EEG ABNORMALITIES IN EARLY CHILDHOOD SCHIZOPHRENIA: A DOUBLE-BLIND STUDY OF PSYCHIATRICALLY DISTURBED AND NORMAL CHILDREN DURING PROMAZINE SEDATION.
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Autistic Disorder↗
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Screening for behavioral health problems in primary care.
PURPOSE OF REVIEW: The epidemiology of behavioral health disorders in children and the current literature on the identification of these problems within primary care are reviewed. Suggestions are offered on how to implement screening within primary care settings. RECENT FINDINGS: The prevalence of behavioral health problems in children is approximately 12-27% yet the detection of these problems within the primary care setting is much lower. Although identification may be improving, underidentification and limited referral for services remain a significant problem. Few physicians use standardized instruments or DSM-IV criteria to identify children. Families, in addition, often do not disclose behavioral health concerns about their child to their physician. Multiple barriers exist for successful screening, including lack of training, limited time and poor reimbursement. Recent evidence suggests that a number of well validated instruments are now available for behavioral health screening within primary care. SUMMARY: Pediatric settings hold the potential to be an optimal environment to address behavioral health concerns due to the frequent contact and trusted relationship many families have with their pediatrician. There is new evidence that screening can be thoughtfully implemented and that system change around the detection of behavioral health problems is possible.
Adolescent↗
[THERAPEUTIC RESULTS IN A GROUP OF MENTAL DEFECTIVES WITH BEHAVIOR DISTURBANCES, IN CHILDHOOD, WITH A NEW MEDICINAL COMBINATION].
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Adolescent↗
Predicting conduct problems: can high-risk children be identified in kindergarten and grade 1?
Externalizing behavior symptoms (EBS) in childhood are a strong predictor of future conduct problems. This study evaluated their predictive accuracy using logistic regression and receiver operating characteristic curve techniques. EBS, alone and in combination with other child and familial risk factors, were used to predict conduct problems 30 months later in a nonclinic population of kindergartners and Grade 1 children. The sensitivity (Sn) and positive predictive value (PPV) of EBS alone were below preset criteria of > or = 50% for each (prevalence < or = 15%). Sn and PPV increased when other child and familial factors were combined with symptoms but did not exceed the preset criteria. From a developmental perspective, substantial stability of EBS exists over time. However, from the perspective of prevention science, significant levels of misclassification will occur when EBS are used to designate high-risk status under the low-prevalence conditions of normal populations.
Attention Deficit Disorder with Hyperactivity↗
The relationship between low family income and psychological disturbance in young children: an Australian longitudinal study.
OBJECTIVE: This study examines the relationship between low family income (LFI) experienced at different points in time, chronic low income status and its impact on child behaviour measured at 5 years of age. METHOD: Longitudinal data from the Mater University Study of Pregnancy were used to measure LFI in families at three points in time (the antenatal period, 6 months post birth and at 5 years cf age). Outcome variables were three independent groups of behaviour problems labelled as externalising, social, attentional and thought (SAT) problems, and internalising problems. These groups were developed from the Child Behaviour Checklist. An analysis based on logistic regression modelling was carried out examining the relationship between LFI and a range of intermediate variables known to be associated with child behaviour problems. RESULTS: The more often families experienced low income, the higher the rate of child behaviour problems at age 5. Low family income was still independently associated with SAT behaviour problems after controlling for smoking in the first trimester, parenting styles, maternal depression and marital dysharmony at age 5. The association between LFI and internalising and externalising behaviour problems was largely mediated by maternal depression. CONCLUSION: Low family income is a significant factor in the aetiology of a variety of child behaviour problems. The mechanisms involved in the link between LFI and childhood internalising and externalising behaviours involve the exposure of the children to maternal depression. However, the relationship between LFI and SAT behaviour problems remains to be elucidated.
Attention Deficit Disorder with Hyperactivity↗
Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood.
Despite recent research indicating that 1 of the pivotal times for identifying pathways to early conduct problems is the toddler period, few family-based preventive interventions have been specifically designed to modify child disruptive behavior during this age period. This randomized trial tested the effectiveness of the Family Check-Up in sustaining maternal involvement and preventing the exacerbation of child conduct problems among 120 at-risk toddler-age boys, half of whom were randomly assigned to a treatment condition. The intervention was associated with reductions in disruptive behavior and greater maternal involvement and was particularly effective for children at greater risk for a persistent trajectory of conduct problems. The results are discussed in relation to other preventive interventions for young children.
Adolescent↗
Teenage mothers' anger over twelve years: partner conflict, partner transitions and children's anger.
BACKGROUND: This study examined the effects of maternal anger, partner transitions and partner conflict on later oppositional and angry behavior of the children of teenage mothers. METHODS: One hundred and twenty-one teenage women were interviewed prior to the birth of the baby and at 3 points subsequently, when children were newborn, 7 years old and 12 years old. Child and teacher reports of children's oppositional behavior were obtained. RESULTS: Women who showed higher levels of anger at Time 1 experienced more conflict with partners and more partner transitions over the next 12 years than women with lower levels of anger. Partner conflict was a stronger predictor of children's oppositional and angry behavior than partner transitions. Maternal anger at Time 1 was associated with maternal anger at Time 4 but neither predicted children's oppositional behavior at Time 4. CONCLUSION: There was support for the theoretical model that suggested that the personality characteristics of teenaged mothers confer some of their risk to children through children's exposure to the mothers' problematic partner relationships.
Adolescent↗
Infant joint attention skill and preschool behavioral outcomes in at-risk children.
This study examined whether infant joint attention (JA) skills predicted social behaviors in a sample of at-risk preschool children (n = 30) with a history of prenatal exposure to cocaine. JA behaviors were assessed with the Early Social and Communication Scales at 12, 15, and 18 months of age. Three classes of JA were measured: Initiating JA (IJA), Responding to JA (RJA), and Requests. Behavioral outcomes were measured at 36 months and included ratings of disruptive and withdrawn behaviors and social competence. JA behaviors were related to behavioral outcomes after controlling for language and cognitive ability. The functionally distinct uses of JA were differentially related to behavioral outcome. IJA negatively predicted disruptive behaviors, whereas Requests positively predicted disruptive behaviors. Infant RJA negatively predicted withdrawn behaviors and positively predicted social competence. These results are interpreted in the context of competing theories that attempt to explain variability in the expression of JA skills in the second year of life.
Attention↗
Quality of movement as predictor of ADHD: results from a prospective population study in 5- and 6-year-old children.
The aims of this prospective study were (1) to examine whether quantitative and/or qualitative aspects of motor performance in 5- to 6-year-old children can predict attention-deficit-hyperactivity disorder (ADHD) 18 months later; (2) to investigate whether this relation is also present in oppositional defiant disorder and conduct disorder (ODD/CD). Quantitative and qualitative aspects of motor performance were tested in a selected community sample (n=401; 232 males, 169 females; mean age 6 years 4 months, SD 6 months, range 5 years 4 months to 7 years 11 months) using the Maastricht Motor Test. Eighteen months later, standardized psychiatric information was obtained with the Amsterdam Diagnostic Interview for Children and Adolescents: 35 children were classified as having ADHD, and 92 children as having ODD/CD. Weighted analyses were used in logistic regression analyses to investigate predictive values. Unlike quantitative aspects of motor performance, qualitative aspects were predictive of ADHD. Motor performance was not predictive of ODD/CD.
Attention Deficit Disorder with Hyperactivity↗
Preschool children with disruptive behavior: three-year outcome as a function of adaptive disability.
A significant discrepancy between intelligence and daily adaptive functioning, or adaptive disability (AD), has been previously found to be a associated with significant psychological morbidity in preschool children with disruptive behavior (DB). The utility of AD as a predictor of later developmental risks was examined in a 3-year longitudinal study of normal (N = 43) and DB preschool children. The DB children were grouped into those with AD (DB+AD; N = 28) and those without AD (DB-only; N = 98). All children were followed with annual evaluations to the end of second grade. Both DB groups demonstrated substantial and pervasive psychological and educational morbidity at 3-year follow-up. In comparison to DB-only children, DB+AD children had more symptoms of attention-deficit hyperactivity disorder (ADHD) and conduct disorder (CD), more severe and pervasive behavior problems at home, more parent-rated externalizing and internalizing, and lower academic competence and more behavioral problems at school. Parents of DB+AD children also reported greater parenting stress than did parents in the other groups. A significant contribution of AD to adverse outcomes in the DB group remained on some measures even after controlling for initial severity of DB. AD also contributed significantly to CD symptoms at follow-up after controlling for initial DB severity and initial CD symptoms. The results corroborate and extend earlier findings of the utility of AD as a risk indicator above severity of DB alone. They also imply that AD in the context of normal intellectual development may arise from both the deficient self-regulation associated with ADHD and from disrupted parenting. with exposure to kindergarten moderating these adverse effects.
Adaptation, Psychological↗
Profiles of externalizing behavior problems for boys and girls across preschool: the roles of emotion regulation and inattention.
Although externalizing behavior typically peaks in toddlerhood and decreases by school entry, some children do not show this normative decline. A sample of 383 boys and girls was assessed at ages 2, 4, and 5 for externalizing behavior and at age 2 on measures of emotion regulation and inattention. A longitudinal latent profile analysis was performed and resulted in 4 longitudinal profiles of externalizing behavior for each gender. Poor emotion regulation and inattention were important predictors of membership in the chronic-clinical profile for girls, whereas socioeconomic status and inattention were important predictors of membership in the chronic-clinical profile for boys. Results are discussed with respect to the development of adaptive skills that lead to normative declines in externalizing behavior across childhood.
Acting Out↗
Peer rejection, aggressive or withdrawn behavior, and psychological maladjustment from ages 5 to 12: an examination of four predictive models.
Findings yielded a comprehensive portrait of the predictive relations among children's aggressive or withdrawn behaviors, peer rejection, and psychological maladjustment across the 5-12 age period. Examination of peer rejection in different variable contexts and across repeated intervals throughout childhood revealed differences in the timing, strength, and consistency of this risk factor as a distinct (additive) predictor of externalizing versus internalizing problems. In conjunction with aggressive behavior, peer rejection proved to be a stronger additive predictor of externalizing problems during early rather than later childhood. Relative to withdrawn behavior, rejection's efficacy as a distinct predictor of internalizing problems was significant early in childhood and increased progressively thereafter. These additive path models fit the data better than did disorder-driven or transactional models.
Adaptation, Psychological↗
Preventive intervention for urban, low-income preschoolers at familial risk for conduct problems: a randomized pilot study.
Conducted a pilot study to test the feasibility of a prevention program for promoting parenting in families of preschoolers at high risk for behavior problems. Risk status was based on a family history of antisocial behavior and residence in a low-income, urban community. Thirty preschoolers (ages 21/2 to 5) and their parents were randomly assigned to a 1-year, home- and clinic-based intervention or to a no-intervention control condition. Despite families' multiple risk factors, high rates of attendance and satisfaction were achieved. Relative to controls, intervention parents were observed to be significantly more responsive and use more positive parenting practices. Results support the feasibility of engaging high-risk families in an intensive prevention program. The meaningful changes achieved in parenting suggest that a preventive approach is promising for families with multiple risk factors.
Adult↗
Recognition and classification of psychopathology in preschool children.
OBJECTIVE: The aim of this paper is to offer a critical overview of research on preschool psychopathology, and to propose a working classification based on the empirical evidence. METHOD: All of the existing factor and cluster analytic studies, and those studies that attempted to establish the reliability and validity of the subcategories in preschool behaviour disorder were reviewed. Applicability of the current classifications (DSM-IV and ICD-10) to preschool age was examined. RESULTS: Empirical evidence suggests a well-established, externalising and internalising dichotomy, and a developmental problems factor where the instrument included these problems. There was also a strong tendency for the externalising and internalising symptoms to overlap. Within the externalising factor, there is evidence suggesting that attention deficit hyperactivity should be separated out and recognised. Categories in the DSM-IV and ICD-10 classification did not correspond with the statistically derived groups. CONCLUSION: A classification of preschool psychopathology that incorporates the age-specific disorders and risk factors is proposed. This is likely to increase the awareness of researchers, taxonomists and clinicians of psychopathology in preschool children, thereby leading to an early recognition.
Attention Deficit and Disruptive Behavior Disorder↗
Age and gender differences in oppositional behavior and conduct problems: a cross-sectional household study of middle childhood and adolescence.
Behavior problems among youths cannot be understood without explaining their age and gender differences, but age and gender differences cannot be explained until they have been accurately described. In a household survey of 1,285 youths aged 9 to 17 years, there were no gender differences in oppositional behavior, but aggression, property offenses, and status offenses were more common among boys. Levels of oppositional behavior were greater at younger ages, aggression peaked near the middle of this age range, and property and status offenses were more prevalent at older ages. These findings are generally consistent with developmental models of conduct problems but are inconsistent with a recent model of gender differences and raise questions about the external validity of current taxonomies.
Adolescent↗
Child psychiatry: how to manage children with behavior problems.
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Child↗
Genetic and environmental causes of covariation in interview assessments of disruptive behavior in child and adolescent twins.
Multirater, face-to-face, interview data relating to conduct disorder (CD), oppositional-defiant disorder (ODD), and inattentive, impulsive, and hyperactive components of attention-deficit hyperactivity disorder (ADHD) in a population-based sample of 1376 pairs of 8- to 16-year-old MZ and DZ twins are analyzed to examine (1) the genetic and environmental causes of correlation among ratings of ODD and CD symptoms and (2) the pattern of genetic and environmental correlation among the three components of ADHD. Parental ratings of ADHD showed marked sibling contrast effects, specific within raters but partly common across components. After these effects were removed, there was a modest genetic correlation between maternal and paternal ratings, but genetic effects were virtually uncorrelated across boys and girls. Genetic correlations among inattention, impulsivity, and hyperactivity were all large but fell well short of unity. There was little evidence that counts of symptoms of CD and ODD were genetically independent but the genetic correlations among ratings of twins, mothers, and fathers were all relatively modest. ODD and CD showed much higher genetic correlations across sexes than did the measures of ADHD. There was no evidence of rater contrast effects or of shared family environment influences in the twin resemblance for ODD and CD.
Adolescent↗
The prediction of behavior problems in 6- to 8- year-old children from mothers' reports of child-rearing practices.
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Acting Out↗