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Diagnostic status and symptomatic behavior of hard-to-manage preschool children in middle childhood and early adolescence.

Followed 2 cohorts of hard-to-manage preschool children and comparison children without early problems to middle childhood and early adolescence. Children with early problems, especially problems that were still evident at school entry, were more likely to meet diagnostic criteria for an externalizing diagnosis at follow-up. Hard-to-manage children in Cohort 1 with problems that persisted from ages 3 through 9 years were much more likely to meet diagnostic criteria at age 13 than children whose early problems were less stable in elementary school. Similarly, hard-to-manage boys in Cohort 2 whose problems persisted at age 6 were more likely to meet criteria for an externalizing diagnosis at age 9 than hard-to-manage boys whose problems appeared less stable at age 6. Across cohorts, children with persistent problems had higher levels of symptoms and more varied symptoms at ages 3 and 4 and over the course of development.

Adolescent↗

Psychosocial adjustment in juvenile arthritis.

Psychosocial adjustment in 102 children with arthritis, ages 4-16, and their families was assessed by parents, who completed the Child Behavior Checklist (CBCL) and Profile of Mood States (POMS). On average, parental distress (POMS) was lower than reference norms. POMS distress was correlated with children's behavioral problems (r = .41) but not with children's social competence (r = .15). General linear models explained 25% of the variance in CBCL behavioral problem scores. Older age was associated with more behavior problems in males, but not females. Disease severity and disease activity were also associated with behavioral problems. Although 27% of the variance in CBCL social competence could be explained, no single predictor variable was especially strong. Poorer social competence was associated with older age and shorter disease duration. Teenagers, especially those with recent onset and those with mild disease activity, may be at increased risk for psychosocial maladjustment.

Adaptation, Psychological↗

Brain tumors in children and adolescents: cognitive and psychological disorders at different ages.

Cognitive and psychological disorders are among the most frequently observed sequelae in brain tumor survivors. The goal of this work was to verify the presence of these disorders in a group of children and adolescents diagnosed with brain tumor before age 18 years, differentiate these disorders according to age of assessment, identify correlations between the two types of impairments and define possible associations between these impairments and clinical variables. The study involved 76 patients diagnosed with brain tumor before age 18 years. Three age groups were formed, and all the patients received a standardized battery of age-matched cognitive and psychological tests. According to our findings, all three groups present with cognitive and psychological-behavioral disorders. Their frequency varies according to age of onset and is strongly associated to time since diagnosis. The performance intelligence quotient (PIQ) was more impaired than the verbal intelligence quotient (VIQ). Internalizing problems, withdrawal and social problems were the most frequent psychological disorders. Correlations were found between cognitive impairment and the onset of the main psychological and behavioral disorders. These findings are relevant as they point out the long-term outcome of brain tumor survivors. Hence, the recommendation to diversify psychological interventions and rehabilitation plans according to the patients' age.

Adolescent↗

The role of social physique anxiety and other variables in predicting eating behaviors in college students.

Early identification of potentially harmful eating patterns is critical in the effective remediation of such behaviors. The purpose of this investigation was to examine the degree to which various factors including gender, family history, and athletic status predict disordered eating behavior; social physique anxiety and percent body fat were added as potential predictor variables. The eating behaviors of student-athletes and nonathlete students were also compared. One hundred eighty undergraduate students (males = 49, females = 131) provided demographic information and completed the Eating Attitudes Test (EAT) and the Social Physique Anxiety Scale (SPAS). Stepwise multiple-regression analysis indicated that social physique anxiety, gender, and body fat (%Fat) combined to predict 34% of disordered eating behaviors: EAT = 0.921 SPA - 1.05 %Fat + 10.95 Gender (1 = M, 2 = F) - 17.82 (R2 = .34, SE = 4.68). A one-way ANOVA comparing the eating behaviors of athletes and nonathletes revealed no significant difference between these groups.

Adolescent↗

[Further development and restandardization of an approach to the diagnosis of aggressive social behavior in childhood].

The present paper continues and concludes an investigation into the restandardization of a first attempt, checked in respect of content and method, at the diagnosis of aggressive social behavior initially concentrating on the 9-11 age group. The work has its origin in a paper by Petermann and Petermann (1980), which we consider could be of significance to gradual restandardization, both in methodological research and in practical clinical application. A previous article demonstrated under various aspects the fundamental suitability of the attempt to restandardization. Arising out of this and the present analysis, some fundamental consequences, both in content and in method, of a fuller development and the therapy oriented employment of the attempt are discussed.

Aggression↗

Psychiatric phenomena in dementia of the Alzheimer type.

Psychiatric symptoms and behavioral disturbances are of importance in dementia of the Alzheimer type (DAT) but have been relatively neglected by researchers. The main psychiatric symptoms are disorders of thought content (delusions and paranoid ideation), disorders of perception (hallucinations and misidentifications) and disorders of affect (depressed and elevated mood). They occur commonly in DAT, and there is evidence that they may indicate subtypes of the disorder in view of their demographic, structural, and prognostic correlates. Personality changes are very common, and these may be the earliest manifestation of dementia. Behavioral disturbances tend to be associated with advanced dementia and are particularly disruptive to caregivers. Structural correlates suggest that some behaviors are a direct result of brain damage. Psychiatric and behavioral features in DAT are important, as they may serve as a model for symptomatology in functional psychiatric disorders.

Aged↗

Childhood videotaped social and neuromotor precursors of schizophrenia: a prospective investigation.

OBJECTIVE: The authors examined videotaped behaviors of children who developed schizophrenia as adults and of comparison subjects to disclose possible social and neuromotor deficits foreshadowing later development of schizophrenia. METHOD: In 1972, a sample of 265 11-13-year-old Danish children were filmed under standardized conditions while they were eating lunch. The examination was part of a larger study investigating early signs of schizophrenia spectrum disorders. Many of the subjects had a parent with schizophrenia, leaving them at high risk for developing a schizophrenia spectrum disorder. In 1991, adult psychiatric outcome data were obtained for 91.3% (N=242). This study systematically analyzed the videotapes to determine whether the children who developed schizophrenia as adults evidenced greater social and/or neuromotor deficits than children who did not develop a psychiatric disorder and children who developed other psychiatric disorders. RESULTS: The findings from this study suggest that the brief videotaped footage of children eating lunch was able to discriminate between the individuals who later developed schizophrenia and those who did not. Specifically, the preschizophrenia children evidenced differences on measures of sociability and general neuromotor functioning (among boys) from the children who developed other psychiatric disorders and the children who did not develop a psychiatric disorder. CONCLUSIONS: Social and neuromotor deficits specific to children who develop schizophrenia in adulthood provide further support for a neurodevelopmental hypothesis of schizophrenia.

Adolescent↗

Predictors of response to cognitive-behavioral group therapy for social phobia.

Response to cognitive-behavioral group therapy for social phobia was assessed at posttest and 6-month follow-up in a sample of 62 clients (41 generalized subtype, 21 nongeneralized). Predictors assessed were depression, expectancy, personality disorder traits, clinician-rated breadth and severity of impairment, and frequency of negative thoughts during social interactions. Outcome measures included self-report questionnaires and behavioral tests of dyadic interaction and a public speech. Although no predictor was related to outcome across all domains of measurement, higher depression, more avoidant personality traits, and lower treatment expectancy were each related to poorer treatment response on one or more outcome criteria. Cognitive change was consistently associated with change on self-report symptom measures, but, contrary to expectation, lower rates of negative thinking at posttest did not predict better maintenance of treatment gains at follow-up.

Adult↗

[Psychopathology of bulimia nervosa: a multidimensional model].

INTRODUCTION: In recent years, a number of studies have been carried out with the intention of isolating clinical dimensions in the psychopathology of bulimia nervosa. Although borderline personality has been considered a core element of the bulimic psychopathology by most of the authors, it has not been incorporated into any of these models. In this context, the present study was aimed at testing the consistence of the more complex model proposed until now, including in the analysis borderline personality as a clinical variable. SAMPLE AND METHODS: A group of 66 female patients fulfilling DSM-IV criteria for bulimia nervosa were assessed using a set of clinical instruments. The isolated items were processed using factor analysis techniques. RESULTS: Five basic dimensions of bulimia nervosa were obtained: 1. body disatisfaction; 2. restrictive eating behaviors; 3. purging behaviors; 4. emotional instability; and 5. disocial behavior. CONCLUSIONS: Our results support the idea that bulimia nervosa is a multidimensional condition. In our model, the dimension emotional instability incorporated borderline features, which tended to be strongly associated to self-defeating behaviors and depressive symptoms.

Adolescent↗

Six-year predictors of problems in a national sample of children and youth: I. Cross-informant syndromes.

OBJECTIVE: To illuminate the development of psychopathology by tracing 6-year predictive paths to outcomes assessed in terms of empirically based syndromes. METHOD: A national sample assessed at ages 4 through 12 years via parent reports was reassessed 3 and 6 years later via parent, teacher, and self-reports. RESULTS: For syndromes having the clearest DSM counterparts, cross-informant predictive paths revealed similar traitlike patterns for Aggressive Behavior in both sexes; Delinquent Behavior was less traitlike, with greater sex differences in predictive paths; the Attention Problems syndrome was developmentally stable, but, surprisingly, it was associated with more diverse difficulties among girls than boys; conversely, Anxious/Depressed was associated with more diverse difficulties among boys than girls. CONCLUSIONS: Quantification of problems via empirically based syndromes can detect important sex, age, and developmental variations that may be masked by uniform diagnostic cutoff points for both sexes and diverse ages. This may be especially true for diagnostic cutoff points derived mainly from clinical cases of one sex, such as depression for girls versus attention and conduct disorders for boys.

Adolescent↗