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PubMed2002

Lost opportunities for intervention: undetected markers for the development of serious juvenile delinquency.

INTRODUCTION: Persistent serious delinquency in young males rarely starts without a history of problem behaviour in childhood. This paper addresses the following questions: (1) At what age does persistent serious offending emerge for the first time? (2) What proportion of persistent serious delinquent boys qualifies for a diagnosis of a disruptive behaviour disorder? (3) What proportion of persistent serious delinquent boys receive help for their behavioural or educational problems, either from mental health professionals or from personnel at school? METHOD: Eight waves of assessments from the oldest sample (ages 13 to 18.5) of the Pittsburgh Youth Study were used to classify boys as persistent serious violent offenders, persistent serious property offenders, persistent non-serious offenders, and non-offenders based on their self-reports. Juvenile court records, diagnostic information and information about help for mental health problems were used. RESULTS: Almost half of the boys who eventually become a persistent serious offender already have an onset of their serious delinquent behaviour by age 12. Two-thirds of the boys who come to the attention of the juvenile court already had behaviour problems for at least five years, and one-third were diagnosed as having a disruptive behaviour disorder by age 13. However, less than half of the persistent serious delinquents had received any help from either mental health professionals or from personnel in schools. CONCLUSIONS: Early behaviour problems and a diagnosis of disruptive behaviour disorder constitute targets for intervention. The relatively low rate of interventions for boys with these problems and who later become persistent serious offenders indicates a high under-utilization of opportunities to prevent serious delinquency by parents and professionals.

Adolescent↗
PubMed1990

Mothers' views on the ages of onset for four childhood disorders.

The mothers of 120 consecutive children in our outpatient clinic were asked a series of questions about their views on the ages at which their children became deviant. The symptoms of autism were the earliest noted at 15 months. Those with symptoms of attention-deficit hyperactivity disorder (ADHD), or conduct disorder plus ADHD, did not separate by age of onset. The mean for both groups was the fourth year of life. Children with conduct disorder alone had a putative age of onset of six years.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Psychiatric hospitalization of preschool children: a follow-up study.

This paper reviews the five year follow-up status of 18 patients initially studied while psychiatrically hospitalized during their preschool years. Only four are currently doing well. Outcome is correlated with patient, family and treatment variables. Possible clinical and research approaches are discussed.

Autistic Disorder↗
PubMed1993

The Spanish translation and cultural adaptation of the Diagnostic Interview Schedule for Children (DISC) in Puerto Rico.

This article illustrates a comprehensive cross-cultural adaptation model used to translate into Spanish and to culturally adapt the Diagnostic Interview Schedule for Children (DISC). The process strived to identify similar phenomena to those identified by the original English version in a dissimilar context. To attain cross-cultural equivalency five important dimensions were addressed: semantic, technical, content, criterion and conceptual. To meet this challenge various steps were taken, including bilingual committee, back-translation, reliability and validity testing. The result is an instrument which could be used, not only in Puerto Rico, but also in other Spanish-speaking child and adolescent populations after appropriate cultural adaptations.

Adolescent↗
PubMed1987

Comparisons between autistic and nonautistic children on the Test for Auditory Comprehension of Language.

Expressive language differences between autistic and nonautistic populations have been a topic of research in the past decade, yet little information is available in regard to the receptive language performances based on standardized tests. Questions as to the existence of sex differences in language have also been raised. The study examines the performance of 19 matched pairs of autistic and nonautistic children on the Test for Auditory Comprehension of Language. As well, the data were analyzed according to sex for each group. The results indicated that there were no significant differences between groups or between the sexes in either group. Questions for further research are raised.

Autistic Disorder↗
PubMed1979

Plasma levels of folates, riboflavin, vitamin B6, and ascorbate in severely disturbed children.

The recent upsurge in megavitamin therapy raises questions about the role of vitamin deficiencies and dependencies in mental health. With this in mind, the plasma levels of folic acid, ascorbic acid, pyridoxine, and riboflavin were studied in approximately 125 children admitted to a child psychiatric unit. There were no apparent decreased levels of vitamins in these children in terms of their age, race, or psychiatric diagnosis. It is postulated that vitamin deficiencies per se cannot be proposed as etiological factors in any of the psychiatric deficits represented. Megavitamin therapy, if successful, is not effective due to crrection of vitamin deficiencies as opposed to vitamin dependencies and may be due to the metabolic onus and consequent effects of such heavy doses of vitamins.

Adolescent↗
PubMed1990

Combining day patient treatment with family work in a child psychiatry clinic.

The 81 youngsters who began attending a day treatment programme within a 1-year period were assessed using an interval design. The children ranged in age from 18 months to 16 years and attended with similarly aged children for 1 day a week. The treatment programme combined family therapy with the day unit's milieu therapy and specific individual treatment programmes for the child. The results indicate that the combination of a 1 day a week attendance and family therapy had a significant clinical impact upon the problems. The pattern of improvement observed would suggest that the day-unit attendance made a unique contribution to the overall outcome.

Adolescent↗
PubMed1994

Interrater reliability of the DSM-III-R with preschool children.

Little attention has been paid to evaluating the use of DSM-III-R with preschool children. Children (N = 510) ages 2 to 5 years who were screened at the time of a pediatric visit were selected to participate in an evaluation which included questionnaires, a semistructured interview, developmental testing, and a play observation. Following the evaluation, two clinical child psychologists independently assigned DSM-III-R diagnoses. For each diagnostic category, kappa and Y coefficients were calculated; Y coefficients are less sensitive to base rates of disorders. For overall agreement, the weighted mean kappa (.61), and mean Y (.66) were moderately high. Overall agreement that the child had at least one of the disruptive disorders was substantial (kappa = .64; Y = .65); agreement that there was at least one of the emotional disorders was moderate for kappa (.54), but substantial for Y (.70). Kappa coefficients were higher for major categories of disorder than for specific disorders; however, Y coefficients did not show a decline for specific disorders. Interrater reliability of DSM-III-R appears to be similar for preschoolers and older children.

Adjustment Disorders↗
PubMed2004

[Depressive disorders and conduct disorders in childhood and adolescence. Prevalence, course, and risk factors].

Mental disorders belong to the most frequent disorders in the community and lead to noticeable functional impairments. The lifetime prevalence of clinical depression (ICD-10 diagnoses F33, F34) up to age 25 is 12.7%, showing a female-male ratio of 2:1. From adolescence onwards, persistence rates of depressive disorders are comparably as high as those found in externalizing disorders. Subclinical depression (ICD-10 subthreshold disorders) at ages 8 and 13 increases the risk for later clinically relevant mental disorders. Conduct disorders (ICD-10 diagnoses F91, F92) are the most frequent mental disorders in children and adolescents with lifetime prevalence rates of 22.4% up to age 25. Conduct disorders show unfavorable courses beginning at preschool age. Precursors of later disorders can be detected as early as toddlerhood. Adverse family factors in childhood and early externalizing problems of the child were most predictive for later conduct disorders. Therefore, the need for early prevention of conduct disorders is highlighted. The focus should be on families with low socioeconomic status (objective: strengthening family and child resources). For depressive disorders, we recommend testing and evaluating the indicated prevention programs in adolescence (objective: strengthening the resources of the adolescent).

Adolescent↗