentive phenotype showed strong familial clustering and evidence of a recessive origin.

Adolescent↗

PubMed2005

Determinants of quality of life in children with psychiatric disorders.

OBJECTIVE: To assess factors that, in addition to childhood psychopathology, are associated with Quality of Life (QoL) in children with psychiatric problems. METHODS: In a referred sample of 252 8 to 18-year-olds, information concerning QoL, psychopathology and a broad range of child, parent, and family/ social network factors was obtained from children, parents, teachers and clinicians. RESULTS: Poor child, parent, and clinician reported QoL was associated with child psychopathology, but given the presence of psychopathology, also with child factors, such as low self-esteem, and poor social skills, and family/social network factors, such as poor family functioning, and poor social support. In multiple linear regression analyses the importance of parent factors, such as parenting stress, was almost negligible. CONCLUSION: To increase QoL of children with psychiatric problems, treatment of symptoms is important, but outcome might improve if treatment is also focussed on other factors that may affect QoL. Results are discussed in relation to current treatment programs.

Adolescent↗

PubMed2005

Cannabis use predicts future psychotic symptoms, and vice versa.

AIMS: To assess if cannabis use is a risk factor for future psychotic symptoms, and vice versa, in adolescents and young adults from the general population. DESIGN: Cohort study. SETTING/PARTICIPANTS: 'Zuid Holland' study, a 14-year follow-up study of 1580 initially 4-16-year-olds who were drawn randomly from the Dutch general population. Because cannabis use is generally condoned in the Netherlands, false-negative reports of cannabis use may occur less frequently than in countries with stricter drug policies, which supports the value of the present study. MEASUREMENTS: Life-time cannabis use and psychotic symptoms, assessed with the Composite International Diagnostic Interview (CIDI). FINDINGS: Cannabis use, in individuals who did not have psychotic symptoms before they began using cannabis, predicted future psychotic symptoms (hazard ratio = 2.81; 95% confidence interval = 1.79-4.43). However, psychotic symptoms in those who had never used cannabis before the onset of psychotic symptoms also predicted future cannabis use (hazard ratio = 1.70; 95% confidence interval = 1.13-2.57). CONCLUSIONS: The results imply either a common vulnerability with varying order of onset or a bi-directional causal relationship between cannabis use and psychosis. More research on patterns and timings of these relationships is needed to narrow down the possibilities.

Adolescent↗

PubMed2004

Associations between visual and auditory hallucinations in children and adolescents, and tobacco use in adulthood.

AIMS: The cross-sectional association between tobacco use and psychotic features has been well established. If psychotic features precede tobacco use, then tobacco may be used to self-medicate psychotic symptoms. The aim was to assess if psychotic features in adolescents constitute a risk factor for later tobacco use. DESIGN: A random target sample of 2,600 children aged 4-16 years from the Dutch general population was followed up across a 14-year interval. At different ages (childhood, adolescence, young adulthood), information about visual and auditory hallucinations was obtained using standardized questionnaires for parents and subjects themselves. At outcome (ages 18-30), tobacco use was assessed. FINDINGS: Auditory hallucinations, but not visual hallucinations, in early and late adolescence, assessed via parents and adolescents themselves, predicted tobacco use in adulthood. CONCLUSIONS: The present study confirmed that auditory psychotic features in adolescence are associated with tobacco use in adulthood. Tobacco may be used to self-medicate auditory, but not visual, hallucinations.

Adolescent↗

PubMed2004

Attention-deficit/hyperactivity disorder (ADHD): parents' judgment about school, teachers' judgment about home.

OBJECTIVE: The aim of this study was to separate sources of observer and situational variance in reporting attention-deficit/hyperactivity disorder (ADHD) symptomatology. METHOD: In a sample of 30 children diagnosed with ADHD, ADHD symptomatology was assessed with the Diagnostic Interview Schedule for Children-Parent Version (DISC-P), with parents and teachers as informants. Both parents and teachers reported about the child's ADHD symptomatology at home as well as at school. RESULTS: Parents and teachers showed high within-observer cross-situational presence of ADHD symptoms. However, the between-observer agreement on the presence of ADHD symptoms within the same situation (home or school) was low. This pattern held equally true for attention/concentration and hyperactivity/impulsivity symptom scores. CONCLUSIONS: In evaluating ADHD symptomatology, it is important to obtain independent reports about the child's behaviour at school from the teacher and about the child's behaviour at home from the parents.

Adolescent↗

PubMed2004

Parent-adolescent disagreement regarding psychopathology in adolescents from the general population as a risk factor for adverse outcome.

This study investigated whether parent-adolescent disagreement regarding adolescents' behavioral and emotional problems predicted adverse outcome. A Dutch sample of 15- to 18-year-olds was prospectively followed across a 4-year interval. The Child Behavior Checklist (CBCL: T. M. Achenbach, 1997) and Youth Self-Report (YSR; T. M. Achenbach, 1991b) were administered at initial assessment, and the following signs of poor outcome were assessed 4 years later: police/judicial contacts, expulsion from school/job, suicidal ideation, unwanted pregnancy, suicide attempts, deliberate self-harm, referral to mental health services, report of having a behavioral or emotional problem, and feeling the need for professional help without actually receiving help. Twenty CBCL syndrome scores, 23 YSR syndrome scores, and 16 discrepancy scores were significant predictors of poor outcome. It was concluded that to determine the prognosis of psychopathology in adolescents, discrepancies between informants may be important.

Adolescent↗

PubMed2004

Quality of life in children with psychiatric disorders: self-, parent, and clinician report.

OBJECTIVE: To study the relationship between child psychiatric disorders and quality of life (QoL). METHOD: In a sample of 310 children (ages 6-18 years) referred for psychiatric problems, children, parents, and clinicians reported on psychopathology and subjective and objective QoL indicators. RESULTS: Six diagnostic categories were distinguished: attention-deficit and disruptive behavior disorders, anxiety disorders, pervasive developmental disorders, mood disorders, other disorders, and no diagnosis. In overall QoL, no differences were found between the diagnostic categories, except in clinician's ratings, who rated children with pervasive developmental disorder as having a poorer QoL than children with other diagnoses. In each diagnostic category specific QoL subdomains were affected: for children with attention-deficit and disruptive behavior disorder, school functioning and social functioning; for children with anxiety disorder, emotional functioning; for children with pervasive developmental disorder, social functioning; and for children with mood disorder, emotional functioning. CONCLUSIONS: Across multiple raters, the distinguished child psychiatric disorders had a different impact on QoL. Knowledge about domains of QoL that are affected in specific child psychiatric disorders can help clinicians to focus on particular QoL domains during the diagnostic process and to define adequate treatment goals.

Adolescent↗

PubMed2004

Improving estimation of the prognosis of childhood psychopathology; combination of DSM-III-R/DISC diagnoses and CBCL scores.

OBJECTIVE: To compare the predictive validity of the clinical-diagnostic and the empirical-quantitative approach to assessment of childhood psychopathology, and to investigate the usefulness of combining both approaches. METHOD: A referred sample (N = 96), aged 6 to 12 years at initial assessment, was followed up across--on average--a period of 3.2 years. It was assessed to what extent DISC/DSM-III-R diagnoses--representing the clinical-diagnostic approach, and CBCL scores--representing the empirical-quantitative approach, predicted the following signs of poor outcome: outpatient/inpatient treatment, or parents' wish for professional help for the child at follow-up, disciplinary problems in school, and police/judicial contacts. RESULTS: Both diagnostic systems added significantly to the prediction of poor outcome, and neither of the two systems was superior. Use of both systems simultaneously provided the most accurate estimation of the prognosis, reflected by the occurrence of future poor outcome. Even diagnostic concepts that are generally regarded as relatively similar, such as ADHD (DSM) and attention problems (CBCL), or conduct disorder (DSM) and delinquent behavior (CBCL), appeared to differ in their ability to predict poor outcome. CONCLUSIONS: The present study supports the use of the empirical-quantitative approach and the clinical-diagnostic approach simultaneously, both in research and in clinical settings, to obtain a comprehensive view of the prognosis of psychopathology in children.

Adolescent↗

PubMed2003

The role of the clinician: three-year predictive value of parents', teachers' and clinicians' judgment of childhood psychopathology.

BACKGROUND: The present study investigated the differential predictive value of parents', teachers', and clinicians' reports of psychopathology for poor outcome in children referred to a child psychiatric outpatient clinic. METHOD: A referred sample (N = 96), aged 6 to 12 years at initial assessment, was followed up after a mean interval of 3.2 years. Data on parent- and teacher-reported problem behavior (Child Behavior Checklist and Teacher's Report Form), and clinician-reported observations and self-reports during a semi-structured clinical interview (SCICA), were linked to outcome measures assessed with a parent questionnaire, including outpatient and inpatient treatment at Time 2, parent's wish for professional help for the child, school problems, and police/judicial contacts. RESULTS: Information from all three informants (clinicians, parents, and teachers) predicted measures of poor outcome after three years. Clinicians' ratings on the SCICA predicted all five outcome measures. Independent of CBCL and TRF scores, SCICA scores predicted parental wish for help and inpatient treatment. CONCLUSIONS: The present study was the first to report that clinician's ratings of self-reported and observed behaviors in a semi-structured interview (SCICA) make an important unique contribution to the multiaxial assessment of problem behaviors.

Child↗

PubMedDate not supplied

The relations between DISC-IV DSM diagnoses of ADHD and multi-informant CBCL-AP syndrome scores.

BACKGROUND: Previous studies have examined the relation between attention problems (APs) obtained with the Child Behavior Checklist (CBCL) and attention deficit hyperactivity disorder (ADHD) assessed with the Diagnostic and Statistical Manual of Mental Disorders (DSM). We will examine this relation across sex using multi-informant data. METHODS: Parents of 12538 twins, aged 7, 10, and 12 years, and teachers of twins, aged 10 years, completed the questionnaires. The mothers of a sample of 283 boys and 291 girls who scored either low or high on longitudinal maternal CBCL-AP were interviewed. RESULTS: Children with a low AP score obtained a negative ADHD diagnosis in 96% of cases. Children with a high AP score obtained a positive diagnosis in 36% (girls) and 59% (boys) of cases. The association between paternal and maternal AP ratings and ADHD was the same, whereas the association between teacher AP ratings and ADHD was low. CONCLUSIONS: The association between AP and ADHD is higher in boys than girls, possibly because of a bias toward the male manifestation of ADHD.

Attention↗