THE SYMPTOM INVENTORIES

 

AN ANNOTATED BIBLIOGRAPHY

 

 

 

 

 

 

 

 

 

 

Kenneth D. Gadow, Ph.D.,  

 

Department of Psychiatry and Behavioral Science

State University of New York

Stony Brook, NY 11794-8790

 

 

 

 

 

 

The citation for this document is as follows: Gadow, K.D. (2015). The Symptom Inventories:  An annotated bibliography.  Stony Brook, NY: Checkmate Plus.   

© 2015 Checkmate Plus


 

 

YEAR: 2016

 

 

16-1. Gadow K.D., Perlman, G., Ramdhany, L., & de Ruiter, J. (2016). Clinical correlates of co-occurring psychiatric and autism spectrum disorder (ASD) symptom-induced impairment in children with ASD. Journal of Abnormal Child Psychology, 44, 129-139.

 

Although psychiatric symptom severity and impairment are overlapping but nevertheless distinct illness parameters, little research has examined whether variables found to be associated with the severity are also correlated with symptom-induced impairment. Parents and teachers completed ratings of symptom-induced impairment for DSM-IV-referenced syndromes, and parents completed a background questionnaire for a consecutively referred sample of primarily male (81%) 6-to-12 year olds with autism spectrum disorder (ASD) (N=221). Some clinical correlates (e.g., IQ<70, maternal level of education, pregnancy complications, current use of psychotropic medication, season of birth) were associated with impairment for several disorders, whereas others were correlated with only a few syndromes (e.g., gender, co-morbid medical conditions) or were not related to impairment in any disorder (e.g., family psychopathology). There was little convergence in findings for parents’ versus teachers’ ratings. Three clinical correlates (season of birth, current psychotropic medication, maternal education) were unique predictors of three or more disorders. Pregnancy complications were uniquely associated with social anxiety and schizoid personality symptom-induced impairment. IQ was a unique predictor of schizophrenia, ASD, oppositional defiant disorder symptom-induced impairment. Children whose mothers had relatively fewer years of education had greater odds for symptom-induced impairment in social anxiety, depression, aggression, and mania and greater number of impairing conditions. Season of birth was the most robust correlate of symptom-induced impairment as rated by teachers but not by parents. Children born in fall evidenced higher rates of co-occurring psychiatric and ASD symptom-induced impairment and total number of impairing conditions. Many variables previously linked with symptom severity are also correlated with impairment. [Child and Adolescent Symptom Inventory-4

 

 

YEAR: 2015

 

15-1. Aparicio, E., Canals, J., Perez, S., & Arija, V. (2015). Dietary intake and nutritional risk in Mediterranean adolescents in relation to the severity of the eating disorder. Public Health Nutrition, 18, 1461-1473.

 

Objective: To assess the relationship between the degree of severity of eating disorders (ED) and energy and nutrient intakes and nutritional risk in a mixed-sex adolescent population without clinical symptoms. Design: Cross-sectional study. Setting: Data were collected in schools. Subjects: Adolescents (n 495) aged 14.2 (SD 1.0) years. The Eating Attitudes Test was used to detect adolescents at risk of ED (rED) and a structured interview based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, was used to diagnose eating disorder not otherwise specified (EDNOS). Dietary intake was quantified using the 24 h recall method over three days and the probability of inadequate intake was determined. Results: Females presented lower intakes of energy, macronutrients and micronutrients (Ca, Fe, Mg, K, P, Na, thiamin, vitamins E, C, B-6, B-12, pantothenic acid, folic acid) because the severity of their ED was greater. These lower dietary intakes led to nutritional risk (for Ca, Fe, Mg, P, vitamins A, D, B-6) in more than 80 % and 60 % of females with EDNOS and rED, respectively. The multiple linear regression models showed that the rED and EDNOS groups presented a lower energy intake of 1597.4 kJ/d (381.8 kcal/d) and 3153.0 kJ/d (753.6 kcal/d), respectively. In contrast, little difference was observed in the nutritional intakes of males. Conclusions: The female adolescents showed lower energy and nutrient intakes as the ED became more severe, which led to energy, vitamin and mineral deficiencies in a high percentage of females with ED. These nutritional risks could hinder adequate physical and psychological development and lead to chronic ED. [Youth’s Inventory-4, Spanish]

 

15-2. Arnold, L.E., Gadow, K.D., Farmer, C.A., Findling, R.L., Bukstein, O., Molina, B.S.G., et al. (2015). Comorbid anxiety and social avoidance in treatment of severe childhood aggression: response to adding risperidone to stimulant and parent training; mediation of disruptive symptom response.  Journal of Child and Adolescent Psychopharmacology, 25, 203-212.

 

Objective: In the four-site Treatment of Severe Childhood Aggression (TOSCA) study, addition of risperidone to stimulant and parent training moderately improved parent-rated disruptive behavior disorder (DBD) symptoms. This secondary study explores outcomes other than DBD and attention-deficit/hyperactivity disorder (ADHD) as measured by the Child and Adolescent Symptom Inventory-4R (CASI-4R). Methods: A total of 168 children ages 6-12 with severe aggression (physical harm), DBD, and ADHD were randomized to parent training plus stimulant plus placebo (basic treatment) or parent training plus stimulant plus risperidone (augmented treatment) for 9 weeks. All received only parent training plus stimulant for the first 3 weeks, then those with room for improvement received a second drug (placebo or risperidone) for 6 weeks. CASI-4R category item means at baseline and week 9 were entered into linear mixed-effects models for repeated measures to evaluate group differences in changes. Mediation of the primary DBD outcome was explored. Results: Parent ratings were nonsignificant with small/negligible effects, but teacher ratings (n=46 with complete data) showed significant augmented treatment advantage for symptoms of anxiety (p=0.013, d=0.71), schizophrenia spectrum (p=0.017, d=0.45), and impairment in these domains (p=0.02, d=0.26), all remaining significant after false discovery rate correction for multiple tests. Improvement in teacher-rated anxiety significantly (p=0.001) mediated the effect of risperidone augmentation on the primary outcome, the Disruptive-total of the parent-rated Nisonger Child Behavior Rating Form. Conclusions: Addition of risperidone to parent training plus stimulant improves not only parent-rated DBD as previously reported, but also teacher-rated anxiety-social avoidance. Improvement in anxiety mediates improvement in DBD, suggesting anxiety-driven fight-or-flight disruptive behavior with aggression, with implications for potential treatment strategies. Clinicians should attend to possible anxiety in children presenting with aggression and DBD. [Child and Adolescent Symptom Inventory-4

 

15-3. Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., et al. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder a randomized clinical trial. Journal of the American Medical Association, 313, 1524-1533.

 

IMPORTANCE: Disruptive behavior is common in children with autism spectrum disorder. Behavioral interventions are used to treat disruptive behavior but have not been evaluated in large-scale randomized trials. OBJECTIVE: To evaluate the efficacy of parent training for children with autism spectrum disorder and disruptive behavior. DESIGN, SETTING, AND PARTICIPANTS: This 24-week randomized trial compared parent training (n = 89) to parent education (n = 91) at 6 centers (Emory University, Indiana University, Ohio State University, University of Pittsburgh, University of Rochester, Yale University). We screened 267 children; 180 children (aged 3-7 years) with autism spectrum disorder and disruptive behaviors were randomly assigned (86% white, 88% male) between September 2010 and February 2014. INTERVENTIONS: Parent training (11 core, 2 optional sessions; 2 telephone boosters; 2 home visits) provided specific strategies to manage disruptive behavior. Parent education (12 core sessions, 1 home visit) provided information about autism but no behavior management strategies. MAIN OUTCOMES AND MEASURES: Parents rated disruptive behavior and noncompliance on co-primary outcomes: the Aberrant Behavior Checklist-Irritability subscale (range, 0-45) and the Home Situations Questionnaire-Autism Spectrum Disorder (range, 0-9). On both measures, higher scores indicate greater severity and a 25% reduction indicates clinical improvement. A clinician blind to treatment assignment rated the Improvement scale of the Clinical Global Impression (range, 1-7), a secondary outcome, with a positive response less than 3. RESULTS: At week 24, the Aberrant Behavior Checklist-Irritability subscale declined 47.7% in parent training (from 23.7 to 12.4) compared with 31.8% for parent education (23.9 to 16.3) (treatment effect, -3.9; 95% CI, -6.2 to -1.7; P < .001, standardized effect size = 0.62). The Home Situations Questionnaire-Autism Spectrum Disorder declined 55% (from 4.0 to 1.8) compared with 34.2% in parent education (3.8 to 2.5) (treatment effect, -0.7; 95% CI, -1.1 to -0.3; P < .001, standardized effect size = 0.45). Neither measure met the prespecified minimal clinically important difference. The proportions with a positive response on the Clinical Global Impression-Improvement scale were 68.5% for parent training vs 39.6% for parent education (P < .001). CONCLUSIONS AND RELEVANCE: For children with autism spectrum disorder, a 24-week parent training program was superior to parent education for reducing disruptive behavior on parent-reported outcomes, although the clinical significance of the improvement is unclear. The rate of positive response judged by a blinded clinician was greater for parent training vs parent education. [Child Symptom Inventory-4]

 

15-4. Bischoff, A.N., Reiersen, A.M., Buttlaire, A., Al-Lozi, A., Doty, T., Marshall, B.A., Hershey, T., & Washington Univ. Wolfram Syndrome R. (2015). Selective cognitive and psychiatric manifestations in Wolfram Syndrome. Orphanet Journal of Rare Diseases, 10, 66.

 

Background: Wolfram Syndrome (WFS) is known to involve diabetes mellitus, diabetes insipidus, optic nerve atrophy, vision loss, hearing impairment, motor abnormalities, and neurodegeneration, but has been less clearly linked to cognitive, sleep, and psychiatric abnormalities. We sought to determine whether these abnormalities are present in children, adolescents, and young adults with WFS compared to age- and gender-matched individuals with and without type 1 diabetes using standardized measures. Methods: Individuals with genetically-confirmed WFS (n = 19, ages 7-27) were compared to age-and gender-equivalent groups of individuals with type 1 diabetes (T1DM; n = 25), and non-diabetic healthy controls (HC: n = 25). Cognitive performance across multiple domains (verbal intelligence, spatial reasoning, memory, attention, smell identification) was assessed using standardized tests. Standardized self- and parent-report questionnaires on psychiatric symptoms and sleep disturbances were acquired from all groups and an unstructured psychiatric interview was performed within only the WFS group. Results: The three groups were similar demographically (age, gender, ethnicity, parental IQ). WFS and T1DM had similar duration of diabetes but T1DM had higher Hb(A1C) levels than WFS and as expected both groups had higher levels than HC. The WFS group was impaired on smell identification and reported sleep quality, but was not impaired in any other cognitive or self-reported psychiatric domain. In fact, the WFS group performed better than the other two groups on selected memory and attention tasks. However, based upon a clinical evaluation of only WFS patients, we found that psychiatric and behavioral problems were present and consisted primarily of anxiety and hypersomnolence. Conclusions: This study found that cognitive performance and psychological health were relatively preserved WFS patients, while smell and sleep abnormalities manifested in many of the WFS patients. These findings contradict past case and retrospective reports indicating significant cognitive and psychiatric impairment in WFS. While many of these patients were diagnosed with anxiety and hypersomnolence, self-reported measures of psychiatric symptoms indicated that the symptoms were not of grave concern to the patients. It may be that cognitive and psychiatric issues become more prominent later in life and/or in later stages of the disease, but this requires standardized assessment and larger samples to determine. In the relatively early stages of WFS, smell and sleep-related symptoms may be useful biomarkers of disease and should be monitored longitudinally to determine if they are good markers of progression as well. [Child Symptom Inventory-4, Youth’s Incentopry-4, Adult Self Report Inventory-4]

 

15-5. Bitsika, V., Sharpley, C.F., Andronicos, N.M., & Agnew, L.L. (2015). Hypothalamus-pituitary-adrenal axis daily fluctuation, anxiety and age interact to predict cortisol concentrations in boys with an autism spectrum disorder. Physiology & Behavior, 138, 200-207.

 

There is considerable evidence of a confound between symptoms of generalised anxiety disorder (GAD) and autism spectrum disorder (ASD) in children who have an ASD. Although there have been several attempts to describe how these two disorders overlap and interact to influence the assessment and diagnosis of children with an ASD, principally by reference to cortisol assayed from these children's saliva, the overall evidence is inconsistent Because previous models of these relationships have focused upon cortisol and GAD to the exclusion of age, diurnal fluctuation in the HPA axis and the source of GAD data, these variables were examined in a sample of 150 young males with an ASD. Results indicated that there was a significant interaction between these variables, with the association between GAD and cortisol demonstrated for children-but not for adolescents, with an interaction between the source of GAD information (self- vs parent-ratings) and whether the child's cortisol concentrations followed the expected diurnal reduction during the day. These data suggest that the validity of cortisol as a biomarker of GAD in children and adolescents with an ASD may be established for only selected subgroups of this population. [Child and Adolescent Symptom Inventory-4R]

 

15-6. Bitsika, V., Sharpley, C.F., Andronicos, N.M., & Agnew, L.L. (2015). Agreement between self- vs parent-ratings of general anxiety disorder symptoms and salivary cortisol in boys with an ASD. Journal of Developmental and Physical Disabilities, 27(4), 467-477.

 

To determine the relative validity of parent-assessed and self-assessed symptoms of Generalized Anxiety Disorder (GAD) in boys with an Autism Spectrum Disorder (ASD). 140 boys with an Autism Spectrum Disorder (ASD) were assessed for GAD by their parents and by themselves, and gave a sample of cortisol during the afternoon of these assessments. There were significant differences between self-assessments and parents' assessments for the total GAD score and on four of the eight individual GAD symptoms. Using cortisol concentrations as a validation index, the two key GAD items were most validly assessed via boys' self-ratings. Key GAD symptoms in boys with an ASD may be best assessed from their self-reports rather than by their parents' reports. Implications for clinical practice are discussed. [Child and Adolescent Symptom Inventory-4R]

 

 

15-7. Borelli, J.L., Ruiz, S.K., Crowley, M.J., Mayes, L.C., De los Reyes, A., & Lewin, A.B. (2015). Children's obsessive compulsive symptoms and fear-potentiated startle responses. Journal of Obsessive-Compulsive and Related Disorders, 6, 101-107.

 

Although clinical observations suggest that youth with obsessive compulsive disorder (OCD) are unable to down-regulate physiological fear responses in innocuous situations, to date no studies have directly addressed this question. In this report we lay the groundwork for future investigation of the emotion regulation processes of youth with obsessive compulsive (OC) symptoms. Using a non-clinical community sample of school-aged children, we evaluated the association between parent-reported child OC symptoms and children's startle responses to experimental conditions with differing levels of threat. Children with higher OC symptoms evidenced signs of context insensitivity in their startle response and greater subjective distress. Specifically, greater OC symptoms were associated with higher startle magnitude during baseline and safe conditions, but lower startle magnitude during threat. Our findings have important implications for the conceptualization and assessment of emotion regulation difficulties among children displaying OC symptoms. (C) 2015 Elsevier Inc. All rights reserved. [Child Symptom Inventory-4]

 

15-8. Brock, R.L. & Kochanska, G. (2015). Decline in the quality of family relationships predicts escalation in children's internalizing symptoms from middle to late childhood. Journal of Abnormal Child Psychology, 43(7), 1295-1308.

 

An integration of family systems perspectives with developmental psychopathology provides a framework for examining the complex interplay between family processes and developmental trajectories of child psychopathology over time. In a community sample of 98 families, we investigated the evolution of family relationships, across multiple subsystems of the family (i.e., interparental, mother-child, father-child), and the impact of these changing family dynamics on developmental trajectories of child internalizing symptoms over 6 years, from preschool age to pre-adolescence. Parent-child relationship quality was observed during lengthy sessions, consisting of multiple naturalistic, carefully scripted contexts. Each parent completed reports about interparental relationship satisfaction and child internalizing symptoms. To the extent that mothers experienced a steeper decline in interparental relationship satisfaction over time, children developed internalizing symptoms at a faster rate. Further, symptoms escalated at a faster rate to the extent that negative mother-child relationship quality increased (more negative affect expressed by both mother and child, greater maternal power assertion) and positive mother-child relationship quality decreased (less positive affect expressed by both mother and child, less warmth and positive reciprocity). Time-lagged growth curve analyses established temporal precedence such that decline in family relationships preceded escalation in child internalizing symptoms. Results suggest that family dysfunction, across multiple subsystems, represents a driving force in the progression of child internalizing symptoms. [Child Symptom Inventory-4]

 

15-9. Brock, R.L., Kochanska, G., O'Hara, M.W., & Grekin, R.S. (2015). Life satisfaction moderates the effectiveness of a play-based parenting intervention in low-income mothers and toddlers. Journal of Abnormal Child Psychology, 43(7), 1283-1294.

 

This multi-method multi-trait study examined moderators and mediators of change in the context of a parenting intervention. Low-income, diverse mothers of toddlers (average age 30 months; N = 186, 90 girls) participated in a play-based intervention (Child-Oriented Play versus Play-as-Usual) aimed at increasing children's committed compliance and reducing opposition toward their mothers, observed in prohibition contexts, and at reducing mother-rated children's behavior problems 6 months after the intervention. Mothers' subjective sense of life satisfaction and fulfillment during the intervention and objective ratings of psychosocial functioning by clinicians, obtained in a clinical interview were posed as moderators, and mothers' observed power-assertive discipline immediately following the intervention was modeled as a mediator of its impact. We tested moderated mediation using structural equation modeling, with all baseline scores (prior to randomization) controlled. Mothers' subjective sense of life satisfaction moderated the impact of the intervention, but clinicians' ratings did not. For mothers highly satisfied with their lives, participating in Child-Oriented Play group, compared to Play-as-Usual group, led to a reduction in power-assertive discipline which, in turn, led to children's increased compliance and decreased opposition and externalizing problems. There were no effects for mothers who reported low life satisfaction. The study elucidates the causal sequence set in motion by the intervention, demonstrates the moderating role of mothers' subjective life satisfaction, highlights limitations of clinicians' ratings, and informs future prevention and intervention efforts to promote adaptive parenting. [Early Childhood Inventory-4]

 

15-10. Cermak, S.A., Duker, L.I.S., Williams, M.E., Dawson, M.E., Lane, C.J., & Polido, J.C.  (2015). Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: a randomized controlled pilot study. Journal of Autism and Developmental Disorders, 45(9), 2876-2888.

 

This pilot and feasibility study examined the impact of a sensory adapted dental environment (SADE) to reduce distress, sensory discomfort, and perception of pain during oral prophylaxis for children with autism spectrum disorder (ASD). Participants were 44 children ages 6-12 (n = 22 typical, n = 22 ASD). In an experimental crossover design, each participant underwent two professional dental cleanings, one in a regular dental environment (RDE) and one in a SADE, administered in a randomized and counterbalanced order 3-4 months apart. Outcomes included measures of physiological anxiety, behavioral distress, pain intensity, and sensory discomfort. Both groups exhibited decreased physiological anxiety and reported lower pain and sensory discomfort in the SADE condition compared to RDE, indicating a beneficial effect of the SADE. [CASI-Anx]

 

15-11. Chan, C.C., Bach, P.A., & Bedwell, J.S. (2015). An integrative approach using third-generation cognitive-behavioral therapies for avoidant personality disorder. Clinical Case Studies, 14(6), 466-481.

 

Evidence-based practice emphasizes the integration of empirically supported treatments with clinical expertise and unique client characteristics. The present study describes an integrative approach using Acceptance and Commitment Therapy (ACT) and skills training adapted from Dialectical Behavior Therapy (DBT) to treat a client with avoidant personality disorder (AvPD), comorbid adjustment disorder, and self-injurious behavior. The process of matching the therapies to the client and specific techniques to symptoms and problem behaviors is described. Ongoing clinical measures indicated reductions in depression, hopelessness, and anxiety. Behavioral measures indicated remission of cutting behavior and increases in social and physical activities. Results from a 1-month follow-up suggested maintenance of gains and continued reduction in symptoms. The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profile at follow-up as compared with pre-treatment indicated significant decreases in the client's experience and perception of her symptoms. Endorsements on the Acceptance and Action Questionnaire-II (AAQ-II) at mid-treatment and follow-up suggested that the client achieved greater psychological flexibility. This case serves as evidence that individuals with AvPD and significant symptoms of anxiety and depression can be receptive to, and can benefit from, the integration of third-generation cognitive-behavioral therapies. [Adult Self Report Inventory-4]

 

15-12. Demopoulos, C., Brandes-Aitken, A.N., Desai, S.S., Hill, S.S., Antovich, A.D., Harris, J., & Marco, E.J. (2015). Shared and divergent auditory and tactile processing in children with autism and children with sensory processing dysfunction relative to typically developing peers. Journal of the International Neuropsychological Society, 21(6), 444-454.

 

The aim of this study was to compare sensory processing in typically developing children (TDC), children with Autism Spectrum Disorder (ASD), and those with sensory processing dysfunction (SPD) in the absence of an ASD. Performance-based measures of auditory and tactile processing were compared between male children ages 8-12 years assigned to an ASD (N = 20), SPD (N = 15), or TDC group (N = 19). Both the SPD and ASD groups were impaired relative to the TDC group on a performance-based measure of tactile processing (right-handed graphesthesia). In contrast, only the ASD group showed significant impairment on an auditory processing index assessing dichotic listening, temporal patterning, and auditory discrimination. Furthermore, this impaired auditory processing was associated with parent-rated communication skills for both the ASD group and the combined study sample. No significant group differences were detected on measures of left-handed graphesthesia, tactile sensitivity, or form discrimination; however, more participants in the SPD group demonstrated a higher tactile detection threshold (60%) compared to the TDC (26.7%) and ASD groups (35%). This study provides support for use of performance-based measures in the assessment of children with ASD and SPD and highlights the need to better understand how sensory processing affects the higher order cognitive abilities associated with ASD, such as verbal and non-verbal communication, regardless of diagnostic classification. [Child Symptom Inventory-4]

 

15-13. Farmer, C.A., Brown, N.V., Gadow, K.D., Arnold, L.E., Kolko, D.G., Findling, R.L., et al. (2015). Comorbid symptomatology moderates response to risperidone, stimulant, and parent training in children with severe aggression, disruptive behavior disorder, and attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 25, 213-224.

 

Objective: In this study, we evaluated parent and child characteristics as predictors and moderators of response in the four-site Treatment of Severe Childhood Aggression (TOSCA) study. Methods: A total of 168 children with severe aggression, disruptive behavior disorder, and attention-deficit/hyperactivity disorder (ADHD) were enrolled in a 9-week trial of basic treatment (n=84, stimulant+parent training+placebo) versus augmented treatment (n=84, stimulant+parent training+risperidone). In the initial report, augmented treatment surpassed basic treatment in reducing the primary outcome of disruptive behavior (D-Total) scores. In the current study, we evaluated parent (income, education, family functioning, employment) and child variables (intelligence quotient [IQ], aggression type, comorbid symptomatology) as predictors or moderators, using linear mixed models and the MacArthur guidelines. Results: Higher scores on ADHD symptom severity and callous/unemotional traits predicted better outcome on D-Total regardless of treatment assignment. Two moderators of D-Total were found: Higher anger/irritability symptoms and lower mania scores were associated with faster response, although not better overall effect at endpoint, in the augmented but not the basic group. Several variables moderated response on secondary outcomes (ADHD severity and prosocial behavior), and were characterized by faster response, although not better outcome, in the augmented but not in the basic group. Maternal education moderated outcome on the measure of positive social behavior; children of mothers with less education benefited more from augmented treatment relative to basic than those with more education. Conclusion: Although these findings require validation, they tentatively suggest that augmented treatment works equally well across the entire sample. Nevertheless, certain child characteristics may be useful indicators for the speed of response to augmented treatment. [Child and Adolescent Symptom Inventory-4R]

 

15-14. Goldschmidt, A.B., Hipwell, A.E., Stepp, S.D., McTigue, K.M., & Keenan, K. (2015). Weight gain, executive functioning, and eating behaviors among girls. Pediatrics, 136(4), E856-E863.

 

OBJECTIVE: Executive functioning and excess weight have been associated in cross-sectional and prospective studies, but mechanisms explaining this relationship are unclear. The current study aimed to further explore the longitudinal relationship between executive functioning and changes in body weight and to determine whether binge eating behaviors mediate this relationship. METHODS: Community-based girls (N = 2450) were assessed by using the behavioral measure of planning, Mazes subtest, and a parent-report measure of impulsivity at age 10; a self-report measure of binge eating at ages 10, 12, and 14; and investigator-measured BMI annually between ages 10 and 16. Regression and bootstrapping analyses explored the relations among age 10 impulsivity and planning, age 12 and age 14 binge eating frequency, and age 10 to 16 BMI changes. RESULTS: Age 10 impulsivity and planning each independently predicted age 10 to 16 BMI changes, after accounting for demographics, verbal comprehension, and BMI at age 10 (Ps < .001). Binge eating tendencies at age 12 mediated the relation between age 10 impulsivity and age 10 to 16 BMI changes, after controlling for demographics, verbal comprehension, binge eating frequency, and BMI at age 10 (indirect effect estimate = 0.0007; 95% confidence interval = 0.0001-0.0020). CONCLUSIONS: Results support the hypothesis that poorer executive functioning predicts weight gain from middle childhood through adolescence in girls, and that this effect may be partially explained by binge-eating behaviors in early adolescence. [Child Symptom Inventory-4]

 

15-15. Hummer, T.A., Wang, Y., Kronenberger, W.G., Dunn, D.W., & Mathews, V.P. (2015). The relationship of brain structure to age and executive functioning in adolescent disruptive behavior disorder. Psychiatry Research-Neuroimaging, 231, 210-217.

 

Characterizing brain maturation in adolescents with disruptive behavior disorders (DBDs) may provide insight into the progression of their behavioral deficits. Therefore, this study examined how age and executive functioning were related to structural neural characteristics in DBD. Thirty-three individuals (aged 13-17) with a DBD, along with a matched control sample, completed neuropsychological testing and underwent magnetic resonance imaging (MRI) to measure gray matter volume and microstructural white matter properties. Voxel-based morphometry quantified gray matter volume, and diffusion tensor imaging measured fractional anisotropy (FA) in white matter tracts. In the anterior cingulare, gray matter volume decreased with age in healthy controls but showed no such change in the DBD sample. In the corpus callosum and superior longitudinal fasciculus (SLF), FA increased with age in the control sample significantly more than in the DBD sample. Executive functioning, particularly working memory, was associated with SLF FA bilaterally. However, the relationship of SLF FA to working memory performance was weaker in the DBD sample. These data suggest that youth with DBD have altered brain development compared with typically developing youth. The abnormal maturation of the anterior cingulare and frontoparietal tracts during adolescence may contribute to the persistence of behavioral deficits in teens with a DBD. [Adolescent Symptom Inventory-4]

 

15-16. Jaffee, S.R., McFarquhar, T., Stevens, S., Ouellet-Morin, I., Melhuish, E., & Belsky, J.  (2015). Interactive effects of early and recent exposure to stressful contexts on cortisol reactivity in middle childhood. Journal of Child Psychology and Psychiatry, 56, 138-146.

 

Background: Given mixed findings as to whether stressful experiences and relationships are associated with increases or decreases in children's cortisol reactivity, we tested whether a child's developmental history of risk exposure explained variation in cortisol reactivity to an experimentally induced task. We also tested whether the relationship between cortisol reactivity and children's internalizing and externalizing problems varied as a function of their developmental history of stressful experiences and relationships. Method: Participants included 400 children (M=9.99years, SD=0.74years) from the Children's Experiences and Development Study. Early risk exposure was measured by children's experiences of harsh, nonresponsive parenting at 3years. Recent risk exposure was measured by children's exposure to traumatic events in the past year. Children's cortisol reactivity was measured in response to a social provocation task and parents and teachers described children's internalizing and externalizing problems. Results: The effect of recent exposure to traumatic events was partially dependent upon a child's early experiences of harsh, nonresponsive parenting: the more traumatic events children had recently experienced, the greater their cortisol reactivity if they had experienced lower (but not higher) levels of harsh, nonresponsive parenting at age 3. The lowest levels of cortisol reactivity were observed among children who had experienced the most traumatic events in the past year and higher (vs. lower) levels of harsh, nonresponsive parenting in early childhood. Among youth who experienced harsh, nonresponsive parent-child relationships in early childhood and later traumatic events, lower levels of cortisol reactivity were associated with higher levels of internalizing and externalizing problems. Conclusions: Hypothalamic-pituitary-adrenal (HPA) axis reactivity to psychological stressors and the relationship between HPA axis reactivity and children's internalizing and externalizing problems vary as a function of a child's developmental history of exposure to stressful relationships and experiences. [Child and Adolescent Symptom Inventory-4R]

 

15-17. Kaat, A.J. & Lecavalier, L. (2015). Reliability and validity of parent- and child-rated anxiety measures in autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(10), 3219-3231.

 

Autism spectrum disorder (ASD) and anxiety frequently co-occur. Research on the phenomenology and treatment of anxiety in ASD is expanding, but is hampered by the lack of instruments validated for this population. This study evaluated the self- and parent-reported Revised Child Anxiety and Depression Scale and the Multidimensional Anxiety Scale in Children-2 among 46 youth with ASD. Internal consistency and test-retest reliability were acceptable, but inter-rater reliability was poor. Parent-child agreement was better for youth with higher IQs, less severe ASD symptoms, or more social cognitive skills. Convergent and divergent validity were acceptable. Demographic characteristics were considered as predictors of anxiety: they were unrelated to parent-report, but younger age and more severe ASD were related to increased self-reported anxiety. [Child Symptom Inventory-4]

 

15-18. Kaat, A.J., Farmer, C.A., Gadow, K.D., Findling, R.L., Bukstein, O.G., Arnold, L.E., Bangalore, S.S., McNamara, N.K. & Aman, M.G. (2015). Factor validity of a proactive and reactive aggression rating scale. Journal of Child and Family Studies, 24(9), 2734-2744.

 

Aggressive behaviors can be classified into proactive and reactive functions, though there is disagreement about whether these are distinct constructs. Data suggest that proactive and reactive aggression have different etiologies, correlates, and response to treatment. Several rating scales are available to characterize aggressive behavior as proactive or reactive; one commonly used scale was originally developed for teacher ratings, referred to here as the Antisocial Behavior Scale (ABS). However, no data are available on the psychometric properties of the ABS for parent ratings. This study examined the factor structure and convergent/divergent validity of the parent-rated ABS among 168 children aged 6-12 years with attention-deficit hyperactivity disorder, a disruptive behavior disorder, and severe aggression enrolled in a randomized clinical trial. Multidimensional item response theory was used to confirm the original factor structure. The proactive and reactive factors were distinct but moderately correlated; the algorithm items exhibited acceptable fit on the original factors. The non-algorithm items caused theoretical problems and model misfit. Convergent and divergent validity of the scale was explored between the ABS and other parent-report measures. Proactive and reactive aggression showed differential correlates consistent with expectations for externalizing symptoms. The subscales were correlated weakly or not at all with most non-externalizing symptoms, with some exceptions. Thus, the original factor structure was supported and we found preliminary evidence for the validity of the scale, though the results suggest that the constructs measured by the ABS may not be totally distinct from general behavior problems in this clinical sample. [Child and Adolescent Symptom Inventory-4R]

 

15-19. Kacanek, D., Angelidou, K., Williams, P.L., Chernoff, M., Gadow, K.D., & Nachman, S. for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) P1055 Study Team. (2015). Psychiatric symptoms and antiretroviral non-adherence in US youth with perinatal HIV: A longitudinal study. AIDS, 29, 1227-1237.

 

Objectives: The relationship of specific psychiatric conditions to adherence has not been examined in longitudinal studies of youth with perinatal HIV infection (PHIV). We examined associations between psychiatric conditions and antiretroviral nonadherence over 2 years. Design: Longitudinal study in 294 PHIV youth, 6–17 years old, in the United States and Puerto Rico. Methods: We annually assessed three nonadherence outcomes: missed above 5% of doses in the past 3 days, missed a dose within the past month, and unsuppressed viral load (>400 copies/ml). We fit multivariable logistic models for nonadherence using Generalized Estimating Equations, and evaluated associations of psychiatric conditions (attention deficit hyperactivity disorder, disruptive behavior, depression, anxiety) at entry with incident nonadherence using multivariable logistic regression. Results: Nonadherence prevalence at study entry was 14% (3-day recall), 32% (past month nonadherence), and 38% (unsuppressed viral load), remaining similar over time. At entry, 38% met symptom cut-off criteria for at least one psychiatric condition. Greater odds of 3-day recall nonadherence were observed at week 96 for those with depression [adjusted odds ratio (aOR) 4.14, 95% confidence interval (CI) 1.11–15.42] or disruptive behavior (aOR 3.36, 95% CI 1.02–11.10], but not at entry. Those with vs. without attention deficit hyperactivity disorder had elevated odds of unsuppressed viral load at weeks 48 (aOR 2.46, 95% CI 1.27–4.78) and 96 (aOR 2.35, 95% CI 1.01–5.45), but not at entry. Among 232 youth adherent at entry, 16% reported incident 3-day recall nonadherence. Disruptive behavior conditions at entry were associated with incident 3-day recall nonadherence (aOR 3.01, 95% CI 1.24–7.31). Conclusion: In PHIV youth, comprehensive adherence interventions that address psychiatric conditions throughout the transition to adult care are needed. [Child and Adolescent Symptom Inventory-4R; Youth (Self Report) Inventory-4R, Child Self Report Inventory-4, Adult Self Report Inventory-4]

 

15-20. Kerr, C., Breheny, K., Lloyd, A., Brazier, J., Bailey, D.B., Berry-Kravis, E., et al. (2015). Developing a utility index for the Aberrant Behavior Checklist (ABC-C) for fragile X syndrome. Quality of Life Research, 24, 305-314.

 

This study aimed to develop a utility index (the ABC-UI) from the Aberrant Behavior Checklist-Community (ABC-C), for use in quantifying the benefit of emerging treatments for fragile X syndrome (FXS). The ABC-C is a proxy-completed assessment of behaviour and is a widely used measure in FXS. A subset of ABC-C items across seven dimensions was identified to include in health state descriptions. This item reduction process was based on item performance, factor analysis and Rasch analysis performed on an observational study dataset, and consultation with five clinical experts and a methodological expert. Dimensions were combined into health states using an orthogonal design and valued using time trade-off (TTO), with lead-time TTO methods used where TTO indicated a state valued as worse than dead. Preference weights were estimated using mean, individual level, ordinary least squares and random-effects maximum likelihood estimation [RE (MLE)] regression models. A representative sample of the UK general public (n = 349; mean age 35.8 years, 58.2 % female) each valued 12 health states. Mean observed values ranged from 0.92 to 0.16 for best to worst health states. The RE (MLE) model performed best based on number of significant coefficients and mean absolute error of 0.018. Mean utilities predicted by the model covered a similar range to that observed. The ABC-UI estimates a wide range of utilities from patient-level FXS ABC-C data, allowing estimation of FXS health-related quality of life impact for economic evaluation from an established FXS clinical trial instrument. [Child and Adolescent Symptom Inventory-4R, Adult Inventory-4]

 

15-21. Lahey, B.B., Rathouz, P.J., Keenan, K., Stepp, S.D., Loeber, R., & Hipwell, A.E. (2015). Criterion validity of the general factor of psychopathology in a prospective study of girls. Journal of Child Psychology and Psychiatry, 56, 415-422.

 

Background: The best-fitting model of the structure of common psychopathology often includes a general factor on which all dimensions of psychopathology load. Such a general factor would be important if it reflects etiologies and mechanisms shared by all dimensions of psychopathology. Nonetheless, a viable alternative explanation is that the general factor is partly or wholly a result of common method variance or other systematic measurement biases. Methods: To test this alternative explanation, we extracted general, externalizing, and internalizing factor scores using mother-reported symptoms across 5-11years of age in confirmatory factor analyses of data from a representative longitudinal study of 2,450 girls. Independent associations between the three psychopathology factor scores and teacher-reported criterion variables were estimated in multiple regression, controlling intelligence, and demographic covariates. Results: The model including the general factor fit significantly better than a correlated two-factor (internalizing/externalizing) model. The general factor was robustly and independently associated with all measures of teacher-reported school functioning concurrently during childhood and prospectively during adolescence. Conclusions: These findings weaken the hypothesis that the general factor of psychopathology in childhood is solely a measurement artifact and support further research on the substantive meaning of the general factor. [Child Symptom Inventory-4]

 

15-22. Lara, D.R., Bisol, L.W., Ottoni, G.L., de Carvalho, H.W., Banerjee, D., Golshan, S., Akiskal, K., &  Akiskal, H.S. (2015). Validation of the "rule of three", the "red sign" and temperament as behavioral markers of bipolar spectrum disorders in a large sample. Journal of Affective Disorders, 183, 195-204.

 

Background: Akiskal proposed the "rule of three" for behavioral indicators with high specificity for bipolarity in patients with major depression episodes. We evaluated these distinctive behaviors in controls and subjects with major depression or bipolar disorder. Methods: data was collected in the BRAINSTEP project with questions on general behaviors, style and talents. Univariate analysis was first conducted in 36,742 subjects and confirmatory multivariate analysis in further 34,505 subjects (22% with a mood disorder). Odds ratios were calculated adjusting for age. Results: Univariate analysis showed that 29 behavioral markers differentiated bipolar subjects from those with unipolar depression. The most robust differences in those with bipolarity (ORs > 4) were >= 3 religion changes, >= 3 marriages, cheating the partner regularly, having >= 60 lifetime sexual partners, pathological love, heavy cursing, speaking >= 3 foreign languages, having >= 2 apparent tattoos, circadian dysregulation and high debts. Most behaviors were expressed in a minority of patients (usually around 5-30%) and usually the "rule of three" was the best numerical marker to distinguish those with bipolarity. However, multivariate analysis confirmed 11 of these markers for differentiating bipolar disorder from unipolar depression (reversed circadian rhythm and high debts for both genders, >= 3 provoked car accidents and talent for poetry in men, and frequent book reading, >= 3 religion changes, >= 60 sexual partners, pathological love >= 2 times, heavy cursing and extravagant dressing style in women). Limitations: Self-report data collection only. Conclusions: These behavioral markers should alert the clinician to perform a thorough investigation of bipolarity in patients presenting with a depressive episode. [Adult Self Report Inventory-4, Portuguese

 

15-23. Leopold, D.R., Bryan, A.D., Pennington, B.F., & Willcutt, E.G. (2015). Evaluating the construct validity of adult ADHD and SCT among college students: a multitrait-multimethod analysis of convergent and discriminant validity. Journal of Attention Disorders, 19, 200-210.

 

Objective: To advance our understanding of adult ADHD and sluggish cognitive tempo (SCT), the present study investigates their construct validity by exploring the nature of trait- and method-related variance in self- and parent-ratings of ADHD and SCT. Method: Using a multitrait-multimethod (MTMM) design, response variance in college undergraduates' (n = 3,925) and a subset of their parents' (n = 2,242) ratings was decomposed into method, trait, and error-specific variance. Results: Global evidence for convergent and discriminant validity was supported, but parameter-level comparisons suggest that method effects, situational specificity, and ADHD's core feature inattention are prominent. Conclusion: This investigation offers two important conclusions: (a) SCT appears to be a related but separate factor from ADHD; and (b) self- and parent-ratings of emerging adult ADHD exhibit low to moderate correlations and support the situational specificity hypothesis, suggesting that multiple raters should be consulted when assessing adult ADHD. Implications of these findings and recommendations for the continued study of SCT are discussed. [Child Symptom Inventory-4]

 

15-24. Lin, Y.J., Lo, K.W., Yang, L.K., & Gau, S.S.S.F. (2015). Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function. Research in Developmental Disabilities, 47, 48-60.

 

The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n = 147) and late-onset ADHD (onset between 7 and 12 years, n = 42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment. [ASRI-4, Chinese translation]

 

15-25. Love, L., Minnis, H., & O'connor, S. (2015). Factors associated with indiscriminate friendliness in high-risk children. Infant Mental Health Journal, 36(4), 427-445.

 

Indiscriminate friendliness (IF) refers to a lack of reticence with strangers and is well-documented in neglected children. This risky behavior is distinct from attachment insecurity, and persists when parenting/caregiving improves. A previous review has suggested that caregiving quality is not associated with IF. This review aimed to explore factors associated with IF and whether quality of caregiving is important. Ten articles were reviewed using the S.H. Downs and N. Black (1998) Checklist for randomized and nonrandomized studies. Overall quality was high. Results showed that IF is present in fostered populations and postinstitutionalized children. Attachment security was not associated with IF. Length of time in institution and inhibitory control were associated with IF. Inhibitory control moderated the association between IF and number of caregivers. Genetic factors predispose children to IF and may impact on persistence. Quality of caregiving was associated with IF. Emotional availability (i.e., the degree to which carer and child are able to respond to each other's emotional signals) predicted IF. Limitations across studies included heterogeneity in IF measurement and unreliable measures of preadoptive care. Parenting may be a useful target for intervention. Future research should focus on developing a standardized measure of IF as well as evaluating a parental intervention. [Early Childhood Inventory-4]

 

15-26. Michelini, G Eley, TC Gregory, AM McAdams, TA (2015). Aetiological overlap between anxiety and attention deficit hyperactivity symptom dimensions in adolescence. Journal of Child Psychology and Psychiatry, 56, 423-431.

 

Background: Anxiety and attention-deficit/hyperactivity (ADH) problems are common in adolescence, often co-occur, and are characterised by high heterogeneity in their phenotypic expressions. Although it is known that anxiety and ADH problems correlate, the relationships between subtypes of anxiety and ADH problems have been scarcely investigated. Methods: Using a large population sample of adolescent twins and siblings we explored the phenotypic and aetiological association between anxiety subtypes (panic/agoraphobia, separation anxiety, social anxiety, physical injury fears, obsessive-compulsive symptoms and generalised anxiety) and the two ADH dimensions (attention problems and hyperactivity/impulsivity). Both phenotypes were assessed using self-report questionnaires. Results: The association between ADH problems and anxiety could be entirely attributed to attention problems, not hyperactivity/impulsivity. Most of the correlations between anxiety subtypes and attention problems showed an approximately equal role of genetic and nonshared environmental factors. Conclusions: The high heterogeneity within anxiety and ADH problems should be taken into account in order to better understand comorbidity between them. [Adolescent Symptom Inventory-4]

 

15-27. Mikami, A.Y., Chong, G.K., Saporito, J.M., & Na, J.J. (2015). Implications of parental affiliate stigma in families of children with ADHD. Journal of Clinical Child and Adolescent Psychology, 44(4), 595-603.

 

This study examined parents' perceptions/awareness and internalization of public courtesy stigma (affiliate stigma) about their children's inattentive and hyperactive/impulsive symptoms, and associations between parental affiliate stigma, parental negativity expressed toward the child, and child social functioning. Participants were families of 63 children (ages 6-10; 42 boys) with attention-deficit/hyperactivity disorder, assessed in a cross-sectional design. After statistical control of children's severity of inattentive and hyperactive/impulsive symptoms (as reported by parents and teachers), parents' self-reports of greater affiliate stigma were associated with more observed negative parenting. The associations between high parental affiliate stigma and children's poorer adult informant-rated social skills and greater observed aggression were partially mediated by increased parental negativity. As well, the positive association between children's adult informant-rated aggressive behavior and parental negativity was partially mediated by parents' increased affiliate stigma. Parental affiliate stigma about their children's inattentive and hyperactive/impulsive symptoms may have negative ramifications for parent-child interactions and children's social functioning. Clinical implications for parent training interventions are discussed. [Child Symptom Inventory-4]

 

15-28. Miller, A.B., Esposito-Smythers, C., & Leichtweis, R.N. (2015). Role of Social Support in Adolescent Suicidal Ideation and Suicide Attempts. Journal of Adolescent Health, 56, 286-292.

 

Purpose: The present study examined the relative contributions of perceptions of social support from parents, close friends, and school on current suicidal ideation (SI) and suicide attempt (SA) history in a clinical sample of adolescents. Methods: Participants were 143 adolescents (64% female; 81% white; range, 12-18 years; M = 15.38; standard deviation = 1.43) admitted to a partial hospitalization program. Data were collected with well-validated assessments and a structured clinical interview. Main and interactive effects of perceptions of social support on SI were tested with linear regression. Main and interactive effects of social support on the odds of SA were tested with logistic regression. Results: Results from the linear regression analysis revealed that perceptions of lower school support independently predicted greater severity of SI, accounting for parent and close friend support. Further, the relationship between lower perceived school support and SI was the strongest among those who perceived lower versus higher parental support. Results from the logistic regression analysis revealed that perceptions of lower parental support independently predicted SA history, accounting for school and close friend support. Further, those who perceived lower support from school and close friends reported the greatest odds of an SA history. Conclusions: Results address a significant gap in the social support and suicide literature by demonstrating that perceptions of parent and school support are relatively more important than peer support in understanding suicidal thoughts and history of suicidal behavior. Results suggest that improving social support across these domains may be important in suicide prevention efforts. [Youth’s Inventory-4]

 

15-29. Ni, H.C., & Gau, S.S.F.  (2015). Co-occurrence of attention-deficit hyperactivity disorder symptoms with other psychopathology in young adults: parenting style as a moderator. Comprehensive Psychiatry, 57, 85-96.

 

The extent to which parenting styles can influence secondary psychiatric symptoms among young adults with ADHD symptoms is unknown. This issue was investigated in a sample of 2284 incoming college students (male, 50.6%), who completed standardized questionnaires about adult ADHD symptoms, other DSM-IV symptoms, and their parents' parenting styles before their ages of 16. Among them, 2.8% and 22.8% were classified as having ADHD symptoms and sub-threshold ADHD symptoms, respectively. Logistic regression was used to compare the comorbid rates of psychiatric symptoms among the ADHD, sub-threshold ADHD and non-ADHD groups while multiple linear regressions were used to examine the moderating role of gender and parenting styles over the associations between ADHD and other psychiatric symptoms. Both ADHD groups were significantly more likely than other incoming students to have other DSM-IV symptoms. Parental care was negatively associated and parental overprotection/control positively associated with these psychiatric symptoms. Furthermore, significant interactions were found of parenting style with both threshold and sub-threshold ADHD in predicting wide-ranging comorbid symptoms. Specifically, the associations of ADHD with some externalizing symptoms were inversely related to level of paternal care, while associations of ADHD and sub-threshold ADHD with wide-ranging comorbid symptoms were positively related to level of maternal and paternal overprotection/control. These results suggest that parenting styles may modify the effects of ADHD on the risk of a wide range of temporally secondary DSM-IV symptoms among incoming college students, although other causal dynamics might be at work that need to be investigated in longitudinal studies. [Adult Self Report Inventory-4, Chinese]

 

15-30. Pardini, D., White, H.R., Xiong, S.Y., Bechtold, J., Chung, T., Loeber, R., & Hipwell, A. (2015). Unfazed or dazed and confused: Does early adolescent marijuana use cause sustained impairments in attention and academic functioning? Journal of Abnormal Child Psychology, 43(7), 1203-1217.

 

There is some suggestion that heavy marijuana use during early adolescence (prior to age 17) may cause significant impairments in attention and academic functioning that remain despite sustained periods of abstinence. However, no longitudinal studies have examined whether both male and female adolescents who engage in low (less than once a month) to moderate (at least once a monthly) marijuana use experience increased problems with attention and academic performance, and whether these problems remain following sustained abstinence. The current study used within-individual change models to control for all potential pre-existing and time-stable confounds when examining this potential causal association in two gender-specific longitudinal samples assessed annually from ages 11 to 16 (Pittsburgh Youth Study N = 479; Pittsburgh Girls Study N = 2296). Analyses also controlled for the potential influence of several pertinent time-varying factors (e.g., other substance use, peer delinquency). Prior to controlling for time-varying confounds, analyses indicated that adolescents tended to experience an increase in parent-reported attention and academic problems, relative to their pre-onset levels, during years when they used marijuana. After controlling for several time-varying confounds, only the association between marijuana use and attention problems in the sample of girls remained statistically significant. There was no evidence indicating that adolescents who used marijuana experienced lingering attention and academic problems, relative to their pre-onset levels, after abstaining from use for at least a year. These results suggest that adolescents who engage in low to moderate marijuana use experience an increase in observable attention and academic problems, but these problems appear to be minimal and are eliminated following sustained abstinence. [Adolescent Symptom Inventory-4]

 

15-31. Rundberg-Rivera, E.V., Townsend, L.D., Schneider, J., Farmer, C.A., Molina, B.B.S.G., & Findling, R.L. et al. (2015). Participant satisfaction in a study of stimulant, parent training, and risperidone in children with severe physical aggression. Journal of Child and Adolescent Psychopharmacology, 25, 225-233.

 

Objective: The purpose of this study was to examine the satisfaction of families who participated in the Treatment of Severe Childhood Aggression (TOSCA) study. Methods: TOSCA was a randomized clinical trial of psychostimulant plus parent training plus placebo (basic treatment) versus psychostimulant plus parent training plus risperidone (augmented treatment) for children with severe physical aggression, disruptive behavior disorder, and attention-deficit/hyperactivity disorder. Parents completed a standardized Parent Satisfaction Questionnaire (PSQ). Results: Of the 168 families randomized, 150 (89.3%) provided consumer satisfaction data. When they were asked if they would join the study again if they had the option to repeat, 136 (91%) said "yes," 11 (7%) said "maybe," and one (<1%) said "no." When asked if they would recommend the study to other parents with children having similar problems, 147 (98%) said "yes" and 3 (2%) said "maybe." Between 71% (rating one aspect of the Parent Training) and 96% (regarding the diagnostic interview) endorsed study procedures using the most positive response option. Asked if there were certain aspects of the study that they especially liked, 64 (43%) spontaneously reported parent training. Treatment assignment (basic vs. augmented) and responder status were not associated with reported satisfaction. However, responder status was strongly associated with parent confidence in managing present (p<0.001) and future (p<0.005) problem behaviors. Conclusions: These findings indicate high levels of satisfaction with TOSCA study involvement and, taken together with previous pediatric psychopharmacology social validity studies, suggest high levels of support for the research experience. These findings may inform research bioethics and may have implications for deliberations of institutional review boards. [Child and Adolescent Symptom Inventory-4R]

 

15-32. Sarver, D.E., Rapport, M.D., Kofler, M.J., Raiker, J.S., & Friedman, L.M. (2015). Hyperactivity in attention-deficit/hyperactivity disorder (ADHD): Impairing deficit or compensatory behavior? Journal of Abnormal Child Psychology, 43(7), 1219-1232.

 

Excess gross motor activity (hyperactivity) is considered a core diagnostic feature of childhood ADHD that impedes learning. This view has been challenged, however, by recent models that conceptualize excess motor activity as a compensatory mechanism that facilitates neurocognitive functioning in children with ADHD. The current study investigated competing model predictions regarding activity level's relation with working memory (WM) performance and attention in boys aged 8-12 years (M = 9.64, SD = 1.26) with ADHD (n = 29) and typically developing children (TD; n = 23). Children's phonological WM and attentive behavior were objectively assessed during four counterbalanced WM tasks administered across four separate sessions. These data were then sequenced hierarchically based on behavioral observations of each child's gross motor activity during each task. Analysis of the relations among intra-individual changes in observed activity level, attention, and performance revealed that higher rates of activity level predicted significantly better, but not normalized WM performance for children with ADHD. Conversely, higher rates of activity level predicted somewhat lower WM performance for TD children. Variations in movement did not predict changes in attention for either group. At the individual level, children with ADHD and TD children were more likely to be classified as reliably Improved and Deteriorated, respectively, when comparing their WM performance at their highest versus lowest observed activity level. These findings appear most consistent with models ascribing a functional role to hyperactivity in ADHD, with implications for selecting behavioral treatment targets to avoid overcorrecting gross motor activity during academic tasks that rely on phonological WM. [Child Symptom Inventory-4]

 

15-33. Scott, L.N., Pilkonis, P.A., Hipwell, A.E., Keenan, K., & Stepp, S.D. (2015). Non-suicidal self-injury and suicidal ideation as predictors of suicide attempts in adolescent girls: A multi-wave prospective study. Comprehensive Psychiatry, 58, 1-10.

 

Although both suicide ideation (SI) and non-suicidal self-injury (NSSI) are known risk factors for suicidal behavior, few longitudinal studies have examined whether having a history of one or both of these factors prospectively predicts increased risk for suicide attempts. According to the theory of acquired capability for suicide, engagement in NSSI may reduce inhibitions around self-inflicted violence, imparting greater risk for suicide attempts among those with SI than would be observed in those with SI who do not have a history of NSSI. We used prospective data from the Pittsburgh Girls Study, a large community sample, to compare groups of girls reporting no SI or NSSI, SI only, or both NSSI and SI between early to late adolescence on any lifetime or recent suicide attempts in late adolescence and early adulthood. As compared to girls with no SI or NSSI history and those with only an SI history, girls with a history of both NSSI and SI were significantly more likely to subsequently report both lifetime and recent suicide attempts. Results are consistent with the acquired capability theory for suicide and suggest that adolescent girls who have engaged in NSSI and also report SI represent a particularly high-risk group in need of prevention and intervention efforts. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4, Adult Self Report Incventory-4]

 

15-34. Sharpley, C.F., Bitsika, V., Agnew, L.L., & Andronicos, N.M. (2015). Eight-month test-retest agreement in morning salivary cortisol, self- and parent-rated anxiety in boys with an autism spectrum disorder. Physiology & Behavior, 151, 207-212.

 

The agreement over time in morning salivary cortisol concentrations and also self- and parent-rated anxiety was investigated in a sample of 16 boys with an ASD. Cortisol and anxiety data were collected eight months apart. Results indicated that there were significant correlations between each pair of measures from the two occasions, suggesting that cortisol concentrations and anxiety did not vary much at all over that time, challenging the assumption that cortisol needs to be measured over multiple days to obtain reliable data from children with an ASD. Implications for research into the ways these children respond to chronic stressors are discussed. [Child and Adolescent Symptom Inventory-4R, Youth Self Report Inventory-4]

 

15-35. Siegel, M., Smith, K.A., Mazefsky, C., Gabriels, R.L., Erickson, C., Kaplan, D., Morrow, E.M., Wink, L., Santangelo, S.L., & ADDIRC. (2015). The autism inpatient collection: methods and preliminary sample description. Molecular Autism, 6, 61.

 

Background: Individuals severely affected by autism spectrum disorder (ASD), including those with intellectual disability, expressive language impairment, and/or self-injurious behavior (SIB), are underrepresented in the ASD literature and extant collections of phenotypic and biological data. An understanding of ASD's etiology and subtypes can only be as complete as the studied samples are representative. Methods: The Autism Inpatient Collection (AIC) is a multi-site study enrolling children and adolescents with ASD aged 4-20 years admitted to six specialized inpatient psychiatry units. Enrollment began March, 2014, and continues at a rate of over 400 children annually. Measures characterizing adaptive and cognitive functioning, communication, externalizing behaviors, emotion regulation, psychiatric co-morbidity, self-injurious behavior, parent stress, and parent self-efficacy are collected. ASD diagnosis is confirmed by the Autism Diagnostic Observation Schedule - 2 (ADOS-2) and extensive inpatient observation. Biological samples from probands and their biological parents are banked and processed for DNA extraction and creation of lymphoblastoid cell lines. Results: Sixty-one percent of eligible subjects were enrolled. The first 147 subjects were an average of 12.6 years old (SD 3.42, range 4-20); 26.5 % female; 74.8 % Caucasian, and 81.6 % non-Hispanic/non-Latino. Mean non-verbal intelligence quotient IQ = 70.9 (SD 29.16, range 30-137) and mean adaptive behavior composite score = 55.6 (SD 12.9, range 27-96). A majority of subjects (52.4 %) were non-or minimally verbal. The average Aberrant Behavior Checklist - Irritability Subscale score was 28.6, well above the typical threshold for clinically concerning externalizing behaviors, and 26.5 % of the sample engaged in SIB. Females had more frequent and severe SIB than males. Conclusions: Preliminary data indicate that the AIC has a rich representation of the portion of the autism spectrum that is understudied and underrepresented in extant data collections. More than half of the sample is non-or minimally verbal, over 40 % have intellectual disability, and over one quarter exhibit SIB. The AIC is a substantial new resource for study of the full autism spectrum, which will augment existing data on higher-functioning cohorts and facilitate the identification of genetic subtypes and novel treatment targets. The AIC investigators welcome collaborations with other investigators, and access to the AIC phenotypic data and biosamples may be requested through the Simons Foundation (www.sfari.org). [Child and Adolescent Symptom Inventory-4R]

 

15-36. Sitzer, D.L., & Stockwell, A.B. (2015). The art of wellness: A 14-week art therapy program for at-risk youth. Arts in Psychotherapy, 45, 69-81.

 

Previous research has indicated a strong need to develop therapies that prevent the development of psychological problems in youth as opposed to treatment after the fact. In the current study, twenty-three female and nineteen male elementary school students with ages ranging from 9 to 12, participated in a single group within-subjects curriculum-based intervention promoting coping skills and resilience. Students engaged in art therapy combined with CBT and DBT modalities. Results indicated significant increases for the total sample in resilience, social and emotional functioning. Results also indicated male students' overall stronger improvement relative to female students. Socio-cultural implications and directions for future research are addressed. [Child Symptom Inventory-4]

 

15-37. Sola, S.B., Ballabriga, M.C.J., & Lloret, M.D.R. (2015). Further validity evidence of the Behavioral Inhibition Observation System (BIOS). PSICOTHEMA, 27(4), 416-423.

 

Background: The Behavioral Inhibition Observation System (BIOS) is a brief clinician-report scale for detecting behavioral inhibition (BI) from direct observation. This study aims to compare the validity coefficients obtained in the natural context of use of the BIOS (i.e., a clinical situation) with those obtained using the BIOS after standardized observation. Method: The participants were 74 randomly selected preschool children who were exposed to systematic observation. Results: The results indicate excellent internal consistency (alpha = .91) and moderate to good inter-rater reliability for all items (ICC from .55 to .88). The correlations with observational measures of BI ranged from .40 to .70, and were mostly equivalent to those of the previous study. The correlations with parents', teachers', and clinicians' measures of BI and related constructs ranged from .30 to .60, and were also equivalent to those obtained in the natural context of use of the BIOS (i.e., clinical situation). Conclusions: The validity coefficients obtained with the BIOS in a non-structured natural observation are mostly equivalent to those obtained in an experimental situation, thus supporting that the BIOS is a cost-efficient instrument for measuring BI from observation in a clinical situation. [Early Childhood Inventory-4, Spanish translation]

 

15-38. Taylor, H.G., Margevicius, S., Schluchter, M., Andreias, L., & Hack, M. (2015). Persisting behavior problems in extremely low birth weight adolescents. Journal of Developmental and Behavioral Pediatrics, 36, 178-187.

 

Objective: To describe behavior problems in extremely low birth weight (ELBW, < 1000 g) adolescents born 1992 through 1995 based on parent ratings and adolescent self-ratings at age 14 years and to examine changes in parent ratings from ages 8-14. Method: Parent ratings of behavior problems and adolescent self-ratings were obtained for 169 ELBW adolescents (mean birth weight 815 g, gestational age 26 wk) and 115 normal birth weight (NBW) controls at 14 years. Parent ratings of behavior at age 8 years were also available. Behavior outcomes were assessed using symptom severity scores and rates of scores above DSM-IV symptom cutoffs for clinical disorder. Results: The ELBW group had higher symptom severity scores on parent ratings at age 14 years than NBW controls for inattentive attention-deficit hyperactivity disorder (ADHD), anxiety, and social problems (all p's < .01). Rates of parent ratings meeting DSM-IV symptom criteria for inattentive ADHD were also higher for the ELBW group (12% vs 1%, p < .01). In contrast, the ELBW group had lower symptom severity scores on self-ratings than controls for several scales. Group differences in parent ratings decreased over time for ADHD, especially among females, but were stable for anxiety and social problems. Conclusions: Extremely low birth weight adolescents continue to have behavior problems similar to those evident at a younger age, but these problems are not evident in behavioral self-ratings. The findings suggest that parent ratings provide contrasting perspectives on behavior problems in ELBW youth and support the need to identify and treat these problems early in childhood. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4, Youth’s Inventory-4]

 

15-39. Theunissen, S.C.P.M., Rieffe, C., Soede, W., Briaire, J.J., Ketelaar, L., Kouwenberg, M., & Frijns, J.H.M. (2015). Symptoms of psychopathology in hearing-impaired children. Ear and Hearing, 36 (4), e190-e198.

 

Objectives: Children with hearing loss are at risk of developing psychopathology, which has detrimental consequences for academic and psychosocial functioning later in life. Yet, the causes of the extensive variability in outcomes are not fully understood. Therefore, the authors wanted to objectify symptoms of psychopathology in children with cochlear implants or hearing aids, and in normally hearing peers, and to identify various risk and protective factors. Design: The large sample (mean age = 11.8 years) included three subgroups with comparable age, gender, socioeconomic status, and nonverbal intelligence: 57 with cochlear implants, 75 with conventional hearing aids, and 129 children who were normally hearing. Psychopathology was assessed by means of self- and parent-report measures.  Results: Children with cochlear implants showed similar levels of symptoms of psychopathology when compared with their normally hearing peers, but children with hearing aids had significantly higher levels of psychopathological symptoms, while their hearing losses were approximately 43 dB lower than those of children with implants. Type of device was related with internalizing symptoms but not with externalizing symptoms. Furthermore, lower age and sufficient language and communication skills predicted less psychopathological symptoms. Conclusions: Children who are deaf or profoundly hearing impaired and have cochlear implants have lower levels of psychopathological symptoms than children with moderate or severe hearing loss who have hearing aids. Most likely, it is not the type of hearing device but rather the intensity of the rehabilitation program that can account for this difference. This outcome has major consequences for the next generation of children with hearing loss because children with profound hearing impairment still have the potential to have levels of psychopathology that are comparable to children who are normally hearing. [Child Symptom Inventory-4, Dutch]

 

15-40. Turpyn, C.C., Chaplin, T.M., Cook, E.C., & Martelli, A.M. (2015). A person-centered approach to adolescent emotion regulation: Associations with psychopathology and parenting. Journal of Experimental Child Psychology, 136, 1-16.

 

Adolescence is a unique period of heightened emotional arousal and still-developing regulatory abilities. Adolescent emotion regulation patterns may be critically involved in adolescents' psychosocial development, but patterns of emotion regulation in youths are not well understood. The current study used latent profile analysis (LPA) to elucidate patterns of emotion expression, experience, and emotion-related physiological arousal in adolescents. A sample of 198 adolescents and their primary caregivers participated in an emotionally arousing parent-adolescent conflict interaction. Adolescents' observed emotion expressions, emotion experiences, and heart rate (HR) and caregiver parenting behaviors were assessed during and/or after the interaction. Parents reported on adolescents' internalizing and externalizing symptoms, and youths reported on depressive symptoms. The LPA revealed four emotion regulation profiles: a moderate HR and high expression profile, a suppression profile (with low negative emotion expression and high emotion experience), a low reactive profile, and a high reactive profile. The moderate HR and high expression profile was associated with lower conduct disorder symptoms, the suppression profile was related to lower anxiety symptoms, and the high reactive profile was associated with higher adolescent depressive symptoms. The high reactive profile and moderate HR and high expression profile were associated with more negative/critical parenting behaviors. Findings suggest that profiles of adolescent emotion regulation can be empirically identified and may be significant risk factors for psychopathology. [Early Childhood Inventory-4]

 

15-41. van der Molen, E., Blokland, A.A.J., Hipwell, A.E., Vermeiren, R.R.J.M., Doreleijers, T.A.H., & Loeber, R. (2015). Girls' childhood trajectories of disruptive behavior predict adjustment problems in early adolescence. Journal of Child Psychology and Psychiatry, 56, 766-773.

 

Background: It is widely recognized that early onset of disruptive behavior is linked to a variety of detrimental outcomes in males, later in life. In contrast, little is known about the association between girls' childhood trajectories of disruptive behavior and adjustment problems in early adolescence.  Methods: This study used nine waves of data from the ongoing Pittsburgh Girls Study. A semiparametric group-based model was used to identify trajectories of disruptive behavior in 1,513 girls from age 6 to 12years. Adjustment problems were characterized by depression, self-harm, Post Traumatic Stress Disorder (PTSD), substance use, interpersonal aggression, sexual behavior, affiliation with delinquent peers, and academic achievement at ages 13 and 14. Results: Three trajectories of childhood disruptive behavior were identified: low, medium, and high. Girls in the high group were at increased risk for depression, self-harm, PTSD, illegal substance use, interpersonal aggression, early and risky sexual behavior, and lower academic achievement. The likelihood of multiple adjustment problems increased with trajectories reflecting higher levels of disruptive behavior. Conclusion: Girls following the high childhood trajectory of disruptive behavior require early intervention programs to prevent multiple, adverse outcomes in adolescence and further escalation in adulthood. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4]

 

15-42. Ventola, P., Yang, D.Y.J., Friedman, H.E., Oosting, D., Wolf, J., Sukhodolsky, D.G., & Pelphrey, K.A. (2015).  Heterogeneity of neural mechanisms of response to pivotal response treatment. Brain Imaging and Behavior, 9, 74-88.

 

We investigated the mechanisms by which Pivotal Response Treatment (PRT) improves social communication in a case series of 10 preschool-aged children with Autism Spectrum Disorder (ASD). Functional magnetic resonance imaging (fMRI) identified brain responses during a biological motion perception task conducted prior to and following 16 weeks of PRT treatment. Overall, the neural systems supporting social perception in these 10 children were malleable through implementation of PRT; following treatment, neural responses were more similar to those of typically developing children (TD). However, at baseline, half of the children exhibited hypoactivation, relative to a group of TD children, in the right posterior superior temporal sulcus (pSTS), and half exhibited hyperactivation in this region. Strikingly, the groups exhibited differential neural responses to treatment: The five children who exhibited hypoactivation at baseline evidenced increased activation in components of the reward system including the ventral striatum and putamen. The five children who exhibited hyperactivation at baseline evidenced decreased activation in subcortical regions critical for regulating the flow of stimulation and conveying signals of salience to the cortex-the thalamus, amygdala, and hippocampus. Our results support further investigation into the differential effects of particular treatment strategies relative to specific neural targets. Identification of treatment strategies that address the patterns of neural vulnerability unique to each patient is consistent with the priority of creating individually tailored interventions customized to the behavioral and neural characteristics of a given person. [Child Symptom Inventory-4]

 

15-43. Wakschlag, L.S., Estabrook, R., Petitclerc, A., Henry, D., Burns, J.L., Perlman, S.B., Voss, J.L., Pine, D.S., Leibenluft, E., & Briggs-Gowan, M.L. (2015). Clinical implications of a dimensional approach: the normal: abnormal spectrum of early irritability. Journal of the American Academy of Child and Adolescent Psychiatry, 54(8), 626-634.

 

Objective: The importance of dimensional approaches is widely recognized, but an empirical base for clinical application is lacking. This is particularly true for irritability, a dimensional phenotype that cuts across many areas of psychopathology and manifests early in life. We examine longitudinal, dimensional patterns of irritability and their clinical import in early childhood. Method: Irritability was assessed longitudinally over an average of 16 months in a clinically enriched, diverse community sample of preschoolers (N = 497; mean = 4.2 years; SD = 0.8). Using the Temper Loss scale of the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) as a developmentally sensitive indicator of early childhood irritability, we examined its convergent/divergent, clinical, and incremental predictive validity, and modeled its linear and nonlinear associations with clinical risk. Results: The Temper Loss scale demonstrated convergent and divergent validity to child and maternal factors. In multivariate analyses, Temper Loss predicted mood (separation anxiety disorder [SAD], generalized anxiety disorder [GAD], and depression/dysthymia), disruptive (oppositional defiant disorder [ODD], attention-deficit/hyperactivity disorder [ADHD], and conduct disorder [CD]) symptoms. Preschoolers with even mildly elevated Temper Loss scale scores showed substantially increased risk of symptoms and disorders. For ODD, GAD, SAD, and depression, increases in Temper Loss scale scores at the higher end of the dimension had a greater impact on symptoms relative to increases at the lower end. Temper Loss scale scores also showed incremental validity over DSM-IV disorders in predicting subsequent impairment. Finally, accounting for the substantial heterogeneity in longitudinal patterns of Temper Loss significantly improved prediction of mood and disruptive symptoms. Conclusion: Dimensional, longitudinal characterization of irritability informs clinical prediction. A vital next step will be empirically generating parameters for the incorporation of dimensional information into clinical decision-making with reasonable certainty. [Early Childhood Inventory-4]

 

15-44. White, S.W., Schry, A.R., Miyazaki, Y., Ollendick, T.H., & Scahill, L. (2015). Effects of verbal ability and severity of autism on anxiety in adolescents with ASD: one-year follow-up after cognitive behavioral therapy. Journal of Clinical Child and Adolescent Psychology, 44(5), 839-845.

 

There is evidence supporting the efficacy of cognitive-behavioral therapy for treatment of anxiety in youth with Autism Spectrum Disorders (ASD), but long-term course of anxiety after treatment and individual predictors of treatment response are unknown. To meet the demands for personalized mental health care, information on the fit between patient and treatment as well as treatment durability is needed. We evaluated change in anxiety symptoms during intervention and 1 year after completion of the treatment, and evaluated predictors of response using an advanced analytical design, with follow-up data from a randomized controlled trial of 22 adolescents (12-17 years) with ASD and 1 or more anxiety disorders. Reduction in anxiety was partially maintained during the year following treatment; greater ASD severity predicted better treatment response. Our finding that brief treatment is associated with sustained gains is promising, given the pervasive and chronic nature of ASD. Implications for the treatment of anxiety in higher functioning adolescents with ASD are considered. (CASI-Anx)

 

15-45. Yerys, B.E., Antezana, L., Weinblatt, R., Jankowski, K.F., Strang, J., Vaidya, C.J., Schultz, R.T., Gaillard, W.D., & Kenworthy, L. (2015). Neural correlates of set-shifting in children with autism. Autism Research, 8(4), 386-397.

 

Autism spectrum disorder (ASD) is often associated with high levels of inflexible thinking and rigid behavior. The neural correlates of these behaviors have been investigated in adults and older adolescents, but not children. Prior studies utilized set-shifting tasks that engaged multiple levels of shifting, and depended on learning abstract rules and establishing a strong prepotent bias. These additional demands complicate simple interpretations of the results. We used functional magnetic resonance imaging (fMRI) to investigate the neural correlates of set-shifting in 20 children (ages 7-14) with ASD and 19 typically developing, matched, control children. Participants completed a set-shifting task that minimized nonshifting task demands through the use of concrete instructions that provide spatial mapping of stimuli-responses. The shift/stay sets were given an equal number of trials to limit the prepotent bias. Both groups showed an equivalent switch cost, responding less accurately and slower to Switch stimuli than Stay stimuli, although the ASD group was less accurate overall. Both groups showed activation in prefrontal, striatal, parietal, and cerebellum regions known to govern effective set-shifts. Compared to controls, children with ASD demonstrated decreased activation of the right middle temporal gyrus across all trials, but increased activation in the mid-dorsal cingulate cortex/superior frontal gyrus, left middle frontal, and right inferior frontal gyri during the Switch vs. Stay contrast. The successful behavioral switching performance of children with ASD comes at the cost of requiring greater engagement of frontal regions, suggesting less efficiency at this lowest level of shifting. [Child and Adolescent Symptom Inventory-4]

 

 

YEAR: 2014

 

14-1. Anagnostou, E., Soorya, L., Brian, J., Dupuis, A., Mankad, D., Smile, S., & Jacob, S. (2014). Intranasal oxytocin in the treatment of autism spectrum disorders: A review of literature and early safety and efficacy data in youth. Brain Research, 1580, 188-198.

 

Background: There is a paucity of treatments targeting core symptom domains in Autism Spectrum Disorder (ASD). Several animal models and research in typically developing volunteers suggests that manipulation of the oxytocin system may have therapeutic potential for the treatment of social deficits. We review the literature for oxytocin and ASD and report on early dosing, safety and efficacy data of multi-dose oxytocin on aspects of social cognition/function, as well as repetitive behaviors and co-occurring anxiety within ASD. Methods: Fifteen children and adolescents with verbal IQs >= 70 were diagnosed with ASD using the ADOS and the ADI-R. They participated in a modified maximum tolerated dose study of intranasal oxytocin (Syntocinon). Data were modeled using repeated measures regression analysis controlling for week, dose, age, and sex. Results: Among 4 doses tested, the highest dose evaluated, 0.4 IU/kg/dose, was found to be well tolerated. No serious or severe adverse events were reported and adverse events reported/observed were mild to moderate. Over 12 weeks of treatment, several measures of social cognition/function, repetitive behaviors and anxiety showed sensitivity to change with some measures suggesting maintenance of effect 3 months past discontinuation of intranasal oxytocip. Conclusions: This pilot study suggests that daily administration of intranasal oxytocin at 0.4 IU/kg/dose in children and adolescents with ASD is safe and has therapeutic potential. Larger studies are warranted. [Child and Adolescent Symptom Inventory-4R; Anxiety Subscales]

 

14-2. AparicioLlopis, E., Canals, J., & Arija, V. (2014). Dietary intake according to the course of symptoms of eating disorders in a schoolbased followup study of adolescents. European Eating Disorders Review, 22(6), 412-422.

 

Children with conduct problems and co-occurring callous-unemotional (CU) traits show more severe, stable, and aggressive antisocial behaviors than those without CU traits. Exposure to negative life events has been identified as an important contributing factor to the expression of CU traits across time, although the directionality of this effect has remained unknown due to a lack of longitudinal study. The present longitudinal study examined potential bidirectional effects of CU traits leading to experiencing more negative life events and negative life events leading to increases in CU traits across 3 years among a sample of community-based school-aged (M = 10.9, SD = 1.71 years) boys and girls (N = 98). Repeated rating measures of CU traits, negative life events and conduct problems completed by children and parents during annual assessments were moderately to highly stable across time. Cross-lagged models supported a reciprocal relationship of moderate magnitude between child-reported CU traits and "controllable" negative life events. Parent-reported CU traits predicted "uncontrollable" life events at the earlier time point and controllable life events at the later time point, but no reciprocal effect was evident. These findings have important implications for understanding developmental processes that contribute to the stability of CU traits in youth. [Child Symptom Inventory-4, Spanish]

 

14-3. Arnold, L. E., Ganocy, S. J., Mount, K., Youngstrom, E. A., Frazier, T., Fristad, M., ... & Marsh, L. (2014). Three-year latent class trajectories of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in a clinical sample not selected for ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 53(7), 745-760.

 

Objective: This study aims to examine trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in the Longitudinal Assessment of Manic Symptoms (LAMS) sample. Method: The LAMS study assessed 684 children aged 6 to 12 years with the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and rating scales semi-annually for 3 years. Although they were selected for elevated manic symptoms, 526 children had baseline ADHD diagnoses. With growth mixture modeling (GMM), we separately analyzed inattentive and hyperactive/impulsive symptoms, covarying baseline age. Multiple standard methods determined optimal fit. The chi(2) and Kruskal Wallis analysis of variance compared resulting latent classes/trajectories on clinical characteristics and medication. Results: Three latent class trajectories best described inattentive symptoms, and 4 classes best described hyperactive/impulsive symptoms. Inattentive trajectories maintained their relative position over time. Hyperactive/impulsive symptoms had 2 consistent trajectories (least and most severe). A third trajectory (4.5%) started mild, then escalated; and a fourth (14%) started severe but improved dramatically. The improving trajectory was associated with the highest rate of ADHD and lowest rate of bipolar diagnoses. Three-fourths of the mildest inattention class were also in the mildest hyperactive/impulsive class; 72% of the severest inattentive class were in the severest hyperactive/impulsive class, but the severest inattention class also included 62% of the improving hyperactive-impulsive class. Conclusion: An ADHD rather than bipolar diagnosis prognosticates a better course of hyperactive/impulsive, but not inattentive, symptoms. High overlap of relative severity between inattention and hyperactivity/impulsivity confirms the link between these symptom clusters. Hyperactive/impulsive symptoms wane more over time. Group means are insufficient to understand individual ADHD prognosis. A small subgroup deteriorates over time in hyperactivity/impulsivity and needs better treatments than currently provided. [Child and Adolescent Symptom Inventory-4R]

 

14-4. Bitsika, V., & Sharpley, C. F. (2014). Which psychological resilience attributes are associated with lower aspects of anxiety in boys with an autism spectrum disorder? Implications for guidance and counselling interventions. British Journal of Guidance & Counselling, 42(5), 544-556.

 

The effect of psychological resilience as a buffer against anxiety was investigated in a sample of 39 boys with high-functioning autism spectrum disorder (ASD) via individual online questionnaire responses to standardised inventories for assessing anxiety and psychological resilience. Ability to handle problems, make good decisions, think before acting and help others were the most powerful buffers against Generalised Anxiety Disorder, while thinking before acting significantly buffered social phobia. Believing that they were able to handle problems was significantly associated with less emotional anxiety about school, work or social activities, being irritable, unable to relax and fatigue. As well as describing the pathways between the components of psychological resilience and anxiety, these findings also suggest several specific directions for training programmes aimed at equipping boys with an ASD with skills to cope more effectively with anxiety. [Child and Adolescent Symptom Inventory-4R]

 

14-5. Bitsika, V., Sharpley, C. F., Sweeney, J. A., & McFarlane, J. R. (2014). HPA and SAM axis responses as correlates of self vs parental ratings of anxiety in boys with an autistic disorder. Physiology & Behavior, 127.

 

Anxiety and Autistic Disorder (AD) are both neurological conditions and both disorders share some features that make it difficult to precisely allocate specific symptoms to each disorder. HPA and SAM axis activities have been conclusively associated with anxiety, and may provide a method of validating anxiety rating scale assessments given by parents and their children with AD about those children. Data from HPA axis (salivary cortisol) and SAM axis (salivary alpha amylase) responses were collected from a sample of 32 high-functioning boys (M age = 11 yr) with an Autistic Disorder (AD) and were compared with the boys' and their mothers' ratings of the boys' anxiety. There was a significant difference between the self-ratings given by the boys and ratings given about them by their mothers. Further, only the boys' self-ratings of their anxiety significantly predicted the HPA axis responses and neither were significantly related to SAM axis responses. Some boys showed cortisol responses which were similar to that previously reported in children who had suffered chronic and severe anxiety arising from stressful social interactions. As well as suggesting that some boys with an AD can provide valid self-assessments of their anxiety, these data also point to the presence of very high levels of chronic HPA-axis arousal and consequent chronic anxiety in these boys. [Child and Adolescent Symptom Inventory-4R]

 

14-6. Burke, J. D., Boylan, K., Rowe, R., Duku, E., Stepp, S. D., Hipwell, A. E., & Waldman, I. D. (2014). Identifying the irritability dimension of ODD: Application of a modified bifactor model across five large community samples of children. Journal of Abnormal Psychology, 123(4), 841-851.

 

The importance of irritability, as measured among the symptoms of oppositional defiant disorder (ODD), has dramatically come to the fore in recent years. New diagnostic categories rely on the distinct clinical utility of irritability, and models of psychopathology suggest it plays a key role in explaining developmental pathways within and between disorders into adulthood. However, only a few studies have tested multidimensional models of ODD, and the results have been conflicting. Further, consensus has not been reached regarding which symptoms best identify irritability. The present analyses use 5 large community data sets with 5 different measures of parent-reported ODD, comprising 16,280 youth in total, to help resolve these questions. Across the samples, ages ranged from 5 to 18, and included both boys and girls. Confirmatory factor analyses demonstrated that a modified bifactor model showed the best fit in each data set. The structure of the model included 2 correlated specific factors (irritability and oppositional behavior) in addition to a general ODD factor. In 4 models, the best fit was obtained using the items "being touchy," "angry," and "often losing temper" as indicators of irritability. Given the structure of the models and the generally high correlation between the specific dimensions, the results suggest that irritability may not be sufficiently distinct from oppositional behavior to support an entirely independent diagnosis. Rather, irritability may be better understood as a dimension of psychopathology that can be distinguished within ODD, and which may be related to particular forms of psychopathology apart from ODD. [Child Symptom Inventory-4]

 

14-7. Casement, M. D., Guyer, A. E., Hipwell, A. E., McAloon, R. L., Hoffmann, A. M., Keenan, K. E., & Forbes, E. E. (2014). Girls’ challenging social experiences in early adolescence predict neural response to rewards and depressive symptoms. Developmental Cognitive Neuroscience, 8, 18-27.

 

Developmental models of psychopathology posit that exposure to social stressors may confer risk for depression in adolescent girls by disrupting neural reward circuitry. The current study tested this hypothesis by examining the relationship between early adolescent social stressors and later neural reward processing and depressive symptoms. Participants were 120 girls from an ongoing longitudinal study of precursors to depression across adolescent development. Low parental warmth, peer victimization, and depressive symptoms were assessed when the girls were 11 and 12 years old, and participants completed a monetary reward guessing fMRI task and assessment of depressive symptoms at age 16. Results indicate that low parental warmth was associated with increased response to potential rewards in the medial prefrontal cortex (mPFC), striatum, and amygdala, whereas peer victimization was associated with decreased response to potential rewards in the mPFC. Furthermore, concurrent depressive symptoms were associated with increased reward anticipation response in mPFC and striatal regions that were also associated with early adolescent psychosocial stressors, with mPFC and striatal response mediating the association between social stressors and depressive symptoms. These findings are consistent with developmental models that emphasize the adverse impact of early psychosocial stressors on neural reward processing and risk for depression in adolescence. [Adolescent Symptom Inventory-4]

 

14-8. Cecil, C. A., Viding, E., Barker, E. D., Guiney, J., & McCrory, E. J. (2014). Double disadvantage: The influence of childhood maltreatment and community violence exposure on adolescent mental health. Journal of Child Psychology and Psychiatry, 55(7), 839-848.

 

Background: Childhood maltreatment is a key risk factor for maladjustment and psychopathology. Although maltreated youth are more likely to experience community violence, both forms of adversity are generally examined separately. Consequently, little is known about the unique and interactive effects that characterize maltreatment and community violence exposure (CVE) on mental health. Methods: Latent Profile Analysis (LPA) was applied to data from a community sample of high-risk adolescents and young adults (n=204, M=18.85) to categorize groups of participants with similar patterns of childhood (i.e. past) maltreatment exposure. Associations between childhood maltreatment, CVE and mental health outcomes were then explored using multivariate regression and moderation analyses. Results: Latent Profile Analysis identified three groups of individuals with low, moderate and severe levels of childhood maltreatment. Maltreatment was associated with more internalizing, externalizing, and trauma-related symptoms. By contrast, CVE showed independent associations with only externalizing and trauma-related symptoms. Typically, childhood maltreatment and CVE exerted additive effects; however, these forms of adversity interacted to predict levels of anger. Conclusions: Exposure to maltreatment and community violence is associated with increased levels of clinical symptoms. However, while maltreatment is associated with increased symptoms across a broad range of mental health domains, the impact of community violence is more constrained, suggesting that these environmental risk factors differentially impact mental health functioning. [Childhood Symptom Inventory-4]

 

14-9. Chervin, R. D., Chung, S., O'Brien, L. M., Hoban, T. F., Garetz, S. L., Ruzicka, D. L., ... & Dillon, J. E. (2014). Periodic leg movements during sleep in children scheduled for adenotonsillectomy: Frequency, persistence, and impact. Sleep Medicine, 15(11), 1362-1369.

 

The importance of irritability, as measured among the symptoms of oppositional defiant disorder (ODD), has dramatically come to the fore in recent years. New diagnostic categories rely on the distinct clinical utility of irritability, and models of psychopathology suggest it plays a key role in explaining developmental pathways within and between disorders into adulthood. However, only a few studies have tested multidimensional models of ODD, and the results have been conflicting. Further, consensus has not been reached regarding which symptoms best identify irritability. The present analyses use 5 large community data sets with 5 different measures of parent-reported ODD, comprising 16,280 youth in total, to help resolve these questions. Across the samples, ages ranged from 5 to 18, and included both boys and girls. Confirmatory factor analyses demonstrated that a modified bifactor model showed the best fit in each data set. The structure of the model included 2 correlated specific factors (irritability and oppositional behavior) in addition to a general ODD factor. In 4 models, the best fit was obtained using the items "being touchy," "angry," and "often losing temper" as indicators of irritability. Given the structure of the models and the generally high correlation between the specific dimensions, the results suggest that irritability may not be sufficiently distinct from oppositional behavior to support an entirely independent diagnosis. Rather, irritability may be better understood as a dimension of psychopathology that can be distinguished within ODD, and which may be related to particular forms of psychopathology apart from ODD. [Child Symptom Inventory-4; Early Childhood Inventory-4]

 

14-10. Chervin, R. D., Garetz, S. L., Ruzicka, D. L., Hodges, E. K., Giordani, B. J., Dillon, J. E., ... & Burns, J. W. (2014). Do respiratory cycle-related EEG changes or arousals from sleep predict neurobehavioral deficits and response to adenotonsillectomy in children? Journal of Clinical Sleep Medicine, 10(8), 903-911.

 

Objectives: Pediatric obstructive sleep apnea (OSA) is associated with hyperactive behavior, cognitive deficits, psychiatric morbidity, and sleepiness, but objective polysomnographic measures of OSA presence or severity among children scheduled for adenotonsillectomy have not explained why. To assess whether sleep fragmentation might explain neurobehavioral outcomes, we prospectively assessed the predictive value of standard arousals and also respiratory cycle-related EEG changes (RCREC), thought to reflect inspiratory microarousals. Methods: Washtenaw County Adenotonsillectomy Cohort II participants included children (ages 3-12 years) scheduled for adenotonsillectomy, for any clinical indication. At enrollment and again 7.2 +/- 0.9 (SD) months later, children had polysomnography, a multiple sleep latency test, parent-completed behavioral rating scales, cognitive testing, and psychiatric evaluation. The RCREC were computed as previously described for delta, theta, alpha, sigma, and beta EEG frequency bands. Results: Participants included 133 children, 109 with OSA (apnea-hypopnea index [AHI] >= 1.5, mean 8.3 +/- 10.6) and 24 without OSA (AHI 0.9 +/- 0.3). At baseline, the arousal index and RCREC showed no consistent, significant associations with neurobehavioral morbidities, among all subjects or the 109 with OSA. At follow-up, the arousal index, RCREC, and neurobehavioral measures all tended to improve, but neither baseline measure of sleep fragmentation effectively predicted outcomes (all p > 0.05, with only scattered exceptions, among all subjects or those with OSA). Conclusion: Sleep fragmentation, as reflected by standard arousals or by RCREC, appears unlikely to explain neurobehavioral morbidity among children who undergo adenotonsillectomy. [Childhood Symptom Inventory-4]

 

14-11. Emeh, C. C., & Mikami, A. Y. (2014). The influence of parent behaviors on positive illusory bias in children with ADHD. Journal of attention disorders, 18(5), 456-465.

 

Objective: To explore the relationship between parental feedback and the accuracy of children's self-perceptions. Children with ADHD have been demonstrated to overestimate their own competence, a phenomenon known as positive illusory bias (PIB). Method: Participants were families of 56 children (41 male) ages 7 to 10, half of whom had clinical diagnoses of ADHD. PIB was assessed by comparing children's self-ratings of their competence relative to teachers' ratings. Laboratory interactions were observed where parental feedback to children was coded. Results: Parental warmth was associated with lower PIB about social competence in children with ADHD, but greater PIB in comparison children. Parent criticism was positively correlated with greater PIB about social competence in children with ADHD, but the relationship was nonsignificant for comparison children. Parent praise was associated with lower PIB about behavioral conduct in comparison children. Conclusion: Results support the self-protective hypothesis of PIB, and implications for interventions are discussed. [Childhood Symptom Inventory-4]

 

14-12. Gadow, K. D., Arnold, L. E., Molina, B. S., Findling, R. L., Bukstein, O. G., Brown, N. V., ... & Aman, M. G. (2014). Risperidone added to parent training and stimulant medication: effects on attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, and peer aggression. Journal of the American Academy of Child & Adolescent Psychiatry, 53(9), 948-959.

 

Objective: In this study, we aimed to expand on our prior research into the relative efficacy of combining parent training, stimulant medication, and placebo (Basic therapy) versus parent training, stimulant, and risperidone (Augmented therapy) by examining treatment effects for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and peer aggression, symptom-induced impairment, and informant discrepancy. Method: Children (6-12 years of age; N = 168) with severe physical aggression, ADHD, and co-occurring ODD/CD received an open trial of parent training and stimulant medication for 3 weeks. Participants failing to show optimal clinical response were randomly assigned to Basic or Augmented therapy for an additional 6 weeks. Results: Compared with Basic therapy, children receiving Augmented therapy experienced greater reduction in parent-rated ODD severity (p = .002, Cohen's d = 0.27) and peer aggression (p = .02, Cohen's d = 0.32) but not ADHD or CD symptoms. Fewer children receiving Augmented (16%) than Basic (40%) therapy were rated by their parents as impaired by ODD symptoms at week 9/endpoint (p = .008). Teacher ratings indicated greater reduction in ADHD severity (p = .02, Cohen's d = 0.61) with Augmented therapy, but not for ODD or CD symptoms or peer aggression. Although both interventions were associated with marked symptom reduction, a relatively large percentage of children were rated as impaired for at least 1 targeted disorder at week 9/endpoint by parents (Basic 47%; Augmented 27%) and teachers (Basic 48%; Augmented 38%). Conclusion: Augmented therapy was superior to Basic therapy in reducing severity of ADHD and ODD symptoms, peer aggression, and symptom-induced impairment, but clinical improvement was generally context specific, and effect sizes ranged from small to moderate. Clinical trial registration information Treatment of Severe Childhood Aggression (The TOSCA Study); http://clinicaltrails.gov/; NCT00796302. [Child and Adolescent Symptom Inventory 4R]

 

14-13. Gadow, K.D., Pinsonneault, J.K., Perlman, G., & Sadee, W. (2014). Association of dopamine gene variants, emotion dysregulation and ADHD in autism spectrum disorder. Research in Developmental Disabilities, 35, 1658-1665.

 

The aim of the present study was to evaluate the association of dopaminergic gene variants with emotion dysregulation (EMD) and attention-deficit/hyperactivity disorder (ADHD) symptoms in children with autism spectrum disorder (ASD). Three dopamine transporter gene (SLC6A3/DAT1)polymorphisms (intron8 5/6 VNTR, 3'-UTR 9/10 VNTR, rs27072 in the 3'-UTR) and one dopamine D2 receptor gene (DRD2) variant (rs2283265) were selected for genotyping based on a priori evidence of regulatory activity or, in the case of DAT1 9/10 VNTR, commonly reported associations with ADHD. A sample of 110 children with ASD Was assessed with a rigorously validated DSM-IV-referenced rating scale. Global EMD severity (parents' ratings) was associated with DAT1 intron8 (eta p(2)=.063) and rs2283265 (eta p(2)=.044). Findings for DAT1 intron8 were also significant for two EMD subscales, generalized anxiety (eta p(2)=.065) and depression (eta p(2)=.059), and for DRD2 rs2283265, depression (eta p(2)=.053). DRD2 rs2283265 was associated with teachers' global ratings of ADHD (eta p(2) =.052). DAT1 intron8 was associated with parent-rated hyperactivity (eta p(2) =.045) and both DAT1 9/10 VNTR (eta p(2)=.105) and DRD2 rs2283265 (eta p(2)=.069) were associated with teacher-rated inattention. These findings suggest that dopaminergic gene polymorphisms may modulate EMD and ADHD symptoms in children with ASD but require replication with larger independent samples. [Child Symptom Inventory-4]

 

14-14. Gadow, K. D., Smith, R. M., & Pinsonneault, J. K. (2014). Serotonin 2A Receptor Gene (HTR2A) Regulatory variants: possible association with severity of depression symptoms in children with autism spectrum disorder. Cognitive and Behavioral Neurology, 27(2), 107-116.

 

Objective and Background: Our aim was to characterize the association of 2 functional single nucleotide polymorphisms (rs6311 and rs6314) in the serotonin 2A receptor gene (HTR2A) with severity of depression symptoms in children with autism spectrum disorder. These polymorphisms have been shown to be associated with depression symptom severity and response to selective serotonin reuptake inhibitor drugs in adults with diagnosed depressive disorder. Methods: Parents of 104 children with autism spectrum disorder rated their children's depressive symptoms using a validated scale based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. We compared severity of depression symptoms across the rs6311 and rs6314 genotypes, measured from the children's genomic DNA. Results: Children homozygous for the G allele of rs6311 had significantly more severe depression symptoms than those with G/A or A/A genotypes (P=0.025). The effect size (partial eta-squared) was small (eta p(2)=0.047) but was somewhat larger when we controlled for severity of generalized anxiety disorder symptoms (P=0.006, eta p(2)=0.072). When we restricted our analyses to white participants, our results were essentially the same as for the entire sample (P=0.004, eta p(2)=0.086). There was no significant association between rs6314 (C/C versus T carriers) and severity of depression. Conclusions: Our findings suggest that the HTR2A functional rs6311 polymorphism, which other studies have associated with differential HTR2A mRNA expression, may modulate the severity of depression symptoms in children with autism spectrum disorder. These tentative, hypothesis-generating findings need replication with larger, independent samples. [Childhood Symptom Inventory-4]

 

14-15. Green, A.E., Kenworthy, L., Mosner, M.G., Gallagher, N.M., Fearon, E.W., & Balhana, C.D. et al. (2014). Abstract analogical reasoning in high-functioning children with autism spectrum disorders. Autism Research, 7, 677-686.

 

Children with autism spectrum disorders (ASD) exhibit a deficit in spontaneously recognizing abstract similarities that are crucial for generalizing learning to new situations. This may contribute to deficits in the development of appropriate schemas for navigating novel situations, including social interactions. Analogical reasoning is the central cognitive mechanism that enables typically developing children to understand abstract similarities between different situations. Intriguingly, studies of high-functioning children with ASD point to a relative cognitive strength in basic, nonabstract forms of analogical reasoning. If this analogical reasoning ability extends to abstract analogical reasoning (i.e., between superficially dissimilar situations), it may provide a bridge between a cognitive capability and core ASD deficits in areas such as generalization and categorization. This study tested whether preserved analogical reasoning abilities in ASD can be extended to abstract analogical reasoning, using photographs of real-world items and situations. Abstractness of the analogies was determined via a quantitative measure of semantic distance derived from latent semantic analysis. Children with ASD performed as well as typically developing children at identifying abstract analogical similarities when explicitly instructed to apply analogical reasoning. Individual differences in abstract analogical reasoning ability predicted individual differences in a measure of social function in the ASD group. Preliminary analyses indicated that children with ASD, but not typically developing children, showed an effect of age on abstract analogical reasoning. These results provide new evidence that children with ASD are capable of identifying abstract similarities through analogical reasoning, pointing to abstract analogical reasoning as a potential lever for improving generalization skills and social function in ASD. [Child and Adolescent Symptom Inventory-4R]

 

14-16. Haghighi, M., Khaterizadeh, M., Chalbianloo, G., Toobaei, S., & Ghanizadeh, A. (2014). Comparing the drawings of children with attention deficit hyperactivity disorder with normal children. Iranian Journal of Psychiatry, 9, 222-227.

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is the most common behavioral problem during childhood and in school-aged children. Various projection drawings have been designed for assessing children's personality and psychological disorders including the tests of draw a person (DAP) and draw a family (DAF). We aimed to compare the differences between typically developing children and children with ADHD using these tests. METHODS: In this case-control study, all the 9-10 year-old boy students studying at the third and fourth grades were enrolled from schools in the 2nd educational district of Shiraz, south of Iran. Eighty students were then selected and enrolled into the ADHD group and the control group. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition- text Revised (DSM-IV-TR), and the Child Symptoms Inventory-4 were used to diagnose the children with ADHD. We evaluated and analyzed impulsiveness, non-impulsiveness, emotional problems and incompatibility indices in the DAP and DAF tests in each group. RESULTS: A significant difference was found in the indices of incompatibility and emotional problems, impulsiveness, non-impulsiveness and DAF between typically developing children and those with ADHD. The mean (±SD) total scores of the above mentioned indices in the ADHD group were 19.79(±2.94), 12.31(±1.84), 5.26(±2.29) and 5.89(±2.13), respectively (P<0.001). The corresponding figures for these indices in the normal group were 12.11(±4.74), 5.63(±2), 10.36± (2.33) and 2.88(±2.13), respectively (P<0.001). CONCLUSION: Significant differences were obtained between the control group and children with ADHD using these two drawing tests. The rate of impulsivity and emotional problems indices in drawings of children with ADHD was markedly more common than those of the typically developing children. This suggests the need for further assessment to screen ADHD. [Child Symptoms Inventory-4, Farsi]

 

14-17. Hammond, R. K., & Hoffman, J. M. (2014). Adolescents with high-functioning autism: An investigation of comorbid anxiety and depression. Journal of Mental Health Research in Intellectual Disabilities, 7(3), 246-263.

 

Adolescents with high-functioning autism (HFA) possess core social and pragmatic deficits, which interfere with normal relationship development. At a time when friendships are increasingly important, many adolescents with HFA realize they are different from their peers. Initial research has indicated that adolescence is the time when symptoms of anxiety and depression are most likely to develop. The purpose of this study was to increase knowledge about anxiety and depression in HFA through focusing on the adolescent development period and obtaining assessment information from multiple sources. Results indicate that adolescents reported elevated levels of social anxiety, separation panic, and anhedonia compared with normative samples. Parents and teachers reported that adolescents experienced significant overall anxiety and depressive symptomatology compared with the normative samples. Manifestations of HFA were associated with higher levels of anxiety as reported by parents. Results bring into question the validity of self-report scales for adolescents with HFA in the ability to accurately self-report and in the measures' capacity to differentiate between internalizing symptoms and core HFA behaviors. [Adolescent Symptom Inventory-4; Youth’s Inventory-4]

 

14-18. Hipwell, A. E., Stepp, S. D., Xiong, S., Keenan, K., Blokland, A., & Loeber, R. (2014). Parental punishment and peer victimization as developmental precursors to physical dating violence involvement among girls. Journal of Research on Adolescence, 24(1), 65-79.

 

The current study examined harsh punishment and peer victimization as developmental precursors to girls' involvement in physical dating violence (PDV) and the putative mediating effect of rejection sensitivity. The sample comprised 475 African-American and European-American participants of the longitudinal Pittsburgh Girls Study who were dating at age 17. About 10% of girls reported significant perpetration or victimization of physical aggression in the relationship. Results showed that initial level and escalation in harsh punishment (between 10 and 13years) and escalation in peer victimization (10-15years) predicted PDV involvement, but this relationship was not mediated by rejection sensitivity. The results highlight the need to consider the impact of early experience of different forms of aggression on girls' risk of PDV involvement. [Child Symptom Inventory-4]

 

14-19. Hong, J., Novick, D., Treuer, T., Montgomery, W., Haynes, V. S., Wu, S., & Haro, J. M. (2014). Patient characteristics associated with treatment initiation among paediatric patients with Attention-Deficit/Hyperactivity Disorder symptoms in a naturalistic setting in Central Europe and East Asia. BMC Psychiatry, 14(1), 304.

 

Background: Cultural views of Attention Deficit/Hyperactivity Disorder (ADHD), differing healthcare systems and funding mechanisms, and the availability of mental health services can greatly influence the perceptions, diagnosis, and treatment of ADHD. There is, however, lack of information about treatment practice and the treatment decision-making process for ADHD, particularly in non-Western countries. Our study compared characteristics of paediatric patients newly diagnosed with ADHD symptoms who did and who did not initiate treatment, and also examined whether any differences varied by region in Central Europe and East Asia. Methods: Data were taken from a 1 year prospective, observational study that included 1,068 paediatric patients newly diagnosed with ADHD symptoms. Clinical severity was measured using the Clinical Global Impression-ADHD-Severity (CGI-ADHD-S) scale and the Child Symptom Inventory-4 (CSI-4) checklist. Logistic regression was used to explore patient characteristics associated with treatment initiation (pharmacotherapy and/or psychotherapy) at baseline for each region. Results: A total of 74.3% of patients initiated treatment at baseline (78.3% in Central Europe and 69.9% in East Asia). Of these, 48.8% started with both pharmacotherapy and psychotherapy in Central Europe, and only 17.1% did so in East Asia. The level of clinical severity was highest in the combination treatment group in Central Europe, but was highest in the psychotherapy only group in East Asia. In East Asia, treatment initiation was associated with being older, being male, and having a higher CGI-ADHD-S score. In Central Europe, treatment initiation was associated with parental psychological distress, having a higher CSI-4 score, and not being involved in bullying. Conclusions: Although factors associated with treatment initiation differed to some extent between Central Europe and East Asia, clinical severity appeared to be one of the most important determinants of treatment initiation in both regions. However, the choice between pharmacotherapy and psychotherapy, either alone or in combination, varied substantially across the regions. [Child Symptom Inventory-4, Czech, Hungarian, Romanian, Slovakian, Korean, Chinese, Mandarin, Turkish]

 

14-20. Hummer, T. A., Kronenberger, W. G., Wang, Y., Anderson, C. C., & Mathews, V. P. (2014). Association of television violence exposure with executive functioning and white matter volume in young adult males. Brain and cognition, 88, 26-34.

 

Prior research has indicated that self-reported violent media exposure is associated with poorer performance on some neuropsychological tests in adolescents. This study aimed to examine the relationship of executive functioning to violent television viewing in healthy young adult males and examine how brain structure is associated with media exposure measures. Sixty-five healthy adult males (ages 18-29) with minimal video game experience estimated their television viewing habits over the past year and, during the subsequent week, recorded television viewing time and characteristics in a daily media diary. Participants then completed a battery of neuropsychological laboratory tests quantifying executive functions and underwent a magnetic resonance imaging (MRI) scan. Aggregate measures of executive functioning were not associated with measures of overall television viewing (any content type) during the past week or year. However, the amount of television viewing of violent content only, as indicated by both past-year and daily diary measures, was associated with poorer scores on an aggregate score of inhibition, interference control and attention, with no relationship to a composite working memory score. In addition, violent television exposure, as measured with daily media diaries, was associated with reduced frontoparietal white matter volume. Future longitudinal work is necessary to resolve whether individuals with poor executive function and slower white matter growth are more drawn to violent programming, or if extensive media violence exposure modifies cognitive control mechanisms mediated primarily via prefrontal cortex. Impaired inhibitory mechanisms may be related to reported increases in aggression with higher media violence exposure. [Adult Self-Report Inventory-4]

 

 

14-21. Keenan, K., Culbert, K. M., Grimm, K. J., Hipwell, A. E., & Stepp, S. D. (2014). Timing and tempo: Exploring the complex association between pubertal development and depression in African American and European American girls. Journal of Abnormal Psychology, 123(4), 725-736.

 

The relative contribution of pubertal timing and tempo to the development of depression has not been tested in a large, representative sample, nor has the interface among pubertal maturation, depression, and race been tested. Participants were a community-based sample of 2,450 girls from the Pittsburgh Girls Study who were interviewed annually from ages 9 to 17 years. Pubertal timing and tempo were characterized as a unitary construct and also separately for pubic hair and breast development using child and maternal report. Depression symptoms were assessed annually. African American girls had higher depression symptoms and progressed through puberty earlier, but at a slower tempo than European American girls. Girls with earlier timing had higher levels of depression symptoms at age 10 years. Slower tempo was associated with higher depression symptoms at age 10, and faster tempo was associated with increases in depression from ages 10 to 13. As well, race moderated the associations among timing, tempo, and depression symptoms, and the association between race and depression was partially mediated by pubertal timing and tempo. Pubertal timing and tempo and race contribute to the developmental course of depression from early to late adolescence. The pattern of association varies as a function of the developmental window within which depression is assessed. Thus, repeated measures of depression symptoms and puberty across the span of pubertal development are necessary for exploring the relative importance of dimensions of pubertal development to depression etiology. [Child Symptom Inventory-4; Adolescent Symptom Inventory-4]

 

14-22. Kim, S., Kochanska, G., Boldt, L. J., Nordling, J. K., & O'Bleness, J. J. (2014). Developmental trajectory from early responses to transgressions to future antisocial behavior: Evidence for the role of the parent–child relationship from two longitudinal studies. Development and Psychopathology, 26(01), 93-109.

 

Parent-child relationships are critical in development, but much remains to be learned about the mechanisms of their impact. We examined the early parent-child relationship as a moderator of the developmental trajectory from children's affective and behavioral responses to transgressions to future antisocial, externalizing behavior problems in the Family Study (102 community mothers, fathers, and infants, followed through age 8) and the Play Study (186 low-income, diverse mothers and toddlers, followed for 10 months). The relationship quality was indexed by attachment security in the Family Study and maternal responsiveness in the Play Study. Responses to transgressions (tense discomfort and reparation) were observed in laboratory mishaps wherein children believed they had damaged a valued object. Antisocial outcomes were rated by parents. In both studies, early relationships moderated the future developmental trajectory: diminished tense discomfort predicted more antisocial outcomes, but only in insecure or unresponsive relationships. That risk was defused in secure or responsive relationships. Moderated mediation analyses in the Family Study indicated that the links between diminished tense discomfort and future antisocial behavior in insecure parent-child dyads were mediated by stronger discipline pressure from parents. By indirectly influencing future developmental sequelae, early relationships may increase or decrease the probability that the parent-child dyad will embark on a path toward antisocial outcomes. [Early Childhood Inventory-4; Child Symptom Inventory-4]

 

14-23. Kimonis, E. R., Centifanti, L. C., Allen, J. L., & Frick, P. J. (2014). Reciprocal influences between negative life events and callous-unemotional traits. Journal of Abnormal Child Psychology, 42(8), 1287-1298.

 

Children with conduct problems and co-occurring callous-unemotional (CU) traits show more severe, stable, and aggressive antisocial behaviors than those without CU traits. Exposure to negative life events has been identified as an important contributing factor to the expression of CU traits across time, although the directionality of this effect has remained unknown due to a lack of longitudinal study. The present longitudinal study examined potential bidirectional effects of CU traits leading to experiencing more negative life events and negative life events leading to increases in CU traits across 3 years among a sample of community-based school-aged (M = 10.9, SD = 1.71 years) boys and girls (N = 98). Repeated rating measures of CU traits, negative life events and conduct problems completed by children and parents during annual assessments were moderately to highly stable across time. Cross-lagged models supported a reciprocal relationship of moderate magnitude between child-reported CU traits and "controllable" negative life events. Parent-reported CU traits predicted "uncontrollable" life events at the earlier time point and controllable life events at the later time point, but no reciprocal effect was evident. These findings have important implications for understanding developmental processes that contribute to the stability of CU traits in youth. [Adolescent Symptom Inventory-4]

 

14-24. Kreiser, N. L., & White, S. W. (2014). Assessment of social anxiety in children and adolescents with autism spectrum disorder. Clinical Psychology: Science and Practice, 21(1), 18-31.

 

Despite the high prevalence of social anxiety in individuals with autism spectrum disorder (ASD), there is little agreement on how to best assess such problems in this population. To inform evidence-based assessment, we conducted a comprehensive review of research that has assessed social anxiety in children and adolescents with ASD without co-occurring intellectual disability. Although some evidence in support of the reliability of existing measures exists, there are concerns about inflated estimates of the co-occurrence of social anxiety because of symptom overlap with ASD diagnostic criteria, and the diagnostic sensitivity of existing measures is questionable. Recommendations for clinical assessment of social anxiety in this population and future directions for research on this topic, including the development of new measures, are provided. [Child Symptom Inventory-4; Adolescent Symptom Inventory-4]

 

14-25. Lau, W. Y. P., Gau, S. S. F., Chiu, Y. N., & Wu, Y. Y. (2014). Autistic traits in couple dyads as a predictor of anxiety spectrum symptoms. Journal of Autism and Developmental Disorders, 44(11), 2949-2963.

 

The link between parental autistic tendency and anxiety symptoms was studied in 491 Taiwanese couples raising biological children with autism spectrum disorders (ASDs). Parental autistic tendency as measured by Autism Spectrum Quotient (AQ) was associated with anxiety symptoms across all domains. Large effect sizes were found in social phobia and post traumatic stress disorders for both parents, and in general anxiety disorder and agoraphobia for mothers. These associations were irrespective of child's autistic tendency, spouse's AQ scores and the couples' compatibility in their autistic tendency. Perceived family support and parental education moderated the link but not child's autistic severity. Research and clinical implications regarding psychiatric vulnerability of parents of children with ASD were drawn and discussed. [Adult Self-Report Inventory-4, Chinese]

 

14-26. Lecavalier, L., Wood, J. J., Halladay, A. K., Jones, N. E., Aman, M. G., Cook, E. H., ... & Scahill, L. (2014). Measuring anxiety as a treatment endpoint in youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(5), 1128-1143.

 

Despite the high rate of anxiety in individuals with autism spectrum disorder (ASD), measuring anxiety in ASD is fraught with uncertainty. This is due, in part, to incomplete consensus on the manifestations of anxiety in this population. Autism Speaks assembled a panel of experts to conduct a systematic review of available measures for anxiety in youth with ASD. To complete the review, the panel held monthly conference calls and two face-to-face meetings over a fourteen-month period. Thirty eight published studies were reviewed and ten assessment measures were examined: four were deemed appropriate for use in clinical trials, although with conditions; three were judged to be potentially appropriate, while three were considered not useful for clinical trials assessing anxiety. Despite recent advances, additional relevant, reliable and valid outcome measures are needed to evaluate treatments for anxiety in ASD. [Child and Adolescent Symptom Inventory-4R; CASI Anxiety Scale]

 

14-27. López-Villalobos, J. A., Llano, A. D., María, J., Rodríguez-Molinero, L., Garrido-Redondo, M., Sacristán-Martín, A. M., ... & Sánchez-Azón, M. I. (2014). Prevalence of oppositional defiant disorder in Spain. Revista de Psiquiatría y Salud Mental (English Edition).

 

Introduction: Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. ODD is one of the most frequent reasons for clinical consultation on mental health during childhood and adolescence. ODD has a high morbidity and dysfunction, and has important implications for the future if not treated early. Objective: To determine the prevalence of ODD in schoolchildren aged 6-16 years in Castile and Leon (Spain). Material and methods: Population study with a stratified multistage sample, and a proportional cluster design. Sample analyzed: 1,049. Cases were defined according to DSM-IV criteria. Results: An overall prevalence rate of 5.6% was found (95% CI: 4.2%-7%). Male gender prevalence = 6.8%; female = 4.3%. Prevalence in secondary education = 6.2%; primary education = 5.3%. No significant differences by gender, age, grade, type of school, or demographic area were found. ODD prevalence without considering functional impairment, such as is performed in some research, would increase the prevalence to 7.4%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, maths and writing), and worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks, and disruption of the class). Conclusions: Castile and Leon has a prevalence rate of ODD slightly higher to that observed in international publications. Depending on the distribution by age, morbidity and clinical dysfunctional impact, an early diagnosis and a preventive intervention are required for health planning. [Child Symptom Inventory-4, Spanish]

 

14-28. Mattison, R. E., Rundberg-Rivera, V., & Michel, C. (2014). Psychotropic medication characteristics for special education students with emotional and/or behavioral disorders. Journal of Child and Adolescent Psychopharmacology, 24(6), 347-353. doi:10.1089/cap.2013.0073

 

Objective: Characteristics of psychotropic medication use have rarely been investigated for special education students with emotional and/or behavioral disorders. Methods: The prevalence of psychotropic medication use was obtained at the beginning of a school year for a cohort of 77 students attending a self-contained middle school for special education students with emotional and/or behavioral problems, in the suburban New York City area. Demographics, intelligence quotient (IQ) and achievement testing, and objective measures of both psychopathology and school functioning were gathered. Results: Overall, psychotropic medication was used in 77.9% of the participants; 52.0% received more than one medication. The most commonly prescribed medicines were atypical antipsychotics (49.4%) followed by attention-deficit/hyperactivity disorder (ADHD) medications (48.0%). Usage patterns for specific diagnostic presentations were examined, and appeared consistent with current clinical practice. Persistent elevated psychopathology appeared frequently in students on medication. Conclusions: Psychotropic medication use in this unique but important sample of special education students appeared generally consistent with recent psychotropic prevalence research. The need for collaboration between special education teachers and prescribing physicians, in order to achieve optimal medication adjustment for these students, was highlighted. [Adolescent Symptom Inventory-4]

 

14-29. Mazefsky, C. A., Borue, X., Day, T. N., & Minshew, N. J. (2014). Emotion regulation patterns in adolescents with highfunctioning autism spectrum disorder: comparison to typically developing adolescents and association with psychiatric symptoms. Autism Research, 7(3), 344-354.

 

Autism spectrum disorder (ASD) is often associated with poor emotional control and psychopathology, such as anxiety and depression; however, little is known about the underlying mechanisms. Emotion regulation (ER) is a potential contributing factor, but there has been limited research on ER and its role in comorbid psychopathology in ASD. In this study, we compared self-reported ER with self- and parent reports of psychopathology in 25 high-functioning adolescents with ASD and 23 age- and Intelligence Quotient (IQ)-matched typically developing controls. Contrary to expectations, both groups reported similar levels of adaptive, voluntary forms of ER (problem solving, acceptance, etc.). However, the ASD group reported significantly greater use of involuntary forms of ER that are typically maladaptive, including remaining focused on the stressor (e.g. rumination and emotional arousal) and shutting down (e.g. emotional numbing and being unable to think or act). Associations between ER and psychopathology were generally more robust using self-report rather than parent report. For both groups, greater endorsement of involuntary ER strategies was associated with higher ratings of psychopathology, whereas voluntary ER strategies focused on changing or adapting to the situation were significantly associated with lower levels of psychopathology. The magnitude and direction of association between ER types and psychopathology were similar for measures of depression and anxiety. These findings can help guide the development of psychosocial treatments targeting dysfunctional ER in adolescents with ASD. Interventions focused on ER as a transdiagnostic process may be a more robust method to improve emotional control and decrease emotional distress in ASD than disorder-specific interventions. [Adolescent Symptom Inventory-4]

 

14-30. McBurnett, K., Villodas, M., Burns, G. L., Hinshaw, S. P., Beaulieu, A., & Pfiffner, L. J. (2014). Structure and validity of sluggish cognitive tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 42(1), 37-48.

 

We evaluated the latent structure and validity of an expanded pool of Sluggish Cognitive Tempo (SCT) items. An experimental rating scale with 44 candidate SCT items was administered to parents and teachers of 165 children in grades 2-5 (ages 7-11) recruited for a randomized clinical trial of a psychosocial intervention for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type. Exploratory factor analyses (EFA) were used to extract items with high loadings (>0.59) on primary factors of SCT and low cross-loadings (0.30 or lower) on other SCT factors and on the Inattention factor of ADHD. Items were required to meet these criteria for both informants. This procedure reduced the pool to 15 items. Generally, items representing slowness and low initiative failed these criteria. SCT factors (termed Daydreaming, Working Memory Problems, and Sleepy/Tired) showed good convergent and discriminant validity in EFA and in a confirmatory model with ADHD factors. Simultaneous regressions of impairment and comorbidity on SCT and ADHD factors found that Daydreams was associated with global impairment, and Sleepy/Tired was associated with organizational problems and depression ratings, across both informants. For teachers, Daydreams also predicted ODD (inversely); Sleepy/Tired also predicted poor academic behavior, low social skills, and problem social behavior; and Working Memory Problems predicted organizational problems and anxiety. When depression, rather than ADHD, was included among the predictors, the only SCT-related associations rendered insignificant were the teacher-reported associations of Daydreams with ODD; Working Memory Problems with anxiety, and Sleepy/Tired with poor social skills. SCT appears to be meaningfully associated with impairment, even when controlling for depression. Common behaviors resembling Working Memory problems may represent a previously undescribed factor of SCT. [Child Symptom Inventory-4]

 

14-31. Morizot, J. (2014). Construct validity of adolescents’ self-reported big five personality traits: Importance of conceptual breadth and initial validation of a short measure. Assessment, 21(5), 580-606.

 

While there are a number of short personality trait measures that have been validated for use with adults, few are specifically validated for use with adolescents. To trust such measures, it must be demonstrated that they have adequate construct validity. According to the view of construct validity as a unifying form of validity requiring the integration of different complementary sources of information, this article reports the evaluation of content, factor, convergent, and criterion validities as well as reliability of adolescents' self-reported personality traits. Moreover, this study sought to address an inherent potential limitation of short personality trait measures, namely their limited conceptual breadth. In this study, starting with items from a known measure, after the language-level was adjusted for use with adolescents, items tapping fundamental primary traits were added to determine the impact of added conceptual breadth on the psychometric properties of the scales. The resulting new measure was named the Big Five Personality Trait Short Questionnaire (BFPTSQ). A group of expert judges considered the items to have adequate content validity. Using data from a community sample of early adolescents, the results confirmed the factor validity of the Big Five structure in adolescence as well as its measurement invariance across genders. More important, the added items did improve the convergent and criterion validities of the scales, but did not negatively affect their reliability. This study supports the construct validity of adolescents' self-reported personality traits and points to the importance of conceptual breadth in short personality measures. [Youth’s Inventory-4]

 

14-32. Olino, T. M., Dougherty, L. R., Bufferd, S. J., Carlson, G. A., & Klein, D. N. (2014). Testing models of psychopathology in preschool-aged children using a structured interview-based assessment. Journal of Abnormal Child Psychology, 42(7), 1201-1211.

 

A number of studies have found that broadband internalizing and externalizing factors provide a parsimonious framework for understanding the structure of psychopathology across childhood, adolescence, and adulthood. However, few of these studies have examined psychopathology in young children, and several recent studies have found support for alternative models, including a bi-factor model with common and specific factors. The present study used parents' (typically mothers') reports on a diagnostic interview in a community sample of 3-year old children (n = 541; 53.9 % male) to compare the internalizing-externalizing latent factor model with a bi-factor model. The bi-factor model provided a better fit to the data. To test the concurrent validity of this solution, we examined associations between this model and paternal reports and laboratory observations of child temperament. The internalizing factor was associated with low levels of surgency and high levels of fear; the externalizing factor was associated with high levels of surgency and disinhibition and low levels of effortful control; and the common factor was associated with high levels of surgency and negative affect and low levels of effortful control. These results suggest that psychopathology in preschool-aged children may be explained by a single, common factor influencing nearly all disorders and unique internalizing and externalizing factors. These findings indicate that shared variance across internalizing and externalizing domains is substantial and are consistent with recent suggestions that emotion regulation difficulties may be a common vulnerability for a wide array of psychopathology. [Child Symptom Inventory-4; Early Childhood Inventory-4]

 

14-33. Olino, T. M., Stepp, S. D., Keenan, K., Loeber, R., & Hipwell, A. (2014). Trajectories of depression and anxiety symptoms in adolescent girls: A comparison of parallel trajectory approaches. Journal of Personality Assessment, 96(3), 316-326.

 

Longitudinal mixture models have become popular in the literature. However, modest attention has been paid to whether these models provide a better fit to the data than growth models. Here, we compared longitudinal mixture models to growth models in the context of changes in depression and anxiety symptoms in a community sample of girls from age 10 to 17. Model comparisons found that the preferred solution was a 5-class parallel process growth mixture model that differed in the course of depression and anxiety symptoms reflecting both ordering of symptoms and qualitative group differences. Comparisons between classes revealed substantive differences on a number of outcomes using this solution. Findings are discussed in the context of clinical assessment and implementation of growth mixture models. [Adolescent Symptom Inventory-4]

 

14-34. Pfiffner, L. J., Hinshaw, S. P., Owens, E., Zalecki, C., Kaiser, N. M., Villodas, M., & McBurnett, K. (2014). A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Journal of Consulting and Clinical Psychology, 82(6), 1115-1127.

 

Objective: This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with attention-deficit/hyperactivity disorder-inattentive type (ADHD-I). Method: In a 2-site randomized controlled trial, 199 children (ages 7-11 years) were randomized to CLAS (N = 74), parent-focused treatment (PFT, N = 74), or treatment as usual (TAU, N = 51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at posttreatment and also at follow-up during the subsequent school year. Results: CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at posttreatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at posttreatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. Conclusions: These findings extend support for CLAS across 2 study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I. [Child Symptom Inventory-4; ADHD Symptom Checklist-4]

 

14-35. Scahill, L., Dimitropoulos, A., McDougle, C. J., Aman, M. G., Feurer, I. D., McCracken, J. T., ... & Vitiello, B. (2014). Children's Yale–Brown Obsessive Compulsive Scale in autism spectrum disorder: component structure and correlates of symptom checklist. Journal of the American Academy of Child & Adolescent Psychiatry, 53(1), 97-107.

 

Objective: Repetitive behaviors in autism spectrum disorders (ASD) range from motor stereotypy to immersion in restricted interests. The modified Children's Yale Brown Obsessive Compulsive Scale for children with autism spectrum disorder (CYBOCS-ASD) includes a Symptom Checklist (behavior present or absent) and 5 severity scales (Time Spent, Interference, Distress, Resistance and Control). Method: We assembled CYBOCS-ASD data from 3 Research Units on Pediatric Psychopharmacology Autism Network trials to explore the component structure of repetitive behaviors in children with ASD. Raters trained to reliability conducted the CYBOCS-ASD in 272 medication-free subjects. Fifteen Symptom Checklist items were endorsed for less than 5% of the sample and were dropped. Principal component analysis was used to explore the clustering of 23 checklist items. Component scores computed for each subject were correlated with other measures. We also examined the distribution of severity scales. Results: The subjects (229 boys and 43 girls; mean age = 7.8 +/- 2.6 years) met criteria for an ASD; half were intellectually disabled. The PCA resulted in a 5-component solution to classify repetitive behaviors (34.4% of the variance): hoarding and ritualistic behavior; sensory and arranging behavior; sameness and self-injurious behavior; stereotypy; restricted interests. Sensory and arranging and stereotypy components were associated with lower adaptive functioning (Pearson r = 0.2-0.3; p < .003). The resistance scale showed little variation, with more than 60% of the sample with the highest score. Conclusions: Rarely endorsed items can be dropped from the Checklist. The resistance item does not appear to be relevant for children with ASD. [Child and Adolescent Symptom Inventory-4]

 

14-36. Schreiber, J. M., Lanham, D. C., Trescher, W. H., Sparks, S. E., Wassif, C. A., Caffo, B. S., ... & Ewen, J. B. (2014). Variations in EEG discharges predict ADHD severity within individual Smith-Lemli-Opitz patients. Neurology, 83(2), 151-159.

 

Objective: We sought to examine the prevalence of EEG abnormalities in Smith-Lemli-Opitz syndrome (SLOS) as well as the relationship between interictal epileptiform discharges (IEDs) and within-subject variations in attentional symptom severity. Methods: In the context of a clinical trial for SLOS, we performed cross-sectional and repeated-measure observational studies of the relationship between EEG findings and cognitive/behavioral factors on 23 children (aged 4-17 years). EEGs were reviewed for clinical abnormalities, including IEDs, by readers blinded to participants' behavioral symptoms. Between-group differences in baseline characteristics of participants with and without IEDs were analyzed. Within-subject analyses examined the association between the presence of IEDs and changes in attention-deficit/hyperactivity disorder (ADHD) symptoms. Results: Of 85 EEGs, 43 (51%) were abnormal, predominantly because of IEDs. Only one subject had documented clinical seizures. IEDs clustered in 13 subjects (57%), whereas 9 subjects (39%) had EEGs consistently free of IEDs. While there were no significant group differences in sex, age, intellectual disability, language level, or baseline ADHD symptoms, autistic symptoms tended to be more prevalent in the "IED" group (according to Autism Diagnostic Observation Schedule-2 criteria). Within individuals, the presence of IEDs on a particular EEG predicted, on average, a 27% increase in ADHD symptom severity. Conclusions: Epileptiform discharges are common in SLOS, despite a relatively low prevalence of epilepsy. Fluctuations in the presence of epileptiform discharges within individual children with a developmental disability syndrome may be associated with fluctuations in ADHD symptomatology, even in the absence of clinical seizures. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4]

 

14-37. Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R., & Hipwell, A. E. (2014). Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Development and Psychopathology, 26(02), 361-378.

 

Theories of borderline personality disorder (BPD) postulate that high-risk transactions between caregiver and child are important for the development and maintenance of the disorder. Little empirical evidence exists regarding the reciprocal effects of parenting on the development of BPD symptoms in adolescence. The impact of child and caregiver characteristics on this reciprocal relationship is also unknown. Thus, the current study examines bidirectional effects of parenting, specifically harsh punishment practices and caregiver low warmth, and BPD symptoms in girls aged 14-17 years based on annual, longitudinal data from the Pittsburgh Girls Study (N = 2,451) in the context of child and caregiver characteristics. We examined these associations through the use of autoregressive latent trajectory models to differentiate time-specific variations in BPD symptoms and parenting from the stable processes that steadily influence repeated measures within an individual. The developmental trajectories of BPD symptoms and parenting were moderately associated, suggesting a reciprocal relationship. There was some support for time-specific elevations in BPD symptoms predicting subsequent increases in harsh punishment and caregiver low warmth. There was little support for increases in harsh punishment and caregiver low warmth predicting subsequent elevations in BPD symptoms. Child impulsivity and negative affectivity, and caregiver psychopathology were related to parenting trajectories, while only child characteristics predicted BPD trajectories. The results highlight the stability of the reciprocal associations between parenting and BPD trajectories in adolescent girls and add to our understanding of the longitudinal course of BPD in youth. [Adolescent Symptom Inventory-4]

 

14-38. Taylor, Z. E., Eisenberg, N., VanSchyndel, S. K., Eggum-Wilkens, N. D., & Spinrad, T. L. (2014). Children’s negative emotions and ego-resiliency: Longitudinal relations with social competence. Emotion, 14(2), 397.

 

We examined the relations of negative emotions in toddlerhood to the development of ego-resiliency and social competence across early childhood. Specifically, we addressed whether fear and anger/frustration in 30-month-old children (N = 213) was associated with the development of ego-resiliency across 4 time points (42 to 84 months), and, in turn, whether ego-resiliency predicted social competence at 84 months. Child anger/frustration negatively predicted the intercept of ego-resiliency at 42 months (controlling for prior ego-resiliency at 18 months) as well as the slope. Fear did not significantly predict either the intercept or slope of ego-resiliency in the structural model, although it was positively correlated with anger/frustration and was negatively related to ego-resiliency in zero-order correlations. The slope of ego-resiliency was positively related to children's social competence at 84 months; however, the intercept of ego-resiliency (set at 42 months) was not a significant predictor of later social competence. Furthermore, the slope of ego-resiliency mediated the relations between anger/frustration and children's later social competence. The results suggest that individual differences in anger/frustration might contribute to the development of ego-resiliency, which, in turn, is associated with children's social competence. [Child Symptom Inventory-4]

 

14-39. Theunissen, S. C., Rieffe, C., Kouwenberg, M., De Raeve, L. J., Soede, W., Briaire, J. J., & Frijns, J. H. (2014). Behavioral problems in school-aged hearing-impaired children: the influence of sociodemographic, linguistic, and medical factors. European Child & Adolescent Psychiatry, 23(4), 187-196.

 

The purpose of this study was to examine several behavioral problems in school-aged hearing-impaired children with hearing aids or cochlear implants, compared to normally hearing children. Additionally, we wanted to investigate which sociodemographic, linguistic, and medical factors contributed to the level of behavioral problems, to pinpoint where targeted interventions can take place. This large, retrospective study included a sample of 261 school-aged children (mean age = 11.8 years, SD = 1.6), that consisted of three age- and gender-matched subgroups: 75 with hearing aids, 57 with cochlear implants, and 129 normally hearing controls. Self- and parent-reports concerning reactive and proactive aggression, delinquency, and symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were used. In addition, several language and intelligence tests were administered. Hearing-impaired children showed significantly more proactive aggression, symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder than their normally hearing peers. More behavioral problems were associated with special schools for the deaf, sign (-supported) language, hearing aids (in contrast to cochlear implants), higher age, male gender, lower socioeconomic status, lower intelligence, and delayed language development. Hearing-impaired children face multiple problems regarding their behavior. The outcomes implicate that professionals should be aware of the higher risk of developing behavioral problems, in order to screen, detect, and treat in time. Furthermore, the associated risk and protective factors emphasize that clinicians must always consider the heterogeneity of the group of hearing-impaired children, in order to help and support the individual patient. [Childhood and Adolescent Symptom Inventory-4, Dutch]

 

14-40. Tolou-Shams, M., Rizzo, C. J., Conrad, S. M., Johnson, S., Oliveira, C., & Brown, L. K. (2014). Predictors of detention among juveniles referred for a court clinic forensic evaluation. Journal of the American Academy of Psychiatry and the Law Online, 42(1), 56-65.

 

Juvenile offenders have disproportionately high rates of psychiatric and substance use disorders relative to their nonoffending counterparts. Less is known about the impact of psychiatric and substance use disorders on repeat juvenile justice involvement among juveniles specifically referred for forensic mental health evaluations. We describe the demographic, psychiatric, and legal history background of 404 juveniles who underwent a court clinic forensic mental health evaluation, and we examine the association between these factors and detention rates of 20 percent over a 12-month postevaluation period. After accounting for known predictors of reoffending, such as prior offense history and externalizing disorders, dual diagnosis (i.e., co-occurring psychiatric and substance use disorders) remained a salient predictor of future detention. Consistent with prior literature on juvenile offending, substance use may greatly enhance the likelihood of subsequent detention. [Adolescent Symptom Inventory-4; Youth’s Inventory-4]

 

14-41. Tseng, M. C. M., Gau, S. S. F., Tseng, W. L., Hwu, H. G., & Lee, M. B. (2014). Co‐occurring eating and psychiatric symptoms in Taiwanese college students: Effects of gender and parental factors. Journal of Clinical Psychology, 70(3), 224-237.

 

Objective: To test whether gender and parental factors moderate the relationships between symptoms of eating disorder (ED) and other psychiatric symptoms. Methods: A total of 5,015 new entrants completed several questionnaires and 541individuals with ED symptoms were identified by the Adult Self-Report Inventory-4 that assessed a wide range of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition psychopathology. The participants also reported on their parents’ attitude toward them before their ages of 16. Results: ED symptoms, female gender, less parental care, and more parental protection were associated with more severe co-occurring psychiatric symptoms. Gender and parental factors also demonstrated differential moderating effects on the relationships between ED and co-occurring psychiatric symptoms. Conclusions: Parenting counseling may be individualized to young adults with ED symptoms and different co-occurring psychiatric symptoms. [Adult Self-Report Inventory-4, Chinese]

 

14-42. Tseng, M. C. M., Gau, S. S. F., Tseng, W. L., Hwu, H. G., & Lee, M. B. (2014). Cooccurring eating and psychiatric symptoms in Taiwanese college students: Effects of gender and parental factors. Journal of Clinical Psychology, 70(3), 224-237.

 

With the publication of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, autism spectrum disorders are defined by two symptom clusters (social communication and restricted/repetitive behaviors) instead of the current three clusters. The current study examined the structure of the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). First, an exploratory factor analysis was replicated whose results were largely comparable to the previous findings. Then, confirmatory factor analyses compared a two and three factor structure for the BISCUIT. Measures of model fit supported both the two and three factor models relatively well. When directly compared, the three factor model was found to be preferred over the two factor model. Implications are discussed. [Adult Self Report Inventory-4, Chinese]

 

14-43. Vander Wyk, B. C., Hoffman, F., & Pelphrey, K. A. (2014). Equivalent neural responses in children and adolescents with and without autism during judgments of affect. Developmental Cognitive Neuroscience, 8, 121-130.

 

Previous research has noted disrupted patterns of neural activation during emotion, processing in individuals with autism spectrum disorders (ASD). However, prior research relied on, designs that may place greater cognitive load on individuals with ASD. In order to address this issue, we adapted the fMRI task of Ochsner et al. (2004a) for children by, presenting fewer stimuli, with fewer valence levels, and longer stimuli duration. A localizer sample of, typically developing children (n = 26) was used to construct regions of interest involved in emotional, processing. Activations in these regions during self- and other-referential emotion processing was, compared in age, IQ, gender matched groups (n = 17 ASD, n = 16 TD). Matched samples replicate, condition contrasts of the localizer, but no group differences were found in behavior measures or, neural activation. An exploratory functional connectivity analysis in a subset of the matched groups, also did not detect striking differences between the groups. These findings suggest that disruptions in activation in emotion processing neural networks in ASD is partially a function of task related cognitive load. [Adolescent Symptom Inventory-4]

 

14-44. Villodas, M. T., McBurnett, K., Kaiser, N., Rooney, M., & Pfiffner, L. J. (2014). Additive effects of parent adherence on social and behavioral outcomes of a collaborative school–home behavioral intervention for ADHD. Child Psychiatry & Human Development, 45(3), 348-360.

 

The present study evaluated the impact of the Collaborative Life Skills Program (CLS), a novel school-home psychosocial intervention, on social and behavioral impairments among children with attention and behavior problems. Fifty-seven ethnically/racially diverse children (70 % boys) with attention and/or behavior problems in the second through fifth grades participated in a pilot study. Ten school-based mental health professionals were trained and then implemented the intervention at their respective schools. Children significantly improved from pre- to post-treatment on parent, teacher, and report card ratings of children's social and behavioral functioning. Treatment improvements were consistent for children with and without co-occurring disruptive behavior problems. The impact of the intervention was enhanced when parents used the intervention strategies more regularly, according to both clinicians' and parents' reports. Findings support the emphasis of CLS on coordinating intervention strategies across contexts to facilitate the generalization of treatment-related improvements in social and behavioral functioning. [Child Symptom Inventory-4; ADHD Symptom Checklist-4]

 

14-45. Wheeler, A., Raspa, M., Bann, C., Bishop, E., Hessl, D., Sacco, P., & Bailey, D. B. (2014). Anxiety, attention problems, hyperactivity, and the Aberrant Behavior Checklist in fragile X syndrome. American Journal of Medical Genetics Part A, 164(1), 141-155.

 

Behavior problems are a common challenge for individuals with fragile X syndrome (FXS) and constitute the primary clinical outcome domain in trials testing new FXS medications. However, little is known about the relationship between caregiver-reported behavior problems and co-occurring conditions such as anxiety and attention problems. In this study, 350 caregivers, each with at least one son or daughter with full-mutation FXS, rated one of their children with FXS using the Aberrant Behavior ChecklistCommunity Version (ABC-C); the Anxiety subscale of the Anxiety, Depression, and Mood Scale; and the Attention/Hyperactivity Items from the Symptom Inventories. In addition to examining family consequences of these behaviors, this study also sought to replicate psychometric findings for the ABC-C in FXS, to provide greater confidence for its use in clinical trials with this population. Psychometric properties and baseline ratings of problem behavior were consistent with other recent studies, further establishing the profile of problem behavior in FXS. Cross-sectional analyses suggest that selected dimensions of problem behavior, anxiety, and hyperactivity are age related; thus, age should serve as an important control in any studies of problem behavior in FXS. Measures of anxiety, attention, and hyperactivity were highly associated with behavior problems, suggesting that these factors at least coincide with problem behavior. However, these problems generally did not add substantially to variance in caregiver burden predicted by elevated behavior problems. The results provide further evidence of the incidence of problem behaviors and co-occurring conditions in FXS and the impact of these behaviors on the family. [Childhood & Adolescent Symptom Inventory-4R; Adult Symptom Inventory-4]

 

14-46. White, S. W., Smith, L. A., & Schry, A. R. (2014). Assessment of global functioning in adolescents with autism spectrum disorders: Utility of the Developmental Disability–Child Global Assessment Scale. Autism, 18(4), 362-369.

 

Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment Scale in a sample of higher functioning adolescents with autism spectrum disorders and comorbid anxiety disorders enrolled in a randomized controlled trial (n = 30). Pretreatment Developmental Disability-Child Global Assessment Scale scores correlated with severity of autism spectrum disorders core symptoms (r = -.388, p = .034), pragmatic communication (r = .407, p = .032), and verbal ability (r = .449, p = .013) and did not correlate with severity of anxiety symptoms or with parent-reported adaptive behavior. Change in Developmental Disability-Child Global Assessment Scale scores during treatment was associated with autism spectrum disorders symptomatic improvement (r = .414, p = .040) and with improved general communication (r = .499, p = .013). Results support the importance of assessing global functioning in addition to symptom change and treatment response in clinical trials. [Adolescent Symptom Inventory-4]

 

14-47. Yoosefi Looyeh, M., Kamali, K., Ghasemi, A., & Tonawanik, P. (2014). Treating social phobia in children through group narrative therapy. The Arts in Psychotherapy, 41(1), 16-20.

 

This study explored the effectiveness of group narrative therapy in treating the symptoms of social phobia among boys. Twenty-four boys, aged 10-11 with a confirmed diagnosis of social phobia were randomly assigned to receive treatment (N= 12) or placed on a waiting list (N= 12) considered as a control group. The treatment group received fourteen 90-min sessions of narrative therapy twice a week. Results showed significant differences in the symptom scores for the intervention and waiting list groups. Assessment by parents and teachers showed that the group narrative therapy had a significant effect on reducing symptoms of social phobia among participants in the treatment group both at home and school settings one week after completion of treatment and sustained after thirty days. [Adolescent Symptom Inventory-4; Child Symptom Inventory-4]

 

 

YEAR: 2013

 

13-1. Arnold, L. E., Mount, K., Frazier, T., Demeter, C., Youngstrom, E. A., Fristad, M. A.,... & Axelson, D. (2012). Pediatric bipolar disorder and ADHD: Family history comparison in the LAMS clinical sample. Journal of Affective Disorders, 141(2), 382-389.

 

Background: Transgenerational association of bipolar spectrum disorder (BPSD) and attention deficit/hyperactivity disorder (ADHD) has been reported, but inconclusively. Method: Children ages 6-12 were systematically recruited at first outpatient visit at 9 clinics at four universities and reliably diagnosed; 621 had elevated symptoms of mania (>12 on the Parent General Behavior Inventory 10-Item Mania Scale); 86 had scores below 12. We analyzed baseline data to test a familial association hypothesis: compared to children with neither BPSD nor ADHD, those with either BPSD or ADHD would have parents with higher rates of both bipolar and ADHD symptoms, and parents of comorbid children would have even higher rates of both. Results: Of 707 children, 421 had ADHD without BPSD, 45 BPSD without ADHD, 117 comorbid ADHD+BPSD, and 124 neither. The rate of parental manic symptoms was similar for the comorbid and BPSD-alone groups, significantly greater than for ADHD alone and "neither" groups, which had similar rates. ADHD symptoms in parents of children with BPSD alone were significantly less frequent than in parents of children with ADHD (alone or comorbid), and no greater than for children with neither diagnosis. Family history of manic symptoms, but not ADHD symptoms, was associated with parent-rated child manic-symptom severity over and above child diagnosis. Limitations: The sample was not epidemiologic, parent symptoms were based on family history questions, and alpha was 0.05 despite multiple tests. Conclusions: These results do not support familial linkage of BPSD and ADHD; they are compatible with heritability of each disorder separately with coincidental overlap. [Child Symptom Inventory-4]

 

13-2. Beauchaine, T. P., Gatzke-Kopp, L., Neuhaus, E., Chipman, J., Reid, M. J., & Webster-Stratton, C. (2013). Sympathetic-and parasympathetic-linked cardiac function and prediction of externalizing behavior, emotion regulation, and prosocial behavior among preschoolers treated for ADHD. Journal of Consulting and Clinical Psychology, 81(3), 481.

 

Objective: To evaluate measures of cardiac activity and reactivity as prospective biomarkers of treatment response to an empirically supported behavioral intervention for attention-deficit/hyperactivity disorder (ADHD). Method: Cardiac preejection period (PEP), an index of sympathetic-linked cardiac activity, and respiratory sinus arrhythmia (RSA), an index of parasympathetic-linked cardiac activity, were assessed among 99 preschool children (ages 4-6 years) with ADHD both at rest and in response to behavioral challenge, before participants and their parents completed 1 of 2 versions of the Incredible Years parent and child interventions. Results: Main effects of PEP activity and reactivity and of RSA activity and reactivity were found. Although samplewide improvements in behavior were observed at posttreatment, those who exhibited lengthened cardiac PEP at rest and reduced PEP reactivity to incentives scored higher on measures of conduct problems and aggression both before and after treatment. In contrast, children who exhibited lower baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Finally, children who exhibited greater RSA withdrawal scored lower on emotion regulation before and after treatment. Conclusions: We discuss these findings in terms of (a) individual differences in underlying neurobiological systems subserving appetitive (i.e., approach) motivation, emotion regulation, and social affiliation and (b) the need to develop more intensive interventions targeting neurobiologically vulnerable children. [Child Symptom Inventory-4]

 

13-3. Becker, S. P., McBurnett, K., Hinshaw, S. P., & Pfiffner, L. J. (2013). Negative social preference in relation to internalizing symptoms among children with ADHD predominantly inattentive type: Girls fare worse than boys. Journal of Clinical Child & Adolescent Psychology, 42(6), 784-795.

 

Despite distinct peer difficulties, less is known about the peer functioning of children with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I) in comparison to the peer functioning of children with ADHD combined type. Our purpose was to examine whether child sex moderated the relations between negative social preference and internalizing/externalizing problems in children with ADHD-I. Participants included 188 children diagnosed with ADHD-I (110 boys; ages 7-11; 54% Caucasian). Teacher ratings of the proportion of classmates who like/accept and dislike/reject the participating child were used to calculate negative social preference scores. Children, parents, and teachers provided ratings of anxious and depressive symptoms, and parents and teachers provided ratings of externalizing problems. Boys and girls did not differ on teachers' negative social preference scores. As hypothesized, however, the relation between negative social preference and internalizing symptoms was moderated by sex such that negative social preference was consistently and more strongly associated with internalizing symptoms among girls than in boys. In terms of externalizing problems, negative social preference was associated with teacher (but not parent) ratings, yet no moderation by child sex was found. Negative social preference is associated with teacher-report of externalizing problems for both boys and girls with ADHD-I, whereas negative social preference is consistently associated with girls' internalizing symptoms across child, parent, and teacher ratings. Implications for future research and interventions are discussed. [Child Symptom Inventory-4]

 

13-4. Belleau, E. L., Phillips, M. L., Birmaher, B., Axelson, D. A., & Ladouceur, C. D. (2013). Aberrant executive attention in unaffected youth at familial risk for mood disorders. Journal of Affective Disorders, 147(1), 397-400.

 

Background: Aberrant attentional processes in individuals with mood disorders - bipolar disorder (BD) and major depressive disorder (MDD) - have been well documented. This study examined whether unaffected youth at familial risk for mood disorders would exhibit poor alerting, orienting, and executive attention relative to age-matched controls. Methods: A sample of youth (8-17 years old) having one parent with either BD or MDD (Mood-Risk, n=29) and youth having healthy parents (HC, n=27) completed the Attention Network Test-Short version (ANT-S), which assesses alerting, orienting, and executive attention. Results: Relative to HCs, the Mood-Risk group had significantly slower reaction times on an index of executive attention, but no differences on indices of alerting or orienting. There were no differences between the two at-risk groups (i.e., youth with BD parent vs. youth with MDD parent) on any ANT-S measure. Limitations: The current study is limited by its cross-sectional design, small sample size, and failure to control for familial environmental factors. Conclusions: The findings extend previous results indicating that altered executive attention may represent an endophenotype for mood disorders in at-risk youth. [Adolescent Symptom Inventory-4]

 

13-5. Bergeron, L., Berthiaume, C., St-Georges, M., Piche, G., & Smolla, N. (2013). Reliability, validity, and clinical se of the Dominic Interactive: A DSM-based, self-report screen for school-aged children. Canadian Journal of Psychiatry, 58(8), 466-475.

 

Objectives: As no single informant can be considered the gold standard of child psychopathology, interviewing of children regarding their own symptoms is necessary. Our study focused on the reliability, validity, and clinical use of the Dominic Interactive (DI), a multimedia self-report screen to assess symptoms for the most frequent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, mental disorders in school-aged children. Methods: A sample of 585 children aged 6 to 11 years from the community and psychiatric clinics was used to analyze the internal consistency, the test-retest estimate of reliability, and the criterion-related validity of the DI against the referral status. In addition, cross-informant correlation coefficients between this instrument (child report) and the Child Symptom Inventory (parent report) were explored in a subsample of 292 participants. Results: For the total sample, Cronbach alpha coefficients ranged from 0.63 to 0.91. Test-retest kappas varied from 0.42 to 0.62 for categories based on cut-off points, except for specific phobias. Intraclass correlation coefficients ranged from 0.70 to 0.81 for symptom scales. The DI discriminated between referred and nonreferred children in psychiatric clinics for all symptom scales. Significant cross-informant correlation coefficients were higher for the externalizing symptoms (0.35 to 0.48) than the internalizing symptoms (0.14 to 0.27). Conclusions: Findings of our study reasonably support adequate psychometric properties of the DI. This instrument offers a developmentally sensitive screening method to obtain unique information from young children about their mental health problems in front-line services, psychiatric clinics, and research settings. [Child Symptom Inventory-4]

 

13-6. Bunte, T. L., Laschen, S., Schoemaker, K., Hessen, D. J., van der Heijden, P. G., & Matthys, W. (2013). Clinical usefulness of observational assessment in the diagnosis of DBD and ADHD in preschoolers. Journal of Clinical Child & Adolescent Psychology, 42(6), 749-761.

 

The aim of the present study was to investigate the clinical usefulness of an observational toolthe Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) in the diagnosis of disruptive behavior disorders (DBD) and attention deficit/hyperactivity disorder (ADHD) in preschoolers. We hypothesized that the DB-DOS may help support the presumption of a diagnosis generated by the information from parents and teachers (or other caregivers). Participants were referred preschool children with externalizing behavioral problems (N=193; 83% male) and typically developing children (N=58; 71% male). In view of the clinical validity study each child was given a diagnosis of either DBD (N=40), or ADHD (N=54) or comorbid (DBD+ADHD; N=66) based on best-estimate diagnosis. The DB-DOS demonstrated good interrater and test-retest reliability for DBD and ADHD symptom scores. Confirmatory factor analysis demonstrated an excellent fit of the DB-DOS multidomain model of DBD symptom scores and a satisfactory fit of ADHD symptom scores. The DB-DOS demonstrated good convergent validity, moderate divergent validity, and good clinical validity on a diagnostic group level for DBD and ADHD symptom scores. The Receiver Operating Characteristic curve analyses revealed that for DBD the sensitivity and specificity are moderate and for ADHD good to excellent. The presumption of a diagnosis based on information from parents, teachers, and cognitive assessment was supported by the DB-DOS in 60% for DBD and 75% for ADHD. The DB-DOS can be used to help support a presumption of a DBD and/or ADHD diagnosis in preschool children. [Early Childhood Inventory-4]

 

13-7. Bunte, T. L., Schoemaker, K., Hessen, D. J., van der Heijden, P. G., & Matthys, W. (2013). Clinical usefulness of the kiddie-disruptive behavior disorder schedule in the diagnosis of DBD and ADHD in preschool children. Journal of Abnormal Child Psychology, 41(5), 681-690.

 

The aim of the present study was to investigate the clinical usefulness of a semi-structured diagnostic parent interview, i.e., the Kiddie-Disruptive Behavior Disorder Schedule (K-DBDS), in preschool children. For Oppositional Defiant Disorder (ODD), to define symptoms two coding methods were compared, i.e., one based on the threshold "often" and the other based on the frequency of behaviors in combination with the presence of clinical concern. For Attention-Deficit/Hyperactivity Disorder (ADHD), to define symptoms, two coding methods were compared, i.e., one with and one without consideration of pervasiveness across contexts. Participants were referred preschool children with externalizing behavioral problems (N = 193; 83% male) and typically developing (TD) children (N = 58; 71% male). The referred children were given a diagnosis of either ODD/CD (N = 39), or ADHD (N = 58) or comorbid ODD/CD+ADHD (N = 57) or no diagnosis (N = 39) based on best-estimate diagnosis. Receiver Operating Characteristic curve analyses showed that a cutoff score of four ODD symptoms using "often" as the threshold for frequency of behaviors led to a sensitivity of 87% and a specificity of 93%; the coding method which included the frequency of behaviors yielded a sensitivity of 56% and a specificity of 100%. For ADHD, a clinical cutoff score of five symptoms without the pervasiveness criterion yielded a sensitivity of 83% and a specificity of 98%; when the pervasiveness criterion was included sensitivity was 77% and specificity 98%. In the clinical assessment of ODD and ADHD in preschool children, the K-DBDS may be used with ODD symptom definition based on the threshold "often" and ADHD pervasiveness across contexts not included. [Early Childhood Inventory-4]

 

13-8. Chung, T., Kim, K. H., Hipwell, A. E., & Stepp, S. D. (2013). White and black adolescent females differ in profiles and longitudinal patterns of alcohol, cigarette, and marijuana use. Psychology of Addictive Behaviors, 27(4), 1110.

 

Emerging research suggests that white youth are more likely to show continuity of alcohol use in the year after drinking onset, compared with black youth. Little is known, however, regarding racial differences in year-to-year continuity of alcohol, cigarette, and marijuana use during adolescence, particularly among females, who are at greater risk for certain substance-related harm than males. This study used latent class/transition analysis to identify profiles of past year alcohol, cigarette, and marijuana use at ages 13-17 in a community sample of 1076 adolescent females (57% black, 43% white). Three profiles of past year substance use were identified in separate analyses by race: "no use," "alcohol only," and "polydrug use." Although similar labels describe the profiles, the probability of endorsing use of a particular substance for a given profile differed by race, precluding direct comparison. Latent transition analyses of five annual waves covering ages 13-17 indicated that an intermittent pattern of use (e. g., use in one year, but not the next) was relatively low at all ages among white girls, but among black girls, an intermittent pattern of use began to decline at age 15. Among black girls, conduct problems at age 12 predicted substance using profiles at age 13, whereas among white girls, intentions to use alcohol and cigarettes at age 12 predicted substance using profiles at age 13. Racial differences in girls' substance use profiles suggest the potential utility of culturally tailored interventions that focus on differences in risk for specific substances and relatively distinct early patterns of use. [Child Symptom Inventory-4]

 

13-9. Conner, C. M., Maddox, B. B., & White, S. W. (2013). Parents’ state and trait anxiety: Relationships with anxiety severity and treatment response in adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(8), 1811-1818.

 

Comorbid anxiety is common among children with Autism Spectrum Disorder (ASD), and parents of children with ASD are more likely to have anxiety disorders. This study investigated the relationship between parents' state and trait anxiety and parent-reported internalizing and externalizing symptoms among adolescents (n = 30) with ASD, as well as the relationship of parents' anxiety symptoms and adolescent treatment response in the context of a randomized controlled trial. Parental state anxiety correlated with severity of adolescent anxiety, and trait anxiety in parents correlated with parent-reported adolescent internalizing and externalizing symptoms. Also, parents of adolescent treatment responders experienced a decrease in their own trait anxiety. Findings highlight the importance of considering parental anxiety when targeting anxiety among youth with ASD. [Adolescent Symptom Inventory-4]

 

13-10. Dougherty, L. R., Smith, V. C., Bufferd, S. J., Stringaris, A., Leibenluft, E., Carlson, G. A., & Klein, D. N. (2013). Preschool irritability: Longitudinal associations with psychiatric disorders at age 6 and parental psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry, 52(12), 1304-1313.

 

Objective: There is increasing scientific and clinical attention to chronic irritability in youth. However, little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of chronic irritability with psychiatric disorders and parental psychopathology in a large community sample of preschoolers. Method: Four hundred sixty-two preschool-age children were assessed at 3 and 6 years of age. Child psychopathology was assessed at baseline (3 years) and follow-up (6 years) using a diagnostic interview, the Preschool Age Psychiatric Assessment, with parents. Items from the Preschool Age Psychiatric Assessment were used to create a dimensional measurement of chronic irritability. Parental psychopathology was assessed with a diagnostic interview at baseline. Results: Chronic irritability was concurrently associated with a wide range of psychiatric disorders and functional impairment at 3 and 6 years of age. Irritability at 3 years predicted depression, oppositional defiant disorder, and functional impairment at 6 years after controlling for baseline disorders. Irritability also was associated with parental depression and anxiety. Conclusions: Findings underscore the central role of irritability in early-emerging mental health problems. They are consistent with longitudinal studies in older youth indicating that chronic irritability predicts later depression and anxiety and support the importance of early detection and interventions targeting preschool irritability. [Early Childhood Inventory-4]

 

13-11. Fanti, K. A. (2013). Individual, social, and behavioral factors associated with co-occurring conduct problems and callous-unemotional traits. Journal of Abnormal Child Psychology, 41(5), 811-824.

 

Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N = 1,674; 50.1 % girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7 %), average risk (33.8 %), co-occurring high CP-high CU (5.4 %), high CP-low CU (5.2 %), and low CP-high CU (6.9 %). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age = 12.12) and middle (Mean age = 14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support. [Adolescent Symptom Inventory-4]

 

13-12. Fanti, K. A., Demetriou, C. A., & Kimonis, E. R. (2013). Variants of callous-unemotional conduct problems in a community sample of adolescents. Journal of Youth and Adolescence, 42(7), 964-979.

 

Callous-unemotional traits are believed to be a childhood precursor to psychopathy, and among youth with conduct problems they designate those showing a particularly severe, stable, and aggressive pattern of antisocial behavior. Youth with callous-unemotional traits are a heterogeneous population and, analogous to adults with psychopathy, research suggests that lower anxious primary and high-anxious secondary variants exist. Using a community sample of 2,306 Greek-Cypriot adolescents (M age = 16 years; 49.7 % female), the first aim of the study was to examine whether variants of callous-unemotional traits could be identified using latent profile analysis of scores on measures of callous-unemotional traits, conduct problems, and anxiety. Additional aims of the study were to compare the identified clusters on external measures theorized to distinguish them (i.e., self-esteem, narcissism, impulsivity, sensation seeking and proactive/reactive aggression) and social factors relevant to adolescent development. Results indicated that, in addition to low risk (i.e., low scores on callous-unemotional traits, conduct problems, and anxiety) and anxious (i.e., high scores on anxiety, low scores on callous-unemotional traits and conduct problems) subgroups, two groups of youth scoring high on callous-unemotional traits and conduct problems were identified. High-anxious secondary callous-unemotional variants were distinguished by lower self-esteem in combination with greater narcissism, aggression, and markedly higher conduct problems, whereas lower anxious primary variants showed higher self-esteem. Secondary callous-unemotional variants also reported greater susceptibility to peer pressure and popularity striving than primary variants. Both variants exhibited poorer outcomes relative to low risk and anxious youth, although anxious youth reported lower self-esteem and higher impulsivity and reactive aggression scores in comparison with low risk youth. Findings integrate two lines of inquiry focused on subtyping children and adults with psychopathic traits and antisocial behaviors. They also support the utility of subtyping callous-unemotional traits based on conduct problems and anxiety levels and provide information on common and distinct risk factors associated with primary and secondary callous-unemotional variants in a community sample of adolescent boys and girls. [Youth’s Inventory-4]

 

13-13. Gadow, K.D. (2013). Association of schizophrenia spectrum and autism spectrum disorder (ASD) symptoms in children with ASD and clinic controls. Research in Developmental Disabilities, 34, 1289-1299.

 

Objective: This study examines relations between the severity of specific symptoms of schizophrenia spectrum disorder (SSD) and severity of the three defining symptom domains of autism spectrum disorder (ASD) in children with ASD (N=147) and child psychiatry outpatient referrals (Controls; N=339). Method: Participants were subdivided into four groups depending on ASD status (±) and whether they met symptom criteria for attention-deficit/hyperactivity disorder (±ADHD). Their mothers and teachers evaluated them with a DSM-IV-referenced rating scale. Results: Correlations between schizoid personality symptoms and ASD social skills deficits were moderate to large, and this was true for children with ASD and Controls, regardless of ADHD status, and for mother’s and teachers’ ratings. Conversely, severity of hallucinations, delusions, and disorganized thinking were minimally correlated with ASD severity with the exception of Controls with ADHD. The disorganized behavior and negative symptoms of schizophrenia evidenced the strongest pattern of associations with ASD symptoms, and this was particularly true for children with co-morbid ADHD (±ASD, all three ASD symptom dimensions), and for teachers’ ratings of all four groups. Nevertheless, there was considerable variability in relations for specific symptoms across informants and groups. Correlations between SSD symptom severity and IQ were generally low, particularly among the ASD Only group and for all teacher-rated symptoms. Conclusion: Associations between ASD and SSD symptoms were often dimension-specific, and this was particularly evident in children without ADHD (±ASD; mothers’ ratings). Findings were interpreted as supporting the deconstruction of complex clinical phenotypes as a means of better understanding interrelations among psychiatric syndromes. [Child and Adolescent Symptom Inventory-4R]

 

13-14. Gadow, K.D., DeVincent, C.J., Siegal, V.I., Olvet, D.M., Kibria, S., Kirsch, S.F., & Hatchwell, E. (2013). Allele-specific associations of 5-HTTLPR/rs25531 with ADHD and autism spectrum disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 40, 292-297.

 

Background: The aims of the present study were to examine the association between a common serotonin transporter gene (SLC6A4) polymorphism 5-HTTLPR/rs25531 with severity of attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) symptoms. Methods: Mothers and teachers completed a validated DSM-IV-referenced rating scale for ADHD and ASD symptoms in 118 children with ASD.  Results: Analyses indicated that children with at least one copy of the S or LG allele obtained significantly more severe maternal ratings of hyperactivity (p=0.001; hp2=0.097) and impulsivity (p=0.027; hp2=0.044) but not inattention (p=0.061; hp2=0.032), controlling for ASD severity, than children homozygous for the LA allele. Conversely, mothers’ ratings indicated that children with LA/LA genotype had more severe ASD social deficits than S+ or LG allele carriers (p=0.003; hp2=0.081), controlling for ADHD symptom severity. Teachers’ ratings though consistent with mothers’ ratings of hyperactivity and social deficits were marginally significant (p=0.07/p=0.09). There was some evidence that the magnitude of parent-teacher agreement regarding symptom severity varied as a function of the child’s genotype.  Conclusion: The 5-HTTLPR/rs25531 polymorphism or its correlates may modulate severity of ADHD and ASD symptoms in children with ASD, but in different ways. These tentative, hypothesis-generating findings require replication with larger independent samples. [Child Symptom Inventory-4]

 

13-15. Gadow, K.D., Kaat, A.J., & Lecavalier, L. (2013). Relation of symptom-induced impairment with other illness parameters in clinic-referred youth. Journal of Child Psychology and Psychiatry, 54, 1198-1207.

 

Objective: To examine the relation of caregiver ratings of psychiatric symptom-induced impairment with number and severity of symptoms and informant agreement in consecutive child psychiatry outpatient referrals. Methods: Parents and teachers completed a broadband DSM-IV-referenced rating scale with disorder-specific impairment for 636 youth (6-18 years). Illness parameters included impairment, number and severity of symptoms, and their combination (symptom+impairment) as well as categorical (cutoff) and dimensional scoring. Results: Agreement between impairment and other illness parameters showed considerable variation as a function of type of parameter, disorder, and informant but to lesser extent age and gender. Many youth who met impairment cutoff for specific disorders did not meet symptom cutoff. Conversely, most youth who met symptom cutoff were impaired. Symptom cutoff evidenced greater convergence with impairment cutoff than combined symptom+impairment cutoffs.  Severity of impairment was moderately to highly correlated with number and severity of symptoms. Parents’ and teachers’ ratings indicated little disorder-specific agreement about youth who met impairment cutoff, symptom cutoff, or combined symptom+impairment cutoff. Therefore, sole reliance on one informant greatly underestimates the pervasiveness of impairment. Conclusion. Findings are consistent with the notion that each illness parameter represents a unique conceptual construct, which has important clinical and research implications. [Child and Adolescent Symptom Inventory-4R]

 

13-16. Hallett, V., Lecavalier, L., Sukhodolsky, D.G., Cipriano, N., Aman, M.G., McCracken, J.T., McDougle, C.J., Tierney, E., King, B.H., Hollander, E., Sikich, L., Bregman, J., Anagnostou, E., Donnelly, C., Katsovich, L., Dukes, K., Vitiello, B., Gadow, K., & Scahill, L. (2013). Exploring the manifestations of anxiety in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 2341-2352.

 

This study explores the manifestation and measurement of anxiety symptoms in 415 children with ASDs on a 20-item, parent-rated, DSM-IV referenced anxiety scale. In both high and low-functioning children (IQ above vs. below 70), commonly endorsed items assessed restlessness, tension and sleep difficulties. Items requiring verbal expression of worry by the child were rarely endorsed. Higher anxiety was associated with functional language, IQ above 70 and higher scores on several other behavioral measures. Four underlying factors emerged: Generalized Anxiety, Separation Anxiety, Social Anxiety and Over-arousal. Our findings extend our understanding of anxiety across IQ in ASD and provide guidance for improving anxiety outcome measurement. [CASI-4 ASD Anxiety Scale (CASI-Anx)]

 

13-17. Hong, J., Novick, D., Treuer, T., Montgomery, W., Haynes, V. S., Wu, S., & Haro, J. M. (2013). Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia. Patient Preference and Adherence, 7, 987.

 

Purpose: To assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia. Patients and methods: Data for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE. Results: Of the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE. Conclusion: Non-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question. [Child Symptom Inventory-4[, Czech, Hungarian, Romanian, Slovakian, Korean, Chinese, Mandarin, Turkish]

 

13-18. Hopkins, J., Lavigne, J. V., Gouze, K. R., LeBailly, S. A., & Bryant, F. B. (2013). Multi-domain models of risk factors for depression and anxiety symptoms in preschoolers: Evidence for common and specific factors. Journal of Abnormal Child Psychology, 41(5), 705-722.

 

Relatively few studies have examined multiple pathways by which risk factors from different domains are related to symptoms of anxiety and depression in young children; even fewer have assessed risks for these symptoms specifically, rather than for internalizing symptoms in general. We examined a theoretically- and empirically-based model of variables associated with these symptom types in a diverse community sample of 796 4-year-olds (391 boys, 405 girls) that included factors from the following domains: contextual (SES, stress and family conflict); parent characteristics (parental depression); parenting (support/engagement, hostility and scaffolding); and child characteristics including negative affect (NA) effortful control (EC) sensory regulation (SR), inhibitory control (IC) and attachment. We also compared the models to determine which variables contribute to a common correlates of symptoms of anxiety or depression, and which correlates differentiate between those symptom types. In the best-fitting model for these symptom types (a) SES, stress and conflict had indirect effects on both symptom types via long-chain paths; (b) caregiver depression had direct effects and indirect ones (mediated through parenting and child effortful control) on both symptom types; (c) parenting had direct and indirect effects (via temperament and SR); and temperament had direct effects on both symptom types. These data provide evidence of common risk factors, as well as indicate some specific pathways/mediators for the different symptom types. EC was related to anxiety, but not depression symptoms, suggesting that strategies to improve child EC may be particularly effective for treatment of anxiety symptoms in young children. [Early Childhood Inventory-4]

 

13-19. Kaat, A.J., Gadow, K.D., & Lecavalier, L. (2013). Psychiatric symptom impairment in children with autism spectrum disorders. Journal of Abnormal Child Psychology, 41, 959-969.

 

The general aim of this study was to examine the relation of psychiatric symptom-induced impairment with other common parameters of mental health in children with autism spectrum disorder (ASD). Prevalence rates are used to illustrate the implications of different criteria for caseness.  Parents/teachers completed DSM-IV-referenced rating scales for 6-12 year old children with ASD (N=115), the majority of whom were boys (86%). Most children were rated by parents (81%) or teachers (86%) as being socially or academically impaired by symptoms of at least one psychiatric disorder. The most common impairing conditions (parent/teacher) were attention-deficit/hyperactivity disorder (67%/71%), oppositional defiant disorder (35%/33%), and anxiety disorder (47%/34%), and the combined rates based on both informants were generally much higher. Agreement between symptom cutoff and impairment cutoff was acceptable for most disorders. A larger percentage of youth were impaired by psychiatric symptoms than met symptom cutoff criteria, and the discrepancy between impairment cutoff and clinical cutoff (impairment cutoff plus symptom cutoff) was even greater. Impairment was moderately to highly correlated with both number and severity of symptoms. Parents’ and teachers’ ratings indicated little agreement as to whether a child was impaired. Findings for youth with ASD were similar to non-ASD child psychiatry outpatient referrals, but clearly different in several ways from comparable studies of community-based samples. [Child and Adolescent Symptom Inventory-4R]

 

13-20. Kashikar-Zuck, S., Zafar, M., Barnett, K. A., Aylward, B. S., Strotman, D., Slater, S. K., ... & Powers, S. W. (2013). Quality of life and emotional functioning in youth with chronic migraine and juvenile fibromyalgia. The Clinical Journal of Pain, 29(12), 1066-1072.

 

Chronic pain in children is associated with significant negative impact on social, emotional, and school functioning. Previous studies on the impact of pain on children's functioning have primarily used mixed samples of pain conditions or single pain conditions (e.g., headache and abdominal pain) with relatively small sample sizes. As a result, the similarities and differences in the impact of pain in subgroups of children with chronic pain have not been closely examined. Objective: To compare pain characteristics, quality of life, and emotional functioning among youth with pediatric chronic migraine (CM) and juvenile fibromyalgia (JFM). Methods: We combined data obtained during screening of patients for 2 relatively large intervention studies of youth (age range, 10 to 18 y) with CM (N=153) and JFM (N=151). Measures of pain intensity, quality of life (Pediatric Quality of Life; PedsQL, child and parent-proxy), depressive symptoms (Children's Depression Inventory), and anxiety symptoms (Adolescent Symptom Inventory-4 Anxiety subscale) were completed by youth and their parent. A multivariate analysis of covariance controlling for effects of age and sex was performed to examine differences in quality of life and emotional functioning between the CM and JFM groups. Results: Youth with JFM had significantly higher anxiety and depressive symptoms, and lower quality of life in all domains. Among children with CM, overall functioning was higher but school functioning was a specific area of concern. Discussion: Results indicate important differences in subgroups of pediatric pain patients and point to the need for more intensive multidisciplinary intervention for JFM patients. [Adolescent Symptom Inventory-4]

 

13-21. Keenan, K., Hipwell, A., Babinski, D., Bortner, J., Henneberger, A., Hinze, A., ... & Sapotichne, B. (2013). Examining the developmental interface of cortisol and depression symptoms in young adolescent girls. Psychoneuroendocrinology, 38(10), 2291-2299.

 

Despite the substantial amount of data supporting a link between HPA-axis functioning and depression, the ontogeny of this association is not known. The aim of the present study was to contribute data on the developmental interface of HPA-axis functioning and depression in girls by testing associations between repeated measures of depression symptoms and cortisol levels in childhood and early adolescence. Girls (N = 232) and their mothers, who were participating in a longitudinal study, were interviewed about depression symptoms annually from ages 9 to 12 years. Cortisol was assayed from saliva at ages 10 and 12 years upon arrival to the lab and following administration of the cold pressor task (CPT). Time of day of collection of saliva and level of pubertal development were included as covariates in model testing. Although most girls did not show an increase in cortisol in response to the CPT, lower levels of output during the CPT were associated with higher levels of depression symptoms. These findings were observed only for cortisol levels assessed at age 12 years. Girls with low levels of cortisol output at age 12, and decreases in output from ages 10 to 12, had stable or slightly increasing depression symptoms from ages 9 to 12 years. We conclude that associations between HPA-axis functioning and depression emerge as early as age 12. However, individual differences in cortisol levels at age 12 also were associated with depression symptoms at earlier ages. The data suggest two possibilities: (1) that childhood depression is associated with HPA-axis dysregulation, but that age related changes in the sensitivity or plasticity of the HPA-axis may result in a delay in the emergence of such an association, or (2) that dysregulation of the functioning of the HPA-axis develops following repeated experience of depression symptoms. [Child Symptom Inventory-4]

 

13-22. Kenworthy, L., Yerys, B. E., Weinblatt, R., Abrams, D. N., & Wallace, G. L. (2013). Motor demands impact speed of information processing in autism spectrum disorders. Neuropsychology, 27(5), 529.

 

The apparent contradiction between preserved or even enhanced perceptual processing speed on inspection time tasks in autism spectrum disorders (ASD) and impaired performance on complex processing speed tasks that require motor output (e.g., Wechsler Processing Speed Index) has not yet been systematically investigated. This study investigates whether adding motor output demands to an inspection time task impairs ASD performance compared to that of typically developing control (TDC) children. The performance of children with ASD (n = 28; mean Full Scale IQ (FSIQ) = 115) and TDC (n = 25; mean FSIQ = 122) children was compared on processing speed tasks with increasing motor demand. Correlations were run between ASD task performance and Autism Diagnostic Observation Schedule (ADOS) Communication scores. Performance by the ASD and TDC groups on a simple perceptual processing speed task with minimal motor demand was equivalent, though it diverged (ASD worse than TDC) on 2 tasks with the same stimuli but increased motor output demands. ASD performance on the moderate but not the high speeded motor output demand task was negatively correlated with ADOS communication symptoms. These data address the apparent contradiction between preserved inspection time in the context of slowed "processing speed" in ASD. They show that processing speed is preserved when motor demands are minimized, but that increased motor output demands interfere with the ability to act on perceptual processing of simple stimuli. Reducing motor demands (e.g., through the use of computers) may increase the capacity of people with ASD to demonstrate good perceptual processing in a variety of educational, vocational, and social settings. [Child Symptom Inventory-4; Child and Adolescent Symptom Inventory-4R]

 

13-23. Kim, S., Nordling, J. K., Yoon, J. E., Boldt, L. J., & Kochanska, G. (2013). Effortful control in “hot” and “cool” tasks differentially predicts children’s behavior problems and academic performance. Journal of Abnormal Child Psychology, 41(1), 43-56.

 

Effortful control (EC), the capacity to deliberately suppress a dominant response and perform a subdominant response, rapidly developing in toddler and preschool age, has been shown to be a robust predictor of children's adjustment. Not settled, however, is whether a view of EC as a heterogeneous rather than unidimensional construct may offer advantages in the context of predicting diverse developmental outcomes. This study focused on the potential distinction between "hot" EC function (delay-of-gratification tasks that called for suppressing an emotionally charged response) and more abstract "cool" EC functions (motor inhibition tasks, suppressing-initiating response or Go-No Go tasks, and effortful attention or Stroop-like tasks). Children (N = 100) were observed performing EC tasks at 38 and 52 months. Mothers, fathers, and teachers rated children's behavior problems and academic performance at 67, 80, and 100 months, and children participated in a clinical interview at 100 months. Structural Equation Modeling (SEM) analyses with latent variables produced consistent findings across all informants: Children's scores in "hot" EC tasks, presumably engaging emotion regulation skills, predicted behavior problems but not academic performance, whereas their scores in "cool" EC tasks, specifically those engaging effortful attention, predicted academic performance but not behavior problems. The models of EC as a heterogeneous construct offered some advantages over the unidimensional models. Methodological and clinical implications of the findings are discussed. [Child Symptom Inventory-4]

 

13-24. King, B. H., Dukes, K., Donnelly, C. L., Sikich, L., McCracken, J. T., Scahill, L., ... & Hirtz, D. (2013). Baseline factors predicting placebo response to treatment in children and adolescents with Autism Spectrum Disorders: A multisite randomized clinical trial. JAMA Pediatrics, 167(11), 1045-1052.

 

Importance: The finding of factors that differentially predict the likelihood of response to placebo over that of an active drug could have a significant impact on study design in this population. Objective: To identify possible nonspecific, baseline predictors of response to intervention in a large randomized clinical trial of children and adolescents with autism spectrum disorders. Design, setting, and participants: Randomized clinical trial of citalopram hydrobromide for children and adolescents with autism spectrum disorders and prominent repetitive behavior. Baseline data at study entry were examined with respect to final outcome to determine if response predictors could be identified. A total of 149 children and adolescents 5 to 17 years of age (mean [SD] age, 9.4 [3.1] years) from 6 academic centers were randomly assigned to citalopram (n = 73) or placebo (n = 76). Participants had autistic disorder, Asperger syndrome, or pervasive developmental disorder, not otherwise specified; had illness severity ratings that were moderate or more than moderate on the Clinical Global Impression-Severity scale; and scored moderate or more than moderate on compulsive behaviors measured with the modified Children's Yale-Brown Obsessive-Compulsive Scale. Interventions: Twelve weeks of treatment with citalopram (10 mg/5 mL) or placebo. The mean (SD) maximum dose of citalopramwas 16.5 (6.5) mg by mouth daily (maximum dose, 20 mg/d). Main outcomes and measures: A positive response was defined as having a score of at least much improved on the Clinical Global Impression-Improvement scale at week 12. Baseline measures included demographic (sex, age, weight, and pubertal status), clinical, and family measures. Clinical variables included baseline illness severity ratings (the Aberrant Behavior Checklist, the Child and Adolescent Symptom Inventory, the Vineland Adaptive Behavior Scales, the Repetitive Behavior Scale-Revised, and the Children's Yale-Brown Obsessive-Compulsive Scale). Family measures included the Caregiver Strain Questionnaire. Results: Several baseline predictors of response were identified, and a principal component analysis yielded 3 composite measures (disruptive behavior, autism/mood, and caregiver strain) that significantly predicted response at week 12. Specifically, participants in the placebo group were significantly less likely than participants in the citalopram group to respond at week 12 if they entered the study more symptomatic on each of the 3 composite measures, and they were at least 2 times less likely to be responders. Conclusions and relevance: This analysis suggests strategies that may be useful in anticipating and potentially mitigating the nonspecific response in randomized clinical trials of children and adolescents with autism spectrum disorders. [Child Symptom Inventory-4]

 

13-25. Kochanska, G., & Kim, S. (2013). Difficult temperament moderates links between maternal responsiveness and children’s compliance and behavior problems in lowincome families. Journal of Child Psychology and Psychiatry, 54(3), 323-332.

 

Background: Research has shown that interactions between young children's temperament and the quality of care they receive predict the emergence of positive and negative socioemotional developmental outcomes. This multimethod study addresses such interactions, using observed and mother-rated measures of difficult temperament, children's committed, self-regulated compliance and externalizing problems, and mothers' responsiveness in a low-income sample. Methods: In 186 thirty-month-old children, difficult temperament was observed in the laboratory (as poor effortful control and high anger proneness), and rated by mothers. Mothers' responsiveness was observed in lengthy naturalistic interactions at 30 and 33months. At 40months, children's committed compliance and externalizing behavior problems were assessed using observations and several well-established maternal report instruments. Results: Parallel significant interactions between child difficult temperament and maternal responsiveness were found across both observed and mother-rated measures of temperament. For difficult children, responsiveness had a significant effect such that those children were more compliant and had fewer externalizing problems when they received responsive care, but were less compliant and had more behavior problems when they received unresponsive care. For children with easy temperaments, maternal responsiveness and developmental outcomes were unrelated. All significant interactions reflected the diathesis-stress model. There was no evidence of differential susceptibility, perhaps due to the pervasive stress present in the ecology of the studied families. Conclusions: Those findings add to the growing body of evidence that for temperamentally difficult children, unresponsive parenting exacerbates risks for behavior problems, but responsive parenting can effectively buffer risks conferred by temperament. [Early Childhood Inventory-4]

 

13-26. Kochanska, G., & Kim, S. (2013). Early attachment organization with both parents and future behavior problems: From infancy to middle childhood. Child Development, 84(1), 283-296.

 

Links between children's attachment security with mothers and fathers, assessed in Strange Situation with each parent at 15 months (N=101), and their future behavior problems were examined. Mothers and fathers rated children's behavior problems, and children reported their own behavior problems at age 8 (N=86). Teachers rated behavior problems at age 61/2 (N = 86). Insecurity with both parents had a robust effect: "Double-insecure" children reported more overall problems, and were rated by teachers as having more externalizing problems than those secure with at least 1 parent. Security with either parent could offset such risks, and security with both conferred no additional benefits. High resistance toward both parents in Strange Situation may confer "dual risk" for future externalizing behavior. [Child Symptom Inventory-4]

 

13-27. Kochanska, G., Kim, S., & Boldt, L. J. (2013). Origins of children's externalizing behavior problems in low-income families: Toddlers' willing stance toward their mothers as the missing link. Development and Psychopathology, 25(4), 891-901.

 

Although children's active role in socialization has been long acknowledged, relevant research has typically focused on children's difficult temperament or negative behaviors that elicit coercive and adversarial processes, largely overlooking their capacity to act as positive, willing, even enthusiastic, active socialization agents. We studied the willing, receptive stance toward their mothers in a low-income sample of 186 children who were 24 to 44 months old. Confirmatory factor analysis supported a latent construct of willing stance, manifested as children's responsiveness to mothers in naturalistic interactions, responsive imitation in teaching contexts, and committed compliance with maternal prohibitions, all observed in the laboratory. Structural equation modeling analyses confirmed that ecological adversity undermined maternal responsiveness, and responsiveness, in turn, was linked to children's willing stance. A compromised willing stance predicted externalizing behavior problems, assessed 10 months later, and fully mediated the links between maternal responsiveness and those outcomes. Ecological adversity had a direct, unmediated effect on internalizing behavior problems. Considering children's active role as willing, receptive agents capable of embracing parental influence can lead to a more complete understanding of detrimental mechanisms that link ecological adversity with antisocial developmental pathways. It can also inform research on the normative socialization process, consistent with the objectives of developmental psychopathology. [Early Childhood Inventory-4]

 

13-28. Kochanska, G., Kim, S., Boldt, L. J., & Yoon, J. E. (2013). Children's callousunemotional traits moderate links between their positive relationships with parents at preschool age and externalizing behavior problems at early school age. Journal of Child Psychology and Psychiatry, 54(11), 1251-1260.

 

Background: Growing research on children's traits as moderators of links between parenting and developmental outcomes has shown that variations in positivity, warmth, or responsiveness in parent-child relationships are particularly consequential for temperamentally difficult or biologically vulnerable children. But very few studies have addressed the moderating role of children's callous-unemotional (CU) traits, a known serious risk factor for antisocial cascades. We examined children's CU traits as moderators of links between parent-child Mutually Responsive Orientation (MRO) and shared positive affect and future externalizing behavior problems. Methods: Participants included 100 two-parent community families of normally developing children, followed longitudinally. MRO and shared positive affect in mother-child and father-child dyads were observed in lengthy, diverse naturalistic contexts when children were 38 and 52months. Both parents rated children's CU traits at 67months and their externalizing behavior problems (Oppositional Defiant Disorder and Conduct Disorder) at 67, 80, and 100months. Results: Children's CU traits moderated links between early positive parent-child relationships and children's future externalizing behavior problems, even after controlling for strong continuity of those problems. For children with elevated CU traits, higher mother-child MRO and father-child shared positive affect predicted a decrease in mother-reported future behavior problems. There were no significant associations for children with relatively lower CU scores. Conclusions: Positive qualities for early relationships, potentially different for mother-child and father-child dyads, can serve as potent factors that decrease probability of antisocial developmental cascades for children who are at risk due to elevated CU traits. [Child Symptom Inventory-4]

 

13-29. Kowatch, R. A., Youngstrom, E. A., Horwitz, S., Demeter, C., Fristad, M. A., Birmaher, B., ... & Findling, R. L. (2013). Prescription of psychiatric medications and polypharmacy in the LAMS cohort. Psychiatric Services, 64(10), 1026-1034.

 

Objective: This study evaluated demographic and clinical correlates and predictors of polypharmacy at baseline assessment in the Longitudinal Assessment of Manic Symptoms (LAMS) sample, a cohort of children age six to 12 years at their first outpatient mental health visit at university-affiliated clinics. Methods: Use of medications in four classes (mood stabilizers, antidepressants, antipsychotics, and stimulants) was assessed, and the Service Assessment for Children and Adolescents classified lifetime and current use of various services. Analyses examined correlates of the number of medications prescribed and odds of polypharmacy, defined as use of two or more concurrent medications. Results: In the total sample, 201 of 698 participants (29%) were prescribed two or more medications. These participants had lower Children's Global Assessment Scale scores, more comorbid disorders, and higher baseline parent-reported mood symptoms than those prescribed no or one medication. White youths were three times as likely as nonwhite youths to be receiving two or more psychotropics, even after adjustment for other demographic and clinical characteristics. Of 262 participants (38% of sample) not being treated with medications, 252 (96%) had a diagnosis of at least one psychiatric disorder (74% had two or more). Conclusions: Findings suggest that patients with greater severity and comorbidity were more likely to receive two or more medications. However, 38% of these children with serious disorders were not receiving psychotropic medication at the time of this assessment. Results counter findings suggesting overtreatment with medications of children with psychiatric disorders in the community. [Child and Adolescent Symptom Inventory-4R]

 

13-30. Ladouceur, C. D., Diwadkar, V. A., White, R., Bass, J., Birmaher, B., Axelson, D. A., & Phillips, M. L. (2013). Fronto-limbic function in unaffected offspring at familial risk for bipolar disorder during an emotional working memory paradigm. Developmental Cognitive Neuroscience, 5, 185-196.

 

Evidence from neuroimaging studies indicate that individuals with bipolar disorder (BD) exhibit altered functioning of fronto-limbic systems implicated in voluntary emotion regulation. Few studies, however, have examined the extent to which unaffected youth at familial risk for BD exhibit such alterations. Using an fMRI emotional working memory paradigm, we investigated the functioning of fronto-limbic systems in fifteen healthy bipolar offspring (8-17 years old) with at least one parent diagnosed with BD (HBO), and 16 age-matched healthy control (HC) participants. Neural activity and functional connectivity analyses focused on a priori neural regions supporting emotion processing (amygdala and ventral striatum) and voluntary emotion regulation (ventrolateral prefrontal cortex (VLPFC), dorsolateral prefrontal cortex (DLPFC), and anterior cingulate cortex (ACC)). Relative to HC, HBO exhibited greater right VLPFC (BA47) activation in response to positive emotional distracters and reduced VLPFC modulation of the amygdala to both the positive and negative emotional distracters; there were no group differences in connectivity for the neutral distracters. These findings suggest that alterations in the functioning of fronto-limbic systems implicated in voluntary emotion regulation are present in unaffected bipolar offspring. Future longitudinal studies are needed to determine the extent to which such alterations represent neurodevelopmental markers of risk for future onset of BD. [Child Symtpom Inventory-4]

 

13-31. Lara, D. R., Ottoni, G. L., Brunstein, M. G., Frozi, J., de Carvalho, H. W., & Bisol, L. W. (2012). Development and validity data of the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). Journal of Affective Disorders, 141(2), 390-398.

 

Background: The internet provides a research opportunity for psychiatry and psychology. This article presents the development and preliminary data of a large web-survey created to study how temperament relates to other psychological measures, behavior and psychiatric disorders. Methods: We used the Affective and Emotional Composite Temperament Scale (AFECTS) to evaluate temperament and we selected several self-report instruments to evaluate behavior, psychological constructs and mental disorders. The system provides anonymous psychological (phase 1) and psychiatric (phase 2) feedback and includes questions to assess the validity of the answers. Each phase has around 450 questions. This system was broadcast utilizing Brazilian media. Results: After the exclusion of 21.5% of the volunteers (those who failed the validation questions), 41,427 participants concluded the first part of the system (mean age = 31.2 +/- 10.5 yrs, 26.9% males), and 21,836 (mean age = 32.5 +/- 10.9 yrs, 25.1% males) completed phase 2. Around 25% have received a psychiatric diagnosis from a mental health professional. Demographic and temperament profiles of those who completed either only 80 questions, only phase 1, or the whole system were similar. The rate of non-serious answers (e. g. on bizarre behaviors) was very low and congruency of answers was very high. The internal consistency of classical trait scales (TCI-R and PANAS) was high (Cronbach's alpha > 0.80) for all dimensions. Limitations: Relatively high dropout rate due to the length of the process and an overrepresentation of female, young and well-educated subjects. Conclusions: The BRAINSTEP provides valid and abundant data on psychological and psychiatric measures. [Adult Self-Report Inventory-4]

 

13-32. Lavigne, J. V., Herzing, L. B., Cook, E. H., LeBailly, S. A., Gouze, K. R., Hopkins, J., & Bryant, F. B. (2013). Gene x Environment effects of serotonin transporter, dopamine receptor D4, and monoamine oxidase A genes with contextual and parenting risk factors on symptoms of oppositional defiant disorder, anxiety, and depression in a community sample of 4-year-old children. Development and Psychopathology, 25(02), 555-575.

 

Genetic factors can play a key role in the multiple level of analyses approach to understanding the development of child psychopathology. The present study examined gene-environment correlations and Gene x Environment interactions for polymorphisms of three target genes, the serotonin transporter gene, the D4 dopamine receptor gene, and the monoamine oxidase A gene in relation to symptoms of anxiety, depression, and oppositional behavior. Saliva samples were collected from 175 non-Hispanic White, 4-year-old children. Psychosocial risk factors included socioeconomic status, life stress, caretaker depression, parental support, hostility, and scaffolding skills. In comparison with the short forms (s/s, s/l) of the serotonin transporter linked polymorphic repeat, the long form (l/l) was associated with greater increases in symptoms of oppositional defiant disorder in interaction with family stress and with greater increases in symptoms of child depression and anxiety in interaction with caretaker depression, family conflict, and socioeconomic status. In boys, low-activity monoamine oxidase A gene was associated with increases in child anxiety and depression in interaction with caretaker depression, hostility, family conflict, and family stress. The results highlight the important of gene-environment interplay in the development of symptoms of child psychopathology in young children. [Early Childhood Inventory-4]

 

13-33. Lerner, M. D., McLeod, B. D., & Mikami, A. Y. (2013). Preliminary evaluation of an observational measure of group cohesion for group psychotherapy. Journal of Clinical Psychology, 69(3), 191-208.

 

Objective Group psychotherapy research would benefit from an observational measure of group cohesion to complement existing self-report measures. This study introduces the Therapy Process Observational Coding System-Group Cohesion scale (TPOCS-GC), which observationally assesses cohesion between each member and the group. Method In total 27 parents participated in a group parent-training social competency intervention for children with attention deficit-hyperactivity disorder. Independent coders double-coded group cohesion and the alliance in 144 client-sessions. Parents, teachers, and children completed cognitive, behavioral, and therapy participation measures. Results The TPOCS-GC demonstrated modest to strong item-level interrater reliability and acceptable internal consistency. Group cohesion evidenced moderate stability over the course of treatment. Relations between TPOCS-GC and theoretically linked and unrelated variables provided some evidence for construct and predictive validity. Conclusions: This preliminary study suggests that the TPOCS-GC is a reliable instrument that may help fill an instrumentation gap in the field. [Child Symptom Inventory-4]

 

13-34. Lin, Y. H., & Gau, S. S. F. (2013). Association between morningness–eveningness and the severity of compulsive internet use: The moderating role of gender and parenting style. Sleep Medicine, 14(12), 1398-1404.

 

Background: Eveningness and Internet addiction are major concerns in adolescence and young adulthood. We investigated the relationship between morningness-eveningness and compulsive Internet use in young adults and explored the moderating effects of perceived parenting styles and family support on such relationships. Methods: The participants consisted of 2731 incoming college students (men, 52.4%; mean age, 19.4 +/- 3.6 years) from a National University in Taiwan. Each participant completed the questionnaires, which included the Morningness-Eveningness Scale (MES), the Yale-Brown Obsessive Compulsive Scale modified for Internet use (YBOCS-IU), the Parental Bonding Instrument for parenting style, the Family Adaptation, Partnership, Growth, Affection, and Resolve questionnaire (APGAR) for perceived family support, and the Adult Self-Report Inventory-4 (ASRI-4) for psychopathology. The morning (n = 459), intermediate (n = 1878), and evening (n = 394) groups were operationally defined by the MES t scores. Results: The results showed that eveningness was associated with greater weekend sleep compensation, increased compulsive Internet use, more anxiety, poorer parenting styles, and less family support; additionally, the most associated variables for increased compulsive Internet use were the tendency of eveningness, male gender, more anxiety symptoms, less maternal affection/care, and a lower level of perceived family support. The negative association between the morning type and compulsive Internet use severity escalated with increased maternal affection/care and decreased with increased perceived family support. The positive association between the evening type and compulsive Internet use severity declined with increased maternal protection. However, the father's parenting style did not influence the relationship between morningness-eveningness and compulsive Internet use severity.  Conclusions: Our findings imply that sleep schedule and the parental and family process should be part of specific measures for prevention and intervention of compulsive Internet use. [Adult Self-Report Inventory-4]

 

13-35. Lockwood, P. L., Sebastian, C. L., McCrory, E. J., Hyde, Z. H., Gu, X., De Brito, S. A., & Viding, E. (2013). Association of callous traits with reduced neural response to others’ pain in children with conduct problems. Current Biology, 23(10), 901-905.

 

Children with conduct problems (CP) persistently violate others' rights and represent a considerable societal cost [1]. These children also display atypical empathic responses to others' distress [2], which may partly account for their violent and antisocial behavior. Callous traits index lack of empathy in these children and confer risk for adult psychopathy [3]. Investigating neural responses to others' pain is an ecologically valid method to probe empathic processing [4], but studies in children with CP have been inconclusive [5, 6]. Using functional magnetic resonance imaging (fMRI), we measured neural responses to pictures of others in pain (versus no pain) in a large sample of children with CP and matched controls. Relative to controls, children with CP showed reduced blood oxygen level-dependent responses to others' pain in bilateral anterior insula (Al), anterior cingulate cortex (ACC), and inferior frontal gyrus, regions associated with empathy for pain in previous studies [7, 8]. In the CP group, callous traits were negatively associated with responses to others' pain in Al and ACC. We conclude that children with CP have atypical neural responses to others' pain. The negative association between callous traits and Al/ACC response could reflect an early neurobiological marker indexing risk for empathic deficits seen in adult psychopathy. [Child and Adolescent Symptom Inventory-4R]

 

13-36. Marmorstein, N. R. (2013). Associations between dispositions to rash action and internalizing and externalizing symptoms in children. Journal of Clinical Child & Adolescent Psychology, 42(1), 131-138.

 

Impulsivity is not a unitary construct; instead, dispositions to rash action can be divided into five moderately-correlated dimensions. However, the associations between these dimensions and symptoms of psychopathology among youth remain unclear. The goal of this study was to examine associations between different dispositions to rash action and psychopathology in a community sample of middle school youth. One hundred forty-four youth (M age = 11.9; 65% Hispanic, 30% African American; 50% male; 81% qualifying for free school lunches) participated in this study. Self-reported questionnaire measures of dispositions to rash action (lack of planning, lack of perseverance, sensation seeking, negative urgency, and positive urgency) and psychopathology symptoms (conduct disorder [CD], alcohol use, depression, overall anxiety, panic, generalized anxiety, social anxiety, and separation anxiety, as well as teacher reports of attention deficit/hyperactivity disorder [ADHD] inattentive and hyperactive symptoms) were used. Negative and positive urgency were positively associated with all symptom types examined except certain anxiety subtypes (and positive urgency was not associated with ADHD symptoms). Lack of planning was positively associated with externalizing and depressive symptoms. Lack of perseverance was positively associated with CD. Sensation seeking was positively associated with both CD and alcohol use. When other dispositions were adjusted for, negative urgency remained a positive predictor of CD, whereas positive urgency remained a positive predictor of depressive and panic symptoms. Sensation seeking was negatively associated with separation anxiety. Psychopathology symptoms are differentially related to dispositions to rash action in children; emotion-based dispositions to rash action may be particularly important targets for future research. [Child Symptom Inventory-4]

 

13-37. Marshal, M. P., Dermody, S. S., Shultz, M. L., Sucato, G. S., Stepp, S. D., Chung, T., ... & Hipwell, A. E. (2013). Mental health and substance use disparities among urban adolescent lesbian and bisexual girls. Journal of the American Psychiatric Nurses Association, 19(5), 271-279.

 

Background: Sexual minority girls (SMGs) report large substance use disparities and victimization experiences, yet there is a dearth of research that focuses exclusively on SMGs. Objective: To examine substance use and mental health disparities among SMGs and to determine whether disparities were larger for African American compared with European American girls. Method: Data were used from Wave 11 of the Pittsburgh Girls Study, a multiple-cohort, prospective study of urban girls. Girls for the current analysis were aged 16 to 19 years. Fifty-five percent were African American. One hundred and seventy-three (8.3%) identified as SMGs, and 1,891 identified as heterosexual. Multiple regression analyses controlling for age, race, and parent education were conducted. Results: SMGs reported a robust pattern of large disparities in externalizing, internalizing, and borderline personality disorder symptoms. There was little evidence to suggest disparities were moderated by race. Conclusion: SMGs and their families would benefit from intervention and prevention programs to reduce disparities among this highly vulnerable population. [Child Symptom Inventory-4; Adult Self-Report Inventory-4]

 

13-38. Mattison, R. E., & Blader, J. C. (2013). What affects academic functioning in secondary special education students with serious emotional and/or behavioral problems? Behavioral Disorders, 38(4), 201-211.

 

Concern is growing over the limited academic progress in special education students with emotional and/or behavioral disorders (EBD). We know little about how academic and behavioral factors interact in these students to affect their academic functioning. Therefore, potential associations were investigated over the course of one school year for 196 secondary students with EBD in a self-contained public school (SCS). Demographics, IQ and achievement testing, teacher checklist ratings for emotional/behavioral problems, and standard measures of school function were gathered. First, academic achievement was studied, and regression analyses showed that both reading and math achievement were significantly increased by higher verbal IQ and lower ADHD-inattentive symptoms (ADHD-I), and math also by higher performance IQ and younger age. Next, general academic performance was examined, and regression analysis demonstrated that major-subject GPA was significantly increased by lower ADHD-I teacher ratings, higher math achievement, and younger age. In comparison, out-of-school suspensions were significantly increased by higher conduct disorder and lower social phobia ratings. Thus, in these students with EBD in an SCS, academic functioning was primarily affected by academic parameters, and by ADHD-I but not by other emotional/behavioral problems. These results can further inform the planning of academic interventions for many students with EBD. [Child Symptom Inventory-4]

 

13-39. Mikami, A. Y., Griggs, M. S., Lerner, M. D., Emeh, C. C., Reuland, M. M., Jack, A., & Anthony, M. R. (2013). A randomized trial of a classroom intervention to increase peers' social inclusion of children with attention-deficit/hyperactivity disorder. Journal of Consulting and Clinical Psychology, 81(1), 100.

 

Objective: Interventions for peer problems among children with attention-deficit/hyperactivity disorder (ADHD) typically focus on improving these children's behaviors. This study tested the proposition that an adjunctive component encouraging the peer group to be socially inclusive of children with ADHD would augment the efficacy of traditional interventions. Method: Two interventions were compared: contingency management training (COMET), a traditional behavioral management treatment to improve socially competent behavior in children with ADHD, and Making Socially Accepting Inclusive Classrooms (MOSAIC), a novel treatment that supplemented behavioral management for children with ADHD with procedures training peers to be socially inclusive. Children ages 6.8-9.8 (24 with ADHD; 113 typically developing [TD]) attended a summer day program grouped into same-age, same-sex classrooms with previously unacquainted peers. Children with ADHD received both COMET and MOSAIC with a repeated measures crossover design. TD children provided sociometric information about the children with ADHD. Results: Whereas the level of behavior problems displayed by children with ADHD did not differ across treatment conditions, children with ADHD displayed improved sociometric preference and more reciprocated friendships, and received more positive messages from peers, when they were in MOSAIC relative to COMET. However, the beneficial effects of MOSAIC over COMET predominantly occurred for boys relative to girls. Conclusions: Data support the concept that adjunctive procedures to increase the inclusiveness of the peer group may ameliorate peer problems among children with ADHD, and suggest the potential utility of modifying MOSAIC to be delivered in regular classroom settings. [Child Symptom Inventory-4]

 

13-40. Mikami, A. Y., Reuland, M. M., Griggs, M. S., Jia, M., & Suldo, S. (2013). Collateral effects of a peer relationship intervention for children with Attention Deficit Hyperactivity Disorder on typically developing classmates. School Psychology Review, 42(4), 458-476.

 

General education teachers often implement classroom practices to address the needs of selected children with clinically significant behavior problems. The extent to which such practices affect the classmates of the selected children is an important question. Making Socially Accepting Inclusive Classrooms (MOSAIC) is a teacher-delivered classroom intervention, designed for and validated to improve the peer relationships of children with attention deficit hyperactivity disorder (ADHD)). The current study examined the collateral effects of MOSAIC on 113 typically developing (TD) classmates (ages 6.8-9.8, 47% boys) of the children with ADHD; TD children did not meet criteria for any clinical disorder. All children were enrolled in a summer program containing 16 classrooms with teachers randomly assigned to MOSAIC or to an active comparison intervention condition. Results indicated that TD children showed reduced negative sociometric nominations from peers, increased reciprocated friendships, and reduced negative interactions with peers in MOSAIC. The positive effects of MOSAIC were accentuated for TD children with higher levels of disruptive behavior. In sum, the benefits of a peer relationship intervention targeted for children with AMID may extend to TD classmates. [Child Symptom Inventory-4]

 

13-41. Moskowitz, L. J., Mulder, E., Walsh, C. E., McLaughlin, D. M., Zarcone, J. R., Proudfit, G. H., & Carr, E. G. (2013). A multimethod assessment of anxiety and problem behavior in children with Autism Spectrum Disorders and Intellectual Disability. American Journal on Intellectual and Developmental Disabilities, 118(6), 419-434.

 

Despite the increased risk for anxiety disorders in children with autism spectrum disorders (ASD), there is a lack of research on the assessment and treatment of anxiety in this population, particularly for those with an intellectual disability (ID). The present study evaluated a multimethod strategy for the assessment of anxiety and problem behavior in three children with ASD and ID. Anxiety was operationally defined using: (1) behavioral data from anxious behaviors, (2) affective/contextual data from parent-report and observer ratings of overall anxiety, and (3) physiological data (heart rate [HR] and respiratory sinus arrhythmia [RSA]). A functional assessment of problem behavior during high-and low-anxiety conditions was conducted. Higher levels of problem behavior and HR and lower RSA were found in the high-anxiety than in the low-anxiety conditions. [Child Symptom Inventory-4]

 

13-42. Pang, K. C., & Beauchaine, T. P. (2013). Longitudinal patterns of autonomic nervous system responding to emotion evocation among children with conduct problems and/or depression. Developmental Psychobiology, 55(7), 698-706.

 

Conduct disorder (CD) and depression co-occur at far greater levels than chance, despite largely separate diagnostic criteria. One potential shared mechanism of this comorbidity is emotion dysregulation, which characterizes both internalizing and externalizing disorders. Previous research demonstrates that respiratory sinus arrhythmia (RSA) a peripheral biomarker of emotion regulationis attenuated among children with CD, and among children with depression. However, few studies have examined biomarkers of emotion regulation as a function of heterotypic comorbidity. We evaluated longitudinal patterns of RSA and RSA reactivity to emotion evocation across three annual assessments among 207 children diagnosed at ages 8-12 years with CD (n=30), depression (n=28), comorbid CD and depression (n=80), or no psychiatric condition (n=69). Using continuous symptom counts as predictors, DepressionxCD interactions were observed for both Time 1 resting RSA and Time 1 RSA reactivity. CD, depression, and their interaction were all associated with low resting RSA at Time 1. In addition, concurrently elevated CD and depression scores predicted the greatest RSA reactivity to emotion evocation. Psychopathology scores were unrelated to developmental changes in RSA and RSA reactivity over time. [Adolescent Symptom Inventory-4]

 

13-43. Pfiffner, L. J., Villodas, M., Kaiser, N., Rooney, M., & McBurnett, K. (2013). Educational outcomes of a collaborative school–home behavioral intervention for ADHD. School Psychology Quarterly, 28(1), 25.

 

This study evaluated educationally relevant outcomes from a newly developed collaborative school-home intervention (Collaborative Life Skills Program [CLS]) for youth with attention and/or behavior problems. Participants included 17 girls and 40 boys in second through fifth grades (mean age = 8.1 years) from diverse ethnic backgrounds. CLS was implemented by 10 school-based mental health professionals at their schools and included 3 integrated components over 12 weeks: group behavioral parent training, classroom behavioral intervention, and a child social and independence skills group. Parent and teacher ratings of attention-deficit/hyperactivity disorder (ADHD) symptoms, organizational skills, and homework problems, and teacher-rated academic skills, report card grades, academic achievement, and classroom observations of student engagement were measured before and after treatment. Significant pre-post improvement was found for all measures, with large effect sizes for ADHD symptoms, organizational skills, and homework problems, and medium to large effects for teacher-rated academic skills, report card grades, academic achievement, and student engagement. Improvements in organizational skills mediated the relationship between improvement in ADHD symptoms and academic skills Significant improvement in both ratings and objective measures (achievement testing, report cards, classroom observations) suggests that improvement exceeded what might be accounted for by expectancy or passage of time. Findings support the focus of CLS on both ADHD symptom reduction and organizational skill improvement and support the feasibility of a model which utilizes school-based mental health professionals as providers. [Child Symptom Inventory-4; ADHD Symptom Checklist-4]

 

13-44. Pouw, L. B., Rieffe, C., Oosterveld, P., Huskens, B., & Stockmann, L. (2013). Reactive/proactive aggression and affective/cognitive empathy in children with ASD. Research in Developmental Disabilities, 34(4), 1256-1266.

 

The main aim of this study was to examine the extent to which affective and cognitive empathy were associated with reactive and proactive aggression, and whether these associations differed between children with an Autism Spectrum Disorder (ASD) and typically developing (TD) children. The study included 133 children (67 ASD, 66 TD, Mage = 139 months), who filled out self-report questionnaires. The main findings showed that the association between reactive aggression and affective empathy was negative in TD children, but positive in children with ASD. The outcomes support the idea that a combination of poor emotion regulation and impaired understanding of others' emotions is associated with aggressive behavior in children with ASD. [Child Symptom Inventory-4]

 

13-45. Salama, C., Morris, M., Armistead, L., Koenig, L. J., Demas, P., Ferdon, C., & Bachanas, P. (2013). Depressive and conduct disorder symptoms in youth living with HIV: The independent and interactive roles of coping and neuropsychological functioning. AIDS Care, 25(2), 160-168.

 

Emerging research suggests the importance of psychosocial characteristics (e.g., coping and social support) for positive adaptation among youth with behaviorally acquired HIV. However, little is known about how these traits interact with cognitive abilities to impact emotional and behavioral adjustment. This study examined whether coping skills and executive functioning interact in their association with psychological adjustment in HIV-positive youth. Data from Project Adolescents Living with HIV/AIDS (ALPHA), a study to examine psychosocial, behavioral and neuropsychological functioning of youth with behaviorally acquired HIV, were used. Fifty-nine participants, aged 1423, diagnosed with HIV prior to age 20 and receiving care in one of two HIV clinics in Atlanta or New York City, were recruited, consented and enrolled. Participants completed measures of depressive symptoms (Beck Depression Inventory), conduct disorder (Adolescent Symptom Index), and use of positive and negative coping strategies (Kidcope). The Wisconsin Card Sorting Test (WCST) assessed abstract reasoning (categories completed) and cognitive inflexibility (perseverative errors). In this sample of HIV-positive youth, depressive symptoms were best predicted by an interactive combination of negative coping skills and poor neuropsychological functioning. Neuropsychological functioning (cognitive inflexibility) and negative coping skills were directly associated with conduct disorder symptoms. Results highlight the importance of including neuropsychological assessment in the evaluation of HIV-positive youth, particularly those with emotional or behavioral problems. [Adolescent Symptom Inventory-4]

 

13-46. Scott, L. N., Whalen, D. J., Zalewski, M., Beeney, J. E., Pilkonis, P. A., Hipwell, A. E., & Stepp, S. D. (2013). Predictors and consequences of developmental changes in adolescent girls' self-reported quality of attachment to their primary caregiver. Journal of Adolescence, 36(5), 797-806.

 

In an at-risk community sample of 2101 girls, we examined trajectories, predictors, and consequences of changes in a central aspect of adolescents' perceived quality of attachment (QOA), i.e., their reported trust in the availability and supportiveness of the primary caregiver. Results demonstrated two distinct epochs of change in this aspect of girls' perceived QOA, with a significant linear decrease in early adolescence (ages 11-14) followed by a plateau from 14 to 16. Baseline parent-reported harsh punishment, low parental involvement, single parent status, and child-reported depression symptoms predicted steeper decreases in attachment during early adolescence, which in turn predicted greater child-reported depression and conduct disorder symptoms in later adolescence. Results suggest that both parent and child factors contribute to trajectories of self-reported QOA in adolescence, and a faster rate of decrease in girls' perceived QOA to caregivers during early adolescence may increase risk for both internalizing and externalizing symptoms. [Child Symptom Inventory-4; Adolescent Symptom Inventory-4]

 

13-47. Sheikh, H. I., Kryski, K. R., Smith, H. J., Dougherty, L. R., Klein, D. N., Bufferd, S. J., ... & Hayden, E. P. (2013). CatecholOmethyltransferase gene val158met polymorphism and depressive symptoms during early childhood. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 162(3), 245-252.

 

Catechol-O-Methyltransferase (COMT) is a critical regulator of catecholamine levels in the brain. A functional polymorphism of the COMT gene, val158met, has been linked to internalizing symptoms (i.e., depression and anxiety) in adolescents and adults. We extended this research by investigating whether the val158met polymorphism was associated with childhood symptoms of depression and anxiety in two independent samples of young children (Ns=476 and 409). In both samples, preschool-aged children were genotyped for the COMT val158met polymorphism. Symptoms of psychopathology were assessed via parent interviews and primary caregiver reports. In both samples, children homozygous for the val allele had higher levels of depressive symptoms compared to children with at least one copy of the met allele. Our findings extend previous research in older participants by showing links between the COMT val158met polymorphism and internalizing symptoms in early childhood. [Early Childhood Inventory-4]

 

13-48. Soylu, E., Soylu, N., Yıldırım, Y. S., Polat, C., & Sakallıoğlu, Ö. (2013). The prevelance of psychiatric symptoms in preschool children with adenotonsillar hypertrophy. International Journal of Pediatric Otorhinolaryngology, 77(7), 1094-1098.

 

Objectives: The aim of this study was to determine the prevalence of psychiatric disorders and. symptoms in preschool-age children who are indicated for operation due to adenotonsillar hypertrophy. Materials and methods: Forty-eight patients between the ages of three and five years with indication for adenotonsillectomy were included in the study, as well as 40 control patients. Cases underwent routine ear nose throat (ENT) examination, flexible nasopharyngoscopy and tympanometry. The Early Childhood Inventory-4 (ECI-4) parent form and Strengths and Difficulties Questionnaire (SDQ) parent form were completed by the parent caring for the child. The SPSS for Windows 16.0 program was used for statistical analysis. Results: Groups were compared according to they received at least one psychiatric diagnosis measured by ECI-4, the group of adenotonsillar hypertrophy was diagnosed more than the control group. Attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and sleep disorders were detected at a higher rate in patients with adenotonsillar hypertrophy. It also was established that in the comparison of the severity of psychiatric symptoms determined by ECI-4, symptom severity of ADHD, ODD, anxiety disorders, and sleep disorders was higher in the adenotonsillar hypertrophy group than in the control group. In the evaluation of the SDQ parent form, it was determined that attention deficit, hyperactivity, behavioral, and peer relations problems occurred more frequently in the adenotonsillar hypertrophy group. Conclusions: In addition to oral respiration, snoring, and disordered breathing during sleep, adenotonsillar hypertrophy may also associated with psychiatric disorders and symptoms. [Early Childhood Inventory-4]

 

13-49. Soylu, E., Soylu, N., Yıldırım, Y. S., Sakallıoğlu, Ö., Polat, C., & Orhan, İ. (2013). Psychiatric disorders and symptoms severity in patients with adenotonsillar hypertrophy before and after adenotonsillectomy. International Journal of Pediatric Otorhinolaryngology, 77(10), 1775-1781.

 

Objective: The objective of this study was to compare the frequency of psychiatric disorders and the severity of psychiatric symptoms in patients with adenotonsillar hypertrophy with a healthy control group and investigate the potential improvement after adenotonsillectomy. Materials and methods: The study group consisted of 40 patients with adenotonsillar hypertrophy and a control group consisted of 35 healthy volunteers without adenotonsillar hypertrophy. A routine ear nose throat (ENT) examination, flexible nasopharyngoscopy and tympanometry were carried out. The same procedures were applied to the control group. The parents of all the participants were required to fill out the Early Childhood Inventory-4 form, the Strengths and Difficulties Questionnaire and a personal information form. At postoperative month six, the patients were re-examined, and their parents were required to fill out the same forms. Results: Attention deficit hyperactivity disorders and sleep disorders determined with the Early Childhood Inventory-4 were more common in the patients with adenotonsillar hypertrophy than in the control group. There was a significant decrease in the rates of both types of disorders at postoperative month six. The total psychiatric symptom severity was higher in the patients with adenotonsillar hypertrophy and the following were more frequent: cases of attention deficit hyperactivity disorder, oppositional defiant disorder, symptom severity of anxiety disorders and sleep disorders determined with the Early Childhood Inventory-4, as well as emotional problems, attention deficit hyperactivity disorder problems, behavioural problems and peer problems determined with the Strengths and Difficulties Questionnaire parent-report form. There was a statistically significant decrease in all the other symptoms at postoperative month six, except for the severity of oppositional defiant disorder symptoms determined with the Early Childhood Inventory-4 and behavioural problems determined with the Strengths and Difficulties Questionnaire parent-report form. There were no differences in the severity of psychiatric disorders or symptoms between the adenotonsillar hypertrophy group and the control group at postoperative month six. Conclusion: Adenotonsillar hypertrophy is associated with psychiatric disorders and symptoms. Adenotonsillectomy ameliorated the symptoms and the severity of these disorders in most cases. [Early Childhood Inventory-4]

 

13-50. Sprafkin, J., Steinberg, E.A., Gadow, K.D., & Drabick, D.A.G. (2013). Agreement among categorical, dimensional, and impairment criteria for ADHD and common comorbidities. Journal of Attention Disorders. Published online February 11, 2013.

 

Objective: To compare the results of categorically- versus dimensionally-based scoring algorithms for a DSM-IV-referenced teacher rating scale for assessing attention-deficit/hyperactivity disorder (ADHD) and commonly co-occurring conditions and to determine their relative agreement with ratings of symptom-induced impairment. Method: Teachers completed Child and Adolescent Symptom Inventory-4R (CASI-4R) ratings for 1092 youth (ages 6-18 years) referred to a child and adolescent psychiatry outpatient service. Caseness was determined according to DSM-IV symptom count (categorical model) and T score (dimensional model) criteria. Results:  Agreement between symptom count and T-score cutoffs was generally good (kappa ≥ 0.61) for ADHD Inattentive, ADHD Hyperactive-Impulsive, ADHD Combined (except adolescent females), Oppositional Defiant Disorder, and Conduct Disorder, but this was not the case for anxiety and depressive disorders where only 15% of kappas were good. Agreement of Impairment Cutoff with T-Score and Symptom Count Cutoffs ranged from poor to good. Conclusions: In general, although in many cases CASI-4R categorical and dimensional scoring algorithms generated similar results, there was considerable variability across disorders, age groups, scoring method, and in some cases, gender. Moreover, symptom counts and T-scores are not a proxy for assessing impairment suggesting that each scoring strategy likely provides unique information for clinical decision-making.

 

13-51. Stephens, R. J., Chung, S. A., Jovanovic, D., Guerra, R., Stephens, B., Sandor, P., & Shapiro, C. M. (2013). Relationship between polysomnographic sleep architecture and behavior in medication-free children with TS, ADHD, TS and ADHD, and controls. Journal of Developmental & Behavioral Pediatrics, 34(9), 688-696.

 

Objective: To describe the relationship between sleep architecture and behavioral measures in unmedicated children and adolescents with Tourette syndrome (TS), attention-deficit hyperactivity disorder (ADHD), TS and comorbid ADHD (TS 1 ADHD), and healthy controls. The study also set out to examine differences in sleep architecture with each diagnosis. Method: A cross-sectional, 2-night consecutive polysomnographic sleep study was conducted in 90 children. All participants were matched for age, gender, and level of intelligence. Results: Scores on the Child Behavior Checklist delinquency measure were modestly but significantly correlated with the number of movements during REM sleep (r = .36, p = .003). Significant correlations were also noted among the number of total arousals and arousals from slow wave sleep (SWS), and scores on the measures of conduct disorder, hyperactivity/immaturity, and restless/disorganized behaviors. There were a few significant differences in sleep architecture among the diagnostic groups. The ADHD-only group exhibited a significantly higher number of total arousals (p < .01) and arousals from SWS (p < .01) compared with the other three study groups. Discussion: Our findings indicate that children with TS and/or ADHD and who have more arousals from sleep are significantly more likely to have issues with conduct disorder, hyperactivity/immaturity, and restless/disorganized behavior. It was also noted that having ADHD, alone or comorbid with TS, is associated with a significantly greater number of movements during both non-REM and REM sleep. This study underscores the compelling need for the diagnosis and treatment of any sleep disorders in children with TS and/or ADHD so as to facilitate better management of problem behaviors. [Child Symptom Inventory-4]

 

13-52. Thornton, L. C., Frick, P. J., Crapanzano, A. M., & Terranova, A. M. (2013). The incremental utility of callous-unemotional traits and conduct problems in predicting aggression and bullying in a community sample of boys and girls. Psychological Assessment, 25(2), 366.

 

The current study tested whether callous-unemotional (CU) traits explained unique variance in measures of aggression and bullying, and in measures assessing cognitive and affective correlates to aggression, when controlling for conduct problem severity. In a sample of 284 ethnically diverse students (ages 9 to 14 years), a self-report measure of CU traits did not explain unique variance in self-report measures of reactive aggression but did interact with conduct problems in predicting proactive aggression, with conduct problems being more strongly related to proactive aggression in students high on CU traits. Conduct problems were also more strongly related to peer-reports of bullying in girls high on CU traits. Further, CU traits were negatively related to behaviors that defend victims of bullying, independent of conduct problem severity. Finally, conduct problems were more strongly related to anger dysregulation in students low on CU traits, and conduct problems were more strongly related to positive expectations for aggressive behavior in girls high on CU traits. These findings provide support for the proposal to include CU traits as a specifier for the diagnosis of conduct disorder. [Early Childhood Inventory-4]

 

13-53. Voltas Moreso, N., Hernández-Martínez, C., Arija Val, V., & Canals Sans, J. (2013). Socio-demographic and psychopathological risk factors in obsessive-compulsive disorder: Epidemiologic study of school population. International Journal of Clinical and Health Psychology, 13(2), 118-126.

 

We assessed the presence of emotional disorders (obsessive-compulsive, anxiety and depressive) in 1,514 Spanish non-referred children (8-12 years old) to investigate the predictive ability of psychopathological and socio-demographic characteristics, and identify which of these were possible correlates for clinical obsessive-compulsive disorder (OCD) and subclinical OCD. At one year later, 562 subjects (risk group and without risk group) were re-assessed and we established the OCD diagnoses or the subclinical OCD diagnoses. We found that 20 participants presented clinical OCD and 46 participants presented subclinical OCD. Somatic and separation anxiety symptomatology were good predictors for clinical OCD, and obsessive concern was a predictor for subclinical OCD. Clinical OCD was associated with order/checking/pollution symptoms and with a lower socioeconomic status (SES). Subclinical OCD was associated with hyperactive and impulsive manifestations, obsessive concern, and superstition/mental compulsion. An early detection and the follow-up of anxiety or obsessive symptoms in children may be important for preventing the course of OCD. [Child Symptom Inventory-4]

 

13-54. Webster-Stratton, C., Reid, M. J., & Beauchaine, T. P. (2013). One-year follow-up of combined parent and child intervention for young children with ADHD. Journal of Clinical Child & Adolescent Psychology, 42(2), 251-261.

 

Efficacies of the Incredible Years (IY) interventions are well-established in children with oppositional defiant disorder (ODD) but not among those with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate 1-year follow-up outcomes among young children with ADHD who were treated with the IY interventions. Four- to 6-year-olds with ADHD (n=49, 73% male) participated in 6 months of treatment using the IY parent and child interventions. Immediate posttreatment results indicated improvements in parenting, children's externalizing and attention problems, and social contact at school. At 1-year follow up, 22 of 27 variables that showed significant posttreatment effects demonstrated maintenance to 1-year follow up. Children with higher ODD symptoms at baseline showed more improvement in oppositionality and total behavior problems, and their mothers showed more improvement on harsh discipline scores. Approximately 70 to 75% of children were reported by their parents and teachers to fall below clinical cutoffs on measures of externalizing symptoms at the 1-year follow up (compared to 50% at baseline), and more than 50% fell below clinical cutoffs on measures of hyperactivity and inattentiveness (all were in the clinical range at baseline). Children with ADHD who were treated with the IY parent and child treatment programs showed maintenance of treatment effects 1 year after treatment. [Child Symptom Inventory-4]

 

13-55. White, S. W., Ollendick, T., Albano, A. M., Oswald, D., Johnson, C., Southam-Gerow, M. A., ... & Scahill, L. (2013). Randomized controlled trial: Multimodal anxiety and social skill intervention for adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(2), 382-394.

 

Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30 adolescents with ASD and anxiety symptoms of moderate or greater severity. The treatment was acceptable to families, subject adherence was high, and therapist fidelity was high. A 16 % improvement in ASD social impairment (within-group effect size = 1.18) was observed on a parent-reported scale. Although anxiety symptoms declined by 26 %, the change was not statistically significant. These findings suggest MASSI is a feasible treatment program and further evaluation is warranted. [Adolescent Symptom Inventory-4]

 

13-56. Williams, P.L., Chernoff, M., Angelidou, K., Brouwers, P., Kacanek, D., Deygoo, N.S., Nachman, N., & Gadow, K.D. (2013). Participation and retention of youth with perinatal HIV infection in mental health research studies: The IMPAACT P1055 psychiatric co-morbidity study. Journal of Acquired Immune Deficiency Syndromes, 63, 401-409.

 

Background: Obtaining accurate estimates of mental health problems among youth perinatally infected with HIV (PHIV) helps clinicians develop targeted interventions but requires enrollment and retention of representative youth into research studies. Methods: The study design for IMPAACT P1055, a US-based, multisite prospective study of psychiatric symptoms among PHIV youth and uninfected controls aged 6 to 17 years old, is described. Participants were compared with nonparticipants by demographic characteristics and reasons were summarized for study refusal. Adjusted logistic regression models were used to evaluate the association of psychiatric symptoms and other factors with loss to follow-up (LTFU). Results: Among 2281 youth screened between 2005 and 2006 at 29 IMPAACT research sites, 580 (25%) refused to participate, primarily because of time constraints. Among 1162 eligible youth approached, 582 (50%) enrolled (323 PHIV and 259 Control), with higher participation rates for Hispanic youth. Retention at 2 years was significantly higher for PHIV than Controls (84% vs 77%, P = 0.03). In logistic regression models adjusting for sociodemographic characteristics and HIV status, youth with any self-assessed psychiatric condition had higher odds of LTFU compared with those with no disorder (adjusted odds ratio = 1.56, 95% confidence interval: 1.00 to 2.43). Among PHIV youth, those with any psychiatric condition had 3-fold higher odds of LTFU (adjusted odds ratio = 3.11, 95% confidence interval: 1.61 to 6.01). Conclusions: Enrollment and retention of PHIV youth into mental health research studies is challenging for those with psychiatric conditions and may lead to underestimated risks for mental health problems. Creative approaches for engaging HIV-infected youth and their families are required for ensuring representative study populations. [Child and Adolescent Symptom Inventory-4R]

 

13-57. Yang, H. N., Tai, Y. M., Yang, L. K., & Gau, S. S. F. (2013). Prediction of childhood ADHD symptoms to quality of life in young adults: Adult ADHD and anxiety/depression as mediators. Research in Developmental Disabilities, 34(10), 3168-3181.

 

Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms may persist, co-occur with anxiety and depression (ANX/DEP), and influence quality of life (QoL) in later life. However, the information about whether these persistent ADHD and ANX/DEP mediate the influence of childhood ADHD on adverse QoL in adulthood is lacking. This study aimed to determine whether adult ADHD symptoms and/or ANX/DEP mediated the association between childhood ADHD and QoL. We assessed 1382 young men aged 19-30 years in Taiwan using self-administered questionnaires for retrospective recall of ADHD symptoms at ages 6-12, and assessment of current ADHD and ANX/DEP symptoms, and QoL. We conducted mediation analyses and compared the values of-mediation ratio (Pm) by adding mediators (adult ADHD and ANX/DEP), individually and simultaneously into a regression model with childhood ADHD as an independent variable and QoL as a dependent variable. Our results showed that both adult ADHD and ANX/DEP symptoms significantly-mediated the association between childhood ADHD and QoL (P-M=0.71 for ANX/DEP, P-M = 0.78 for adult ADHD symptoms, and P-M = 0.91 for both). The significance of negative correlations between childhood ADHD and four domains of adult QoL disappeared after adding these two mediators in the model. Our findings suggested that the strong relationship between childhood ADHD and adult life quality can be explained by the presence of persistent ADHD symptoms and co-occurring ANX/DEP. These two mediators are recommended to be included in the assessment and intervention for ADHD to offset the potential adverse life quality outcome in ADHD. [Adult Self-Report Inventory-4]

 

13-58. Yau, G., Schluchter, M., Taylor, H. G., Margevicius, S., Forrest, C. B., Andreias, L., ... & Hack, M. (2013). Bullying of extremely low birth weight children: Associated risk factors during adolescence. Early Human Development, 89(5), 333-338.

 

Background: Preterm children have many risk factors which may increase their susceptibility to being bullied. Aims: To examine the prevalence of bullying among extremely low birth weight (ELBW, <1 kg) and normal birth weight (NBW) adolescents and the associated sociodemographic, physical, and psychosocial risk factors and correlates among the ELBW children. Methods: Cohort study of self-reports of bullying among 172 ELBW adolescents born 1992-1995 compared to 115 NBW adolescents of similar age, sex and sociodemographic status. Reports of being bullied were documented using the KIDSCREEN-52 Questionnaire which includes three Likert type questions concerning social acceptance and bullying. Multiple linear regression analyses adjusting for sociodemographic factors were used to examine the correlates of bullying among the ELBW children. Results: Group differences revealed a non-significant trend of higher mean bullying scores among ELBW vs. NBW children (1.56 vs. 1.16, p = 0.057). ELBW boys had significantly higher bullying scores than NBW boys (1.94 vs. 0.91, p<0.01), whereas ELBW and NBW girls did not differ (1.34 vs. 1.30, p = 0.58). Bullying of ELBW children was significantly associated with subnormal IQ functional limitations, anxiety and ADHD, poor school connectedness, less peer connectedness, less satisfaction with health and comfort, and less risk avoidance. Conclusion: ELBW boys, but not girls, are more likely to be victims of bullying than NBW boys. School and health professionals need to be aware of the risk of bullying among ELBW male adolescents. [Adolescent Symptom Inventory-4; Youth’s Inventory-4]

 

13-59. Yerys, B. E., Kenworthy, L., Jankowski, K. F., Strang, J., & Wallace, G. L. (2013). Separate components of emotional go/no-go performance relate to autism versus attention symptoms in children with autism. Neuropsychology, 27(5), 537-545.

 

Objective: The present investigation examined whether higher functioning children with autism would demonstrate impaired response inhibition performance in an emotional go/no-go task, and whether severity of attention-deficit/hyperactivity disorder (ADHD) or autism symptoms correlated with performance. Method: Forty-four children (21 meeting criteria for autism; 23 typically developing controls [TDCs]) completed an emotional go/no-go task in which an emotional facial expression (angry, fearful, happy, or sad) was the go stimulus and a neutral facial expression was the no-go stimulus, and vice versa. Results: The autism group was faster than the TDC group on all emotional go, trials. Moreover, the children in the autism group who had the fastest reaction times on emotional go trials were rated as having the greatest number of symptoms (Autism Diagnostic Observation Schedule Social + Communication score), even after accounting for the association with ADHD symptoms. The autism group also made more impulsive responses (i.e., lower d', more false alarms) than the TDC group on all trials. As d' decreased or false alarms increased, so did ADHD symptoms. Hyperactivity/impulsivity symptoms were significantly correlated with false alarms, but inattention symptoms were not. There was not a significant relationship between no-go false alarms and autism symptoms; even after partialing out associations with autism symptoms, the significant correlation between ADHD symptoms and no-go false alarms remained. Conclusion: The present findings support a comorbidity model that argues for shared and independent risk factors, because ADHD and autism symptoms related to independent aspects of emotional go/no-go performance. [Child Symptom Inventory-4; Child and Adolescent Symptom Inventory-4R]

 

13-60. Yerys, B. E., Ruiz, E., Strang, J., Sokoloff, J., Kenworthy, L., & Vaidya, C. J. (2013). Modulation of attentional blink with emotional faces in typical development and in autism spectrum disorders. Journal of Child Psychology and Psychiatry, 54(6), 636-643.

 

Background: The attentional blink (AB) phenomenon was used to assess the effect of emotional information on early visual attention in typically developing (TD) children and children with autism spectrum disorders (ASD). The AB effect is the momentary perceptual unawareness that follows target identification in a rapid serial visual processing stream. It is abolished or reduced for emotional stimuli, indicating that emotional information has privileged access to early visual attention processes. Methods: We examined the AB effect for faces with neutral and angry facial expressions in 8- to 14-year-old children with and without an ASD diagnosis. Results: Children with ASD exhibited the same magnitude AB effect as TD children for both neutral and angry faces. Conclusions: Early visual attention to emotional facial expressions was preserved in children with ASD. [Child Symptom Inventory-4; Child and Adolescent Symptom Inventory-4R]

 

 

YEAR: 2012

 

12-1. Alderson, RM, Rapport, MD, Kasper, LJ, Sarver, DE, & Kofler, MJ. (2012). Hyperactivity in boys with attention deficit/hyperactivity disorder (ADHD): The association between deficient behavioral inhibition, attentional processes, and objectively measured activity. Child Neuropsychology, 18, 487-505.

 

Contemporary models of ADHD hypothesize that hyperactivity reflects a byproduct of inhibition deficits. The current study investigated the relationship between children's motor activity and behavioral inhibition by experimentally manipulating demands placed on the limited-resource inhibition system. Twenty-two boys (ADHD=11, TD=11) between the ages of 8 and 12 years completed a conventional stop-signal task, two choice-task variants (no-tone, ignore-tone), and control tasks while their motor activity was measured objectively by actigraphs placed on their nondominant wrist and ankles. All children exhibited significantly higher activity rates under all three experimental tasks relative to control conditions, and children with ADHD moved significantly more than typically developing children across conditions. No differences in activity level were observed between the inhibition and noninhibition experimental tasks for either group, indicating that activity level was primarily associated with basic attentional rather than behavioral inhibition processes. [Child Symptom Inventory-4]

 

12-2. Arnold, LE, Mount, K, Frazier, T, Demeter, C, Youngstrom, EA, Fristad, MA, Birmaher, B, Horwitz, S, Findling, RL, Kowatch, R, & Axelson, D. (2012). Pediatric bipolar disorder and ADHD: Family history comparison in the LAMS clinical sample. Journal of Affective Disorders, 141, 382-389. 

 

Background: Transgenerational association of bipolar spectrum disorder (BPSD) and attention deficit/hyperactivity disorder (ADHD) has been reported, but inconclusively. Method: Children ages 6-12 were systematically recruited at first outpatient visit at 9 clinics at four universities and reliably diagnosed; 621 had elevated symptoms of mania (>12 on the Parent General Behavior Inventory 10-Item Mania Scale); 86 had scores below 12. We analyzed baseline data to test a familial association hypothesis: compared to children with neither BPSD nor ADHD, those with either BPSD or ADHD would have parents with higher rates of both bipolar and ADHD symptoms, and parents of comorbid children would have even higher rates of both. Results: Of 707 children, 421 had ADHD without BPSD, 45 BPSD without ADHD, 117 comorbid ADHD+BPSD, and 124 neither. The rate of parental manic symptoms was similar for the comorbid and BPSD-alone groups, significantly greater than for ADHD alone and "neither" groups, which had similar rates. ADHD symptoms in parents of children with BPSD alone were significantly less frequent than in parents of children with ADHD (alone or comorbid), and no greater than for children with neither diagnosis. Family history of manic symptoms, but not ADHD symptoms, was associated with parent-rated child manic-symptom severity over and above child diagnosis. Limitations: The sample was not epidemiologic, parent symptoms were based on family history questions, and alpha was 0.05 despite multiple tests. Conclusions: These results do not support familial linkage of BPSD and ADHD; they are compatible with heritability of each disorder separately with coincidental overlap. [Child and Adolescent Symptom Inventory-4R]

 

12-3. Beauchaine, TP, & Gatzke-Kopp, LM. (2012). Instantiating the multiple levels of analysis perspective in a program of study on externalizing behavior. Development and Psychopathology, 24, 1003-1018. 

 

During the last quarter century, developmental psychopathology has become increasingly inclusive and now spans disciplines ranging from psychiatric genetics to primary prevention. As a result, developmental psychopathologists have extended traditional diathesis stress and transactional models to include causal processes at and across all relevant levels of analysis. Such research is embodied in what is known as the multiple levels of analysis perspective. We describe how multiple levels of analysis research has informed our current thinking about antisocial and borderline personality development among trait impulsive and therefore vulnerable individuals. Our approach extends the multiple levels of analysis perspective beyond simple Biology x Environment interactions by evaluating impulsivity across physiological systems (genetic, autonomic, hormonal, neural), psychological constructs (social, affective, motivational), developmental epochs (preschool, middle childhood, adolescence, adulthood), sexes (male, female), and methods of inquiry (self-report, informant report, treatment outcome, cardiovascular, electrophysiological, neuroimaging). By conducting our research using any and all available methods across these levels of analysis, we have arrived at a developmental model of trait impulsivity that we believe confers a greater understanding of this highly heritable trait and captures at least some heterogeneity in key behavioral outcomes, including delinquency and suicide. [Child Symptom Inventory-4]

 

12-4. Bolden, J, Rapport, MD, Raiker, JS, Sarver, DE, & Kofler, MJ. (2012). Understanding phonological memory deficits in boys with attention-deficit/hyperactivity disorder (ADHD): dissociation of short-term storage and articulatory rehearsal processes. Journal of Abnormal Child Psychology, 40, 999-1011.

 

The current study dissociated and examined the two primary components of the phonological working memory subsystem-the short-term store and articulatory rehearsal mechanism-in boys with ADHD (n = 18) relative to typically developing boys (n = 15). Word lists of increasing length (2, 4, and 6 words per trial) were presented to and recalled by children following a brief (3 s) interval to assess their phonological short-term storage capacity. Children's ability to utilize the articulatory rehearsal mechanism to actively maintain information in the phonological short-term store was assessed using word lists at their established memory span but with extended rehearsal times (12 s and 21 s delays). Results indicate that both phonological shortterm storage capacity and articulatory rehearsal are impaired or underdeveloped to a significant extent in boys with ADHD relative to typically developing boys, even after controlling for age, SES, IQ, and reading speed. Larger magnitude deficits, however, were apparent in short-term storage capacity (ES = 1.15 to 1.98) relative to articulatory rehearsal (ES = 0.47 to 1.02). These findings are consistent with previous reports of deficient phonological short-term memory in boys with ADHD, and suggest that future attempts to develop remedial cognitive interventions for children with ADHD will need to include active components that require children to hold increasingly more information over longer time intervals. [Child Symptom Inventory-4]

 

12-5. Bufferd, SJ, Dougherty, LR, Carlson, GA, Rose, S, & Klein, DN. (2012). Psychiatric disorders in preschoolers: Continuity from ages 3 to 6. American Journal of Psychiatry, 169, 1157-1164.

 

Objective: Recent studies indicate that many preschoolers meet diagnostic criteria for psychiatric disorders. However, data on the continuity of these diagnoses are limited, particularly from studies examining a broad range of disorders in community samples. Such studies are necessary to elucidate the validity and clinical significance of psychiatric diagnoses in young children. The authors examined the continuity of specific psychiatric disorders in a large community sample of preschoolers from the Preschool period (age 3) to the beginning of the school-age period (age 6). Method: Eligible families with a 3-year child were recruited from the community through commercial mailing lists. For 462 children, the child's primary caretaker was interviewed at baseline and again when the child was age 6, using the parent-report Preschool Age Psychiatric Assessment, a comprehensive diagnostic interview. The authors examined the continuity of DSM-IV diagnoses from ages 3 to 6. Results: Three-month rates of disorders were relatively stable from age 3 to age 6. Children who met criteria for any diagnosis at age 3 were nearly five times as likely as the others to meet criteria for a diagnosis at age 6. There was significant homotypic continuity from age 3 to age 6 for anxiety, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder, and heterotypic continuity between depression and anxiety, between anxiety and oppositional defiant disorder, and between ADHD and oppositional defiant disorder. Conclusions: These results indicate that preschool psychiatric disorders are moderately stable, with rates of disorders and patterns of homotypic and heterotypic continuity similar to those observed in samples of older children. [Early Childhood Inverntory-4]

 

12-6. Canals, J, Hernandez-Martinez, C, Cosi, S, & Voltas, N. (2012). The epidemiology of obsessive-compulsive disorder in Spanish school children. Journal of Anxiety Disorders, 26, 746-752.

 

We aimed to assess the prevalence (at three levels of severity) and other epidemiological data of OCD in a sample of 1,514 Spanish non-referred children. The estimated prevalence was 1.8% for OCD, 5.5% for subclinical OCD and 4.7% for DC symptomatology. We did not find significant differences between genders or academic grade regarding DC symptoms and OCD, but more subclinical prevalence was found in males than in females. Socio-demographic variables were not related to any level of OCD, but academic performance was significantly lower in clinical OCD. The co-morbidity between OCD and any psychiatric disorder was high (85%) and higher for emotional disorders than for behavioral disorders. The impairment was associated with comorbidity and was worse for OCD with comorbid emotional problems. The results suggest that OCD is not rare in school children and adolescents and that it has an impact on their personal functioning. We suggest the possibility of an early diagnosis and treatment. [Child Symptom Inventory-4, Spanish]

 

12-7. Canals, J, Hernandez-Martinez, C, Cosi, S, & Domenech, E. (2012). Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population. Journal of Anxiety Disorders, 26, 785-791. 

 

We aimed to find a valid cutoff score for the Screen for Child Anxiety Related Emotional Disorders, child (SCARED-C) and parent (SCARED-P) Spanish versions for detecting Anxiety Disorders (AD) in a non-clinical population. The predictive accuracy of the SCARED-C and SCARED-P was assessed using the Area Under the Curve (AUC) of ROC curves. In general, the predictive accuracy of the SCARED-C (full version, short version, and four factors) was good and better than that of the SCARED-P. To differentiate between children who meet the diagnostic criteria for any AD and children who do not, we propose cutoff scores of 25 and 17 for the SCARED-C and SCARED-P, respectively. The sensitivities are 75.9% and 62.8%, and the specificities are 68.5% and 69.5%. The SCARED-C factor that had the best predictive accuracy was Somatic panic followed by Separation Anxiety, Generalized Anxiety and Social Phobia. The SCARED-P factor with the best predictive accuracy was Separation Anxiety. The results support the use of SCARED-C as a screening test for Anxiety disorders while SCARED-P should only be used as complementary information. [Child Symptom Inventory-4, Spanish]

 

12-8. Caspersen, ID, & Habekost, T. (2013). Selective and sustained attention in children with spina bifida myelomeningocele. Child Neuropsychology, 19, 55-77. 

 

Spina bifida myelomeningocele (SBM) is a neural tube defect that has been related to deficits in several cognitive domains including attention. Attention function in children with SBM has often been studied using tasks that are confounded by complex motor demands or tasks that do not clearly distinguish perceptual from response-related components of attention. We used a verbal-report paradigm based on the Theory of Visual Attention and a new continuous performance test, the Dual Attention to Response Task, for measuring parameters of selective and sustained attention in 6 children with SBM and 18 healthy control children. The two tasks had minimal motor demands, were functionally specific and were sensitive to minor deficits. As a group, the children with SBM were significantly less efficient at filtering out irrelevant stimuli. Moreover, they exhibited frequent failures of sustained attention and response control in terms of omission errors, premature responses, and prolonged inhibition responses. All 6 children with SBM showed deficits in one or more parameters of attention; for example, three patients had elevated visual perception thresholds, but large individual variation was evident in their performance patterns, which highlights the relevance of an effective case-based assessment method in this patient group. Overall, the study demonstrates the strengths of a new testing approach for evaluating attention function in children with SBM. [Child Symptom Inventory-4]

 

12-9. Chaplin, TM, Sinha, R, Simmons, JA, Healy, SM, Mayes, LC, Hommer, RE, & Crowley, MJ. (2012). Parent-adolescent conflict interactions and adolescent alcohol use. Addictive Behaviors, 37, 605-612.

 

Objective: One important factor in adolescents' development of problem alcohol use is their family environment. Yet, the mechanisms that relate parenting to youth alcohol use are not well characterized. This study employed a naturalistic laboratory-based approach to observe parenting behaviors (support, structure, criticism) and adolescents' physiological and emotional responses to parent-adolescent interactions to examine associations with adolescent alcohol use. Method: Fifty eight 10-16 year olds and their parents completed a 10 minute Parent Adolescent Interaction Task (PAIT) in which they discussed a mutually highly-rated conflict topic. Parental support, structure, and criticism were coded from the interaction. Adolescents' heart rate (HR), blood pressure (BP), reported emotions, and salivary cortisol were assessed before, during, and after the interaction. Results: Findings indicated that lower parental structure and support were associated with youth's greater diastolic BP and anger arousal in response to the PAIT. Furthermore, higher FIR, systolic BP, and cortisol responses to the interaction were associated with youth's alcohol use. Conclusions: Findings suggest that heightened emotional and physiological responses to parent-adolescent conflict interactions in youth may be one pathway by which parenting is associated with adolescent alcohol use and risk for abuse. [Child Symptom Inventory-4]

 

12-10. Chervin, RD, Ruzicka, DL, Hoban, TF, Fetterolf, JL, Garetz, SL, Guire, KE, Dillon, JE, Felt, BT, Hodges, EK, & Giordani, BJ. (2012). Esophageal pressures, polysomnography, and neurobehavioral outcomes of adenotonsillectomy in children. Chest, 142, 101-110.

 

Background: Esophageal pressure monitoring during polysomnography in children offers a gold-standard, "preferred" assessment for work of breathing, but is not commonly used in part because prospective data on incremental clinical utility are scarce. We compared a standard pediatric apnea/hypopnea index to quantitative esophageal pressures as predictors of apnea-related neurobehavioral morbidity and treatment response. Methods: Eighty-one children aged 7.8 +/- 2.8 (SD) years, including 44 boys, had traditional laboratory-based pediatric polysomnography, esophageal pressure monitoring, multiple sleep latency tests, psychiatric evaluations, parental behavior rating scales, and cognitive testing, all just before clinically indicated adenotonsillectomy, and again 7.2 +/- 0.8 months later. Esophageal pressures were used, along with nasal pressure monitoring and oronasal thermocouples, not only to identify respiratory events but also more quantitatively to determine the most negative esophageal pressure recorded and the percentage of sleep time spent with pressures lower than -10 cm H2O. Results: Both sleep-disordered breathing and neurobehavioral measures improved after surgery. At baseline, one or both quantitative esophageal pressure measures predicted a disruptive behavior disorder (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined attention-deficit/hyperactivity disorder, conduct disorder, or oppositional defiant disorder) and more sleepiness and their future improvement after adenotonsillectomy (each P < .05). The pediatric apnea/hypopnea index did not predict these morbidities or treatment outcomes (each P > .10). The addition of respiratory effort-related arousals to the apnea/hypopnea index did not improve its predictive value. Neither the preoperative apnea/hypopnea index nor esophageal pressures predicted baseline hyperactive behavior, cognitive performance, or their improvement after surgery. Conclusions: Quantitative esophageal pressure monitoring may add predictive value for some, if not all, neurobehavioral outcomes of sleep-disordered breathing. [Child Symptom Inventory-4]

 

12-11. Crowell, SE, Beauchaine, TP, Hsiao, RC, Vasilev, CA, Yaptangco, M, Linehan, MM, & McCauley, E. (2012). Differentiating adolescent self-injury from adolescent depression: possible implications for borderline personality development. Journal of Abnormal Child Psychology, 40, 45-57.

 

Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report markers of vulnerability and risk. Such a comparison may have important implications for treatment, prevention, and developmental models of self injury and borderline personality disorder. We used a multi-method, multi-informant approach to examine how adolescent SII differs from adolescent depression. Self-injuring, depressed, and typical adolescent females (n = 25 per group) and their mothers completed measures of psychopathology and emotion regulation, among others. In addition, we assessed electrodermal responding (EDR), a peripheral biomarker of trait impulsivity. Participants in the SII group (a) scored higher than depressed adolescents on measures of both externalizing psychopathology and emotion dysregulation, and (b) exhibited attenuated EDR, similar to patterns observed among impulsive, externalizing males. Self-injuring adolescents also scored higher on measures of borderline pathology. These findings reveal a coherent pattern of differences between self-injuring and depressed adolescent girls, consistent with theories that SII differs from depression in etiology and developmental course. [Youth (Self Report) Inventory-4]

 

12-12. D'Angelo, EJ, & Augenstein, TM (2012). Developmentally informed evaluation of depression: evidence-based instruments. Child and Adolescent Psychiatric Clinics of North America, 21, 279-+ .

     

This article has two primary aims: (1) to describe how to incorporate evidence-based assessment procedures into diagnostic practice and (2) to present a review of the more commonly used interview methods and clinical measures of depression among preschoolers, school-age children, and adolescents. [Youth (Self Report) Inventory-4, Child Symptom Inventory-4]

 

12-13. Drabick, DAG, & Gadow, KD (2012). Deconstructing oppositional defiant disorder: clinic-based evidence for an anger/irritability phenotype. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 384-393. 

Objective: To examine risk factors and co-occurring symptoms associated with mother-reported versus teacher-reported anger/irritability symptoms (AIS) of oppositional defiant disorder (ODD) in a clinic-based sample of 1,160 youth aged 6 through 18 years. Method: Participants completed a background history questionnaire (mothers), school functioning questionnaire (mothers, teachers), and DSM-IV referenced symptom checklists (mothers, teachers). Youth meeting AIS criteria for ODD were compared to youth with ODD who met criteria for noncompliant symptoms (NS) but not AIS and to clinic controls. Results: Compared with NS youth, youth with AIS were rated as exhibiting higher levels of anxiety and mood symptoms for both mother- and teacher-defined groups, and higher levels of conduct disorder symptoms for mother-defined younger and older youth. The remaining group differences for developmental, psychosocial, and psychiatric correlates varied as a function of informant and youth's age. Conclusions: Evidence suggests that AIS may constitute a more severe and qualitatively different ODD clinical phenotype, but informant and age of youth appear to be important considerations. [Child and Adolescent Symptom Inventory-4R]

 

12-14. Eigsti, IM, Schuh, J, Mencl, E, Schultz, RT, & Paul, R (2012). The neural underpinnings of prosody in autism. Child Neuropsychology, 18, 600-617.

 

This study examines the processing of prosodic cues to linguistic structure and to affect, drawing on fMRI and behavioral data from 16 high-functioning adolescents with autism spectrum disorders (ASD) and 11 typically developing controls. Stimuli were carefully matched on pitch, intensity, and duration, while varying systematically in conditions of affective prosody (angry versus neutral speech) and grammatical prosody (questions versus statement). To avoid conscious attention to prosody, which normalizes responses in young people with ASD, the implicit comprehension task directed attention to semantic aspects of the stimuli. Results showed that when perceiving prosodic cues, both affective and grammatical, activation of neural regions was more generalized in ASD than in typical development, and areas recruited reflect heightened reliance on cognitive control, reading of intentions, attentional management, and visualization. This broader recruitment of executive and "mind-reading" brain areas for a relative simple language-processing task may be interpreted to suggest that speakers with high-functioning autism (HFA) have developed less automaticity in language processing and may also suggest that "mind-reading" or theory of mind deficits are intricately bound up in language processing. Data provide support for both a right-lateralized as well as a bilateral model of prosodic processing in typical individuals, depending upon the function of the prosodic information. [Child Symptom Inventory-4]

 

12-15. Farmer, C, Lecavalier, L, Yu, S, Arnold, LE, McDougle, CJ, Scahill, L, Handen, B, Johnson, CR, Stigler, KA, Bearss, K, Swiezy, NB, & Aman, MG (2012). Predictors and moderators of parent training efficacy in a sample of children with autism spectrum disorders and serious behavioral problems. Journal of Autism and Developmental Disorders, 42, 1037-1044.

 

The Research Units on Pediatric Psychopharmacology-Autism Network reported additional benefit when adding parent training (PT) to antipsychotic medication in children with autism spectrum disorders and serious behavior problems. The intent-to-treat analyses were rerun with putative predictors and moderators. The Home Situations Questionnaire (HSQ) and the Hyperactivity/Noncompliance subscale of the Aberrant Behavior Checklist were used as outcome measures. Candidate predictors and moderators included 21 demographics and baseline measures of behavior. Higher baseline HSQ scores predicted greater improvement on the HSQ regardless of treatment assignment, but no other predictors of outcome were observed. None of the variables measured in this study moderated response to PT. Antipsychotic medication plus PT appears to be equally effective for children with a wide range of demographic and behavioral characteristics. [Child Symptom Inventory-4]

 

12-16. Gadow, KD (2012). Schizophrenia spectrum and attention-deficit/hyperactivity disorder symptoms in autism spectrum disorder and controls. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1076-1084.

 

Objective: This study compared the differential severity of specific symptoms of schizophrenia spectrum disorder (SSD) in children with autism spectrum disorder (ASD) and child psychiatry outpatient referrals (controls). Each group was further subdivided into subgroups with and without co-occurring attention-deficit/hyperactivity disorder (ADHD). Method: Children with ASD (n = 147) and controls (n = 335) were evaluated with parent and teacher versions of a psychometrically established DSM-IV-referenced rating scale. Results: The two ASD groups (with and without ADHD) had a larger number of more severe SSD symptoms than their respective control groups (with and without ADHD), extending the observation of an association between ASD and SSD to subgroups with and without co-occurring ADHD. The ASD groups exhibited more severe schizoid personality symptoms than controls, but findings for schizophrenia symptoms were mixed. The ASD + ADHD group generally had more severe disorganized thought, disorganized behavior, and negative schizophrenia symptoms than controls (with and without ADHD); nevertheless, findings varied according to ADHD status (present versus absent), individual symptom (symptom specificity), and informant (informant specificity). Ratings of hallucinations and delusions indicated mild severity and few group differences. Negative symptoms such as inappropriate emotional reactions evidenced considerable group divergence. Conclusion: Findings provide additional support for an interrelation between ASD and SSD symptoms and the differential influence of neurobehavioral syndromes on co-occurring symptom severity, underscore the multidimensionality of SSD in children with ASD, and suggest how symptom phenotypes may contribute to a better understanding of the etiology, nosology, and possibly clinical management. [Child and Adolescent Symptom Inventory-4R]

 

12-17. Gadow, KD, Angelidou, K, Chernoff, M, Williams, PL, Heston, J, Hodge, J, & Nachman, S (2012). Longitudinal study of emerging mental health concerns in youth perinatally infected with hiv and peer comparisons. Journal of Developmental and Behavioral Pediatrics, 33, 456-468. 

 

Objective: Cross-sectional research indicates high rates of mental health concerns among youth with perinatal HIV infection (PHIV), but few studies have examined emerging psychiatric symptoms over time. Methods: Youth with PHIV and peer comparisons who were HIV-exposed but uninfected or living in households with HIV-infected family members (HIV-affected) and primary caregivers participated in a prospective, multisite, longitudinal cohort study. Groups were compared for differences in the incidence of emerging psychiatric symptoms during 2 years of follow-up and for differences in psychotropic drug therapy. Logistic regression models were used to evaluate the association of emerging symptoms with HIV status and psychosocial risk factors. Results: Of 573 youth with study entry assessments, 92% attended at least 1 annual follow-up visit (PHIV: 296; comparisons: 229). A substantial percentage of youth who did not meet symptom criteria for a psychiatric disorder at study entry did so during follow-up (PHIV = 36%; comparisons = 42%). In addition, those who met criteria at study entry often met criteria during follow-up (PHIV = 41%; comparisons = 43%). Asymptomatic youth with PHIV were significantly more likely to receive psychotropic medication during follow-up than comparisons. Youth with greater HIV disease severity (entry CD4% <25% vs 25% or more) had higher probability of depression symptoms (19% vs 8%, respectively). Conclusions: Many youth in families affected by HIV are at risk for development of psychiatric symptoms. [Child and Adolescent Symptom Inventory-4R; Youth (Self Report) Inventory-4R, Child Self Report Inventory-4, Adult Self Report Inventory-4]

 

12-18. Gadow, KD, & DeVincent, CJ (2012). Comparison of children with autism spectrum disorder with and without schizophrenia spectrum traits: gender, season of birth, and mental health risk factors. Journal of Autism and Developmental Disorders, 42, 2285-2296.

 

Children with autism spectrum disorder (ASD) with and without co-occurring schizophrenia spectrum traits (SST) were examined for differences in co-occurring psychiatric symptoms, background characteristics, and mental health risk factors. Participating mothers and teachers completed a DSM-IV-referenced rating scale and a background questionnaire (mothers only) describing 147 children (6-12 years) with ASD. There was a clear pattern of group differences in co-occurring psychiatric symptom severity (+SST > SST-) and background characteristics. Children with impairing SST had more mental health risk factors. Girls were more likely to be classified SST according to mothers' ratings. Children born in spring-summer were more likely to be classified non-SST by teachers' ratings. Findings provide tentative evidence that SST may be a useful marker of behavioral heterogeneity within the ASD clinical phenotype. [Child and Adolescent Symptom Inventory-4R]

 

12-19. Gadow, KD, & Drabick, DAG (2012). Anger and irritability symptoms among youth with ODD: cross-informant versus source-exclusive syndromes. Journal of Abnormal Child Psychology, 40, 1073-1085. 

 

We examined differences in co-occurring psychological symptoms and background characteristics among clinically referred youth with oppositional defiant disorder (ODD) with and without anger/irritability symptoms (AIS) according to either parent or teacher (source-exclusive) and both informants (cross-informant), youth with noncompliant symptoms (NS) of ODD, and non-ODD clinic controls. Parents and teachers evaluated 1127 youth (ages 6-18) with a DSM-IV-referenced rating scale to assess ODD and co-occurring psychological symptoms. Parents also completed a background questionnaire (demographic, developmental, treatment, relationship, and academic characteristics) and teachers rated school functioning. Source-exclusive AIS groups were associated with different clinical features, and there was some evidence that cross-informant youth had more mental health concerns than source-exclusive groups. Findings varied to some extent among older (12-18 years) versus younger (6-11 years) youth. In general, the NS group (youth without AIS) was the most similar to clinic controls. AIS and NS are likely candidates for component phenotypes in ODD and continued research into their pathogenesis may have important implications for nosology, etiology, and intervention. [Child and Adolescent Symptom Inventory-4R]

 

12-20. Gadow, KD, & Drabick, DAG (2012). Symptoms of autism and schizophrenia spectrum disorders in clinically referred youth with oppositional defiant disorder. Research in Developmental Disabilities, 33, 1157-1168. 

 

Examined autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) symptoms in a clinically referred, non-ASD sample (N = 1160: ages 6-18) with and without oppositional defiant disorder (ODD). Mothers and teachers completed DSM-IV-referenced symptom checklists. Youth with ODD were subdivided into angry/irritable symptom (AIS) or noncompliant symptom (NS) subtypes. Two different classification strategies were used: within-informant (source-specific) and between-informant (source-exclusive). For the source-specific strategy, youth were classified AIS. NS, or Control (C) according to mothers' and teachers' ratings separately. A second set of analyses focused on youth classified AIS according to mother or teacher report but not both (source-exclusive) versus both mother and teacher (cross-informant) AIS. Results indicated the mother-defined source-specific AIS groups generally evidenced the most severe ASD and SSD symptoms (AIS > NS > C), but this was more pronounced among younger youth. Teacher-defined source-specific ODD groups exhibited comparable levels of symptom severity (AIS, NS > C) with the exception of SSD (AIS > NS > C; younger youth). Source-exclusive AIS groups were clearly differentiated from each other, but there was little evidence of differential symptom severity in cross-informant versus source-exclusive AIS. These findings were largely dependent on the informant used to define the source-exclusive groups. AIS and NS groups differed in their associations with ASD and SSD symptoms. Informant discrepancy provides valuable information that can inform nosological and clinical concerns and has important implications for studies that use different strategies to configure clinical phenotypes. [Child and Adolescent Symptom Inventory-4R]

 

12-21. Gadow, KD, Guttmann-Steinmetz, S, Rieffe, C, & DeVincent, CJ (2012). Depression symptoms in boys with autism spectrum disorder and comparison samples. Journal of Autism and Developmental Disorders, 42, 1353-1363.

 

This study compares severity of specific depression symptoms in boys with autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), or chronic multiple tic disorder (CMTD) and typically developing boys (Controls). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 (CSI-4) and a demographic questionnaire. Mothers' and teachers' ratings generally indicated the most severe symptoms in boys with ASD +/- A ADHD. Associations of depression with ASD severity and IQ varied considerably for specific symptoms of depression, ASD functional domain, and informant. Findings provide additional support for the differential influence of neurobehavioral syndromes on co-occurring symptom severity and illustrate how more fine-grained analyses of clinical phenotypes may contribute to a better understanding of etiology and current nosology.

 

12-22. Giacobo, RS, Jane, MC, Bonillo, A, Ballespi, S, & Diaz-Reganon, N (2012). Somatic symptoms, severe mood dysregulation, and aggressiveness in preschool children. European Journal of Pediatrics, 171, 111-119.

 

Many researchers have studied somatic symptoms in children. However, its association with severe mood dysregulation (SMD) is poorly known. The aim of this study is to detect the presence of SMD in preschool children and to know the prevalence of somatic symptoms and associations with psychopathology, SMD, and aggressiveness. The study population consists of children between 3 to 6 years of age enrolled in Barcelona's kindergarten schools (n = 319). Their parents completed questionnaires about the presence of somatic symptoms in children, absences from school and pediatric visits, child psychiatric symptoms, presence of symptoms of SMD, and aggressiveness. Teachers were also informed about SMD and aggressiveness. Children who complained frequent somatic symptoms (three or more in the last 2 weeks) were compared with those who did not. Two hundred five children (64.3%) reported at least one physical complaint in the 2 weeks preceding the study. One hundred participants (31.3%) reported frequent somatic complaints. Positive associations were found with anxiety symptomatology, separation anxiety, social phobia, pediatric visits, and school absences, but not with aggressiveness or SMD symptoms. Somatic symptoms are common in a sample of preschool children but do not show a positive association with the symptoms of SMD. [Early Childhood Inventory-4]

 

12-23. Goetz, M, Yeh, CB, Ondrejka, I, Akay, A, Herczeg, I, Dobrescu, I, Kim, BN, Jin, XM, Riley, AW, Martenyi, F, Harrison, G, & Treuer, T (2012). A 12-month prospective, observational study of treatment regimen and quality of life associated with ADHD in Central and Eastern Europe and Eastern Asia. Journal of Attention Disorders, 16, 44-59.

 

Objectives: This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. Methods: 977 Male and female patients aged 6-17 years seeking treatment for symptoms of ADHD were assessed using the Child and Adolescent Symptom Inventory-4 Parent Checklists, and the Clinical Global Impressions-ADHD-Severity scale. QoL was assessed using the Child Health and Illness Profile-Child Edition parent report form. Patients were grouped according to whether they were prescribed psycho-and/or pharmacotherapy (treatment) or not (no/'other' treatment). Results: No statistically significant differences were observed between cohorts (treatment vs. no/'other' treatment) in terms of change in QoL, although there was improvement over 12 months, with a greater improvement experienced by patients in the treatment cohort in both study regions (CEE and Eastern Asia). Psychoeducation/counselling and methylphenidate were the predominant ADHD treatments prescribed. Conclusions: Although both treatment and no/'other' treatment cohorts showed improvements in mean QoL over 12 months, the difference was small and not statistically significant. A major limitation was the higher than anticipated number of patients switching treatments, predominantly from the no/'other' treatment cohort. [Czech, Hungarian, Romanian, Slovakian, Korean, Chinese, Mandarin, Turkish]

 

 

12-24. Gouze, KR, Lavigne, JV, Hopkins, J, Bryant, FB, & Lebailly, SA (2012). The relationship between temperamental negative affect, effortful control, and sensory regulation: a new look. Infant Mental Health Journal, 33, 620-632. 

Temperamental negative affectivity (NA) and effortful control (EC) have long been of interest to psychologists, but sensory regulation (SR) has received less attention. Using confirmatory factor analysis, the present study reexamined the Rothbart model of EC and NA using the Children's Behavior Questionnaire (CBQ; M.K. Rothbart, S.A. Ahadi, K.L. Hershy, & P. Fisher, 2001), along with alternative models of EC, NA, and SR using the CBQ and Short Sensory Profile. The results failed to replicate the Rothbart model of EC and NA, which includes SR within the EC and NA factors. A good fit was found for a three-factor model (EC, NA, and SR) that was replicated in a holdout sample. A three-factor model also showed a good fit when EC, NA, and SR items similar to symptoms of behavior problems were eliminated.  [Early Childhood Inventory-4]

 

12-25. Griggs, MS, & Mikami, AY (2012). Parental attention-deficit/hyperactivity disorder predicts child and parent outcomes of parental friendship coaching treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 1236-1246.

 

Objective: This study investigated the impact of parental attention-deficit/hyperactivity disorder (ADHD) symptoms on the peer relationships and parent child interaction outcomes of children with ADHD among families completing a randomized controlled trial of parental friendship coaching (PFC) relative to control families. Method: Participants were 62 children with ADHD (42 boys and 20 girls, 6 through 10 years old) and their parents. Approximately half of the families received PFC (a 3-month parent training intervention targeting the peer relationships of children with ADHD), and the remainder represented a no-treatment control group. Results: Parental inattention predicted equivalent declines in children's peer acceptance in both treatment and control families. However, treatment amplified differences between parents with high versus low ADHD symptoms for some outcomes: Control families declined in functioning regardless of parents' symptom levels. However, high parental inattention predicted increased child peer rejection and high parental inattention and impulsivity predicted decreased parental facilitation among treated families (indicating reduced treatment response). Low parental symptoms among treated families were associated with improved functioning in these areas. For other outcomes, treatment attenuated differences between parents with high versus low ADHD symptoms: Among control parents, high parental impulsivity was associated with increasing criticism over time, whereas all treated parents showed reduced criticism regardless of symptom levels. Follow-up analyses indicated that the parents experiencing poor treatment response are likely those with clinical levels of ADHD symptoms. Conclusions: Results underscore the need to consider parental ADHD in parent training treatments for children with ADHD. [Child Symptom Inventory-4]

 

12-26. Grondhuis, SN, & Aman, MG (2012). Assessment of anxiety in children and adolescents with autism spectrum disorders. Research In Autism Spectrum Disorders, 6, 1345-1365.

 

Anxiety disorders are among the most common comorbid conditions in children and adolescents with autism spectrum disorders (ASDs), although assessment presents unique challenges. Many symptoms of anxiety appear to overlap with common presentations of autism. Furthermore, deficits in language and cognitive functioning make it difficult for such children to convey their emotional states accurately. A comprehensive review of the recent literature was conducted to assay the types and rates of use of tools for evaluating anxiety symptoms in children and adolescents with ASDs. We identified strengths and weaknesses in existing scales, identified instruments that (although imperfect) seem to have a good coverage for youngsters with ASDs, recommended strategies for studying anxiety in these youth, and offered suggestions for future scale development. [Child Symptom Inventory-4, Child and Adolescent Symptom Inventory-4]

 

12-27. Guilfoyle, SM, Wagner, JL, Smith, G, & Modi, AC (2012). Early screening and identification of psychological comorbidities in pediatric epilepsy is necessary. Epilepsy & Behavior, 25, 495-500.

 

Youth with epilepsy often have co-occurring psychological symptoms that are due to underlying brain pathology, seizures, and/or antiepileptic drug side effects. The primary study aim was to compare the psychological comorbidities of youth with new-onset epilepsy versus chronic epilepsy. Primary caregivers of youth with either new-onset (n=82; M-age=9.9+/-2.9) or chronic epilepsy (n=76; M-age=12.8+/-3.3) completed the Behavioral Assessment Scale for Children-2nd Edition. Compared to those with new-onset epilepsy, the chronic group had significantly higher depressive and withdrawal symptoms, as well as lower activities of daily living. A higher proportion of youth with chronic epilepsy exhibited at-risk/clinically elevated depressive symptoms and difficulties with activities of daily living compared to the new-onset group. Proactive screening in youth with epilepsy to ensure timely identification of psychological symptoms and to guide early psychological intervention is warranted. [Adolescent Symptom Inventory-4, Child Symptom Inventory-4]

 

12-28. Houck, CD, Hadley, W, Tolou-Shams, M, & Brown, L (2012). Truancy is associated with sexual risk among early adolescents. Journal of Developmental and Behavioral Pediatrics, 33, 728-731. 

 

Objective: While previous studies have identified relationships between school truancy and adolescent substance use risk, sexual risk remains unaddressed. Methods: Urban early adolescents (mean age, 13.14 years) with mental health symptoms completed audio computer-assisted self-interviews regarding risk behaviors. Results: Teens who reported a history of skipping school (n = 25), compared with those who did not (n = 113), indicated greater frequency of having ever engaged in oral, vaginal, and anal sex, as well as nonintercourse sexual behaviors. They also reported less value in remaining abstinent but did not demonstrate differences in HIV knowledge or school connectedness. Conclusion: Truancy may serve as an important marker for the early identification of youth at risk for unintended pregnancy or sexually transmitted diseases. [Adolescent Symptom Inventory-4]

 

12-29. Kahn, RE, Frick, PJ, Youngstrom, E, Findling, RL, & Youngstrom, JK (2012). The effects of including a callous-unemotional specifier for the diagnosis of conduct disorder. Journal of Child Psychology and Psychiatry, 53, 271-282. 

 

Background: With Significant CallousUnemotional Traits has been proposed as a specifier for conduct disorder (CD) in the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The impact of this specifier on children diagnosed with CD should be considered. Methods: A multi-site cross-sectional design with volunteers (n = 1136) in the third-seventh grades and 566 consecutive referrals (ages 5-18) to a community mental health center were used to estimate the prevalence rates of CD with and without the proposed specifier. In addition, the degree of emotional and behavioral (especially physical aggression) disturbance and level of impairment in youth with and without CD and with and without the specifier was evaluated. Results: In the community sample, 10%-32% of those with CD and 2%-7% of those without CD met the callous-unemotional (CU) specifier threshold depending on informant. In the clinic-referred sample, 21%-50% of those with CD and 14%-32% without CD met the CU specifier threshold depending on informant. Those with CD and the specifier showed higher rates of aggression in both samples and higher rates of cruelty in the clinicreferred sample. Conclusions: Results indicate between 10% and 50% of youth with CD would be designated with the proposed CU specifier. Those with CD and the specifier appear to be more severe on a number of indices, including aggression and cruelty. [Child Symptom Inventory-4]

 

12-30. Keenan, K (2012). Mind the Gap: Assessing impairment among children affected by proposed revisions to the diagnostic criteria for oppositional defiant disorder. Journal of Abnormal Psychology, 121, 352-359. 

 

The Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) workgroup for disruptive behavior disorders is considering adopting a frequency threshold for symptoms of oppositional defiant disorder (ODD). In the present study, the impact of substituting the term "often" with a specific age-based frequency on impairment and prognosis among preschool children was tested in a longitudinal design. Mutually exclusive groups were created to identify children who met criteria for ODD based on a symptom threshold of "often," as in Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-4), and those that met criteria for ODD based on a threshold of "1-2 times per day," which approximated the proposal for DSM-5. Comparisons of these groups to each other and to nondiagnosed peers determined the impact of changing the symptom threshold on impairment and prognosis. Close to one-third of children who met DSM-4 criteria for ODD did not meet criteria under the alternative diagnosis; African American children were overrepresented in this group. Preschoolers who met DSM-4, but not the alternative criteria, had higher rates of ODD, conduct disorder (CD), and were more impaired than their nondiagnosed peers at baseline and follow-up. Preschoolers meeting DSM-4 criteria were less impaired than children meeting the alternative ODD criteria at baseline according to parent, but not according to teacher report. No differences could be detected between those meeting DSM-4 and those meeting the alternative criteria in rate of ODD, CD, or impairment at follow-up. Among clinically referred preschool children, changing the symptom threshold for ODD could result in a sizable group of children who would no longer meet diagnostic criteria, despite demonstrating significant morbidity concurrently and prospectively. [Early Childhood Inventory-4]

 

12-31. Kim, S, Nordling, JK, Yoon, JE, Boldt, LJ, & Kochanska, G (2012). Effortful control in "hot" and "cool" tasks differentially predicts children's behavior problems and academic performance. Journal of Abnormal Child Psychology, 41, 43-56.

 

Effortful control (EC), the capacity to deliberately suppress a dominant response and perform a subdominant response, rapidly developing in toddler and preschool age, has been shown to be a robust predictor of children's adjustment. Not settled, however, is whether a view of EC as a heterogeneous rather than unidimensional construct may offer advantages in the context of predicting diverse developmental outcomes. This study focused on the potential distinction between "hot" EC function (delay-of-gratification tasks that called for suppressing an emotionally charged response) and more abstract "cool" EC functions (motor inhibition tasks, suppressing-initiating response or Go-No Go tasks, and effortful attention or Stroop-like tasks). Children (N = 100) were observed performing EC tasks at 38 and 52 months. Mothers, fathers, and teachers rated children's behavior problems and academic performance at 67, 80, and 100 months, and children participated in a clinical interview at 100 months. Structural Equation Modeling (SEM) analyses with latent variables produced consistent findings across all informants: Children's scores in "hot" EC tasks, presumably engaging emotion regulation skills, predicted behavior problems but not academic performance, whereas their scores in "cool" EC tasks, specifically those engaging effortful attention, predicted academic performance but not behavior problems. The models of EC as a heterogeneous construct offered some advantages over the unidimensional models. Methodological and clinical implications of the findings are discussed. [Child Symptom Inventory-4]

 

12-32. Kim, JJ, Freeman, SFN, Paparella, T, & Forness, SR (2012). Five-year follow-up of preschoolers with autism and comorbid psychiatric disorders. Behavioral Disorders, 38, 57-70.

 

Although several studies have examined the prevalence of comorbid psychiatric disorders in children with autism spectrum disorders, there are no current longitudinal studies of such children regarding the impact of comorbidity. In this study, 44 of an original sample of 175 preschoolers were located after 5 1/2 years, at an average chronological age of 10 years 3 months, and reassessed for comorbid disorders; a subsample was surveyed regarding use of special education and mental health services. Findings not only suggest continued comorbidity but also somewhat higher than expected use of behavioral services, often requiring out-of-school funding. The differential impact of comorbidity is discussed in relation to special education and access to related services. [Adolescent Symptom Inventory-4, Child Symptom Inventory-4]

 

12-33. Kochanska, G, & Kim, S (2012). Toward a new understanding of legacy of early attachments for future antisocial trajectories: Evidence from two longitudinal studies. Development and Psychopathology, 24, Special Issue, 783-806.

 

Early parent-child attachment has been extensively explored as a contributor to children's future adaptive or antisocial outcomes, but the specific developmental mechanisms remain to be fully understood. We examined long-term indirect developmental sequelae of early security in two longitudinal community samples followed from infancy to early school age: the Family Study (102 mothers, fathers, and infants) and the Parent-Child Study (102 mothers and infants). Constructs at multiple levels (child characteristics, parent-child security, parental discipline, and child antisocial outcomes) were assessed using a range of methods (extensive behavioral observations in a variety of settings, informants' ratings). Both studies supported the proposed model of infant attachment as a potent catalyst that moderates future developmental socialization trajectories, despite having few long-term main effects. In insecure dyads, a pattern of coercion emerged between children who were anger prone as toddlers and their parents, resulting in parents' increased power-assertive discipline. Power assertion in turn predicted children's rule-breaking conduct and a compromised capacity to delay in laboratory paradigms, as well as oppositional, disruptive, callous, and aggressive behavior rated by parents and teachers at early school age. This causal chain was absent in secure dyads, where child anger proneness was unrelated to power assertion, and power assertion was unrelated to antisocial outcomes. Early insecurity appeared to act as a catalyst for the parent-child dyad embarking on a mutually adversarial path toward antisocial outcomes, whereas security defused such a maladaptive dynamic. The possible mechanisms of those effects were proposed.  [Child Symptom Inventory-4]

 

12-34. Lara, DR, Ottoni, GL, Brunstein, MG, Frozi, J, de Carvalho, HW, & Bisol, LW, (2012). Development and validity data of the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). Journal of Affective Disorders, 141, 390-398.

 

Background: The internet provides a research opportunity for psychiatry and psychology. This article presents the development and preliminary data of a large web-survey created to study how temperament relates to other psychological measures, behavior and psychiatric disorders. Methods: We used the Affective and Emotional Composite Temperament Scale (AFECTS) to evaluate temperament and we selected several self-report instruments to evaluate behavior, psychological constructs and mental disorders. The system provides anonymous psychological (phase 1) and psychiatric (phase 2) feedback and includes questions to assess the validity of the answers. Each phase has around 450 questions. This system was broadcast utilizing Brazilian media. Results: After the exclusion of 21.5% of the volunteers (those who failed the validation questions), 41,427 participants concluded the first part of the system (mean age = 31.2 +/- 10.5 yrs, 26.9% males), and 21,836 (mean age = 32.5 +/- 10.9 yrs, 25.1% males) completed phase 2. Around 25% have received a psychiatric diagnosis from a mental health professional. Demographic and temperament profiles of those who completed either only 80 questions, only phase 1, or the whole system were similar. The rate of non-serious answers (e. g. on bizarre behaviors) was very low and congruency of answers was very high. The internal consistency of classical trait scales (TCI-R and PANAS) was high (Cronbach's alpha > 0.80) for all dimensions. Limitations: Relatively high dropout rate due to the length of the process and an overrepresentation of female, young and well-educated subjects. Conclusions: The BRAINSTEP provides valid and abundant data on psychological and psychiatric measures. [Adult Self Report Inventory-4]

 

12-35. Lavigne, JV, Gouze, KR, Hopkins, J, Bryant, FB, & LeBailly, SA (2012). A multi-domain model of risk factors for ODD symptoms in a community sample of 4-year-olds. Journal of Abnormal Child Psychology, 40, 741-757. 

 

Few studies have been designed to assess the pathways by which risk factors are associated with symptoms of psychopathology across multiple domains, including contextual factors, parental depression, parenting, and child characteristics. The present study examines a cross-sectional model of risk factors for symptoms of Oppositional Defiant Disorder (ODD) in a diverse community sample of 796 four-year-old children. In the best-fitting model: (a) SES had indirect effects on contextual factors of stress and conflict, parental depression, and parenting factors including hostility, support, and scaffolding; (b) stress and conflict had both direct effects on ODD symptoms, and indirect effects via parental depression and parenting; (c) parenting had direct effects on ODD symptoms and indirect effects via child effortful control (EC), negative affect (NA) and sensory regulation (SR); (c) NA, EC, and SR had direct effects on symptom frequency, and attachment had indirect effects via EC, and SR. These results highlight the importance of using a multi-domain model to examine risk factors for symptoms of ODD, and also provide information about areas to target in treatment. [Early Childhood Inventory-4]

 

12-36. Lefler, EK, Hartung, CM, & Fedele, DA (2012). Psychometric properties of a primary care mental health screening tool for young children. Childrens Health Care, 41, 79-96.

 

The purpose of this article is to examine the psychometric properties of the Primary Care Mental Health Screener (PCMHS; Hartung & Lefler, 2010) for children. Fifty-eight parent-child dyads with children ages 3 to 8 were recruited. Child participants were administered IQ and achievement measures, and parents completed the screening tool and multiple measures of emotional, behavior, and social functioning. Receiver Operating Characteristic analyses suggest that the PCMHS has promising psychometric properties for several common clinical disorders (i.e., attention deficit hyperactivity disorder, oppositional defiant disorder, and anxiety). The PCMHS is a promising new screening tool. Implications, limitations, and future directions for research on children's mental health screening are discussed. [Early Childhood Inventory-4, Child Symptom Inventory-4]

 

12-37. Looyeh, MY, Kamali, K, & Shafieian, R (2012). An exploratory study of the effectiveness of group narrative therapy on the school behavior of girls with attention-deficit/hyperactivity symptoms. Archives of Psychiatric Nursing, 26, 404-410. 

 

This study explored the effectiveness of group narrative therapy for improving the school behavior of a small sample of girls with attention-deficit/hyperactivity disorder (ADHD). Fourteen clinics referred 9- to 11-year-old girls with a clinical diagnosis of ADHD were randomly assigned to treatment and wait-list control groups. Posttreatment ratings by teachers showed that narrative therapy had a significant effect on reducing ADHD symptoms 1 week after completion of treatment and sustained after 30 days. [Child Symptom Inventory-4]

 

12-38. Lopez-Villalobos, JA, Andres-De Llano, J, Sanchez-Azon, MI, Sanguino-Andres, R, & Alberola-Lopez, S (2012). Disruptive behavior disorders: Multidimensional analysis. International Journal of Clinical and Health Psychology, 12, 405-417.

 

The study focuses on the analysis of the contribution of sociodemographic, clinical, academic and family variables to the likelihood of the presence of disruptive behaviour disorder (DBD). Ex post facto, retrospective, transversal, comparative study in two groups (cases of DBD and clinical controls) is used. Ages range 6 to 16 years. Sample of 1,847 clinical cases. Cases and controls are defined by clinical interview according to DSM-IV-TR criteria. A descriptive phase and an estimated logistic regression procedure are included. The proposed model is significant and correctly classified 87.2% of cases. The variables male sex (OR = 1.82, p = .00), comorbidity (OR = 7.68, p = .00), borderline intellectual functioning (OR = 3.15, p = .00), less educated mothers (OR = 1.57, p = .04) and repeat the course (OR = 2, p = .00), significantly increased the probability for DBD. The variables age, psychiatric history, divorced parents and fathers' educational level are not significant in the model. DBD has multidimensional association with clinical, academic and family variables, being eligible for the inclusion in prevention programs. [Child Symptom Inventory-4]

 

12-39. Margulies, DM, Weintraub, S, Basile, J, Grover, PJ, & Carlson, GA (2012). Will disruptive mood dysregulation disorder reduce false diagnosis of bipolar disorder in children? Bipolar Disorders, 14, 488-496.

 

Objectives: The frequency of diagnosis of bipolar disorder has risen dramatically in children and adolescents. The DSM-V Work Group has suggested a new diagnosis termed disruptive mood dysregulation disorder (DMDD) (formerly temper dysregulation disorder with dysphoria) to reduce the rate of false diagnosis of bipolar disorder in young people. We sought to determine if the application of the proposed diagnostic criteria for DMDD would reduce the rate of diagnosis of bipolar disorder in children. Patients and methods: Eighty-two consecutively hospitalized children, ages 5 to 12 years, on a childrens inpatient unit were rigorously diagnosed using admission interviews of the parents and the child, rating scales, and observation over the course of hospitalization. Results: Overall, 30.5% of inpatient children met criteria for DMDD by parent report, and 15.9% by inpatient unit observation. Fifty-six percent of inpatient children had parent-reported manic symptoms. Of those, 45.7% met criteria for DMDD by parent-report, though only 17.4% did when observed on the inpatient unit. Conclusion: Although DMDD does decrease the rate of diagnosis of bipolar disorder in children, how much depends on whether history or observation is used. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4]

 

12-40. Marmorstein, NR. (2012). Associations between dispositions to rash action and internalizing and externalizing symptoms in children. Journal of Clinical Child and Adolescent Psychology, 42, 131-138. 

 

Impulsivity is not a unitary construct; instead, dispositions to rash action can be divided into five moderately-correlated dimensions. However, the associations between these dimensions and symptoms of psychopathology among youth remain unclear. The goal of this study was to examine associations between different dispositions to rash action and psychopathology in a community sample of middle school youth. One hundred forty-four youth (M age = 11.9; 65% Hispanic, 30% African American; 50% male; 81% qualifying for free school lunches) participated in this study. Self-reported questionnaire measures of dispositions to rash action (lack of planning, lack of perseverance, sensation seeking, negative urgency, and positive urgency) and psychopathology symptoms (conduct disorder [CD], alcohol use, depression, overall anxiety, panic, generalized anxiety, social anxiety, and separation anxiety, as well as teacher reports of attention deficit/hyperactivity disorder [ADHD] inattentive and hyperactive symptoms) were used. Negative and positive urgency were positively associated with all symptom types examined except certain anxiety subtypes (and positive urgency was not associated with ADHD symptoms). Lack of planning was positively associated with externalizing and depressive symptoms. Lack of perseverance was positively associated with CD. Sensation seeking was positively associated with both CD and alcohol use. When other dispositions were adjusted for, negative urgency remained a positive predictor of CD, whereas positive urgency remained a positive predictor of depressive and panic symptoms. Sensation seeking was negatively associated with separation anxiety. Psychopathology symptoms are differentially related to dispositions to rash action in children; emotion-based dispositions to rash action may be particularly important targets for future research. [Child Symptom Inventory-4]

 

12-41. Marshal, MP, Sucato, G, Stepp, SD, Hipwell, A, Smith, HA, Friedman, MS, Chung, T, & Markovic, N (2012). Substance use and mental health disparities among sexual minority girls: results from the Pittsburgh girls study. Journal of Pediatric and Adolescent Gynecology, 25, 15-18.

 

Purpose: To examine substance use and mental health disparities between sexual minority girls and heterosexual girls. Methods: Data from the Pittsburgh Girls Study were analyzed. All girls were 17 years old. Girls were included if they were not missing self-reported sexual orientation and mental health data (N = 527). Thirty-one girls (6%) endorsed same-sex romantic orientation/identity or current same-sex attraction. Bivariate analyses were conducted to test group differences in the prevalence of substance use and suicidal behavior, and group differences in depression, anxiety, borderline personality disorder (BPD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms. Results: Compared with heterosexual girls, sexual minority girls reported higher past-year rates of cigarette, alcohol, and heavy alcohol use, higher rates of suicidal ideation and self-harm, and higher average depression, anxiety, BPD. ODD, and CD symptoms. Conclusions: Sexual minority girls are an underrepresented group in the health disparities literature, and compared with heterosexual girls, they are at higher risk for mental health problems, most likely because of minority stress experiences such as discrimination and victimization. The disparities found in this report highlight the importance of discussing sexual orientation as part of a comprehensive preventive care visit. [Child Symptom Inventory-4]

 

12-42. McCabe, K, Yeh, M, Lau, A, & Argote, CB. (2012). Parent-child interaction therapy for Mexican Americans: results of a pilot randomized clinical trial at follow-up. Behavior Therapy, 43, 606-618.

 

We examined treatment effects over a 6- to 24-month period posttreatment for 3 different interventions for externalizing behavior problems in young Mexican American (MA) children: a culturally modified version of Parent-Child Interaction Therapy (PCIT), called Guiando a Nitios Activos (GANA), standard PCIT, and treatment as usual (TAU). Fifty-eight MA families with a 3- to 7-year-old child with clinically significant behavior problems were randomly assigned to GANA, standard PCIT, or TAU. As previously reported, all three treatment approaches produced significant pre-post improvement in conduct problems across a wide variety of parent-report measures, and those effects remained significant over the follow-up period. GANA produced results that were significantly superior to TAU on 6 out of 10 parent-report measures 6 to 24 months posttreatment, and GANA significantly outperformed PCIT on child internalizing symptoms. However, PCIT and TAU did not differ significantly from one another. These data suggest that both PCIT and GANA produce treatment gains that are maintained over time, and that GANA continues to outperform TAU over the long term. [Early Childhood Inventory-4]

 

12-43. McPartland, JC, Crowley, MJ, Perszyk, DR, Mukerji, CE, Naples, AJ, Wu, J, & Mayes, LC (2012). Preserved reward outcome processing in ASD as revealed by event-related potentials. Journal of Neurodevelopmental Disorders, 4, Article Number: 16. 

 

Background: Problems with reward system function have been posited as a primary difficulty in autism spectrum disorders. The current study examined an electrophysiological marker of feedback monitoring, the feedback-related negativity (FRN), during a monetary reward task. The study advanced prior understanding by focusing exclusively on a developmental sample, applying rigorous diagnostic characterization and introducing an experimental paradigm providing more subtly different feedback valence (reward versus non-reward instead of reward versus loss). Methods: Twenty-six children with autism spectrum disorder and 28 typically developing peers matched on age and full-scale IQ played a guessing game resulting in monetary gain ("win") or neutral outcome ("draw"). ERP components marking early visual processing (N1, P2) and feedback appraisal (FRN) were contrasted between groups in each condition, and their relationships to behavioral measures of social function and dysfunction, social anxiety, and autism symptomatology were explored. Results: FRN was observed on draw trials relative to win trials. Consistent with prior research, children with ASD exhibited a FRN to suboptimal outcomes that was comparable to typical peers. ERP parameters were unrelated to behavioral measures. Conclusions: Results of the current study indicate typical patterns of feedback monitoring in the context of monetary reward in ASD. The study extends prior findings of normative feedback monitoring to a sample composed exclusively of children and demonstrates that, as in typical development, individuals with autism exhibit a FRN to suboptimal outcomes, irrespective of neutral or negative valence. Results do not support a pervasive problem with reward system function in ASD, instead suggesting any dysfunction lies in more specific domains, such as social perception, or in response to particular feedback-monitoring contexts, such as self-evaluation of one's errors. [Child Symptom Inventory-4]

 

12-44. Miller, LJ, Nielsen, DM, & Schoen, SA (2013). Attention deficit hyperactivity disorder and sensory modulation disorder: A comparison of behavior and physiology. Research in Developmental Disabilities, 33, 804-818.

 

Children with attention deficit hyperactivity disorder (ADHD) are impulsive, inattentive and hyperactive, while children with sensory modulation disorder (SMD), one subtype of Sensory Processing Disorder, have difficulty responding adaptively to daily, sensory experiences. ADHD and SMD are often difficult to distinguish. To differentiate these disorders in children, clinical ADHD, SMD, and dual diagnoses were assessed. All groups had significantly more sensory, attention, activity, impulsivity, and emotional difficulties than typical children, but with distinct profiles. Inattention was greater in ADHD compared to. SMD. Dual diagnoses had more sensory-related behaviors than ADHD and more attentional difficulties than SMD. SMD had more sensory issues, somatic complaints, anxiety/depression, and difficulty adapting than ADHD. SMD had greater physiological/electrodermal reactivity to sensory stimuli than ADHD and typical controls. Parent-report measures identifying sensory, attentional, hyperactive, and impulsive difficulties varied in agreement with clinician's diagnoses. Evidence suggests ADHD and SMD are distinct diagnoses. [Child Symptom Inventory-4]

 

12-45. Nachman, S, Chernoff, M, Williams, P, Hodge, J, Heston, J, & Gadow, KD (2012). Human immunodeficiency virus disease severity, psychiatric symptoms, and functional outcomes in perinatally infected youth. Archives of Pediatrics & Adolescent Medicine, 166, 528-535.

 

Objective: To evaluate associations between human immunodeficiency virus (HIV) disease severity and psychiatric and functional outcomes in youth with perinatal HIV infection. Design: Cross-sectional analysis of entry data from an observational, prospective 2-year study. Logistic and linear regression models adjusted for potential confounders were used. Setting: Twenty-nine sites of the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group study in the United States and Puerto Rico. Participants: Youth aged 6 to 17 years who had HIV infection (N=319). Main Exposures: Antiretroviral treatment and perinatal HIV infection. Main Outcome Measures: Youth and primary caregivers were administered an extensive battery of measures that assessed psychiatric symptoms; cognitive, social, and academic functioning; and quality of life. Results: Characteristics of HIV were a current CD4 percentage of 25% or greater (74% of participants), HIV RNA levels of less than 400 copies/mL (59%), and current highly active antiretroviral therapy (81%). Analyses indicated associations of past and current Centers for Disease Control and Prevention class C designation with less severe attention-deficit/hyperactivity disorder inattention symptoms, older age at nadir CD4 percentage and lower CD4 percentage at study entry with more severe conduct disorder symptoms, higher RNA viral load at study entry with more severe depression symptoms, and lower CD4 percentage at study entry with less severe symptoms of depression. There was little evidence of an association between specific antiretroviral therapy and severity of psychiatric symptoms. A lower nadir CD4 percentage was associated with lower quality of life, worse Wechsler Intelligence Scale for Children Coding Recall scores, and worse social functioning. Conclusion: Human immunodeficiency virus illness severity markers are associated with the severity of some psychiatric symptoms and, notably, with cognitive, academic, and social functioning, all of which warrant additional study. [Child and Adolescent Symptom Inventory-4R]

 

12-46. Namdari, P, Nazari, H, & Pournia, Y (2012). Epidemiologic feature of attention deficit and hyperactivity disorder (ADHD) in elementary school children. Hong Kong Journal of Paediatrics, 17, 162-166. 

 

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric disorders starting from childhood that has afflicted 3-5% of school children. ADHD has destructive effects on people's social, educational, personality, and behaviuoral relationships in childhood and adulthood. This cross-sectional school based study included all the students studying in grades one to five at elementary schools in Khorramabad (N=945), Iran. Eight girls and 8 boys schools were selected using a cluster, multi-stage sampling method. The Child Symptom Inventories-4 (CSI4) standardised questionnaire was used to collect the data. The questionnaires were completed by teachers and parents in separate meetings. The cases that showed ADHD underwent clinical examinations by psychiatrists. The results were analysed via descriptive statistics and X-2 tests using the SPSS software. Out of 945 children, 50.7% and 49.3% were girls and boys respectively. Among the people studied, 3.17% suffered from ADHD including 40% from attention deficit, 33.3% from hyperactivity, and 26.6% from the combined type. ADHD was more prevalent in boys than in girls (4.9% vs. 1.5%). There was a significant relationship between children's gender and ADHD (p<0.005). The students in grade 5 showed the lowest, and those in grades 2 and 3 showed the highest ADHD rates. However, no significant relationships were found between parents age, educational level, occupation, income, grade, and psychiatric problems in family. Identifying behavioral disorders including ADHD in school children and adolescents, due to their high prevalence, seems to be necessary. Therefore, this study was conducted to investigate ADHD prevalence in elementary school students of Khorramabad.

 

12-47. Pardini, D, Stepp, S, Hipwell, A, Stouthamer-Loeber, M, & Loeber, R (2012). The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 62-73.

 

Objective: A callous-unemotional (CU) subtype of conduct disorder (CD) has been proposed as an addition to the fifth edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5). This study tested the hypothesis that young girls with the CU subtype of CD would exhibit more severe antisocial behavior and less severe internalizing problems over time relative to girls with CD alone. Second, the developmental outcomes of girls with CU traits in the absence of CD was examined because these girls would be overlooked by the proposed CU subtyping scheme. Method: Theses issues were examined in a community sample of 1,862 girls 6 to 8 years of age at study onset. Outcomes included internalizing and externalizing problems, academic achievement, and global impairment assessed concurrently and at a 6-year follow-up. Results: Girls with the CU subtype of CD had higher levels of externalizing disorder symptoms, bullying, relational aggression, and global impairment than girls with CD alone. Girls with CD alone tended to have more anxiety problems than girls with the CU subtype of CD. Girls with high CU traits without CD exhibited higher ODD and attention-deficit/hyperactivity disorder (ADHD) symptoms and lower academic achievement at the 6-year follow-up relative to girls without CU traits and CD. Group differences at the 6-year follow-up were primarily accounted for by baseline differences on the outcomes. Conclusions: The proposed DSM-5 CU subtype of CD identifies young girls who exhibit lower anxiety problems and more severe aggression, CD symptoms, academic problems and global impairment across time than girls with CD alone. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4]

 

12-48. Pardini, DA, & Byrd, AL (2012). Perceptions of aggressive conflicts and others' distress in children with callous-unemotional traits: I'll show you who's boss, even if you suffer and I get in trouble'. Journal of Child Psychology and Psychiatry, 53, 283-291. 

 

Background: Children with callous-unemotional (CU) traits may have a particularly malevolent view of social conflicts and a pervasive insensitivity to others distress. The current study examined whether children with CU traits have unique expectations and values regarding the consequences of aggressive conflicts and a ubiquitous lack of concern for others feelings independent of co-occurring aggression. Methods: Participants were 96 (46 males, 50 females) children recruited from elementary schools within an urban city. Associations between CU traits and child reports of outcome expectancies/ values following aggressive conflicts and facets of empathy were examined after controlling for aggression, academic abilities, and demographic covariates. Results: Children with higher CU traits were less likely to expect that aggression would result in victim suffering and feelings of remorse. After controlling for co- occurring aggression, children with higher CU traits were more likely to expect that aggression would result in peer dominance, while children with higher levels of aggression were more likely to expect that attacking others would reduce their aversive behavior. Children with higher CU traits were less concerned that aggressive behavior would result in punishment, victim suffering, and feelings of remorse. Moreover, children with higher CU traits reported lower levels of empathetic concern and sadness in response to others' distress outside of aggressive conflicts. Conclusions: Children with CU traits tend to minimize the extent to which aggression causes victim suffering and openly acknowledge caring less about distress and suffering in others. They are less intimidated by the possibility of being punished for aggressive behavior and tend to view aggression as an effective means for dominating others. In sum, children with CU traits have a particularly malicious social schema that may be difficult to change using conventional treatment methods. [Child Symptom Inventory-4]

 

12-49. Poch, FV, Carrasco, MG, Moreno, YG, Ballabriga, MCJ, & Aznar, FC (2012). Disruptive behavior in adolescence and its relationship with temperament and coping styles. Psicothema, 24, 567-572.

 

Disruptive behavior in adolescence and its relationship with temperament and coping styles. Employing the DSM-IV TR classification, which classifies both antisocial behavior disorder and oppositional defiant disorder under the label of disruptive behavior disorder, a study was conducted with two aims: a) to determine the symptomatological differences of disruptive behavior disorder in adolescence depending on gender, age and school location, and b) to analyse the relationships between temperament, coping and the psychopathological dimensions of antisocial and oppositional defiant behavior. The YI-4, EATQ-R and ACS were administered to a sample of 1,240 adolescents between 11 and 17 years of age. The results show that boys display a greater number of antisocial behaviors than girls. No differences in school location were observed. In the oppositional defiant symptoms, there were differences according to age group, with 13 to 14 years being an age when there is a greater symptomatology. The data indicate a positive correlation with psychopathological dimensions of both surgency and non-productive coping and a negative correlation with effortful control and productive coping. [Youths (Self Report) Inventory-4]

 

12-50. Raiker, JS, Rapport, MD, Kofler, MJ, & Sarver, DE (2012). Objectively-measured impulsivity and attention-deficit/hyperactivity disorder (ADHD): testing competing predictions from the working memory and behavioral inhibition models of ADHD. Journal of Abnormal Child Psychology, 40, 699-713.

 

Impulsivity is a hallmark of two of the three DSM-IV ADHD subtypes and is associated with myriad adverse outcomes. Limited research, however, is available concerning the mechanisms and processes that contribute to impulsive responding by children with ADHD. The current study tested predictions from two competing models of ADHD-working memory (WM) and behavioral inhibition (BI)-to examine the extent to which ADHD-related impulsive responding was attributable to model-specific mechanisms and processes. Children with ADHD (n = 21) and typically developing children (n = 20) completed laboratory tasks that provided WM (domain-general central executive [CE], phonological/visuospatial storage/rehearsal) and BI indices (stop-signal reaction time [SSRT], stop-signal delay, mean reaction time). These indices were examined as potential mediators of ADHD-related impulsive responding on two objective and diverse laboratory tasks used commonly to assess impulsive responding (CPT: continuous performance test; VMTS: visual match-to-sample). Bias-corrected, bootstrapped mediation analyses revealed that CE processes significantly attenuated between-group impulsivity differences, such that the initial large-magnitude impulsivity differences were no longer significant on either task after accounting for ADHD-related CE deficits. In contrast, SSRT partially mediated ADHD-related impulsive responding on the CPT but not VMTS. This partial attenuation was no longer significant after accounting for shared variance between CE and SSRT; CE continued to attenuate the ADHD-impulsivity relationship after accounting for SSRT. These findings add to the growing literature implicating CE deficits in core ADHD behavioral and functional impairments, and suggest that cognitive interventions targeting CE rather than storage/rehearsal or BI processes may hold greater promise for alleviating ADHD-related impairments. [Child Symptom Inventory-4]

 

12-51. Sauder, CL, Beauchaine, TP, Gatzke-Kopp, LM, Shannon, KE, & Aylward, E. (2012). Neuroanatomical correlates of heterotypic comorbidity in externalizing male adolescents. Journal of Clinical Child and Adolescent Psychology, 41, 346-352.

 

Children and adolescents with externalizing behavior disorders including attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) often present with symptoms of comorbid internalizing psychopathology. However, few studies have examined central nervous system correlates of such comorbidity. We evaluated interactions between externalizing and internalizing symptoms in predicting mesolimbic, septo-hippocampal, and anterior cingulate volumes among 12- to 16-year-old boys with either ADHD, ADHD and CD, or no psychiatric condition (n = 35). These regions were chosen given established links to trait impulsivity, trait anxiety, and behavior regulation, respectively. Collapsed across groups, Externalizing x Internalizing symptom interactions accounted for individual differences in gray matter densities in each region. Externalizing youth with comorbid internalizing symptoms showed smaller reductions in gray matter than individuals with externalizing psychopathology alone. These results suggest that internalizing symptoms are associated with less severe structural compromises in brain regions subserving motivation and behavior regulation among externalizing boys. [Adolescent Symptom Inventory-4]

 

12-52. Scahill, L, McCracken, JT, Bearss, K, Robinson, F, Hollander, E, King, B, Bregman, J, Sikich, L, Dukes, K, Sullivan, L, Anagnostou, E, Donnelly, C, Kim, YS, Ritz, L, Hirtz, D, & Wagner, A. (2012). Design and subject characteristics in the federally-funded citalopram trial in children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 42, 432-440.

 

The Studies to Advance Autism Research and Treatment Network conducted a randomized trial with citalopram in children with Pervasive developmental disorders (PDDs). We present the rationale, design and sample characteristics of the citalopram trial. Subjects (128 boys, 21 girls) had a mean age of 9.3 (+/- 3.12) years; 132 (88.6%) were diagnosed with autistic disorder (4.7% with Asperger's Disorder; 6.7% with PDD-not otherwise specified). Less than half of the subjects were intellectually disabled; 117 (78.5%) were rated Moderate or Marked on the Clinical Global Impression for Severity. Study measures were similar to previous Research Units on Pediatric Psychopharmacology trials. Subjects in this trial were slightly older and more likely to have complaints of repetitive behavior than participants in RUPP trials. [Child Symptom Inventory-4]

 

12-53. Stepp, SD, Burke, JD, Hipwell, AE, & Loeber, R (2012). Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls. Journal of Abnormal Child Psychology, 40, 7-20. 

 

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1,233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8 to 10 and 10 to 13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10 to 13 and the rate of growth in ODD scores from 8 to 10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls. [Child Symptom Inventory-4]

 

12-54. Sans, JC, Hernandez-Martinez, C, Munoz, SC, Garcia, LL, & Trallero, JT (2012). The Leyton Obsessional Inventory-Child Version: Validity and reliability in Spanish non-clinical population. International Journal of Clinical and Health Psychology, 12, 81-96.

 

We assessed the factor structure, validity and reliability of the Spanish version of the Leyton Obsessional Inventory-Child Version (LOI-CV) and determined the optimal cut-off score for detecting obsessive-compulsive disorder (OCD). A total of 1,514 students (aged 8-12) participated in the first phase of the study and 562 of these participated in the second phase (participants at risk of mood and anxiety disorders and controls without risk). The LOI-CV was administered in both phases and the OCD diagnosis was made in the second phase. In the exploratory factor analysis, we obtained three factors that explained 45.84% of the variance: Order/checking/pollution, Obsessive concern and Superstition/mental compulsion. The reliability was good (.79-.90). The cut-off scores selected were 21 for the total score and 10 for the interference score, both of which had a sensitivity of 82.4% and a specificity of 84.1% and 83.8%, respectively, for detecting OCD. LOI-CV scores were significantly higher in children with OCD diagnosis than in children with subclinical diagnosis and children without diagnosis. There were no gender or age differences in the LOI-CV scores. The results support the validity and reliability of the LOI-CV as a screening test for OCD in a non-clinical population. [Child Symptom Inventory-4]

 

12-55. Sebastian, CL, McCrory, EJP, Cecil, CAM, Lockwood, PL, De Brito, SA, Fontaine, NMG, & Viding, E (2012). Neural responses to affective and cognitive theory of mind in children with conduct problems and varying levels of callous-unemotional traits. Archives of General Psychiatry, 69, 814-822. 

 

Context: Reduced neural responses to others' distress is hypothesized to play a critical role in conduct problems coupled with callous-unemotional traits, whereas increased neural responses to affective stimuli may accompany conduct problems without callous-unemotional traits. Heterogeneity of affective profiles in conduct problems may account for inconsistent neuroimaging findings in this population. Objectives: To broaden understanding of neural processing in conduct problems using an affective processing task including an empathy component as well as to explore dimensional contributions of conduct problems symptoms and callous-unemotional traits to variance in affective neural responses. Design: Case-control study. Setting: On-campus neuroimaging facility. Participants: Thirty-one boys with conduct problems (mean age, 14.34 years) and 16 typically developing control subjects (mean age, 13.51 years) matched for age (range, 10-16 years), IQ, socioeconomic status, handedness, and race/ethnicity. Participants were recruited using screening questionnaires in a community-based volunteer sample. Main Outcome Measures: Functional magnetic resonance imaging of a task contrasting affective and cognitive theory of mind judgments. Results: Relative to typically developing children, children with conduct problems showed reduced activation in right amygdala and anterior insula for affective vs cognitive theory of mind judgments. Furthermore, in the right amygdala, regression analysis within the conduct-problems group showed suppressor effects between ratings of conduct problems and callous-unemotional traits. Specifically, unique variance associated with conduct problems was positively correlated with amygdala reactivity, whereas unique variance associated with callous-unemotional traits was negatively correlated with amygdala reactivity. These associations were not explained by hyperactivity, depression/anxiety symptoms, or alcohol use ratings. Conclusions: Childhood conduct problems are associated with amygdala and anterior insula hypoactivity during a complex affective processing task including an empathy component. Suppressor effects between conduct problems and callous-unemotional traits in the amygdala suggest a potential neural substrate for heterogeneity in affective profiles associated with conduct problems. [Child and Adolescent Symptom Inventory-4R]

 

12-56. Silk, JS, Stroud, LR, Siegle, GJ, Dahl, RE, Lee, KH, & Nelson, EE (2012). Peer acceptance and rejection through the eyes of youth: pupillary, eyetracking and ecological data from the Chatroom Interact task. Social Cognitive and Affective Neuroscience, 7, 93-105.

 

We developed an ecologically valid virtual peer interaction paradigm-the Chatroom Interact Task in which 60 pre-adolescents and adolescents (ages 9-17 years) were led to believe that they were interacting with other youth in a simulated internet chatroom. Youth received rejection and acceptance feedback from virtual peers. Findings revealed increased pupil dilation, an index of increased activity in cognitive and affective processing regions of the brain, to rejection compared to acceptance trials, which was greater for older youth. Data from a cell-phone Ecological Momentary Assessment (EMA) protocol completed following the task indicated that increased pupillary reactivity to rejection trials was associated with lower feelings of social connectedness with peers in daily life. Eyetracking analyses revealed attentional biases toward acceptance feedback and away from rejection feedback. Biases toward acceptance feedback were stronger for older youth. Avoidance of rejection feedback was strongest among youth with increased pupillary reactivity to rejection, even in the seconds leading up to and following rejection feedback. These findings suggest that adolescents are sensitive to rejection feedback and seek to anticipate and avoid attending to rejection stimuli. Furthermore, the salience of social rejection and acceptance feedback appears to increase during adolescence. [Adolescent Symptom Inventory-4, Child Symptom Inventory-4]

 

12-57. Strickland, J, Hopkins, J, & Keenan, K (2012). Mother-teacher agreement on preschoolers' symptoms of ODD and CD: does context matter? Journal of Abnormal Child Psychology, 40, 933-943.

 

The aims of this study were to examine mother-teacher agreement on oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms and diagnoses in preschool children; to determine if context is a source of disagreement; and to explore if sex, referral status, and age moderated agreement rates. Participants included 158 male and 139 female 3- to 5-year old preschool children, their mothers, and teachers. A structured interview, the Kiddie-Disruptive Behavior Disorder Schedule was used for maternal report and teachers completed the Early Childhood Inventory-4. Results indicated that mothers reported more symptoms and diagnoses of ODD and CD than teachers, and mother-teacher agreement on both ODD and CD symptoms and diagnoses was low. Level of mother-teacher agreement increased when reporting on behavior in the same context; however, the rates remain modest. Referral status increased the likelihood of mother and teacher agreement on several ODD and CD symptoms, as well as ODD and CD diagnosis. These data suggest that context plays a role in mother-teacher agreement in the assessment of young children's ODD and CD symptoms.

 

12-58. Tan, PZ, Forbes, EE, Dahl, RE, Ryan, ND, Siegle, GJ, Ladouceur, CD, & Silk, JS (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53, 197-206.

 

Background: Reviews have highlighted anxious youths affective disturbances, specifically, elevated negative emotions and reliance on ineffective emotion regulation strategies. However, no study has examined anxious youths emotional reactivity and regulation in real-world contexts. Methods: This study utilized an ecological momentary assessment approach to compare real-world emotional experiences of 65 youth with generalized anxiety disorder, social anxiety disorder, or social phobia (ANX) and 65 age-matched healthy controls (CON), ages 9-13 years. Results: Hierarchical linear models revealed that ANX reported higher levels of average past-hour peak intensity of nervous, sad and upset emotions than CON youth but similar levels during momentary reports of current emotion. As expected, ANX youth reported more frequent physiological reactions in response to a negative event; however, there were no group differences in how frequently they used cognitive-behavioral strategies. Avoidance, distraction and problem solving were associated with the down-regulation of all negative emotions except nervousness for both ANX and CON youth; however, group differences emerged for acceptance, rumination and physiological responding. Conclusions: In real-world contexts, ANX youth do not report higher levels of momentary negative emotions but do report heightened negative emotions in response to challenging events. Moreover, ANX youth report no differences in how frequently they use adaptive regulatory strategies but are more likely to have physiological responses to challenging events. They are also less effective at using some strategies to down-regulate negative emotion than CON youth. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4]

 

12-59. Tanaka, JW, Wolf, JM, Klaiman, C, Koenig, K, Cockburn, J, Herlihy, L, Brown, C, Stahl, SS, South, M, McPartland, JC, Kaiser, MD, & Schultz, RT. (2012).  The perception and identification of facial emotions in individuals with autism spectrum disorders using the Let's Face It! Emotion Skills Battery. Journal of Child Psychology and Psychiatry, 53, 1259-1267.

 

Background: Although impaired socialemotional ability is a hallmark of autism spectrum disorder (ASD), the perceptual skills and mediating strategies contributing to the social deficits of autism are not well understood. A perceptual skill that is fundamental to effective social communication is the ability to accurately perceive and interpret facial emotions. To evaluate the expression processing of participants with ASD, we designed the Lets Face It! Emotion Skills Battery (LFI! Battery), a computer-based assessment composed of three subscales measuring verbal and perceptual skills implicated in the recognition of facial emotions. Methods: We administered the LFI! Battery to groups of participants with ASD and typically developing control (TDC) participants that were matched for age and IQ. Results: On the Name Game labeling task, participants with ASD (N = 68) performed on par with TDC individuals (N = 66) in their ability to name the facial emotions of happy, sad, disgust and surprise and were only impaired in their ability to identify the angry expression. On the Matchmaker Expression task that measures the recognition of facial emotions across different facial identities, the ASD participants (N = 66) performed reliably worse than TDC participants (N = 67) on the emotions of happy, sad, disgust, frighten and angry. In the PartsWholes test of perceptual strategies of expression, the TDC participants (N = 67) displayed more holistic encoding for the eyes than the mouths in expressive faces whereas ASD participants (N = 66) exhibited the reverse pattern of holistic recognition for the mouth and analytic recognition of the eyes. Conclusion: In summary, findings from the LFI! Battery show that participants with ASD were able to label the basic facial emotions (with the exception of angry expression) on par with age- and IQ-matched TDC participants. However, participants with ASD were impaired in their ability to generalize facial emotions across different identities and showed a tendency to recognize the mouth feature holistically and the eyes as isolated parts. [Child Symptom Inventory-4]

 

12-60. Theunissen, SCPM, Rieffe, C, Kouwenberg, M, De Raeve, L, Soede, W, Briaire, JJ, & Frijns, JHM. (2012). Anxiety in children with hearing aids or cochlear implants compared to normally hearing controls. Laryngoscope, 122, 654-659.

 

Objectives/Hypothesis: The objectives of this study were to examine the levels of anxiety in hearing-impaired children with hearing aids or cochlear implants compared to normally hearing children, and to identify individual variables that were associated with differences in the level of anxiety. Study Design: Large retrospective cohort study. Methods: Self-reports and parent-reports concerning general anxiety, social anxiety, and generalized anxiety disorder were used. The study group (mean age, 11.8 years) consisted of three age-matched subgroups: 32 children with cochlear implants, 51 children with conventional hearing aids, and 127 children without hearing loss. Results: Levels of anxiety in children with cochlear implants and normally hearing children were similar. Early implantation was associated with lower levels of general and social anxiety. Remarkably, children with conventional hearing aids had higher levels of social anxiety, and their parents also reported more generalized anxiety disorder. Conclusions: The outcomes demonstrate that in their level of anxiety, children with cochlear implants might be more comparable to normally hearing children than to children with hearing aids. This positive finding can be the consequence of audiological factors or other aspects of the cochlear implant rehabilitation program. [Child Symptom Inventory-4]

 

12-61. Tudor, ME, DeVincent, CJ, & Gadow, KD. (2012). Prenatal pregnancy complications and psychiatric symptoms: Children with ASD versus clinic controls. Research in Autism Spectrum Disorders, 6, 1401-1405.

 

The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a DSM-IV-referenced rating scale and developmental history questionnaire. Participants were classified as having >= 1 PPC (+PPC) versus none (-PPC). Children with ASD were significantly more likely to have PPC than Controls. Intra-group comparisons demonstrated that children in the ASD + PPC group had more severe anxiety than ASD/-PPC group. The Control + PPC group obtained higher symptom ratings of inattention., hyperactivity, and oppositional behavior than Control/-PPC. Children in the ASD + PPC group were rated as having more severe anxiety and depression symptoms than Control + PPC. Dissimilar associations in ASD and non-ASD samples were found, suggesting divergent pathogenic processes in different clinical phenotypes. [Child and Adolescent Symptom Inventory-4R]

 

12-62. van der Molen, E, Hipwell, AE, Vermeiren, R, & Loeber, R. (2012). Cumulative effects of mothers' risk and promotive factors on daughters' disruptive behavior. Journal of Abnormal Child Psychology, 40, 727-739.

 

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043). Maternal risk and promotive factors were operative at different time points in girls' development. Maternal warmth explained variance in girls' disruptive behavior, even after controlling for maternal risk factors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of risk factors increased the chance on girls' disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more risk factors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternal factors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls' disruptive behavior. [Child Symptom Inventory-4]

 

12-63. Viding, E, Sebastian, CL, Dadds, MR, Lockwood, PL, Cecil, CAM, De Brito, SA, & McCrory, EJ (2012). Amygdala response to preattentive masked fear in children with conduct problems: the role of callous-unemotional traits. American Journal of Psychiatry, 169, 1109-1116. 

 

Objective: In children with conduct problems, high levels of callous-unemotional traits are associated with amygdala hypoactivity to consciously perceived fear, while low levels of callous-unernotional traits may be associated with amygdala hyperactivity. Behavioral data suggest that fear processing deficits in children with high callous-unemotional traits may extend to stimuli presented below conscious awareness (preattentively). The authors investigated the neural basis of this effect. Amygdala involvement was predicted on the basis of its role in preattentive affective processing in healthy adults and its dysfunction in previous studies of conduct problems. Method: Functional MRI was used to measure neural responses to fearful and calm faces presented preattentively (for 17 ms followed by backward masking) in boys with conduct problems and high callous-unemotional traits (N=15), conduct problems and low callous-unemotional traits (N=15), and typically developing comparison boys (N=16). Amygdala response to fearful and calm faces was predicted to differentiate groups, with the greatest response in boys with conduct problems and low callous-unemotional traits and the lowest in boys with conduct problems and high callous-unemotional traits. Results: In the right amygdala, a greater amygdala response was seen in boys with conduct problems and low callous-unemotional traits than in those with high callous-unemotional traits. The findings were not explained by symptom levels of conduct disorder, attention-deficit hyperactivity disorder, anxiety, or depression. Conclusions: These data demonstrate differential amygdala activity to preattentively presented fear in children with conduct problems grouped by callous-unemotional traits, with high levels associated with lower amygdala reactivity. The study's findings complement increasing evidence suggesting that callous-unemotional traits are an important specifier in the classification of children with conduct problems. [Child Symptom Inventory-4]

 

12-64. Wang, Y, Horst, KK, Kronenberger, WG, Hummer, TA, Mosier, KM, Kalnin, AJ, Dunn, DW, & Mathews, VP. (2012). White matter abnormalities associated with disruptive behavior disorder in adolescents with and without attention-deficit/hyperactivity disorder. Psychiatry Research-Neuroimaging, 202, 245-251.

 

Disruptive behavior disorders (DBD) are among the most commonly diagnosed mental disorders in children and adolescents. Some important characteristics of DBD vary based on the presence or absence of comorbid attention-deficit/hyperactivity disorder (ADHD), which may affect the understanding of and treatment decision-making related to the disorders. Thus, identifying neurobiological characteristics of DBD with comorbid ADHD (DBD + ADHD) can provide a basis to establish a better understanding of the condition. This study aimed to assess abnormal white matter microstructural alterations in DBD + ADHD as compared to DBD alone and healthy controls using diffusion tensor imaging (DTI). Thirty-three DBD (19 with comorbid ADHD) and 46 age-matched healthy adolescents were studied using DTI. Fractional anisotropy (FA), and mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were analyzed using tract-based spatial statistics (TBSS). Significantly lower FA and higher MD. RD and AD in many white matter fibers were found in adolescents with DBD + ADHD compared to controls. Moreover, lower FA and higher RD were also found in the DBD + ADHD versus the DBD alone group. Alterations of white matter integrity found in DBD patients were primarily associated with ADHD, suggesting that ADHD comorbidity in DBD is reflected in greater abnormality of microstructural connections. [Adolescent Symptom Inventory-4]

 

12-65. White, SW, Schry, AR, & Maddox, BB (2012). Brief report: the assessment of anxiety in high-functioning adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 42, 1138-1145.

 

Anxiety may exacerbate interpersonal difficulties and contribute to secondary behavioral problems in adolescents with High-Functioning Autism Spectrum Disorder (HFASD). This study was conducted to assess the psychometric properties and construct validity of measures of anxiety with a sample (n = 30) of adolescents with HFASD and comorbid anxiety disorders. Results indicate that the measures (CASI-Anxiety Scale; Sukhodolsky et al. 2008; MASC; March 1998) possess acceptable internal consistency, and there is evidence of discriminant validity. Most of the adolescents, however, under-reported problems with anxiety, compared to parent-reported and clinician-derived reports and given they were seeking treatment for anxiety problems. Findings highlight the importance of using multiple raters in clinical practice and consideration of rater discrepancies in clinical research.

 

12-66. Witwer, AN, Lecavalier, L, & Norris, M (2012). Reliability and validity of the children's interview for psychiatric syndromes-parent version in autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 1949-1958.

 

The Children's Interview for Psychiatric Syndromes-Parent Version (P-ChIPS) is a structured psychiatric interview designed to assess the presence of psychiatric disorders in children and adolescents. This study examined the reliability and validity of the P-ChIPS in 61 youngsters (6- to 17-years-old) with Autism Spectrum Disorders. Reliability analyses were conducted according to level of functioning and language level. Results indicated that interrater reliability values were largely in the good to excellent range. Concordance between the P-ChIPS and the Child and Adolescent Symptoms Inventory-4R was fair for the majority of disorders. Percent overall agreement for most disorders was good, lending support to the validity of the P-ChIPS. The results of this study suggest that the P-ChIPS is appropriate for this population.

 

 

YEAR: 2011

 

11-1. Bastiaens, L. (2011). Improvement in global psychopathology increases quality of life during treatment of ADHD with atomoxetine or stimulants. Psychiatric Quarterly, 82, 303-308.

 

To evaluate what determines the increase in quality of life during treatment for ADHD: improvement in core ADHD symptoms or improvement in global psychopathology ratings. A prospective follow-up of ADHD patients in one community clinic. Standardized evaluation and outcome measures were used, including the Mini International Neuropsychiatric Interview, Child Symptom Inventory, 18 item ADHD rating scale, and the Health and Life Functioning Scale. 75 patients between the ages of 6 and 12 were treated with atomoxetine or stimulants with a stable dose for 10 months. At end point, there were modest improvements in ADHD symptoms, global psychopathology, level of functioning and quality of life. The improvement in quality of life was driven by a decrease in global psychopathology, not by a decrease in ADHD symptoms. The treatment for ADHD may need to be broadened beyond the core symptoms. A chronic disease management model may well be applicable. [Child Symptom Inventory-4]

 

11-2. Brenner, S.L., & Beauchaine, T.P. (2011). Pre-ejection period reactivity and psychiatric comorbidity prospectively predict substance use initiation among middle-schoolers: A pilot study. Psychophysiology, 48, 1587-1595.

 

Youth with conduct problems (CPs) or depression are at high risk for early initiation of substance use, and for future substance use disorders (SUDs). Comorbid CPs and depression increase risk even further, yet understanding how these conditions interact remains elusive. One hypothesis is that altered mesolimbic dopamine function contributes to symptoms of CPs, depression, and SUDs. Cardiac pre-ejection period (PEP) reactivity to incentives is linked theoretically and functionally to central dopamine responding. We evaluated PEP reactivity to reward as a prospective biomarker of substance use in a study of 206 youth with depression, CPs, CPs and depression, or no psychiatric condition. Children were 8-12 years old at the first of three annual assessments. Reduced PEP reactivity was associated with increased likelihood of future alcohol use, and CPs interacted with anxiety and depression to double risk for marijuana and other substance use. [Child Symptom Inventory-4]

 

11-3. Bufferd, S.J., Dougherty, L.R., Carlson, G.A., & Klein, D.N. (2011). Parent-reported mental health in preschoolers: findings using a diagnostic interview. Comprehensive Psychiatry, 52, 359-369.

 

Previous research suggests that many preschoolers meet criteria for psychiatric diagnoses; still, relatively little is known about preschool mental health, particularly emotional problems, in the community. This study investigated the rates of parent-reported DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) disorders in a large community sample of preschoolers using the Preschool Age Psychiatric Assessment (PAPA). Five hundred forty-one parents were interviewed with the PAPA. Of the children, 27.4% met criteria for a PAPA/DSM-IV diagnosis; 9.2% met criteria for 2 or more diagnoses. Oppositional defiant disorder (ODD) (9.4%), specific phobia (9.1%), and separation anxiety disorder (5.4%) were the most common diagnoses; depression (1.8%), selective mutism (1.5%), and panic disorder (0.2%) were the least common. In addition, there was significant comorbidity/covariation between depression, anxiety, and ODD and between ODD and attention-deficit/hyperactivity disorder (odds ratios = 1.81-18.44; P < .05), and significant associations with measures of psychosocial functioning. The stability and clinical significance of diagnoses and patterns of comorbidity must be elucidated in future research. [Early Childhood Inventory-4]

 

11-4. Chelonis, J.J., Johnson, T.A., Ferguson, S.A., Berry, K.J., Kubacak, B., Edwards, M.C., & Paule, M.G. (2011).Effect of methylphenidate on motivation in children with attention-deficit/hyperactivity disorder. Experimental and Clinical Psychopharmacology, 19, 145-153.

 

The effects of methylphenidate (MPH) on motivation were examined using a progressive ratio (PR) task in children who were prescribed MPH for the treatment of ADHD. Twenty-one children, 7 to 12 years of age, completed two test sessions, one under the effects of medication and one not. During each session, children pressed a lever to earn nickel reinforcers, where the first press resulted in a reinforcer and 10 additional presses were required for each subsequent reinforcer. Children on MPH had a significantly higher breakpoint than when off medication. This MPH-associated increase in the breakpoint manifested as a significant decrease in the interresponse times (IRT). Further, MPH administration resulted in a significant decrease in IRT variability. In contrast, MPH administration had no significant effects on the means and variability of postreinforcement pause duration. These results suggest that MPH increased motivation in children being treated for ADHD. Further, the inability of MPH to significantly reduce postreinforcement pause duration while simultaneously decreasing IRTs suggests that while MPH may increase motivation to perform an ongoing task, it may have little effect on the initiation of that task. [Child Symptom Inventory-4]

 

11-5. Chien, Y.L., Gau, S.S.F., & Gadow, K.D. (2011). Sex difference in the rates and co-occurring conditions of psychiatric symptoms in incoming college students in Taiwan. Comprehensive Psychiatry, 52, 195-207.

 

Objective: The authors investigated the sex difference in the rates and co-occurring patterns in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition referenced psychiatric symptoms among incoming first-year college students in Taiwan. Methods: This was a college-based questionnaire survey. The participants included 273 1 incoming first-year college students (male, 52.4%; mean age, 19.3 +/- 2.6 years). The participants completed the Chinese version of the Adult Self Report Inventory-4 for the assessment of a wide range of psychiatric symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom criteria. The participant rate was 74.1%. Results: There were 55% of the participants having at least one psychiatric symptom. Symptoms of agoraphobia, body dysmorphic, and gender identity disorder were more prevalent in women; those of obsession-compulsion, tics, conduct problems, schizoid personality, and kleptomania were more prevalent in men. The magnitude of symptom correlations between compulsion and gender identity disorder, dysthymia, and antisocial personality, and between gender identity disorder and schizophrenia was significantly greater in male participants, whereas that between conduct problems and obsession and motor tics was significantly greater in female participants. Conclusions: The Chinese version of the Adult Self Report Inventory-4 identified similar sex difference in psychiatric symptoms as Western studies. The sex difference in co-occurring psychiatric conditions warrants further investigation.

 

11-6. Coutanche, M.N., Thompson-Schill, S.L., & Schultz, R.T. (2011). Multi-voxel pattern analysis of fMRI data predicts clinical symptom severity. NeuroImage, 57, 113-123.

 

Multi-voxel pattern analysis (MVPA) has been applied successfully to a variety of fMRI research questions in healthy participants. The full potential of applying MVPA to functional data from patient groups has yet to be fully explored. Our goal in this study was to investigate whether MVPA might yield a sensitive predictor of patient symptoms. We also sought to demonstrate that this benefit can be realized from existing datasets, even when they were not designed with MVPA in mind. We analyzed data from an fMRI study of the neural basis for face processing in individuals with an Autism Spectrum Disorder (ASD), who often show fusiform gyrus hypoactivation when presented with unfamiliar faces, compared to controls. We found reliable correlations between MVPA classification performance and standardized measures of symptom severity that exceeded those observed using a univariate measure; a relation that was robust across variations in ROI definition. A searchlight analysis across the ventral temporal lobes identified regions with relationships between classification performance and symptom severity that were not detected using mean activation. These analyses illustrate that MVPA has the potential to act as a sensitive functional biomarker of patient severity. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4, Adult Self Report Inventory-4]

 

11-7. Crapanzano, A.M., Frick, P.J., Childs, K., & Terranova, A.M. (2011). Gender differences in the assessment, stability, and correlates to bullying roles in middle school children. Behavioral Sciences & the Law, 29, 677-694.

 

The current study investigated bullying behaviors in 284 school children in the fourth through seventh grades at the time of the initial assessment. Peer ratings of bullying behavior were obtained at the end of the spring semester of one school year and at the end of the fall semester of the next school year. Importantly, peer ratings were obtained by assessing not only the level at which participants actually bully other students but also whether participants help bullies to hurt the victim (assister), encourage bullies (reinforce), or help the victim of bullying (defender). Our results did not support the utility of differentiating between bullies, assisters, or reinforcers. Specifically, these bullying roles were highly intercorrelated, both concurrently and across school years, and they showed similar correlations with aggression and several characteristics often associated with aggression (i.e., conduct problems, callous-unemotional traits, and positive expectancies about aggression). In contrast, ratings of defending designated a particularly prosocial group of students. Finally, whereas bullying appeared to be very similar in boys and girls, it was somewhat more stable across school years and was related to lower levels of prosocial behavior in boys, both of which could suggest that bullying may be somewhat more related to social group dynamics in girls. [Youth (Self Report) Inventory-4]

 

11-8. Davis, D.W., & Williams, P.G. (2011). Attention deficit/hyperactivity disorder in preschool-age children: issues and concerns. Clinical Pediatrics, 50, 144-152.

 

The diagnosis of attention deficit/hyperactivity disorder (ADHD) in children has been steadily increasing over the past 10 years. ADHD is associated with numerous health, behavioral, social, and academic outcomes. The use of medication is common for the treatment of ADHD. However, the evidence base for pharmacological and non-pharmacological treatments for children younger than 6 years of age is limited. Both short-term and long-term studies of efficacy and safety of all interventions are needed in this population, especially the use of psychotropic medications. Understanding the long-term effects of psychotropic medication on the developing brains of preschoolers has important implications for outcomes into adulthood. Nonpharmacologic evidence-based interventions are available and should serve as the first line of treatment in this population. Future research needs include further evidence regarding specific curricula, dose, duration, delivery methods, and staff training to ensure optimal intervention outcomes. [Early Childhood Inventory-4]

 

11-9. Dougherty, L.R., Bufferd, S.J., Carlson, G.A., Dyson, M., Olino,T.M., Durbin, C.E., & Klein, D.N. (2011). Preschoolers' observed temperament and psychiatric disorders assessed with a parent diagnostic interview. Journal of Clinical Child and Adolescent Psychology, 40, 295-306.   

 

Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year-old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured diagnostic interview on preschool psychopathology. In bivariate analyses, temperamental dysphoria and low exuberance were associated with depression; fear, low exuberance, and low sociability were associated with anxiety disorders; and disinhibition and dysphoria were associated with oppositional defiant disorder. Although there were no bivariate associations between temperament and attention-deficit/hyperactivity disorder, disinhibition emerged as a unique predictor in multivariate analyses. Findings indicate that the pattern of relations between temperament and psychopathology in older youth and adults is evident as early as age 3. [Early Childhood Inventory-4]

 

11-10. Drabick, D. A. G, Bubier, J., Chen, D., Price, J., & Lanza, H. I. (2011). Source-specific oppositional defiant disorder among inner-city children: prospective prediction and moderation. Journal of Clinical Child and Adolescent Psychology, 40, 23-35.   

 

We examined prospective prediction from parent- and teacher-reported oppositional defiant disorder (ODD) symptoms to parent-reported ODD, conduct disorder (CD), major depressive disorder (MDD), and generalized anxiety disorder symptoms and whether child executive functioning abilities moderated these relations among an urban, low-income sample of first- to third-grade children (N=87). Time 1 parent-reported ODD predicted each Time 2 outcome. Time 1 teacher-reported ODD predicted Time 2 CD and MDD symptoms. After controlling for Time 1 co-occurring symptoms, only prediction from Time 1 teacher-reported ODD to CD and MDD symptoms remained significant. Child executive functioning abilities moderated relations between Time 1 parent-reported ODD and Time 2 ODD, and Time 1 teacher-reported ODD and Time 2 CD and MDD. Among children with better executive functioning abilities, higher Time 1 ODD was associated with higher Time 2 symptoms. [Child Symptom Inventory-4]

 

11-11. Egger, H.L., & Emde, R.N. (2011). Developmentally sensitive diagnostic criteria for mental health disorders in early childhood the diagnostic and statistical manual of mental disorders-iv, the research diagnostic criteria-preschool age, and the diagnostic classification of mental health and developmental disorders of infancy and early childhood-revised. American Psychologist, 66, 95-106.

 

As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children. [Early Childhood Inventory-4]

 

11-12. Findling, R.L.    Horwitz, S.M., Birmaher, B., Kowatch, R.A., Fristad, M.A., Youngstrom, E.A., Frazier, T.W., Axelson, D., Ryan, N.,  Demeter, C.A., Depew, J., Fields, B., Gill, M.K., Deyling, E.A., Rowles, B.M., & Arnold, L. E. (2011). Clinical characteristics of children receiving antipsychotic medication. Journal of Child and Adolescent Psychopharmacology, 21, 311-319.

 

This study explored the demographic and diagnostic features of children who were currently receiving antipsychotics compared to children who were receiving other psychotropics in a cohort of children with and without elevated symptoms of mania (ESM). Participants were recruited from 10 child outpatient mental health clinics associated with four universities. Guardians with children between 6-12 years who presented for new clinical evaluations completed the Parent General Behavior Inventory-10 Item Mania Scale (PGBI-10M). All children who scored 12 on the PGBI-10M and a select demographically matched comparison group of patients who scored <= 11 were invited to participate. Children were divided into two groups: those receiving at least one antipsychotic medication and those receiving other psychotropic medications. The groups were compared on demographics, diagnoses, psychiatric symptoms, functioning, and past hospitalizations. Of the 707 children enrolled in the Longitudinal Assessment of Manic Symptoms (LAMS) study, 443 (63%) were prescribed psychotropic medication at baseline: 157 (35%) were receiving an antipsychotic and 286 (65%) were prescribed other agents. Multivariate results indicated that being prescribed antipsychotics was related to being white, previous hospitalization, having a psychotic or bipolar 1 disorder and the site where the child was receiving services (p < 0.001). In this sample, it is relatively common for a child to be prescribed an antipsychotic medication. However, the only diagnoses associated with a greater likelihood of being treated with an antipsychotic were psychotic disorders or unmodified DSM-IV bipolar 1 disorder. [Child and Adolescent Symptom Inventory-4]

 

11-13. Gabis, L.V.,  Baruch, Y.K., Jokel, A., & Raz, R. (2011). Psychiatric and autistic comorbidity in fragile X syndrome across ages. Journal of Child Neurology, 26, 940-948.

 

Fragile X syndrome is caused by CGG trinucleotide repeat expansion within the fragile X mental retardation 1 gene, when repeat number exceeds 200. The typical psychiatric profile of fragile X syndrome patients includes cognitive and behavioral deficits, psychiatric comorbidity, and autistic characteristics. Specific psychiatric features have not yet been clarified, specifically in relationship to age and genetic characteristics. The objective of this study was to characterize psychiatric comorbidities in subjects with fragile X syndrome at different ages. Subjects with fragile X syndrome and their unaffected siblings were recruited and their parents filled out functional-behavioral and psychiatric comorbidities questionnaires. Adolescents with fragile X syndrome showed decreased prevalence of functional-behavioral deficits. Incidence and severity of most psychiatric comorbidities were lower in older subjects. Incidence of generalized anxiety disorder increased with age in the fragile X syndrome group. The typical profile of patients with fragile X syndrome changes with age. Unaffected siblings exhibit anxiety and motor tics. [Adolescent Symptom Inventory-4]

 

11-14. Gadow, K.D., & Nolan, E.E. (2011). Methylphenidate and comorbid anxiety disorder in children with both chronic multiple tic disorder and ADHD. Journal of Attention Disorders, 15, 246-256.

 

Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial with rating scales and laboratory measures. Results: The +ANX group obtained more severe parent, teacher, and child ratings of anxiety and more severe parent ratings of depression, tics, oppositional defiant disorder (ODD), and peer aggression than the -ANX group. Treatment with short-term MPH-IR was associated with improvement in ADHD, ODD, and peer aggression in the +ANX group. When controlling for ODD severity, there were no apparent group differences in therapeutic response to MPH-IR in children +/- ANX. There was little evidence that MPH-IR contributed to improvement in anxiety or depression symptoms in the +ANX group. There was some indication that children with comorbid anxiety may differentially experience greater increase in systolic blood pressure (0.5 mg/kg of MPH-IR > placebo). Conclusion: Findings suggest that the co-occurrence of diagnosed CMTD+ADHD+ANX represents a particularly troublesome clinical phenotype, at least in the home setting. Comorbid anxiety disorder was not associated with a less favorable response to MPH-IR in children with ADHD+CMTD, but replication with larger samples is warranted before firm conclusions can be drawn about potential group differences. [Child Symptom Inventory]

 

11-15. Gastgeb, H. Z., Wilkinson, D. A., Minshew, N. J., & Strauss, M. S. (2011). Can individuals with autism abstract prototypes of natural faces? Journal of Autism and Developmental Disorders, 41, 1609-1618.   

 

There is a growing amount of evidence suggesting that individuals with autism have difficulty with face processing. One basic cognitive ability that may underlie face processing difficulties is the ability to abstract a prototype. The current study examined prototype formation with natural faces using eye-tracking in high-functioning adults with autism and matched controls. Individuals with autism were found to have significant difficulty forming prototypes of natural faces. The eye-tracking data did not reveal any between group differences in the general pattern of attention to the faces, indicating that these difficulties were not due to attentional factors. Results are consistent with previous studies that have found a deficit in prototype formation and extend these deficits to natural faces. [Adult Self Report Inventory-4]

 

11-16. Ghanizadeh, A. (2011). Overlap of ADHD and oppositional defiant disorder DSM-IV derived criteria. Archives of Iranian Medicine, 14, 179-182.

 

Objective: One possible reason for being controversies regarding ADHD may be related to the validity and reliability of diagnostic criteria of attention deficit hyperactivity disorder and oppositional defiant disorder. Diagnostic criteria of oppositional defiant disorder include eight symptoms. This study examines the factor structure of oppositional defiant disorder symptoms, its discriminant validity from attention deficit hyperactivity disorder, its convergent validity and internal reliability. Methods: Parents of 111 referral children and adolescents with attention deficit hyperactivity disorder completed DSM-IV referenced based attention deficit hyperactivity disorder and oppositional defiant disorder checklists. Results: Factor analysis indicated that the attention deficit hyperactivity disorder symptom of: "often has trouble organizing activities" and "often runs about or climbs when and where it is not appropriate" were a part of the oppositional defiant disorder component. These symptoms less often than other symptoms differentiate attention deficit hyperactivity disorder from oppositional defiant disorder. The convergent validity for oppositional defiant disorder symptoms ranged from 0.64 to 0.79. Conclusion: The parent-rating checklist of oppositional defiant disorder symptoms properly differentiates oppositional defiant disorder from attention deficit hyperactivity disorder. However, two items of the attention deficit hyperactivity disorder were listed as symptoms of oppositional defiant disorder. If the factor loading of the items is to be confirmed in further studies, it might be necessary to revise these symptoms criterion in future editions of DSM-IV diagnostic criteria. [Child Symptom Inventory-4]

 

11-17. Griggs, M.S., & Mikami, A.Y. (2011). The role of maternal and child ADHD symptoms in shaping interpersonal relationships. Journal of Abnormal Child Psychology, 39, 437-449.

 

The current study investigated the influence of maternal ADHD symptoms on: (a) mothers' own social functioning; (b) their child's social functioning; and (c) parent-child interactions following a lab-based playgroup involving children and their peers. Participants were 103 biological mothers of children ages 6-10. Approximately half of the children had ADHD, and the remainder were comparison youth. After statistical control of children's ADHD diagnostic status and mothers' educational attainment, mothers' own inattentive ADHD symptoms predicted poorer self-reported social skills. Children with ADHD were reported to have more social problems by parents and teachers, as well as received fewer positive sociometric nominations from playgroup peers relative to children without ADHD. After control of child ADHD status, higher maternal inattention and hyperactivity/impulsivity each predicted children having more parent-reported social problems; maternal inattention predicted children receiving more negative sociometric nominations from playgroup peers. There were interactions between maternal ADHD symptoms and children's ADHD diagnostic status in predicting some child behaviors and parent-child relationship measures. Specifically, maternal inattention was associated with decreased prosocial behavior for children without ADHD, but did not influence the prosocial behavior of children with ADHD. Maternal inattention was associated with mothers' decreased corrective feedback and, at a trend level, decreased irritability toward their children with ADHD, but there was no relationship between maternal inattention and maternal behaviors for children without ADHD. A similar pattern was observed for maternal hyperactivity/impulsivity and mothers' observed irritability towards their children. Treatment implications of findings are discussed. [Child Symptom Inventory-4]

 

11-18. Griggs, M.S., & Mikami, A.Y. (2011). Parental attention-deficit/hyperactivity disorder predicts child and parent outcomes of parental friendship coaching treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 1236-1246.   

 

Objective: This study investigated the impact of parental attention-deficit/hyperactivity disorder (ADHD) symptoms on the peer relationships and parent child interaction outcomes of children with ADHD among families completing a randomized controlled trial of parental friendship coaching (PFC) relative to control families. Method: Participants were 62 children with ADHD (42 boys and 20 girls, 6 through 10 years old) and their parents. Approximately half of the families received PFC (a 3-month parent training intervention targeting the peer relationships of children with ADHD), and the remainder represented a no-treatment control group. Results: Parental inattention predicted equivalent declines in children's peer acceptance in both treatment and control families. However, treatment amplified differences between parents with high versus low ADHD symptoms for some outcomes: Control families declined in functioning regardless of parents' symptom levels. However, high parental inattention predicted increased child peer rejection and high parental inattention and impulsivity predicted decreased parental facilitation among treated families (indicating reduced treatment response). Low parental symptoms among treated families were associated with improved functioning in these areas. For other outcomes, treatment attenuated differences between parents with high versus low ADHD symptoms: Among control parents, high parental impulsivity was associated with increasing criticism over time, whereas all treated parents showed reduced criticism regardless of symptom levels. Follow-up analyses indicated that the parents experiencing poor treatment response are likely those with clinical levels of ADHD symptoms. Conclusions: Results underscore the need to consider parental ADHD in parent training treatments for children with ADHD. [Child Symptom Inventory-4]

 

11-19. Guyer, A.E., Choate, V.R., Grimm, K.J., Pine, D.S., & Keenan, K. (2011). Emerging depression is associated with face memory deficits in adolescent girls. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 180-190.

 

Objective: To examine the association between memory for previously encoded emotional faces and depression symptoms assessed over 4 years in adolescent girls. Investigating the interface between memory deficits and depression in adolescent girls may provide clues about depression pathophysiology. Method: Participants were 213 girls recruited from a longitudinal, community-based study; the majority were African American. Scores on depressive screening measures at age 8 were used to increase the base rate of depression. Depression symptoms and diagnoses were assessed annually for 4 years. In year 4, when the girls were 12 to 13 years old, a face emotion encoding task was administered during which ratings were generated in response to sad, fearful, angry, and happy faces. A surprise memory task followed whereby participants identified which of two faces, displaying neutral expressions, they had seen previously. Results: Girls with higher depression symptom levels from ages 9 to 12 years evidenced lower accuracy in identifying previously encoded emotional faces. Controlling for IQ, higher depression symptom level was associated with a memory deficit specific to previously encoded sad and happy faces. These effects were not moderated by race. Conclusions: Individual differences in face memory deficits relate to individual differences in emerging, early adolescent depression, and may be vulnerability markers for depression. [Child Symptom Inventory-4]

 

11-20. Hipwell, A.E.,  Sapotichne, B., Klostermann, S., Battista, D., & Keenan, K. (2011). Autobiographical memory as a predictor of depression vulnerability in girls. Journal of Clinical Child and Adolescent Psychology, 40, 254-265.  

 

Overgeneral autobiographical memory (AM), the tendency to recall categories of events when asked to provide specific instances from one's life, is purported to be a marker of depression vulnerability that develops in childhood. Although early adolescence is a period of risk for depression onset especially among girls, prospective examination of this putative risk factor is lacking. The current study examined the prospective associations between AM recall and depressive symptomatology in an enriched community sample of predominantly African American girls. Girls (n=195) were interviewed about depressive symptoms at ages 11 and 12 years, and AM recall was assessed at age 11. The findings showed that overgeneral retrieval to positive, but not negative, cue words predicted subsequent depressive symptoms after controlling for age 11 symptoms, race, poverty, and Verbal IQ. A moderating effect of race was also shown, whereby overgeneral AM bias predicted depressive symptoms more strongly among European American girls. [Child Symptom Inventory-4]

 

11-21. Hipwell, A.E., Stepp, S.D., Keenan, K., Chung, T., & Loeber, R. (2011). Brief report: Parsing the heterogeneity of adolescent girls' sexual behavior: Relationships to individual and interpersonal factors. Journal of Adolescence, 34, 589-592.

 

Clusters of pre-sexual and sexual behaviors were identified in an urban US sample of 546 mid-adolescent girls. No distinct group of girls engaging in sexually risky behavior was revealed. Sexually active girls were older, lived with a single parent, and reported more substance use and depression, but similar levels of conduct problems, impulsivity and deviant peers to girls engaging in pre-sexual behavior. [Adolescent Symptom Inventory-4]

 

11-22. Hu, M.C., Griesler, P., Schaffran, C., & Kandel, D. (2011). Risk and protective factors for nicotine dependence in adolescence. Journal of Child Psychology and Psychiatry, 52, 1063-1072.

 

Background: We investigated the role of psychosocial and proximal contextual factors on nicotine dependence in adolescence. Methods: Data on a multiethnic cohort of 6th to 10th graders from the Chicago public schools were obtained from four household interviews conducted with adolescents over two years and one interview with mothers. Structural equation models were estimated on 660 youths who had smoked cigarettes by the first interview. Results: Pleasant initial sensitivity to tobacco use, parental nicotine dependence (ND), adolescent ND and extensiveness of smoking at the initial interview had the strongest total effects on adolescent ND two years later. Perceived peer smoking and adolescent conduct problems were of lesser importance. Parental ND directly impacted adolescent ND two years later and had indirect effects through pleasant initial sensitivity and initial extensiveness of smoking. Parental depression affected initial adolescent dependence and depression but adolescent depression had no effect on ND. The model had greater explanatory power for males than females due partly to the stronger effect of conduct problems on dependence for males than females. Conclusions: The findings underscore the importance of the initial drug experience and familial factors on adolescent nicotine dependence and highlight the factors to be the focus of efforts targeted toward preventing ND among adolescents. [Youth (Self Report) Inventory-4]

 

11-23. Hummer, T. A., Kronenberger, W. G., Wang, Y., Dunn, D.W., Mosier, K.M., Kalnin, A.J., & Mathews, V.P. (2011). Executive functioning characteristics associated with ADHD comorbidity in adolescents with disruptive behavior disorders. Journal of Abnormal Child Psychology, 39, 11-19.

 

The nature of executive dysfunction in youth with disruptive behavior disorders (DBD) remains unclear, despite extensive research in samples of children with attention-deficit hyperactivity disorder (ADHD). To determine the relationship between DBD, ADHD, and executive function deficits in aggressive teens, adolescents with DBD and comorbid ADHD (DBD + ADHD; n = 25), DBD without ADHD (DBD-ADHD; n = 23), and healthy controls (HC; n = 25) were compared on neurocognitive tests and questionnaires measuring executive functioning. Teens with DBD + ADHD performed worse on both neurocognitive and questionnaire measures of executive function than the DBD-ADHD and HC groups. Results suggest that subgroups of DBD may exist depending on the presence or absence of comorbid ADHD, which may have implications for the selection and efficacy of treatment strategies. [Adolescent Symptom Inventory-4]

 

11-24. Jack, A., Mikami, A.Y., & Calhoun, C.D.) (2011). The moderating role of verbal aggression on the relationship between parental feedback and peer status among children with ADHD. Journal of Abnormal Child Psychology, 39, 1059-1071.   

 

We examined associations between children's sociometric status and (a) observed parental feedback as well as (b) child aggression. Participants were 94 children ages 6-10 (64 male; 44 with ADHD) and their parents. Children's peer status, parental feedback to their children, and child aggression were all assessed during lab-based playgroups of four children and their parents. Parent criticism in front of the child's peers was associated with the child receiving more negative ("disliked") and fewer positive ("liked") nominations, but only for children who displayed aggression; this interaction applied almost exclusively to children with ADHD. Parent praise in front of peers was associated with fewer negative nominations when children displayed low levels of aggression, but more at higher levels. Additional analyses revealed that relationships did not exist in the full sample between privately-given parental feedback and children's peer status. Processes by which peers use overheard adult feedback to inform their assessments of children are discussed. [Child Symptom Inventory-4]

 

11-25. Kaiser, N.M., McBurnett, K., & Pfiffner, L.J. (2011). Child ADHD severity and positive and negative parenting as predictors of child social functioning: evaluation of three theoretical models. Journal of Attention Disorders, 15, 193-203.

 

Objective: Prior research has established links between child social functioning and both parenting and child ADHD severity; however, research examining the way that these variables work together is lacking. The current article aims to test three possible models (main effects, mediation, and moderation) by which ADHD severity and positive and negative parenting on the part of both mothers and fathers may work together to predict child social functioning. Method: In a combined sample of children ages 5 to 11 with and without ADHD (N = 143), multiple regression was used to assess: (a) the main effects of ADHD severity and of positive and negative parenting by both mothers and fathers on child social skill and aggressive behavior; (b) parenting as a potential mediator of the relation between ADHD severity and child social skill and aggressive behavior; and (c) ADHD severity as a potential moderator of the relation between parenting and child social skill and aggressive behavior dependent variables. Results: Significant main effects of both ADHD severity and parenting on child social skill and aggression were found. There was some evidence to support parenting (particularly negative parenting) as a mediator of the relation between ADHD severity and child social skill and aggression. There was no evidence of significant moderational effects. Conclusion: Parenting and ADHD severity are independently associated with child social skill and aggressive behavior. To the extent that these associations are causal, multimodal treatment targeting both symptom reduction and improved parenting may be especially effective for the treatment of social problems related to childhood ADHD. Furthermore, evidence for parenting as a mediator of the relation between ADHD severity and child outcomes suggests that changes in child symptoms may also improve parenting practices, thus leading to improved child outcomes. [Child Symptom Inventory-4]

 

11-26. Kofler, M.J., Rapport, M.D., Bolden, J., Sarver, D.E., Raiker, J.S., & Alderson, R.M. (2011). Working memory deficits and social problems in children with ADHD. Journal of Abnormal Child Psychology, 39, 805-817.

 

Social problems are a prevalent feature of ADHD and reflect a major source of functional impairment for these children. The current study examined the impact of working memory deficits on parent-and teacher-reported social problems in a sample of children with ADHD and typically developing boys (N=39). Bootstrapped, bias-corrected mediation analyses revealed that the impact of working memory deficits on social problems is primarily indirect. That is, impaired social interactions in children with ADHD reflect, to a significant extent, the behavioral outcome of being unable to maintain a focus of attention on information within working memory while simultaneously dividing attention among multiple, on-going events and social cues occurring within the environment. Central executive deficits impacted social problems through both inattentive and impulsive-hyperactive symptoms, whereas the subsidiary phonological and visuospatial storage/rehearsal systems demonstrated a more limited yet distinct relationship with children's social problems. [Child Symptom Inventory-4]

 

11-27. Kroneman, L.M., Hipwell, A.E., Loeber, R., Koot, H.M., & Pardini, D.A. (2011). Contextual risk factors as predictors of disruptive behavior disorder trajectories in girls: the moderating effect of callous-unemotional features. Journal of Child Psychology and Psychiatry, 52, 167-175.

 

Background: The presence of callous-unemotional (CU) features may delineate a severe and persistent form of conduct problems in children with unique developmental origins. Contextual risk factors such as poor parenting, delinquent peers, or neighborhood risk are believed to influence the development of conduct problems primarily in children with low levels of CU features. However, longitudinal studies examining the moderating effect of CU features on the relation between contextual risk factors and conduct problems trajectories in girls are rare. Methods: Growth curve analysis was conducted using five annual measurements of oppositional defiant disorder/conduct disorder (ODD/CD) behaviors in a community sample of 1,233 girls aged 7-8 at study onset. The relation between contextual risk factors in multiple domains (i.e., family, peer, community) and trajectories of ODD/CD behaviors across time were examined for girls with differing levels of CU features. Results: Growth curve analysis indicated that CU features were associated with chronically high levels of ODD/CD symptoms over time. Low levels of parental warmth were also associated with chronically high levels of ODD/CD, and this effect was particularly pronounced for girls with high CU features. Exposure to harsh parenting was associated with higher ODD/CD behaviors for girls in childhood regardless of their level of CU features, but this effect dissipated over time. [Child Symptom Inventory-4]

 

11-28. Lanza, H. I., & Drabick, D. A. G. (2011) Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms. Journal of Abnormal Child Psychology, 39, 83-94.   

 

Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI. [Child Symptom Inventory-4]

 

11-29. Lavigne, J.V., Hopkins, J., Gouze, K.R., Bryant, F.B., LeBailly, S.A., Binns, H.J., & Lavigne, P.M. (2011). Is smoking during pregnancy a risk factor for psychopathology in young children? a methodological caveat and report on preschoolers. Journal of Pediatric Psychology, 36, 10-24.

 

Objective While studies of the effects of prenatal smoking on child psychopathology have found positive relationships, most studies (1) failed to control for a range of correlates of maternal smoking that could affect children's behavior; (2) have been conducted with school-age rather than younger children, so it is not clear when such problems emerge; and (3) have not examined the effects on internalizing problems. Method This study examined the effects of prenatal smoke exposure on behaviors associated with externalizing and internalizing behavior problems and negative temperament in a diverse community sample of 679 4-year-olds. Results After controlling for correlates that include socioeconomic status, life stress, family conflict, maternal depression, maternal scaffolding skills, mother-child attachment, child negative affect and effortful control, smoking during pregnancy was no longer associated with child behavior or emotional problems. Conclusions Future studies need to control for a wide range of covariates of maternal smoking. [Early Childhood Inventory-4]

 

11-30. Lecavalier, L., Gadow, K.D.,  Devincent, C.J., Houts, C.R., & Edwards, M.C. (2011). Validity of DSM-IV syndromes in preschoolers with autism spectrum disorders. Autism, 15, 527-543.   

 

Behavior and emotional problems are often present in very young children with autism spectrum disorders (ASDs) but their nosology has been the object of scant empirical attention. The objective of this study was to assess the construct validity of select Diagnostic and Statistical Manual of Mental Disorders (DSM)-defined syndromes (ADHD, ODD, Mood disorder) in preschoolers with ASD (N = 229). Parents and teachers completed the Early Childhood Inventory-4, a behavior rating scale based on the DSM-IV, and ratings were submitted to confirmatory factor analysis. Results generally supported the DSM nosology in this population. There was some evidence that parent ratings were associated with better fit indices (e.g. RSMEA = .062) than teachers (e.g. RMSEA = .083). For both raters, fit indices appeared to improve when the ADHD factor was broken into its constituent parts. However, hyperactivity symptoms accounted for little unique additional variance in the model. Findings lend support to the DSM as a conceptual model for behavioral syndromes in preschoolers with ASDs and also reinforce the importance of source-specificity when considering psychiatric disorders in children with ASDs.

 

11-31. Lerner, M.D., Mikami, A.Y., & McLeod, B.D. (2011).  The alliance in a friendship coaching intervention for parents of children with ADHD. Behavior Therapy, 42, 449-461.

 

The alliance between parent and therapist was observed in a group-based parent-training intervention to improve social competency among children with attention-deficit/hyperactivity disorder (ADHD). The intervention, called Parental Friendship Coaching (PFC), was delivered to 32 parents in small groups as part of a randomized clinical trial. PFC was delivered in eight, 90-minute sessions to parents; there was no child treatment component. Observed parent-therapist alliance recorded among 27 of the parents was measured using the Therapy Process Observational Coding System- Alliance scale (TPOCS-A; McLeod, 2005). Early alliance and change in alliance over time predicted improvements in several parenting behaviors and child outcomes, including peer sociometrics in a lab-based playgroup. These preliminary findings lend support to the importance of examining the parent-therapist alliance in parent-training groups for youth social and behavioral problems. [Child Symptom Inventory-4]

 

11-32. Mikami, A.Y., & Lorenzi, J. (2011). Gender and conduct problems predict peer functioning among children with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 40, 777-786.

   

Children with attention-deficit/hyperactivity disorder (ADHD) often have poor relationships with peers. However, research on this topic has predominantly focused on boys. This study considered child gender, ADHD status, and dimensionally assessed conduct problems as predictors of peer relationship difficulties. Participants were 125 children (ages 6-10; 67% male), 63 with clinical diagnoses of ADHD and 62 non-ADHD comparison youth. Conduct problems were reported by teachers and observed in a lab playgroup. Peer relationships were assessed by parent report, teacher report, and peer sociometric nominations in the playgroup. Results suggested that children with ADHD, as well as those with high conduct problems, displayed more impaired peer relationships than did comparison children and those with low conduct problems, but overall there were no gender differences in social functioning. However, statistical interactions appeared such that the negative impact of conduct problems on peer relationships was stronger for girls than for boys. [Child Symptom Inventory-4]

 

11-33. Mikami, A.Y., Ransone, M.L., & Calhoun, C.D. (2011). influence of anxiety on the social functioning of children with and without ADHD. Journal of Attention Disorders, 15, 473-484.

 

Objective: This investigation examined the contribution of anxiety to the social functioning of children with and without ADHD. Method: Participants were 62 children with ADHD (ages 6-10 years and 68% boys) and 62 age- and sex-matched comparison children. Children's social functioning was measured through parent and teacher reports, observations of social behaviors during a lab-based playgroup with previously unacquainted peers, and peer nominations during that lab-based playgroup. Results: Anxiety symptoms incrementally predicted adult-informant reports of poorer social functioning after controlling for demographic covariates, ADHD status, and oppositional-defiant disorder (ODD) status. However, anxiety was not associated with peer nominations received at the playgroup. There were some indications that anxiety may have greater influence on the functioning of comparison children relative to children with ADHD or ODD. Conclusion: Anxiety may contribute to the peer problems of children both with and without ADHD. [Child Symptom Inventory-4]

 

11-34. Molinuevo, B., Pardo, Y., & Torrubia, R. (2011). Psychometric analysis of the Catalan version of the Alabama Parenting Questionnaire (APQ) in a community sample. Spanish Journal of Psychology, 14, 944-955.   

 

The aim of this study was to adapt to Catalan the parents' and children's global report forms of the Alabama Parenting Questionnaire (APQ), using a community sample of 364 children between 10 and 15 years old and their families. Sociodemographic information (from parents) and the presence of externalizing problems (from parents and teachers) were collected. The results suggest a 3-factor structure corresponding to the scales of Positive Parenting Practices (PPP), Inconsistent and Negative Discipline (IND) and Poor Monitoring/Supervision (PMS). The internal consistency is acceptable in all the scales, except for the IND in the children's format. The scales also present good convergent and discriminant validity, and the relations with the external variable studied pointed in the expected direction: inefficient parenting practices are related to the presence of more behavior problems in children. To sum up, the Catalan version of the parents' and children's global report forms of the APQ are considered suitable for use in the area of children's and adolescents' behavior problems. [Child Symptom Inventory-4]

 

11-35. Numis, A.L., Major, P., Montenegro, M.A., Muzykewicz, D.A., Pulsifer, M.B., & Thiele, E.A. (2011). Identification of risk factors for autism spectrum disorders in tuberous sclerosis complex. Neurology, 76, 981-987.

 

Objective: The purpose of this study was to assess the prevalence of and to identify epidemiologic, genetic, electrophysiologic, and neuroanatomic risk factors for autism spectrum disorders (ASD) in a cohort of patients with tuberous sclerosis complex (TSC). Methods: A total of 103 patients with TSC were evaluated for ASD. A retrospective review of patients' records was performed, including mutational analysis. EEG reports were analyzed for the presence of ictal and interictal epileptiform features. Brain MRI scans were evaluated for TSC neuropathology, including tuber burden. Results: Of the 103 patients with TSC, 40% were diagnosed with an ASD. On univariate analysis, patients with ASD were less likely to have mutations in the TSC1 gene. Patients with ASD also had an earlier age at seizure onset and more frequent seizures. On EEG, those with ASD had a significantly greater amount of interictal epileptiform features in the left temporal lobe only. On MRI, there were no differences in the regional distribution of tuber burden, although those with TSC2 and ASD had a higher prevalence of cyst-like tubers. Conclusions: The development of ASD in TSC is not well understood. Given our findings, ASD may be associated with persistent seizure activity early in development in particular brain regions, such as those responsible for social perception and communication in the left temporal lobe. The presence of cyst-like tubers on MRI could provide a structural basis or marker for ASD pathology in TSC, although studies assessing their effect on cortical function are needed. [Child Symptom Inventory-4]

 

11-36. Schlund, M.W.,  Cataldo, M.F., Siegle, G.J., Ladouceur, C.D., Silk, J.S., Forbes, E.E., McFarland, A., Iyengar, S., Dahl, R.E., & Ryan, N.D. (2011). Pediatric functional magnetic resonance neuroimaging: tactics for encouraging task compliance. Behavioral and Brain Functions, 7, 10.

 

Background: Neuroimaging technology has afforded advances in our understanding of normal and pathological brain function and development in children and adolescents. However, noncompliance involving the inability to remain in the magnetic resonance imaging (MRI) scanner to complete tasks is one common and significant problem. Task noncompliance is an especially significant problem in pediatric functional magnetic resonance imaging (fMRI) research because increases in noncompliance produces a greater risk that a study sample will not be representative of the study population. Method: In this preliminary investigation, we describe the development and application of an approach for increasing the number of fMRI tasks children complete during neuroimaging. Twenty-eight healthy children ages 913 years participated. Generalization of the approach was examined in additional fMRI and event-related potential investigations with children at risk for depression, children with anxiety and children with depression (N = 120). Essential features of the approach include a preference assessment for identifying multiple individualized rewards, increasing reinforcement rates during imaging by pairing tasks with chosen rewards and presenting a visual 'road map' listing tasks, rewards and current progress. Results: Our results showing a higher percentage of fMRI task completion by healthy children provides proof of concept data for the recommended tactics. Additional support was provided by results showing our approach generalized to several additional fMRI and event-related potential investigations and clinical populations. Discussion: We proposed that some forms of task noncompliance may emerge from less than optimal reward protocols. While our findings may not directly support the effectiveness of the multiple reward compliance protocol, increased attention to how rewards are selected and delivered may aid cooperation with completing fMRI tasks. Conclusion: The proposed approach contributes to the pediatric neuroimaging literature by providing a useful way to conceptualize and measure task noncompliance and by providing simple cost effective tactics for improving the effectiveness of common reward-based protocols. [Child and Adolescent Symptom Inventory-4]

 

11-37. Sprafkin, J., Mattison, R.E., Gadow, K.D., Schneider, J., & Lavigne, J.V. (2011). A brief DSM-IV-referenced teacher rating scale for monitoring behavioral improvement in ADHD and co-occurring symptoms. Journal of Attention Disorders, 15, 235-245.

 

Objective: To examine the psychometric properties of the 30-item teacher's version of the Child and Adolescent Symptom Inventory Progress Monitor (CASI-PM-T), a DSM-IV-referenced rating scale for monitoring change in ADHD and co-occurring symptoms in youths receiving behavioral or pharmacological interventions. Method: Three separate studies were conducted to determine (a) which items from longer diagnostic instruments were most representative of ADHD and commonly occurring psychiatric syndromes in clinic-referred samples (N = 406) aged between 3 and 18 years, (b) the reliability and validity of the CASI-PM-T in students enrolled in full-time special education programs at the elementary and middle school levels (N = 169), and (c) the clinical utility of measuring behavioral change in a sample of outpatient ADHD children beginning treatment with stimulant medication. Results: Internal consistency reliabilities (.71-.94), 2-week test-retest reliabilities (r = .70-.90), and interrater agreement (r = .44-.78) for the CASI-PM-T symptom categories were comparable to the full-length CASI-4. Convergence was also found between corresponding CASI-PM-T categories and consultant diagnoses of ADHD and ODD as well as school functioning measures of grade-point average and suspensions. The CASI-PM-T also demonstrated sensitivity to stimulant medication treatment effects. Conclusion: Findings provide preliminary support for the reliability, validity, and clinical utility of the CASI-PM-T.

 

11-38. Strickland, J., Keller, J., Lavigne, J.V., Gouze, K., Hopkins, J., & LeBailly, S. (2011). The structure of psychopathology in a community sample of preschoolers. Journal of Abnormal Child Psychology, 39, 601-610.

 

Despite growing interest in the development of alternative diagnostic classification systems for psychopathology in young children, little is known about the adequacy of the DSM symptom structure for describing psychopathology in this population. This paper examines the fit of the DSM-IV emotional (ED) and disruptive behavior disorder (DD) symptom structure in a community sample of 796 4-year-old children. Using the parent-report Child Symptom Inventory-4 (CSI-4), the best model fit for ED included separate factors for Social Phobia, Separation Anxiety Disorder, Generalized Anxiety Disorder, and Major Depressive Disorder. For DD, the best model included separate Attention Deficit Hyperactivity Disorder-Inattentive type (ADHD-I), Attention Deficit Hyperactivity Disorder-Hyperactive/Impulsive type (ADHD-HI), and Oppositional Defiant Disorder diagnoses. These findings support using DSM-IV nosology to classify EDs in a community sample of preschool children, and suggest differentiation of ADHD into ADHD-I and ADHD-HI.

 

11-39. Underwood, M.K., Beron, K.J., & Rosen, L.H. (2011). Joint trajectories for social and physical aggression as predictors of adolescent maladjustment: Internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Development and Psychopathology, 23, 659-678.

 

This investigation examined the relation between developmental trajectories jointly estimated for social and physical aggression and adjustment problems at age 14. Teachers provided ratings of children's social and physical aggression in Grades 3, 4, 5, 6, and 7 for a sample of 255 children (131 girls, 21% African American, 52% European American, 21% Mexican American). Participants, parents, and teachers completed measures of the adolescent's adjustment to assess internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Results showed that membership in a high and rising trajectory group predicted rule-breaking behaviors and borderline personality features. Membership in a high desister group predicted internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. The findings suggest that although low levels of social and physical aggression may not bode poorly for adjustment, individuals engaging in high levels of social and physical aggression in middle childhood may be at greatest risk for adolescent psychopathology, whether they increase or desist in their aggression through early adolescence. [Adolescent Symptom Inventory-4, Youth (Self Report) Inventory-4]

 

11-40. van der Molen, E., Hipwell, A.E., Vermeiren, R., & Loeber, R. (2011). Maternal characteristics predicting young girls' disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 40, 179-190.

 

Little is known about the relative predictive utility of maternal characteristics and parenting skills on the development of girls' disruptive behavior. The current study used five waves of parent- and child-report data from the ongoing Pittsburgh Girls Study to examine these relationships in a sample of 1,942 girls from age 7 to 12 years. Multivariate generalized estimating equation analyses indicated that European American race, mother's prenatal nicotine use, maternal depression, maternal conduct problems prior to age 15, and low maternal warmth explained unique variance. Maladaptive parenting partly mediated the effects of maternal depression and maternal conduct problems. Both current and early maternal risk factors have an impact on young girls' disruptive behavior, providing support for the timing and focus of the prevention of girls' disruptive behavior. [Child Symptom Inventory-4]

 

11-41. Villalobos, J. A. L., Pintado, I.S.,  Sanchez-Mateos, J.D., de Llano, J.M.A., Azon, M.I.S., & Lopez, S.A. (2011). Utility of a statistical model of cognitive styles in attention deficit hyperactivity disorder. PSICOTHEMA, 23, 818-823.   

 

Utility of a statistical model of cognitive styles in attention deficit hyperactivity disorder. The purpose of this study was to determine the best statistical model of cognitive styles, based on the MFFT-20, CEFT and Stroop tests to predict attention deficit hyperactivity disorder (ADHD), analyzing the validity of the model for the diagnosis of the disease. We studied 100 ADHD cases (DSM-IV criteria) and 100 controls, age ranging between 7 and 11 years. Controls were randomly recruited and matched in age, gender and sociodemographic area with ADHD cases. On average, ADHD cases showed more impulsiveness (d: 1.28), less cognitive flexibility (d: 0.91) and more field dependence (d: 1.62) than controls. The logistic regression model that predicts ADHD best is made up of age, CEFT, MFFT-20 and Stroop tests and the formula derived from the model shows 85% sensitivity and 85% specificity for ADHD, regarding the DSM-IV criteria as the standard. The statistical model of cognitive styles presents valid indicators to diagnose ADHD, contributing to an increase in the objectivity of its analysis. [Child Symptom Inventory-4]

 

11-42. Webster-Stratton, C.H, Reid, M. J., & Beauchaine, T. (2011). Combining parent and child training for young children with ADHD. Journal of Clinical Child and Adolescent Psychology, 40, 191-203.   

 

The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder (ADHD). We conducted a randomized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD (ages 4-6). Mother reported significant treatment effects for appropriate and harsh discipline, use of physical punishment, and monitoring, whereas fathers reported no significant parenting changes. Independent observations revealed treatment effects for mothers' praise and coaching, mothers' critical statements, and child total deviant behaviors. Both mothers and fathers reported treatment effects for children's externalizing, hyperactivity, inattentive and oppositional behaviors, and emotion regulation and social competence. There were also significant treatment effects for children's emotion vocabulary and problem-solving ability. At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children's social competence. [Child Symptom Inventory-4]

 

11-43. Weiss, M.D., Wasdell, M., Gadow, K.D., Greenfield, B., Hechtman, L., & Gibbins, C. (2011). Clinical correlates of oppositional defiant disorder and attention-deficit/hyperactivity disorder in adults. Postgraduate Medicine, 123, 177-184.

 

Objective: Oppositional defiant disorder (ODD) is a common comorbidity of attention-deficit/hyperactivity disorder (ADHD) in both children and adolescents. Although there is research demonstrating that ADHD persists into adulthood, less is known about the frequency of its persistence, clinical characteristics, and impairment when associated with comorbid ODD in adults with ADHD. Method: Data from a randomized clinical trial of adults with ADHD were analyzed to determine the prevalence and clinical correlates of comorbid ODD. As per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, patients who reported having >= 4 symptoms "often" or "very often" were classified as meeting the symptom criteria for the disorder. Results: Forty percent of this sample met symptom criteria for ODD. Subjects with ODD were more likely to have other comorbid disorders, lower investigator ratings of overall functioning, and lower patient life satisfaction (P < 0.05). A regression analysis using these variables predicted 40% of the variance of ODD as a comorbid condition in addition to ADHD. Although the presence or absence of ODD at baseline does not moderate response of ADHD symptoms with treatment, improvement in ODD symptoms was mediated by improvement in ADHD symptoms (P < 0.0001). Oppositional defiant disorder treatment was more responsive to dextroamphetamine than paroxetine, despite the contribution of irritability and reactive tantrums, as symptoms of the disorder. Conclusion: Oppositional defiant disorder is a valid and impairing disorder requiring evaluation and treatment in adults. [Adult Self Report Inventory-4]

 

11-44. Willcutt, E.G., Boada, R., Riddle, M.W., Chhabildas, N., DeFries, J.C., & Pennington, Bruce F. (2011). Colorado Learning Difficulties Questionnaire: Validation of a parent-report screening measure. Psychological Assessment, 23, 778-791.   

 

This study evaluated the internal structure and convergent and discriminant evidence for the Colorado Learning Difficulties Questionnaire (CLDQ), a 20-item parent-report rating scale that was developed to provide a brief screening measure for learning difficulties. CLDQ ratings were obtained from parents of children in 2 large community samples and 2 samples from clinics that specialize in the assessment of learning disabilities and related disorders (total N = 8,004). Exploratory and confirmatory factor analyses revealed 5 correlated but separable dimensions that were labeled reading, math, social cognition, social anxiety, and spatial difficulties. Results revealed strong convergent and discriminant evidence for the CLDQ Reading scale, suggesting that this scale may provide a useful method to screen for reading difficulties in both research studies and clinical settings. Results are also promising for the other 4 CLDQ scales, but additional research is needed to refine each of these measures. [Child Symptom Inventory-4, Adolescent Symptom Inventory-4]

 

YEAR: 2010

 

10-1. Alderson, R. M., Rapport, M.D., Hudec, K.L., Sarver, D.E., & Kofler, M.J. (2010). Competing core processes in attention-deficit/hyperactivity disorder (ADHD): do working memory deficiencies underlie behavioral inhibition deficits? Journal of Abnormal Child Psychology, 38, 497-507.

 

The current study examined competing predictions of the working memory and behavioral inhibition models of ADHD. Behavioral inhibition was measured using a conventional stop-signal task, and central executive, phonological, and visuospatial working memory components (Baddeley 2007) were assessed in 14 children with ADHD and 13 typically developing (TD) children. [Child Symptom Inventory-4 was one of several diagnostic instruments.] Bootstrapped mediation analyses revealed that the visuospatial working memory system and central executive both mediated the relationship between group membership (ADHD, TD) and stop-signal task performance. Conversely, stop-signal task performance mediated the relationship between group membership and central executive processes, but was unable to account for the phonological and visuospatial storage/rehearsal deficits consistently found in children with ADHD. Comparison of effect size estimates for both models suggested that working memory deficits may underlie impaired stop-signal task performance in children with ADHD. The current findings therefore challenge existing models of ADHD that describe behavioral inhibition as a core deficit of the disorder.

 

10-2. Andreias, L., Borawski, E., Schluchter, M., Taylor, G., Klein, N., & Hack, M. (2010). Neighborhood influences on the academic achievement of extremely low birth weight children. Journal of Pediatric Psychology, 35, 275-283.

 

Objective: To examine neighborhood effects on academic achievement of children with extremely low birth weight (ELBW < 1000 g) and normal birth weight (NBW) controls. Methods: The study included 183 8-year-old children with ELBW born during 1992-1995 and 176 sociodemographically similar NBW controls. Academic achievement was measured via The Woodcock-Johnson III Academic Skills Cluster. Results: Children with ELBW had significantly lower achievement scores (89 +/- 16 vs. 97 +/- 13). A multilevel estimation of predictors of academic achievement revealed that neighborhood poverty was significantly associated with lower achievement (beta = -.17; 95% CI -.3, -.05; p < .01). Additional correlates included birth weight status, male sex, and parent ratings of attention deficit hyperactivity disorder symptoms [Child Symptom Inventory-4]. Family characteristics included maternal education and parent protection. Conclusions: Neighborhood characteristics affect academic achievement of both children with ELBW and NBW controls, over and above individual and family influences. Interventions designed to address family and neighborhood factors may potentially improve these outcomes.

 

10-3. Borelli, J.L., David, D.H., Crowley, M.J., & Mayes, L.C. (2010). Links between disorganized attachment classification and clinical symptoms in school-aged children. Journal of Child and Family Studies, 19, 243-256.

 

Research examining the links between disorganized attachment and clinical symptoms largely has neglected middle childhood due to lack of available measurement tools. The few studies that have examined these links in other developmental phases have found higher clinical symptoms in disorganized individuals. Our study extended this research by using a recently-developed attachment interview measure ideally suited to evaluate disorganized attachment in middle childhood. We examined concurrent associations among disorganized attachment in 8-12 year old children and symptoms of psychopathology theoretically hypothesized for their links with disorganized attachment. Using child- and parent-reports, we measured symptoms of depression [Child Symptom Inventory-4], social anxiety [Child Symptom Inventory-4], shyness, inattention, and thought problems. During our two-session study, 97 children completed the Child Attachment Interview, and children and parents completed clinical questionnaires. Results suggested that disorganized attachment was associated with higher child reports of depressive symptoms and shyness, and with parent-reports of social anxiety, inattention, and thought problems, and that disorganized children are more likely to have symptoms that meet clinical criteria. Implications for the relation of attachment to psychopathology are discussed.

 

10-4. Burke, J.D., Hipwell, A.E., & Loeber, R. (2010). Dimensions of oppositional defiant disorder as predictors of depression and conduct disorder in preadolescent girls. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 484-492.

 

Objective: To examine whether oppositional defiant disorder (ODD) rather than conduct disorder (CD) may explain the comorbidity between behavioral disorders and depression; to test whether distinct affective and behavioral dimensions can be discerned within the symptoms of ODD; and to determine whether an affective dimension of ODD symptoms is specifically predictive of later depression. Method: The dimensions of ODD and their prediction to later CD and depression were examined in a community sample of 2,451 girls between the ages of 5 and 8 years, followed up annually over a 5-year period, using parent, child, and teacher questionnaire ratings of the severity of symptoms of psychopathology. [Child Symptom Inventory-4 was used to as measure of conduct disorder, oppositional defiant disorder, depression, ADHD, anxiety.] Results: Dimensions of negative affect, oppositional behavior, and antagonistic behavior were found within ODD symptoms. Negative affect predicted later depression. Oppositional and antagonistic behavior predicted CD overall, and for Caucasian girls, negative affect also predicted later CD. CD was not predictive of later depression, controlling for comorbid conditions. Conclusions: ODD plays a key role in the early development of psychopathology. It is central in the comorbidity between internalizing and externalizing psychopathology, which may be caused by a dimension of negative affective symptoms within ODD. How this dimension relates to later CD appears to vary by race.

 

10-5. Chowdhury, M., Aman, M. G., Scahill, L., Swiezy, N., Arnold, L. E., Lecavalier, L., Johnson, C., Handen, B., Stigler, K., Bearss, K., Sukhodolsky, D., & McDougle, C. J. (2010).The Home Situations Questionnaire-PDD version: Factor structure and psychometric properties. Journal of Intellectual Disability Research, 54, 281-291.

 

Background: The Home Situations Questionnaire (HSQ) is a caregiver-rated scale designed to assess behavioural non-compliance in everyday settings that has been used in several studies in typically developing children. Currently there is no accepted measure of behavioural non-compliance in children with pervasive developmental disorders (PDDs). Methods: Investigators of the Research Units on Pediatric Psychopharmacology Autism Network modified the HSQ for children with PDDs by adding five items (making 25 total items), and used it as the primary outcome measure in a clinical trial. In the current investigation, we examined the factor structure and psychometric properties of the modified scale, the HSQ-PDD. Results: An exploratory factor analysis with oblique rotations yielded two factors: 'Socially Inflexible' (14 items) and 'Demand-Specific' (six items). Item content of both factors appeared to fit well with the rubric of PDDs. Internal consistency, using Cronbach's alpha statistic, was 0.90 for 'Socially Inflexible', and 0.80 for 'Demand-Specific.' The obtained sub-scales and HSQ-PDD Total score showed moderate correlations with selected sub-scales of the Aberrant Behavior Checklist, Child and Adolescent Symptom Inventory-4, and Children's Yale-Brown Obsessive Compulsive Scale, and low correlations with the Vineland Adaptive Behavior sub-scales. Conclusions: The HSQ-PDD appears to be well suited for children with PDDs, although the Demand-Specific sub-scale may benefit from addition of more items. We provided sub-scale means and standard deviations for this relatively severe group of children with PDDs, and discussed the factor structure with respect to previous research

 

10-6. Connor, D.F., Steeber, J., & McBurnett, K. (2010). A review of attention-deficit/hyperactivity disorder complicated by symptoms of oppositional defiant disorder or conduct disorder. Journal of Developmental and Behavioral Pediatrics, 31, 427-440.

 

Background: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder with significant functional impairment. ADHD is frequently complicated by oppositional symptoms, which are difficult to separate from comorbidity with oppositional defiant disorder, conduct disorder, and aggressive symptoms. This review addresses the impact of oppositional symptoms on ADHD, disease course, functional impairment, clinical management, and treatment response. Review of clinical evidence: Oppositional defiant disorder or conduct disorder may be comorbid in more than half of ADHD cases and are more common with the combined than with the inattentive ADHD subtype. Comorbid symptoms of oppositional defiant disorder and conduct disorder in patients with ADHD can have a significant impact on the course and prognosis for these patients and may lead to differential treatment response to both behavioral and pharmacologic treatments. Impact on clinical management: Assessment of oppositional symptoms is an essential part of ADHD screening and diagnosis and should include parental, as well as educator, input. [Describes several ODD measures including the ODD subscale of the Child Symptom Inventory-4.] Although clinical evidence remains limited, some stimulant and nonstimulant medications have shown effectiveness in treating both core ADHD symptoms and oppositional symptoms. Conclusions: Oppositional symptoms are a key consideration in ADHD management, although the optimum approach to treating ADHD complicated by such symptoms remains unclear. Future research should focus on the efficacy and safety of various behavioral and medication regimens, as well as longitudinal studies to further clarify the relationships between ADHD, oppositional defiant disorder, and conduct disorder.

 

10-7. Dougherty, L.R., Klein, D.N., Durbin, C.E., Hayden, E.P., & Olino, T.M. (2010). Temperamental positive and negative emotionality and children's depressive symptoms: a longitudinal prospective study from age three to age ten. Journal of Social and Clinical Psychology, 29, 462-488.

 

This study examined associations between temperament at age 3 and maternal reports of youths' depressive symptoms at ages 7 and 10. Fifty-three preschool aged children were assessed for positive emotionality (PE) and negative emotionality (NE) using maternal reports of temperament and laboratory and naturalistic home observations Neither PE nor NE at age 3 predicted depressive symptoms [Child Symptom Inventory-4] at age 7 after controlling for children's anxious/depressive symptoms at age 3 However, both observational and parent-report measures indicated that lower PE at age 3 predicted greater depressive symptoms at age 10 after controlling for NE and anxious/depressive symptoms at age 3 Moreover, mothers' reports indicated that children with both lower PE and higher NE at age 3 exhibited the greatest increase in depressive symptoms at age 10 Our findings are consistent with models asserting that low PE and/or low PE in conjunction with high NE is a temperamental risk factor for depressive symptoms.

 

10-8. Freeman, R.D., Soltanifar, A., & Baer, S. (2010). Stereotypic movement disorder: easily missed. Developmental Medicine and Child Neurology, 52, 733-738.

 

Aim: To expand the understanding of stereotypic movement disorder (SMD) and its differentiation from tics and autistic stereotypies. Method: Forty-two children (31 males, mean age 6y 3mo, SD 2y 8mo; 11 females, mean age 6y 7mo, SD 1y 9mo) consecutively diagnosed with SMD, without-self-injurious behavior, intellectual disability, sensory impairment, or an autistic spectrum disorder (ASD), were assessed in a neuropsychiatry clinic. A list of probe questions on the nature of the stereotypy was administered to parents (and to children if developmentally ready). Questionnaires administered included the Stereotypy Severity Scale, Short Sensory Profile, Strengths and Difficulties Questionnaire, Repetitive Behavior Scale - Revised, and the Developmental Coordination Disorder Questionnaire. The stereotyped movement patterns were directly observed and in some cases further documented by video recordings made by parents. The probe questions were used again on follow-up at a mean age of 10 years 7 months (SD 4y 4mo). [Child Symptom Inventory-4 was used to assess co-morbidities.] Results: Mean age at onset was 17 months. Males exceeded females by 3:1. Family history of a pattern of SMD was reported in 13 and neuropsychiatric comorbidity in 30 (attention-deficit-hyperactivity disorder in 16, tics in 18, and developmental coordination disorder in 16). Obsessive-compulsive disorder occurred in only two. The Short Sensory Profile correlated with comorbidity (p < 0.001), the Stereotypy Severity Scale (p=0.009), and the Repetitive Behavior Scale (p < 0.001); the last correlated with the Stereotypy Severity Scale (p=0.001). Children (but not their parents) liked their movements, which were usually associated with excitement or imaginative play. Mean length of follow-up was 4 years 8 months (SD 2y 10mo). Of the 39 children followed for longer than 6 months, the behavior stopped or was gradually shaped so as to occur primarily privately in 25. Misdiagnosis was common: 26 were initially referred as tics, 10 as ASD, five as compulsions, and one as epilepsy. Co-occurring facial grimacing in 15 children and vocalization in 22 contributed to diagnostic confusion. Interpretation: SMD occurs in children without ASD or intellectual disability. The generally favorable clinical course is largely due to a gradual increase in private expression of the movements. Severity of the stereotypy is associated with sensory differences and psychopathology. Differentiation of SMD from tics and ASD is important to avoid misdiagnosis and unnecessary treatment.

 

10-9. Gadow, K.D., Chernoff, M., Williams, P.L., Brouwers, P., Morse, E., Heston, J., Hodge, J., Di Poalo, V., Deygoo, N.S., Nachman, S. (2010). Co-occuring psychiatric symptoms in children perinatally infected with HIV and peer comparison sample. Journal of Developmental and Behavioral Pediatrics, 31, 116-128.

 

Objective: To compare the rates of psychopathology in youths perinatally infected with HIV (N = 319) with a comparison sample of peers (N=256) either HIV-exposed or living in households with HIV-infected family members. Method: Participants were randomly recruited from 29 sites in the United States and Puerto Rico and completed an extensive battery of measures including standardized DSM-IV-referenced ratings scales [Child and Adolescent Symptom Inventory-4R; Youth (Self Report) Inventory-4R, Child Self Report Inventory-4, Adult Self Report Inventory-4]. Results: The HIV+ group was relatively healthy (73% with CD4% >25%), and 92% were actively receiving antiretroviral therapy. Youths with HIV (17%) met symptom and impairment criteria for the following disorders: attention-deficit/hyperactivity disorder (12%), oppositional defiant disorder (5%), conduct disorder (1%), generalized anxiety disorder (2%), separation anxiety disorder (1%), depressive disorder (2%), or manic episode (1%). Many youths with HIV (27%) and peers (26%) were rated (either self-or caregiver report) as having psychiatric problems that interfered with academic or social functioning. With the exception of somatization disorder, the HIV+ group did not evidence higher rates or severity of psychopathology than peers, although rates for both groups were higher than the general population. Nevertheless, self-awareness of HIV infection in younger children was associated with more severe symptomatology, and youths with HIV had higher lifetime rates of special education (44 vs 32%), psychopharmacological (23 vs 12%), or behavioral (27 vs 17%) interventions. Youth-caregiver agreement was modest, and youths reported more impairment. Conclusion: HIV infection was not associated with differentially greater levels of current psychopathology; nevertheless, investigation of relations with developmental changes and specific illness parameters and treatments are ongoing.

 

10-10. Gadow, K.D., DeVincent, C.J., Olvet, D.M., Pisarevskaya, V., & Hatchwell, E. (2010). Association of DRD4 polymorphism with severity of oppositional defiant disorder, separation anxiety disorder, and repetitive behaviors in children with autism spectrum disorder. European Journal of Neuroscience, 32, 1058-1065.

 

The objective was to examine whether a common polymorphism in the dopamine D4 receptor gene (DRD4) might be a potential biomarker for behavioral variation within the autism spectrum disorder clinical phenotype. Children (N = 66) were evaluated with a validated mother- and teacher-completed DSM-IV-referenced rating scale [Child Symptom Inventory-4]. Partial eta-squared (ηp2) was used to gauge the magnitude of group differences: 0.01−0.06 = small, 0.06−0.14 = moderate and > 0.14 = large. Children who were 7-repeat allele carriers had more severe oppositional defiant disorder behaviors according to mothers’ (ηp2 = 0.10) and teachers’ (ηp2 = 0.06) ratings than noncarriers, but the latter was marginally significant (P = 0.07). Children who were 7-repeat allele carriers also obtained more severe maternal ratings of tics (ηp2 = 0.07) and obsessions–compulsions (ηp2 = 0.08). Findings for maternal ratings of separation anxiety were marginally significant (P = 0.08, ηp2 = 0.05). Analyses of combined DRD4 and dopamine transporter gene (DAT1) genotypes approached significance (P = 0.05) for teachers’ ratings of oppositional behavior and mothers’ ratings of tics. DRD4 allelic variation may be a prognostic biomarker for challenging behaviors in children with autism spectrum disorder, but these exploratory findings remain tentative pending replication with larger independent samples.

 

10-11. Gadow, K.D., DeVincent, C.J., Pisarevskaya, V., Olvet, D.M., Xu, W., Mendell, N., Finch, S.J., & Hatchwell, E. (2010). Parent-child DRD4 genotype as a potential biomarker for oppositional, anxiety, and repetitive behaviors in children with autism spectrum disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 34, 1208-1214.

 

The primary objective of the present study was to examine whether a combination of parent-child DRD4 genotypes results in more informative prognostic biomarkers of oppositional, separation anxiety, and repetitive behaviors in children with autism spectrum disorder (ASD). Based on prior research indicating the 7-repeat allele as a potential risk variant, participants were sorted into one of four combinations of parent-child genotypes. Owing to the possibility of parent-of-origin effects, analyses were conducted separately for mother-child (MC) and father-child (FC) dyads. Mothers completed a validated DSM-IV-referenced rating scale [Child Symptom Inventory-4]. Partial eta-squared (hp2) was used to determine the magnitude of group differences: 0.01-0.06=small, 0.06-0.14=moderate, and >0.14=large. Analyses indicated that children in MC dyads with matched genotypes had the least (7-/7-) and most (7+/7+) severe mother-rated oppositional-defiant (hp2=0.11) and separation anxiety (hp2=0.19) symptoms. Conversely, youths in FC dyads with matched genotypes had the least (7-/7-) and most (7+/7+) severe obsessive-compulsive behaviors (hp2=0.19) and tics (hp2=0.18). Youths whose parents were both noncarriers had less severe tics than peers with at least one parental carrier, and the effect size was large (hp2=0.16). There was little evidence that noncarrier children were rated more severely by mothers who were carriers versus noncarriers. Transmission Disequilibrium Test analyses provided preliminary evidence for undertransmission of the 2-repeat allele in youths with more severe tics (p=0.02). Parent genotype may be helpful in constructing prognostic biomarkers for behavioral disturbances in ASD; however, findings are tentative pending replication with larger, independent samples.

 

10-12. Gadow, K.D., & Nolan, E.E. (2010). Methylphenidate and co-morbid anxiety disorder in children with both chronic multiple tic disorder and ADHD. Journal of Attention Disorders, doi: 10.1177/1087054709356405

 

Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial with rating scales and laboratory measures [including Child Symptom Inventory]. Results: The +ANX group obtained more severe parent, teacher, and child ratings of anxiety and more severe parent ratings of depression, tics, oppositional defiant disorder (ODD), and peer aggression than the -ANX group. Treatment with short-term MPH-IR was associated with improvement in ADHD, ODD, and peer aggression in the +ANX group. When controlling for ODD severity, there were no apparent group differences in therapeutic response to MPH-IR in children +/-ANX. There was little evidence that MPH-IR contributed to improvement in anxiety or depression symptoms in the +ANX group. There was some indication that children with comorbid anxiety may differentially experience greater increase in systolic blood pressure (0.5 mg/kg of MPH-IR > placebo). Conclusion: Findings suggest that the co-occurrence of diagnosed CMTD+ADHD+ANX represents a particularly troublesome clinical phenotype, at least in the home setting. Comorbid anxiety disorder was not associated with a less favorable response to MPH-IR in children with ADHD+CMTD, but replication with larger samples is warranted before firm conclusions can be drawn about potential group differences.

 

10-13. Gadow, K.D., Roohi, J., DeVincent, C.J., Kirsch, S., & Hatchwell, E. (2010). Brief Report: Glutamate transporter gene (SLC1A1) single nucleotide polymorphism (rs301430) and repetitive behaviors and anxiety in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40, 1139-1145.

 

Investigated association of single nucleotide polymorphism (SNP) rs301430 in glutamate transporter gene (SLC1A1) with severity of repetitive behaviors (obsessive-compulsive behaviors, tics) and anxiety in children with autism spectrum disorder (ASD). Mothers and/or teachers completed a validated DSM-IV-referenced rating scale [Child Symptom Inventory-4] for 67 children with autism spectrum disorder. Although analyses were not significant for repetitive behaviors, youths homozygous for the high expressing C allele had more severe anxiety than carriers of the T allele. Allelic variation in SLC1A1 may be a biomarker for or modifier of anxiety symptom severity in children with ASD, but study findings are best conceptualized as tentative pending replication with larger independent samples.

 

10-14. Guttmann-Steinmetz, S., Gadow, K.D., DeVincent, C.J., & Crowell, J. (2010).Anxiety symptoms in boys with autism spectrum disorder, attention-deficit hyperactivity disorder, or chronic multiple tic disorder and community controls. Journal of Autism and Developmental Disorders, 40, 1006-1016.

 

We compared symptoms of generalized anxiety disorder (GAD) and separation anxiety disorder (SAD) in 5 groups of boys with neurobehavioral syndromes: attention-deficit/hyperactivity disorder (ADHD) plus autism spectrum disorder (ASD), ADHD plus chronic multiple tic disorder (CMTD), ASD only, ADHD only, and community Controls. Anxiety symptoms were assessed using parent and teacher versions of a DSM-IV-referenced rating scale [Child Symptom Inventory-4]. All three groups of boys with co-morbid ADHD evidenced more severe anxiety than Controls. Group differences in anxiety varied as a function of symptom, disorder, informant, and co-morbidity supporting the notion that co-morbid neurobehavioral syndromes differentially impact clinical features of co-occurring anxiety symptoms. Findings also suggest that GAD and SAD are phenomenologically unique, even in children with ASD. Implications for nosology are discussed.

 

10-15. Hayashida, K., Anderson, B., Paparella, T., Freeman, S.F.N.), & Forness, S.R. (2010). Comorbid psychiatric diagnoses in preschoolers with autism spectrum disorders. Behavioral Disorders, 35, 243-254.

 

Although comorbid or co-occurring psychiatric diagnoses such as attention deficit hyperactivity disorder, anxiety disorders, depression, and oppositional defiant or conduct disorders have been well studied in children or adolescents with autism spectrum disorders (ASDs), very little research is available on preschool samples. The current study involves 175 preschoolers with ASDs attending a day-treatment preschool for interdisciplinary services in a clinical psychiatric hospital. Two different diagnostic instruments [one of which was the Early Childhood Inventory-4] were used not only to determine clinical cutoffs for the previously mentioned disorders but also to confirm ASDs diagnoses. Although most comorbid diagnoses were found at rates comparable to those found in previous studies, depression or dysthymia tended to be prevalent at much higher levels than expected. Practical implications of these findings are discussed.

 

10-16. Hummer, T.A., Wang, Y., Kronenberger, W.G., Mosier, K.M., Kalnin, A.J., Dunn, D.W., & Mathews, V.P. (2010). Short-term violent video game play by adolescents alters prefrontal activity during cognitive inhibition. Media Psychology, 13, 136-154.

 

Prior research has indicated an association between exposure to violent media and aggressive thoughts, feelings, and behavior, potentially as a result of effects on inhibitory mechanisms. However, the role of violence in video games in modulating subsequent neural activity related to cognitive inhibition has received little attention. To examine short-term effects of playing a violent video game, 45 adolescents were randomly assigned to play either a violent or a nonviolent video game for 30 minutes immediately prior to functional magnetic resonance imaging (fMRI). [The Adolescent Symptom Inventory-4 was used to screen out psychopathology.] During the fMRI procedure, participants performed a go/no-go task that required them to press a button for each target stimulus and withhold the response for non-target stimuli. Participants who played the violent game demonstrated a lower BOLD response in right dorsolateral prefrontal cortex (DLPFC) when responses were appropriately inhibited. The DLPFC is involved with executive functioning, including suppression of unwanted thoughts and behaviors. In addition, responses in the DLPFC demonstrated stronger inverse connectivity with precuneus in the nonviolent game players. These results provide evidence that playing a violent video game can modulate prefrontal activity during cognitive inhibition.

 

10-17. Jones, A.P., Happe, F.G.E., Gilbert, F., Burnett, S., & Viding, E. (2010). Feeling, caring, knowing: different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder. Journal of Child Psychology and Psychiatry, 51, 1188-1197.

  

Background: Empathy dysfunction is one of the hallmarks of psychopathy, but it is also sometimes thought to characterise autism spectrum disorders (ASD). Individuals with either condition can appear uncaring towards others. This study set out to compare and contrast directly boys with psychopathic tendencies and boys with ASD on tasks assessing aspects of affective empathy and cognitive perspective taking. The main aim of the study was to assess whether a distinct profile of empathy deficits would emerge for boys with psychopathic tendencies and ASD, and whether empathy deficits would be associated with conduct problems in general, rather than psychopathic tendencies or ASD specifically. Methods: Four groups of boys aged between 9 and 16 years (N = 96) were compared: 1) psychopathic tendencies, 2) ASD, 3) conduct problems [assessed with the Child Symptom Inventory-4 and Adolescent Symptom Inventory-4] and 4) comparison. Tasks were included to probe attribution of emotions to self, empathy for victims of aggression and cognitive perspective-taking ability. Results: Boys with psychopathic tendencies had a profile consistent with dysfunctional affective empathy. They reported experiencing less fear and less empathy for victims of aggression than comparison boys. Their cognitive perspective-taking abilities were not statistically significantly different from those of comparison boys. In contrast, boys with ASD had difficulties with tasks requiring cognitive perspective taking, but reported emotional experiences and victim empathy that were in line with comparison boys. Boys with conduct problems did not differ from comparison boys, suggesting that the affective empathy deficit seen in boys with psychopathic tendencies was specific to that group, rather than common to all boys with conduct problems. Conclusions: Although both groups can appear uncaring, our findings suggest that the affective/information processing correlates of psychopathic tendencies and ASD are quite different. Psychopathic tendencies are associated with difficulties in resonating with other people's distress, whereas ASD is characterised by difficulties in knowing what other people think.

 

10-18. Klein, J.B., Lavigne, J.V., & Seshadri, R. (2010). Clinician-assigned and parent-report questionnaire-derived child psychiatric diagnoses: Correlates and consequences of disagreement. American Journal of Orthopsychiatry, 80, 375-385.

 

The objectives of this study were to determine (a) if child characteristics relate to disagreement between clinician-assigned diagnoses and diagnoses derived from parent-report questionnaire, which were available to clinicians, and (b) if disagreement predicts subsequent number of clinic visits attended. This study evaluated the odds of agreement versus disagreement for internalizing and externalizing problems as a function of child age, gender, race, public-aid status, symptom severity, and impairment among 900 children (3-19 years) in a large, urban, child psychiatry clinic. A mixed-effects regression approach was used to evaluate the relationship between disagreement and visit attendance. Internalizing problem disagreement was more likely for children who were males, older, less symptomatic, and receiving Medicaid. Externalizing problem disagreement was more likely for children who were female, older, less impaired, and less symptomatic. Internalizing disagreement predicted significantly fewer visits; externalizing disagreement did not. Clinician-parent disagreement about the nature of child problems may have clinical consequences, especially for internalizing disorders. Attention to child characteristics that predict agreement may diminish discrepancies and reduce attrition from treatment.

 

10-19. Kochanska, G., Koenig, J.L., Barry, R.A., Kim, S., & Yoon, J.E. (2010). Children's conscience during toddler and preschool years, moral self, and a competent, adaptive developmental trajectory. Developmental Psychology, 46, 1320-1332.

  

We investigated whether children's robust conscience, formed during early family socialization, promotes their future adaptive and competent functioning in expanded ecologies. We assessed two dimensions of conscience in young children (N=100) at 25, 38, and 52 months in scripted laboratory contexts: internalization of their mothers' and fathers' rules, observed when the child was alone, and empathic concern toward each parent, observed in simulated distress paradigms. We also assessed the child's self-perception on moral dimensions (the moral self), using a puppet interview at 67 months. At 80 months, parents and teachers produced an overall measure of competent, adaptive functioning by rating children on multiple scales of competent, prosocial, rule-abiding behavior and antisocial behavior. [Child Symptom Inventory-4 was used to assess symptoms of conduct disorder and oppositional defiant disorder.] As expected, children with histories of a stronger internalization of both parents' rules were more competent and better socialized; for maternal rules, that link was mediated by the child's moral self. The link between the child's history of empathy toward the mother and future socialization was also significant, but it was not mediated by the moral self. This study elucidates the roles of classic components of morality-moral conduct, affect, and self-as antecedents of an adaptive developmental trajectory from toddler to early school age.

 

10-20. Kochanska, G., Woodard, J., Kim, S., Koenig, J.L., Yoon, J.E., & Barry, R.A. (2010).Positive socialization mechanisms in secure and insecure parent-child dyads: two longitudinal studies. Journal of Child Psychology and Psychiatry, 51, 998-1009.  

 

Background: Implications of early attachment have been extensively studied, but little is known about its long-term indirect sequelae, where early security organization moderates future parent-child relationships, serving as a catalyst for adaptive and maladaptive processes. Two longitudinal multi-trait multi-method studies examined whether early security amplified beneficial effects of children's willing, receptive stance toward the parent on socialization outcomes. Methods: We examined parent-child early attachment organization, assessed in the Strange Situation at 14-15 months, as moderating links between children's willing stance toward parents and socialization outcomes in Study 1 (108 mothers and children, followed to 73 months) and Study 2 (101 mothers, fathers, and children, followed to 80 months). Children's willing stance was observed as committed compliance at 14 and 22 months in Study 1, and as responsiveness to the parent in naturalistic interactions and teaching contexts at 25 and 67 months in Study 2. Socialization outcomes included children's internalization of maternal prohibition, observed at 33, 45, and 56 months, and maternal ratings of children's externalizing problems at 73 months in Study 1, and mothers' and fathers' ratings of children's oppositional defiant disorder and conduct disorder symptoms at 80 months in Study 2. [Child Symptom Inventory-4 was used to assess conduct disorder and oppositional defiant disorder symptoms.] Results: Indirect effects of attachment were replicated across both studies and diverse measures: Attachment security significantly amplified the links between children's willing stance to mothers and all outcomes. Secure children's willing, cooperative stance to mothers predicted future successful socialization outcomes. Insecure children's willing stance conferred no beneficial effects. Conclusions:Implications of early attachment extend to long-term, indirect developmental sequelae. Security in the first year serves as a catalyst for future positive socialization processes.

 

10-21. Koenig, K., White, S.W., Pachler, M., Lau, M., Lewis, M., Klin, A., & Scahill, L. (2010). Promoting social skill development in children with pervasive developmental disorders: A feasibility and efficacy study. Journal of Autism and Developmental Disorders, 40, 1209-1218.

 

A randomized controlled design was employed to evaluate a social skills intervention for children with pervasive developmental disorders. Aims included evaluating the acceptability of the program and gathering preliminary evidence on efficacy. Forty-four children, ages 8-11 years, were randomly assigned to treatment or wait list. [The Child Symptom Inventory-4 was used as a screen for psychiatric problems.] Treatment consisted of a 16-week group intervention designed to teach appropriate social behavior. Between group comparisons showed that children in treatment were rated as improved on the primary outcome measure, (unblinded parent report), but not on the secondary outcome measure, a parent questionnaire. Parents reported a high level of satisfaction with the intervention. The study supports the feasibility of this intervention to families and highlights challenges for future research in social skills intervention.

 

10-22. Kofler, M.J., Rapport, M.D., Bolden, J., Sarver, D.E., & Raiker, J.S. (2010). ADHD and working memory: the impact of central executive deficits and exceeding storage/rehearsal capacity on observed inattentive behavior. Journal of Abnormal Child Psychology, 38, 149-161.

 

Inattentive behavior is considered a core and pervasive feature of ADHD; however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory deficits and inattentive behavior. The current study investigated whether inattentive behavior in children with ADHD is functionally related to the domain-general central executive and/or subsidiary storage/rehearsal components of working memory. [Child Symptom Inventory-4 was one of several diagnostic instruments.] Objective observations of children's attentive behavior by independent observers were conducted while children with ADHD (n = 15) and typically developing children (n = 14) completed counterbalanced tasks that differentially manipulated central executive, phonological storage/rehearsal, and visuospatial storage/rehearsal demands. Results of latent variable and effect size confidence interval analyses revealed two conditions that completely accounted for the attentive behavior deficits in children with ADHD: (a) placing demands on central executive processing, the effect of which is evident under even low cognitive loads, and (b) exceeding storage/rehearsal capacity, which has similar effects on children with ADHD and typically developing children but occurs at lower cognitive loads for children with ADHD.

 

10-23. Lai, M.C., Chiu, Y.N., Gadow, K.D., Gau, S.S., & Hwu, H.G. (2010). Correlates of gender dysphoria in Taiwanese university students. Archives of Sexual Behavior, 39, 1415-1428.

 

There have been no published reports regarding the epidemiological and psychiatric features of gender dysphoria in non-clinical young adults. The current study aimed to investigate the demographics, co-occurring psychiatric symptoms, and perceived parenting style and family support in Taiwanese young adults with gender dysphoria. The sample consisted of 5010 university freshmen (male, 51.6%) with a mean age of 19.6 years (SD = 2.7) from a national university in Taiwan. The questionnaires used for this university-based survey included the Adult Self Report Inventory-4 for psychopathology (including gender dysphoria), the Parental Bonding Instrument for parenting style, and the Family APGAR for perceived family support. Results showed that gender dysphoria was more prevalent in females (7.3%) than males (1.9%). Young adults with gender dysphoria were more likely to meet a wide but specific range of co-occurring psychiatric symptoms. The most significantly associated symptoms for males were agoraphobia, hypochondriasis, manic episode, and pathological gambling, and for females dissociative disorder, hypochondriasis, and body dysmorphic disorder. Both males and females with gender dysphoria perceived significantly less support from their families and less affection/care from both parents. Findings suggest that gender dysphoria, associated with a specific range of psychopathology and family/parenting dissatisfaction (with both similar and dissimilar patterns between sexes), is not uncommon in Taiwanese university students, particularly in females. This implies the importance of attention and specific measures to offset psychiatric conditions and to promote mental well-being of this population.

 

10-24. Leathers, S.J., Falconnier, L., & Spielfogel, J. E. (2010). Predicting family reunification, adoption, and subsidized guardianship among adolescents in foster care. American Journal of Orthopsychiatry, 80, 422-431.

 

Although national legislation has attempted to decrease the length of time that children spend in foster care, these policies have been less effective with adolescents than with children, raising questions about how best to promote permanency for adolescents. This study examined factors that predict adolescent adoption, subsidized guardianship, and reunification. The caseworkers and foster parents of 203 randomly selected 12- to 13-year-olds placed in traditional or specialized foster care were interviewed. Permanency outcomes were prospectively tracked for 8 years. By the end of the study, over 40% of the adolescents were placed in permanent homes. As hypothesized, a strong relationship with a biological mother predicted successful reunification, and a high degree of integration into a foster home predicted adoption. Additionally, when compared with adoption, subsidized guardianship with foster parents occurred more frequently for youth with strong relationships with their biological mothers and weaker relationships with their foster families. Unexpectedly, behavior problems were not related to any permanency outcomes. Results suggest that promotion of strong relationships with adults is the key in efforts to find permanent families for foster children. Furthermore, efforts to attain permanency should not cease during adolescence.

 

10-25. Loeber, R., Stepp, S.D., Chung, T., Hipwell, A.E., & White, H.R. (2010). Time-varying associations between conduct problems and alcohol use in adolescent girls: The moderating role of race. Journal of Studies on Alcohol and Drugs, 71, 544-553.  

 

Objective: The aims of this study were to examine the time-varying developmental associations between conduct problems and early alcohol use in girls between ages 11 and 15 and to test the moderating role of race. Method: The study is based on annual, longitudinal data from oldest cohort in the Pittsburgh Girls Study (n = 566; 56% African American, 44% White). Two models of the association between conduct problems [assessed with the Child Symptom Inventory-4 and the Adolescent Symptom Inventory-4] and alcohol use were tested using latent growth curve analyses: conduct-problem-effect (conduct problems predict time-specific variation in alcohol use trajectory) and alcohol-effect (alcohol use predicts time-specific variation in conduct problem trajectory) models. Results: Girls' conduct problems and alcohol use increased over ages 11-15. Results provided support for a conduct-problem-effect model, although the timing of the associations between conduct problems and alcohol use differed by ethnicity. Among White girls, conduct problems prospectively predicted alcohol use at ages 11-13 but not later, whereas among African American girls, prospective prediction was observed at ages 13-14 but not earlier. Conclusions: Study findings indicate developmental differences in the time-varying association of conduct problems and alcohol use during early adolescence for African American and White girls. Ethnic differences in the development of alcohol use warrant further study, and have potential implications for culture-specific early screening and preventive interventions.

 

10-26. Lopez-Villalobos, A., Serrano-Pintado, J., Andres-De Llano, J.M., Sanchez-Mateos, J.D., Alberola-Lopez, S., & Sanchez-Azon, M.I. (2010). Usefullness of the Stroop test in attention deficit hyperactivity disorder. Revista de Neurologia, 50, 333-340.

 

Aims. The aim of this study is to analyse the differences in the Stroop effect between cases with attention deficit hyperactivity disorder (ADHD) and controls. It also seeks to find the best model based on the third task of the colours and words test (Stroop-CW) for predicting ADHD and to analyse the validity of the Stroop-CW test for diagnosing the disorder. Subjects and methods. The sample studied consisted of 100 cases of ADHD according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria [Child Symptom Inventory-4] and 100 controls, between 7 and 11 years of age, who were evaluated using the Stroop test. The controls were recruited at random and paired by age, sex and sociodemographic area with the cases. Results. The cases present a mean cognitive style that is significantly less flexible (d = -1.06) and they also display a lower capacity to inhibit or control automatic responses than the controls at all ages (7 years: d = 1.67; 8 years: d = 1.02; 9 years: d = 1.32; 10 years: d = 2.04; 11 years: d = 0.89). The model of logistic regression analysis that best predicts ADHD is made up of age and Stroop-CW. The formulation derived from the model offers a sensitivity of 81% and a specificity of 72%, taking the criteria of the DSM-IV for ADHD as the reference test. Conclusions. The Stroop-CW test presents usefulness and complementary criteria validity for the diagnosis of ADHD.

 

10-27. Lopez-Villalobos, J.A., Serrano-Pintado, I., Delgado-Sanchez-Mateos, J., de Llano, J.M.A., Alberola-Lopez, S., Sacristan-Martin, Perez-Garcia, I., & Camina-Gutierrez, A.B. (2010). Use of Matching Familiar Figures Test 20 in the diagnosis of children with attention deficit hyperactivity disorder. International Journal of Clinical and Health Psychology, 10, 499-517. 

 

The descriptive study focused on the differences among patients with Attention Deficit Hyperactivity Disorder (ADHD) and controls, in relation to cognitive impulsivity and to find the best model based in Matching Familiar Figures Test 20 (MFFT-20) which permits to predict and to diagnose ADHD, analyzing the validity of the test for the diagnostic of the disease. Ex post facto study. We study 100 ADHD cases (DSM-IV criteria) and 100 controls, ranging between 7 and 11 years of age, analyzed with MFFT-20. Controls were randomly recruited and matched by age, gender and sociodemography area with cases. Cases show an average cognitive style significantly more impulsive (effect size d = 1.29) with a smaller sum of latencies (effect size d = .71) and a bigger sum of errors (effect size d = 2.20). The logistic regression model that best predicts ADHD in constituted by age and errors score of MFFT-20. The derived formula from the model shows a 80% of sensivity and a 80% of specificity for ADHD, regarding as gold standard the DSM-IV criteria. MFFT-20 test shows indicators of appropriate validity for diagnose in ADHD, contributing to increase the objectivity in his analysis.

 

10-28. Marmorstein, N.R., White, H., Chung, T., Hipwell, A., Stouthamer-Loeber, M. & Loeber, R. (2010). Associations between first use of substances and change in internalizing symptoms among girls: differences by symptom trajectory and substance use. Journal of Clinical Child and Adolescent Psychology, 39, 545-558.

 

Abstract: This study examined how girls' initial use of alcohol, cigarettes, and marijuana related to changes in depressive [assessed with the Child Symptom Inventory-4], generalized anxiety, and social anxiety symptoms, and whether these changes varied based on which internalizing symptom trajectories the girls were on. Data came from the Pittsburgh Girls Study, a community-based study of girls assessed at ages 5 to 8 and followed for 6 years. Growth mixture modeling was used to identify trajectory groups. The results indicated that for girls on a high depressive symptom trajectory, initial use of marijuana was related to further increases in depressive symptoms. Initial uses of alcohol and cigarettes were associated with overall increases in depressive symptoms, and the initial use of cigarettes was associated with an overall increase in generalized anxiety symptoms. Initial use of all substances was related to change in social anxiety, but the direction of change varied by trajectory group and substance. Links between initial use and internalizing symptoms depended on the type of substance, type of internalizing symptom, and trajectory group.

 

10-29. Mikami, A.Y., Jack, A., Emeh, C.C., & Stephens, H.F. (2010). Parental influence on children with attention-deficit/hyperactivity disorder: I. Relationships between parent behaviors and child peer status. Journal of Abnormal Child Psychology, 38, 721-736.

 

We examined associations between children's peer relationships and (a) their parents' social competence as well as (b) their parents' behaviors during the children's peer interactions. Participants were families of 124 children ages 6-10 (68% male), 62 with ADHD and 62 age- and sex-matched comparison youth. [Child Symptom Inventory-4 was used to help identify chuildren with ADHD.] Children's peer relationships were assessed via parent and teacher report, and sociometric nominations in a lab-based playgroup. Parental characteristics were assessed via parent self-report and observations of behavior during their child's playgroup. After statistical control of relevant covariates, parents of children with ADHD reported poorer social skills of their own, arranged fewer playdates for their children, and displayed more criticism during their child's peer interaction than did parents of comparison youth. Parents' socialization with other parents and facilitation of the child's peer interactions predicted their children having good peer relationships as reported by teachers and peers, whereas parental corrective feedback to the child and praise predicted poor peer relationships. Parents' ratings of their child's social skills were positively associated with ratings of their own social skills, but negatively associated with criticism and facilitation of the child's peer interactions. Relationships between parental behaviors and peer relationships were stronger for youth with ADHD than for comparison youth. The relevance of findings to interventions is discussed.

 

10-30. Mikami, A.Y., Lerner, M.D., Griggs, M.S., McGrath, A., & Calhoun, C.D. (2010). Parental influence on children with attention-deficit/hyperactivity disorder: II. Results of a pilot intervention training parents as friendship coaches for children. Journal of Abnormal Child Psychology, 38, 737-749.

 

We report findings from a pilot intervention that trained parents to be "friendship coaches" for their children with Attention-Deficit/Hyperactivity Disorder (ADHD). Parents of 62 children with ADHD (ages 6-10; 68% male) were randomly assigned to receive the parental friendship coaching (PFC) intervention, or to be in a no-treatment control group. [Child Symptom Inventory-4 was used to help identify chuildren with ADHD.] Families of 62 children without ADHD were included as normative comparisons. PFC was administered in eight, 90-minute sessions to parents; there was no child treatment component. Parents were taught to arrange a social context in which their children were optimally likely to develop good peer relationships. Receipt of PFC predicted improvements in children's social skills and friendship quality on playdates as reported by parents, and peer acceptance and rejection as reported by teachers unaware of treatment status. PFC also predicted increases in observed parental facilitation and corrective feedback, and reductions in criticism during the child's peer interaction, which mediated the improvements in children's peer relationships. However, no effects for PFC were found on the number of playdates hosted or on teacher report of child social skills. Findings lend initial support to a treatment model that targets parental behaviors to address children's peer problems.

 

10-31. Molfese, V.J.,  Molfese, P.J., Molfese, D.L., Rudasill, K.M., Armstrong, N., & Starkey, G. (2010). Executive function skills of 6-8 year olds: Brain and behavioral evidence and implications for school achievement. Contemporary Educational Psychology, 35, 116-125.

 

Academic and social success in school has been linked to children's self-regulation. This study investigated the assessment of the executive function (EF) component of self-regulation using a low-cost, easily administered measure to determine whether scores obtained from the behavioral task would agree with those obtained using a laboratory-based neuropsychological measure of EF skills. The sample included 74 children (37 females; M = 86.2 months) who participated in two assessments of working memory and inhibitory control: Knock-Tap (NEPSY: Korkman, Kirk, & Kemp, 1998), and participated in event-related potential (ERP) testing that included the directional stroop test (DST, Davidson, Cruess, Diamond, O'Craven, and Savoy (1999)). [The Child Symptom Inventory-4 was used to screen out psychopathology.] Three main findings emerged. First, children grouped as high vs. low performing on the NEPSY Knock-Tap Task were found to perform differently on the more difficult conditions of the DST (the Incongruent and Mixed Conditions), suggesting that the Knock-Tap Task as a low-cost and easy to administer assessment of EF skills may be one way for teachers to identify students with poor inhibitory control skills. Second, children's performance on the DST was strongly related to their ERP responses, adding to evidence that differences in behavioral performance on the DST as a measure of EF skills reflect corresponding differences in brain processing. Finally, differences in brain processing on the DST task also were found when the children were grouped based on Knock-Tap performance. Simple screening procedures can enable teachers to identify children whose distractibility, inattentiveness, or poor attention spans may interfere with classroom learning.

 

10-32. New, J.J., Schultz, R.T., Wolf, J., Niehaus, J.L., Klin, A., German, T.C., & Scholl, B.J. (2010). The scope of social attention deficits in autism: Prioritized orienting to people and animals in static natural scenes. Neuropsychologia, 48, 51-59.  

 

A central feature of autism spectrum disorder (ASD) is an impairment in 'social attention'-the prioritized processing of socially relevant information, e.g. the eyes and face. Socially relevant stimuli are also preferentially attended in a broader categorical sense, however: observers orient preferentially to people and animals (compared to inanimate objects) in complex natural scenes. To measure the scope of social attention deficits in autism, observers viewed alternating versions of a natural scene on each trial, and had to 'spot the difference' between them-where the difference involved either an animate or inanimate object. Change detection performance was measured as an index of attentional prioritization. Individuals with ASD showed the same prioritized social attention for animate categories as did control [screened with the Child Symptom Inventory-4] participants. This could not be explained by lower level visual factors, since the effects disappeared when using blurred or inverted images. These results suggest that social attention - and its impairment in autism - may not be a unitary phenomenon: impairments in visual processing of specific social cues may occur despite intact categorical prioritization of social agents.

 

10-33. Obradovic, J., & Hipwell, A. (2010). Psychopathology and social competence during the transition to adolescence: The role of family adversity and pubertal development. Development and Psychopathology, 22, 621-634

 

This study examined developmental processes linking competence and psychopathology in an urban sample of girls during their transition to adolescence. Longitudinal associations among indices of externalizing symptom, social competence, and internalizing symptoms were also tested within contexts of family adversity and girls' pubertal status. Child, parent, and teacher report were employed to assess core constructs across six annual assessment waves, starting at age 9. Results revealed the significant effect of prior levels of externalizing symptoms [conduct disorder and oppositional defiant disorder assessed with the Child Symptom Inventory-4] on changes in social competence and internalizing symptoms, as well as reciprocal relations between social competence and internalizing symptoms. In addition, girl's maladaptive functioning predicted increases in family adversity exposure over time. Last, more mature pubertal status in early assessment waves was linked to an increase in internalizing symptoms; however, this association was reversed by the last assessment, when most girls had reached advance stages of puberty. The timing of these effects reveals important targets for future interventions aimed at promoting the successful adaptation of girls in adolescence.

 

10-34. Ondrejka, I., Abali, O., Paclt, I., Gacser, M., Iftene, F., Walton, R., Harrison, G., Treuer, T., & Martenyi, F. (2010). A prospective observational study of attention-deficit/hyperactivity disorder in Central and Eastern Europe and Turkey: Symptom severity and treatment options in a paediatric population. International Journal of Psychiatry in Clinical Practice, 14, 116-126.

 

Objective. This study investigates the relationship between treatment regimen, symptom severity, comorbidities and health outcomes of paediatric patients with attention-deficit/hyperactivity disorder (ADHD) in Central and Eastern Europe (CEE). Methods. Males and females aged 6-17 years with ADHD symptoms participated in this 12-month, prospective, observational, non-randomised study. Symptoms and comorbidities were assessed using the Child and Adolescent Symptom Inventory-4 Parent Checklists (CSI-4; ASI-4, categories L/O), and the Clinical Global Impressions-ADHD-Severity scale (CGI-ADHD-S). Baseline data are presented. Results. The study included 566 patients from Czech Republic, Hungary, Romania, Slovakia and Turkey. Psychiatrists made all diagnoses using The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV), World Health Organization International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), and "other" criteria (73, 27 and 0.4%, respectively). Patients were grouped into two cohorts based on whether they were prescribed psycho- and/or pharmacotherapy (n=443) or not (n=123). Patients receiving prescribed treatment were older and demonstrated higher symptom severity scores than those receiving no or "other" treatment. Most patients were prescribed conventional treatment for ADHD at baseline. Conclusions. Continued assessment of this population may aid the treatment and outcomes of ADHD in CEE. [Czech, Hungarian, Romanian, Slovakian, Korean, Chinese, Mandarin, Turkish]

 

10-35. Pears, K.C., Bruce, J., Fisher, P. A., Kim, H.K. (2010). Indiscriminate friendliness in maltreated foster children. Child Maltreatment, 15, 64-75.

 

Indiscriminate friendliness is well documented in children adopted internationally following institutional rearing but is less studied in maltreated foster children. Precursors and correlates of indiscriminate friendliness were examined in 93 preschool-aged maltreated children residing in foster care and 60 age-matched, nonmaltreated children living with their biological parents. Measures included parent reports, official case record data, and standardized laboratory assessments. Foster children exhibited higher levels of indiscriminate friendliness than nonmaltreated children. Inhibitory control [assessed in part with the Early Childhood Inventory-4] was negatively associated with indiscriminate friendliness even after controlling for age and general cognitive ability. Additionally, the foster children who had experienced a greater number of foster caregivers had poorer inhibitory control, which was in turn associated with greater indiscriminate friendliness. The results indicate a greater prevalence of indiscriminate friendliness among foster children and suggest that indiscriminate friendliness is part of a larger pattern of dysregulation associated with inconsistency in caregiving.

 

10-36. Rincon, R.A., Ballabriga, M.C.J., Martin, A.B.,  Poch, F.V., Corcoll-Champredonde, A., Rodriguez, G.G., Burgos, R.M.Z., Perez, N.C.D., & Carbones, J. (2010). Evaluation of oppositional defiant symptoms in six to eight year-old children: Agreement between parents and teachers Psicothema, 22, 455-459.

 

Evaluation of oppositional defiant symtoms in 6- to 8 year-old Children:Agreement between parimts and teachers. The main goal of this study is to determine the degree of agreement between the reports provided by parents and teachers about oppositional defiant symptoms in school children between the ages of 6 and 8 years. In addition, it attempts to determine whether children's age and sex affect the level of agreement between informants. Parents and teachers assessed 702 girls and boys at 25 schools in the Region of Osona, Barcelona (Spain) with the Child Symptom Inventory-4 (parents. and teachers' version). The results indicate a very low agreement practically null between the valuations of both informants: furthermore, no significant difference (Inc to the variables age and sex of the children was observed in the above-mentioned valuations. The parents tended to appraise most of the symptoms of the Oppositional Defant Disorder as present and to evaluate their severity as being more intense.

 

10-37. Ruggero, C.J., Carlson, G.A., Kotov, R., & Bromet, E.J. (2010). Ten-year diagnostic consistency of bipolar disorder in a first-admission sample. Bipolar Disorders, 12, 21-31.  

 

Objectives: A number of reports have examined the stability of the diagnosis of schizophrenia, but fewer studies have considered the long-term consistency of a bipolar diagnosis or factors that influence the likelihood of a diagnostic change. The present study sought to estimate how consistently a bipolar diagnosis was made across a 10-year period and factors associated with consistency, particularly demographic and clinical characteristics, childhood-related factors, and illness course. Methods: The sample included 195 first-admission patients presenting with psychosis who were assessed soon after hospitalization and at 6-month, 2-year, and 10-year follow-up and diagnosed with bipolar disorder on at least one of these assessments. Diagnoses were made using best-estimate procedures and were blind to all previous consensus diagnoses. Respondents who were consistently diagnosed with bipolar disorder were compared to those whose diagnosis shifted across assessments. Results: Overall, 50.3% (n = 98) of the 195 respondents were diagnosed with bipolar disorder at every available assessment, but 49.7% (n = 97) had a diagnostic shift to a non-bipolar disorder at least once over the course of the 10-year study. Childhood psychopathology [assessed in part with the Child Symptom Inventory-4] and poorer illness course were among the few variables associated with increased odds of a change in diagnosis. Conclusions: Even with optimal assessment practices, misdiagnosis of bipolar disorder is common, with complex clinical presentations often making it difficult to consistently diagnose the disorder over the long term.

 

10-38. Schlund, M.W., Siegle, G.J., Ladouceur, C.D., Silk, J.S., Cataldo, M.F., Forbes, E.E., Dahl, R.E., & Ryan, N.D. (2010). Nothing to fear? Neural systems supporting avoidance behavior in healthy youths. Neuroimage, 52, 710-719.

 

Active avoidance involving controlling and modifying threatening situations characterizes many forms of clinical pathology, particularly childhood anxiety. Presently our understanding of the neural systems supporting human avoidance is largely based on nonhuman research. Establishing the generality of nonhuman findings to healthy children is a needed first step towards advancing developmental affective neuroscience research on avoidance in childhood anxiety. Accordingly, this investigation examined brain activation patterns to threatening cues that prompted avoidance in healthy youths. [The Child Symptom Inventory-4 was used to screen out psychopathology.] During functional magnetic resonance imaging, fifteen youths (ages 9-13) completed a task that alternately required approach or avoidance behaviors. On each trial either a threatening 'Snake' cue or a 'Reward' cue advanced towards a bank containing earned points. Directional buttons enabled subjects to move cues away from (Avoidance) or towards the bank (Approach). Avoidance cues elicited activation in regions hypothesized to support avoidance in nonhumans (amygdala, insula, striatum and thalamus). Results also highlighted that avoidance response rates were positively correlated with amygdala activation and negatively correlated with insula and anterior cingulate activation. Moreover, increased amygdala activity was associated with decreased insula and anterior cingulate activity. Our results suggest that nonhuman neurophysiological research findings on avoidance may generalize to neural systems associated with avoidance in childhood. Perhaps most importantly, the amygdala/insula activation observed suggests that threat-related responses can be maintained even when aversive events are consistently avoided, which may account for the persistence of avoidance-coping in childhood anxiety. The present approach may offer developmental affective neuroscience a conceptual and methodological framework for investigating avoidance in childhood anxiety.

 

10-39. Serchuck, L.K., Williams, P.L., Nachman, S., Gadow, K.D., Chernoff, M., & Schwartz, L. (2010). Prevalence of pain and association with psychiatric symptom severity in perinatally HIV-infected children as compared to controls living in HIV-affected households. AIDS Care, 22, 640-648.

 

This cross-sectional study evaluated the prevalence of pain and psychiatric symptoms in perinatally HIV-infected children at entry into P1055, a multicenter investigation of the prevalence and severity of psychiatric symptoms in HIV-infected children. Subjects 6-17 years of age and their primary caregivers were recruited from 29 International Maternal Pediatric Adolescent AIDS Clinical Trials sites in the USA and Puerto Rico. A total of 576 children (320 HIV+ and 256 HIV- children) were enrolled from June 2005 to September 2006. Subject self-reports of pain were measured by the Wong-Baker visual analog scale and Short-Form McGill Pain Questionnaire. Symptomatology for anxiety, depression, and dysthymia was assessed through Symptom Inventory instruments [assessed with the Child and Adolescent Symptom Inventory-4R]. Caregiver's assessment of their child's pain and psychiatric symptomatology was similarly measured. Logistic regression models were used to evaluate predictors of pain. We found that a higher proportion of HIV-infected than uninfected subjects reported pain in the last two months (41% vs 32%, p=0.04), last two weeks (28% vs 19%, p=0.02), and lasting more than one week (20% vs 11%, p=0.03). Among HIV-infected youth, females (OR=1.53, p=0.09), White race (OR=2.15, p=0.04), and Centers for Disease Control (CDC) class C (OR=1.83, p=0.04) were significantly more likely to report pain. For all subjects, only 52% of caregivers recognized their child's pain and just 22% were aware that pain affected their child's daily activities. The odds of reported pain in HIV+ increased with higher symptom severity for generalized anxiety (OR=1.14, p=0.03), major depression (OR=1.15, p=0.03), and dysthymia (OR=1.18, p=0.01). This study underscores the importance of queries concerning pain and emotional stressors in the care of HIV+ and uninfected children exposed to HIV+ individuals. The discordance between patient and caregiver reports of pain and its impact on activities of daily living highlights that pain in children is under-recognized and therefore potentially under-treated.

 

10-40. Sismanlar, S.G., Anik, Y., Coskun, A., Agaoglu, B., Karakaya, I., & Yavuz, C.I. (2010). The volumetric differences of the fronto-temporal region in young offspring of schizophrenic patients. European Child & Adolescent Psychiatry, 19, 151-157.  

 

The aim of this study is to examine the volumetric differences of the fronto-temporal region in the offspring of schizophrenic patients in comparison to normal. Twenty-six offspring of chronic schizophrenic patients aged between 8 and 15 years and 23 control children [evaluated with the Child Symptom Inventory-4] were matched with respect to cranial MRI. Chronic schizophrenic patients were reevaluated with SCID-I to confirm their diagnosis. Parents of children in the control group completed SCL-90-R and were evaluated by clinical interview to exclude any psychotic disorder. The diagnoses of psychiatric disorders in all of the children were established by DSM-IV-based clinical interviews with children and parents. They underwent IQ evaluation by WISC-R and evaluated with cranial MRI. Hippocampus, thalamus, amygdala, corpus callosum, frontal, and temporal lobe volumes were measured and compared by using MANCOVA. After covarying whole brain volume, age and gender, statistically significant decrease in the measurements of corpus callosum and hippocampi, and a non-significant trend toward smaller temporal lobes were observed in the high-risk children. The structure of hippocampal formation and corpus callosum were impaired in the children of the schizophrenic patients which suggests a neurodevelopmental abnormality in subjects with genetic high risk for schizophrenia.

 

10-41. Sprafkin, J., Mattison, R.E., Gadow, K.D., Schneider, J., &  Lavigne, J. (2010). A DSM-IV-referenced teacher rating scale for monitoring behavioral improvement. Journal of Attention Disorders.

 

Objective: To examine the psychometric properties of the 30-item teacher’s version of the Child and Adolescent Symptom Inventory Progress Monitor (CASI-PM-T), a DSM-IV-referenced rating scale for monitoring change in ADHD and co-occurring symptoms in youths receiving behavioral or pharmacological interventions. Method: Three separate studies were conducted to determine (a) which items from longer diagnostic instruments were most representative of ADHD and commonly occurring psychiatric syndromes in clinic-referred samples (N=406) ages 3-18 years, (b) the reliability and validity of the CASI-PM-T in students enrolled in full-time special education programs at the elementary and middle school levels (N = 169), and (c) the clinical utility of measuring behavioral change in a sample of outpatient ADHD children beginning treatment with stimulant medication. Results: Internal consistency reliabilities (.71 to .94), 2-week test-retest reliabilities (r = .70 to .90), and interrater agreement (r = .44 to .78) for the CASI-PM-T symptom categories were comparable to the full-length CASI-4. Convergence was also found between corresponding CASI-PM-T categories and consultant diagnoses of ADHD and ODD as well as school functioning measures of grade-point average and suspensions. The CASI-PM-T also demonstrated sensitivity to stimulant medication treatment effects. Conclusion: Findings provide preliminary support for the reliability, validity, and clinical utility of the CASI-PM-T.

 

10-42. Stepp, S.D., Pilkonis, P.A., Hipwell, A.E., Loeber, R., & Stouthamer-Loeber, M. (2010). Stability of borderline personality disorder features in girls. Journal of Personality Disorders, 24, 460-472.

 

Little empirical evidence exists regarding developmental antecedents of borderline personality disorder (BPD) features in children and adolescents. As a first step in addressing this gap in our knowledge, this study examined the factor structure and stability of putative underlying BPD features, specifically impulsivity, negative affectivity, and interpersonal aggression, in 6-12-year-old girls. We report on results from exploratory and confirmatory factor analyses of underlying BPD dimensions as rated by parents and teachers over six successive data waves in a large, community sample of girls (N = 2,451). [Child Symptom Inventory-4 was used to assess ADHD, oppositional defiant disorder, conduct disorder, and major depressive episode symptoms.]  Six factors were derived from parent ratings (i.e., Cognitive Dyscontrol, (Lack of) Self-Control, Hostility, Depression/Anxiety, Hyperactivity, and Relational Aggression) and five factors were derived from teacher reports (i.e., Cognitive Dyscontrol, Hyperactivity, (Lack of) Self-Control, Relational Aggression, and Depression). The item composition of similar parent and teacher factors was highly consistent. The year-to-year stability from ages 6 to 12 was high for parent factor scores (r ranging from .71-.85) and moderately high for teacher factor scores (r ranging from .49-.77). These findings suggest that underlying dimensions of BPD features can be reliably measured and are stable in 6-12-year-old girls.

 

10-43. Volpe, R.J., & Gadow, K.D. (2010). Creating abbreviated rating scales to monitor classroom inattention-overactivity, aggression, and peer conflict: Reliability, validity, and treatment sensitivity. School Psychology Review, 39, 350-363.   

 

Rating scales developed to measure child emotional and behavioral problems typically are so long as to make their use in progress monitoring impractical in typical school settings. This study examined two methods of selecting items from existing rating scales to create shorter instruments for use in assessing response to intervention. The psychometric properties of two sets of abbreviated rating scales derived from the IOWA Conners Teacher Rating Scale and the teacher-completed Peer Conflict Scale were examined and compared to the longer original versions of these scales. The rating scales were evaluated using data from a randomized, placebo-controlled, crossover trial of immediate release methylphenidate involving a sample 65 children between 6 and 12 years old who met research diagnostic criteria for attention deficit hyperactivity disorder and either chronic motor tic disorder or Tourette's disorder. Specifically, the abbreviated and original versions of the rating scales were examined for internal consistency, temporal stability, concurrent validity, and treatment sensitivity. Results indicate that there were few significant differences between versions of the scales, which support the use of abbreviated rating scales for use in progress monitoring. Implications for practice and future research are discussed.

 

10-44. Weisbrot, D.M., Ettinger, A.B., Gadow, K.D., Belman, A., MacAllister, W.S., Milazzo, M., Reed, M.L., Serrano, D., & Krupp, L.B. (2010). Psychiatric comorbidity in pediatric patients with demyelinating disorders. Journal of Child Neurology, 25, 192-202.  

 

Little is known about psychiatric aspects of pediatric demyelinating conditions. A total of 23 youths (6-17 years) with demyelinating conditions underwent semistructured psychiatric interviews using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Adolescents and parents completed the Child Symptom Inventory-4 and the Youth's Inventory-4. Fears and conceptions of their neurological problems were elicited. In all, 48% (n=11) met criteria for current psychiatric diagnoses, including 27% (n = 3) with depressive disorders and 64% (n=7) with anxiety disorders. Fears and conceptions of the illness were severe and diverse. Depressive and anxiety disorders are common in pediatric demyelinating disease. Clinicians should therefore screen for psychiatric comorbidity symptoms as part of the routine evaluation of such patients.

 

10-45. Williams, P.L., Leister, E., Chernoff, M., Nachman, S., Morse, E., Di Poalo, V., & Gadow, K.D. (2010). Substance use and its association with psychiatric symptoms in perinatally HIV-infected and HIV-affected adolescents. AIDS and Behavior, 14, 1072-1082.

 

Drug use in combination with psychiatric illness may lead to unsafe sexual risk behavior and increased risk for secondary HIV transmission among adolescents with HIV infection. We compared the prevalence of substance use for perinatally HIV-infected youth to uninfected adolescents living in families affected by HIV infection, and evaluated the association of psychiatric symptoms [assessed with the Child and Adolescent Symptom Inventory-4R] with risk of substance use. Among 299 adolescents (196 HIV+, 103 HIV−) aged 12–18 years enrolled in IMPAACT P1055, a multisite US cohort study, 14% reported substance use at enrollment (HIV+: 13%, HIV−: 16%). In adjusted logistic regression models, adolescents had significantly higher odds of substance use if they met symptom criteria for ADHD [adjusted odds ratio (aOR) = 2.7, Wald χ2 = 5.18, P = 0.02], major depression or dysthymia (aOR = 4.0, Wald χ2 = 7.36, P = 0.01), oppositional defiant disorder (aOR = 4.8, Wald χ2 = 12.7, P = 0.001), or conduct disorder (aOR = 15.4, Wald χ2 = 28.12, P = 0.001). Among HIV-infected youth, those with lower CD4 lymphocyte percentage (CD4% < 25%) had significantly increased risk of substance use (aOR=2.7, Wald χ2 = 4.79, P = 0.03). However, there was no overall association of substance use with HIV infection status, and the association between psychiatric symptoms and substance use did not differ by HIV status. Programs to prevent substance use should target both HIV-infected and uninfected adolescents living in families affected by HIV infection, particularly those with psychiatric symptoms.

 

YEAR: 2009

 

09-1. Babio, N., Canals, J., Pietrobelli, A., Perez, S., & Arija, V. (2009). A two-phase population study: relationships between overweight, body composition and risk of eating disorders. Nutricion Hospitalaria, 24, 485-491.  

 

Background: Overweight and eating disorder (ED) are major public health problems in adolescents. Aims: To assess the association of overweight, body composition and anthropometric characteristics with the probability being at risk of ED. Methods: A two-phase study was used. 329 girls and 96 boys (aged 12-18 years) from an initial sample of 2967 adolescents were studied. The BMI, percentage of fat mass estimated by bioimpedance (FM(BIA)), waist circumference, waist-to-height ratio, and waist-to-hip ratio (WHipr) were calculated. The Eating Attitudes Test, Youth's Inventory-4 and a questionnaire to evaluate social influences were administered. Results: A total of 34.7% of girls and 53.6% of boys at risk of ED were overweight (including obesity). For girls, overweight frequency was significantly higher in risk ED group than in control group. Increases of one point in the BMI or FM(BIA) increased the probability of being at risk of ED by 12% (3.0-19.0) and 4% (0.0-8.0), respectively. An increase in Whipr was negatively associated with ED risk. Smoking and symptoms of dysthymia and  generalized anxiety disorder also increase the probability of being at risk of ED in adolescent girls. In adolescent boys, these relations were not observed. Conclusions: The higher BMI and the percentage of FM(BIA) are associated with greater risk of ED in adolescent girls, when psychological factors are present. Increases in the WHipr, characteristic of childhood body is negatively associated with that risk.

 

09-2. Barnes, M.E., Huss, E.A., Garrod, K.N., Van Raay, E., Dayyat, E., Gozal, D., & Molfese, D.L. (2009). Impairments in attention in occasionally snoring children: an event-related potential study. Developmental Neuropsychology, 34, 629-649.

 

To determine whether minimal snoring is benign in children. PROCEDURE: 22 rarely snoring children (mean age = 6.9 years, 11 females) and age- and sex-matched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed the Conners Parent Rating Scales-Revised Long (CPRS-R:L). [The Child Symptom Inventory-4 was used to screen children for significant behavioral disorders.] RESULTS: Snorers scored significantly higher on four CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 msec post-stimulus onset predicted CPRS-R:L Attention Deficit Hyperactivity Disorder (ADHD) Index scores. CONCLUSIONS: Occasional snorers, according to parental report, do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in snorers.

 

09-3. Bartgis, J., Lefler, E., Hartung, C.M., & Thomas, D.G. (2009). Contrast sensitivity in children with and without attention deficit hyperactivity disorder symptoms. Developmental Neuropsychology, 34, 663-682.   

 

Dopamine regulation may play a role in attention-deficit hyperactivity disorder (ADHD). Visual contrast sensitivity has been proposed as a measure of retinal dopamine that may predict frontal lobe dopamine levels. Individuals with disorders involving dopamine dysregulation (e.g., Parkinson's disease, Phenylketonuria) have shown poor contrast sensitivity. In this study, 110 6- to 13-year-old children with and without ADHD completed a task measuring visual contrast sensitivity. [ADHD was assessed with the Child Symptom Inventory-4.] As predicted, contrast sensitivity was significantly worse in children with ADHD-Combined Type than controls. Contrast sensitivity was significantly correlated with inattention and hyperactivity. However, unlike many neuropsychological studies of ADHD, only hyperactivity accounted for unique variance.

 

09-4. Bastiaens, L. (2009). A non-randomized, open study with Aripiprazole and Ziprasidone for the treatment of aggressive behavior in youth in a community clinic. Community Mental Health Journal, 45, 73-77.  

 

Forty-six patients (36 male, mean age 11.9 +/- 2.6) with a variety of diagnoses and with significant aggressive behavior were treated in an open, non-randomized fashion with Aripiprazole or Ziprasidone. Patients were diagnosed with the Mini International Neuropsychiatric Interview and the Child/Adolescent Symptom Inventory-4. The primary outcome measure was the Overt Aggression Scale (OAS). After 2 months, 34 patients were still in treatment. The average improvement of the OAS in these 34 patients was 63%. Clinical Global Impression-Improvement Scale was 2.1 +/- A 1.2. Neither at baseline, nor at 2 months, were there any statistically significant differences between the Aripiprazole and Ziprasidone groups. Sedation was the most common side effect.

 

09-5. Birmaher, B., Ehmann, M., Axelson, D.A., Goldstein, B.L., Monk, K., Kalas, C., Kupfer, D., Gill, M.K., Leibenluft, E., Bridge, J., Guyer, A., Egger, H.L., & Brent, D.A. (2009). Schedule for affective disorders and schizophrenia for school-age children (K-SADS-PL) for the assessment of preschool children - A preliminary psychometric study. Journal of Psychiatric Research, 43, 680-686.

 

Objective: To assess the psychometrics of the schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL) in diagnosing DSM-IV psychiatric disorders and subsyndromal symptomatology in preschool children. Method: Parents were interviewed about their children using the K-SADS-PL, and they completed the Early Childhood Inventory-4 (ECI-4) and child behavior checklist for ages 11/2-5 years (CBCL). Discriminant, divergent, and convergent validity of the K-SADS-PL were evaluated in 204 offspring ages 2-5 years old of parents from an ongoing study. Inter-rater reliability as well as predictive validity of intake diagnoses at second assessment approximately two years after intake were evaluated. Fourteen children were also assessed by the preschool age psychiatric assessment (PAPA). Results: Children who were diagnosed with oppositional defiant disorder, attention deficit hyperactivity disorder, anxiety, mood, or elimination disorders had significantly higher scores on the ECI-4 than children without these disorders. Significant correlations were found for all convergent CBCL scales. Divergent validity was acceptable for emotional disorders. Inter-rater kappa coefficients for all diagnoses were good. Above noted results were similar for children with at least one positive K-SADS-PL key screen symptom. A significantly higher percentage of children with an intake diagnosis had a diagnosis approximately two years after intake compared to those without an intake disorder. Overall, there was consistency between the PAPA and the K-SADS-PL. Conclusions: Pending further testing, the K-SADS-PL may prove useful for the assessment of psychopathology in preschoolers.

 

09-6. Boles, D.B., Adair, L.P., & Joubert, A.-M. (2009). A preliminary study of lateralized processing in attention-deficit/hyperactivity disorder. Journal of General Psychology, 136, 243-258.

 

Attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in spatial and sustained attention processes normally linked to the right parietal and frontal lobes. However, data on lateralization changes in attention processes are sparse. Little research has addressed whether the problems may reflect a more widespread lateralization disorder or whether there are lateralization changes over time. To address these issues, the authors examined several tasks, each using a lateralized process largely localized to a particular lobe and 2 age ranges (11-14 and 18-26 years) of unmedicated ADHD participants and control participants. [Diagnoses were based on part on the Child Symptom Inventory-4 and the Adult Self Report Inventory-4.] ADHD children bisected lines significantly more rightward compared with control children, indicating an altered spatial attention process normally localized to the right parietal lobe. This problem was absent in young adults, suggesting a developmental resolution. The authors observed sustained attention decrements at both ages appearing earlier in the left hemisphere during a vigil. Finally, in these preliminary data, ADHD-related problems appeared specific to attention processes.

 

09-7. Bubier, J.L., Drabick, D.A.G., & Breiner, T. (2009). Autonomic functioning moderates the relations between contextual factors and externalizing behaviors among inner-city children. Journal of Family Psychology, 23, 500-510.

 

Although previous research has identified various child-specific and contextual risk factors associated with externalizing behaviors, there is a dearth of literature examining child X context interactions in the prospective prediction of externalizing behaviors. To address this gap, we examined autonomic functioning as a moderator of the relation between contextual factors (i.e., neighborhood cohesion and harsh parental behaviors) and externalizing behaviors [measured with the Child Symptom Inventory-4]. Participants were an ethnic minority, inner-city sample of first through fourth grade children (N = 57, 50% male) and their primary caregivers who participated in two assessments approximately 1 year apart. Results indicated that baseline sympathetic functioning moderated the relation between (a) neighborhood cohesion and externalizing behaviors and (b) harsh parental behaviors and externalizing behaviors. Post-hoc probing of these interactions revealed that higher levels of neighborhood cohesion prospectively predicted (a) higher levels of externalizing behaviors among children with heightened baseline sympathetic functioning, and (b) lower levels of externalizing behaviors among children with attenuated baseline sympathetic functioning. In addition, among children with heightened baseline sympathetic functioning, higher levels of harsh parental behaviors prospectively predicted higher levels of externalizing behaviors.

 

09-8. Chen, E.Y., McCloskey, M.S., & Keenan, K.E. (2009). Subtyping dietary restraint and negative affect in a longitudinal community sample of girls. International Journal of Eating Disorders, 42, 275-283.

 

Objective: This Study tests the validity of the "dietary-depressive" Subtype (typified by greater negative affect) and a "dietary" subtype (typified by dietary restraint only) using a diverse longitudinal community sample. Method: Girls at ages 10, 12, and 14 completed the Child Eating Attitudes Test, the Child Symptom Inventory-4, and Body Image Measure. Body Mass Index was assessed at each age. Results: Unlike previous studies, cluster analysis revealed an at-risk "dietary-depressive" (R+) subtype (18.7%, 100/534) and a not at-risk (R-) subtype, distinguished by few depressive symptoms and little dietary restraint (81.31%, 434/534), but no "dietary" subtype, When compared with the R- subtype, the R+ subtype had significantly greater eating disordered behavior and attitudes. The R+ subtype at age 10 was a risk factor for binge-eating but not obesity at ages 12 and 14. Discussion: Dietary restraint and depressive symptoms combined predict binge-eating. longitudinally in a diverse community sample of girls.

 

09-9. Chernoff, M., Nachman, S., Williams, P., Brouwers, P., Heston, J., Hodge, J., Di Poalo, V., Deygoo, N.S., Gadow, K.D., and the IMPAACT  P1055 Study Team. (2009). Mental health treatment patterns in perinatally HIV-Infected youth and controls. Pediatrics, 124, 627-636.

 

Background: Youths perinatally infected with HIV (HIV+) often receive psychotropic medication and behavioral treatment for emotional and behavioral symptoms. We describe patterns of intervention for HIV+ and controls in the United States. Methods: 319 HIV+ and 256 Controls, aged 6-17 years, enrolled in IMPAACT 1055, a prospective, 2 year observational study of psychiatric symptoms. 174 of Controls were perinatally HIV-exposed and 82 were uninfected children living in households with HIV+ members. Youths and their primary caregivers completed Youth’s (Self-Report) Inventory-4R and the Child and Adolescent Symptom Inventory-4R (CASI-4R), respectively. Children’s medication and behavioral psychiatric intervention histories were collected at entry.  We evaluated the association of past or current psychiatric treatment with HIV-status, baseline symptoms and impairment using multiple logistic regression, controlling for potential confounders. Results: HIV+ and controls had similar prevalence of psychiatric symptoms (61%) and impairment (14-15%).  104 (18%) participants received psychotropic medications: stimulants (14%), antidepressants (6%) and neuroleptics (4%) and 127 (22%) received behavioral treatment. More HIV+ than Controls received psychotropic medication (23% vs. 12%, p<0.001) and behavioral treatment (27% vs. 17%, p=0.01). After adjusting for symptom class and confounders, HIV+ children had twice the odds of controls to have received stimulants and over 4 times the odds to have received antidepressants. Caregiver-reported symptoms or impairment were associated with higher odds of intervention than reports by children alone. Conclusions: HIV+ children are more likely to receive mental health interventions than controls.  Pediatricians and caregivers should consider available mental health treatment options for all children living in families affected by HIV.

 

09-10. De Los Reyes, A., Henry, D.B., Tolan, P.H., & Wakschlag, L.S. (2009). Linking informant discrepancies to observed variations in young children's disruptive behavior. Journal of Abnormal Child Psychology, 37, 637-652.

 

Prior work has not tested the basic theoretical notion that informant discrepancies in reports of children's behavior exist, in part, because different informants observe children's behavior in different settings. We examined patterns of observed preschool disruptive behavior across varying social contexts in the laboratory and whether they related to parent-teacher rating discrepancies of disruptive behavior in a sample of 327 preschoolers. [Teacher ratings were obtained with the Early Childhood Inventory-4.]  Observed disruptive behavior was assessed with a lab-based developmentally sensitive diagnostic observation paradigm that assesses disruptive behavior across three interactions with the child with parent and examiner. Latent class analysis identified four patterns of disruptive behavior: (a) low across parent and examiner contexts, (b) high with parent only, (c) high with examiner only, and (d) high with parent and examiner. Observed disruptive behavior specific to the parent and examiner contexts were uniquely related to parent-identified and teacher-identified disruptive behavior, respectively. Further, observed disruptive behavior across both parent and examiner contexts was associated with disruptive behavior as identified by both informants. Links between observed behavior and informant discrepancies were not explained by child impairment or observed problematic parenting. Findings provide the first laboratory-based support for the Attribution Bias Context Model (De Los Reyes and Kazdin Psychological Bulletin 131:483-509, 2005), which posits that informant discrepancies are indicative of cross-contextual variability in children's behavior and informants' perspectives on this behavior. These findings have important implications for clinical assessment, treatment outcomes, and developmental psychopathology research.

 

09-11. DeVincent, C.J., & Gadow, K.D. (2009). Relative clinical utility of three Child Symptom Inventory-4 scoring algorithms for differentiating children with autism spectrum disorder vs. attention-deficit hyperactivity disorder. Autism Research, 2, 312-321.  

 

Objective: The present study compared three separate Child Symptom Inventory-4 (CSI-4) scoring algorithms for differentiating children with autism spectrum disorder (ASD) from youngsters with attention-deficit/hyperactivity disorder (ADHD). Method: Parents/teachers completed the CSI-4, a DSM-IV-referenced rating scale, for 6 to 12-year-old clinical referrals with ASD (N=186) and ADHD (N=251). Algorithms were based on either all CSI-4 items (forward logistic regressions) or the 12 DSM-IV symptoms of pervasive developmental disorder (PDD) included in the CSI-4. Results: ROC analyses indicated generally good to excellent values for area under the curve, sensitivity, specificity, and positive predictive power. Algorithms for parent ratings were superior to teacher ratings. The algorithm based solely on PDD symptoms evidenced the greatest generalizability. Conclusion: Although algorithms generated from regression analyses produced greater clinical utility for specific samples, the PDD-based algorithm resulted in greater stability across samples.

 

09-12. Domenech-Llaberia, E., Vinas, F., Pla, E., Claustre J.M., Mitjavila, M., Corbella, T., Canals, J. (2009). Prevalence of major depression in preschool children. European Child & Adolescent Psychiatry, 18, 597-604.   

 

The prevalence of preschool major depressive disorder (MDD) was studied in the community. The whole population of children between 3 and 6 years attending preschool nurseries in three areas (one urban, one rural and one suburban) in Spain (n = 1,427) were contacted. Selection was by a two-stage procedure. At stage I, the ESDM 3-6, a screening measure for preschool depression, was used to identify a sample for more intensive interviewing. Sensitivity and specificity of the cut-off point of the ESDM 3-6 had been previously tested in a pilot study (n = 229). [One of the assessment instruments was the Early Childhood Inventory-4.] During the first stage, 222 preschool children (15.6%) were found to be probable depressives, because they scored 27 or more, the cut-off used. At stage II, the children were interviewed and diagnosed by the consensus of two clinicians, blind to the ESDM 3-6 results. DSM-IV diagnostic criteria were used to define caseness. A total of 16 children (1.12%) met the MDD criteria. The prevalence by areas was urban 0.87%, rural 0.88%, suburban 1.43%. Sex distribution prevalence was 1:1. This study is a contribution to the scarce epidemiology of preschool depression in the community.

 

09-13. Dunn, D. W., Austin, J. K.., & Perkins, S.M. (2009). Prevalence of psychopathology in childhood epilepsy: categorical and dimensional measures. Developmental Medicine and Child Neurology, 51, 364-372.

 

Objective: Few studies have utilized both categorical and dimensional measures of psychopathology in children with epilepsy. Method: We evaluated 173 children (88 males, 85 females; mean age 11.7y [SD 1.8]; range 9-14y) who had epilepsy (generalized 36%, partial 61%) for at least 6 months. The primary caregiver completed a dimensional measure, the Child Behavior Checklist (CBCL), and a categorical measure, either the Child Symptom Inventory-4 (CSI-4) or the Adolescent Symptom Inventory-4 (ASI-4). Correlation coefficients were computed between the CBCL scores and CSI/ASI symptom scores. Results: For all children, diagnostic risk was higher than norms on CSI/ASI for attention-deficit-hyperactivity disorder (ADHD) inattentive type, ADHD combined type, oppositional defiant disorder, and dysthymic disorder. For children between 9 and 12 years, elevated scores were found on CBCL, total, internalizing, and attention problems, and on CSI, diagnostic risk for conduct disorder and Asperger syndrome. For children of 13 and 14 years, ASI diagnostic risk was higher for specific phobia, obsessions, posttraumatic stress disorder, motor tics, antisocial personality, panic attack, somatization disorder, and enuresis. CBCL and symptom scores on the CSI/ASI were significantly correlated. Conclusion: The conclusion was that children with epilepsy have high rates of behavioral difficulties on both dimensional and categorical measures. Concurrent validity for the CSI/ASI was supported.

 

09-14. Feng, X., Keenan, K., Hipwell, A.E, Henneberger, A.K., Rischall, M.S., Butch, J., Coyne, C., Boeldt, D., Hinze, A.K., & Babinski, D.E. (2009).  Longitudinal associations between emotion regulation and depression in preadolescent girls: Moderation by the caregiving environment. Developmental Psychology, 45, 798-808.

 

Identifying childhood precursors for depression has been challenging and yet important for understanding the rapid increase in the rate of depression among adolescent girls. This study examined the prospective relations of preadolescent girls' emotion regulation and parenting style with depressive symptoms. Participants were 225 children and their biological mothers recruited from a larger longitudinal community study. [The Child Symptom Inventory-4 was used as a screening tool for depressive symptoms.] Girls' observed positive and negative emotion during a conflict resolution task with mothers, their ability to regulate sadness and anger, and their perception of parental acceptance and psychological control were assessed at age 9. Depressive symptoms were assessed by self-report at ages 9 and 10. The results indicated interactions between child emotion characteristics and parenting in predicting later depression. Specifically, low levels of positive emotion expression predicted higher levels of depressive symptoms in the context of moderate to high parental psychological control. Low levels of sadness regulation were predictive of high levels of depressive symptoms in the context of low to moderate parental acceptance. Findings from this study support the hypothesis that the prospective association between vulnerabilities in emotion regulation and depression are moderated by the caregiving environment.

 

09-15. Gadow, K.D., DeVincent, C.J., & Schneider, J. (2009). Comparative study of children with ADHD Only, autism spectrum disorder+ADHD, and chronic multiple tic disorder+ADHD. Journal of Attention Disorders, 12, 474-485.

 

Objective: Children with diagnosed autism spectrum disorder (ASD) and chronic multiple tic disorder (CMTD) typically meet criteria for attention deficit/hyperactivity disorder (ADHD). The identification of similarities and differences in co-occurring psychiatric symptoms and mental health risk/protective factors among groups of children with ADHD only, ASD+ADHD, and CMTD+ADHD may eventually lead to a better understanding of these clinical phenotypes. Method: Children with ASD+ADHD (n=88), CMTD+ADHD (n=66), and ADHD Only (n=66) were evaluated using the parent- and teacher-completed Child Symptom Inventory-4, and a parent-completed questionnaire about medical, treatment, and family history. Results: All three groups were highly similar in severity of oppositional defiant disorder and conduct disorder symptoms.  With regard to the various types of anxiety examined in this study, the ASD+ADHD group generally exhibited the most severe symptoms, although the CMTD+ADHD group was rated as having the most generalized anxiety. The two co-morbid groups had the most involved medical histories and greatest likelihood of a family history of psychopathology. Conclusion: The three ADHD groups differed in clinically meaningful ways, and the apparent association between tics and anxiety may explain in part the elevated levels of anxiety in both ASD and CMTD groups.

 

09-16. Gadow, K.D., Roohi, J., DeVincent, C.J., & Kirsch, S., & Hatchwell, E. (2009). Association of COMT (Val158Met) and BDNF (Val66Met) gene polymorphisms with anxiety, ADHD and tics in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 39, 1542-1551. DOI 10.1007/s10803-009-0794-4

 

Background: To examine rs4680 (COMT) and rs6265 (BDNF) as genetic markers of anxiety, ADHD, and tics. Methods: Parents and teachers completed a DSM-IV-referenced rating scale [Child Symptom Inventory-4] for a total sample of 67 children with autism spectrum disorder (ASD) Results: Both COMT (p=.06) and BDNF (p=.07) genotypes were marginally significant for teacher ratings of social anxiety (hp2=.06). Analyses also indicated associations of BDNF genotype with parent-rated ADHD (p=.01; hp2=.10) and teacher-rated tics (p=.04; hp2=.07). There was also evidence of a possible interaction (p=.02, hp2=.09) of BDNF genotype with DAT1 3’ VNTR with tic severity. Conclusion: BDNF and COMT may be biomarkers for phenotypic variation in ASD, but these preliminary findings remain tentative pending replication with larger, independent samples.

 

09-17. Gatzke-Kopp, L.M., Beauchaine, T.P., Shannon, K.E., Chipman, J., Fleming, A.P, Crowell, S., Liang, O., Johnson, L. C., & Aylward, E. (2009). neurological correlates of reward responding in adolescents with and without externalizing behavior disorders. Journal of Abnormal Psychology, 118, 203-213.

 

Opposing theories of striatal hyper- and hypodopaminergic functioning have been suggested in the pathophysiolopy of externalizing behavior disorders. [Potential participants were initially screened with the Adolescent Symptom Inventory-4.] To test these competing theories, the authors used functional MRI to evaluate neural activity during a simple reward task in 12- to 16-year-old boys with attention-deficit/hyperactivity disorder and/or conduct disorder (n = 19) and in controls with no psychiatric condition (n = 11). The task proceeded in blocks during which participants received either (a) monetary incentives for correct responses or (b) no rewards for correct responses. Controls exhibited striatal activation only during reward, shifting to anterior cingulate activation during nonreward. In contrast, externalizing adolescents exhibited striatal activation during both reward and nonreward. Externalizing psychopathology appears to be characterized by deficits in processing the omission of predicted reward, which may render behaviors that are acquired through environmental contingencies difficult to extinguish when those contingencies change.

 

09-18. Guttmann-Steinmetz, S., Gadow, K.D., & DeVincent, C.J. (2009). Oppositional defiant and conduct disorder behaviors in boys with autism spectrum disorder with and without attention-deficit hyperactivity disorder versus several comparison samples. Journal of Autism and Developmental Disorders, 39, 976-985.

 

We compared disruptive behaviors in boys with either autism spectrum disorder (ASD) plus ADHD (n=74), ADHD plus chronic tic disorder (CMTD) (n=47), ADHD Only (n=59), or ASD Only (n=107). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 (CSI-4) including parent- (n=168) and teacher-rated (n=173) community Controls. Parents rated children in the three ADHD groups comparably for each symptom of oppositional defiant disorder (ODD) and conduct disorder (CD). Teacher ratings indicated that the ASD+ADHD group evidenced a unique pattern of ODD symptom severity, differentiating them from the other ADHD groups, and from the ASD Only group. The clinical features of ASD appear to influence co-morbid, DSM-IV-defined ODD, with implications for nosology.

 

09-19. Hack, M., Taylor, H.G., Schluchter, M., Andreias, L., Drotar, D., & Klein, N. (2009). Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics, 30, 122-130.

 

Objective: To describe the prevalence of behavioral problems and symptomatology suggestive of Autism and Asperger's disorders at age 8 years among extremely low birth weight (ELBW, < 1 kg) children, born 1992 through 1995. Method: Parent reports of the behavior of 219 ELBW (mean birth weight, 810 g; gestational age 26 weeks) were compared with 176 normal birth weight children of similar maternal socio-demographic status, sex, and age. Behavior was assessed via the Child Symptom Inventory-4 that includes both Symptom Severity Scores and scores meeting DSM-IV criteria for disorders. Results: ELBW compared with normal birth weight children had significantly higher mean Symptom Severity Scores for the inattentive, hyperactive, and combined types of attention-deficit hyperactivity disorder (all p <.001) as well as higher scores for Generalized Anxiety (p <.01) and Autistic (p <.001) and Asperger's (p <.01) disorders. When DSM-IV criteria were considered, ELBW children also had significantly higher rates of attention-deficit hyperactivity disorder of the inattentive (100% vs 3%, p <.01) and combined (5% vs 0.6%, p <.05) types. Conclusions: Attention-deficit hyperactivity disorder, mainly the inattentive type is prevalent among ELBW children. Our findings of an increase in symptoms pertaining to Autistic and Asperger's disorders at school age agree with recent reports of others during early childhood. Early identification and intervention for these problems might improve child functioning and ameliorate parent and child distress.

 

09-20. Huang-Pollock, C. L., Mikami, A.Y., Pfiffner, L., & McBurnett, K. (2009). Can executive functions explain the relationship between attention deficit hyperactivity disorder and social adjustment? Journal of Abnormal Child Psychology, 37, 679-691.

 

This study examined the ability of executive functions (EF) to account for the relationship between Attention Deficit Hyperactivity Disorder (ADHD) status and social adjustment as indexed by parent and teacher report and by performance on a standardized observational "chat room" task. Children with the Combined subtype (ADHD-C; n=23), the Primarily Inattentive Subtype (ADHD-I; n=33), and non-ADHD controls (n=36) participated. [Potential participants were initially screened with the Child Symptom Inventory-4.] EF did not mediate the relationship between ADHD status and parent or teacher report of social adjustment. EF accounted for about 40-50% of the variance between ADHD status and the ability of children to detect subtle verbal cues as well as memory for the conversation in the chat room task, but did not mediate the relationship between ADHD and the number of prosocial, hostile, or on-topic statements that were made. Results are consistent with other recent reports, and suggest that the role of EF deficits in the production of social skill deficits in ADHD may not be as prominent as is typically assumed. The implications for the development of intervention programs designed to target core cognitive etiologic factors are discussed.

 

09-21. Keenan, K., Feng, X., Hipwell, A., & Klostermann, S. (2009).Depression begets depression: Comparing the predictive utility of depression and anxiety symptoms to later depression. Journal of Child Psychology and Psychiatry, 50, 1167-1175.

 

Background: The high comorbidity between depressive and anxiety disorders, especially among females, has called into question the independence of these two symptom groups. It is possible that childhood anxiety typically precedes depression in girls. Comparing of the predictive utility of symptoms of anxiety with the predictive utility of symptoms of depression from early childhood to early adolescence is needed to test this hypothesis. Methods: Data from a population-based sample of 2,451 girls were used to examine age-related changes and year-to-year stability within and across symptoms of major depression [assessed with the Child Symptom Inventory-4], separation anxiety, and generalized/social anxiety by maternal report from ages 6 to 12. In addition, the predictive utility of symptoms of major depression, separation anxiety, and generalized/social anxiety at ages 7-10 years of age to depressive disorders at ages 11-13 was tested. Results: Symptoms of separation anxiety demonstrated a linear decrease, depression symptoms a linear increase and symptoms of generalized/social anxiety an increase from 6-8, a plateau 8-10, followed by a decrease from 10-12 years. Year-to-year changes in symptoms of major depression were best predicted by depressive symptoms in the previous year, although a small amount of additional variance was accounted for by separation anxiety symptoms in early childhood and generalized/social anxiety symptoms in mid to later childhood. Age 8 was the earliest age from which depressive disorders in early adolescence could be predicted from symptoms of depression and generalized social anxiety. Conclusions: Homotypic continuity of depression and anxiety symptoms from early childhood to early adolescence is more common in girls than heterotypic continuity. Some additional information about year-to-year changes in depression symptoms and later depressive disorder is gained by assessing anxiety symptoms. Depressive symptoms themselves, however, appear to be the strongest and most reliable predictor of later depression.

 

09-22. Keenan, K., Hipwell, A.E., Hinze, A.E., & Babinski, D.E. (2009). The association of pain and depression in preadolescent girls: Moderation by race and pubertal stage. Journal of Pediatric Psychology, 34, 727-737.

 

Objective: To test whether an association between pain response and depression in females is present during preadolescence using a controlled pain stimulus and a clinically relevant assessment of depressive symptoms. Method: In a sample of 232 girls, pain threshold and tolerance were assessed at age 10 years using the cold pressor task, and a diagnostic interview was used to assess depression symptoms at 10 and 11 years of age. [The Child Symptom Inventory-4 was used as an initial screen for depression symptoms.]  Results: Response to pain at age 10 was associated with depressive symptoms at ages 10 and 11; race and pubertal stage moderated the association. Pain response and depression were more strongly associated among girls who had reached advanced stages of pubertal development and among European American girls. Conclusions: The results add to the existing literature on the co-occurrence of depression and pain by demonstrating modest but consistent concurrent and prospective associations between response to pain and depression among girls during preadolescence.

 

09-23. Keenan, K., Hipwell, A., Hinze, A., & Babinski, D. (2009). Equanimity to Excess: Inhibiting the Expression of Negative Emotion is Associated with Depression Symptoms in Girls. Journal of Abnormal Child Psychology, 37, 739-747.  

 

Emotion dysregulation is often invoked as an important construct for understanding risk for psychopathology, but specificity of domains of emotion regulation in clinically relevant research is often lacking. In the present study Gross' (2001) model of emotion regulation is used to generate hypotheses regarding the relative contribution of two specific types of deficits in emotion regulation, inhibited and disinhibited expression of negative emotion, to individual differences in depressive symptoms in preadolescent girls. A sample of 232 9-year-old girls was recruited from a community based study. [The Child Symptom Inventory-4 was used as an initial screen for depression symptoms.] Depression symptoms were assessed via diagnostic interview. The mother and interviewer rated the girl's level of impairment. Questionnaires and observations were used to assess inhibited and disinhibited expression of negative emotion. Differences in inhibited expression of negative emotion typically explained more variance in depressive symptoms and impairment across informants than did disinhibited expression of negative emotion. Although disinhibited expression of negative emotion is associated with depression and impairment, inhibited expression appeared to be a necessary ingredient, suggesting that inhibited expression may be a particularly relevant deficit in emotion regulation in the development of depression in females.

 

09-24. Kochanska, G., Barry, R.A., Jimenez, N.B., Hollatz, A., & Woodard, J. (2009). Guilt and effortful control: Two mechanisms that prevent disruptive developmental trajectories. Journal of Personality and Social Psychology, 97, 322-333. 

 

Children's guilt associated with transgressions and their capacity for effortful control are both powerful forces that inhibit disruptive conduct. The authors examined how guilt and effortful control, repeatedly observed from toddlerhood to preschool age, jointly predicted children's disruptive outcomes in 2 multimethod, multitrait longitudinal studies (Ns = 57 and 99). Disruptive outcomes were rated by mothers at 73 months (Study 1) and mothers, fathers, and teachers at 52 and 67 months (Study 2). [Disruptive behaviors were assessed in part with the Child Symptom Inventory-4.] In both studies, guilt moderated effects of effortful control: For highly guilt-prone children, variations in effortful control were unrelated to future disruptive outcomes. but for children who were less guilt prone, effortful control predicted such outcomes. Guilt may inhibit transgressions through an automatic response due to negative arousal triggered by memories of past wrongdoing, regardless of child capacity for deliberate inhibition. Effortful control that engages a deliberate restraint may offset risk for disruptive conduct conferred by low guilt.

 

09-25. Kochanska, G., Barry, R.A., Stellern, S.A., & O'Bleness, J.J. (2009). Early attachment organization moderates the parent-child mutually coercive pathway to children's antisocial conduct. Child Development, 80, 1288-1300.

 

This multimethod study of 101 mothers, fathers, and children elucidates poorly understood role of children's attachment security as moderating a common maladaptive trajectory: from parental power assertion, to child resentful opposition, to child antisocial conduct. [Disruptive behaviors were assessed in part with the Child Symptom Inventory-4.] Children's security was assessed at 15 months, parents' power assertion observed at 25 and 38 months, children's resentful opposition to parents observed at 52 months, and antisocial conduct rated by parents at 67 months. Moderated mediation analyses indicated that in insecure dyads, parental power assertion predicted children's resentful opposition, which then predicted antisocial conduct. This mechanism was absent in secure dyads. Early insecurity acts as a catalyst for a dyad embarking on mutually adversarial path toward antisocial outcomes, whereas early security defuses this maladaptive trajectory.

 

 

09-26. Lavigne, J.V., Cromley, T., Sprafkin, J., & Gadow, K.D. (2009). The Child and Adolescent Symptom Inventory Progress Monitor: A brief DSM-IV-referenced parent-report scale for children and adolescents. Journal of Child and Adolescent Psychopharmacology, 19, 241-252.

 

Because clinics generally serve children with a wide range of co-morbid disorders, and time constraints limit data collection needed to monitor symptom change, there is a strong need to develop assessment instruments that are brief but comprehensive, and can be administered repeatedly during clinical management. The Child and Adolescent Symptom Inventory-Progress Monitor-Parent Form (CASI-PM-P) is a 29-item rating scale designed to evaluate symptom change for commonly-referred child and adolescent disorders. Its intended applications include monitoring longer-term changes in clinical status and assessing intervention responsiveness. To enhance practicality, there is one version of the CASI-PM-P for all age groups with a common set of norms for both genders. Scoring procedures allow clinicians to assess whether observed symptom changes exceeded chance fluctuations.  Using a clinical sample of 2,693 children ages 3-17 years, the 29 symptom-related items were identified that had the best item-to-total minus item correlations on the three age-appropriates scales of the Symptom Inventories.  Item-to-total minus item correlations of similar magnitude were also obtained for those items with the standardization sample. In clinical samples, the CASI-PM-P scores had both high levels of internal consistency and test-retest reliability, and were sensitive to change in a treated sample. Collectively, the findings support the reliability and validity of the CASI-PM-P as a measure of behavioral change in clinical settings, while continued research will be necessary to improve clinical utility and provide better documentation of the scale’s strengths and weaknesses.

 

09-27. Lavigne, J.V., LeBailly, S.A., Hopkins, J., Gouze, K.R., & Binns, H. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. Journal of Clinical Child and Adolescent Psychology, 38, 315-328.

 

Few studies have examined the epidemiology of preschoolers' psychopathology. This study included 796 4-year-old children recruited from schools and pediatric practices in a diverse, urban area. Psychiatric disorder was assessed by a structured interview adapted for preschool children and by questionnaire [including the Early Childhood Inventory-4]. The most common disorders were oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). Generalized anxiety disorder (GAD) and depressive disorders were reported in less than 1% of the sample. Race/ethnicity differences were not significant. Gender differences showed ADHD-inattentive type more common among boys, with no gender differences for GAD, major depressive disorder, dysthymia, separation anxiety disorder, or ODD at any level of impairment. The overall comorbidity rate was 6.4%. Approximately 3% of individuals receiving a diagnosis had received mental health services.

 

09-28. Ladouceur, C.D., Silk, J.S., Dahl, R.E., Ostapenko, L., Kronhaus, D.M., & Phillips, M.L. (2009). Fearful faces influence attentional control processes in anxious youth and adults. Emotion, 9, 855-864.

 

This study examined the effects of trait anxiety and age on performance on an emotional working memory task designed to investigate attentional control processes in the context of emotion. Participants included children, adolescents, and adults (8-30 years old). [Participants were evaluated with Adolescent Symptom Inventory-4 and the Child Symptom Inventory-4.] They performed the Emotional Face N-Back (EFNBACK) task, a modified n-back working memory task with four emotional distracter types (no picture, neutral, fearful, and happy) and two memory-load conditions (0-back and 2-back), and completed self-report trait anxiety measures. Results indicated that participants high in trait anxiety had slower reaction times on the fearful 2-back memory-load condition. A significant interaction with age indicated that this effect was greater in the younger participants. These findings suggest that anxious individuals, particularly younger ones, exhibit difficulty resisting interference from threat-related stimuli when greater attentional resources are being recruited.

 

09-29. Lecavalier, L., Gadow, K.D., DeVincent, C.J., & Edwards, M.C. (2009). Validation of DSM-IV model of psychiatric syndromes in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 278-289.

 

The objective of this study was to assess the internal construct validity of the DSM-IV as a conceptual model for characterizing behavioral syndromes in children with ASD. Parent and teachers completed the Child Symptom Inventory-4, a DSM-IV-referenced rating scale, for 6-to-12 year old clinic referrals with an ASD (N=498). Ratings were submitted to confirmatory factor analysis and models were assessed for fit. Results were also compared to those obtained for a sample of non-ASD psychiatric outpatient school-age children. Fit indices ranged from acceptable to good for the ASD samples and compared well to those obtained in typically-developing children. Findings lend support to the notion that DSM-IV syndromes may be an appropriate conceptual model for characterizing behavioral phenotypes in ASD.

 

09-30. Lecavalier, L., Gadow, K.D., DeVincent, C.J., Houts, C., & Edwards, M.C. (2009). Deconstructing the PDD clinical phenotype: internal validity of the DSM-IV. Journal of Child Psychology and Psychiatry, 50, 1246-1254.

  

Background: Empirical studies of the structure of autism symptoms have challenged the three-domain model of impairment currently characterizing pervasive developmental disorders (PDD). The objective of this study was to assess the internal validity of the DSM as a conceptual model for describing PDD, while paying particular attention to certain subject characteristics. Methods: Parents and teachers completed a DSM-IV-referenced rating scale [Early Childhood Inventory-4, Child Symptom Inventory-4] for 3- to 12-year-old clinic referrals with a PDD (n=730). Ratings were submitted to confirmatory factor analysis and different models were assessed for fit. Results: Measures of fit indicated that the three-factor solution based on the DSM was superior to other models. Most indices of fit were acceptable, but showed room for improvement. Fit indices varied according to the rater (parent or teacher), child's age (preschool versus school aged), PDD subtype (autism, Asperger's, pervasive developmental disorder not otherwise specified (PDDNOS)), and IQ. Conclusions: More research needs to be done before discarding current classification systems. Subject characteristics, modality of assessment, and procedural variations in statistical analyses impact conclusions about the structure of PDD symptoms.

 

09-31. Loeber, R., Hipwell, A., Battista, D., Sembower, M., & Stouthamer-Loeber, M. (2009). Intergenerational transmission of multiple problem behaviors: Prospective relationships between mothers and daughters. Journal of Abnormal Child Psychology, 37, 1035-1048.

 

Much of the research examining intergenerational continuity of problems from mother to offspring has focused on homotypic continuity (e. g., depression), despite the fact that different types of mental health problems tend to cluster in both adults and children. It remains unclear whether mothers with multiple mental health problems compared to mothers with fewer or no problems are more likely to have daughters with multiple mental health problems during middle childhood (ages 7 to 11). Six waves of maternal and child data from the Pittsburgh Girls Study (n = 2,451) were used to examine the specificity of effects of maternal psychopathology on child adjustment. Child multiple mental health problems comprised disruptive behavior, ADHD symptoms [assessed with the Child Symptom Inventory-4], depressed mood, anxiety symptoms and somatic complaints, while maternal multiple mental health problems consisted of depression, prior conduct problems and somatic complaints. Generalized Estimating Equations (GEE) was used to examine the prospective relationships between mother's single and multiple mental health problems and their daughter's single and multiple mental health problems across the elementary school-aged period (ages 7-11 years). The results show that multiple mental health problems in the mothers predicted multiple mental health problems in the daughters even when earlier mental health problem of the daughters, demographic factors, and childrearing practices were controlled. Maternal low parental warmth and harsh punishment independently contributed to the prediction of multiple mental health problems in their daughter, but mediation analyses showed that the contribution of parenting behaviors to the explanation of girls' mental health problems was small.

 

09-32. Loeber, R., Pardini, D., Hipwell, A., Stouthamer-Loeber, M., Keenan, K., Sembower, M.A. (2009). Are there stable factors in preadolescent girls' externalizing behaviors? Journal of Abnormal Child Psychology, 37, 777-791.    

 

Relatively little is known about the factor structure of disruptive behavior among preadolescent girls. The present study reports on exploratory and confirmatory factor analyses of disruptive girl behavior over four successive data waves as rated by parents and teachers in a large, representative community sample of girls (N = 2,451). Five factors were identified from parent ratings (oppositional behavior/conduct problems, inattention, hyperactivity/impulsivity, relational aggression, and callous-unemotional behaviors), and four factors were identified derived from teacher ratings (oppositional behavior/conduct problems/callous-unemotional behaviors, inattention, hyperactivity/impulsivity, and relational aggression). [Disruptive behaviors were assessed in part with the Child Symptom Inventory-4.] There was a high degree of consistency of items loading on equivalent factors across parent and teacher ratings. Year-to-year stability of factors between ages five and 12 was high for parent ratings (ICC = 0.70 to 0.88), and slightly lower for teacher ratings (ICC = 0.56 to 0.83). These findings are discussed in terms of possible adjustment to the criteria for children's disruptive behavior disorders found in the Diagnostic and Statistical Manual for Mental Disorders.

 

09-33. Martényi, F., Treuer, T.,  Gau, S. S.-F., Hong, S.D., Palaczky, M., Šuba, J., Tiberiu, M., Uhlíková, P., Xu, T., Zoroğlu, S., Gadow, K.D.,  Walton, R., & Harrison, G. (2009).  Attention-deficit/hyperactivity disorder diagnosis, co-morbidities, treatment patterns and quality of life in a paediatric population in Central and Eastern Europe and Asia. Journal of Child and Adolescent Psychopharmacology, 19, 363-376.

 

Attention deficit/hyperactivity disorder (ADHD) is often poorly understood, and treatment practices are variable. This 12-month, prospective, observational study provides information about the diagnosis, co-morbidities, treatment patterns, and quality of life (QOL) of patients aged 6-17 years with ADHD symptoms from eastern Asia and central and eastern Europe. Here, we present baseline data for the 1068 enrolled and eligible patients in the study (median age 8 years, 82.2% male). Patients were grouped into two cohorts based on whether they were prescribed psycho-and/or pharmacotherapy (n = 794) or not (n = 274) at study entry. On average, patients receiving treatment were significantly older (9.1 vs. 8.4 years, p<0.001), more severely ill (Clinical Global Impressions [CGI]-ADHD-S, 4.6 vs. 4.2, p<0.001; Child Symptom Inventory-4 Parent Checklist (CSI-4) ADHD: C, 35.2 vs. 31.9, p<0.001), and had significantly higher CSI-4 symptom severity scores relating to various co-morbidities than patients not receiving treatment. At study initiation, patient's health-related QOL was significantly impaired as measured on the Child Health and Illness Profile-Child Edition (CHIP-CE) rating scale, with significantly more impairment in the treated group of patients for the Comfort, Risks Avoidance, and Achievement domains. These results provide a description of ADHD and treatment practices in these regions and establish a baseline for gauging changes over time in the study sample.

 

09-34. Mattison, R.E., & Schneider, J. (2009). First-year effectiveness on school functioning of a self-contained ED middle school. Behavioral Disorders, 34, 60-71.    

 

Students new to a self-contained middle school for students with emotional disturbance (ED) were followed during their first year to assess the effectiveness of the program on school functioning and psychopathology. Measures for academic functioning (grade point average and subject failures), attendance (absenteeism and lateness), and disciplinary referrals (with and without out-of-school suspension) were obtained for the year prior to enrollment as well as at the completion of the first year in the program. Pre and post psychopathology were also rated for the students through the teacher version of the Adolescent Symptom Inventory (ASI-4T). Significant improvement with an average effect size of .61 was found for 5 of the 6 functional measures, as well as for the conduct disorder and attention-deficit hyperactivity disorder (inattentive type) categories of the ASI-4T. Thus, first-year effectiveness was found for the ED program, although the levels of absenteeism, disciplinary referrals, and psychopathology remained of concern.

 

09-35. McCabe, K., & Yeh, M. (2009). Parent-child interaction therapy for Mexican Americans: A randomized clinical trial. Journal of Clinical Child and Adolescent Psychology, 38, 753-759. 

 

This study compared the effectiveness of a culturally modified version of Parent-Child Interaction Therapy (PCIT), called Guiando a Ninos Activos (GANA), to the effectiveness of standard PCIT and Treatment as Usual (TAU) for young Mexican American children with behavior problems. Fifty-eight Mexican American families whose 3- to 7-year-old child had a clinically significant behavior problems [assessed in part with the Early Childhood Inventory-4] were randomly assigned to GANA, standard PCIT, or TAU. All three treatment approaches produced significant pre-post improvement in conduct problems across a wide variety of parent-report measures. GANA produced results that were significantly superior to TAU across a wide variety of both parent report and observational indices; however, GANA and PCIT did not differ significantly from one another. PCIT was superior to TAU on two of the parent report indices and almost all of the observational indices. There were no significant differences between the three groups on treatment dropout, and families were more satisfied with both GANA and PCIT than with TAU.

 

09-36. Miranda, A., Grau, D., Rosel, J., & Melia, A. (2009). Understanding discipline in families of children with attention-deficit/hyperactivity disorder: a structural equation model. Spanish Journal of Psychology, 12, 496-505.

 

One hundred and fifty-five mothers of children with attention deficit/hyperactivity disorder (ADHD) completed a semi-structured interview, the Parenting Stress Index Questionnaire (Abidin, 1990), to evaluate parenting stress. The Parenting Scale (Arnold, O'Leary, Wolff & Acker, 1993) was also administered to measure dysfunctional discipline strategies. Structural equation modeling was used to test a model in which the independent variables were the Child's Characteristics and the Socio-Educational Status of his or her family; intermediate variables were Parenting Stress concerning the Child Domain and concerning the Parent Domain; and the dependent variable was Parental Discipline. The results confirm our hypotheses. Interventions in these families should therefore incorporate a component focused on Parenting Stress (in both the Child Domain and the Parent Domain), as a determinant of Parental Discipline.

 

09-37. Pakalnis, A., Splaingard, M., Splaingard, D., Kring, D., & Colvin, A. (2009). Serotonin effects on sleep and emotional disorders in adolescent migraine source. Headache, 49, 1486-1492.

 

Objectives: To determine frequency of emotional disorders and sleep disturbances in adolescent migraineurs with episodic and chronic headaches. To determine the relationship of whole blood serotonin, caffeine consumption, and frequency of sleep and mood disorders. Background: The neurotransmitter serotonin has been implicated to play a role in the initiation and maintenance of sleep and in modulating mood. A putative role in migraine pathophysiology is also known. Methods: Adolescents from 13 to 17 years of age were identified from our headache clinic with episodic or chronic migraine (according to International Classification of Headache Disorders-Second Edition criteria) and healthy controls enrolled. Psychological rating scales were completed, including Adolescent Symptom Inventory-4 and Child Depression Inventory. Sleep questionnaires (Pediatric Sleep Questionnaire and Child Sleep Habit Questionnaire) were completed by the teenager's parents/guardian. Whole blood serotonin levels were drawn and analyzed and caffeine consumption obtained by history. Results: A total of 18 controls (8 girls) and 15 patients each with episodic migraines (9 girls) and chronic migraine (10 girls) were studied. Patients with headache had significantly more sleep problems than controls. Patients with chronic migraines had increased daytime sleepiness and dysthymia compared with teenagers with episodic migraines. Serotonin levels were not significantly different, and no association was noted between serotonin levels and sleep abnormalities or emotional rating scales. Increased caffeine intake was related to sleep and depressive complaints. Conclusions: Sleep and emotional disorders were common in adolescents with migraine. Sleep disorders and dysthymia were more prevalent with increased headache frequency. No correlation was noted with whole blood serotonin levels.

 

09-38. Rapport, M.D., Bolden, J., Kofler, M. J., Sarver, D.E., Raiker, J.S., & Alderson, R. M. (2009). Hyperactivity in boys with attention-deficit/hyperactivity disorder (ADHD): A ubiquitous core symptom or manifestation of working memory deficits? Journal of Abnormal Child Psychology, 37, 521-534.

 

Hyperactivity is currently considered a core and ubiquitous feature of attention-deficit/hyperactivity disorder (ADHD); however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory (WM) and activity level. The current study investigated whether children's activity level is functionally related to WM demands associated with the domain-general central executive and subsidiary storage/rehearsal components using tasks based on Baddeley's (Working memory, thought, and action. New York: Oxford University Press 2007) WM model. Activity level was objectively measured 16 times per second using wrist- and ankle-worn actigraphs while 23 boys between 8 and 12 years of age completed control tasks and visuospatial/phonological WM tasks of increasing memory demands. [Assessment instruments included the Child Symptom Inventory-4.] All children exhibited significantly higher activity rates under all WM relative to control conditions, and children with ADHD (n = 12) moved significantly more than typically developing children (n=11) under all conditions. Activity level in all children was associated with central executive but not storage/rehearsal functioning, and higher activity rates exhibited by children with ADHD under control conditions were fully attenuated by removing variance directly related to central executive processes.

 

09-39. Roohi, J., DeVincent, C.J., Hatchwell, E., & Gadow, K.D. (2009). Association of a monoamine oxidase-A gene promoter polymorphism with ADHD and anxiety in boys with autism spectrum disorder. Journal of Autism and Developmental Disorders, 39, 67-74.

 

The aim of the present study was to examine the association between a variable number tandem repeat (VNTR) functional polymorphism in the promoter region of the MAO-A gene and severity of ADHD and anxiety in boys with ASD. Parents and teachers completed a DSM-IV-referenced rating scale [Child Symptom Inventory-4] for 5 -to-14 year old boys with ASD (n=43). Planned comparisons indicated that children with the 4- versus 3-repeat allele had significantly (p<.05) more severe parent-rated ADHD inattention and impulsivity, and more severe teacher-rated symptoms of generalized anxiety. Our results support a growing body of research indicating that concomitant behavioral disturbances in children with ASD warrant consideration as clinical phenotypes, but replication with independent samples is necessary to confirm this preliminary finding.

 

09-40. Schneider, J., Gadow, K.D., Crowell, J.A., & Sprafkin, J. (2009). Anxiety in boys with attention-deficit/hyperactivity disorder with and without chronic multiple tic disorder. Journal of Child and Adolescent Psychopharmacology, 19, 737-748.  

 

Objective: This study examined the psychosocial and behavioral concomitants of anxiety in clinic-referred boys with attention-deficit/hyperactivity disorder (ADHD) with and without chronic multiple tic disorder (CMTD). Method: ADHD boys with (n=65) and without (n=94) CMTD were evaluated with measures of psychiatric symptoms [including the Child Symptom Inventory-4], mental health risk factors, and academic and social performance. Results: Boys with CMTD evidenced more severe anxiety and less social competence and were more likely to be living with only one biological parent than the ADHD Only group, but the magnitude of group differences was generally small. The severity of generalized anxiety, separation anxiety, social phobia, and obsessive-compulsive symptoms were uniquely associated with a different pattern of risk factors, and there was some evidence that these patterns differed for the two groups of boys. Conclusion: Boys with CMTD had a relatively more severe and complex pattern of anxiety that was associated with different clinical features, all of which suggests that ADHD plus CMTD might better be conceptualized as a distinct clinical entity from ADHD Only. However, findings from the extant literature are mixed, and therefore this remains a topic for further study.

 

09-41. Schoenfeld, N.A., & Mathur, S.R. (2009). Effects of cognitive-behavioral Intervention on the school performance of students with emotional or behavioral disorders and anxiety. Behavioral Disorders, 34, 184-195.

 

Despite widespread treatment success in clinical settings, anxiety disorders are rarely targeted for intervention in students with emotional or behavioral disorders (EBD) who exhibit them. This study examined the effects of a school-based anxiety intervention on the performance of 3 students attending school in a self-contained EBD setting. Using a single-subject, multiple-baseline design across students, this study examined changes in anxiety, maladaptive behavior, and academic engagement as functions of participation in the cognitive-behavioral anxiety intervention, FRIENDS for Life. [Child Symptom Inventory-4 was used to assess symptoms of generalized anxiety disorder.] All 3 participants showed improvement across all measures. Implications for the implementation of a school-based intervention for EBD students who experience high degrees of anxiety, as well as study limitations and directions for future research, are discussed.

 

09-42. Shannon, K.E., Sauder, C., Beauchaine, T.P., & Gatzke-Kopp, L.M. (2009). Disrupted effective connectivity between the medial frontal cortex and the caudate in adolescent boys with externalizing behavior disorders. Criminal Justice and Behavior, 36, 1141-1157.   

 

Studies addressing the neural correlates of criminal behavior have focused primarily on the prefrontal cortex and the amygdala. However, few studies have examined dopaminergic inputs to these or other brain regions, despite the fact that central dopamine (DA) dysfunction is associated with both trait impulsivity and novelty seeking. Given long-standing associations between both of these personality traits and externalizing psychopathology, the authors examined effective connectivity between the caudate nucleus and the anterior cingulate cortex, two areas that rely on DA input to facilitate associative learning and goal directed behavior. [Potential participants were initially evaluated with the Child Symptom Inventory-4 or the Adolescent Symptom Inventory-4.] Dysfunction in top-down and bottom-up processing within this dopaminergically mediated frontostriatal circuit may be an important biological vulnerability that increases one's likelihood of engaging in delinquent and criminal behavior. When compared with controls, reduced effective connectivity between these regions among adolescents with externalizing psychopathology was found, suggesting deficiencies in frontostriatal circuitry.

 

09-43 Silk, J.S., Siegle, G.J., Whalen, D.J., Ostapenko, L.J., Ladoucer, C.D., & Dahl, R.E. (2009). Pubertal changes in emotional information processing: Pupillary, behavioral, and subjective evidence during emotional word verification. Development and Psychopathology, 21, 7-26. 

 

This study investigated pupillary and behavioral responses to an emotional word valence identification paradigm among 32 pre-/early pubertal and 34 mid-/late pubertal typically developing children and adolescents [pre-screened on either the Child Symptom Inventory-4 or Adolescent Symptom Inventory-4]. Participants were asked to identify the valence of positive, negative, and neutral words while pupil dilation was assessed using an eyetracker. Mid-/late pubertal children showed greater peak pupillary reactivity to words presented during the emotional word identification task than pre-/early pubertal children, regardless of word valence. Mid-/late pubertal children also showed smaller sustained pupil dilation than pre-/early pubertal children after the word was no longer on screen. These findings were replicated controlling for participants' age. In addition, mid-/late pubertal children had faster reaction times to all words, and rated themselves as mote emotional during their laboratory visit compared to pre-/early pubertal children, Greater recall of emotional words following the task was associated with mid-/late pubertal Status, and greater recall of emotional words was also associated with higher peak pupil dilation. These results provide physiological, behavioral, and subjective evidence consistent with a model of puberty-specific changes in neurobehavioral systems underpinning emotional reactivity.

 

09-44. Volpe, R. J., Gadow, K.D., Blom-Hoffman, J., & Feinberg, A.B. (2009). Factor-analytic and individualized approaches to constructing brief measures of ADHD behaviors. Journal of Emotional and Behavioral Disorders, 17, 118-128.   

 

Two studies were performed to examine a factor-analytic and an individualized approach to creating short progress-monitoring measures from the longer ADHD-Symptom Checklist-4 (ADHD-SC4). In study 1, teacher ratings on items of the ADHD: Inattentive (IA) and ADHD:Hyperactive-Impulsive (HI) scales of the ADHD-SC4 were factor analyzed in a normative data sample of 493 students aged 5 to 12 years. Items with the highest factor loadings were then selected to create abbreviated IA and HI scales for study 2. In study 2, the psychometric characteristics of two shortened progress-monitoring measures (factor derived and individualized) and the original IA and HI scales of the ADHD-SC4 were examined in a sample of 26 students aged 4 to 17 years in a medication titration study involving baseline and three doses of methylphenidate. The results indicated comparable psychometric properties across the original and abbreviated versions of the IA and HI scales.

 

09-45. Wang, Y., Mathews, V.P., Kalnin, A.J., Mosier, K.M., Dunn, D.W., Saykin, A.J., & Kronenberger, W.G. (2009).

Short term exposure to a violent video game induces changes in frontolimbic circuitry in adolescents. Brain Imaging and Behavior, 3, 38-50. 

 

Despite evidence of effects of violent video game play on behavior, the underlying neuronal mechanisms involved in these effects remain poorly understood. We report a functional MRI (fMRI) study during two modified Stroop tasks performed immediately after playing a violent or nonviolent video game. [Youths were screened for psychopathology with the Adolescent Symptoms Inventory-4.] Compared with the violent video game group, the nonviolent video game group demonstrated more activation in some regions of the prefrontal cortex during the Counting Stroop task. In contrast to the violent video game group, significantly stronger functional connectivity between left dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) was identified in the nonviolent video game group. During an Emotional Stroop task, the violent video game group showed more activity in the right amygdala and less activation in regions of the medial prefrontal cortex (MPFC). Furthermore, functional connectivity analysis revealed the negative coupling between right amygdala and MPFC in the nonviolent video game group. By contrast, no significant functional connectivity between right amygdala and MPFC was found in the violent video game group. These results suggest differential engagement of neural circuitry in response to short term exposure to a violent video game as compared to a nonviolent video game.

 

09-46. White, S.W., Ollendick, T., Scahill, L., Oswald, D., & Albano, A.M. (2009). Preliminary efficacy of a cognitive-behavioral treatment program for anxious youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1652-1662.

  

Anxiety is a commonly occurring psychiatric concern in adolescents with autism spectrum disorders (ASD). This pilot study examined the preliminary efficacy of a manual-based intervention targeting anxiety and social competence in four adolescents with high-functioning ASD. Anxiety and social functioning were assessed at baseline, midpoint, endpoint, and 6 months following treatment. [Anxiety was assessed with the 20-item Child and Adolescent Symptom Inventory-4 Autism Spectrum Disorder Anxiety Scale (CASI-Anx).] Treatment consisted of cognitive-behavioral therapy, supplemented with parent education and group social skills training. The treatment program was effective in reducing anxiety in three of the four subjects and improving the social skills in all four subjects. Recommendations for the assessment and treatment of anxiety youth with ASD such as use of self-report measures to complement clinician and parent-reports and adaptations to traditional child-based CBT, are offered.

 

 

YEAR: 2008

 

08-1. Abikoff, H.B., Vitiello, B., Riddle, M.A., Cunningham, C., Greenhill, L.L., Swanson, J.M., Chuang, S.Z., Davies, M.,  Kastelic, E., Wigal, S.B., Evans, L., Ghuman, J.K., Kollins, S.H., McCracken, J.T., McGough, J.J., Murray, D.W., Posner, K., Skrobala, A.M., & Wigal, T. (2008). Methylphenidate effects on functional outcomes in the preschoolers with attention-deficit/hyperactivity disorder treatment study (PATS). Journal of Child and Adolescent Psychopharmacology, 17, 581-592.

 

Objective: The purpose of this study was to examine the effects of methylphenidate (MPH) on functional outcomes, including children's social skills, classroom behavior, emotional status, and parenting stress, during the 4-week, double-blind placebo controlled phase of the Preschoolers with Attention Deficit/ Hyperactivity Disorder (ADHD) Treatment Study (PATS). Methods: A total of 114 preschoolers who had improved with acute MPH treatment, were randomized to their best MPH dose (M=4.22 mg/day; n=63) or placebo (PL; n=51). Assessments included the Clinical Global Impression-Severity (CGI-S), parent and teacher versions of the Strengths and Weaknesses of ADHD-Symptoms and Normal Behaviors (SWAN), Social Competence Scale (SCS), Social Skills Rating System (SSRS), and Early Childhood Inventory-4 (ECI-4), and Parenting Stress Index (PSI). Results: Medication effects varied by informant and outcome measure. Parent measures and teacher SWAN scores did not differentially improve with MPH. Parent-rated depression (p=0.02) and dysthymia (p=0.001) on the ECI worsened with MPH, but scores were not in the clinical range. Significant medication effects were found on clinician CGI-S (p=0.0001) and teacher social competence ratings (SCS, p=0.03).Conclusions: Preschoolers with ADHD treated with MPH for 4 weeks improve in some aspects of functioning. Additional improvements might require longer treatment, higher doses, and/or intensive behavioral treatment in combination with medication.

 

08-2. Alderson, R.M., Rapport, M.D., Sarver, D.E., & Kofler, M.J. (2008). ADHD and behavioral inhibition: A re-examination of the stop-signal task. Journal of Abnormal Child Psychology, 36, 989-998. 

 

The current study investigates two recently identified threats to the construct validity of behavioral inhibition as a core deficit of attention-deficit/hyperactivity disorder (ADHD) based on the stop-signal task: calculation of mean reaction time from go-trials presented adjacent to intermittent stop-trials, and non-reporting of the stop-signal delay metric. [One of the diagnostic measures was the Child Symptom Inventory-4.] Children with ADHD (n = 12) and typically developing (TD) children (n = 11) were administered the standard stop-signal task and three variant stop-signal conditions. These included a no-tone condition administered without the presentation of an auditory tone; an ignore-tone condition that presented a neutral (i.e., not associated with stopping) auditory tone; and a second ignore-tone condition that presented a neutral auditory tone after the tone had been previously paired with stopping. Children with ADHD exhibited significantly slower and more variable reaction times to go-stimuli, and slower stop-signal reaction times relative to TD controls. Stop-signal delay was not significantly different between groups, and both groups' go-trial reaction times slowed following meaningful tones. Collectively, these findings corroborate recent meta-analyses and indicate that previous findings of stop-signal performance deficits in ADHD reflect slower and more variable responding to visually presented stimuli and concurrent processing of a second stimulus, rather than deficits of motor behavioral inhibition.

 

08-3. Barry, J.J., Ettinger, A.B., Friel, P., Gilliam, F.G., Harden, C.L., Hermann, B., Kanner, A.M., Caplan, R., Plioplys, S., Salpekar, J., Dunn, D., Austin, J., & Jones, J. (2008). Consensus statement: The evaluation and treatment of people with epilepsy and affective disorders. Epilepsy & Behavior, 13(Suppl.1), S1-S29.

 

Affective disorders in people with epilepsy (PWE) have become increasingly recognized as a primary factor in the morbidity and mortality of epilepsy. To improve the recognition and treatment of affective disorders in PWE, an expert panel comprising members from the Epilepsy Foundation's Mood Disorders Initiative have composed a Consensus Statement. This document focuses on depressive disorders in particular and reviews the appearance and treatment of the disorder in children, adolescents, and adults. Idiosyncratic aspects of the appearance of depression in this population, along with physiological and cognitive issues and barriers to treatment, are reviewed. Finally, a suggested approach to the diagnosis of affective disorders in PWE is presented in detail. This includes the use of psychometric tools for diagnosis [Child Symptom Inventory-4 and Youth’s Inventory-4 are two of several measures noted] and a stepwise algorithmic approach to treatment. Recommendations are based on the general depression literature as well as epilepsy-specific studies. It is hoped that this document will improve the overall detection and subsequent treatment of affective illnesses in PWE.

 

08-4. Bastiaens, L. (2008). Both atomoxetine and stimulants improve quality of life in an ADHD population treated in a community clinic. Psychiatric Quarterly, 79, 133-137.

 

Objective: To evaluate change in quality of life in a community clinic ADHD population treated with atomoxetine or stimulants. No direct comparisons between atomoxetine and stimulants to improve quality of life in ADHD are available. Methods: A prospective, nonrandomized comparison between ADHD patients treated with atomoxetine or stimulants in one clinic. Structured diagnostic assessment tools [including the Child Symptom Inventory-4 and the Adolescent Symptom Inventory-4] and a specific quality of life measure were used. Results: 84 patients (atomoxetine n = 39/stimulants n = 45), between the ages of 5 and 18, were treated for approximately 8 months. At end point, there were no significant differences in improvements of quality of life between the two groups. Age, participation in psychotherapy, and parental disability were not correlated with quality of life changes. Patients with lower baseline scores improved most. Conclusions: Both atomoxetine and stimulants led to a modest increase in quality of life in this community clinic ADHD population.

 

08-5. Beachine, T.P., Hong, J., & Marsh, P. (2008). Sex differences in autonomic correlates of conduct problems and aggression. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 788-796.

 

Objective: To examine sex differences in autonomic nervous system functioning in children and adolescents with conduct problems and to evaluate the role of aggression in predicting autonomic nervous system functioning, over and above the effects of disruptive behavior. Although deficiencies in autonomic responding among boys with oppositional defiant disorder and/or conduct disorder are well documented, it remains unclear whether such findings extend to girls or apply only to children with aggressive forms of conduct problems. Method: Electrodermal responding, cardiac pre-ejection period, and respiratory sinus arrhythmia were recorded while boys (n = 110; 53 with conduct problems, 57 controls) and girls (n = 65; 33 with conduct problems, 32 controls) between the ages of 8 and 12 sat for an extended baseline, then played a game with conditions of reward and frustrative nonreward. [Aggressive behavior was assessed with the Child Symptom Inventory-4.] Results: Both sex effects and aggression effects were found. Aggressive boys with conduct problems demonstrated reduced autonomic functioning, consistent with previous research. In contrast, aggressive girls with conduct problems exhibited greater electrodermal responding than controls, with no differences in cardiovascular reactivity to incentives. Conclusions: Observed sex differences in the autonomic correlates of conduct problems and aggression may suggest different etiological mechanisms of externalizing psychopathology for girls compared with boys.

 

08-6. Bubier, J.L., & Drawback, D.A.G. (2008). Affective decision-making and externalizing behaviors: The role of autonomic activity Journal of Abnormal Child Psychology, 36, 941-953.

 

We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms [assessed with the Child Symptom Inventory-4] , and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls.

 

08-7. Cromley, T., & Lavigne, J.V. (2008). Predictors and consequences of early gains in child psychotherapy. Psychotherapy, 45, 42-60.

 

This study examined the predictors and consequences of early gains among children (n=130) receiving psychotherapeutic treatment as usual for a variety of disorders. Classification tree analysis showed that not receiving Medicaid, plus receiving a medication consult, were associated with any early gain (i.e., reliable change on one or more clinical scales of the Child Symptom Inventory-4, with the early gain either remaining in the clinical range or moving to a subclinical level) within the first eight treatment sessions, but only Medicaid status predicted subclinical gains. Overall, patients showing a subclinical early gain showed better long-term improvement in treatment than those with no subclinical gain; patterns of change for those with and without any early gain were similar but with smaller differences between groups.

 

08-8. Crowell, S.E., Beauchaine, T.P., McCauley, E., Smith, C.J., Vasilev, C.A., & Stevens, A.L. (2008). Parent-child interactions, peripheral serotonin, and self-inflicted injury in adolescents. Journal of Consulting and Clinical Psychology, 76, 15-21

 

Self-inflicted injury in adolescence indicates significant emotional and psychological suffering. Although data on the etiology of self-injury are limited, current theories suggest that the emotional lability observed among self-injuring adolescents results from complex interactions between individual biological vulnerabilities and environmental risk. For example, deficiencies in serotonergic functioning, in conjunction with certain family interaction patterns, may contribute to the development of emotional lability and risk for self-injury. The authors explored the relation between peripheral serotonin levels and mother-child interaction patterns among typical (n = 21) and self-injuring (n = 20) adolescents. [Measures of psychopathology included the Adolescent Symptom Inventory-4 and the Youth’s Inventory-4.] Findings revealed higher levels of negative affect and lower levels of both positive affect and cohesiveness among families of self-injuring participants. Peripheral serotonin was also correlated with the expression of positive affect within dyads. Furthermore, adolescents' serotonin levels interacted with negativity and conflict within dyads to explain 64% of the variance in self-injury. These findings underscore the importance of considering both biological and environmental risk factors in understanding and treating self-injuring adolescents.

 

08-9. DeVincent, C., Gadow, K.D., Strong, G., Schwartz, J., & Cuva, S. (2008). Screening for autism spectrum disorder with the Early Childhood Inventory-4. Journal of Developmental and Behavioral Pediatrics, 29, 1-10.

 

Objective: The early identification of children with Autism Spectrum Disorders (ASD) is critical for the remediation of developmental deficits. This study examined the clinical utility of ASD scoring algorithms for the Early Childhood Inventory-4 (ECI-4), a DSM-IV-referenced rating scale, as a practical solution for screening 3-to-5 year old children for ASD in medical and public school settings. Methods: Parents/teachers completed the ECI-4 for 3-to-5 year old clinic referrals with an ASD (N=196) or nonASD psychiatric (N=135) diagnosis. Children attending early childhood (i.e., day care, preschool, Head Start) programs were also rated by their parents (N=507) and teachers (N=407). Results: Stepwise logistic regression was used to generate ASD scoring algorithms for the ECI-4. ROC analyses generally indicated high levels of sensitivity/specificity for recommended ASD cutoff scores for parent (clinic: .96/.80; preschool: .92/.96) and teacher (clinic: .81/.79; preschool: .97/.92) ratings. Conclusion: Findings indicate that the ECI-4 shows promise as a clinically useful screening measure for ASD in clinic-referred and preschool children. Further research is clearly warranted.

 

08-10. Domenech-Llaberia, E., Jane, M.C., Corbella, T., Ballespi, S., & Mitjavila, M., & Canals, J. (2008) Teacher reports of peer aggression in preschool: its relationship to DSM-IV externalizing symptoms Spanish Journal of Psychology, 11, 433-442.

 

Objective: to establish the prevalence and associations of peer aggression as manifested in preschool children, in community-based populations and to study links with DSM-IV externalizing diagnoses. Method: Subjects were 1.104 children, 3-to-5-year-olds attending rural and urban pre-schools classes. Teachers, completed the Peer Conflict Scale (PCs) to inform about direct physical and verbal aggression, object aggression and symbolic aggression and the questionnaire on psychopathology, Early Childhood Inventory-4. Results: 6.6% (n = 73) had at least one positive item on the PCS. This percentage dropped to 2.6% (n = 29) if we take into account a minimum of three positive items. Physical direct aggression was the more prevalent type of aggressive behavior, followed by verbal aggression, object aggression and symbolic aggression. Significant differences by gender and age were found. Peer aggression was associated with male gender from three years of age. Physical, object and verbal aggressive behavior was linked with externalizing disorders. This association was very strong with oppositional disorder. Conclusions: The present research with a Spanish population confirms the existence of peer aggression in preschoolers and the gender differences. Our chief contribution is about the age of emergence of sex differences and gender differences in different types of peer aggression

 

08-11. Drabick, D.A.G., Gadow, K.D., & Loney, J. (2008). Co-occurring ODD and GAD symptom groups: Source-specific syndromes and cross-informant comorbidity. Journal of Clinical Child and Adolescent Psychology, 37, 314-326.

 

Objective: Despite important clinical and nosological implications, the comorbidity of oppositional defiant disorder (ODD) and generalized anxiety disorder (GAD) has received little attention. Method: A clinic-based sample of 243 boys (aged 6-10 years), their parents, and teachers participated in an evaluation that involved assessments of behavioral, academic, and family functioning. ODD and GAD symptom groups were defined using various combinations of mother- and teacher-reports using the Child Symptom Inventory-4. Results: ODD symptom groups were associated with CD symptoms, and GAD symptom groups with MDD symptoms, regardless of rater. ADHD symptoms were associated with ODD and GAD symptom groups; however, covarying ADHD symptoms altered few findings. The ODD+GAD symptom groups were associated with higher rates of co-occurring symptoms and risk factors within (source-specific syndromes) and across (cross-informant comorbidity) informants.

 

08-12. Gadow, K.D., DeVincent, C.J., & Drabick, D.A.G. (2008). Oppositional defiant disorder as a clinical phenotype in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 38, 1302-1310.

 

Objective: To examine the validity of oppositional defiant disorder (ODD) as a clinical phenotype distinct from attention-deficit hyperactivity disorder (ADHD), parents and teachers completed either the Early Childhood Inventory-4 or the Child Symptom Inventory-4, DSM-IV-referenced rating scales and a background questionnaire for 608 children (ages 3-12 years) with autism spectrum disorder (ASD). Method: The ASD sample was separated into four groups: ODD, ADHD, ODD+ADHD, and neither (NONE). Comparison samples were nonASD clinic (n=326) and community (n>800) controls. Results: In the ASD sample, all three ODD/ADHD groups were clearly differentiated from the NONE group, and the ODD+ADHD group had the most severe co-occurring symptoms, medication use, and environmental disadvantage. There were few differences between ASD+ODD and ASD+ADHD groups. Conclusion: Findings for ASD and control samples were similar, supporting overlapping mechanisms in the pathogenesis of ODD.

 

08-13. Fastenau, P.S., Shen, J.Z., Dunn, D.W., & Austin, J.K. (2008). Academic underachievement among children with epilepsy proportion exceeding psychometric criteria for learning disability and associated risk factors. Journal of Learning Disabilities, 41, 195-207.  

 

This study assessed rates of learning disabilities (LD) by several psychometric definitions in children with epilepsy and identified risk factors. Participants (N = 173, ages 8-15 years) completed IQ screening, academic achievement testing, and structured interviews. Children with significant head injury, chronic physical conditions, or mental retardation were excluded. Using an IQ-achievement discrepancy definition, 48% exceeded the cutoff for LD in at least one academic area; using low-achievement definitions, 41% to 62% exceeded cutoffs in at least one academic area. Younger children with generalized nonabsence seizures were at increased risk for math LD using the IQ-achievement discrepancy definition; age of seizure onset and attention-deficit/hyperactivity disorder (ADHD) [assessed with the Child Symptom Inventory-4, Adolescent Symptom Inventory-4] were risk factors for reading and math LD using low-achievement definitions. Writing was the most common domain affected, but neither ADHD nor seizure variables reliably identified children at risk for writing LD. Although children with earlier seizure onset, generalized nonabsence seizures, and comorbid ADHD appear to be at increased risk for some types of LD by some definitions, these findings largely suggest that all children with epilepsy should be considered vulnerable to LD. A diagnosis of epilepsy (even with controlled seizures and less severe seizure types) should provide sufficient cause to screen school-age children for LD and comorbid ADHD.

 

08-14. Gadow, K.D., DeVincent, C., & Schneider, J. (2008). Predictors of psychiatric symptoms in children with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 38, 1710-1720.

 

Objective: This study examined mental health risk/protective factors for DSM-IV psychiatric symptoms in children with an autism spectrum disorder (ASD) and their contribution to functioning separate from ASD symptom severity. Method: Mothers/teachers completed the Child Symptom Inventory-4 and measures of risk/protection and social, adaptive, and school functioning in 6-to-12 year olds with a diagnosed ASD (N=238). Results: Bivariate correlations and simultaneous regression analyses indicated a unique pattern of predictors for attention-deficit/hyperactivity disorder, aggression, anxiety, and depression symptoms. Moreover, psychiatric symptoms differentially predicted social and school performance. Conclusion: Findings indicate that co-occurring psychiatric symptoms and their associated mental health risk/protective factors may have important clinical implications and generally support a biopsychosocial model of psychopathology in children with an ASD that appears to share many similarities with models for nonASD children.

 

08-15. Gadow, K.D., Nolan, E.E., Sverd, J., Sprafkin, J., & Schneider, J. (2008). Methylphenidate in children with oppositional defiant disorder and both co-morbid chronic multiple tic disorder and ADHD. Journal of Child Neurology, 23, 981-990.

 

Objective: Our primary objective was to determine if immediate-release methylphenidate is an effective treatment for oppositional defiant disorder diagnosed from mother’s report in children with both chronic multiple tic disorder and attention-deficit hyperactivity disorder (ADHD). Method: Children (N=31) ages 6 to 12 years received placebo and three doses of methylphenidate twice daily for 2 weeks each, under double-blind conditions and were assessed with ratings scales and laboratory measures. [Diagnostic measures included the Child Symptom Inventory-4.]  Results: Results indicated significant improvement in both oppositional and ADHD behaviors with medication; however, magnitude of treatment effect varied considerably as a function of disorder (ADHD>oppositional behaviors), informant (teacher>mother), assessment instrument, and specific oppositional behavior (rebellious>disobeys rules). Drug response was comparable to children (N=26) who did not have diagnosed oppositional defiant disorder, but co-morbidity appeared to alter the perceived benefits for ADHD according to mother’s report. Conclusion: Methylphenidate is an effective short-term treatment for oppositional behavior in children with co-morbid ADHD and chronic multiple tic disorder.

 

08-16. Gadow, K.D., Roohi, J., DeVincent, C.J., & Hatchwell, E. (2008). Association of ADHD, tics, and anxiety with dopamine transporter (DAT1) genotype in autism spectrum disorder. Journal of Child Psychology and Psychiatry, 49, 1331-1338.

 

Background: Autism spectrum disorder (ASD) is associated with high rates of psychiatric disturbance to include attention-deficit/hyperactivity disorder (ADHD), tic disorder, and anxiety disorders. The aim of the present study was to examine the association between a variable number tandem repeat (VNTR) functional polymorphism located in the 3’-untranslated region of the dopamine transporter gene (DAT1) and the severity of these symptoms as well as the association between the DAT1 DdeI polymorphism and severity of tics. Methods: Parents (n=62) and teachers (n=57) completed [the Child Symptom Inventory-4] a DSM-IV-referenced rating scale for 67 children with ASD. Results: According to parent ratings, children with the 10-10 repeat allele (versus a combined group of all other genotypes) exhibited less severe symptoms of hyperactivity and impulsivity as well as less severe language deficits. Teacher ratings indicated that social anxiety and tic symptoms were more severe for children with the 10-10 genotype versus all others. Exploratory analyses provided preliminary support for the notion that heterozygosity (9-10 repeat genotype) may be a risk/protective factor. There were no associations of tic severity with the DAT1 DdeI polymorphism. Conclusion: Collectively, these results suggest that the extraordinary variability in ASD clinical phenotypes may be explained in part by the same genes that are implicated in a host of other psychiatric disorders in nonASD populations. Nevertheless, replication with independent samples is necessary to confirm this preliminary finding.

 

08-17. Gadow, K.D., Schwartz, J., DeVincent, C., Strong, G., & Cuva, S. (2008). Clinical utility of autism spectrum disorder scoring algorithms for the Child Symptom Inventory. Journal of Autism and Developmental Disorders, 38, 419-427.

 

Objective: Few studies examine the clinical utility of autism spectrum disorder (ASD) rating scales for screening referrals to child psychiatry clinics. Method: Parents/teachers from Long Island, NY, completed the Child Symptom Incentory-4, a DSM-IV-referenced rating scale for 6-to-12 year old clinical referrals with an ASD (N=317) or nonASD psychiatric (N=191) diagnosis. Two separate groups of children attending public school, regular education classes in the same geographic area were also rated by their parents (N=446) and teachers (N=464). Results: Stepwise forward regression generated a scoring algorithm based on a subset of all CSI-4 items that best differentiated ASD from nonASD children. ROC analyses indicated high levels of sensitivity/specificity for recommended ASD cutoff scores for parent and teacher ratings.

 

08-18. Ghanizadeh, A.A. (2008). A preliminary study on screening prevalence of pervasive developmental disorder in schoolchildren in Iran Journal of Autism and Developmental Disorders, 38, 759-763.  

 

To study prevalence rates of pervasive developmental disorder (PDD) symptoms and differences between subtypes in school age Iranian children. A random sample of 2,000 school age children from both genders was selected. A parent-completed, DSM-IV-referenced rating scale of PDD symptoms [Child Symptom Inventory-4] was used. About 1.9% of the sample obtained screening cutoff scores for probable autistic disorder and 0.5 for probable asperger's disorder. The rate of probable PDD was not more in girls than the boys. The rate of suspected cases of PDD in Iran is very high and probable autistic disorder is not gender related. It shows the need for more consideration of PDD in the mental health programs planning.

 

08-19. Gouze, K.R., & Wendel, R. (2008). Integrative Module-Based Family Therapy: Application and training. Journal of Marital and Family Therapy, 34, 269-286. 

 

The field of marriage and family therapy is currently at a crossroads. The challenge for contemporary therapists is how to incorporate the wisdom of previous models with the accountability that comes from evidence-based practice. The Integrative Module-Based Family Therapy treatment model provides a formalized series of steps that clinicians can use in their case planning and implementation. It is based on nine clinically relevant modules for assessment [such as the Child Symptom Inventory-4] and intervention that are consistent with current best practices and empirically supported treatments. It thus meets the need for a structured family therapy practice and training approach that is respectful of the "art" of family therapy while still adhering to the principles of the "science" of evidence-based treatment.  CSI-4

 

08-20. Griesler, P.C., Kandel, D.B., Schaffran, C., Hu, M.C., & Davies, M. (2008). Adolescents' inconsistency in self-reported smoking - A comparison of reports in school and in household settings. Public Opinion Quarterly, 72, 260-290.

 

Extent and sources of inconsistency in self-reported cigarette smoking between self-administered school surveys and household interviews was examined in two longitudinal multiethnic adolescent samples, the urban Transition to Nicotine Dependence in Adolescence (TND) (N = 832) and the National Longitudinal Study of Adolescent Health (Add Health) (N = 4,414). Inconsistency was defined as a positive report of smoking in school followed by a negative report in the household. Smoking questions were ascertained with paper-and-pencil instruments (PAPI-SAQ) in school in both studies, and computer-assisted personal interviewing (CAPI) in TND but audio computer-assisted self-interviewing (ACASI) in Add Health in the household. [The Youth’s Inventory-4 was used to assess depression.] In TND, 23.5 percent of youths who reported smoking lifetime and 20.4 percent of those who reported smoking the last 12 months in the school survey reported in the household never having smoked; in Add Health, the latter was 8.6 percent. Logistic regressions identified five common correlates of inconsistency across the two studies: younger age, ethnic minority status, lesser involvement in deviant activities, having nonsmoking parents and friends. In TND, interviewing of youth and parent by the same interviewer increased inconsistent reporting. Matching the definition of inconsistent reporting and the age, gender and race/ethnic distributions of TND on an urban Add Health subsample reduced the predicted rate of inconsistency in TND. The estimated bias attributable to CAPI compared with ACASI methodology did not reach significance in the aggregated matched samples suggesting that irrespective of administration mode, household interviews decrease reporting of smoking, especially among younger, minority and more conventional youths embedded in a social network of nonsmokers.

 

08-21. Hartley, S.L., Sikora, D.M., & Mccoy, R. (2008). Prevalence and risk factors of maladaptive behaviour in young children with Autistic Disorder. Journal of Intellectual Disability Research, 52, 819-829.  

 

Background: Children with Autistic Disorder (AD) evidence more co-occurring maladaptive behaviours than their typically developing peers and peers with intellectual disability because of other aetiologies. The present study investigated the prevalence of Clinically Significant maladaptive behaviours during early childhood and identified at-risk subgroups of young children with AD. Method: Parents rated their child's maladaptive behaviours on the Child Behaviour Checklist (CBCL) in 169 children with AD aged 1.5 to 5.8 years. Results: One-third of young children with AD had a CBCL Total Problems score in the Clinically Significant range. The highest percentage of Clinically Significant scores were in the Withdrawal, Attention, and Aggression CBCL syndrome scales. There was a high degree of co-morbidity of Clinically Significant maladaptive behaviours. Several subject characteristic risk factors for maladaptive behaviours were identified. Conclusions: Findings highlight the need to include behavioural management strategies aimed at increasing social engagement, sustained attention and decreasing aggressive behaviour in comprehensive intervention programmes for young children with AD.

 

08-22. Hu, M.C., Muthen, B., Schaffran, C., Griesler, P.C., & Kandel, D.B. (2008).Developmental trajectories of criteria of nicotine dependence in adolescence. Drug and Alcohol Dependence, 98, 94-104.  

 

We describe the nature and predictors of developmental trajectories of symptoms of DSM-IV nicotine dependence in adolescence following smoking initiation. Data are front a longitudinal cohort of 324 new smokers from grades 6-10 in the Chicago Public Schools interviewed 5 times at 6-month intervals. Monthly data on DSM-IV symptoms of nicotine dependence were available for 36 months. [Depression symptoms were assessed with the Youth’s (Self Report) Inventory-4.] Growth Mixture modeling was applied to the monthly histories to identify trajectories of DSM-IV criteria of nicotine dependence. A four-class Solution best fitted the data: no DSM criterion (47.7%): early onset/chronic course (19.8%): early onset/remission (17.3%): late onset (15.2%). Blunt use prior to cigarette use was associated with the three symptomatic trajectories. Conduct disorder and prior heavy smoking were associated with Class 2 (chronic). Conduct disorder differentiated Class 2 front Class 4 (late onset). while pleasant initial sensitivity to the first tobacco experience was associated with Classes 2 and 3 (remit) and differentiated Class 2 front Class 4. Novelty seeking characterized Class 3. Parental dependence differentiated chronicity (Class 2) front remission (Class 3) among those who developed symptoms early. Being Hispanic reduced membership in Classes 3 and 4. and being male for Class 3. The data highlight the importance of parental nicotine dependence as a risk factor for early and sustained nicotine dependence by the offspring. Pleasant initial sensitivity and Conduct disorder for early onset of dependence and blunt use prior to smoking for all trajectories. The factors important for onset of dependence are not necessarily the same as those for Sustained Course.

 

08-23. Keenan, K., Hipwell, A., Feng, X., Babinski, D., Hinze, A., Rischall, M., Henneberger, A. (2008). Subthreshold symptoms of depression in preadolescent girls are stable and predictive of depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1433-1442.  

 

Objective: Given the risk for adolescent depression in girls to lead to a chronic course of mental illness, prevention of initial onset could have a large impact on reducing chronicity. If symptoms of depression that emerge during childhood were stable and predictive of later depressive disorders and impairment, then secondary prevention of initial onset of depressive disorders would be possible. Method: Drawing from the Pittsburgh Girls Study, an existing longitudinal study, 232 nine-year-old girls were recruited for the present study, half of whom screened high on a measure of depression [which included the Child Symptom Inventory-4] at age 8 years. Girls were interviewed about depressive symptoms using a diagnostic interview at ages 9, 10, and 11 years. Caregivers and interviewers rated impairment in each year. Results: The stability coefficients for DSM-IV symptom counts for a 1- to 2-year interval were in the moderate range (i.e., intraclass coefficients of 0.40-0.59 for continuous symptom counts and Kendall taub coefficients of 0.34-0.39 for symptom level stability). Depressive disorders were also relatively stable at this age. Poverty moderated the stability, but race and pubertal stage did not. Among the girls who did not meet criteria for a depressive disorder at age 9 years, the odds of meeting criteria for depressive disorders and for demonstrating impairment at age 10 or 11 years increased by 1.9 and 1.7, respectively, for every increase in the number of depression symptoms. Conclusions: Early-emerging symptoms of depression in girls are stable and predictive of depressive disorders and impairment. The results suggest that secondary prevention of depression in girls may be accomplished by targeting subthreshold symptoms manifest during childhood.

 

08-24. Kochanska, G., Barry, R.A., Aksan, N., & Boldt, L.J. (2008). A developmental model of maternal and child contributions to disruptive conduct: the first six years. Journal of Child Psychology and Psychiatry, 49, 1220-1227.

 

Background: The parent-child relationship is considered important for children's future conscience, and conscience is seen as protecting them from disruptive behavior problems, but specific mechanisms of this developmental process are rarely studied. Methods: This multi-trait multi-method study examined, in a longitudinal design, paths linking early maternal responsiveness to the child with the child's future conscience and disruptive behavior in 102 mother-child dyads. We tested a conceptual model where maternal responsiveness to the child, observed at 7 and 15 months, engenders a responsive stance in the child, observed at 25 and 38 months; that stance, in turn, becomes enduring and generalized, promoting multiple aspects of the child's conscience, observed at 52 months. In turn, conscience serves as a protective factor from disruptive behavior problems, rated by mothers and fathers at 67 months [Child Symptom Inventory-4]. Results: The postulated paths were examined using sequential regressions and mediation effects were tested using bootstrapping analyses. Child responsive stance at 25-38 months fully mediated the link between maternal responsiveness in infancy and conscience at 52 months, and conscience fully mediated the link between child responsive stance and future disruptive behavior at 67 months. Conclusions: Examination of developmental links among early maternal behavior, the child's responsive stance toward the mother, conscience, and disruptive behavior is a promising step toward elucidating mechanisms of children's adaptive and maladaptive trajectories.

 

08-25. Krull, K.R., Brouwers, P.,  Jain, N. , Zhang, L. , Bomgaars, L., Dreyer, Z., Mahoney, D., Bottomley, S., & Okcu, M.F. (2008). Folate pathway genetic polymorphisms are related to attention disorders in childhood leukemia survivors. Journal of Pediatrics, 152, 101-105.

 

Objective: To test the hypothesis that 5,10-methylenetetrahydroreductase (MTHFR) polymorphisms can partially explain the individual variation in developing attention-deficit/hyperactivity disorder (ADHD) after acute lymphoblastic leukemia (ALL) therapy.  Study design: Parents of 48 survivors of childhood ALL completed a clinical diagnostic process to identify subtypes of ADHD. [ADHD was assessed with the Child Symptom Inventory-4.] Genotyping was performed with peripheral blood DNA for MTHFR (C677T and A1298C) polymorphisms. Results: Eleven of the 48 patients (22.9%) had scores consistent with the inattentive symptoms of ADHD. Patients with genotypes related to lower folate levels (11 out of 39; 39.2%) were more likely to have ADHD. The A1298C genotype appeared to be the predominant linkage to the inattentive symptoms, leading to a 7.4-fold increase in diagnosis, compared with a 1.3-fold increase for the C677T genotype. Age at diagnosis and sex were not associated with inattentiveness. Conclusions: Preliminary data imply a strong relationship between MTHFR polymorphisms and the inattentive symptoms of ADHD in survivors of childhood.

 

08-26. Ladouceur, C.D., Almeida, J.R.C., Birmaher, B., Axelson, D.A., Nau, S., Kalas, C., Monk, K., Kupfer, D.J., & Phillips, M.L. (2008). Subcortical gray matter volume abnormalities in healthy bipolar offspring: Potential neuroanatomical risk marker for bipolar disorder? Journal of the American Academy of Child and Adolescent Psychiatry, 47, 532-539.

 

Objective: A growing number of structural neuroimaging studies have shown that bipolar disorder (BD) is associated with gray matter (GM) volume abnormalities in brain regions known to support affect regulation. The goal of this study was to examine whole-brain regional GM volume in healthy bipolar offspring (HBO) relative to age-matched controls to identify possible structural abnormalities that may be associated with risk for BD. Method: Participants were 20 youths (8-17 years old) with at least one parent diagnosed with BD, and 22 age-matched healthy individuals. All of them were free of Axis I diagnoses. High-resolution magnetic resonance imaging structural images were acquired using a 3-T Siemens scanner. Voxel-based morphometric analyses were conducted using SPM5. [Child Symptom Inventory-4 was one of several measures used to evaluate psychiatric disorders.]  Results: Relative to controls, HBO had significantly increased GM volume in left parahippocampal/hippocampal gyrus (p < .05 corrected), following whole-brain analyses. This increase was correlated with puberty but not age in HBO. Region-of-interest analyses on the amygdala and orbitomedial prefrontal cortex did not yield any significant group differences after conducting small volume correction. Conclusions: The pattern of increased GM volume in parahippocampal/hippocampal gyrus in HBO suggests a potential marker for risk for BD. It can also be considered as a potential neuroprotective marker for the disorder because HBO were free of current psychopathology. Prospective studies examining the relationship between changes in GM volume in these regions and subsequent development of BD in HBO will allow us to elucidate further the role of this region in either conferring risk for or protecting against the development of BD.

 

08-27. Lecavalier, L., &  Gadow, K.D. (2008). Pharmacology effects and side effects. In Matson, J.L. (Ed.), Clinical Assessment and Intervention for Autism Spectrum Disorders (pp. 221-263). Elsevier Science.

 

This book chapter reviews evidence-based assessment instruments for evaluating response to psychotropic medication in individuals with autism spectrum disorder and includes discussion of the Symptom Inventories.

 

08-28. Loney, B.R., Fowler, S.N., & Joiner, T.E. (2008) Adolescent conduct problems and bulimic tendencies: Study of an emotional distress hypothesis. Journal of Psychopathology and Behavioral Assessment, 30, 298-306.

 

Prior research has documented an association between adolescent conduct problems and bulimic tendencies. However, there is limited theoretical modeling to explain this association, and prior studies have generally failed to assess for potential mediating variables of impulsivity, anxiety, and depression. The current study assessed these mediating variables in further exploring for unique associations between adolescent conduct problems and bulimic tendencies. A non-referred adolescent sample was assessed for bulimic tendencies, conduct problems, impulsivity, anxiety, and depression using a multi-informant assessment battery including parent, teacher, and self-report measures [including the Adolescent Symptom Inventory-4 oppositional defiant disorder and conduct disorder symptom categories]. There was a significant bivariate association between conduct problems and bulimic tendencies, r=0.29, p < 0.01. However, this association was fully mediated by anxiety and depression symptoms. This suggests that emotional distress could be a primary factor linking adolescent conduct problems and bulimic tendencies. Implications include the potential for more regular screening of youth with conduct problems for associated eating disturbances.

 

08-29. Moreland, A.D., & Dumas, J.E. (2008) Categorical and dimensional approaches to the measurement of disruptive behavior in the preschool years: A meta-analysis. Clinical Psychology Review, 28, 1059-1070.

 

Preschool disruptive behavior problems were investigated in a meta-analysis of 26 studies using categorical and/or dimensional approaches to assessment. The review sought to distinguish early disruptiveness from normative preschool conduct by showing that, irrespective of assessment methodology: (a) disruptiveness can be adequately measured in the preschool years; (b) early disruptiveness is stable over time; and (c) disruptive children referred for clinical services in the preschool years can be distinguished from non-referred peers. [Four of the studies used the Early Childhood Inventory-4.] Results indicated that: categorical and dimensional approaches to measurement of early disruptiveness provide comparable data (effect size d = 2.29); both approaches yield comparable estimates of the stability of preschool disruptive behavior over time (categorical approach: d = 1.15; dimensional approach: d = 0.84); and both approaches discriminate between referred and non-referred preschoolers (d = 1.05 and d = .95). Limitations of the existing literature and of this analysis are discussed, as are suggestions for future research.

 

08-30. Pears, K.C., Kim, H.K., & Fisher, P.A. (2008). Psychosocial and cognitive functioning of children with specific profiles of maltreatment. Child Abuse & Neglect, 32, 958-971.

 

Objective: Up to 90% of child welfare system cases involve multiple types of maltreatment; however, studies have rarely incorporated multiple dimensions of maltreatment. The present study employed a latent profile analysis to identify naturally occurring subgroups of children who had experienced maltreatment. Methods: Reports of maltreatment incidents for 117 preschool-aged foster children were classified along two dimensions: type (e.g., physical abuse, sexual abuse, physical neglect, supervisory neglect, or emotional maltreatment) and severity within type. Results: The analyses revealed four distinct profiles showing moderate to high levels of maltreatment: (a) supervisory neglect/emotional maltreatment; (b) sexual abuse/emotional maltreatment/neglect (when not otherwise specified neglect refers to both supervisory and physical neglect); (c) physical abuse/emotional maltreatment/neglect; and (d) sexual abuse/physical abuse/emotional maltreatment/neglect. Profile membership was examined with respect to the children's cognitive functioning and externalizing and internalizing problems [assessed in part with the Early Childhood Inventory-4]: lower cognitive functioning was related to profiles with neglect or physical abuse (or both), externalizing was highest in the sexual abuse/physical abuse/emotional maltreatment/neglect profile, and internalizing was highest in the profiles with physical OF sexual abuse (or both).Conclusions: There appear to be distinct profiles of maltreatment among preschoolers that have differential associations to measures of adjustment. Policy and practice implications and future research directions are discussed. Practice implications: Using different profiles Of Maltreatment to understand specific vulnerabilities may guide in tailoring interventions to the needs of maltreated children.

 

08-31. Poch, F.V., Ballabriga, M.C.J., Sans, J.C., Hidalgo, G.E., Sola, S.B., & Domenech-Llaberia, E. (2008). Assessment of psychopathology in preschool age children through the Early Childhood Inventory-4 (ECI-4): Agreement among parents and teachers. Psicothema, 20, 481-486.

 

The main purpose of this study is to determine the level of agreement among parents and teachers as informants in each one of the dimensions or diagnostic categories of the Early Childhood Inventory-4 (ECI-4). Moreover, the effect of health problems in parents in the description and appraisal of behaviour of a sample of 204 students of preschool (3-6 years) of various socioeconomic profiles is analyzed. The results indicate that parents tend to value the symptoms with greater severity, and higher agreement was observed when informing about developmental disorders.

 

08-32. Rapport, M.D., Alderson, R.M., Kofler, M.J., Sarver, D.E., Bolden, J., & Sims, V. (2008). Working memory deficits in boys with attention-deficit/hyperactivity disorder (ADHD): The contribution of central executive and subsystem processes Journal of Abnormal Child Psychology, 36, 825-837.

 

The current study investigated contradictory findings from recent experimental and meta-analytic studies concerning working memory deficits in ADHD. Working memory refers to the cognitive ability to temporarily store and mentally manipulate limited amounts of information for use in guiding behavior. Phonological (verbal) and visuospatial (nonverbal) working memory were assessed across four memory load conditions in 23 boys (12 ADHD, 11 typically developing) using tasks based on Baddeley's (Working memory, thought, and action, Oxford University Press, New York, 2007) working memory model. [One of several ADHD assessment measures was the Child Symptom Inventory-4.]  The model posits separate phonological and visuospatial storage and rehearsal components that are controlled by a single attentional controller (CE: central executive). A latent variable approach was used to partial task performance related to three variables of interest: phonological buffer/rehearsal loop, visuospatial buffer/rehearsal loop, and the CE attentional controller. ADHD-related working memory deficits were apparent across all three cognitive systems-with the largest magnitude of deficits apparent in the CE-even after controlling for reading speed, nonverbal visual encoding, age, IQ, and SES.

 

08-33. Reynolds, S., & Lane, S.J. (2008). Diagnostic validity of sensory over-responsivity: A review of the literature and case reports. Journal of Autism and Developmental Disorders, 38, 516-529.  

 

Atypical responses to sensory stimulation are frequently reported to co-occur with diagnoses such as autism, ADHD, and Fragile-X syndrome. It has also been suggested that children and adults may present with atypical sensory responses while failing to meet the criteria for other medical or psychological diagnoses. This may be particularly true for individuals with over-responsivity to sensation. This article reviews the literature related to sensory over-responsivity and presents three pediatric cases [using the Child Symptom Inventory-4 to screen for co-morbidities] that present a profile of having sensory over-responsivity without a co-occurring diagnosis. Findings from these cases provide very preliminary evidence to support the suggestion that sensory over-responsivity can occur as a sole diagnosis. Within this small group, tactile over-responsivity was the most common and pervasive form of this condition.

 

08-34. Smith, K.G., & Corkum, P. (2008). Systematic review of measures used to diagnose attention-deficit/hyperactivity disorder in research on preschool children. Topics in Early Childhood Special Education, 27, 164-173.

 

The diagnosis of attention-deficit/hyper activity disorder (ADHD) in preschool children is challenging because the behavioral manifestations of the disorder are not uncommon for many children this age. Therefore, the assessment of ADHD in preschoolers needs to be multifaceted and requires the use of a variety of assessment measures. A systematic review of the literature from 1985 through to 2005 found 38 relevant articles related to ADHD in preschool children. We extracted the assessment measures used to identify ADHD in preschoolers [which included the Early Childhood Inventory-4] and categorized them into 4 core areas of measurement: standardized rating scales, structured interviews, direct observations of behavior, and direct measures of attention and hyperactivity-impulsivity. We examined quality indicators, such as symptom description, psychometric properties, and logistics, for the most frequent measures in each measurement areas. Our review of the literature highlights the need for more developmentally appropriate measures in 3 of the 4 core areas.

 

08-35. Sukhodolsky, D.G., Scahill, L., Gadow, K.D., Eugene, A.L., Aman, M.G., McDougle, C.J., McCracken, J.T., Tierney, E., White, S.W., Lecavalier, L., & Vitiello, B. (2008). Parent-rated anxiety symptoms in children with pervasive developmental disorders: Frequency and association with core autism symptoms and cognitive functioning. Journal of Abnormal Child Psychology, 36, 117-128.

 

Background: In addition to the core symptoms, children with Pervasive Developmental Disorders (PDD) often exhibit other problem behaviors such as aggression, hyperactivity, and anxiety, which can contribute to overall impairment and, therefore, become the focus of clinical attention. Limited data are available on the prevalence of anxiety in these children. We examined frequency and correlates of parent-rated anxiety symptoms in a large sample of children with PDD. Methods: The goals of this study were to examine the frequency and correlates of parent-rated anxiety symptoms in a sample of 171 medication-free children with PDD who participated in two NIH-funded medication trials. Twenty items of the Child and Adolescent Symptom Inventory-4 (CASI-4)  ADDIN EN.CITE <EndNote><Cite><Author>Gadow</Author><Year>1997</Year><RecNum>1106</RecNum><MDL><REFERENCE_TYPE>1</REFERENCE_TYPE><AUTHORS><AUTHOR>Gadow, K. D.</AUTHOR><AUTHOR>Sprafkin, J.</AUTHOR></AUTHORS><YEAR>1997</YEAR><TITLE>Child Symptom Inventory - 4</TITLE><PLACE_PUBLISHED>Stony Brook, NY</PLACE_PUBLISHED><PUBLISHER>Checkmate Plus</PUBLISHER></MDL></Cite></EndNote>(Gadow & Sprafkin, 1997) were used to measure anxiety. Results: Forty three percent of the total sample met screening cut-off criteria for at least one anxiety disorder. Higher levels of anxiety on the 20-item CASI scale were associated with higher IQ, the presence of functional language use, and with higher levels of stereotyped behaviors. In children with higher IQ, anxiety was also associated with greater impairment in social reciprocity. Conclusion: Anxiety is common in PDD and warrants consideration in clinical evaluation and treatment planning. This study suggests that parent ratings could be a useful source of information about anxiety symptoms in this population. Some anxiety symptoms such as phobic and social anxiety may be closer to core symptoms of PDD. Further efforts to validate tools to ascertain anxiety are needed, as are studies to empirically test approaches to treat anxiety in PDD.

 

08-36. Tarbell, S., & Li, B.U.K.. (2008). Psychiatric symptoms in children and adolescents with cyclic vomiting syndrome and their parents. Headache, 48, 259-266.

 

Objective: To conduct a pilot study to evaluate the prevalence of psychiatric symptoms in children and adolescents with cyclic vomiting syndrome and to assess-family history of psychiatric disorder. Background: Little is known about psychiatric comorbidity in youth with cyclic vomiting syndrome, a periodic syndrome. Methods: Eighty-five parents, of children aged 3-18 years with cyclic vomiting syndrome confirmed in a multidisciplinary clinic, completed the age-appropriate Child Symptom Inventory-4 (CSI-4), a questionnaire that screens for psychiatric symptoms in pediatric patients. Twenty-one adolescents aged 13-18 years completed the Youth's Inventory-4, a self-report form of this questionnaire. Sixty-two parents completed a family psychiatric history checklist. Results: These children and their parents evidenced a high prevalence of anxiety and mood symptoms compared to norms of the CSI-4 and population norms for internalizing psychiatric disorders. On the age-appropriate CSI-4, 47% of subjects met diagnostic cut-off for an anxiety disorder, and 14% for an affective disorder. Discrepancies were found in parent and adolescent reports for symptoms of panic disorder (chi-square=4.83, df =1, p=.028), posttramnatic stress disorder (chi-square=6.87, df=1, p=.009), and somatization disorder (chi-square=6.41, df=1, p=.01), with parents reporting significantly more symptoms than the adolescents. Internalizing disorders were also prevalent in the parents with 59% endorsing either an anxiety and/or an affective disorder. Mothers reported a significantly higher prevalence of anxiety disorders (35%) than did fathers (13%) (chi-square=8.43, df=1, p<.004).Conclusion: Children and adolescents with cyclic vomiting syndrome appear to be at increased risk for internalizing psychiatric disorders, especially anxiety disorders. Further research using standardized psychiatric interviews and a control group are indicated to further assess psychiatric disorders in children and adolescents with cyclic vomiting syndrome.

 

08-37. Villalobos, J.A.L. (2008). Freedom from distraction factor in the attention deficit hyperactivity disorder: A short model Psicothema, 20, 718-723.   

 

Attention deficit hyperactivity disorder (ADHD) usually presents a profile in which the freedom from distraction factor of the WISC-R (FDF) is affected to a greater extent than the verbal comprehension factor (VCF) and the perceptual organization factor (POF). The formulation FDF< (VCF + POF)/2 has good sensitivity for ADHD. The aim of this study was to reduce the number of tests needed for the formulation FDF< (VCF + POF)/2, maintaining the sensitivity for ADHD and concordance with the complete formulation. A clinical sample of 167 children with ADHD is analyzed (6-16 years). The cases of ADHD were defined according to DSM-IV criteria and they were assessed with WISC-R, Child Symptom Inventory-4 and Social and Occupational Activity Assessment Scale. Lineal regression method was used to reduce the number of tests. The results showed that the short formulation reduces the number of tests by half and it has 83% sensitivity for ADHD. This formulation presents a good concordance with the complete version. The FDF is significantly lower than the VCF, POF and intellectual quotient in cases of ADHD. Comorbidity, social or school activity do not have a significant influence on the probability that FDF< (VCF + POF)/2.

 

08-38. Wakschlag, L.S., Briggs-Gowan, M.J., Hill, C., Danis, B., Leventhal, B.L., Keenan, K., Egger, H.L., Cicchetti, D., & Burns, J., & Carter, A.S. (2008). Observational assessment of preschool disruptive behavior, part II: Validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). Journal of the American Academy of Child and Adolescent Psychiatry, 47, 632-641.

 

Objective: To examine the validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS), a new observational method for assessing preschool disruptive behavior. Method: A total of 327 behaviorally heterogeneous preschoolers from low-income environments comprised the validation sample. Parent and teacher reports were used to identify children with clinically significant disruptive behavior. [The teacher version of the Early Childhood Inventory-4 was used to assess ODD and CD symptoms.]  The DB-DOS assessed observed disruptive behavior in two domains, problems in Behavioral Regulation and Anger Modulation, across three interactional contexts: Examiner Engaged, Examiner Busy, and Parent. Convergent and divergent validity of the DB-DOS were tested in relation to parent and teacher reports and independently observed behavior. Clinical validity was tested in terms of criterion and incremental validity of the DB-DOS for discriminating disruptive behavior status and impairment, concurrently and longitudinally. Results: DB-DOS scores were significantly associated with reported and independently observed behavior in a theoretically meaningful fashion. Scores from both DB-DOS domains and each of the three DB-DOS contexts contributed uniquely to discrimination of disruptive behavior status, concurrently and predictively. Observed behavior on the DB-DOS also contributed incrementally to prediction of impairment over time, beyond variance explained by meeting DSM-IV disruptive behavior disorder symptom criteria based on parent/teacher report. Conclusions: The multidomain, multicontext approach of the DB-DOS is a valid method for direct assessment of preschool disruptive behavior. This approach shows promise for enhancing accurate identification of clinically significant disruptive behavior in young children and for characterizing subtypes in a manner that can directly inform etiological and intervention research.

 

08-39. Wolf, J.M., Tanaka, J.W., Klaiman, C., Cockburn, J., Herlihy, L., Brown, C., South, M., McPartland, J., Kaiser, M.D., Phillips, R., & Schultz, R.T. (2008). Specific impairment of face-processing abilities in children with autism spectrum disorder using the Let's Face It! Skills Battery. Autism Research, 1, 329-340.  

 

Although it has been well established that individuals with autism exhibit difficulties in their face recognition abilities, it has been debated whether this deficit reflects a category-specific impairment of faces or a general perceptual bias toward the local-level information in a stimulus. In this study, the Let's Face It! Skills Battery [Tanaka & Schultz, 2008] of developmental face- and object-processing measures was administered to a large sample of children diagnosed with autism spectrum disorder (ASD) and typically developing children [screened for psychopathology with the Child Symptom Inventory-4]. The main finding was that when matched for age and IQ individuals with ASD were selectively impaired in their ability to recognize faces across changes in orientation, expression and featural information. In a face discrimination task, ASD participants showed a preserved ability to discriminate featural and configural information in the mouth region of a face, but were compromised in their ability to discriminate featural and configural information in the eyes. On object-processing tasks, ASD participants demonstrated a normal ability to recognize automobiles across changes in orientation and a superior ability to discriminate featural and configural information in houses. These findings indicate that the face-processing deficits in ASD are not due to a local-processing bias, but reflect a category-specific impairment of faces characterized by a failure to form view-invariant face representations and discriminate information in the eye region of the face.

 

 

YEAR: 2007

 

07-1. Beauchaine, T.P., Gatzke-Kopp, L., & Mead, H.K. (2007). Polyvagal theory and developmental psychopathology: Emotion dysregulation and conduct problems from preschool to adolescence. Biological Psychology, 74, 174-184.

 

Objective: In science, theories lend coherence to vast amounts of descriptive information. However, current diagnostic approaches in psychopathology are primarily atheoretical, emphasizing description over etiological mechanisms. We describe the importance of Polyvagal Theory toward understanding the etiology of emotion dysregulation, a hallmark of psychopathology. When combined with theories of social reinforcement and motivation, Polyvagal Theory specifies etiological mechanisms through which distinct patterns of psychopathology emerge. Method: In this paper, we summarize three studies evaluating autonomic nervous system functioning in children (ages 4-18) with conduct problems [defined in part with Child and Adolescent Symptom Inventories]. Results: At all age ranges, these children exhibit attenuated sympathetic nervous system responses to reward, suggesting deficiencies in approach motivation. By middle school, this reward insensitivity is met with inadequate vagal modulation of cardiac output, suggesting additional deficiencies in emotion regulation. We propose a biosocial developmental model of conduct problems in which inherited impulsivity is amplified through social reinforcement of emotional lability. Implications for early intervention are discussed.

 

07-2. Chervin, R.D., Weatherly, R.A., Garetz, S.L., Ruzicka, D.L., Giordani, B.J., Hodges, E.K., Dillon, J.E., Guire, K.E. (2007). Pediatric sleep questionnaire: Prediction of sleep apnea and outcomes. Archives of Otolaryngology-Head & Neck Surgery, 133, 216-222.

 

Objectives: To further validate a questionnaire about symptoms of childhood obstructive sleep apnea (OSA) and to compare the questionnaire with polysomnography in their ability to predict outcomes of adenotonsillectomy. Method: Retrospective analysis of data from a longitudinal study. The Washtenaw County Adenotonsillectomy Cohort, comprising 105 children aged 5.0 to 12.9 years at entry. Parents completed the 22-item Sleep-Related Breathing Disorder (SRBD) scale of the Pediatric Sleep Questionnaire, and children underwent polysomnography before and 1 year after clinically indicated adenotonsillectomy (n = 78, usually for suspected OSA) or unrelated surgical care (n = 27).Measures included commonly used hyperactivity ratings [e.g., Child Symptom Inventory-4], attention tests, and sleepiness tests. Results: At baseline, a high SRBD scale score (1 SD above the mean) predicted an approximately 3-fold increased risk of OSA on polysomnography (odds ratio, 2.80; 95% confidence interval, 1.68-4.68). One year later, OSA and symptoms had largely resolved, but a high SRBD score still predicted an approximately 2-fold increased risk of residual OSA on polysomnography (odds ratio, 1.89; 95% confidence interval, 1.13-3.18). Compared with several standard polysomnographic measures of OSA, the baseline SRBD scale better predicted initial hyperactivity ratings and 1-year improvement, similarly predicted sleepiness and its improvement, and similarly failed to predict attention deficit or its improvement. Conclusions: The SRBD scale predicts polysomnographic results to an extent useful for research but not reliable enough for most individual patients. However, the SRBD scale may predict OSA-related neurobehavioral morbidity and its response to adenotonsillectomy as well or better than does polysomnography.

 

07-3. Drabick, D. A. G., Gadow, K.D., & Loney, J. (2007). Source-specific ODD: Comorbidity and risk factors in referred elementary school boys. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 92-101.

 

Objective: To examine differences in risk factors and comorbid conditions for oppositional defiant disorder (ODD) symptom groups in a sample of 248 elementary school boys (ages 6-10) recruited from 1994-1996. Method: The boys and their mothers received multiple assessments of cognitive, behavioral, academic, and family functioning, including a clinic-based evaluation in Stony Brook, NY. ODD was defined using four different strategies for aggregating data from mother and teacher reports of DSM-IV symptoms from the Child Symptom Inventory-4. Results: Source-specific ODD symptom groups had better internal validity and were more differentiated than groups defined using the other strategies. The mother-defined ODD symptom group (ODD/M) had higher levels of maternal detachment than the teacher-defined symptom group (ODD/T), and the ODD/T group had more social problems than the ODD/M group. The classification agreement group (ODD/M+T) evidenced higher levels of sensation seeking, maternal control, and comorbid symptoms than the ODD/M and ODD/T groups. Controlling for co-occurring attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) symptoms altered some of the relations among ODD, comorbid symptoms, and psychosocial correlates. Conclusion: Patterns of co-occurring psychiatric symptoms and psychosocial correlates of ODD symptom groups varied depending on the rater(s) used to determine group membership. Results support continued research into source specificity for conceptualizing ODD.

 

07-4. DeVincent, C.J., Gadow, K.D., Delosh, D., & Geller, L. (2007). Sleep disturbance and its relation to DSM-IV psychiatric symptoms in preschool-aged children with pervasive developmental disorder and community controls. Journal of Child Neurology. 22, 161-169

 

Objective: This study describes the relation between sleep problems and psychiatric symptoms in preschool-aged children (3 to 5 years) with Pervasive Developmental Disorder and a community-based sample of children attending early childhood programs. Method: Parents completed the Early Childhood Inventory-4, a DSM-IV-referenced rating scale for two samples: children with Pervasive Developmental Disorder (N=112) and nondisabled youngsters (N=497). Results: Although children with Pervasive Developmental Disorder had significantly greater number and severity of sleep problems than the community preschoolers, sleep disturbed children in both samples exhibited more severe behavioral difficulties—primarily symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder—than children without sleep problems. Conclusion: Sleep problems are an indicator of similar comorbid psychiatric symptoms in both children with and without Pervasive Developmental Disorder, which suggests commonalities in their etiology.

 

07-5. Edwards, M.C., Gardner, E.S., Chelonis, J.J., Schulz, E.G., Flake, R.A., & Diaz, P.F. (2007). Estimates of the validity and utility of the Conners' continuous performance test in the assessment of inattentive and/or hyperactive-impulsive behaviors in children. Journal of Abnormal Child Psychology, 35, 393-404.

 

Objective: This study evaluated the validity and classification utility of the Conners' Continuous Performance Test (CCPT) in the assessment of inattentive and hyperactive-impulsive behaviors in children. Significant, positive correlations between the CCPT parameters and behavioral ratings of ADHD behaviors were hypothesized. In addition, it was hypothesized that the CCPT parameters would perform better than a random test (chance) and show fair to moderate utility of classification across the different indices. Method: Participants were 104 children between 6 and 12 years of age who were referred for evaluation of attention problems. [Co-morbidities were screened with the Child Symptom Inventory-4.]  Results: The first hypothesis was not supported. There were no significant, positive correlations between the CCPT parameters and parent and teacher ratings of inattentive and hyperactive-impulsive behaviors. The second hypothesis was only partially supported. The CCPT Overall Index and the Omission Errors (84th percentile cutoff) performed better than a random test; however, the utility of the CCPT Overall Index only ranged from poor to slight. Receiver operating characteristic analyses showed the accuracy of the CCPT to be low. The implications and limitations of this study and future research directions are discussed.

 

07-6. Gadow, K.D., Sprafkin, J., Schneider, J., Nolan, E.E., Schwartz, J., & Weiss, M.D. (2007). ODD, ADHD, versus ODD+ADHD in clinic and community adults. Journal of Attention Disorders, 11, 374-383.

 

Objective: To seek evidence for the validity of oppositional defiant disorder (ODD) as a behavioral syndrome in adults. Method: Two groups of adults, a mental health outpatient Clinic sample (N=490) and a non-referred Community sample (N=900) completed a DSM-IV-referenced rating scale, the Adult Self Report Inventory-4 (ASRI-4), and a brief questionnaire (social, educational, occupational, and treatment variables). Participants were separated into four groups on the basis of ASRI-4 scores: ODD, ADHD, ODD+ADHD, and NONE. Results: In general, the three symptom groups were more severe than the NONE group; the ODD+ADHD and NONE groups were the most and least severe, respectively; and there were clear differences between the ODD and ADHD groups. The pattern of group differences was generally similar in both samples. Conclusion: Findings support the distinction between ADHD and ODD symptom presentations in adults, and the notion that the co-morbid condition is a unique clinical entity, both of which are consistent with the child literature. Nevertheless, additional research with larger samples of patients will be necessary to establish ODD as a potential behavioral syndrome in adults.

 

07-7. Gadow, K. D., Sverd, J., Nolan, E.E., Sprafkin, J., & Schneider, J. (2007). Immediate-release methylphenidate for ADHD in children with comorbid chronic multiple tic disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 46, 840-848.

 

Objective: To examine the safety and efficacy of immediate-release methylphenidate (MRH-IR) for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children with Tourette’s disorder (96%) or chronic motor tic disorder (4%). Method: Two cohorts of pre-pubertal children (N=71) received placebo and three doses of methylphenidate (0.1, 0.3, and 0.5 mg/kg) twice daily for 2 weeks each, under double-blind conditions as part of their involvement in a long-term observation study (1989-2004). [Diagnostic measures included the Child Symptom Inventory-4.] Treatment effects were assessed with an extensive battery of parent-, teacher-, child- and physician-completed rating scales and laboratory tasks. Results: MPH-IR effectively suppressed ADHD, oppositional defiant disorder, and peer aggression behaviors. There was no evidence that MPH-IR altered the overall severity of tic disorder or OCD behaviors. Teacher ratings indicated that MPH-IR therapy decreased tic frequency and severity.  Conclusion:  MPH-IR appears to be a safe and effective short-term treatment for ADHD in the majority of children with chronic tic disorder; nevertheless, the possibility of tic exacerbation in susceptible individuals warrants careful monitoring of all patients.

 

07-8. Gatzke-Kopp, L.M., &  Beauchaine, T.P. (2007). Direct and passive prenatal nicotine exposure and the development of externalizing psychopathology. Child Psychiatry & Human Development, 38, 255-269.

 

Objective: The association between maternal smoking during pregnancy and childhood antisocial outcomes has been demonstrated repeatedly across a variety of outcomes. Yet debate continues as to whether this association reflects a direct programming effect of nicotine on fetal brain development, or a phenotypic indicator of heritable liability passed from mother to child. Method: In the current study, we examine relations between maternal smoking and child behavior among 133 women and their 7-15-year-olds, who were recruited for clinical levels of psychopathology. In order to disentangle correlates of maternal smoking, women who smoked during pregnancy were compared with (a) those who did not smoke, and (b) those who did not smoke but experienced significant second-hand exposure. Results: Second-hand exposure was associated with increased externalizing psychopathology in participant mothers' offspring. Moreover, regression analyses indicated that smoke exposure during pregnancy predicted conduct disorder symptoms [assessed with the Child Symptom Inventory-4], over and above the effects of income, parental antisocial tendencies, prematurity, birth weight, and poor parenting practices. This is the first study to extend the findings of externalizing vulnerability to second hand smoke exposure.

 

07-9. Greve, K.W., Bianchini, K.J., Stickle, T.R., Love, J.M., Doane, B.M., & Thompson, M.D. (2007). Effects of a community toxic release on the psychological status of children. Child Psychiatry & Human Development, 37, 307-323.

 

Objective: This study sought to determine the emotional effects of a major community toxic release on children in the exposed community while controlling for the potential effects of response bias. Controlling for the response bias inherent in litigated contexts is an advance over previous studies of toxic exposure in children. Method: A randomly selected representative sample of Exposed children (n = 31) was compared to a matched Control group (n = 28) from a nearby, unexposed community. Symptoms and complaints were assessed via interview with the children and their guardians, surveys and checklists, and well-established psychological instruments. Results: Even when biased responding was controlled the Exposed children experienced more psychological distress, more physical symptoms, and greater general concern over their physical functioning than the Controls. The Exposed children also reported some concern about their future health and cancer risk but usually only if asked. Limitations and future research directions are discussed.

 

07-10. Huang-Pollock, C.L., Mikami, A.Y., Pfiffner, L., & McBurnett, K. (2007). ADHD subtype differences in motivational responsivity but not inhibitory control: Evidence from a reward-based variation of the stop signal paradigm. Journal of Clinical Child and Adolescent Psychology, 36, 127-136.

 

In this study we examined prepotent motor inhibition and responsiveness to reward using a variation of the stop signal reaction time (SSRT) task in clinic and community-recruited children ages 7 to 12 with attention-deficit/hyperactivity disorder-inattentive type (ADHD--I), ADHD-combined type (ADHD-C), and non-ADHD controls. Contrary to theoretical expectations, we found evidence for inhibitory weaknesses in ADHD-I. [The Child Symptom Inventory-4 was used as one of several measures.] We also found evidence that although children with ADHD-I were able to improve their inhibitory control given reward-based motivation, the improvement depended on the order of reward conditions. Results suggest that the 2 primary subtypes of ADHD share similar neuropsychological weaknesses in inhibitory control but that there are subtype differences in response to success and failure that contribute to a child's ultimate level of performance.

 

07-11. Kollins, S.,  Greenhill, L., Swanson, J., Wigal, S., et al. (2006). Rationale, design, and methods of the preschool ADHD Treatment Study (PATS). Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1275-1283.

 

Objective: To describe the rationale and design of the Preschool ADHD Treatment Study (PATS). Method: PATS was a National Institutes of Mental Health-funded, multicenter, randomized, efficacy trial designed to evaluate the short-term (5 weeks) efficacy and long-term (40 weeks) safety of methylphenidate (MPH) in preschoolers with attention-deficit/ hyperactivity disorder (ADHD). Three hundred three subjects ages 3 to 5.5 years old who met criteria for a primary DSM-IV diagnosis of ADHD entered the trial. Subjects participated in an 8-phase, 70-week trial that included screening, parent training, baseline, open-label safety lead-in, double-blind crossover titration, double-blind parallel efficacy, open-label maintenance, and double-blind discontinuation. [One of many evaluation instruments was the Early Childhood Inventory-4.] Medication response was assessed during the crossover titration phase using a combination of parent and teacher ratings. Special ethical considerations throughout the trial warranted a number of design changes. Results: This report describes the design of this trial, the rationale for reevaluation and modification of the design, and the methods used to conduct the trial. Conclusions: The PATS adds to a limited literature and improves our understanding of the safety and efficacy of MPH in the treatment of preschoolers with ADHD, but changes in the design and problems in implementation of this study impose some specific limitations that need to be addressed in future studies.

 

07-12. Kopp, L.M., & Beauchaine, T.P. (2007). Patterns of psychopathology in the families of children with conduct problems, depression, and both psychiatric conditions. Journal of Abnormal Child Psychology, 35, 301-312.

 

Objective: Comorbid conduct problems (CPs) and depression are observed far more often than expected by chance, which is perplexing given minimal symptom overlap. In this study, relations between parental psychopathology and children's diagnostic status were evaluated to test competing theories of comorbidity. Method: Participants included 180 families with an 8-12-year-old child diagnosed with CPs, depression, both conditions, or neither condition. [Child diagnostic classifications were based on the Child Symptom Inventory-4.] Results: Although no single theory of comorbidity was supported fully, evidence suggested that CPs and depression may be inherited separately. Paternal antisocial characteristics and maternal depression provided independent prediction of both child depression and CPs. However, paternal antisocial behavior moderated the effect of maternal depression on CPs. For children with antisocial fathers, CPs were observed regardless of maternal depression levels. In contrast, a strong relation was observed between CPs and maternal depression for children without antisocial fathers.

 

07-13. Kronenberger, W.G., Giauque, A.L., & Dunn, D.W. (2007). Development and validation of the outburst monitoring scale for children and adolescents Journal of Child and Adolescent Psychopharmacology, 17, 511-526.

 

Objective: The aim of this study was to develop a parent-completed questionnaire measure of specific types of aggressive behaviors in children and adolescents. Method: Two studies tested the psychometrics of the Outburst Monitoring Scale (OMS), a questionnaire measure of verbal, property, self, and physical aggression, based in part on the categories of the Overt Aggression Scale. In Study 1, parents of 23 adolescents with a history of aggressive-disruptive behavior and 30 control adolescents completed the OMS and other measures of aggressive-disruptive behavior [including the Adolescent Symptom Inverntory-4]. In Study 2, parents of 9 adolescents with a history of aggressive-disruptive behavior completed the OMS and other measures of aggressive-disruptive behavior during open-label treatment with methylphenidate and quetiapine. Results: Results from both studies demonstrated adequate internal consistency of OMS sub-scale and total scores. OMS scores correlated significantly with measures of conduct disorder and oppositional defiant disorder and differentiated between control and aggressive sub-samples. Changes in OMS scores during treatment correlated with changes in other measures of aggressive and disruptive behavior. Conclusion: The OMS demonstrated good internal consistency, strong correlations with other measures of aggressive/disruptive behavior, good differential validity, and sensitivity to change during a medication trial. The OMS offers a quick, valid, questionnaire-based alternative for measuring frequencies of specific aggressive behaviors in clinical and research settings.

 

07-14. Lewandowski, A., & Drotar, D. (2007).The relationship between parent-reported social support and adherence to medical treatment in families of adolescents with type 1 diabetes. Journal of Pediatric Psychology, 32, 427-436.

 

Objective: To investigate the relationships between both mother-reported spousal support and social network support, and mother-adolescent diabetes-related conflict, discrepancies in decision-making autonomy (DDMA), and adolescent adherence to diabetes treatment. Method: Fifty-one mothers of adolescents with IDDM completed self-report measures of social support, diabetes-related conflict, and adolescent autonomy for diabetes care. [Mothers completed the Oppositional Defiant Disorder category of the Adolescent Symptom Inventory-4.] Analyses tested conflict and DDMA as mediators between mother-reported social support and adolescent adherence to treatment. Results: Increased levels of mother-adolescent conflict were associated with poorer treatment adherence and both mother-reported diabetes-related conflict and DDMA predicted adolescents' glycemic control. Higher levels of mother-reported spousal support were associated with less conflict and greater adherence to treatment. Sobel's test indicated a statistical trend for conflict as a mediator between spousal support and adolescent treatment adherence (p <.07). DDMA did not predict mother-adolescent conflict and did not emerge as a mediator between mother-reported social support and adolescent adherence. Conclusions: This study highlights the role of spousal support for mothers of adolescents with IDDM and indicates that the level of spousal support mothers receive may play an important rote in the health care behaviors of their adolescents.

 

07-15. Lopez-Villalobos, J. A., Serrano-Pintado, I., Delgado Sanchez-Mateos, J., Ruiz-Sanz, F., Sanchez-Azon, M. I., & Sacristan-Martin, A. M. (2007). Attention deficit hyperactivity disorder: Intellectual profile and the freedom from distraction factor. Revista De Neurologia, 44, 589-595.

 

Objective: Attention deficit hyperactivity, disorder (ADHD) usually presents a neuropsychological profile in which the freedom from distraction factor (FDF) is affected to a greater extent than the verbal comprehension factor (VCF) and the perceptual organisation fiactor (POF). To determine the intellectual profile of clinical cases with ADHD through a specific analysis of the FDF in which we evaluated the differences compared with the VCF and the POF, between types of ADHD and with WISC-R criteria, as well as the variables that affect the probability of FDF < VCF and POE. Method: Our study involved a clinical sample (of 167 cases of ADHD between 6 and 16 years of age. The cases were defined according to DSM-IV criteria and the evaluation was performed using WISC-R, the Child Symptom Inventory-4 and the social and occupational activity assessment scale. Both descriptive and exploratory, statistics were used. Means were compared using ANOVA and/or t tests. Alpha was accepted if it was equal to or below 0.05 and a logistic regression method was used (alpha model parameters below or equal to 0.05). In each factor a 95% confidence interval and odds ratio were determined. Results: The criterion, FDF < VCF and FOP accounted for 71.3% of the cases with ADHD and FDF < (VCF + POF)/2 represented 81.4% (sensitivity: 81.4%). The FDF is significantly lower that? both the mean that corresponds to factorial criteria derived from the WISC-R and the VCF and POF in the cases that were analysed. The mean FDF scores were significantly higher in ADHD-H (a type in which hyperactive-impulsivity predominates) than in ADHD-C (combined type) and ADHD-1 (inattentive type). Comorbidity, social or school activity and intellectual quotient do not have a significant influence on the probability that FDF < VCF and POE. Conclusion: The FDF is a neuropsychologicool dimension that is useful in evaluating ADHD.

 

07-16. Mikami, A.Y., Huang-Pollock, C.L., Pfiffner, L.J., McBurnett, K., & Hangai, D. (2007). Social skills differences among attention-deficit/hyperactivity disorder types in a chat room assessment task. Journal of Abnormal Child Psychology, 35, 509-521.

 

Objective: This study assessed social skills in 116 children aged 7-12 with ADHD-Combined Type (ADHD-C; n=33), ADHD-Inattentive Type (ADHD-I; n=45), and comparison children (n=38), with consideration of the role sluggish cognitive tempo (SCT) symptoms play in distinguishing profiles. [The Child Symptom Inventory-4 was used as a screening tool for ASHD.] Method: Social skills were assessed using a novel computerized chat room task, in which participants were encouraged to join a conversation and type messages to interact with four computer-simulated peers. Every participant received the identical stimulus from the simulated peers, but was free to respond to it in his or her own unique way. Results: Relative to comparison children, children with ADHD-C made off-topic and hostile responses; children with ADHD-I made off-topic responses, few responses and showed poor memory for the conversation. ADHD subtype differences remained after statistical control of IQ, reading achievement, typing skill, and comorbid disruptive behavior disorders. SCT symptoms, most prevalent among children with ADHD-I, predicted a distinct pattern of social withdrawal and lower hostility. Parent and teacher ratings and in-vivo observations of social skills correlate with this new measure.

 

07-17. Pfiffner, L.J., Mikami,  A.Y.,  Huang-Pollock, C., Easterlin, B., Zalecki, C., & McBurnett, K.. (2007). A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1041-1050.

 

Objective: To evaluate the efficacy of a behavioral psychosocial treatment integrated across home and school (Child Life and Attention Skills Program) with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I). Method: Sixty-nine children ages 7 to 11 years were randomized to the Child Life and Attention Skills Program or a control group who did not receive the intervention. We compared groups posttreatment and at 3- to 5-month follow-up on parent and teacher ratings of inattention sluggish cognitive tempo, and functional impairment. [The Child Symptom Inventory-4 was the primary outcome measure.] Results: Children randomized to the Child Life and Attention Skills Program were reported to have significantly fewer inattention and sluggish cognitive tempo symptoms, and significantly improved social and organizational skills, relative to the control group. Gains were maintained at follow-up. Conclusions: Behavioral psychosocial treatment, when specifically adapted for ADHD-I and coordinated among parents, teachers, and children, appears efficacious in reducing symptoms and impairment associated with ADHD-I.

 

07-18. Shannon, K.E., Beauchaine, T.P., Brenner, S.L., Neuhaus, E., & Gatzke-Kopp, L. (2007). Familial and temperamental predictors of resilience in children at risk for conduct disorder and depression. Development and Psychopathology, 19, 701-727.

 

Objective: In this study, we evaluated predictors of resilience among 8- to 12-year-old children recruited from primarily low socioeconomic status neighborhoods, 117 of whom suffered from clinical levels of conduct problems and/or depression and 63 of whom suffered from no significant symptoms. [The Child Symptom Inventory-4 was used to evaluate DSM-IV symptoms.] Method: Tests of interactions were conducted between (a) paternal antisocial behavior and maternal depression and (b) several physiological indices of child temperament and emotionality in predicting (c) children's conduct problems and depression. Results: Both internalizing and externalizing outcomes among children were associated specifically with maternal melancholic depression, and not with nonmelancholic depression. In addition, low levels of respiratory sinus arrhythmia (RSA) among children conferred significant risk for depression, regardless of maternal melancholia, whereas high RSA offered partial protection. Furthermore, high levels of maternal melancholia conferred significant risk for child depression, regardless of paternal antisocial behavior, whereas low levels of maternal melancholia offered partial protection. Finally, low levels of electrodermal responding (EDR) conferred significant risk for conduct problems, regardless of paternal antisocial behavior, whereas high EDR offered partial protection. None of the identified protective factors offered complete immunity from psychopathology. Conclusion: These findings underscore the complexity of resilience and resilience-related processes, and suggest several potential avenues for future longitudinal research.

 

07-19. Sprafkin, J., & Gadow, K.D. (2007). Is item randomization necessary? A comparison of the psychometric properties of two ADHD rating scale formats. Journal of Child and Adolescent Psychopharmacology. 17, 75-84.

 

Objective: Although behavior rating scales are generally considered de riguer for best clinical practices, they are often time consuming to score, especially if items are randomized. This study compares the reliability, validity, and clinical utility of two methods of ordering ADHD Symptom Checklist-4 (ADHD-SC4) rating scale items; namely, diagnostic-cluster versus randomized-order formats.  Method: Participants were parents of 207 children between 5 and 17 years old referred to a child psychiatry outpatient service and who were diagnosed as having a variety of emotional and behavioral disorders. Children were assessed with a battery of standardized assessment instruments and clinical interviews.  Half received the standard, diagnostic clusters version of the ADHD-SC4 and half a randomized order version. Results: Findings indicate comparable internal consistency, convergent/discriminant validity, and sensitivity for identifying children with ADHD and ODD. Conclusion: The findings of this study suggest that item arrangement has few apparent negative implications for clinical utility of the ADHD-SC4.

 

07-20. Sprafkin, J., Gadow, K.D., Weiss, M.D., Schneider, J., & Nolan, E.E. (2007). Psychiatric comorbidity in ADHD symptom subtypes in clinic and community adults. Journal of Attention Disorders, 11, 114-124.

 

Objective: To compare psychiatric comorbidity between the three symptom subtypes of attention-deficit/hyperactivity disorder (ADHD), inattentive (I), hyperactive-impulsive (H), and combined (C), in adults. Methods: Two groups of adults, a mental health outpatient Clinic sample (N=487) and a nonreferred Community sample (N=900) completed the Adult Self Report Inventory-4 (ASRI-4), a DSM-IV-referenced rating scale and a brief questionnaire (social, educational, occupational, and treatment variables). Participants were assigned to one of four groups: ADHD:I, ADHD:H, ADHD:C, and NONE. Results: In general, all three ADHD symptom groups reported more severe comorbid symptoms than the NONE group; the ADHD:C and NONE groups were the most and least severe, respectively; and there were clear differences between the ADHD:I and ADHD:H groups. The pattern of group differences was generally similar in both samples. Conclusions: ADHD symptom subtypes in adults are associated with distinct clinical correlates, which is consistent with the research on child ADHD subtypes. The diversity of self-reported, co-occurring psychiatric symptoms in adults who meet symptom criteria for ADHD suggests that restricting diagnostic and treatment evaluations to ADHD behaviors is ill-advised.

 

07-21. Sullivan K., Hatton, D.D., Hammer, J., Sideris, J., Hooper, S., Ornstein, P.A., & Bailey, D.B. (2007). Sustained attention and response inhibition in boys with fragile X syndrome: Measures of continuous performance. American Journal of Medical Genetics Part B-Neuropsychiatric Genetics, 144:517-532.

 

Sustained attention and response inhibition were examined in boys with fall mutation fragile X syndrome (FXS) using adapted visual and auditory continuous performance tests (CPTs). Only 61% of 56 boys with visual CPT data and 54% of 52 boys with auditory data were able to demonstrate sufficient understanding to complete the visual and auditory CPTs, respectively. Mental age (MA) predicted whether boys with FXS were able to demonstrate understanding of the CPTs. The performance of boys with FXS who were able to complete the CPTs was compared to a sample of boys without disabilities matched on MA. Boys with FXS demonstrated similar or smaller declines in sustained attention over task time than their MA-matched peers on the visual and auditory CPTs, respectively, but consistently demonstrated greater declines in response inhibition over task time than their MA-matched peers. There were no differences between groups for response time of hits. Higher MAs consistently predicted better sustained attention and response inhibition over task time on the visual and auditory CPTs. Furthermore, boys taking psychotropic medication performed better at the beginning of most tasks, although their performance deteriorated at a faster rate over time, and boys rated as meeting diagnostic criteria for ADHD-hyperactive type [assessed with the Child Symptom Inverntory-4 or Adolescent Symptom Inventory-4] had more difficulty over task time with response inhibition on the auditory CPT. For both boys with FXS and their MA matches, performance was better on the visual CPT than on the auditory CPT though this effect may be attributable to a number of factors other than the modality.

 

07-22. Sullivan, K., Hooper, S., & Hatton, D. (2007). Behavioural equivalents of anxiety in children with fragile X syndrome: parent and teacher report. Journal of Intellectual Disability Research, 51, 54-65.

 

Background: Identifying many of the diagnostic criteria for anxiety and depression in individuals with intellectual disability (ID) can be challenging because they may be unable to recognize and communicate their emotional experiences accurately. The purpose of this study is to identify behavioural equivalents of anxiety in children with fragile X syndrome (FXS), the leading inherited cause of ID. Methods: Parents and teachers of 43 children (aged 6-14 years) with full mutation FXS completed two standardized questionnaires on children's problem behaviour and psychiatric symptoms, [one of which was the Child Symptom Inventory-4]. Items from the questionnaires thought to be possible behavioural equivalents of anxiety were identified and grouped into four domains: Avoidance Behaviours-Confrontational; Avoidance Behaviours-Non-confrontational; Anxiety Continuum Behaviours; and Behavioural Dysregulation. The mean rating for the four groups of items was used to predict the children's status for exhibiting significant problems with anxiety as defined by the Diagnostic and Statistical Manual of Mental Disorders-oriented Anxiety Subscale from the problem behaviour scale. Results: The predictor variables classified 81% (parent rating) and 86% (teacher rating) of the children correctly. Avoidance Behaviours - Confrontational and Avoidance Behaviours - Non-confrontational (teacher rating) and Anxiety Continuum Behaviours (parent and teacher rating) made unique contributions to the models. Conclusions: Children who are unable to identify and communicate that they worry about general day-to-day events may exhibit more observable behaviours resembling active and passive avoidance (e.g. arguing, avoiding difficult tasks, staring off) or have specific phobias and compulsions. These findings suggest that there are behavioural equivalents for anxiety disorder in children with FXS and, more generally, support the notion of behavioural equivalents in ID.

 

07-23. Wade, C.A., Ortiz, C., & Gorman, B.S.(2007).Two-session group parent training for bedtime noncompliance in head start preschoolers. Child & Family Behavior Therapy, 29, 23-55.

 

Objective: Bedtime struggles are some of the most common childhood behavior problems. These disruptions are associated with children's daytime misbehavior, impaired social functioning, poorer school performance, and even an increased risk of child abuse. These problems also have a number of negative consequences for members of the child's family. Of the evidence-based treatments for bedtime noncompliance in young children, graduated extinction is the most widely used by clinicians. A number of studies have demonstrated its efficacy. The present study is the first to examine the efficacy of graduated extinction with children from ethnic minority or low socioeconomic backgrounds. Additionally, this is one of the first studies to examine the effects of graduated extinction when it is delivered in a group format. Method: In an interrupted time-series design, five parents of children enrolled at a Head Start preschool site participated in one of two groups that received instruction on the use of graduated extinction. [The Early Childhood Inventory-4 was used as a screen for emotional disorders.] Results: According to visual inspection as well as single case and multilevel statistical analyses, parents reported that at posttest their children experienced large reductions in both bedtime and daytime behavior problems. Parents also reported that their own levels of depression and stress declined during this period. At two-month follow-up, gains in the children's bedtime behavior were maintained. Parents also reported high levels of satisfaction with the intervention. Conclusion: These results suggest that graduated extinction for bedtime noncompliance is effective for a wide range of parents and can be successfully administered in a group setting.

 

07-24. Wightman, A., Schluchter, M., Drotar, D., Andreias, L., Taylor, H.G., Klein, N., Wilson-Costello, D., & Hack, M. (2007). Parental protection of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics, 28, 317-326.

 

Objective: To examine parent protection and its correlates among 8-year-old ELBW children compared with normal birth weight (NBW) controls. Methods: The population included 217 eight-year-old ELBW children born 1992-1995 (92% of the surviving birth cohort; mean birth weight, 811 g; mean gestational age, 26.4 weeks) and 176 NBW controls. The primary outcome measure, the Parent Protection Scale (PPS), included a total score and four domains including Supervision, Separation, Dependence, and Control. Multivariate analyses were performed to examine the predictors of parental protection and overprotection. [The Child Symptom Inventory-4 was included in the initial assessment battery.]  Results: After adjusting for socioeconomic status (SES), race, sex, and age of the child, parents of ELBW children reported significantly higher mean total Parent Protection Scale scores (31.1 vs 29.7, p = .03) than parents of NBW children and higher scores on the subscale of Parent Control (8.0 vs 7.5, p = .04). These differences were not significant when the 36 children with neurosensory impairments were excluded. Parents of ELBW children also reported higher rates of overprotection than controls (10% vs 2%, p = .001 ), findings that remained significant even after excluding children with neurosensory impairments (8% vs 2%, p = .011). Multivariate analyses revealed lower SES to be associated with higher total Parent Protection Scale scores in both the ELBW (p < .001) and NBW (p < .05) groups. Additional correlates included neurosensory impairment (p < .05) and functional limitations (p < .001) in the ELBW group and black race (p < .05) and maternal depression (p < .01) in the NBW group. Lower child IQ was significantly associated with higher PPS scores only in the neurosensory impaired subgroup of ELBW children. Conclusions: Longer term follow-up will be necessary to examine the effects of the increased parent protection on the development of autonomy and interpersonal relationships as the children enter adolescence.

 

 

 YEAR: 2006

 

 

06-1. Chervin, R.D., Ruzicka, D.L., Giordani, B.J., Weatherly, R.A., Dillon, J.E., Hodges, E.K., Marcus, C.L., & Guire, K.E. (2006). Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy. Pediatrics, 17:769-778.

 

Objective: Most children with sleep-disordered breathing (SDB) have mild-to-moderate forms, for which neurobehavioral complications are believed to be the most important adverse outcomes. To improve understanding of this morbidity, its long-term response to adenotonsillectomy, and its relationship to polysomnographic measures, we studied a series of children before and after clinically indicated adenotonsillectomy or unrelated surgical care. Method: We recorded sleep and assessed behavioral, cognitive, and psychiatric morbidity in 105 children 5.0 to 12.9 years old: 78 were scheduled for clinically indicated adenotonsillectomy, usually for suspected SDB, and 27 for unrelated surgical care. One year later, we repeated all assessments in 100 of these children. Results: Subjects who had an adenotonsillectomy, in comparison to controls, were more hyperactive on well-validated parent rating scales [including the Child Symptom Inventory-4], inattentive on cognitive testing, sleepy on the Multiple Sleep Latency Test, and likely to have attention-deficit/hyperactivity disorder (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) as judged by a child psychiatrist. In contrast, 1 year later, the 2 groups showed no significant differences in the same measures. Subjects who had an adenotonsillectomy had improved substantially in all measures, and control subjects improved in none. However, polysomnographic assessment of baseline SDB and its subsequent amelioration did not clearly predict either baseline neurobehavioral morbidity or improvement in any area other than sleepiness. Conclusion: Children scheduled for adenotonsillectomy often have mild-to-moderate SDB and significant neurobehavioral morbidity, including hyperactivity, inattention, attention-deficit/hyperactivity disorder, and excessive daytime sleepiness, all of which tend to improve by 1 year after surgery. However, the lack of better correspondence between SDB measures and neurobehavioral outcomes suggests the need for better measures or improved understanding of underlying causal mechanisms.

 

06-2. Crowell, S.E., Beauchaine, T.P., Gatzke-Kopp, L., Sylvers, P., Mead, H., & Chipman-Chacon, J. (2006). Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children. Journal of Abnormal Psychology, 115, 174-178.

 

Objective: Numerous studies have revealed autonomic underarousal in conduct-disordered adolescents and antisocial adults. It is unknown, however, whether similar autonomic markers are present in at-risk preschoolers. Method: In this study, the authors compared autonomic profiles of 4- to 6-year-old children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD; n = 18) with those of age-matched controls (n = 20). [Symptom groups were defined on the basis of scores on the parent-completed Child Symptom Inventory-4.]  Results: Children with ADHD and ODD exhibited fewer electrodermal responses and lengthened cardiac preejection periods at baseline and during reward. Although group differences were not found in baseline respiratory sinus arrhythmia, heart rate changes among ADHD and ODD participants were mediated exclusively by parasympathetic withdrawal, with no independent sympathetic contribution. Heart rate changes among controls were mediated by both autonomic branches. Conclusion: These results suggest that at-risk preschoolers are autonomically similar to older externalizing children.

 

06-3. Drabick, D.A.G., Gadow, K.D., & Sprafkin, J. (2006). Co-occurrence of conduct disorder and depression in a clinic-based sample of boys with ADHD. Journal of Child Psychology and Psychiatry, 47, 766-774.

 

Background: Children with attention-deficit/hyperactivity disorder (ADHD) are at risk for the development of comorbid conduct disorder ( CD) and depression. The current study examined potential psychosocial risk factors for CD and depression in a clinic-based sample of 203 boys ( aged 6-10 years) with ADHD. Method: The boys and their mothers participated in an evaluation that involved assessments of cognitive, behavioral, academic, and family functioning and included the Child Symptom Inventory-4. Potential predictors of CD and depression involved four domains: parenting behaviors, family environment, academic/cognitive functioning, and peer relations. ADHD groups were defined using mother- and teacher-report of DSM-IV symptoms. Mother-ratings of DSM-IV symptoms were obtained for a subsample of 91 boys approximately 5 years after the initial assessment. Results: For both mother- and teacher-defined ADHD groups, social problems were related to depression symptoms; hostile, inconsistent, and detached parenting behaviors were related to CD symptoms; and family environment characterized by low cohesion, high conflict, and low marital satisfaction was related to CD and depression symptoms. For the teacher-defined ADHD group, parenting variables also predicted depression symptoms. Academic and cognitive variables did not predict CD or depression symptoms when parenting, family, and peer relationship variables were taken into account. Depression prospectively predicted CD, but not the reverse, and parental hostile control and familial conflict prospectively predicted CD for the teacher-defined ADHD group only. Conclusion: Source-specificity is a useful consideration when describing the relation of parenting and home environment with CD and depression symptoms in boys with ADHD. Intervention efforts that address these parenting, family, and peer relationship variables may aid in preventing the development of comorbid conditions.

 

06-4. Egger, H.L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47, 313-337.

 

We review recent research on the presentation, nosology and epidemiology of behavioral and emotional psychiatric disorders in preschool children (children ages 2 through 5 years old), focusing on the five most common groups of childhood psychiatric disorders: attention deficit hyperactivity disorders, oppositional defiant and conduct disorders, anxiety disorders, and depressive disorders. We review the various approaches to classifying behavioral and emotional dysregulation in preschoolers and determining the boundaries between normative variation and clinically significant presentations. While highlighting the limitations of the current DSM-IV diagnostic criteria for identifying preschool psychopathology and reviewing alternative diagnostic approaches, we also present evidence supporting the reliability and validity of developmentally appropriate criteria for diagnosing psychiatric disorders in children as young as two years old. Despite the relative lack of research on preschool psychopathology compared with studies of the epidemiology of psychiatric disorders in older children, the current evidence now shows quite convincingly that the rates of the common child psychiatric disorders and the patterns of comorbidity among them in preschoolers are similar to those seen in later childhood. We review the implications of these conclusions for research on the etiology, nosology, and development of early onset of psychiatric disorders, and for targeted treatment, early intervention and prevention with young children. [The authors summarize research findings for the Early Childhood Inventory-4. They also note “that relatively stable psychopathological characteristics can be reliably identified in preschoolers, consider the encouraging psychometric properties of the CBCL 1½-5 (Achenbach & Rescorla, (2000) and the Early Childhood Inventory-4 (Gadow & Sprafkin, 1997)” p. 315.]

 

06-5. Gadow, K.D., DeVincent, C.J., & Pomeroy, J. (2006). ADHD symptom subtypes in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 36, 271-283.

 

Objective: This study describes and compares DSM-IV ADHD symptom subtypes in children with and without pervasive developmental disorder (PDD). Method: Parents and teachers completed Early Childhood Inventory-4 for 3-to-5 (N=182/135) and the Child Symptom Inventory-4 for 6-to-12 (N=301/191) year old children with PDD and clinic controls, respectively. Results: ADHD subtypes were clearly differentiated from the nonADHD group and showed a differential pattern of co-occurring psychiatric symptoms, which was more pronounced for teacher- than parent-defined subtypes and for older versus younger children. The combined (C) type was rated more oppositional and aggressive (ages 3-12) and as having more severe PDD symptoms (ages 6-12) than the inattentive (I) type and from less advantaged home environments than the I and hyperactive-impulsive (H) subtypes. The H group was the least impaired subtype. ADHD subtype differences were similar for both PDD and nonPDD children. Conclusion: Findings support the notion that ADHD may be a clinically meaningful syndrome in children with PDD.

 

06-6. Hooper, S.R., Ashley, T.A., Roberts, J.E., Zeisel, S.A., & Poe, M.D. (2006).The relationship of otitis media in early childhood to attention dimensions during the early elementary school years. Journal of Developmental and Behavioral Pediatrics, 27, 281-289.

 

Objective: This study examined the impact of otitis media with effusion (OME) and associated hearing loss between 6 and 48 months of age on attention dimensions (i.e., selective/focus, sustained) during the elementary school years. Method: A prospective cohort design in which 74 African American infants were recruited between ages 6 and 12 months. Ear examinations were done repeatedly using both otoscopy and tympanometry, and hearing was assessed using standard audiometric procedures between 6 and 48 months. Multiple measures of attention including direct assessment, behavioral observations, parent/teacher ratings [to include the Child Symptom Inventory-4] were administered from kindergarten through second grade to assess two theoretical dimensions of attention: selective/focused and sustained. The home environment was assessed annually. Results: Findings indicated that neither early childhood OME nor hearing loss showed significant correlations with any of the longitudinal or cross-sectional measures of selective/focused attention and sustained attention. In contrast, children with mothers who had fewer years of education and who lived in less responsive and supportive home environments scored higher on both parent and teacher ratings of sustained attention (i.e., hyperactivity) through the second grade of elementary school. For NEPSY Auditory Attention in second grade, a significant interaction between the Home Observation for Measurement of the Environment and hearing loss was uncovered. This interaction showed that children with hearing loss from poor home environments experienced greater difficulties on the NEPSY Auditory Attention task than those with hearing loss from good home environments. Conclusion: These findings do not support a direct linkage of a history of OME and associated hearing loss to difficulties in selective/focused attention or sustained attention in early elementary school children. Relationships between sociodemographic variables and attention-related functions appear stronger and should be considered as mediators in any examination of the linkages between early OME and subsequent attention functions.

 

06-7. Jane, M.C., Canals, J., Ballespi, S., Vinas, F., Esparo, G., & Domenech, E. (2006). Parents and teachers reports of DSM-IV psychopathological symptoms in preschool children. Social Psychiatry and Psychiatric Epidemiology, 41, 386-393.

 

Objective: This study used DSM-IV criteria to analyse reports from teachers and parents and to compare behavioural and emotional symptoms in Spanish preschool children from both urban and rural populations. Method: The field survey was conducted in two geographical areas in Catalonia (Spain). A sample of 1104 children (56.67% boys and 43.32% girls) aged 3-6 years participated in this study: 697 were from urban areas and 408 from rural ones. The Early Childhood Inventory-teachers' and parents' versions (ECI-4) [Gadow KD, Sprafkin J (1997)-was used as the screening instrument. Results: The teachers' and parents' reports assigned 32.7 and 46.7%, respectively, to one or more ECI-4 categories. Significant differences between sexes were found in teachers' reports. The whole disorders were significantly more prevalent in the urban sample than in the rural one (30.6 vs. 20.3%). The most prevalent disorders in both areas were Anxiety Disorders and Behavioural Problems, and the least prevalent were Mood Disorders and Autistic Disorders. Conclusion: The findings indicate that there are some differences in the prevalence rates of preschool psychopathological disorders between rural and urban Spanish areas.

 

06-8. Kandel, D.B., Schaffran, C., Griesler, P.C., Hu, M.C., Davies, M., & Benowitz, N. (2006). Salivary cotinine concentration versus self-reported cigarette smoking: Three patterns of inconsistency in adolescence. Nicotine & Tobacco Research, 8, 525-537.

 

Objective: The present study examined the extent and sources of discrepancies between self-reported cigarette smoking and salivary cotinine concentration among adolescents. Method: The data are from household interviews with a cohort of 1,024 adolescents from an urban school system. Histories of tobacco use in the last 7 days and saliva samples were obtained. Results: Logistic regressions identified correlates of three inconsistent patterns: ( a) Pattern 1-self-reported nonsmoking among adolescents with cotinine concentration above the 11.4 ng/mg cutpoint (n=176), (b) Pattern 2 - low cotinine concentration ( below cutpoint) among adolescents reporting having smoked within the last 3 days (n=155), and (c) Pattern 3-high cotinine concentration (above cutpoint) among adolescents reporting not having smoked within the last 3 days (n=869). Rates of inconsistency were high among smokers defined by cotinine levels or self-reports (Pattern 1=49.1%; Pattern 2=42.0%). Controlling for other covariates, we found that reports of nonsmoking among those with high cotinine ( Pattern 1) were associated with younger age, having few friends smoking, little recent exposure to smokers, and being interviewed by the same interviewer as the parent and on the same day. Low cotinine concentration among self-reported smokers ( Pattern 2) was negatively associated with older age, being African American, number of cigarettes smoked, depth of inhalation, and exposure to passive smoke but positively associated with less recent smoking and depressive symptoms as assessed with the Youths Inventory-4 (YI-4). High cotinine concentrations among self-reported nonsmokers was positively associated with exposure to passive smoke ( Pattern 3). The data are consonant with laboratory findings regarding ethnic differences in nicotine metabolism rate. The inverse relationship of cotinine concentration with YI-4 depressive symptoms has not previously been reported. Depressed adolescent smokers may take in smaller doses of nicotine than nondepressed smokers; alternatively, depressed adolescents may metabolize nicotine more rapidly.

 

O6-9. Klassen, A.F., Miller, A., & Fine, S. (2006). Agreement between parent and child report of quality of life in children with attention-deficit/hyperactivity disorder. Child Care Health and Development, 32, 397-406.

 

Objective: There is little information in the research literature of agreement between parent and child in reports of child quality of life (QOL) for a sample of children diagnosed with attention-deficit/ hyperactivity disorder (ADHD). The aim of our study was to determine whether parent and child concordance is greater for physical domains of QOL than for psychosocial domains; whether parents rate their child's QOL better or poorer than their child's ratings; and whether concordance is related to demographic, socioeconomic or clinical factors. Method: The study was a questionnaire survey of children aged 10-17 referred to the ADHD clinic and diagnosed with ADHD in the province of British Columbia (Canada) between November 2001 and October 2002 and their parent. Results: Fifty-eight children diagnosed with ADHD and their parents completed our study questionnaire. The main outcome measure was the Child Health Questionnaire, which permitted comparisons on eight QOL domains and one single item. Intraclass correlation coefficients were moderate for five domains (range from 0.40 to 0.51), and good for three domains (range from 0.60 to 0.75). Children rated their QOL significantly better than their parents in four areas and poorer in one. Standardized Response Means indicated clinically important differences in mean scores for Behaviour and Self-esteem. Compared with population norms, across most domains, children with ADHD reported comparable health. Discrepancies between parent-child ratings were related to the presence of a comorbid oppositional/defiant disorder, a psychosocial stressor and increased ADHD symptoms. Conclusion: Although self-report is an important means of eliciting QOL data, in children with ADHD, given the discrepancies in this study between parent and child report, measuring both perspectives seems appropriate.

 

06-10. Leathers, S.J. (2006). Placement disruption and negative placement outcomes among adolescents in long-term foster care: The role of behavior problems. Child Abuse & Neglect, 30, 307-324.

 

Objective: This study examined risk of placement disruption and negative placement outcomes (e.g., residential treatment and incarceration) among adolescents placed in traditional family foster care for a year or longer. Method: The caseworkers and foster parents of 179 randomly selected 12-13-year-old adolescents placed in traditional foster care were interviewed by telephone. Interviews included standardized measures of externalizing behavioral problems [Oppositional Defiant Disorder and Conduct Disorder symptom categories of the Child Symptom Inventory-4] and several other variables that have been previously associated with placement movement. Disruption from the youth's foster home at the time of the interview was prospectively tracked for 5 years. Results: Over half of the youth experienced a disruption of their placement. Contrary to expectations, behavior problems as reported by caseworkers, but not foster parents, were predictive of placement disruption. However, the foster parent's report of behavior problems predicted risk of negative outcome after a period of 5 years. As hypothesized, integration in the foster home was highly predictive of placement stability and mediated the association between behavior problems and risk of disruption. Conclusion: Results suggest that integration in the foster home might be an important dimension of placement adaptation that should be considered during service planning for foster youth in long-term foster care. In addition, using standardized measures of behavior with both foster parents and caseworkers might be necessary to assess both long-term risk of negative outcomes and more immediate risk of placement disruption.

 

06-11. Loney, B.R., Butler, M.A., Lima, E.N., Counts, C.A., & Eckel, L.A . (2006). The relation between salivary cortisol, callous-unemotional traits, and conduct problems in an adolescent non-referred sample. Journal of Child Psychology and Psychiatry, 47, 30-36.

 

Objective: Background: Previous research has suggested that adult psychopathic behavior and child callous-unemotional (CU) traits are uniquely related to low emotional reactivity. Salivary cortisol is a promising biological measure of emotional reactivity that has been relatively overlooked in research on CU traits and antisocial behavior. The current study examined for gender differences in the relation between resting salivary cortisol levels and CU traits in a non-referred adolescent sample. Salivary testosterone levels were assessed to provide discriminant validity for cortisol analyses and were not expected to bear a relation to CU traits. Method: An extreme groups strategy was used to recruit 108 adolescents (53 male, 55 female) from a larger screening sample who exhibited various combinations of low and high scores on parent-report measures of CU traits and conduct problems. [The latter were assessed with the Adolescent Symptom Inventory-4]. Resting saliva samples were assayed for cortisol and testosterone levels using a radioimmunoassay procedure. Results: Consistent with prediction, male participants exhibiting elevated CU traits were uniquely characterized by low cortisol levels relative to male comparison groups (p <.05). Testosterone levels did not differentiate groups and no hormone effects were found for female participants. Conclusion: The current findings build upon recent research in suggesting that low cortisol may be a biological marker for male CU traits.

 

06-12. Loney, B.R., Lima, E.N., & Butler, M.A.. (2006).Trait affectivity and nonreferred adolescent conduct problems. Journal of Clinical Child and Adolescent Psychology, 35, 329-336.

 

Objective: This study examined for profiles of positive trait affectivity (PA) and negative trait affectivity (NA) associated with adolescent conduct problems. Prior trait affectivity research has been relatively biased toward the assessment of adults and internalizing symptomatology. Consistent with recent developmental modeling of antisocial behavior, this study, proposed that conduct problems are uniquely associated with 2 PA-NA profiles (i.e., high PA-high NA and low PA-low NA). Method: A nonreferred sample of 109 adolescents ages 12 to 19 was recruited to assess the independent relations between rating scale measures of the PA-NA dimensions and conduct problems [sum of the Oppositional Defiant Disorder and Conduct Disorder symptom categories of the Adolescent Symptom Inventory-4], controlling for related internalizing (anxiety and depression) and externalizing (hyperactivity-impulsivity) symptomatology. Results: The results generally confirmed the proposed interaction between the PA-NA dimensions in the prediction of adolescent conduct problems. [Also reported are correlations between the ASI-4 and the CDI and the RCMAS.]

 

06-13. Scahill, L., McDougle, C.J., Williams, S.K., Dimitropoulos, A., Aman, M.G., McCracken, J.T., Tierney, E., Arnold, L.E., Cronin, P., Grados, M., Ghuman, J., Koenig, K., Lam, K.S.L., McGough, J., Posey, D.J., Ritz, L., Swiezy, N.B., & Vitiello, B. (2006). Children's Yale-Brown Obsessive Compulsive Scale modified for pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1114-1123.

 

Objective: To examine the psychometric properties of the Children's Yale-Brown Obsessive Compulsive Scales (CYBOCS) modified for pervasive developmental disorders (PDDs). Method: Rater