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Journal of Child Psychology and Psychiatry

Impact factor: 5.422 5-Year impact factor: 6.235 Print ISSN: 0021-9630 Online ISSN: 1469-7610 Publisher: Wiley Blackwell (Blackwell Publishing)

Subjects: Developmental Psychology, Psychiatry

Most recent papers:

  • Research Review: What have we learned about adolescent substance use?
    Kevin M. Gray, Lindsay M. Squeglia.
    Journal of Child Psychology and Psychiatry. 4 days ago
    Background Adolescence is a critical biological, psychological, and social developmental stage involving heightened risk for substance use and associated adverse consequences. This review, synthesizing emerging findings on this complex topic, is intended to inform research and clinical care focused on adolescents. Methods Literature searches were conducted using PubMed, yielding a cross‐section of observational and interventional studies focused on adolescent substance use. Findings were organized and categorized to cover key areas of epidemiology, neurobiology, prevention, and treatment. Findings Adolescent substance‐related attitudes and use patterns have evolved over time, informed by adult and peer behaviors, public policy, media messaging, substance availability, and other variables. A number of risk and resiliency factors contribute to individual differences in substance use and related consequences. Advances in observational techniques have provided enhanced understanding of adolescent brain development and its implications for substance use. Prevention efforts have yielded mixed results, and while a number of adolescent‐targeted evidence‐based treatments for substance use disorders have been developed, effect sizes are generally modest, indicating the need for further research to enhance prevention and treatment outcomes. Conclusions Substance use in adolescence is heterogeneous, ranging from normative to pathological, and can lead to significant acute and long‐term morbidity and mortality. Understanding risk and resiliency factors, underlying neurobiology, and optimal developmentally sensitive interventions is critical in addressing substance‐associated problems in adolescence.
    July 17, 2017   doi: 10.1111/jcpp.12783   open full text
  • Research Review: The role of obstetric and neonatal complications in childhood attention deficit and hyperactivity disorder – a systematic review.
    Marta Serati, Jennifer L. Barkin, Giulia Orsenigo, Alfredo Carlo Altamura, Massimiliano Buoli.
    Journal of Child Psychology and Psychiatry. 4 days ago
    Background Attention deficit and hyperactivity disorder (ADHD) is a developmental disorder characterized by an inability to sustain attention, activity levels and impulse control, and, according to the latest studies, the prevalence is about 8% and in some countries less than 1%. Currently, it is well‐known that complications during the perinatal period have significant implications on child's physical and mental health. Purpose of the present paper is to review the literature about the association between perinatal complications and future risk of an ADHD diagnosis. Methods A research in the main database sources has been conducted to obtain a systematic review on the perinatal risk factors of ADHD. Results Among perinatal complications, available data indicate low birth weight (LBW) (Cohen's d effect size range: 0.31–1.64‐small effect size) and preterm birth (PB) (range d: 0.41–0.68) as the most important factors associated with a future diagnosis of ADHD. Conclusions PB and LBW children should be carefully monitored for an early diagnosis of ADHD limiting the impact of the disease in life span. A systematic review focusing on these risk factors have not been published until now, in the next future preventive strategies should be developed in order to minimize ADHD onset.
    July 17, 2017   doi: 10.1111/jcpp.12779   open full text
  • Working memory and organizational skills problems in ADHD.
    Michael J. Kofler, Dustin E. Sarver, Sherelle L. Harmon, Allison Moltisanti, Paula A. Aduen, Elia F. Soto, Nicole Ferretti.
    Journal of Child Psychology and Psychiatry. 4 days ago
    Background This study tested model‐driven predictions regarding working memory's role in the organizational problems associated with ADHD. Method Children aged 8–13 (M = 10.33, SD = 1.42) with and without ADHD (N = 103; 39 girls; 73% Caucasian/Non‐Hispanic) were assessed on multiple, counterbalanced working memory tasks. Parents and teachers completed norm‐referenced measures of organizational problems (Children's Organizational Skills Scale; COSS). Results Results confirmed large magnitude working memory deficits (d = 1.24) and organizational problems in ADHD (d = 0.85). Bias‐corrected, bootstrapped conditional effects models linked impaired working memory with greater parent‐ and teacher‐reported inattention, hyperactivity/impulsivity, and organizational problems. Working memory predicted organization problems across all parent and teacher COSS subscales (R2 = .19–.23). Approximately 38%–57% of working memory's effect on organization problems was conveyed by working memory's association with inattentive behavior. Unique effects of working memory remained significant for both parent‐ and teacher‐reported task planning, as well as for teacher‐reported memory/materials management and overall organization problems. Attention problems uniquely predicted worse organizational skills. Hyperactivity was unrelated to parent‐reported organizational skills, but predicted better teacher‐reported task planning. Conclusions Children with ADHD exhibit multisetting, broad‐based organizational impairment. These impaired organizational skills are attributable in part to performance deficits secondary to working memory dysfunction, both directly and indirectly via working memory's role in regulating attention. Impaired working memory in ADHD renders it extraordinarily difficult for these children to consistently anticipate, plan, enact, and maintain goal‐directed actions.
    July 17, 2017   doi: 10.1111/jcpp.12773   open full text
  • Annual Research Review: Early adversity, the hypothalamic–pituitary–adrenocortical axis, and child psychopathology.
    Kalsea J. Koss, Megan R. Gunnar.
    Journal of Child Psychology and Psychiatry. 4 days ago
    Background Research on early adversity, stress biology, and child development has grown exponentially in recent years. Findings We review the current evidence for the hypothalamic–pituitary–adrenocortical (HPA) axis as a stress‐mediating mechanism between various forms of childhood adversity and psychopathology. We begin with a review of the neurobiology of the axis and evidence for relations between early adversity–HPA axis activity and HPA axis activity–psychopathology, as well as discuss the role of regulatory mechanisms and sensitive periods in development. Conclusions We call attention to critical gaps in the literature to highlight next steps in this research including focus on developmental timing, sex differences, stress buffering, and epigenetic regulation. A better understanding of individual differences in the adversity–HPA axis–psychopathology associations will require continued work addressing how multiple biological and behavioral systems work in concert to shape development.
    July 17, 2017   doi: 10.1111/jcpp.12784   open full text
  • Violence exposure is associated with adolescents' same‐ and next‐day mental health symptoms.
    Candice L. Odgers, Michael A. Russell.
    Journal of Child Psychology and Psychiatry. 8 days ago
    Background Young people exposed to violence are at increased risk for mental health and behavioral problems. However, very little is known about the immediate, or same‐day, associations between violence exposure and adolescents' mental health symptoms or whether daily symptom or behavioral reactivity marks future problems. Methods Young adolescents were assessed three times a day for 30 consecutive days using mobile‐phone‐based Ecological Momentary Assessment (EMA) (N = 151 adolescents). Over 12,500 assessments and 4,329 person days were obtained via the EMA. Adolescents were recruited from low‐income neighborhoods based on parent‐reported risk for externalizing symptoms. Mental health symptoms were assessed via parent and child report at baseline, multiple times per day via EMA assessments of the adolescents, and again 18 months later when 93% of the adolescents were reinterviewed. Results Results from multilevel models illustrated that young adolescents were more likely to experience symptoms of anger (OR = 1.74, CI: 1.31–2.30), depression (OR = 1.66, CI: 1.26–2.19), and conduct problems (OR = 2.63, CI: 1.71–4.04) on days that they were exposed versus not exposed to violence. Increases in depressive symptoms were also observed on days following violence exposure (OR = 1.46, CI: 1.09–1.97). Adolescents with the highest levels of violence exposure across the 30‐day EMA were less behaviorally reactive to violence exposures in daily life, and heightened behavioral reactivity predicted increased risk for substance use across early adolescence. Conclusions Findings support the need to focus on both the immediate and long‐term associations between violence exposure and adolescents' mental health and behavior. Results also suggest that heightened behavioral reactivity during early adolescence may signal emerging substance use problems.
    July 13, 2017   doi: 10.1111/jcpp.12763   open full text
  • Very early hallucinatory experiences: a school‐based study.
    Baptiste Pignon, Pierre A. Geoffroy, Axelle Gharib, Pierre Thomas, Dan Moutot, William Brabant, Brigitte Weens, Marie‐Pierre Dupond, Annick Caron, Bruno Falissard, François Medjkane, Renaud Jardri.
    Journal of Child Psychology and Psychiatry. 9 days ago
    Background The prevalence and clinical significance of hallucinatory experiences among children below 7 years of age remain unknown. We aimed to determine the independent influences of sensory deficits, the presence of an imaginary companion and metacognition on hallucinatory experiences. We assumed that hallucinatory experiences were associated with (a) sensory deficits, (b) the presence of an imaginary companion (IC) and (c) metacognition defaults (i.e. first‐ and second‐order theory of mind default). Methods All children in the third year of preschool from a region of Northern France underwent medical screening. We compared the prevalence rates of visual, auditory and audio‐visual hallucinatory experiences based on (a) the presence of visual or auditory deficits, (b) the actual presence of an IC and (c) metacognition. The analyses were adjusted for age. Results A total of 1,087 children aged between 5 and 7 years were included. The prevalence rates of auditory, visual and audio‐visual hallucinatory experiences were 15.8%, 12.5% and 5.8%, respectively. The prevalences of different types of hallucinatory experiences were not significantly different according to sensory deficit. The prevalences of all types of hallucinatory experiences were significantly higher among children with an IC and among children with metacognition defaults. Conclusions The association between hallucinatory experiences and sensory deficits might concern only long‐lasting deficits. The association with the presence of an IC confirms experimental findings of the likelihood of perceiving words among meaningless auditory stimuli. Relations between hallucinatory experiences and theory of mind need to be addressed in longitudinal studies.
    July 12, 2017   doi: 10.1111/jcpp.12780   open full text
  • Research Review: Harnessing the power of individual participant data in a meta‐analysis of the benefits and harms of the Incredible Years parenting program.
    Patty Leijten, Frances Gardner, Sabine Landau, Victoria Harris, Joanna Mann, Judy Hutchings, Jennifer Beecham, Eva‐Maria Bonin, Stephen Scott.
    Journal of Child Psychology and Psychiatry. 10 days ago
    Background Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well‐being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely. Methods We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent‐reported outcomes, including parenting practices, children's mental health, and parental mental health. Results Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self‐efficacy, and stress) did not improve. There was no evidence of harmful effects. Conclusions The Incredible Years parenting program improves the aspects of family well‐being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent‐reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes.
    July 11, 2017   doi: 10.1111/jcpp.12781   open full text
  • Prereader to beginning reader: changes induced by reading acquisition in print and speech brain networks.
    Katarzyna Chyl, Bartosz Kossowski, Agnieszka Dębska, Magdalena Łuniewska, Anna Banaszkiewicz, Agata Żelechowska, Stephen J. Frost, William Einar Mencl, Marek Wypych, Artur Marchewka, Kenneth R. Pugh, Katarzyna Jednoróg.
    Journal of Child Psychology and Psychiatry. 11 days ago
    Background Literacy acquisition is a demanding process that induces significant changes in the brain, especially in the spoken and written language networks. Nevertheless, large‐scale paediatric fMRI studies are still limited. Methods We analyzed fMRI data to show how individual differences in reading performance correlate with brain activation for speech and print in 111 children attending kindergarten or first grade and examined group differences between a matched subset of emergent‐readers and prereaders. Results Across the entire cohort, individual differences analysis revealed that reading skill was positively correlated with the magnitude of activation difference between words and symbol strings in left superior temporal, inferior frontal and fusiform gyri. Group comparisons of the matched subset of pre‐ and emergent‐readers showed higher activity for emergent‐readers in left inferior frontal, precentral, and postcentral gyri. Individual differences in activation for natural versus vocoded speech were also positively correlated with reading skill, primarily in the left temporal cortex. However, in contrast to studies on adult illiterates, group comparisons revealed higher activity in prereaders compared to readers in the frontal lobes. Print‐speech coactivation was observed only in readers and individual differences analyses revealed a positive correlation between convergence and reading skill in the left superior temporal sulcus. Conclusions These results emphasise that a child's brain undergoes several modifications to both visual and oral language systems in the process of learning to read. They also suggest that print‐speech convergence is a hallmark of acquiring literacy.
    July 10, 2017   doi: 10.1111/jcpp.12774   open full text
  • Cannabis use and psychotic‐like experiences trajectories during early adolescence: the coevolution and potential mediators.
    Josiane Bourque, Mohammad H. Afzali, Maeve O'Leary‐Barrett, Patricia Conrod.
    Journal of Child Psychology and Psychiatry. July 05, 2017
    Background The authors sought to model the different trajectories of psychotic‐like experiences (PLE) during adolescence and to examine whether the longitudinal relationship between cannabis use and PLE is mediated by changes in cognitive development and/or change in anxiety or depression symptoms. Methods A total of 2,566 youths were assessed every year for 4‐years (from 13‐ to 16‐years of age) on clinical, substance use and cognitive development outcomes. Latent class growth models identified three trajectories of PLE: low decreasing (83.9%), high decreasing (7.9%), and moderate increasing class (8.2%). We conducted logistic regressions to investigate whether baseline levels and growth in cannabis use were associated with PLE trajectory membership. Then, we examined the effects of potential mediators (growth in cognition and anxiety/depression) on the relationship between growth in cannabis use and PLE trajectory. Results A steeper growth in cannabis use from 13‐ to 16‐years was associated with a higher likelihood of being assigned to the moderate increasing trajectory of PLE [odds ratio, 2.59; 95% confidence interval (CI), 1.11–6.03], when controlling for cumulative cigarette use. Growth in depression symptoms, not anxiety or change in cognitive functioning, mediated the relationship between growth in cannabis use and the PLE moderate increasing group (indirect effect: 0.07; 95% CI, 0.03–0.11). Conclusions Depression symptoms partially mediated the longitudinal link between cannabis use and PLE in adolescents, suggesting that there may be a preventative effect to be gained from targeting depression symptoms, in addition to attempting to prevent cannabis use in youth presenting increasing psychotic experiences.
    July 05, 2017   doi: 10.1111/jcpp.12765   open full text
  • Child‐care quality moderates the association between maternal depression and children's behavioural outcome.
    Justine Charrois, Sylvana M. Côté, Christa Japel, Jean R. Séguin, Stéphane Paquin, Richard E. Tremblay, Catherine M. Herba.
    Journal of Child Psychology and Psychiatry. July 05, 2017
    Background Maternal depression is a risk factor for adverse outcomes in the child, including emotional and behavioural difficulties. There is evidence that child care attendance during the preschool years may moderate associations between familial risk factors and child outcome. However, the possibility that high‐quality child care provides protection for children exposed to maternal depression or that low‐quality child care provides additional risk has not been investigated. We study whether child‐care quality moderates the association between probable history of maternal depression (PMD) and child behavioural and emotional outcomes over the preschool period. Methods Within a longitudinal study, we examined PMD (no depression; clinical PMD before the child's birth; subclinical PMD from 0 to 5 years; clinical PMD from 0 to 5 years), child‐care quality and child emotional and behavioural difficulties at the ages of 2, 3 and 4 years. Child‐care quality was evaluated in settings, and trajectories were calculated to reflect (a) global quality and (b) two quality subfactors: ‘Teaching and interactions’ and ‘Provision for learning’. Data were analysed for 264 families. Results Significant interactions emerged between clinical PMD and global quality of child care for children's externalising behaviour (b = −.185, p = .008), more specifically hyperactivity/inattention (b = −.237, p = .002). In the context of clinical PMD, children attending high‐quality child care presented fewer difficulties than those attending a low‐quality care. Child‐care quality was not associated with outcomes for children whose mothers did not report a PMD or a PMD before their birth. Conclusions In the context of PMD, high‐quality child care was associated with fewer behavioural problems and may thus constitute a protective factor.
    July 05, 2017   doi: 10.1111/jcpp.12764   open full text
  • Implicit identification with death predicts change in suicide ideation during psychiatric treatment in adolescents.
    Catherine R. Glenn, Evan M. Kleiman, Daniel D.L. Coppersmith, Angela C. Santee, Erika C. Esposito, Christine B. Cha, Matthew K. Nock, Randy P. Auerbach.
    Journal of Child Psychology and Psychiatry. July 04, 2017
    Background Suicidal thoughts and behaviors are major public health concerns in youth. Unfortunately, knowledge of reliable predictors of suicide risk in adolescents is limited. Promising research using a death stimuli version of the Implicit Association Test (Death IAT) indicates that stronger identification with death differs between adults with and without a history of suicidal thoughts and behaviors and uniquely predicts suicide ideation and behavior. However, research in adolescents is lacking and existing findings have been mixed. This study extends previous research by testing whether implicit identification with death predicts changes in suicide ideation during psychiatric treatment in adolescents. Methods Participants included 276 adolescents, ages 13–19, admitted to a short‐term residential treatment program. At hospital admission and discharge, adolescents completed the Death IAT and measures of recent suicidal thoughts. Results At admission, implicit identification with death was associated with recent suicide ideation, but did not differ between those who engaged in prior suicidal behavior and those who did not. Prospectively, adolescents' implicit identification with death at admission significantly predicted their suicide ideation severity at discharge, above and beyond explicit suicide ideation. However, this effect only was significant for adolescents with longer treatment stays (i.e., more than 13 days). Conclusions Implicit identification with death predicts suicidal thinking among adolescents in psychiatric treatment. Findings clarify over what period of time implicit cognition about death may predict suicide risk in adolescents.
    July 04, 2017   doi: 10.1111/jcpp.12769   open full text
  • Explaining the relationship between temperament and symptoms of psychiatric disorders from preschool to middle childhood: hybrid fixed and random effects models of Norwegian and Spanish children.
    Lars Wichstrøm, Eva Penelo, Kristine Rensvik Viddal, Nuria Osa, Lourdes Ezpeleta.
    Journal of Child Psychology and Psychiatry. July 03, 2017
    Background Four explanations for the concurrent and prospective associations between temperament and psychopathology in children have been suggested: predisposition, complication/scar, common cause/continuity, and pathoplasty/exacerbation. Because the confounding effects of common causes have not been ruled out in prior work, the support for the various explanations is uncertain. Methods Screen‐stratified community samples of 4‐year olds in Trondheim, Norway (n = 1,042), and 3‐year olds in Barcelona, Spain (n = 622), were assessed biennially for symptoms of attention‐deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct (CD), anxiety, and depressive disorders through interviewer‐based psychiatric interviews across four waves of data collection. The parents completed child temperament ratings. The data were analyzed with random and fixed effects regression adjusted for all time‐invariant unmeasured confounders (e.g., genetics, common methods bias, item overlap). Results In both Norway and Spain and across ages, negative affect predisposed children to symptoms of all disorders except CD, low effortful control predisposed children to ADHD and ODD‐symptoms, and surgency predisposed children to increased ADHD‐symptoms. Complication effects were observed in the Spanish children for ADHD‐symptoms, which increased surgency and diminished effortful control, and for ODD‐symptoms, which decreased surgency. The common cause and pathoplasty/exacerbation explanations were not supported. Conclusions The present results are consistent with the view that temperament plays a causal role in the development of symptoms of psychiatric disorders in children. Because temperament is malleable, interventions targeting the affective, attentional, and behavioral regulatory components of temperament may reduce psychopathology in children.
    July 03, 2017   doi: 10.1111/jcpp.12772   open full text
  • Improving language comprehension in preschool children with language difficulties: a cluster randomized trial.
    Åste M. Hagen, Monica Melby‐Lervåg, Arne Lervåg.
    Journal of Child Psychology and Psychiatry. July 03, 2017
    Background Children with language comprehension difficulties are at risk of educational and social problems, which in turn impede employment prospects in adulthood. However, few randomized trials have examined how such problems can be ameliorated during the preschool years. Methods We conducted a cluster randomized trial in 148 preschool classrooms. Our intervention targeted language comprehension skills and lasted 1 year and 1 month, with five blocks of 6 weeks and intervention three times per week (about 75 min per week). Effects were assessed on a range of measures of language performance. Results Immediately after the intervention, there were moderate effects on both near, intermediate and distal measures of language performance. At delayed follow‐up (7 months after the intervention), these reliable effects remained for the distal measures. Conclusions It is possible to intervene in classroom settings to improve the language comprehension skills of children with language difficulties. However, it appears that such interventions need to be intensive and prolonged.
    July 03, 2017   doi: 10.1111/jcpp.12762   open full text
  • Diffusion tensor imaging studies of attention‐deficit/hyperactivity disorder: meta‐analyses and reflections on head motion.
    Yuta Aoki, Samuele Cortese, Francisco Xavier Castellanos.
    Journal of Child Psychology and Psychiatry. July 03, 2017
    Background Diffusion tensor imaging studies have shown atypical fractional anisotropy (FA) in individuals with attention‐deficit/hyperactivity disorder (ADHD), albeit with conflicting results. We performed meta‐analyses of whole‐brain voxel‐based analyses (WBVBA) and tract‐based spatial statistics (TBSS) studies in ADHD, along with a qualitative review of TBSS studies addressing the issue of head motion, which may bias results. Methods We conducted a systematic literature search (last search on April 1st, 2016) to identify studies comparing FA values between individuals with ADHD and typically developing (TD) participants. Signed differential mapping was used to compute effect sizes and integrate WBVBA and TBSS studies, respectively. TBSS datasets reporting no between‐group motion differences were identified. Results We identified 14 WBVBA (ADHDn = 314, TDn = 278) and 13 TBSS datasets (ADHDn = 557, TDn = 568). WBVBA meta‐analysis showed both significantly lower and higher FA values in individuals with ADHD; TBSS meta‐analysis showed significantly lower FA in ADHD compared with TD in four clusters: two in the corpus callosum (isthmus and posterior midbody), one in right inferior fronto‐occipital fasciculus, and one in left inferior longitudinal fasciculus. However, four of six datasets confirming no group‐differences in motion showed no significant between‐group FA differences. Conclusions A growing diffusion tensor imaging (DTI) literature (total N = 1,717) and a plethora of apparent findings suggest atypical interhemispheric connection in ADHD. However, FA results in ADHD should be considered with caution, since many studies did not examine potential group differences in head motion, and most of the studies reporting no difference in motion showed no significant results. Future studies should address head motion as a priority and assure that groups do not differ in head motion.
    July 03, 2017   doi: 10.1111/jcpp.12778   open full text
  • Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait‐list in pediatric posttraumatic stress disorder following single‐incident trauma: a multicenter randomized clinical trial.
    Carlijn Roos, Saskia Oord, Bonne Zijlstra, Sacha Lucassen, Sean Perrin, Paul Emmelkamp, Ad Jongh.
    Journal of Child Psychology and Psychiatry. June 28, 2017
    Background Practice guidelines for childhood posttraumatic stress disorder (PTSD) recommend trauma‐focused psychotherapies, mainly cognitive behavioral therapy (CBT). Eye movement desensitization and reprocessing (EMDR) therapy is a brief trauma‐focused, evidence‐based treatment for PTSD in adults, but with few well‐designed trials involving children and adolescents. Methods We conducted a single‐blind, randomized trial with three arms (n = 103): EMDR (n = 43), Cognitive Behavior Writing Therapy (CBWT; n = 42), and wait‐list (WL; n = 18). WL participants were randomly reallocated to CBWT or EMDR after 6 weeks; follow‐ups were conducted at 3 and 12 months posttreatment. Participants were treatment‐seeking youth (aged 8–18 years) with a DSM‐IV diagnosis of PTSD (or subthreshold PTSD) tied to a single trauma, who received up to six sessions of EMDR or CBWT lasting maximally 45 min each. Results Both treatments were well‐tolerated and relative to WL yielded large, intent‐to‐treat effect sizes for the primary outcomes at posttreatment: PTSD symptoms (EMDR: d = 1.27; CBWT: d = 1.24). At posttreatment 92.5% of EMDR, and 90.2% of CBWT no longer met the diagnostic criteria for PTSD. All gains were maintained at follow‐up. Compared to WL, small to large (range d = 0.39–1.03) intent‐to‐treat effect sizes were obtained at posttreatment for negative trauma‐related appraisals, anxiety, depression, and behavior problems with these gains being maintained at follow‐up. Gains were attained with significantly less therapist contact time for EMDR than CBWT (mean = 4.1 sessions/140 min vs. 5.4 sessions/227 min). Conclusions EMDR and CBWT are brief, trauma‐focused treatments that yielded equally large remission rates for PTSD and reductions in the severity of PTSD and comorbid difficulties in children and adolescents seeking treatment for PTSD tied to a single event. Further trials of both treatments with PTSD tied to multiple traumas are warranted.
    June 28, 2017   doi: 10.1111/jcpp.12768   open full text
  • Gene‐based interaction analysis shows GABAergic genes interacting with parenting in adolescent depressive symptoms.
    Evelien Van Assche, Tim Moons, Ozan Cinar, Wolfgang Viechtbauer, Albertine J. Oldehinkel, Karla Van Leeuwen, Karine Verschueren, Hilde Colpin, Diether Lambrechts, Wim Van den Noortgate, Luc Goossens, Stephan Claes, Ruud Winkel.
    Journal of Child Psychology and Psychiatry. June 28, 2017
    Background Most gene‐environment interaction studies (G × E) have focused on single candidate genes. This approach is criticized for its expectations of large effect sizes and occurrence of spurious results. We describe an approach that accounts for the polygenic nature of most psychiatric phenotypes and reduces the risk of false‐positive findings. We apply this method focusing on the role of perceived parental support, psychological control, and harsh punishment in depressive symptoms in adolescence. Methods Analyses were conducted on 982 adolescents of Caucasian origin (Mage (SD) = 13.78 (.94) years) genotyped for 4,947 SNPs in 263 genes, selected based on a literature survey. The Leuven Adolescent Perceived Parenting Scale (LAPPS) and the Parental Behavior Scale (PBS) were used to assess perceived parental psychological control, harsh punishment, and support. The Center for Epidemiologic Studies Depression Scale (CES‐D) was the outcome. We used gene‐based testing taking into account linkage disequilibrium to identify genes containing SNPs exhibiting an interaction with environmental factors yielding a p‐value per single gene. Significant results at the corrected p‐value of p < 1.90 × 10−4 were examined in an independent replication sample of Dutch adolescents (N = 1354). Results Two genes showed evidence for interaction with perceived support: GABRR1 (p = 4.62 × 10−5) and GABRR2 (p = 9.05 × 10−6). No genes interacted significantly with psychological control or harsh punishment. Gene‐based analysis was unable to confirm the interaction of GABRR1 or GABRR2 with support in the replication sample. However, for GABRR2, but not GABRR1, the correlation of the estimates between the two datasets was significant (r (46) = .32; p = .027) and a gene‐based analysis of the combined datasets supported GABRR2 × support interaction (p = 1.63 × 10−4). Conclusions We present a gene‐based method for gene–environment interactions in a polygenic context and show that genes interact differently with particular aspects of parenting. This accentuates the importance of polygenic approaches and the need to accurately assess environmental exposure in G × E.
    June 28, 2017   doi: 10.1111/jcpp.12766   open full text
  • Polygenic scores for schizophrenia and educational attainment are associated with behavioural problems in early childhood in the general population.
    Philip R. Jansen, Tinca J.C. Polderman, Koen Bolhuis, Jan Ende, Vincent W.V. Jaddoe, Frank C. Verhulst, Tonya White, Danielle Posthuma, Henning Tiemeier.
    Journal of Child Psychology and Psychiatry. June 19, 2017
    Background Genome‐wide association studies in adults have identified numerous genetic variants related to psychiatric disorders and related traits, such as schizophrenia and educational attainment. However, the effects of these genetic variants on behaviour in the general population remain to be fully understood, particularly in younger populations. We investigated whether polygenic scores of five psychiatric disorders and educational attainment are related to emotional and behaviour problems during early childhood. Methods From the Generation R Study, we included participants with available genotype data and behavioural problems measured with the Child Behavior Checklist (CBCL) at the age of 3 (n = 1,902), 6 (n = 2,202) and 10 years old (n = 1,843). Polygenic scores were calculated for five psychiatric disorders and educational attainment. These polygenic scores were tested for an association with the broadband internalizing and externalizing problem scales and the specific CBCL syndrome scale scores. Results Analysis of the CBCL broadband scales showed that the schizophrenia polygenic score was associated with significantly higher internalizing scores at 3, 6 and 10 years and higher externalizing scores at age 3 and 6. The educational attainment polygenic score was associated with lower externalizing scores at all time points and lower internalizing scores at age 3. No associations were observed for the polygenic scores of bipolar disorder, major depressive disorder and autism spectrum disorder. Secondary analyses of specific syndrome scores showed that the schizophrenia polygenic score was strongly related to the Thought Problems scores. A negative association was observed between the educational attainment polygenic score and Attention Problems scores across all age groups. Conclusions Polygenic scores for adult psychiatric disorders and educational attainment are associated with variation in emotional and behavioural problems already at a very early age.
    June 19, 2017   doi: 10.1111/jcpp.12759   open full text
  • Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single‐trial design.
    Lotte Hendriks, Rianne A. Kleine, Mieke Heyvaert, Eni S. Becker, Gert‐Jan Hendriks, Agnes Minnen.
    Journal of Child Psychology and Psychiatry. June 14, 2017
    Background The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma. Methods Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90‐min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90‐min booster sessions. In a single‐trial design, the participants were randomly allocated to one of five baseline lengths (4–8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self‐reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician‐administered PTSD diagnostic status and symptom severity (primary outcome), as well as self‐reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline‐to‐6‐month follow‐up). Results Time‐series analyses showed that self‐reported PTSD symptom severity significantly declined following treatment (p = .002). Pre‐postgroup analyses demonstrated significant reductions of clinician‐administered PTSD symptom severity and self‐reported comorbidity that persisted during the 3‐ and 6‐month follow‐ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events. Conclusions The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial.
    June 14, 2017   doi: 10.1111/jcpp.12756   open full text
  • Female‐specific association of NOS1 genotype with white matter microstructure in ADHD patients and controls.
    Hanneke Ewijk, Janita Bralten, Esther D.A. Duin, Marina Hakobjan, Jan K. Buitelaar, Dirk J. Heslenfeld, Pieter J. Hoekstra, Catharina Hartman, Martine Hoogman, Jaap Oosterlaan, Barbara Franke.
    Journal of Child Psychology and Psychiatry. June 07, 2017
    Background The nitric oxide synthase gene (NOS1) exon 1f (ex1f) VNTR is a known genetic risk factor for Attention‐Deficit/Hyperactivity Disorder (ADHD), particularly in females. NOS1 plays an important role in neurite outgrowth and may thus influence brain development, specifically white matter (WM) microstructure, which is known to be altered in ADHD. The current study aimed to investigate whether NOS1 is associated with WM microstructure in (female) individuals with and without ADHD. Methods Diffusion Tensor Imaging (DTI) scans were collected from 187 participants with ADHD (33% female) and 103 controls (50% female), aged 8–26 years, and NOS1‐ex1f VNTR genotype was determined. Whole‐brain analyses were conducted for fractional anisotropy (FA) and mean diffusivity (MD) to examine associations between NOS1 and WM microstructure, including possible interactions with gender and diagnosis. Results Consistent with previous literature, NOS1‐ex1f was associated with total ADHD and hyperactivity‐impulsivity symptoms, but not inattention; this effect was independent of gender. NOS1‐ex1f was also associated with MD values in several major WM tracts in females, but not males. In females, homozygosity for the short allele was linked to higher MD values than carriership of the long allele. MD values in these regions did not correlate with ADHD symptoms. Results were similar for participants with and without ADHD. Conclusions NOS1‐ex1f VNTR is associated with WM microstructure in females in a large sample of participants with ADHD and healthy controls. Whether this association is part of a neurodevelopmental pathway from NOS1 to ADHD symptoms should be further investigated in future studies.
    June 07, 2017   doi: 10.1111/jcpp.12742   open full text
  • Sex differences in the associations between vagal reactivity and oppositional defiant disorder symptoms.
    Pablo Vidal‐Ribas, Andrew Pickles, Florin Tibu, Helen Sharp, Jonathan Hill.
    Journal of Child Psychology and Psychiatry. June 02, 2017
    Background Vagal reactivity to stress in children has been associated with future psychiatric outcomes. However, results have been mixed possibly because these effects are in opposite direction in boys and girls. These sex differences are relevant in the context of development of psychopathology, whereby the rates of psychiatric disorders differ by sex. In this study, we aimed to examine the association between vagal reactivity, assessed as a reduction in respiratory sinus arrhythmia (RSA) in response to a challenge, and the development of future oppositional defiant disorder (ODD) symptoms in boys and girls. In addition, we examine the specific associations with ODD symptom dimensions, named irritability and headstrong. We hypothesized that increased vagal reactivity was associated with increased ODD symptoms in girls and a reduction in ODD symptoms in boys. Methods Participants were members of the Wirral Child Health and Development Study, a prospective epidemiological longitudinal study of 1,233 first‐time mothers recruited at 20 weeks’ gestation. RSA during four nonstressful and one stressful (still‐face) procedures was assessed when children were aged 29 weeks in a sample stratified by adversity (n = 270). Maternal reports of ODD symptoms were collected when children were 2.5 years old (n = 253), 3.5 years old (n = 826), and 5 years old (n = 770). Structural equation modeling (SEM) was employed to test our hypotheses. Results There was a significant sex difference in the prediction of ODD symptoms due to the opposite directionality in which increasing vagal reactivity was associated with an increase in ODD symptoms in girls and a reduction of ODD symptoms in boys. This Sex by Vagal reactivity interaction was common for both ODD dimensions, with no sex by dimension‐specific associations. Conclusions Physiological reactivity to a stressful situation predicts differently ODD symptoms in boys and girls very early in life, with no difference across irritability and headstrong components. Findings are discussed in the context of the several mechanisms involved on the later development of distinct psychiatric disorders in boys and girls.
    June 02, 2017   doi: 10.1111/jcpp.12750   open full text
  • MEMO: an mHealth intervention to prevent the onset of depression in adolescents: a double‐blind, randomised, placebo‐controlled trial.
    Robyn Whittaker, Karolina Stasiak, Heather McDowell, Iain Doherty, Matthew Shepherd, Shireen Chua, Enid Dorey, Varsha Parag, Shanthi Ameratunga, Anthony Rodgers, Sally Merry.
    Journal of Child Psychology and Psychiatry. June 02, 2017
    Background Depression often starts in adolescence making it an ideal time to intervene. We developed a universal cognitive behavioural therapy‐based programme (MEMO CBT) to be delivered via multimedia mobile phone messages for teens. Methods We conducted a prospective multicentre, randomised, placebo‐controlled superiority trial in 15 high schools in Auckland, New Zealand, comparing MEMO CBT with a control programme [MEMO control] matched for intensity and type of message but with alternative content not targeting depression. The primary outcome was the change in score on the Children's Depression Rating Scale‐Revised from baseline to 12 months. Secondary outcomes included the change in scores in the self‐reported Reynold's Adolescent Depression Rating Scale‐Second Edition, the Moods and Feelings Questionnaire, suicidal ideation using selected items from the Youth Risk Behaviour Survey, the Pediatric Quality of Life questionnaire, 12‐month period prevalence of the diagnosis of depressive disorder using the Kiddie‐Schedule for Affective Disorders and Schizophrenia, and students' ratings of their satisfaction with the programme. Results Eight hundred and fifty‐five students (13–17 years old, mean 14.3 years) were randomly assigned to MEMO CBT (426) or to MEMO Control (429). Participants (68% female) had a mean CDRS‐R at baseline of 21.5 (SD: 5). Overall 394 (93%) from the intervention group and 392 (91%) from the control group were followed up at 12 months. At the end of the intervention (approximately 9 weeks) the mean CDRS‐R scores were 20.8 in the intervention group versus 20.4 in the control group, and at 12 months they were 22.4 versus 22.4 (p value for difference in change from baseline = 0.3). There was no obvious association between the amount of the intervention viewed by participants and outcomes. Conclusions There was no evidence of benefit from the mobile phone CBT intervention compared with a control programme. Universal depression prevention remains a challenge.
    June 02, 2017   doi: 10.1111/jcpp.12753   open full text
  • Anxiety disorders, gender nonconformity, bullying and self‐esteem in sexual minority adolescents: prospective birth cohort study.
    Abbeygail Jones, Emily Robinson, Olakunle Oginni, Qazi Rahman, Katharine A. Rimes.
    Journal of Child Psychology and Psychiatry. June 01, 2017
    Background Sexual minority adolescents (i.e. youth not exclusively heterosexual) report more anxiety than heterosexual youth on symptom questionnaires but no research has used standardised diagnostic tools to investigate anxiety disorder risk. This study uses a UK birth cohort to investigate the risk of anxiety disorders in sexual minority and heterosexual youth using a computerised structured clinical interview and explores the influence of gender nonconformity, bullying and self‐esteem. Methods Participants were 4,564 adolescents (2,567 girls and 1,996 boys) from the Avon Longitudinal Study of Parents and Children (ALSPAC). Logistic regression analyses were performed to investigate the association between sexual orientation at 15.5 years and the presence of an anxiety disorder at 17.5 years. Covariates including maternal occupation, ethnicity, mother‐reported childhood gender nonconformity at 30, 42 and 57 months, child‐reported gender nonconformity at 8 years, child‐reported bullying between 12 and 16 years and self‐esteem at 17.5 years were added sequentially to regression models. Results Sexual minority adolescents (i.e. those not exclusively heterosexual) had higher early childhood gender nonconformity (CGN), lower self‐esteem and reported more bullying than adolescents identifying as 100% heterosexual. Minority sexual orientation at 15.5 years was associated with increased risk of an anxiety disorder at 17.5 years for girls (OR 2.55, CI 1.85–3.52) and boys (OR 2.48, CI 1.40–4.39). Adjusting for ethnicity, maternal occupation, mother‐reported and child‐reported CGN had minimal impact on this association. Adjusting for bullying between 12 and 16 years and self‐esteem at 17.5 years reduced the strength of the associations, although the overall association remained significant for both sexes (girls OR 2.14 and boys OR 1.93). Conclusions Sexual minority youth are at increased risk of anxiety disorders relative to heterosexual youth at 17.5 years. Bullying between 12–16 years and lower self‐esteem may contribute to this risk.
    June 01, 2017   doi: 10.1111/jcpp.12757   open full text
  • A randomised controlled trial of an iPad‐based application to complement early behavioural intervention in Autism Spectrum Disorder.
    Andrew J.O. Whitehouse, Joanna Granich, Gail Alvares, Margherita Busacca, Matthew N. Cooper, Alena Dass, Thi Duong, Rajes Harper, Wendy Marshall, Amanda Richdale, Tania Rodwell, David Trembath, Pratibha Vellanki, Dennis W. Moore, Angelika Anderson.
    Journal of Child Psychology and Psychiatry. May 25, 2017
    Background Technology‐based interventions for Autism Spectrum Disorder (ASD) have proliferated, but few have been evaluated within the context of a randomised controlled trial (RCT). This RCT evaluated the efficacy of one technology‐based early intervention programme (Therapy Outcomes By You; TOBY) in young children with ASD. Methods TOBY is an app‐based learning curriculum designed for children and parents as a complement to early behavioural intervention. Eighty children (16 female) were recruited to this RCT within 12 months of receiving a diagnosis of ASD (M age = 3.38; SD = 0.69) and randomised to receive either treatment‐as‐usual (community‐based intervention, n = 39) or the TOBY therapy (at least 20 min/day) plus treatment‐as‐usual (n = 41) for a period of 6 months. Outcomes were assessed at 3 and 6 months postbaseline. (Australian New Zealand Clinical Trials Registry: ACTRN12614000738628; Results Children in the TOBY intervention group averaged 19 min/day engaging with the app in the first 3 months, but only 2 min/day during the second 3 months. There was no group difference in scores on the primary outcome, the Autism Treatment Evaluation Checklist, at either the 3‐ or 6‐month follow‐up. However, significant improvements at the 6‐month follow‐up were observed in the TOBY intervention group relative to the treatment‐as‐usual group on three secondary outcomes: the Fine Motor and Visual Reception subscales of the Mullen Scale of Early Learning and the Total Words Understood scale of the MacArthur‐Bates Communicative Development Index. Statistical trends towards improvement in the TOBY intervention group were observed on measures of adaptive function, although these decreased in magnitude from the 3‐ to 6‐month follow‐up. Conclusions This study provides evidence that technology‐based interventions may provide a relatively low‐cost addition to existing therapist‐delivered interventions for children with ASD. However, sustained use of the app over the full 6‐month period was a challenge for most families.
    May 25, 2017   doi: 10.1111/jcpp.12752   open full text
  • Research Review: What do we know about psychopathic traits in children?
    Randall T. Salekin.
    Journal of Child Psychology and Psychiatry. May 24, 2017
    Background Research on the topic of child psychopathy has advanced over the past decade increasing what we know. Method This qualitative review examines the research base for child psychopathy and emphasizes its three dimensions: grandiose‐manipulative, callous‐unemotional, and daring‐impulsive. Literature is reviewed addressing the cognitive, emotional, motivational, personality, parenting, and biological correlates. Results Support has emerged for the phenotypic construct of child psychopathy, while questions remain regarding definitional issues and key external correlates (e.g., reward and punishment processing, parenting, molecular genetics, brain imaging). Conclusions While the construct appears to be valid, future work should broaden its focus from callous unemotional traits to all three dimensions of the construct, enhance measurement precision, and examine dimension interactions. Such research could have important implications for CD specification for future versions of the DSM and ICD and speed etiological knowledge and clinical care for youth with conduct problems.
    May 24, 2017   doi: 10.1111/jcpp.12738   open full text
  • Homotypic and heterotypic continuity of symptoms of psychiatric disorders from age 4 to 10 years: a dynamic panel model.
    Lars Wichstrøm, Jay Belsky, Silje Steinsbekk.
    Journal of Child Psychology and Psychiatry. May 23, 2017
    Background Childhood psychiatric disorders and their symptoms evince both within‐disorder (homotypic) and between‐disorder (heterotypic) continuities. These continuities may be due to earlier symptoms causing later symptoms or, alternatively, that the same (unknown) causes (e.g., genetics) are operating across time. Applying a novel data analytic approach, we disentangle these two explanations. Methods Participants in a Norwegian community study were assessed biennially from 4 to 10 years of age with clinical interviews (n = 1,042). Prospective reciprocal relations between symptoms of disorders were analyzed with a dynamic panel model within a structural equation framework, adjusting for all unmeasured time‐invariant confounders and time‐varying negative life‐events. Results Homotypic continuities in symptoms characterized all disorders; strongest for attention‐deficit/hyperactivity disorder (ADHD) (r = .32–.62), moderate for behavioral disorders (r = .31–.48) and for anxiety and depression (r = .15–.40), and stronger between 8 and 10 than between 4 and 6 years. Heterotypic continuity also characterized all disorders. A dynamic panel model showed that most continuities were due to unmeasured time‐invariant factors rather than effects of earlier symptoms on later symptoms, although symptoms of behavioral disorders, which evinced two‐year homotypic continuity (B = .14, 95% CI: .04, .25), did influence later symptoms of ADHD (B = .13, CI: .03, .23), and earlier ADHD symptoms influenced later anxiety disorder symptoms (B = .07, CI: .01, .12). Conclusions Homotypic and heterotypic continuities of symptoms of childhood psychiatric disorders are mostly due to unobserved time‐invariant factors. Nonetheless, symptoms of earlier behavioral disorders may affect later symptoms of such disorders and of ADHD, and ADHD may increase the risk of later anxiety. Thus, even if interventions do not alter basic etiological factors, symptom reduction may itself cause later symptom reduction.
    May 23, 2017   doi: 10.1111/jcpp.12754   open full text
  • Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.
    Elizabeth L. Prado, Souheila Abbeddou, Seth Adu‐Afarwuah, Mary Arimond, Per Ashorn, Ulla Ashorn, Jaden Bendabenda, Kenneth H. Brown, Sonja Y. Hess, Emma Kortekangas, Anna Lartey, Kenneth Maleta, Brietta M. Oaks, Eugenia Ocansey, Harriet Okronipa, Jean Bosco Ouédraogo, Anna Pulakka, Jérôme W. Somé, Christine P. Stewart, Robert C. Stewart, Stephen A. Vosti, Elizabeth Yakes Jimenez, Kathryn G. Dewey.
    Journal of Child Psychology and Psychiatry. May 23, 2017
    Background Previous reviews have identified 44 risk factors for poor early child development (ECD) in low‐ and middle‐income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD. Methods We conducted path analyses of factors associated with 18‐month language and motor development in four prospective cohorts of children who participated in trials conducted as part of the International Lipid‐Based Nutrient Supplements (iLiNS) Project in Ghana (n = 1,023), Malawi (n = 675 and 1,385), and Burkina Faso (n = 1,122). In two cohorts, women were enrolled during pregnancy. In two cohorts, infants were enrolled at 6 or 9 months. In multiple linear regression and structural equation models (SEM), we examined 22 out of 44 factors identified in previous reviews, plus 12 additional factors expected to be associated with ECD. Results Out of 42 indicators of the 34 factors examined, 6 were associated with 18‐month language and/or motor development in 3 or 4 cohorts: child linear and ponderal growth, variety of play materials, activities with caregivers, dietary diversity, and child hemoglobin/iron status. Factors that were not associated with child development were indicators of maternal Hb/iron status, maternal illness and inflammation during pregnancy, maternal perceived stress and depression, exclusive breastfeeding during 6 months postpartum, and child diarrhea, fever, malaria, and acute respiratory infections. Associations between socioeconomic status and language development were consistently mediated to a greater extent by caregiving practices than by maternal or child biomedical conditions, while this pattern for motor development was not consistent across cohorts. Conclusions Key elements of interventions to ensure quality ECD are likely to be promotion of caregiver activities with children, a variety of play materials, and a diverse diet, and prevention of faltering in linear and ponderal growth and improvement in child hemoglobin/iron status.
    May 23, 2017   doi: 10.1111/jcpp.12751   open full text
  • The efficacy of early language intervention in mainstream school settings: a randomized controlled trial.
    Silke Fricke, Kelly Burgoyne, Claudine Bowyer‐Crane, Maria Kyriacou, Alexandra Zosimidou, Liam Maxwell, Arne Lervåg, Margaret J. Snowling, Charles Hulme.
    Journal of Child Psychology and Psychiatry. May 19, 2017
    Background Oral language skills are a critical foundation for literacy and more generally for educational success. The current study shows that oral language skills can be improved by providing suitable additional help to children with language difficulties in the early stages of formal education. Methods We conducted a randomized controlled trial with 394 children in England, comparing a 30‐week oral language intervention programme starting in nursery (N = 132) with a 20‐week version of the same programme starting in Reception (N = 133). The intervention groups were compared to an untreated waiting control group (N = 129). The programmes were delivered by trained teaching assistants (TAs) working in the children's schools/nurseries. All testers were blind to group allocation. Results Both the 20‐ and 30‐week programmes produced improvements on primary outcome measures of oral language skill compared to the untreated control group. Effect sizes were small to moderate (20‐week programme: d = .21; 30‐week programme: d = .30) immediately following the intervention and were maintained at follow‐up 6 months later. The difference in improvement between the 20‐week and 30‐week programmes was not statistically significant. Neither programme produced statistically significant improvements in children's early word reading or reading comprehension skills (secondary outcome measures). Conclusions This study provides further evidence that oral language interventions can be delivered successfully by trained TAs to children with oral language difficulties in nursery and Reception classes. The methods evaluated have potentially important policy implications for early education.
    May 19, 2017   doi: 10.1111/jcpp.12737   open full text
  • The etiology of autistic traits in preschoolers: a population‐based twin study.
    Eveline L. Zeeuw, Catharina E.M. Beijsterveldt, Rosa A. Hoekstra, Meike Bartels, Dorret I. Boomsma.
    Journal of Child Psychology and Psychiatry. May 19, 2017
    Background Autism Spectrum Disorders (ASD) are highly heritable, but the exact etiological mechanisms underlying the condition are still unclear. Methods Using a multiple rater twin design in a large sample of general population preschool twins, this study aimed to (a) estimate the contribution of genetic and environmental factors to autistic traits, controlling for the possible effects of rater bias, (b) to explore possible sex differences in etiology and (c) to investigate the discordance in autistic traits in monozygotic and same‐sex dizygotic twin pairs. The Netherlands Twin Register collected maternal and paternal ratings on autistic traits from a general population of 38,798 three‐year‐old twins. Autistic traits were assessed with the DSM‐oriented Pervasive Developmental Problems scale of the Child Behavior Check List for preschoolers (1½–5 years). Results Mother and fathers showed high agreement in their assessment of autistic traits (r = .60–.66). Differences between children in autistic traits were largely accounted for by genetic effects (boys: 78% and girls: 83%). Environmental effects that are unique to a child also played a modest role. Environmental effects shared by children growing up in the same family were negligible, once rater bias was controlled for. While the prevalence for clinical ASD is higher in boys than in girls, this study did not find evidence for striking differences in the etiology of autistic traits across the sexes. Even though the heritability was high, 29% of MZ twin pairs were discordant for high autistic traits (clinical range vs. normal development), suggesting that despite high genetic risk, environmental factors might lead to resilience, unaffected status in the context of genetic risk, in some children. Conclusions It is important to focus future research on risk factors that might interplay with a genetic disposition for ASD, but also on protective factors that make a difference in the lives of children at genetic risk.
    May 19, 2017   doi: 10.1111/jcpp.12741   open full text
  • Psychometric characteristics of the mental health crisis assessment scale in youth with autism spectrum disorder.
    Luther G. Kalb, Louis P. Hagopian, Alden L. Gross, Roma A. Vasa.
    Journal of Child Psychology and Psychiatry. May 19, 2017
    Background Youth with autism spectrum disorder (ASD) exhibit high rates of psychopathology. These symptoms can pose a risk of injury to self or others when the child is in crisis. Despite this danger, there are no instruments available to identify those with ASD who are at risk or actively in crisis. This study examined the psychometric properties of the Mental Health Crisis Assessment Scale (MCAS), a 28 item parent report measure. Methods The MCAS was administered to the parents of 606 children and young adults (aged 3–25 years, M age = 13 years, SD = 5 years) enrolled in the Interactive Autism Network, an online registry of families raising a child with ASD. The MCAS asks parents to rate the severity of various emotional and behavioral symptoms exhibited by their child. The parent then selects the behavior they perceive as the most dangerous behavior and rates the acuity of as well as their efficacy in managing this behavior. The MCAS was tested for internal consistency, construct validity, criterion validity, and convergent validity. Results The MCAS demonstrated strong internal consistency (Total Scale Cronbach's α = .88). The exploratory and confirmatory factor analyses suggested that a two factor (acuity and behavioral efficacy) model fit the data well, providing evidence of construct validity. Criterion validity, which was assessed by comparing the MCAS to clinician determination of crisis, indicated high levels of agreement (ROC = .85). Strong positive relationships emerged between the MCAS and measures of family distress (r = .56), parental stress, and frustration (r = .48), and use of emergency psychiatric services (OR = 24.2, 95% CI: 8.6–68.2), indicating convergent validity of the measure (all p < .05). Conclusions Results of the psychometric analyses suggest the MCAS appears to be a promising tool that can measure mental health crises in youth with ASD.
    May 19, 2017   doi: 10.1111/jcpp.12748   open full text
  • Web‐based integrated bipolar parenting intervention for parents with bipolar disorder: a randomised controlled pilot trial.
    Steven H. Jones, Jelena Jovanoska, Rachel Calam, Laura D. Wainwright, Helen Vincent, Ozgur Asar, Peter J. Diggle, Rob Parker, Rita Long, Matthew Sanders, Fiona Lobban.
    Journal of Child Psychology and Psychiatry. May 16, 2017
    Background People with bipolar disorder (BD) experience additional parenting challenges associated with mood driven fluctuations in communication, impulse control and motivation. This paper describes a novel web‐based self‐management approach (Integrated Bipolar Parenting Intervention; IBPI) to support parents with BD. Method Parents with BD with children aged 3–10 years randomised to IBPI plus treatment as usual (TAU) or waitlist control (WL). IBPI offered 16 weeks access to interactive self‐management information concerning BD and parenting issues. Feasibility was through recruitment, retention and web usage. Clinical outcomes were assessed at baseline, 16, 24, 36 and 48 weeks. Trial Registration Number: ISRCTN75279027. Results Ninety seven participants were recruited with 98% retention to end of intervention and 90% to final follow‐up (56%–94% data analysed of retained participants; higher rates for observer measures). 77% of IBPI participants accessed the website (53% accessed parenting modules). Child behaviour, parenting sense of competence and parenting stress improved significantly in IBPI compared to WL to end of intervention, sustained to 48 weeks. Impacts of IBPI on family functioning, parent mood and time to mood relapse were not significant. Conclusions Online self‐management support for parents with BD is feasible, with promising improvements in parenting and child behaviour outcomes. A definitive clinical and cost‐effectiveness trial is required to confirm and extend these findings.
    May 16, 2017   doi: 10.1111/jcpp.12745   open full text
  • Family‐based promotion of mental health in children affected by HIV: a pilot randomized controlled trial.
    Theresa S. Betancourt, Lauren C. Ng, Catherine M. Kirk, Robert T. Brennan, William R. Beardslee, Sara Stulac, Christine Mushashi, Estella Nduwimana, Sylvere Mukunzi, Beatha Nyirandagijimana, Godfrey Kalisa, Cyamatare F. Rwabukwisi, Vincent Sezibera.
    Journal of Child Psychology and Psychiatry. May 15, 2017
    Background Children affected by HIV are at risk for poor mental health. We conducted a pilot randomized controlled trial (RCT) of the Family Strengthening Intervention (FSI‐HIV), a family home‐visiting intervention to promote mental health and improve parent–child relationships in families with caregivers living with HIV, hypothesizing that child and family outcomes would be superior to usual care social work services. Methods Eighty two families (N = 170 children, 48.24% female; N = 123 caregivers, 68.29% female) with at least one HIV‐positive caregiver (n = 103, 83.74%) and school‐aged child (ages 7–17) (HIV+ n = 21, 12.35%) were randomized to receive FSI‐HIV or treatment‐as‐usual (TAU). Local research assistants blind to treatment conducted assessments of child mental health, parenting practices, and family functioning at baseline, post‐intervention, and 3‐month follow‐up. Multilevel modeling assessed effects of FSI‐HIV on outcomes across three time points. Trial Registration: NCT01509573, ‘Pilot Feasibility Trial of the Family Strengthening Intervention in Rwanda (FSI‐HIV‐R).';NCT01509573?term=Pilot+Feasibility+Trial+of+the+Family+Strengthening+Intervention+in+Rwanda+%28FSI‐HIV‐R%29&rank=1. Results At 3‐month follow‐up, children in FSI‐HIV showed fewer symptoms of depression compared to TAU by both self‐report (β = −.246; p = .009) and parent report (β = −.174; p = .035) but there were no significant differences by group on conduct problems, functional impairment, family connectedness, or parenting. Conclusions Family‐based prevention has promise for reducing depression symptoms in children affected by HIV. Future trials should examine the effects of FSI‐HIV over time in trials powered to examine treatment mediators.
    May 15, 2017   doi: 10.1111/jcpp.12729   open full text
  • Brainstem as a developmental gateway to social attention.
    Ronny Geva, Ayelet Dital, Dan Ramon, Jessica Yarmolovsky, Maor Gidron, Jacob Kuint.
    Journal of Child Psychology and Psychiatry. May 15, 2017
    Background Evolution preserves social attention due to its key role in supporting survival. Humans are attracted to social cues from infancy, but the neurobiological mechanisms for the development of social attention are unknown. An evolutionary‐based, vertical‐hierarchical theoretical model of self‐regulation suggests that neonatal brainstem inputs are key for the development of well‐regulated social attention. Methods Neonates born preterm (N = 44, GA 34 w.) were recruited and diagnosed at birth as a function of their auditory brainstem evoked responses (ABR). Participants enrolled in a prospective 8‐year‐long, double‐blind, follow‐up study comparing participants with brainstem dysfunctions and well‐matched controls. Groups had comparable fetal, neonatal, and familial characteristics. Methods incorporated EEG power analysis and gaze tracking during the Attention Network Test (ANT, four cue types, and two targets) and a Triadic Gaze Engagement task (TGE, three social cue levels). Results Results showed that neonatal brainstem compromise is related to long‐term changes in Alpha‐ and Theta‐band power asymmetries (p < .034, p < .016, respectively), suggesting suppressed bottom‐up input needed to alert social attention. Gaze tracking indicated dysregulated arousal‐modulated attention (p < .004) and difficulty in gaze engagement to socially neutral compared to nonsocial cues (p < .012). Conclusions Integrating models of Autism and cross‐species data with current long‐term follow‐up of infants with discrete neonatal brainstem dysfunction suggests neonatal brainstem input as a gateway for bottom‐up regulation of social attention.
    May 15, 2017   doi: 10.1111/jcpp.12746   open full text
  • Randomized controlled trial of Functional Family Therapy for offending and antisocial behavior in UK youth.
    Sajid Humayun, Lauren Herlitz, Melanie Chesnokov, Moira Doolan, Sabine Landau, Stephen Scott.
    Journal of Child Psychology and Psychiatry. May 15, 2017
    Background Youth offending and antisocial behavior (ASB) are associated with low quality mental health and relationships and usually lead to poor adult functioning; they are very costly for society. Family interventions are effective in children but there are few reliably effective and inexpensive interventions for adolescents. Functional Family Therapy (FFT) is an evidence‐based intervention but seldom tested outside the United States. Methods One hundred and eleven adolescents (10–17 years of age, M = 15.0, SD = 1.63) and their families were randomized to FFT + Management As Usual (MAU) (n = 65) or to MAU (n = 46). Assessments were made at baseline 6, and 18 months after randomization and included interviews and questionnaires of parenting behaviors, conduct disorders (CDs) and offending. Parent–child interaction was directly observed and police records obtained. Trial registration: ISRCTN27650478. Results Eighty‐nine (80%) were followed‐up. In both groups, there were large reductions over time in all measures of offending and antisocial behavior (e.g. primary outcome p < 0.001), but no significant changes over time in parenting behavior or the parent–child relationship. However, there were no differences between intervention and control groups at 6 or 18 months on self‐reported delinquency, police records of offending, symptoms or diagnoses of CDs, parental monitoring or supervision, directly observed child negative behavior, or parental positive or negative behavior. Against predictions, the intervention group showed lower levels of directly observed child positive behavior at 18 months compared to controls. Conclusions In contrast to most previous trials of FFT, FFT+MAU did not lead to greater reductions in youth ASB and offending compared to MAU alone, and did not lead to improvements in parenting or the parent–child relationship. This may be because the trial was more rigorously conducted than prior studies; equally, the possibility that MAU was effective requires further research.
    May 15, 2017   doi: 10.1111/jcpp.12743   open full text
  • Longitudinal epigenetic predictors of amygdala:hippocampus volume ratio.
    Esther Walton, Charlotte A.M. Cecil, Matthew Suderman, Jingyu Liu, Jessica A. Turner, Vince Calhoun, Stefan Ehrlich, Caroline L. Relton, Edward D. Barker.
    Journal of Child Psychology and Psychiatry. May 08, 2017
    Background The ratio between amygdala:hippocampal (AH) volume has been associated with multiple psychiatric problems, including anxiety and aggression. Yet, little is known about its biological underpinnings. Here, we used a methylome‐wide approach to test (a) whether DNA methylation in early life (birth, age 7) prospectively associates with total AH volume ratio in early adulthood, and (b) whether significant DNA methylation markers are influenced by prenatal risk factors. Methods Analyses were based on a subsample (n = 109 males) from the Avon Longitudinal Study of Parents and Children, which included measures of prenatal risk, DNA methylation (Infinium Illumina 450k), T1‐weighted brain scans and psychopathology in early adulthood (age 18–21). Amygdala and hippocampus measures were derived using Freesurfer 5.3.0. Methylation markers related to AH volume ratio across time were identified using longitudinal multilevel modeling. Results Amygdala:hippocampal volume ratio correlated positively with age 18 psychosis‐like symptoms (p = .007). Methylation of a probe in the gene SP6 associated longitudinally with (a) higher AH volume ratio (FDR q‐value = .01) and (b) higher stressful life events during pregnancy (p = .046). SP6 is expressed in the hippocampus and amygdala and has been implicated in cognitive decline in Alzheimer's disease. The association between SP6 DNA methylation, AH volume ratio and psychopathology was replicated in an independent dataset of 101 patients with schizophrenia and 111 healthy controls. Conclusions Our findings suggest that epigenetic alterations in genes implicated in neurodevelopment may contribute to a brain‐based biomarker of psychopathology.
    May 08, 2017   doi: 10.1111/jcpp.12740   open full text
  • Development and validation of an item response theory‐based Social Responsiveness Scale short form.
    Alexandra Sturm, Megan Kuhfeld, Connie Kasari, James T. McCracken.
    Journal of Child Psychology and Psychiatry. May 02, 2017
    Background Research and practice in autism spectrum disorder (ASD) rely on quantitative measures, such as the Social Responsiveness Scale (SRS), for characterization and diagnosis. Like many ASD diagnostic measures, SRS scores are influenced by factors unrelated to ASD core features. This study further interrogates the psychometric properties of the SRS using item response theory (IRT), and demonstrates a strategy to create a psychometrically sound short form by applying IRT results. Methods Social Responsiveness Scale analyses were conducted on a large sample (N = 21,426) of youth from four ASD databases. Items were subjected to item factor analyses and evaluation of item bias by gender, age, expressive language level, behavior problems, and nonverbal IQ. Results Item selection based on item psychometric properties, DIF analyses, and substantive validity produced a reduced item SRS short form that was unidimensional in structure, highly reliable (α = .96), and free of gender, age, expressive language, behavior problems, and nonverbal IQ influence. The short form also showed strong relationships with established measures of autism symptom severity (ADOS, ADI‐R, Vineland). Degree of association between all measures varied as a function of expressive language. Conclusions Results identified specific SRS items that are more vulnerable to non‐ASD‐related traits. The resultant 16‐item SRS short form may possess superior psychometric properties compared to the original scale and emerge as a more precise measure of ASD core symptom severity, facilitating research and practice. Future research using IRT is needed to further refine existing measures of autism symptomatology.
    May 02, 2017   doi: 10.1111/jcpp.12731   open full text
  • Increased pupil dilation to angry faces predicts interpersonal stress generation in offspring of depressed mothers.
    Cope Feurer, Katie L. Burkhouse, Greg Siegle, Brandon E. Gibb.
    Journal of Child Psychology and Psychiatry. May 02, 2017
    Background Interpersonal stress generation is one mechanism hypothesized to increase risk for the intergenerational transmission of depression. Although there is some evidence of stress generation in offspring of depressed mothers, specific predictors of stress generation in these youth remain unknown. The goal of this study was to examine a peripheral measure of cognitive‐affective reactivity (i.e. pupil dilation) to emotional interpersonal stimuli as a predictor of stress generation in offspring of depressed mothers. Method The study included 129 mothers and their offspring (ages 8–15) recruited from the community who participated at two time points separated by 6 months. Youth's average pupil dilation to emotional faces (angry, happy, sad) as well as maternal lifetime history of major depressive disorder were assessed at baseline. In addition, both time points included assessments of youth's levels of self‐generated (dependent) and independent episodic life stress in the preceding 6 months. Results Youth's pupil dilation to angry, but not sad or happy, faces predicted prospective increases in dependent interpersonal stress across the follow‐up. This effect was only observed in offspring of depressed mothers and was not seen in offspring of never‐depressed mothers. Conclusions This study highlights a potential risk factor (heightened reactivity to facial displays of anger) that may identify which offspring of depressed mothers are at greatest risk for interpersonal stress generation.
    May 02, 2017   doi: 10.1111/jcpp.12739   open full text
  • Statistical word learning in children with autism spectrum disorder and specific language impairment.
    Eileen Haebig, Jenny R. Saffran, Susan Ellis Weismer.
    Journal of Child Psychology and Psychiatry. May 02, 2017
    Background Word learning is an important component of language development that influences child outcomes across multiple domains. Despite the importance of word knowledge, word‐learning mechanisms are poorly understood in children with specific language impairment (SLI) and children with autism spectrum disorder (ASD). This study examined underlying mechanisms of word learning, specifically, statistical learning and fast‐mapping, in school‐aged children with typical and atypical development. Methods Statistical learning was assessed through a word segmentation task and fast‐mapping was examined in an object‐label association task. We also examined children's ability to map meaning onto newly segmented words in a third task that combined exposure to an artificial language and a fast‐mapping task. Results Children with SLI had poorer performance on the word segmentation and fast‐mapping tasks relative to the typically developing and ASD groups, who did not differ from one another. However, when children with SLI were exposed to an artificial language with phonemes used in the subsequent fast‐mapping task, they successfully learned more words than in the isolated fast‐mapping task. There was some evidence that word segmentation abilities are associated with word learning in school‐aged children with typical development and ASD, but not SLI. Follow‐up analyses also examined performance in children with ASD who did and did not have a language impairment. Children with ASD with language impairment evidenced intact statistical learning abilities, but subtle weaknesses in fast‐mapping abilities. Conclusions As the Procedural Deficit Hypothesis (PDH) predicts, children with SLI have impairments in statistical learning. However, children with SLI also have impairments in fast‐mapping. Nonetheless, they are able to take advantage of additional phonological exposure to boost subsequent word‐learning performance. In contrast to the PDH, children with ASD appear to have intact statistical learning, regardless of language status; however, fast‐mapping abilities differ according to broader language skills.
    May 02, 2017   doi: 10.1111/jcpp.12734   open full text
  • Modulations of cognitive flexibility in obsessive compulsive disorder reflect dysfunctions of perceptual categorization.
    Nicole Wolff, Judith Buse, Jadwiga Tost, Veit Roessner, Christian Beste.
    Journal of Child Psychology and Psychiatry. April 28, 2017
    Background Despite cognitive inflexibility is trait like in obsessive compulsive disorder (OCD) patients and underlies clinical symptomatology, it is elusive at what stage of information processing deficits, leading to cognitive inflexibility, emerges. We hypothesize that inhibitory control mechanisms during early stimulus categorization and integration into a knowledge system underlie these deficits. Methods We examined N = 25 adolescent OCD patients and matched healthy controls (HC) in a paradigm manipulating the importance of the knowledge system to perform task switching. This was done using a paradigm in which task switches were signaled either by visual stimuli or by working memory processes. This was combined with event‐related potential recordings and source localization. Results Obsessive compulsive disorder patients showed increased switch costs in the memory as compared with the cue‐based block, while HC showed similar switch costs in both blocks. At the neurophysiological level, these changes in OCD were not reflected by the N2 and P3 reflecting response‐associated processes but by the P1 reflecting inhibitory control during sensory categorization processes. Activation differences in the right inferior frontal gyrus and superior temporal gyrus are associated with the P1 effect. Conclusions Cognitive flexibility in adolescent OCD patients is strongly modulated by working memory load. Contrary to common sense, not response‐associated processes, but inhibitory control mechanisms during early stimulus categorization processes are likely to underlie cognitive inflexibility in OCD. These processes are associated with right inferior frontal and superior temporal gyrus mechanisms.
    April 28, 2017   doi: 10.1111/jcpp.12733   open full text
  • Neurobehavioural and cognitive development in infants born to mothers with eating disorders.
    Manuela Barona, Emma Taborelli, Freya Corfield, Susan Pawlby, Abigail Easter, Ulrike Schmidt, Janet Treasure, Nadia Micali.
    Journal of Child Psychology and Psychiatry. April 28, 2017
    Introduction Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs. Methods Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8 days postpartum (active ED, n = 15; past ED, n = 20; healthy controls, n = 28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1‐year postpartum (active ED, n = 18; past ED, n = 19; healthy controls, n = 28). In order to maintain the largest possible sample at each time point, sample size varied across time points. Results Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B = −0.34 (−1.81, −0.26)]. Infants of mothers with a past ED had poorer language [B = −0.33 (−13.6, −1.9)] and motor development [B = −0.32 (−18.4, −1.3)] compared with healthy controls. Conclusions Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1 year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED.
    April 28, 2017   doi: 10.1111/jcpp.12736   open full text
  • Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta‐analysis.
    Ekin Secinti, Ellen J. Thompson, Marcus Richards, Darya Gaysina.
    Journal of Child Psychology and Psychiatry. April 27, 2017
    Background Childhood chronic physical illness is associated with a greater vulnerability for emotional problems (i.e. depression and anxiety) in childhood. However, little is known about life‐long effects of childhood chronic physical illness on mental health. The present study aims to systematically review evidence for associations between eight chronic physical illnesses with childhood onset (arthritis, asthma, cancer, chronic renal failure, congenital heart disease, cystic fibrosis, type 1 diabetes, and epilepsy) and adult emotional problems. Methods A database search of MEDLINE, PsycARTICLES, PsycINFO, and ScienceDirect was undertaken, and random effects meta‐analyses were used to synthesise evidence from eligible studies. Results In total, 37 studies were eligible for the systematic review (n = 45,733) and of these, 34 studies were included in the meta‐analyses (n = 45,358). There were overall associations between childhood chronic physical illness and adult depression (OR = 1.31; 95% CI [1.12, 1.54]) and anxiety (OR = 1.47; 95% CI [1.13, 1.92]). Separate meta‐analyses for childhood asthma, type 1 diabetes and cancer were also conducted, with cancer being significantly associated with adult depression (OR = 1.19; 95% CI [1.00, 1.42]). Conclusions The effects of childhood chronic physical illness on the risk of emotional problems persist beyond childhood and adolescence. Mental health prevention and intervention strategies targeting children with chronic physical illnesses can have long‐term benefits.
    April 27, 2017   doi: 10.1111/jcpp.12727   open full text
  • Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups.
    Matthew D. Lerner, Andres De Los Reyes, Deborah A.G. Drabick, Alan H. Gerber, Kenneth D. Gadow.
    Journal of Child Psychology and Psychiatry. April 27, 2017
    Background Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost‐effective procedure. Methods Children with ASD (N = 283; 82% boys; Mage = 10.5 years) were drawn from a specialty ASD clinic. Parents and teachers provided ratings of the three core DSM‐IV‐TR domains of ASD symptoms (communication, social, and perseverative behavior) with the Child and Adolescent Symptom Inventory‐4R (CASI‐4R). External validators included child psychotropic medication status, frequency of ASD‐relevant school‐based services, and the Autism Diagnostic Observation Schedule (ADOS‐2). Results Four distinct subgroups emerged that ranged from large between‐informant discrepancy (informant‐specific) to relative lack of discrepancy (i.e. informant agreement; cross‐situational): Moderate Parent/Low Teacher or Low Parent/Moderate Teacher Severity (Discrepancy), and Moderate or High Symptom Severity (Agreement). Subgroups were highly distinct (mean probability of group assignment = 94%). Relative to Discrepancy subgroups, Agreement subgroups were more likely to receive psychotropic medication, school‐based special education services, and an ADOS‐2 diagnosis. These differential associations would not have been identified based solely on CASI‐4R scores from one informant. Conclusions The degree of parent–teacher discrepancy about ASD symptom severity appears to provide more clinically useful information than reliance on a specific symptom domain or informant, and thus yields an innovative, cost‐effective approach to assessing functional impairment. This conclusion stands in contrast to existing symptom clustering approaches in ASD, which treat within‐informant patterns of symptom severity as generalizable across settings. Within‐child variability in symptom expression across settings may yield uniquely useful information for characterizing the ASD phenotype.
    April 27, 2017   doi: 10.1111/jcpp.12730   open full text
  • A randomised controlled trial to test the effect of promoting caregiver contingent talk on language development in infants from diverse socioeconomic status backgrounds.
    Michelle McGillion, Julian M. Pine, Jane S. Herbert, Danielle Matthews.
    Journal of Child Psychology and Psychiatry. April 21, 2017
    Background Early language skills are critical for later academic success. Lower socioeconomic status (SES) children tend to start school with limited language skills compared to advantaged peers. We test the hypothesis that this is due in part to differences in caregiver contingent talk during infancy (how often the caregiver talks about what is in the focus of the infant's attention). Methods In a randomised controlled trial with high and low SES families, 142 11‐month olds and their caregivers were randomly allocated to either a contingent talk intervention or a dental health control. Families in the language intervention watched a video about contingent talk and were asked to practise it for 15 min a day for a month. Caregiver communication was assessed at baseline and after 1 month. Infant communication was assessed at baseline, 12, 15, 18 and 24 months. Results At baseline, social gradients were observed in caregiver contingent talk to their 11‐month olds (but not in infant communication). At posttest, when infants were 12 months old, caregivers across the SES spectrum who had been allocated to the language intervention group engaged in significantly more contingent talk. Lower SES caregivers in this intervention group also reported that their children produced significantly more words at 15 and 18 months. Effects of the intervention did not persist at 24 months. Instead expressive vocabulary at this age was best predicted by baseline infant communication, baseline contingent talk and SES. Conclusions A social gradient in children's communication emerges during the second year of life. A low‐intensity intervention demonstrated that it is possible to increase caregiver contingent talk and that this is effective in promoting vocabulary growth for lower SES infants in the short term. However, these effects are not long‐lasting, suggesting that follow‐up interventions may be necessary to yield benefits lasting to school entry.
    April 21, 2017   doi: 10.1111/jcpp.12725   open full text
  • Language disorder and retrospectively reported sexual abuse of girls: severity and disclosure.
    E.B. Brownlie, Eva Graham, Lin Bao, Emiko Koyama, Joseph H. Beitchman.
    Journal of Child Psychology and Psychiatry. April 13, 2017
    Background Despite emerging evidence for an association between communication disorders and maltreatment, little research has examined sexual abuse characteristics or disclosure experiences among individuals with language disorder (LD). Given that communication difficulties may constitute a barrier to disclosure, the disclosure experiences among individuals with and without communication difficulties may also differ. Methods Five‐year‐old children identified with a language and/or speech disorder from a nonclinical community sample and a control group were followed to adulthood in a prospective longitudinal study. At age 31, participants completed a behaviorally specific questionnaire on experiences of sexual abuse and questionnaires on disclosure experiences and social reactions to disclosure. Due to low endorsement of sexual victimization among male participants and low sample size, results are reported for women only and exclude nine participants with speech disorder without LD. Participation rates were 28 of 40 in the LD cohort and 45 of 51 controls. Sexual victimization severity was defined using an index combining five indicators (duration, invasiveness, relationship to perpetrator, coercive tactics used, and number of perpetrators). Subthreshold sexual victimization was defined as a single, noncontact incident with a perpetrator unknown to the child; experiences with greater severity were classified as child sexual abuse. Results Among women who reported sexual victimization by age 18, invasiveness and overall severity were greater in the LD cohort than in the control cohort. Women in the LD cohort (43%) were more likely than controls (16%) to report child sexual abuse, excluding subthreshold experiences. There were no differences between cohorts in probability of disclosure, latency to disclosure, or social reactions. Conclusions Women with a history of child LD in a nonclinical sample reported substantial child sexual abuse experiences. Implications for understanding associations between LD and mental health and for prevention and early intervention are discussed.
    April 13, 2017   doi: 10.1111/jcpp.12723   open full text
  • Affective empathy, cognitive empathy and social attention in children at high risk of criminal behaviour.
    Lisette Zonneveld, Evelien Platje, Leo Sonneville, Stephanie Goozen, Hanna Swaab.
    Journal of Child Psychology and Psychiatry. April 11, 2017
    Background Empathy deficits are hypothesized to underlie impairments in social interaction exhibited by those who engage in antisocial behaviour. Social attention is an essential precursor to empathy; however, no studies have yet examined social attention in relation to cognitive and affective empathy in those exhibiting antisocial behaviour. Methods Participants were 8‐ to 12‐year‐old children at high risk of developing criminal behaviour (N = 114, 80.7% boys) and typically developing controls (N = 43, 72.1% boys). The high‐risk children were recruited through an ongoing early identification and intervention project of the city of Amsterdam, focusing on the underage siblings or children of delinquents and those failing primary school. Video clips with neutral and emotional content (fear, happiness and pain) were shown, while heart rate (HR), skin conductance level (SCL) and skin conductance responses (SCRs) were recorded to measure affective empathy. Answers to questions about emotions in the clips were coded to measure cognitive empathy. Eye‐tracking was used to evaluate visual scanning patterns towards social relevant cues (eyes and face) in the clips. Results The high‐risk group did not differ from the control group in social attention and cognitive empathy, but showed reduced HR to pain and fear, and reduced SCL and SCRs to pain. Conclusions Children at high risk of developing criminal behaviour show impaired affective empathy but unimpaired social attention and cognitive empathy. The implications for early identification and intervention studies with antisocial children are discussed.
    April 11, 2017   doi: 10.1111/jcpp.12724   open full text
  • Randomised trial of a parent‐mediated intervention for infants at high risk for autism: longitudinal outcomes to age 3 years.
    J. Green, A. Pickles, G. Pasco, R. Bedford, M.W. Wan, M. Elsabbagh, V. Slonims, T. Gliga, E.J.H. Jones, C.H.M. Cheung, T. Charman, M.H. Johnson,.
    Journal of Child Psychology and Psychiatry. April 10, 2017
    Background There has been increasing interest in the potential for pre‐emptive interventions in the prodrome of autism, but little investigation as to their effect. Methods A two‐site, two‐arm assessor‐blinded randomised controlled trial (RCT) of a 12‐session parent‐mediated social communication intervention delivered between 9 and 14 months of age (Intervention in the British Autism Study of Infant Siblings‐Video Interaction for Promoting Positive Parenting), against no intervention. Fifty‐four infants (28 intervention, 26 nonintervention) at familial risk of autism but not otherwise selected for developmental atypicality were assessed at 9‐month baseline, 15‐month treatment endpoint, and 27‐ and 39‐month follow‐up. Primary outcome: severity of autism prodromal symptoms, blind‐rated on Autism Observation Schedule for Infants or Autism Diagnostic Observation Schedule 2nd Edition across the four assessment points. Secondary outcomes: blind‐rated parent–child interaction and child language; nonblind parent‐rated communication and socialisation. Prespecified intention‐to‐treat analysis combined estimates from repeated measures within correlated regressions to estimate the overall effect of the infancy intervention over time. Results Effect estimates in favour of intervention on autism prodromal symptoms, maximal at 27 months, had confidence intervals (CIs) at each separate time point including the null, but showed a significant overall effect over the course of the intervention and follow‐up period (effect size [ES] = 0.32; 95% CI 0.04, 0.60; p = .026). Effects on proximal intervention targets of parent nondirectiveness/synchrony (ES = 0.33; CI 0.04, 0.63; p = .013) and child attentiveness/communication initiation (ES = 0.36; 95% CI 0.04, 0.68; p = .015) showed similar results. There was no effect on categorical diagnostic outcome or formal language measures. Conclusions Follow‐up to 3 years of the first RCT of a very early social communication intervention for infants at familial risk of developing autism has shown a treatment effect, extending 24 months after intervention end, to reduce the overall severity of autism prodromal symptoms and enhance parent–child dyadic social communication over this period. We highlight the value of extended follow‐up and repeat assessment for early intervention trials.
    April 10, 2017   doi: 10.1111/jcpp.12728   open full text
  • Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology.
    Dorothy V.M. Bishop, Margaret J. Snowling, Paul A. Thompson, Trisha Greenhalgh,.
    Journal of Child Psychology and Psychiatry. March 30, 2017
    Background Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. Methods The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities. Results We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co‐occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability. Conclusions This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.
    March 30, 2017   doi: 10.1111/jcpp.12721   open full text
  • A life history approach to delineating how harsh environments and hawk temperament traits differentially shape children's problem‐solving skills.
    Jennifer H. Suor, Melissa L. Sturge‐Apple, Patrick T. Davies, Dante Cicchetti.
    Journal of Child Psychology and Psychiatry. March 22, 2017
    Background Harsh environments are known to predict deficits in children's cognitive abilities. Life history theory approaches challenge this interpretation, proposing stressed children's cognition becomes specialized to solve problems in fitness‐enhancing ways. The goal of this study was to examine associations between early environmental harshness and children's problem‐solving outcomes across tasks varying in ecological relevance. In addition, we utilize an evolutionary model of temperament toward further specifying whether hawk temperament traits moderate these associations. Methods Two hundred and one mother–child dyads participated in a prospective multimethod study when children were 2 and 4 years old. At age 2, environmental harshness was assessed via maternal report of earned income and observations of maternal disengagement during a parent–child interaction task. Children's hawk temperament traits were assessed from a series of unfamiliar episodes. At age 4, children's reward‐oriented and visual problem‐solving were measured. Results Path analyses revealed early environmental harshness and children's hawk temperament traits predicted worse visual problem‐solving. Results showed a significant two‐way interaction between children's hawk temperament traits and environmental harshness on reward‐oriented problem‐solving. Simple slope analyses revealed the effect of environmental harshness on reward‐oriented problem‐solving was specific to children with higher levels of hawk traits. Conclusions Results suggest early experiences of environmental harshness and child hawk temperament traits shape children's trajectories of problem‐solving in an environment‐fitting manner.
    March 22, 2017   doi: 10.1111/jcpp.12718   open full text
  • Temperamental markers in toddlers with autism spectrum disorder.
    Suzanne L. Macari, Judah Koller, Daniel J. Campbell, Katarzyna Chawarska.
    Journal of Child Psychology and Psychiatry. March 20, 2017
    Background Although temperament has been recognized as an important contributor to childhood psychopathology, its role in emergent autism spectrum phenotypes is not well understood. This study examined whether toddlers with autism spectrum disorder (ASD) display temperamental vulnerabilities compared to toddlers with other developmental challenges, whether these characteristics are distinct from core autism symptoms, if they are stable over time, and if they contribute to social outcomes in preschool. Methods Parents of 165 toddlers with ASD, 58 nonverbal ability‐ and chronological age‐ (CA) matched developmentally delayed (DD) toddlers, and 92 CA‐matched typically developing (TD) toddlers completed the Toddler Behavior Assessment Questionnaire‐Supplemental (TBAQ‐S) at 26 months (SD = 6; Time 1). TBAQ‐S data were also available for a subset of toddlers with ASD (n = 126) at 43 months (SD = 9; Time 2). Results Compared to the DD and TD groups, toddlers with ASD exhibited vulnerabilities within the Effortful Control domain as well as the Surgency domain. They also displayed greater Negative Emotionality compared to TD peers. In the ASD group, temperamental characteristics were not concurrently related to autism severity or developmental level and individual differences were highly stable over time. Changes in Perceptual Sensitivity, Inhibitory Control, and Low‐Intensity Pleasure from age 2 to 3.5 uniquely predicted autism symptom severity and adaptive social skill level at Time 2. Conclusions Temperamental vulnerabilities in toddlers with ASD are stable over time and involve attentional and behavioral control as well as affective reactivity. They contribute uniquely to social outcomes in preschool and are likely to signal risk for developing later maladaptive attentional, affective, and behavioral symptoms. Considering biologically based dimensions may shed light on noncore facets of the early ASD phenotype that are potentially relevant to the emergence of comorbid conditions later in childhood.
    March 20, 2017   doi: 10.1111/jcpp.12710   open full text
  • Annual Research Review: Childhood maltreatment, latent vulnerability and the shift to preventative psychiatry – the contribution of functional brain imaging.
    Eamon J. McCrory, Mattia I. Gerin, Essi Viding.
    Journal of Child Psychology and Psychiatry. March 13, 2017
    Background Childhood maltreatment is a potent predictor of poor mental health across the life span. We argue that there is a need to improve the understanding of the mechanisms that confer psychiatric vulnerability following maltreatment, if we are to progress from simply treating those with a manifest disorder, to developing effective preventative approaches that can help offset the likelihood that such disorders will emerge in the first place. Methods We review extant functional neuroimaging studies of children and adolescents exposed to early neglect and/or maltreatment, including physical, sexual and emotional abuse across four neurocognitive domains: threat processing, reward processing, emotion regulation and executive control. Findings are discussed in the context of ‘latent vulnerability’, where alterations in neurocognitive function are considered to carry adaptive value in early adverse caregiving environments but confer long‐term risk. Results Studies on threat processing indicate heightened as well as depressed neural responsiveness in maltreated samples, particularly in the amygdala, thought to reflect threat hypervigilance and avoidance respectively. Studies on reward processing generally report blunted neural response to anticipation and receipt of rewards, particularly in the striatum, patterns associated with depressive symptomatology. Studies on emotion regulation report increased activation of the anterior cingulate cortex (ACC) during active emotion regulation, possibly reflecting greater effortful processing. Finally, studies of executive control report increased dorsal ACC activity during error monitoring and inhibition. Conclusions An emerging body of work indicates that altered neurocognitive functioning following maltreatment: (a) is evident even in the absence of overt psychopathology; (b) is consistent with perturbations seen in individuals presenting with psychiatric disorder; (c) can predict future psychiatric symptomatology. These findings suggest that maltreatment leads to neurocognitive alterations that embed latent vulnerability to psychiatric disorder, establishing a compelling case for identifying those children at most risk and developing mechanistically informed models of preventative intervention. Such interventions should aim to offset the likelihood of any future psychiatric disorder.
    March 13, 2017   doi: 10.1111/jcpp.12713   open full text
  • Young adult outcomes in the follow‐up of the multimodal treatment study of attention‐deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.
    James M. Swanson, L. Eugene Arnold, Brooke S.G. Molina, Margaret H. Sibley, Lily T. Hechtman, Stephen P. Hinshaw, Howard B. Abikoff, Annamarie Stehli, Elizabeth B. Owens, John T. Mitchell, Quyen Nichols, Andrea Howard, Laurence L. Greenhill, Betsy Hoza, Jeffrey H. Newcorn, Peter S. Jensen, Benedetto Vitiello, Timothy Wigal, Jeffery N. Epstein, Leanne Tamm, Kimberly D. Lakes, James Waxmonsky, Marc Lerner, Joy Etcovitch, Desiree W. Murray, Maximilian Muenke, Maria T. Acosta, Mauricio Arcos‐Burgos, William E. Pelham, Helena C. Kraemer,.
    Journal of Child Psychology and Psychiatry. March 10, 2017
    Background The Multimodal Treatment Study (MTA) began as a 14‐month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7–10 years of age) diagnosed with attention‐deficit/hyperactivity disorder (ADHD)‐combined type. It transitioned into an observational long‐term follow‐up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2–16 years after baseline. Methods Primary (symptom severity) and secondary (adult height) outcomes in adulthood were specified. Treatment was monitored to age 18, and naturalistic subgroups were formed based on three patterns of long‐term use of stimulant medication (Consistent, Inconsistent, and Negligible). For the follow‐up, hypothesis‐generating analyses were performed on outcomes in early adulthood (at 25 years of age). Planned comparisons were used to estimate ADHD‐LNCG differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication. Results For ratings of symptom severity, the ADHD‐LNCG comparison was statistically significant for the parent/self‐report average (0.51 ± 0.04, p < .0001, d = 1.11), documenting symptom persistence, and for the parent/self‐report difference (0.21 ± 0.04, p < .0001, d = .60), documenting source discrepancy, but the comparisons of naturalistic subgroups reflecting medication effects were not significant. For adult height, the ADHD group was 1.29 ± 0.55 cm shorter than the LNCG (p < .01, d = .21), and the comparisons of the naturalistic subgroups were significant: the treated group with the Consistent or Inconsistent pattern was 2.55 ± 0.73 cm shorter than the subgroup with the Negligible pattern (p < .0005, d = .42), and within the treated group, the subgroup with the Consistent pattern was 2.36 ± 1.13 cm shorter than the subgroup with the Inconsistent pattern (p < .04, d = .38). Conclusions In the MTA follow‐up into adulthood, the ADHD group showed symptom persistence compared to local norms from the LNCG. Within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity.
    March 10, 2017   doi: 10.1111/jcpp.12684   open full text
  • Structural and functional connectivity in children and adolescents with and without attention deficit/hyperactivity disorder.
    Dienke J. Bos, Bob Oranje, Michelle Achterberg, Chantal Vlaskamp, Sara Ambrosino, Marcel A. Reus, Martijn P. Heuvel, Serge A.R.B. Rombouts, Sarah Durston.
    Journal of Child Psychology and Psychiatry. March 10, 2017
    Background Attention deficit/hyperactivity disorder (ADHD) has frequently been associated with changes in resting‐state functional connectivity, and decreased white matter (WM) integrity. In the current study, we investigated functional connectivity within Default Mode and frontal control resting‐state networks (RSNs) in children with and without ADHD. We hypothesized the RSNs of interest would show a pattern of impaired functional integration and segregation and corresponding changes in WM structure. Methods Resting‐state fMRI and diffusion‐weighted imaging data were acquired from 35 participants with ADHD and 36 matched typically developing peers, aged 6 through 18 years. Functional connectivity was assessed using independent component analysis. Network topology and WM connectivity were further investigated using graph theoretical measures and tract‐based spatial statistics (TBSS). Results Resting‐state fMRI analyses showed increased functional connectivity in right inferior frontal gyrus (IFG), and bilateral medial prefrontal cortex (mPFC) within the Default Mode and frontal control networks. Furthermore, a more diffuse spatial pattern of functional connectivity was found in children with ADHD. We found no group differences in structural connectivity as assessed with TBSS or graph theoretical measures. Conclusions Resting‐state networks show a more diffuse pattern of connectivity in children with ADHD. The increases in functional connectivity in right IFG and bilateral mPFC in children with ADHD may reflect reduced or delayed functional segregation of prefrontal brain regions. As these functional changes were not accompanied by changes in WM, they may precede the development of the frequently reported changes in WM structure.
    March 10, 2017   doi: 10.1111/jcpp.12712   open full text
  • Stress vulnerability in adolescents with chronic fatigue syndrome: experimental study investigating heart rate variability and skin conductance responses.
    Katharine A. Rimes, Kate Lievesley, Trudie Chalder.
    Journal of Child Psychology and Psychiatry. March 09, 2017
    Background Stress vulnerability has been implicated in adolescent chronic fatigue syndrome (CFS), but has rarely been investigated directly. This study compared psychological and physiological responses to a laboratory social performance task in adolescents with CFS with chronic illness (asthma) and healthy control groups. Methods Adolescents with CFS (n = 60), adolescents with asthma (n = 31) and healthy adolescents (n = 78) completed questionnaires before and after a social performance task. Skin conductance responses (SCR; mean SCR and Max–Min) and heart rate variability (low frequency/high frequency; LF/HF and root mean square difference of successive RR intervals; RMSSD) was measured before, during and after the task. Results Baseline heart rate variability (HRV) (RMSSD) was significantly lower in the CFS and Asthma groups than the HC. During the speech, the CFS and Asthma groups had higher HRV (LF/HF) than the HC, adjusting for baseline LF/HF. Although the asthma group showed a subsequent reduction in HRV during recovery, the CFS group did not. Similarly, during recovery after the task, the CFS group showed a continued increase in skin conductance (Min–Max), unlike the Asthma and HC groups. Compared to control groups, adolescents with CFS expected to find the task more difficult, were more anxious beforehand and afterwards, rated it as more difficult, evaluated their performance more negatively and had lower observer ratings of performance. Parents of adolescents with CFS expected that their child would perform less well in the task than parents of control participants. Conclusions Adolescents with CFS showed autonomic nervous system responses that are consistent with chronic stress vulnerability, difficulty coping with acute stress and slower recovery after acute stress. Self‐report measures also indicated greater trait, pre‐ and posttask anxiety in the CFS group.
    March 09, 2017   doi: 10.1111/jcpp.12711   open full text
  • A randomized controlled trial to examine the effects of the Tackling Teenage psychosexual training program for adolescents with autism spectrum disorder.
    Kirsten Visser, Kirstin Greaves‐Lord, Nouchka T. Tick, Frank C. Verhulst, Athanasios Maras, Esther J.M. Vegt.
    Journal of Child Psychology and Psychiatry. March 09, 2017
    Background Previous research underscores the importance of psychosexual guidance for adolescents with autism spectrum disorder (ASD). Such guidance is provided in the Tackling Teenage Training (TTT) program, in which adolescents with ASD receive psycho‐education and practice communicative skills regarding topics related to puberty, sexuality, and intimate relationships. This randomized controlled trial investigated the effects of the TTT program on (a) cognitive outcomes (i.e. psychosexual knowledge, and insight in interpersonal boundaries) and (b) behavioral outcomes (i.e. skills needed for romantic relationships and problematic sexual behavior). Methods A total of 189 cognitively able adolescents with ASD, aged 12–18 years old, were randomized to an intervention condition (n = 95) or a waiting‐list control condition (n = 94). We assessed outcomes using self‐reported as well as parent‐reported questionnaires at baseline (T1), posttreatment (T2; after 6 months), and follow‐up (T3; after 12 months). Results Linear mixed model analyses showed significant treatment effects for psychosexual knowledge and adequate insight in boundaries, both posttreatment and at follow‐up. All adolescents increased significantly over time in their social responsiveness and decreased their problematic sexual behavior, irrespectively of condition. The TTT program was most effective for younger adolescents with ASD; following the TTT program resulted in higher psychosexual knowledge, and higher social functioning for these adolescents. Conclusions The results of this study indicate that the TTT program is effective as a psycho‐educational program to provide adolescents with ASD with the knowledge and insight they need to prepare themselves for a healthy psychosexual development. Further research is needed to investigate how this increased knowledge and insight can subsequently ameliorate improvements in romantic skills and prevent the development of problematic sexual behavior and victimization.
    March 09, 2017   doi: 10.1111/jcpp.12709   open full text
  • Reduced hair cortisol after maltreatment mediates externalizing symptoms in middle childhood and adolescence.
    Lars O. White, Marcus Ising, Kai Klitzing, Susan Sierau, Andrea Michel, Annette M. Klein, Anna Andreas, Jan Keil, Leonhard Quintero, Bertram Müller‐Myhsok, Manfred Uhr, Ruth Gausche, Jody T. Manly, Michael J. Crowley, Clemens Kirschbaum, Tobias Stalder.
    Journal of Child Psychology and Psychiatry. February 28, 2017
    Background The enduring impact of childhood maltreatment on biological systems and ensuing psychopathology remains incompletely understood. Long‐term effects of stress may be reflected in cumulative cortisol secretion over several months, which is now quantifiable via hair cortisol concentrations (HCC). We conducted a first comprehensive investigation utilizing the potential of hair cortisol analysis in a large sample of maltreated and nonmaltreated children and adolescents. Method Participants included 537 children and adolescents (3–16 years; 272 females) with maltreatment (n = 245) or without maltreatment histories (n = 292). Maltreated subjects were recruited from child protection services (CPS; n = 95), youth psychiatric services (n = 56), and the community (n = 94). Maltreatment was coded using the Maltreatment Classification System drawing on caregiver interviews and complemented with CPS records. Caregivers and teachers reported on child mental health. HCC were assessed in the first 3 cm hair segment. Results Analyses uniformly supported that maltreatment coincides with a gradual and dose‐dependent reduction in HCC from 9 to 10 years onwards relative to nonmaltreated controls. This pattern emerged consistently from both group comparisons between maltreated and nonmaltreated subjects (27.6% HCC reduction in maltreated 9–16‐year‐olds) and dimensional analyses within maltreated subjects, with lower HCC related to greater maltreatment chronicity and number of subtypes. Moreover, both group comparisons and dimensional analyses within maltreated youth revealed that relative HCC reduction mediates the effect of maltreatment on externalizing symptoms. Conclusions From middle childhood onwards, maltreatment coincides with a relative reduction in cortisol secretion, which, in turn, may predispose to externalizing symptoms.
    February 28, 2017   doi: 10.1111/jcpp.12700   open full text
  • ‘Mixed blessings’: parental religiousness, parenting, and child adjustment in global perspective.
    Marc H. Bornstein, Diane L. Putnick, Jennifer E. Lansford, Suha M. Al‐Hassan, Dario Bacchini, Anna Silvia Bombi, Lei Chang, Kirby Deater‐Deckard, Laura Di Giunta, Kenneth A. Dodge, Patrick S. Malone, Paul Oburu, Concetta Pastorelli, Ann T. Skinner, Emma Sorbring, Laurence Steinberg, Sombat Tapanya, Liliana Maria Uribe Tirado, Arnaldo Zelli, Liane Peña Alampay.
    Journal of Child Psychology and Psychiatry. February 28, 2017
    Background Most studies of the effects of parental religiousness on parenting and child development focus on a particular religion or cultural group, which limits generalizations that can be made about the effects of parental religiousness on family life. Methods We assessed the associations among parental religiousness, parenting, and children's adjustment in a 3‐year longitudinal investigation of 1,198 families from nine countries. We included four religions (Catholicism, Protestantism, Buddhism, and Islam) plus unaffiliated parents, two positive (efficacy and warmth) and two negative (control and rejection) parenting practices, and two positive (social competence and school performance) and two negative (internalizing and externalizing) child outcomes. Parents and children were informants. Results Greater parent religiousness had both positive and negative associations with parenting and child adjustment. Greater parent religiousness when children were age 8 was associated with higher parental efficacy at age 9 and, in turn, children's better social competence and school performance and fewer child internalizing and externalizing problems at age 10. However, greater parent religiousness at age 8 was also associated with more parental control at age 9, which in turn was associated with more child internalizing and externalizing problems at age 10. Parental warmth and rejection had inconsistent relations with parental religiousness and child outcomes depending on the informant. With a few exceptions, similar patterns of results held for all four religions and the unaffiliated, nine sites, mothers and fathers, girls and boys, and controlling for demographic covariates. Conclusions Parents and children agree that parental religiousness is associated with more controlling parenting and, in turn, increased child problem behaviors. However, children see religiousness as related to parental rejection, whereas parents see religiousness as related to parental efficacy and warmth, which have different associations with child functioning. Studying both parent and child views of religiousness and parenting are important to understand the effects of parental religiousness on parents and children.
    February 28, 2017   doi: 10.1111/jcpp.12705   open full text
  • Adolescent daytime sleepiness as a risk factor for adult crime.
    Adrian Raine, Peter H. Venables.
    Journal of Child Psychology and Psychiatry. February 23, 2017
    Background While recent cross‐sectional research has documented a relationship between sleep problems and antisocial behavior, the longitudinal nature of this relationship is unknown. This study tests both the hypothesis that adolescent daytime sleepiness is associated with later adult criminal offending, and also tests a biopsychosocial mediation model in which social adversity predisposes to sleepiness, which in turn predisposes to attentional impairment, and to adult crime. Methods Schoolboys aged 15 years rated themselves on self‐report sleepiness. Age 15 antisocial behavior was assessed by teacher ratings and self‐reports, while convictions for crime were assessed at age 29. Attentional capacity at age 15 was assessed by autonomic orienting, with arousal assessed by the electroencephalogram (EEG). Results Sleepy adolescents were more likely to be antisocial during adolescence, and were 4.5 times more likely to commit crime by age 29. The sleepiness–adult crime relationship withstood control for adolescent antisocial behavior. Self‐report sleepiness predicted to adult crime over and above objective measures of daytime sleepiness (EEG theta activity) and age 15 antisocial behavior. Poor daytime attention partly mediated the sleep–crime relationship. Mediation analyses also showed that social adversity predisposed to daytime sleepiness which was associated with reduced attention which in turn predisposed to adult crime. Conclusions Findings are the first to document a longitudinal association between sleepiness in adolescence and crime in adulthood. The longitudinal nature of this relationship, controlling for age 15 antisocial behavior, is consistent with the hypothesis that adolescent sleepiness predisposes to later antisociality. Findings are also consistent with the notion that the well‐established link between social adversity and adult crime is partly explained by sleepiness. Results suggest that a very brief and simple assessment of subjective daytime sleepiness may have prognostic clinical value, and that interventions to reduced sleepiness could be a useful avenue for future crime prevention.
    February 23, 2017   doi: 10.1111/jcpp.12693   open full text
  • Maternal perinatal and concurrent depressive symptoms and child behavior problems: a sibling comparison study.
    Line C. Gjerde, Espen Moen Eilertsen, Ted Reichborn‐Kjennerud, Tom A. McAdams, Henrik Daae Zachrisson, Imac Maria Zambrana, Espen Røysamb, Kenneth S. Kendler, Eivind Ystrom.
    Journal of Child Psychology and Psychiatry. February 23, 2017
    Background Previous studies have found significant associations between maternal prenatal and postpartum depression and child behavior problems (CBP). The present study investigates whether associations remain in a prospective, longitudinal design adjusted for familial confounding. Methods The sample comprised 11,599 families including 17,830 siblings from the Norwegian Mother and Child Cohort study. Mothers reported depressive symptoms at gestational weeks 17 and 30, as well as 6 months, 1.5, 3, and 5 years postpartum. Fathers’ depression was measured at gestational week 17. At the last three time‐points, child internalizing and externalizing problems were concurrently assessed. We performed multilevel analyses for internalizing and externalizing problems separately, using parental depression as predictors. Analyses were repeated using a sibling comparison design to adjust for familial confounding. Results All parental depressive time‐points were significantly and positively associated with child internalizing and externalizing problems. After sibling comparison, however, only concurrent maternal depression was significantly associated with internalizing [estimate = 2.82 (1.91–3.73, 95% CI)] and externalizing problems [estimate = 2.40 (1.56–3.23, 95% CI)]. The effect of concurrent maternal depression on internalizing problems increased with child age. Conclusions Our findings do not support the notion that perinatal maternal depression is particularly detrimental to children's psychological development, as the most robust effects were found for maternal depression occurring during preschool years.
    February 23, 2017   doi: 10.1111/jcpp.12704   open full text
  • SLC2A3 single‐nucleotide polymorphism and duplication influence cognitive processing and population‐specific risk for attention‐deficit/hyperactivity disorder.
    Sören Merker, Andreas Reif, Georg C. Ziegler, Heike Weber, Ute Mayer, Ann‐Christine Ehlis, Annette Conzelmann, Stefan Johansson, Clemens Müller‐Reible, Indrajit Nanda, Thomas Haaf, Reinhard Ullmann, Marcel Romanos, Andreas J. Fallgatter, Paul Pauli, Tatyana Strekalova, Charline Jansch, Alejandro Arias Vasquez, Jan Haavik, Marta Ribasés, Josep Antoni Ramos‐Quiroga, Jan K. Buitelaar, Barbara Franke, Klaus‐Peter Lesch.
    Journal of Child Psychology and Psychiatry. February 22, 2017
    Background Attention‐deficit/hyperactivity disorder (ADHD) is a common, highly heritable neurodevelopmental disorder with profound cognitive, behavioral, and psychosocial impairments with persistence across the life cycle. Our initial genome‐wide screening approach for copy number variants (CNVs) in ADHD implicated a duplication of SLC2A3, encoding glucose transporter‐3 (GLUT3). GLUT3 plays a critical role in cerebral glucose metabolism, providing energy for the activity of neurons, which, in turn, moderates the excitatory–inhibitory balance impacting both brain development and activity‐dependent neural plasticity. We therefore aimed to provide additional genetic and functional evidence for GLUT3 dysfunction in ADHD. Methods Case–control association analyses of SLC2A3 single‐nucleotide polymorphisms (SNPs) and CNVs were conducted in several European cohorts of patients with childhood and adult ADHD (SNP, n = 1,886 vs. 1,988; CNV, n = 1,692 vs. 1,721). These studies were complemented by SLC2A3 expression analyses in peripheral cells, functional EEG recordings during neurocognitive tasks, and ratings of food energy content. Results Meta‐analysis of all cohorts detected an association of SNP rs12842 with ADHD. While CNV analysis detected a population‐specific enrichment of SLC2A3 duplications only in German ADHD patients, the CNV + rs12842 haplotype influenced ADHD risk in both the German and Spanish cohorts. Duplication carriers displayed elevated SLC2A3 mRNA expression in peripheral blood cells and altered event‐related potentials reflecting deficits in working memory and cognitive response control, both endophenotypic traits of ADHD, and an underestimation of energy units of high‐caloric food. Conclusions Taken together, our results indicate that both common and rare SLC2A3 variation impacting regulation of neuronal glucose utilization and energy homeostasis may result in neurocognitive deficits known to contribute to ADHD risk.
    February 22, 2017   doi: 10.1111/jcpp.12702   open full text
  • Structural hierarchy of autism spectrum disorder symptoms: an integrative framework.
    Hyunsik Kim, Cara M. Keifer, Craig Rodriguez‐Seijas, Nicholas R. Eaton, Matthew D. Lerner, Kenneth D. Gadow.
    Journal of Child Psychology and Psychiatry. February 14, 2017
    Background In an attempt to resolve questions regarding the symptom classification of autism spectrum disorder (ASD), previous research generally aimed to demonstrate superiority of one model over another. Rather than adjudicating which model may be optimal, we propose an alternative approach that integrates competing models using Goldberg's bass‐ackwards method, providing a comprehensive understanding of the underlying symptom structure of ASD. Methods The study sample comprised 3,825 individuals, consecutive referrals to a university hospital developmental disabilities specialty clinic or a child psychiatry outpatient clinic. This study analyzed DSM‐IV‐referenced ASD symptom statements from parent and teacher versions of the Child and Adolescent Symptom Inventory‐4R. A series of exploratory structural equation models was conducted in order to produce interpretable latent factors that account for multivariate covariance. Results Results indicated that ASD symptoms were structured into an interpretable hierarchy across multiple informants. This hierarchy includes five levels; key features of ASD bifurcate into different constructs with increasing specificity. Conclusions This is the first study to examine an underlying structural hierarchy of ASD symptomatology using the bass‐ackwards method. This hierarchy demonstrates how core features of ASD relate at differing levels of resolution, providing a model for conceptualizing ASD heterogeneity and a structure for integrating divergent theories of cognitive processes and behavioral features that define the disorder. These findings suggest that a more coherent and complete understanding of the structure of ASD symptoms may be reflected in a metastructure rather than at one level of resolution.
    February 14, 2017   doi: 10.1111/jcpp.12698   open full text
  • Income within context: relative income matters for adolescent social satisfaction and mental health.
    Nicole S. Sorhagen, Tabitha J. Wurster.
    Journal of Child Psychology and Psychiatry. February 10, 2017
    Background Previous research has shown that a mismatch between one's own socioeconomic status (SES) and the SES of the surrounding context can lead to maladaptive outcomes, such as increased social stigma and low levels of belongingness (Johnson, Richeson, & Finkel, Journal of Personality and Social Psychology, 100, 2011, 838; Ostrove, The Journal of Social Issues, 59, 2003, 771). This study examines an adolescent population, as contextual comparisons should be especially salient at this time. Methods Participants included over 900 adolescents at age 15 involved in a multisite longitudinal study. Results Results showed that lower relative income status predicted increased social dissatisfaction, internalizing and externalizing problems, after controlling for family SES. Moreover, the effect of relative income was indirectly related to these problems through social dissatisfaction. Exploratory multigroup analyses by gender suggested that the adolescent girls may be driving the effects of relative income. Conclusions Findings are discussed in regard to adolescent socioemotional functioning, as well as the implications for gender differences related to relative income status.
    February 10, 2017   doi: 10.1111/jcpp.12695   open full text
  • Research Review: Language problems in children with Attention‐Deficit Hyperactivity Disorder – a systematic meta‐analytic review.
    Hannah Korrel, Kathryn L. Mueller, Tim Silk, Vicki Anderson, Emma Sciberras.
    Journal of Child Psychology and Psychiatry. February 10, 2017
    Background Children with Attention‐Deficit Hyperactivity Disorder (ADHD) appear to have a higher risk of language problems compared with typically developing children, although the types of language problems experienced are less clear. This review aims to establish the types of language problems experienced by children with ADHD according to systematically reviewed literature and determine the empirical evidence for language problems in children with ADHD compared with non‐ADHD controls. Methods A standardized search protocol was used on databases: CINAHL, Medline, and PsychINFO. We identified studies with the following inclusion criteria: (a) confirmed ADHD status at the time of the study, (b) inclusion of a non‐ADHD control group, (c) use of a validated language measure, and (d) age ≤ 18. t‐Tests, Pearson's r, and Hedges g effect sizes (ES) were calculated using summary statistics. Random effects meta‐analyses were conducted for the language domain suitable for analysis. Publication bias was investigated using both the trim and fill and p‐curve techniques. Results Twenty‐one studies were included in the systematic review (ADHD = 1,209; Control = 1,101), within which 60 of 68 separate analyses found significant differences between the ADHD and control group on the language measures (p < .05). Follow‐up meta‐analyses found evidence for large deficits in the ADHD groups overall (10/11 studies met p < .05; weighted mean ES [WMES]: 1.04); expressive (10/10 met p < .05; WMES: 1.23); receptive (12/14 met p < .05; WMES: 0.97), and pragmatic language (4/4 studies met p < .05; WMES: 0.98) compared with controls. Conclusions This study demonstrates that children with ADHD have poorer performance on measures of overall, expressive, receptive, and pragmatic language compared with controls. A screening of language functioning may be a valuable addition to the assessment of ADHD.
    February 10, 2017   doi: 10.1111/jcpp.12688   open full text
  • Explaining the sex difference in dyslexia.
    Anne B. Arnett, Bruce F. Pennington, Robin L. Peterson, Erik G. Willcutt, John C. DeFries, Richard K. Olson.
    Journal of Child Psychology and Psychiatry. February 08, 2017
    Background Males are diagnosed with dyslexia more frequently than females, even in epidemiological samples. This may be explained by greater variance in males’ reading performance. Methods We expand on previous research by rigorously testing the variance difference theory, and testing for mediation of the sex difference by cognitive correlates. We developed an analytic framework that can be applied to group differences in any psychiatric disorder. Results Males’ overrepresentation in the low performance tail of the reading distribution was accounted for by mean and variance differences across sex. There was no sex difference at the high performance tail. Processing speed (PS) and inhibitory control partially mediated the sex difference. Verbal reasoning emerged as a strength in males. Conclusions Our results complement a previous finding that PS partially mediates the sex difference in symptoms of attention deficit/hyperactivity disorder (ADHD), and helps explain the sex difference in both dyslexia and ADHD and their comorbidity.
    February 08, 2017   doi: 10.1111/jcpp.12691   open full text
  • Early adversity and learning: implications for typical and atypical behavioral development.
    Jamie L. Hanson, Wouter Bos, Barbara J. Roeber, Karen D. Rudolph, Richard J. Davidson, Seth D. Pollak.
    Journal of Child Psychology and Psychiatry. February 03, 2017
    Background Children who experience early adversity often develop emotion regulatory problems, but little is known about the mechanisms that mediate this relation. We tested whether general associative learning processes contribute to associations between adversity, in the form of child maltreatment, and negative behavioral outcomes. Methods Eighty‐one participants between 12 and 17 years of age were recruited for this study and completed a probabilistic learning Task. Forty‐one of these participants had been exposed to physical abuse, a form of early adversity. Forty additional participants without any known history of maltreatment served as a comparison group. All participants (and their parents) also completed portions of the Youth Life Stress Interview to understand adolescent's behavior. We calculated measures of associative learning, and also constructed mathematical models of learning. Results We found that adolescents exposed to high levels of adversity early in their lives had lower levels of associative learning than comparison adolescents. In addition, we found that impaired associative learning partially explained the higher levels of behavioral problems among youth who suffered early adversity. Using mathematical models, we also found that two components of learning were specifically affected in children exposed to adversity: choice variability and biases in their beliefs about the likelihood of rewards in the environment. Conclusions Participants who had been exposed to early adversity were less able than their peers to correctly learn which stimuli were likely to result in reward, even after repeated feedback. These individuals also used information about known rewards in their environments less often. In addition, individuals exposed to adversity made decisions early in the learning process as if rewards were less consistent and occurred more at random. These data suggest one mechanism through which early life experience shapes behavioral development.
    February 03, 2017   doi: 10.1111/jcpp.12694   open full text
  • Developmental change in the association between adolescent depressive symptoms and the home environment: results from a longitudinal, genetically informative investigation.
    Laurie J. Hannigan, Tom A. McAdams, Thalia C. Eley.
    Journal of Child Psychology and Psychiatry. February 02, 2017
    Background Depression is already highly prevalent by late adolescence, indicating that research into its developmental emergence should consider earlier risk factors and environmental contexts. The home environment is a key context for children and adolescents throughout development. However, the nature of relationships that exist between aspects of the home environment and the development of depressive symptoms cannot be assumed. Genetically informative studies have been used to provide insights about the aetiology of such relationships, often finding them to be partly confounded by the influence of children's genes. Here, we investigate developmental change in the aetiology of the association between aspects of the home environment and depressive symptoms at the onset of adolescence. Methods We used longitudinal child‐ and parent‐report data from >5,000 twin pairs enrolled in the UK‐representative Twins Early Development Study. Multivariate, genetically sensitive structural equation models were used to decompose latent variance and covariance in depressive symptoms (measured at 12 and 16 years) and aspects of the home environment (at 9 and 14 years) into genetic and environmental influences. Results Going from childhood to adolescence, genetic influences accounted for an increasing proportion of the association [30% (16–42) of r = .44 in childhood; 40% (25–61) of r = .43 in adolescence], at the expense of shared environmental influences, which decreased from 70% (58–83) to 48% (29–62). Unique environmental influences accounted for a significant proportion of the association in adolescence only [12% (06–18)]. Developmental changes could largely be attributed to subtle shifts in the relative importance of stable aetiological factors, rather than the emergence of influences unique to adolescence. Conclusions These findings emphasise the importance of developmental and aetiological context in interpreting associations between aspects of the home environment and child emotional outcomes.
    February 02, 2017   doi: 10.1111/jcpp.12689   open full text
  • Shared familial risk factors between attention‐deficit/hyperactivity disorder and overweight/obesity – a population‐based familial coaggregation study in Sweden.
    Qi Chen, Ralf Kuja‐Halkola, Arvid Sjölander, Eva Serlachius, Samuele Cortese, Stephen V. Faraone, Catarina Almqvist, Henrik Larsson.
    Journal of Child Psychology and Psychiatry. January 25, 2017
    Background Despite meta‐analytic evidence for the association between attention‐deficit/hyperactivity disorder (ADHD) and overweight/obesity, the mechanisms underlying the association are yet to be fully understood. Methods By linking multiple Swedish national and regional registers, we identified 472,735 index males born during 1973–1992, with information on body weight and height directly measured before they were conscripted for military service. We further identified 523,237 full siblings born during 1973–2002 for the index males. All individuals were followed up from their third birthday to December 31, 2009 for ADHD diagnosis. Logistic regression models were used to estimate the association between overweight/obesity in index males and ADHD in their full siblings. Results Siblings of index males with overweight/obesity had increased risk for ADHD (overweight: OR = 1.14, 95% CI = 1.05–1.24; obesity: OR = 1.42, 95% CI = 1.24–1.63), compared with siblings of index males with normal weight. The results were adjusted for birth year of the index male and sex of the sibling. After further adjustment for ADHD status of the index male, the familial coaggregation remained significant (overweight: OR = 1.13, 95% CI = 1.04–1.22; obesity: OR = 1.38, 95% CI = 1.21–1.57). The results were similar across sex of the siblings. Conclusions Attention‐deficit/hyperactivity disorder and overweight/obesity share familial risk factors, which are not limited to those causing overweight/obesity through the mediation of ADHD. Future research aiming at identifying family‐wide environmental risk factors as well as common pleiotropic genetic variants contributing to both traits is warranted.
    January 25, 2017   doi: 10.1111/jcpp.12686   open full text
  • Research Review: The effectiveness of multidimensional family therapy in treating adolescents with multiple behavior problems – a meta‐analysis.
    Thimo M. Pol, Machteld Hoeve, Marc J. Noom, Geert Jan J.M. Stams, Theo A.H. Doreleijers, Lieke Domburgh, Robert R.J.M. Vermeiren.
    Journal of Child Psychology and Psychiatry. January 25, 2017
    Background Multidimensional family therapy (MDFT) is a well‐established treatment for adolescents showing both substance abuse and/or antisocial behavior. Method The effectiveness of MDFT in reducing adolescents’ substance abuse, delinquency, externalizing and internalizing psychopathology, and family malfunctioning was examined by means of a (three‐level) meta‐analysis, summarizing 61 effect sizes from 19 manuscripts (N = 1,488 participants). Results Compared with other therapies, the overall effect size of MDFT was significant, albeit small in magnitude (d = 0.24, p < .001), and similar across intervention outcome categories. Moderator analysis revealed that adolescents with high severity problems, including severe substance abuse and disruptive behavior disorder, benefited more from MDFT than adolescents with less severe conditions. Conclusions It can be concluded that MDFT is effective for adolescents with substance abuse, delinquency, and comorbid behavior problems. Subsequently, it is important to match specific characteristics of the adolescents, such as extent of impairment, with MDFT.
    January 25, 2017   doi: 10.1111/jcpp.12685   open full text
  • Annual Research Review: Understudied populations within the autism spectrum – current trends and future directions in neuroimaging research.
    Allison Jack, Kevin A. Pelphrey.
    Journal of Child Psychology and Psychiatry. January 19, 2017
    Background Autism spectrum disorders (ASDs) are a heterogeneous group of neurodevelopmental conditions that vary in both etiology and phenotypic expression. Expressions of ASD characterized by a more severe phenotype, including autism with intellectual disability (ASD + ID), autism with a history of developmental regression (ASD + R), and minimally verbal autism (ASD + MV) are understudied generally, and especially in the domain of neuroimaging. However, neuroimaging methods are a potentially powerful tool for understanding the etiology of these ASD subtypes. Scope and methodology This review evaluates existing neuroimaging research on ASD + MV, ASD + ID, and ASD + R, identified by a search of the literature using the PubMed database, and discusses methodological, theoretical, and practical considerations for future research involving neuroimaging assessment of these populations. Findings There is a paucity of neuroimaging research on ASD + ID, ASD + MV, and ASD + R, and what findings do exist are often contradictory, or so sparse as to be ungeneralizable. We suggest that while greater sample sizes and more studies are necessary, more important would be a paradigm shift toward multimodal (e.g. imaging genetics) approaches that allow for the characterization of heterogeneity within etiologically diverse samples.
    January 19, 2017   doi: 10.1111/jcpp.12687   open full text
  • Maltreatment‐associated neurodevelopmental disorders: a co‐twin control analysis.
    Lisa Dinkler, Sebastian Lundström, Ruchika Gajwani, Paul Lichtenstein, Christopher Gillberg, Helen Minnis.
    Journal of Child Psychology and Psychiatry. January 17, 2017
    Background Childhood maltreatment (CM) is strongly associated with psychiatric disorders in childhood and adulthood. Previous findings suggest that the association between CM and psychiatric disorders is partly causal and partly due to familial confounding, but few studies have investigated the mechanisms behind the association between CM and neurodevelopmental disorders (NDDs). Our objective was to determine whether maltreated children have an elevated number of NDDs and whether CM is a risk factor for an increased NDD ‘load’ and increased NDD symptoms when controlling for familial effects. Methods We used a cross‐sectional sample from a population‐representative Swedish twin study, comprising 8,192 nine‐year‐old twins born in Sweden between 1997 and 2005. CM was defined as parent‐reported exposure to emotional abuse/neglect, physical neglect, physical abuse, and/or sexual abuse. Four NDDs were measured with the Autism–Tics, AD/HD, and other comorbidities inventory. Results Maltreated children had a greater mean number of NDDs than nonmaltreated children. In a co‐twin control design, CM‐discordant monozygotic twins did not differ significantly for their number of NDDs, suggesting that CM is not associated with an increased load of NDDs when genetic and shared environmental factors are taken into account. However, CM was associated with a small increase in symptoms of attention‐deficit/hyperactivity disorder and autism spectrum disorder in CM‐discordant MZ twins, although most of the covariance of CM with NDD symptoms was explained by common genetic effects. Conclusions Maltreated children are at higher risk of having multiple NDDs. Our findings are, however, not consistent with the notion that CM causes the increased NDD load in maltreated children. Maltreated children should receive a full neurodevelopmental assessment, and clinicians should be aware that children with multiple NDDs are at higher risk of maltreatment.
    January 17, 2017   doi: 10.1111/jcpp.12682   open full text
  • Oppositional defiant disorder dimensions: genetic influences and risk for later psychopathology.
    Amy J. Mikolajewski, Jeanette Taylor, William G. Iacono.
    Journal of Child Psychology and Psychiatry. January 06, 2017
    Background This study was undertaken to determine how well two oppositional defiant disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree to which these outcomes can be attributed to genetic influences shared with ODD dimensions. Methods Psychopathology was assessed via diagnostic interviews of 1,225 twin pairs at ages 11 and 17. Results Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed that the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Conclusions Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions.
    January 06, 2017   doi: 10.1111/jcpp.12683   open full text
  • Annual Research Review: On the relations among self‐regulation, self‐control, executive functioning, effortful control, cognitive control, impulsivity, risk‐taking, and inhibition for developmental psychopathology.
    Joel T. Nigg.
    Journal of Child Psychology and Psychiatry. December 30, 2016
    Background Self‐regulation (SR) is central to developmental psychopathology, but progress has been impeded by varying terminology and meanings across fields and literatures. Methods The present review attempts to move that discussion forward by noting key sources of prior confusion such as measurement‐concept confounding, and then arguing the following major points. Results First, the field needs a domain‐general construct of SR that encompasses SR of action, emotion, and cognition and involves both top‐down and bottom‐up regulatory processes. This does not assume a shared core process across emotion, action, and cognition, but is intended to provide clarity on the extent of various claims about kinds of SR. Second, top‐down aspects of SR need to be integrated. These include (a) basic processes that develop early and address immediate conflict signals, such as cognitive control and effortful control (EC), and (b) complex cognition and strategies for addressing future conflict, represented by the regulatory application of complex aspects of executive functioning. Executive function (EF) and cognitive control are not identical to SR because they can be used for other activities, but account for top‐down aspects of SR at the cognitive level. Third, impulsivity, risk‐taking, and disinhibition are distinct although overlapping; a taxonomy of the kinds of breakdowns of SR associated with psychopathology requires their differentiation. Fourth, different aspects of the SR universe can be organized hierarchically in relation to granularity, development, and time. Low‐level components assemble into high‐level components. This hierarchical perspective is consistent across literatures. Conclusions It is hoped that the framework outlined here will facilitate integration and cross‐talk among investigators working from different perspectives, and facilitate individual differences research on how SR relates to developmental psychopathology.
    December 30, 2016   doi: 10.1111/jcpp.12675   open full text
  • Anger‐irritability as a mediator of attention deficit hyperactivity disorder risk for adolescent alcohol use and the contribution of coping skills.
    Seth C. Harty, Elizabeth M. Gnagy, William E. Pelham, Brooke S.G. Molina.
    Journal of Child Psychology and Psychiatry. December 19, 2016
    Background Research on susceptibility to alcohol use disorder within the attention deficit/hyperactivity disorder (ADHD) population has begun to expand examination of putative moderators and mediators in order to develop effective treatments. Specific dysregulated emotions have been separately associated with ADHD and with alcohol use difficulties. The current study is the first to conjointly study these variables by testing anger‐irritability as a mediator of ADHD risk for adolescent alcohol use. Methods Frequency of binge drinking, drunkenness, and alcohol problems were examined for 142 children with ADHD followed into adolescence and compared to 100 demographically similar youth without ADHD. Parent‐rated anger‐irritability was tested as a mediator. Behavioral and cognitive coping skills, which are key clinical treatment targets, were studied as moderators of these associations. Results Childhood ADHD was positively associated with anger‐irritability and the drinking outcomes in adolescence. Anger‐irritability mediated the association between ADHD and alcohol use problems, but not binge drinking or drunkenness. Behavioral and cognitive, but not avoidant, coping played a moderating role, but only of the association between childhood ADHD and anger‐irritability. Conclusions Active coping strategies by adolescents with ADHD may reduce the vulnerability to alcohol problems through a reduction of negative emotions. Future research on additional mediators and treatments that target these skills is encouraged.
    December 19, 2016   doi: 10.1111/jcpp.12668   open full text
  • Cognitive therapy as an early treatment for post‐traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action.
    Richard Meiser‐Stedman, Patrick Smith, Anna McKinnon, Clare Dixon, David Trickey, Anke Ehlers, David M. Clark, Adrian Boyle, Peter Watson, Ian Goodyer, Tim Dalgleish.
    Journal of Child Psychology and Psychiatry. December 15, 2016
    Background Few efficacious early treatments for post‐traumatic stress disorder (PTSD) in children and adolescents exist. Previous trials have intervened within the first month post‐trauma and focused on secondary prevention of later post‐traumatic stress; however, considerable natural recovery may still occur up to 6‐months post‐trauma. No trials have addressed the early treatment of established PTSD (i.e. 2‐ to 6‐months post‐trauma). Methods Twenty‐nine youth (8–17 years) with PTSD (according to age‐appropriate DSM‐IV or ICD‐10 diagnostic criteria) after a single‐event trauma in the previous 2–6 months were randomly allocated to Cognitive Therapy for PTSD (CT‐PTSD; n = 14) or waiting list (WL; n = 15) for 10 weeks. Results Significantly more participants were free of PTSD after CT‐PTSD (71%) than WL (27%) at posttreatment (intent‐to‐treat, 95% CI for difference .04–.71). CT‐PTSD yielded greater improvement on child‐report questionnaire measures of PTSD, depression and anxiety; clinician‐rated functioning; and parent‐reported outcomes. Recovery after CT‐PTSD was maintained at 6‐ and 12‐month posttreatment. Beneficial effects of CT‐PTSD were mediated through changes in appraisals and safety‐seeking behaviours, as predicted by cognitive models of PTSD. CT‐PTSD was considered acceptable on the basis of low dropout and high treatment credibility and therapist alliance ratings. Conclusions This trial provides preliminary support for the efficacy and acceptability of CT‐PTSD as an early treatment for PTSD in youth. Moreover, the trial did not support the extension of ‘watchful waiting’ into the 2‐ to 6‐month post‐trauma window, as significant improvements in the WL arm (particularly in terms of functioning and depression) were not observed. Replication in larger samples is needed, but attention to recruitment issues will be required.
    December 15, 2016   doi: 10.1111/jcpp.12673   open full text
  • Annual Research Review: An expanded account of information‐processing mechanisms in risk for child and adolescent anxiety and depression.
    Jennifer Y. F. Lau, Allison M. Waters.
    Journal of Child Psychology and Psychiatry. December 14, 2016
    Background Anxiety and depression occurring during childhood and adolescence are common and costly. While early‐emerging anxiety and depression can arise through a complex interplay of ‘distal’ factors such as genetic and environmental influences, temperamental characteristics and brain circuitry, the more proximal mechanisms that transfer risks on symptoms are poorly delineated. Information‐processing biases, which differentiate youth with and without anxiety and/or depression, could act as proximal mechanisms that mediate more distal risks on symptoms. This article reviews the literature on information‐processing biases, their associations with anxiety and depression symptoms in youth and with other distal risk factors, to provide direction for further research. Methods Based on strategic searches of the literature, we consider how youth with and without anxiety and/or depression vary in how they deploy attention to social‐affective stimuli, discriminate between threat and safety cues, retain memories of negative events and appraise ambiguous information. We discuss how these information‐processing biases are similarly or differentially expressed on anxiety and depression and whether these biases are linked to genetic and environmental factors, temperamental characteristics and patterns of brain circuitry functioning implicated in anxiety and depression. Findings Biases in attention and appraisal characterise both youth anxiety and depression but with some differences in how these are expressed for each symptom type. Difficulties in threat‐safety cue discrimination characterise anxiety and are understudied in depression, while biases in the retrieval of negative and overgeneral memories have been observed in depression but are understudied in anxiety. Information‐processing biases have been studied in relation to some distal factors but not systematically, so relationships remain inconclusive. Conclusions Biases in attention, threat‐safety cue discrimination, memory and appraisal may characterise anxiety and/or depression risk. We discuss future research directions that can more systematically test whether these biases act as proximal mechanisms that mediate other distal risk factors.
    December 14, 2016   doi: 10.1111/jcpp.12653   open full text
  • Hybrid implementation model of community‐partnered early intervention for toddlers with autism: a randomized trial.
    Stephanie Y. Shire, Ya‐Chih Chang, Wendy Shih, Suzanne Bracaglia, Maria Kodjoe, Connie Kasari.
    Journal of Child Psychology and Psychiatry. December 14, 2016
    Background Interventions found to be effective in research settings are often not as effective when implemented in community settings. Considering children with autism, studies have rarely examined the efficacy of laboratory‐tested interventions on child outcomes in community settings using randomized controlled designs. Methods One hundred and thirteen children with autism enrolled in public early intervention classrooms in low resource neighborhoods were randomized to Joint Attention, Symbolic Play, Engagement, and Regulation (JASPER) intervention or treatment as usual waitlist for 10 weeks with 1‐month follow‐up. Results Teaching assistants delivered JASPER at adequate fidelity. Children randomized to JASPER demonstrated significant gains over treatment as usual in core developmental outcomes of joint engagement, joint attention, and play skills that were maintained at follow‐up. Conclusions Supervised teaching assistants delivered JASPER intervention with a range of toddlers with autism leading to significant gains in developmental outcomes.
    December 14, 2016   doi: 10.1111/jcpp.12672   open full text
  • Annual Research Review: Breaking cycles of violence – a systematic review and common practice elements analysis of psychosocial interventions for children and youth affected by armed conflict.
    Felicity L. Brown, Anne M. Graaff, Jeannie Annan, Theresa S. Betancourt.
    Journal of Child Psychology and Psychiatry. December 10, 2016
    Background Globally, one in 10 children live in regions affected by armed conflict. Children exposed to armed conflict are vulnerable to social and emotional difficulties, along with disrupted educational and occupational opportunities. Most armed conflicts occur in low‐ and middle‐income countries (LMICs), where mental health systems are limited and can be further weakened by the context of war. Research is needed to determine feasible and cost‐effective psychosocial interventions that can be delivered safely by available mental health workforces (including nonspecialists). A vital first step toward achieving this is to examine evidence‐based psychosocial interventions and identify the common therapeutic techniques being used across these treatments. Methods A systematic review of psychosocial interventions for conflict‐affected children and youth living in LMICs was performed. Studies were identified through database searches (PsycINFO, PubMed, Cochrane Central Register of Controlled Trials, PILOTS and Web of Science Core Collection), hand‐searching of reference lists, and contacting expert researchers. The PracticeWise coding system was used to distill the practice elements within clinical protocols. Results Twenty‐eight randomized controlled trials and controlled trials conducted in conflict‐affected settings, and 25 efficacious treatments were identified. Several practice elements were found across more than 50% of the intervention protocols of these treatments. These were access promotion, psychoeducation for children and parents, insight building, rapport building techniques, cognitive strategies, use of narratives, exposure techniques, and relapse prevention. Conclusions Identification of the common practice elements of effective interventions for conflict‐affected children and youth can inform essential future treatment development, implementation, and evaluation for this vulnerable population. To further advance the field, research should focus on identifying which of these elements are the active ingredients for clinical change, along with attention to costs of delivery, training, supervision and how to sustain quality implementation over time.
    December 10, 2016   doi: 10.1111/jcpp.12671   open full text
  • Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta‐review.
    Chris Hollis, Caroline J. Falconer, Jennifer L. Martin, Craig Whittington, Sarah Stockton, Cris Glazebrook, E. Bethan Davies.
    Journal of Child Psychology and Psychiatry. December 10, 2016
    Background Digital health interventions (DHIs), including computer‐assisted therapy, smartphone apps and wearable technologies, are heralded as having enormous potential to improve uptake and accessibility, efficiency, clinical effectiveness and personalisation of mental health interventions. It is generally assumed that DHIs will be preferred by children and young people (CYP) given their ubiquitous digital activity. However, it remains uncertain whether: DHIs for CYP are clinically and cost‐effective, CYP prefer DHIs to traditional services, DHIs widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence‐base for DHIs and considers the key research questions and approaches to evaluation and implementation. Methods We conducted a meta‐review of scoping, narrative, systematic or meta‐analytical reviews investigating the effectiveness of DHIs for mental health problems in CYP. We also updated a systematic review of randomised controlled trials (RCTs) of DHIs for CYP published in the last 3 years. Results Twenty‐one reviews were included in the meta‐review. The findings provide some support for the clinical benefit of DHIs, particularly computerised cognitive behavioural therapy (cCBT), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCTs evaluating DHIs for attention deficit/hyperactivity disorder (ADHD), autism, anxiety, depression, psychosis, eating disorders and PTSD. The benefits of DHIs in managing ADHD, autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost‐effectiveness of DHIs. Conclusions Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHIs. Issues include variable uptake and engagement with DHIs, lack of an agreed typology/taxonomy for DHIs, small sample sizes, lack of blinded outcome assessment, combining different comparators, short‐term follow‐up and poor specification of the level of human support. Research and practice recommendations are presented that address the key research questions and methodological issues for the evaluation and clinical implementation of DHIs for CYP.
    December 10, 2016   doi: 10.1111/jcpp.12663   open full text
  • A harsh parenting team? Maternal reports of coparenting and coercive parenting interact in association with children's disruptive behaviour.
    Rachel M. Latham, Katharine M. Mark, Bonamy R. Oliver.
    Journal of Child Psychology and Psychiatry. December 05, 2016
    Background Parenting and coparenting are both important for children's adjustment, but their interaction has been little explored. Using a longitudinal design and considering two children per family, we investigated mothers’ and fathers’ perceptions of coparenting as moderators of associations between their coercive parenting and children's disruptive behaviour. Methods Mothers and fathers from 106 ‘intact’ families were included from the Twins, Family and Behaviour study. At Time 1 (Mchild age = 3 years 11 months, SDchild age = 4.44 months) parents reported on their coercive parenting and children's disruptive behaviour via questionnaire; at Time 2 (Mchild age = 4 years 8 months, SDchild age = 4.44 months) perceptions of coparenting and the marital relationship were collected by telephone interview. Questionnaire‐based reports of children's disruptive behaviour were collected at follow‐up (Mchild age = 5 years 11 months, SDchild age = 5.52 months). Multilevel modelling was used to examine child‐specific and family‐wide effects. Results Conservative multilevel models including both maternal and paternal perceptions demonstrated that maternal perceptions of coparenting and overall coercive parenting interacted in their prediction of parent‐reported child disruptive behaviour. Specifically, accounting for perceived marital quality, behavioural stability, and fathers’ perceptions, only in the context of perceived higher quality coparenting was there a positive association between mother‐reported overall coercive parenting and children's disruptive behaviour at follow‐up. Conclusions When combined with highly coercive parenting, maternal perceptions of high quality coparenting may be detrimental for children's adjustment.
    December 05, 2016   doi: 10.1111/jcpp.12665   open full text
  • Tipping points? Curvilinear associations between activity level and mental development in toddlers.
    Megan Flom, Madeleine Cohen, Kimberly J. Saudino.
    Journal of Child Psychology and Psychiatry. December 05, 2016
    Background The Theory of Optimal Stimulation (Zentall & Zentall, Psychological Bulletin, 94, 1983, 446) posits that the relation between activity level (AL) and cognitive performance follows an inverted U shape where midrange AL predicts better cognitive performance than AL at the extremes. Methods We explored this by fitting linear and quadratic models predicting mental development from AL assessed via multiple methods (parent ratings, observations, and actigraphs) and across multiple situations (laboratory play, laboratory test, home) in over 600 twins (2‐ and 3‐year olds). Results Only observed AL in the laboratory was curvilinearly related to mental development scores. Results replicated across situations, age, and twin samples, providing strong support for the optimal stimulation model for this measure of AL in early childhood. Conclusions Different measures of AL provide different information. Observations of AL which include both qualitative and quantitative aspects of AL within structured situations are able to capture beneficial aspects of normative AL as well as detriments of both low and high AL.
    December 05, 2016   doi: 10.1111/jcpp.12670   open full text
  • Observed fearlessness and positive parenting interact to predict childhood callous‐unemotional behaviors among low‐income boys.
    Rebecca Waller, Daniel S. Shaw, Luke W. Hyde.
    Journal of Child Psychology and Psychiatry. December 05, 2016
    Background Callous‐unemotional behaviors identify children at risk for severe and chronic antisocial behavior. Research is needed to establish pathways from temperament and parenting factors that give rise to callous‐unemotional behaviors, including interactions of positive versus harsh parenting with child fearlessness. Methods Multimethod data, including parent reports and observations of parent and child behavior, were drawn from a prospective, longitudinal sample of low‐income boys (N = 310) with assessments at 18, 24, and 42 months, and at ages 10–12 years old. Results Parent‐reported callous‐unemotional, oppositional, and attention‐deficit factors were separable at 42 months. Callous‐unemotional behaviors at 42 months predicted callous‐unemotional behaviors at ages 10–12, accounting for earlier oppositional and attention‐deficit behaviors and self‐reported child delinquency at ages 10–12. Observations of fearlessness at 24 months predicted callous‐unemotional behaviors at 42 months, but only when parents exhibited low observed levels of positive parenting. The interaction of fearlessness and low positive parenting indirectly predicted callous‐unemotional behaviors at 10–12 via callous‐unemotional behaviors at 42 months. Conclusions Early fearlessness interacts with low positive parenting to predict early callous‐unemotional behaviors, with lasting effects of this person‐by‐context interaction on callous‐unemotional behaviors into late childhood.
    December 05, 2016   doi: 10.1111/jcpp.12666   open full text
  • The role of age of disclosure of biological origins in the psychological wellbeing of adolescents conceived by reproductive donation: a longitudinal study from age 1 to age 14.
    Elena Ilioi, Lucy Blake, Vasanti Jadva, Gabriela Roman, Susan Golombok.
    Journal of Child Psychology and Psychiatry. December 02, 2016
    Background The question of whether children should be told of their biological origins is one of the most controversial issues regarding the birth of children through donated eggs, sperm, embryos or surrogacy. Methods In the sixth phase of this longitudinal study when the children were aged 14 years, family relationships and adolescent adjustment were examined in 87 families created through reproductive donation and 54 natural conception families. The quality of family relationships was assessed by standardised interview with mothers and by standardised questionnaires and an observational measure with mothers and adolescents. Adolescent adjustment was assessed using standardised questionnaires. Systematic information on whether and when parents had told children about their biological origins was obtained at earlier phases of the study. Results There were no overall differences between disclosing families and either nondisclosing or natural conception families. However, within the disclosing families, more positive family relationships and higher levels of adolescent wellbeing were found for adolescents who had been told about their biological origins before age 7. Conclusions The earlier children born through reproductive donation are told about their biological origins, the more positive are the outcomes in terms of the quality of family relationships and psychological wellbeing at adolescence.
    December 02, 2016   doi: 10.1111/jcpp.12667   open full text
  • Maternal prepregnancy body mass index and offspring attention‐deficit/hyperactivity disorder: a quasi‐experimental sibling‐comparison, population‐based design.
    Erica D. Musser, Michael T. Willoughby, Suzanne Wright, Elinor L. Sullivan, Diane D. Stadler, Brent F. Olson, Robert D. Steiner, Joel T. Nigg.
    Journal of Child Psychology and Psychiatry. November 30, 2016
    Background High maternal prepregnancy body mass index (BMI) has been associated with increased risk of offspring attention‐deficit/hyperactivity disorder (ADHD). However, whether this effect is attributable to maternal or familial level confounds has been little examined. Methods The present study sought to examine these associations, utilizing data from the medical records of a health care system which treats 350,000 patients annually and a sibling‐comparison design in a sample of 4,682 children born to 3,645 mothers. Results When examining the overall maternal effect, a linear association was observed between maternal prepregnancy BMI and child ADHD [b = 0.04, 95% confidence interval (95% CI) = 0.02–0.06, p = .0003], such that a one‐unit (i.e. 1 kg/m2) increase in prepregnancy BMI was associated with a 4% increase in the odds of ADHD (exp b = 1.04). However, when the model was reparameterized to take full advantage of the sibling design to allow for the examination of both maternal and child‐specific effects, the child‐specific prepregnancy BMI effect was not reliably different from zero (b = −0.08, 95% CI = −0.23 to 0.06, p = .24). In contrast, at the maternal‐level, average prepregnancy BMI was a reliably non‐zero predictor of child ADHD (b = 0.04, 95% CI = 0.02–0.06, p < .0001) with each one‐unit increase in maternal prepregnancy BMI associated with a 4.2% increase in the odds of ADHD (exp b = 1.04, 95% CI = 1.02–1.06). Conclusions The association between maternal prepregnancy BMI and offspring ADHD may be better accounted for by familial or maternal confounds rather than a direct causal effect of BMI.
    November 30, 2016   doi: 10.1111/jcpp.12662   open full text
  • Telephone‐assisted self‐help for parents of children with attention‐deficit/hyperactivity disorder who have residual functional impairment despite methylphenidate treatment: a randomized controlled trial.
    Christina Dose, Christopher Hautmann, Mareike Buerger, Stephanie Schuermann, Katrin Woitecki, Manfred Doepfner.
    Journal of Child Psychology and Psychiatry. November 23, 2016
    Background Self‐help parenting interventions have been shown to be effective in the management of children with attention‐deficit/hyperactivity disorder (ADHD) and may be useful when there are barriers to face‐to‐face therapist‐led parent trainings. Previous studies indicate that behavioral interventions might be a useful adjunct to medication in children with residual ADHD symptoms, and regarding comorbid oppositional symptoms and multiple domains of functional impairment. In the present study, we examined whether a telephone‐assisted self‐help (TASH) parenting behavioral intervention (written materials plus telephone counseling) enhanced the effects of methylphenidate treatment in children with ADHD. Methods In this randomized controlled trial, parents of 103 school‐aged children with ADHD and residual functional impairment despite methylphenidate treatment were randomly assigned to either the enhancement group, which received the TASH intervention as adjunct to routine clinical care (including continued medication), or to the active control group, which received routine clinical care only (including continued medication). Parent‐completed outcome measures at baseline and at 12 months (postassessment) included functional impairment, ADHD symptoms, oppositional defiant disorder (ODD) symptoms, parenting behavior, and parental satisfaction with the intervention ( NCT01660425; URL: Results Intention‐to‐treat analyses of covariance (ANCOVAs), which controlled for baseline data, revealed significant and moderate intervention effects for ODD symptoms and negative parenting behavior at the postassessment, whereas per‐protocol analyses additionally showed significant and moderate effects on functional impairment (primary outcome). Parents expressed high satisfaction with the program. Conclusions The TASH program enhances effects of methylphenidate treatment in families who complete the intervention. The discontinuation rate of about 30% and comparison between completing and discontinuing families suggest that the program may be more suitable for families with a higher educational level and fewer additional stresses.
    November 23, 2016   doi: 10.1111/jcpp.12661   open full text
  • Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder.
    Khaled Saad, Ahmed A. Abdel‐Rahman, Yasser M. Elserogy, Abdulrahman A. Al‐Atram, Amira A. El‐Houfey, Hisham A. K. Othman, Geir Bjørklund, Feiyong Jia, Mauricio A. Urbina, Mohamed Gamil M. Abo‐Elela, Faisal‐Alkhateeb Ahmad, Khaled A. Abd El‐Baseer, Ahmed E. Ahmed, Ahmad M. Abdel‐Salam.
    Journal of Child Psychology and Psychiatry. November 21, 2016
    Background Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children. Methods This study is a double‐blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3–10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25‐hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and the Autism Treatment Evaluation Checklist (ATEC). Trial registration number: UMIN‐CTR Study Design: trial number: UMIN000020281. Results Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4‐month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD. Conclusions This study is the first double‐blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide‐scale studies are needed to critically validate the efficacy of vitamin D in ASD.
    November 21, 2016   doi: 10.1111/jcpp.12652   open full text
  • Externalizing problems in childhood and adolescence predict subsequent educational achievement but for different genetic and environmental reasons.
    Gary J. Lewis, Kathryn Asbury, Robert Plomin.
    Journal of Child Psychology and Psychiatry. November 10, 2016
    Background Childhood behavior problems predict subsequent educational achievement; however, little research has examined the etiology of these links using a longitudinal twin design. Moreover, it is unknown whether genetic and environmental innovations provide incremental prediction for educational achievement from childhood to adolescence. Methods We examined genetic and environmental influences on parental ratings of behavior problems across childhood (age 4) and adolescence (ages 12 and 16) as predictors of educational achievement at age 16 using a longitudinal classical twin design. Results Shared‐environmental influences on anxiety, conduct problems, and peer problems at age 4 predicted educational achievement at age 16. Genetic influences on the externalizing behaviors of conduct problems and hyperactivity at age 4 predicted educational achievement at age 16. Moreover, novel genetic and (to a lesser extent) nonshared‐environmental influences acting on conduct problems and hyperactivity emerged at ages 12 and 16, adding to the genetic prediction from age 4. Conclusions These findings demonstrate that genetic and shared‐environmental factors underpinning behavior problems in early childhood predict educational achievement in midadolescence. These findings are consistent with the notion that early‐childhood behavior problems reflect the initiation of a life‐course persistent trajectory with concomitant implications for social attainment. However, we also find evidence that genetic and nonshared‐environment innovations acting on behavior problems have implications for subsequent educational achievement, consistent with recent work arguing that adolescence represents a sensitive period for socioaffective development.
    November 10, 2016   doi: 10.1111/jcpp.12655   open full text
  • Infant social attention: an endophenotype of ASD‐related traits?
    Emily J.H. Jones, Kaitlin Venema, Rachel K. Earl, Rachel Lowy, Sara J. Webb.
    Journal of Child Psychology and Psychiatry. November 08, 2016
    Background As a neurodevelopmental disorder, symptoms of ASD likely emerge from a complex interaction between preexisting genetic vulnerabilities and the child's environment. One way to understand causal paths to ASD is to identify dimensional ASD‐related traits that vary in the general population and that predispose individuals with other risk factors toward ASD. Moving beyond behavioral traits to explore underlying neurocognitive processes may further constrain the underlying genetics. Endophenotypes are quantitative, heritable, trait‐related differences that are generally assessed with laboratory‐based methods, can be identified in the general population, and may be more closely tied to particular causal chains that have a more restricted set of genetic roots. The most fruitful endophenotypes may be those observed in infancy, prior to the emergence of behavioral symptoms that they are hypothesized to cause. Social motivation is an ASD‐related trait that is highly heritable. In this study, we investigate whether infant endophenotypes of social attention relate to familial risk for lower social motivation in the general population. Methods We examined whether infant social attention (measured using habituation, EEG power, and event‐related potential tasks previously used in infants/toddlers with ASD) varies quantitatively with parental social motivation in 117 six‐month‐old and 106 twelve‐month‐old typically developing infants assessed cross‐sectionally. To assess heritable aspects of social motivation, primary caregiver biological parents completed two self‐report measures of social avoidance and discomfort that have shown high heritability in previous work. Results Parents with higher social discomfort and avoidance had infants who showed shorter looks to faces but not objects; reduced theta power during naturalistic social attention; and smaller P400 responses to faces versus objects. Conclusions Early reductions in social attention are continuously related to lower parental social motivation. Alterations in social attention may be infant endophenotypes of social motivation traits related to ASD.
    November 08, 2016   doi: 10.1111/jcpp.12650   open full text
  • Neural correlates of explicit and implicit emotion processing in relation to treatment response in pediatric anxiety.
    Katie L. Burkhouse, Autumn Kujawa, Heide Klumpp, Kate D. Fitzgerald, Christopher S. Monk, K. Luan Phan.
    Journal of Child Psychology and Psychiatry. November 08, 2016
    Background Approximately 40%–45% of youth with anxiety disorders do not achieve remission (or a substantial reduction in symptoms) following treatment, highlighting the need to identify predictors of treatment response. Given the well‐established link between attentional biases and anxiety disorders in youth and adults, this study examined the neural correlates of directing attention toward and away from emotional faces in relation to pediatric anxiety treatment response. Method Prior to beginning treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT), 37 youth (age 7–19 years) with generalized and/or social anxiety disorder completed a task with conditions that manipulated whether participants were instructed to match emotional faces (explicit emotion processing) or match shapes in the context of emotional face distractors (implicit emotion processing) during functional magnetic resonance imaging. Results Results revealed that reduced activation in superior frontal gyrus (SFG), encompassing the dorsal anterior cingulate cortex (ACC) and dorsomedial prefrontal cortex (PFC), during implicit processing of emotional faces predicted a greater reduction in anxiety severity pre‐to‐post treatment. Post hoc analyses indicated that effects were not significantly moderated by the type of treatment or anxiety type. Conclusions Findings suggest that less recruitment of SFG, including the dorsal ACC and dorsomedial PFC, during implicit emotion processing predicts a greater reduction in youth anxiety symptoms pre‐to‐post treatment. Youth who exhibit reduced activation in these areas while matching shapes in the context of emotional face distractors may have more to gain from CBT and SSRI treatment due to preexisting deficits in attentional control. These findings suggest that neuroimaging may be a useful tool for predicting which youth are most likely to benefit from anxiety treatment.
    November 08, 2016   doi: 10.1111/jcpp.12658   open full text
  • When does speech sound disorder matter for literacy? The role of disordered speech errors, co‐occurring language impairment and family risk of dyslexia.
    Marianna E. Hayiou‐Thomas, Julia M. Carroll, Ruth Leavett, Charles Hulme, Margaret J. Snowling.
    Journal of Child Psychology and Psychiatry. November 07, 2016
    Background This study considers the role of early speech difficulties in literacy development, in the context of additional risk factors. Method Children were identified with speech sound disorder (SSD) at the age of 3½ years, on the basis of performance on the Diagnostic Evaluation of Articulation and Phonology. Their literacy skills were assessed at the start of formal reading instruction (age 5½), using measures of phoneme awareness, word‐level reading and spelling; and 3 years later (age 8), using measures of word‐level reading, spelling and reading comprehension. Results The presence of early SSD conferred a small but significant risk of poor phonemic skills and spelling at the age of 5½ and of poor word reading at the age of 8. Furthermore, within the group with SSD, the persistence of speech difficulties to the point of school entry was associated with poorer emergent literacy skills, and children with ‘disordered’ speech errors had poorer word reading skills than children whose speech errors indicated ‘delay’. In contrast, the initial severity of SSD was not a significant predictor of reading development. Beyond the domain of speech, the presence of a co‐occurring language impairment was strongly predictive of literacy skills and having a family risk of dyslexia predicted additional variance in literacy at both time‐points. Conclusions Early SSD alone has only modest effects on literacy development but when additional risk factors are present, these can have serious negative consequences, consistent with the view that multiple risks accumulate to predict reading disorders.
    November 07, 2016   doi: 10.1111/jcpp.12648   open full text
  • Executive functioning and local‐global visual processing: candidate endophenotypes for autism spectrum disorder?
    Lien Van Eylen, Bart Boets, Nele Cosemans, Hilde Peeters, Jean Steyaert, Johan Wagemans, Ilse Noens.
    Journal of Child Psychology and Psychiatry. November 02, 2016
    Background Heterogeneity within autism spectrum disorder (ASD) hampers insight in the etiology and stimulates the search for endophenotypes. Endophenotypes should meet several criteria, the most important being the association with ASD and the higher occurrence rate in unaffected ASD relatives than in the general population. We evaluated these criteria for executive functioning (EF) and local‐global (L‐G) visual processing. Methods By administering an extensive cognitive battery which increases the validity of the measures, we examined which of the cognitive anomalies shown by ASD probands also occur in their unaffected relatives (n = 113) compared to typically developing (TD) controls (n = 100). Microarrays were performed, so we could exclude relatives from probands with a de novo mutation in a known ASD susceptibility copy number variant, thus increasing the probability that genetic risk variants are shared by the ASD relatives. An overview of studies investigating EF and L‐G processing in ASD relatives was also provided. Results For EF, ASD relatives – like ASD probands – showed impairments in response inhibition, cognitive flexibility and generativity (specifically, ideational fluency), and EF impairments in daily life. For L‐G visual processing, the ASD relatives showed no anomalies on the tasks, but they reported more attention to detail in daily life. Group differences were similar for siblings and for parents of ASD probands, and yielded larger effect sizes in a multiplex subsample. The group effect sizes for the comparison between ASD probands and TD individuals were generally larger than those of the ASD relatives compared to TD individuals. Conclusions Impaired cognitive flexibility, ideational fluency and response inhibition are strong candidate endophenotypes for ASD. They could help to delineate etiologically more homogeneous subgroups, which is clinically important to allow assigning ASD probands to different, more targeted, interventions.
    November 02, 2016   doi: 10.1111/jcpp.12637   open full text
  • Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial.
    Sam Porter, Tracey McConnell, Katrina McLaughlin, Fiona Lynn, Christopher Cardwell, Hannah‐Jane Braiden, Jackie Boylan, Valerie Holmes,.
    Journal of Child Psychology and Psychiatry. October 27, 2016
    Background Although music therapy (MT) is considered an effective intervention for young people with mental health needs, its efficacy in clinical settings is unclear. We therefore examined the efficacy of MT in clinical practice. Methods Two hundred and fifty‐one child (8–16 years, with social, emotional, behavioural and developmental difficulties) and parent dyads from six Child and Adolescent Mental Health Service community care facilities in Northern Ireland were randomised to 12 weekly sessions of MT plus usual care [n = 123; 76 in final analyses] or usual care alone [n = 128; 105 in final analyses]. Follow‐up occurred at 13 weeks and 26 weeks postrandomisation. Primary outcome was improvement in communication (Social Skills Improvement System Rating Scales) (SSIS) at 13 weeks. Secondary outcomes included social functioning, self‐esteem, depression and family functioning. Results There was no significant difference for the child SSIS at week 13 (adjusted difference in mean 2.4; 95% CI −1.2 to 6.1; p = .19) or for the guardian SSIS (0.5; 95% CI −2.9 to 3.8; p = .78). However, for participants aged 13 and over in the intervention group, the child SSIS communication was significantly improved (6.1, 95% CI 1.6 to 10.5; p = .007) but not the guardian SSIS (1.1; 95% CI −2.9 to 5.2; p = .59). Overall, self‐esteem was significantly improved and depression scores were significantly lower at week 13. There was no significant difference in family or social functioning at week 13. Conclusions While the findings provide some evidence for the integration of music therapy into clinical practice, differences relating to subgroups and secondary outcomes indicate the need for further study. ISRCTN Register; ISRCTN96352204.
    October 27, 2016   doi: 10.1111/jcpp.12656   open full text
  • Longitudinal study of cerebral surface morphology in youth with 22q11.2 deletion syndrome, and association with positive symptoms of psychosis.
    Petya D. Radoeva, Ravi Bansal, Kevin M. Antshel, Wanda Fremont, Bradley S. Peterson, Wendy R. Kates.
    Journal of Child Psychology and Psychiatry. October 27, 2016
    Background 22q11.2 deletion syndrome (22q11DS) is a genetic disorder that greatly increases risk of developing schizophrenia. We previously characterized cerebral surface morphology trajectories from late childhood to mid adolescence in a cohort of youth with 22q11DS. Herein, we extend the study period into early adulthood, and describe further the trajectories associated with severe psychiatric symptoms in this cohort. Methods Participants included 76 youth with 22q11DS and 30 unaffected siblings, assessed at three timepoints, during which high resolution, anatomic magnetic resonance images were acquired. High‐dimensional, nonlinear warping algorithms were applied to images in order to derive characteristics of cerebral surface morphology for each participant at each timepoint. Repeated‐measures, linear regressions using a mixed model were conducted, while covarying for age and sex. Results Alterations in cerebral surface morphology during late adolescence/early adulthood in individuals with 22q11DS were observed in the lateral frontal, orbitofrontal, temporal, parietal, occipital, and cerebellar regions. An Age x Diagnosis interaction revealed that relative to unaffected siblings, individuals with 22q11DS showed age‐related surface protrusions in the prefrontal cortex (which remained stable or increased during early adulthood), and surface indentations in posterior regions (which seemed to level off during late adolescence). Symptoms of psychosis were associated with a trajectory of surface indentations in the orbitofrontal and parietal regions. Conclusions These results advance our understanding of cerebral maturation in individuals with 22q11DS, and provide clinically relevant information about the psychiatric phenotype associated with the longitudinal trajectory of cortical surface morphology in youth with this genetic syndrome.
    October 27, 2016   doi: 10.1111/jcpp.12657   open full text
  • Association between irritability and bias in attention orienting to threat in children and adolescents.
    Giovanni A. Salum, Karin Mogg, Brendan P. Bradley, Argyris Stringaris, Ary Gadelha, Pedro M. Pan, Luis A. Rohde, Guilherme V. Polanczyk, Gisele G. Manfro, Daniel S. Pine, Ellen Leibenluft.
    Journal of Child Psychology and Psychiatry. October 26, 2016
    Background Irritability, a frequent complaint in children with psychiatric disorders, reflects increased predisposition to anger. Preliminary work in pediatric clinical samples links irritability to attention bias to threat, and the current study examines this association in a large population‐based sample. Methods We studied 1,872 children (ages 6–14) using the Development and Well‐Being Assessment (DAWBA), Childhood Behavior Checklist (CBCL), and dot‐probe tasks. Irritability was defined using CBCL items that assessed temper tantrums and hot temper. The dot‐probe task assessed attention biases for threat‐related (angry face) stimuli. Multiple regression analysis was used to assess specificity of associations to irritability when adjusting for demographic variables and co‐occurring psychiatric traits. Propensity score matching analysis was used to increase causal inference when matching for demographic variables and co‐occurring psychiatric traits. Results Irritability was associated with increased attention bias toward threat‐related cues. Multiple regression analysis suggests associations between irritability and threat bias are independent from demographic variables, anxiety, and externalizing traits (attention‐deficit/hyperactivity, conduct, and headstrong/hurtful), but not from broad internalizing symptoms. Propensity score matching analysis indicated that this association was found for irritable versus nonirritable groups matched on demographic and co‐occurring traits including internalizing symptoms. Conclusions Irritability in children is associated with biased attention toward threatening information. This finding, if replicated, warrants further investigation to examine the extent to which it contributes to chronic irritability and to explore possible treatment implications.
    October 26, 2016   doi: 10.1111/jcpp.12659   open full text
  • Research Review: Neural response to threat in children, adolescents, and adults after child maltreatment – a quantitative meta‐analysis.
    Tyler C. Hein, Christopher S. Monk.
    Journal of Child Psychology and Psychiatry. October 25, 2016
    Background Child maltreatment is common and has long‐term consequences for affective function. Investigations of neural consequences of maltreatment have focused on the amygdala. However, developmental neuroscience indicates that other brain regions are also likely to be affected by child maltreatment, particularly in the social information processing network (SIPN). We conducted a quantitative meta‐analysis to: confirm that maltreatment is related to greater bilateral amygdala activation in a large sample that was pooled across studies; investigate other SIPN structures that are likely candidates for altered function; and conduct a data‐driven examination to identify additional regions that show altered activation in maltreated children, teens, and adults. Methods We conducted an activation likelihood estimation analysis with 1,733 participants across 20 studies of emotion processing in maltreated individuals. Results Maltreatment is associated with increased bilateral amygdala activation to emotional faces. One SIPN structure is altered: superior temporal gyrus, of the detection node, is hyperactive in maltreated individuals. The results of the whole‐brain corrected analysis also show hyperactivation of the parahippocampal gyrus and insula in maltreated individuals. Conclusions The meta‐analysis confirms that maltreatment is related to increased bilateral amygdala reactivity and also shows that maltreatment affects multiple additional structures in the brain that have received little attention in the literature. Thus, although the majority of studies examining maltreatment and brain function have focused on the amygdala, these findings indicate that the neural consequences of child maltreatment involve a broader network of structures.
    October 25, 2016   doi: 10.1111/jcpp.12651   open full text
  • Food fussiness and food neophobia share a common etiology in early childhood.
    Andrea D. Smith, Moritz Herle, Alison Fildes, Lucy Cooke, Silje Steinsbekk, Clare H. Llewellyn.
    Journal of Child Psychology and Psychiatry. October 14, 2016
    Background ‘Food fussiness’ (FF) is the tendency to be highly selective about which foods one is willing to eat, and emerges in early childhood; ‘food neophobia’ (FN) is a closely related characteristic but specifically refers to rejection of unfamiliar food. These behaviors are associated, but the extent to which their etiological architecture overlaps is unknown. The objective of this study was to quantify the relative contribution of genetic and environmental influences to variation in FF and FN in early childhood; and to establish the extent to which they share common genetic and environmental influences. Method Participants were 1,921 families with 16‐month‐old twins from the Gemini birth cohort. Parents completed the Child Eating Behaviour Questionnaire which included three FF items and four FN items. Bivariate quantitative genetic modeling was used to quantify: (a) genetic and environmental contributions to variation in FF and FN; and (b) the extent to which genetic or environmental influences on FF and FN are shared across the traits. Results Food fussiness and FN were strongly correlated (r = .72, p < .001). Proportions of variation in FF were equally explained by genetic (.46; 95% CI: 0.41–0.52) and shared environmental influences (.46; 95% CI: 0.41–0.51). Shared environmental effects accounted for a significantly lower proportion of variation in FN (.22; 95% CI: 0.14–0.30), but genetic influences were not significantly different from those on FF (.58, 95% CI: 0.50–0.67). FF and FN largely shared a common etiology, indicated by high genetic (.73; 95% CI: 0.67–0.78) and shared environmental correlations (.78; 95% CI: 0.69–0.86) across the two traits. Conclusions Food fussiness and FN both show considerable heritability at 16 months but shared environmental factors, for example the home environment, influenced more interindividual differences in the expression of FF than in FN. FF and FN largely share a common etiology.
    October 14, 2016   doi: 10.1111/jcpp.12647   open full text
  • A DRD4 gene by maternal sensitivity interaction predicts risk for overweight or obesity in two independent cohorts of preschool children.
    Robert D. Levitan, Pauline Jansen, Barbara Wendland, Henning Tiemeier, Vincent W. Jaddoe, Patricia P. Silveira, James L. Kennedy, Leslie Atkinson, Alison Fleming, Marla Sokolowski, Helene Gaudreau, Meir Steiner, Laurette Dubé, Jill Hamilton, Ellen Moss, Ashley Wazana, Michael Meaney.
    Journal of Child Psychology and Psychiatry. October 11, 2016
    Background Recent evidence suggests that early exposure to low maternal sensitivity is a risk factor for obesity in children and adolescents. A separate line of study shows that the seven‐repeat (7R) allele of the dopamine‐4 receptor gene (DRD4) increases susceptibility to environmental factors including maternal sensitivity. The current study integrates these lines of work by examining whether preschoolers carrying the 7R allele are more vulnerable to low maternal sensitivity as it relates to overweight/obesity risk. Method The Maternal Adversity Vulnerability and Neurodevelopment (MAVAN) project in Canada was used as the discovery cohort (N = 203), while the Generation R study in the Netherlands was used as a replication sample (N = 270). Regression models to predict both continuous BMI z‐scores and membership in any higher BMI category based on established World Health Organization (WHO) cutoffs for 48 months of age were completed. Results In both cohorts, there was a significant maternal sensitivity by DRD4 by sex interaction predicting higher body mass indices and/or obesity risk. As hypothesized, post hoc testing revealed an inverse relationship between maternal sensitivity and body mass indices in 7R allele carriers relative to noncarriers. This finding was strongest in girls in the Canadian cohort and in boys in the Dutch cohort. Conclusions Many children who carry the 7R allele of DRD4 appear to be more influenced by maternal sensitivity as it relates to overweight/obesity risk, consistent with a plasticity effect. Given the relatively small sample sizes available for these analyses, further replications will be needed to confirm and extend these results.
    October 11, 2016   doi: 10.1111/jcpp.12646   open full text
  • A cluster‐randomised, controlled trial of the impact of Cogmed Working Memory Training on both academic performance and regulation of social, emotional and behavioural challenges.
    Caitlin Hitchcock, Martin S. Westwell.
    Journal of Child Psychology and Psychiatry. October 08, 2016
    Background We explored whether school‐based Cogmed Working Memory Training (CWMT) may optimise both academic and psychological outcomes at school. Training of executive control skills may form a novel approach to enhancing processes that predict academic achievement, such as task‐related attention, and thereby academic performance, but also has the potential to improve the regulation of emotion, social problems and behavioural difficulties. Methods Primary school children (Mean age = 12 years, N = 148) were cluster‐randomised to complete active CWMT, a nonadaptive/placebo version of CWMT, or no training. Results No evidence was found for training effects on task‐related attention when performing academic tasks, or performance on reading comprehension and mathematics tasks, or teacher‐reported social, emotional and behavioural difficulties. Conclusions CWMT did not improve control of attention in the classroom, or regulation of social, emotional and behavioural difficulties.
    October 08, 2016   doi: 10.1111/jcpp.12638   open full text
  • Annual Research Review: Quality of life and childhood mental and behavioural disorders – a critical review of the research.
    Ulf Jonsson, Iman Alaie, Anna Löfgren Wilteus, Eric Zander, Peter B. Marschik, David Coghill, Sven Bölte.
    Journal of Child Psychology and Psychiatry. October 06, 2016
    Background An individual's subjective perception of well‐being is increasingly recognized as an essential complement to clinical symptomatology and functional impairment in children's mental health. Measurement of quality of life (QoL) has the potential to give due weight to the child's perspective. Scope and methodology Our aim was to critically review the current evidence on how childhood mental disorders affect QoL. First, the major challenges in this research field are outlined. Then we present a systematic review of QoL in children and adolescents aged 0–18 years formally diagnosed with a mental and behavioural disorder, as compared to healthy or typically developing children or children with other health conditions. Finally, we discuss limitations of the current evidence base and future directions based on the results of the systematic review and other relevant literature. Findings and conclusions The systematic review identified 41 eligible studies. All were published after the year 2000 and 21 originated in Europe. The majority examined QoL in neurodevelopmental disorders, including attention‐deficit hyperactivity disorder (k = 17), autism spectrum disorder (k = 6), motor disorders (k = 5) and intellectual disability (k = 4). Despite substantial heterogeneity, studies demonstrate that self‐reported global QoL is significantly reduced compared to typical/healthy controls across several disorders and QoL dimensions. Parents’ ratings were on average substantially lower, casting doubt on the validity of proxy‐report. Studies for large diagnostic groups such as depressive disorders, anxiety disorders, (early onset) schizophrenia and eating disorders are largely lacking. We conclude that representative, well‐characterized normative and clinical samples as well as longitudinal and qualitative designs are needed to further clarify the construct of QoL, to derive measures of high ecological validity, and to examine how QoL fluctuates over time and is attributable to specific conditions or contextual factors.
    October 06, 2016   doi: 10.1111/jcpp.12645   open full text
  • DSM‐IV, DSM‐5, and ICD‐11: Identifying children with posttraumatic stress disorder after disasters.
    BreAnne A. Danzi, Annette M. La Greca.
    Journal of Child Psychology and Psychiatry. September 28, 2016
    Background Different criteria for diagnosing posttraumatic stress disorder (PTSD) have been recommended by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) and the proposed 11th edition of the International Classification of Diseases (ICD‐11). Although children are vulnerable to PTSD following disasters, little is known about whether these revised criteria are appropriate for preadolescents, as diagnostic revisions have been based primarily on adult research. This study investigated rates of PTSD using DSM‐IV, DSM‐5, and ICD‐11 diagnostic criteria, and their associations with symptom severity, impairment, and PTSD risk factors. Methods Children (7–11 years) exposed to Hurricanes Ike (n = 327) or Charley (n = 383) completed measures 8–9 months postdisaster. Using diagnostic algorithms for DSM‐IV, DSM‐5, and ICD‐11, rates of ‘probable’ PTSD were calculated. Results Across samples, rates of PTSD were similar. However, there was low agreement across the diagnostic systems, with about a third overlap in identified cases. Children identified only by ICD‐11 had higher ‘core’ symptom severity but lower impairment than children identified only by DSM‐IV or DSM‐5. ICD‐11 was associated with more established risk factors for PTSD than was DSM‐5. Conclusions Findings revealed differences in PTSD diagnosis across major diagnostic systems for preadolescent children, with no clear advantage to any one system. Further research on developmentally sensitive PTSD criteria for preadolescent children is needed.
    September 28, 2016   doi: 10.1111/jcpp.12631   open full text
  • Parenting and cognitive and psychomotor delay due to small‐for‐gestational‐age birth.
    Xiuhong Li, Rina D. Eiden, Leonard H. Epstein, Edmond D. Shenassa, Chuanbo Xie, Xiaozhong Wen.
    Journal of Child Psychology and Psychiatry. September 28, 2016
    Background To examine whether different dimensions of parenting at different ages help small‐for‐gestational‐age (SGA) children ‘catch‐up’ the normal children in cognition and psychomotor. Methods We analyzed data of 800 children born SGA and 3,000 children born appropriate‐for‐gestational‐age (AGA) from the Early Childhood Longitudinal Study‐Birth cohort. The Two Bag Task was used to measure 2‐year or 4‐year parenting dimensions. Children's reading, math, gross motor, and fine motor scores were assessed at 5 years. Multivariable linear regression models were fitted to test the interactions between SGA and 2‐year or 4‐year parenting dimensions on 5‐year cognitive and psychomotor outcomes (dependent variables). Results There were significant interactions between SGA and early parenting on 5‐year reading, math, and fine motor scores. The gap between SGA and AGA children in 5‐year fine motor score was attenuated to null [−0.25 (95% confidence interval, −0.41, −0.09) vs. 0.03 (−0.13, 0.20)] when 2‐year parental sensitivity score increased from 1 standard deviation (SD) below mean (Mean − SD) to 1 SD above mean (Mean + SD). The gap between SGA and AGA children in 5‐year fine motor [−0.28 (−0.44, −0.13) vs. 0.06 (−0.09, 0.22)] and math [−1.32 (−2.27, −0.37) vs. 0.20 (−0.77, 1.17)] scores was also attenuated to null when 4‐year parental emotional support score increased from Mean − SD to Mean + SD. In contrast, the gap between SGA and AGA children in 5‐year reading score increased from 0.49 (−0.90, 1.88) to −1.31 (−2.55, −0.07) when 4‐year parental intrusiveness score increased from Mean − SD to Mean + SD. Similarly, the gap between SGA and AGA children in fine motor score increased with 4‐year parental negative regard from 0.02 (−0.14, 0.18) to −0.23 (−0.38, −0.08). Conclusions Early high‐quality parenting may buffer some adversity in long‐term reading, math, and fine motor skills related to SGA birth, whereas low‐quality parenting can amplify the adversity.
    September 28, 2016   doi: 10.1111/jcpp.12644   open full text
  • Children with ADHD symptoms show decreased activity in ventral striatum during the anticipation of reward, irrespective of ADHD diagnosis.
    Branko M. Hulst, Patrick Zeeuw, Dienke J. Bos, Yvonne Rijks, Sebastiaan F. W. Neggers, Sarah Durston.
    Journal of Child Psychology and Psychiatry. September 28, 2016
    Background Changes in reward processing are thought to be involved in the etiology of attention‐deficit/hyperactivity disorder (ADHD), as well as other developmental disorders. In addition, different forms of therapy for ADHD rely on reinforcement principles. As such, improved understanding of reward processing in ADHD could eventually lead to more effective treatment options. However, differences in reward processing may not be specific to ADHD, but may be a trans‐diagnostic feature of disorders that involve ADHD‐like symptoms. Methods In this event‐related fMRI study, we used a child‐friendly version of the monetary incentive delay task to assess performance and brain activity during reward anticipation. Also, we collected questionnaire data to assess reward sensitivity in daily life. For final analyses, data were available for 27 typically developing children, 24 children with ADHD, and 25 children with an autism spectrum disorder (ASD) and ADHD symptoms. Results We found decreased activity in ventral striatum during anticipation of reward in children with ADHD symptoms, both for children with ADHD as their primary diagnosis and in children with autism spectrum disorder and ADHD symptoms. We found that higher parent‐rated sensitivity to reward was associated with greater anticipatory activity in ventral striatum for children with ADHD symptoms. In contrast, there was no relationship between the degree of ADHD symptoms and activity in ventral striatum. Conclusions We provide evidence of biological and behavioral differences in reward sensitivity in children with ADHD symptoms, regardless of their primary diagnosis. Ultimately, a dimensional brain‐behavior model of reward sensitivity in children with symptoms of ADHD may be useful to refine treatment options dependent on reward processing.
    September 28, 2016   doi: 10.1111/jcpp.12643   open full text
  • Reduced tract integrity of the model for social communication is a neural substrate of social communication deficits in autism spectrum disorder.
    Yu‐Chun Lo, Yu‐Jen Chen, Yung‐Chin Hsu, Wen‐Yih Isaac Tseng, Susan Shur‐Fen Gau.
    Journal of Child Psychology and Psychiatry. September 28, 2016
    Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with social communication deficits as one of the core symptoms. Recently, a five‐level model for the social communication has been proposed in which white matter tracts corresponding to each level of the model are identified. Given that the model for social communication subserves social language functions, we hypothesized that the tract integrity of the model for social communication may be reduced in ASD, and the reduction may be related to social communication deficits. Methods Sixty‐two right‐handed boys with ASD and 55 typically developing (TD) boys received clinical evaluations, intelligence tests, the Social Communication Questionnaire (SCQ), and MRI scans. Generalized fractional anisotropy (GFA) was measured by diffusion spectrum imaging to indicate the microstructural integrity of the tracts for each level of the social communication model. Group difference in the tract integrity and its relationship with the SCQ subscales of social communication and social interaction were investigated. Results We found that the GFA values of the superior longitudinal fasciculus III (SLF III, level 1) and the frontal aslant tracts (FAT, level 2) were decreased in ASD compared to TD. Moreover, the GFA values of the SLF III and the FAT were associated with the social interaction subscale in ASD. Conclusions The tract integrity of the model for social communication is reduced in ASD, and the reduction is associated with impaired social interaction. Our results support that reduced tract integrity of the model for social communication might be a neural substrate of social communication deficits in ASD.
    September 28, 2016   doi: 10.1111/jcpp.12641   open full text
  • Complex PTSD as proposed for ICD‐11: validation of a new disorder in children and adolescents and their response to Trauma‐Focused Cognitive Behavioral Therapy.
    Cedric Sachser, Ferdinand Keller, Lutz Goldbeck.
    Journal of Child Psychology and Psychiatry. September 28, 2016
    Background To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD‐11, and to relate the emerging classes with treatment outcome of Trauma‐Focused Cognitive Behavioral Therapy (TF‐CBT). Methods Latent classes analysis (LCA) was used to explore the symptom profiles of the clinical baseline assessment of N = 155 children and adolescents participating in a randomized controlled trial of TF‐CBT. The treatment outcomes of patients with posttraumatic stress disorder (PTSD) and of patients with CPTSD were compared by a t‐test for depended samples and a repeated‐measures ANOVA. Results The LCA revealed two distinct classes: a PTSD class characterized by elevated core symptoms of PTSD (n = 62) and low symptoms of disturbances in self‐organization versus a complex PTSD class with elevated PTSD core symptoms and elevated symptoms of disturbances in self‐organization (n = 93). The Group × Time interaction regarding posttraumatic stress symptoms was not significant. Pre–post effect sizes regarding posttraumatic stress symptoms were large for both groups (PTSD: d = 2.81; CPTSD: d = 1.37). For disturbances in self‐organization in the CPTSD class, we found medium to large effect sizes (d = 0.40–1.16) after treatment with TF‐CBT. Conclusions The results provide empirical evidence of the ICD‐11 CPTSD and PTSD distinction in a clinical sample of children and adolescents. In terms of relative improvement from their respective baseline posttraumatic stress symptoms, patients with PTSD and CPTSD responded equally to TF‐CBT; however, those with CPTSD ended treatment with clinically and statistically greater symptoms than those with PTSD.
    September 28, 2016   doi: 10.1111/jcpp.12640   open full text
  • Moderators of treatment response to trauma‐focused cognitive behavioral therapy among youth in Zambia.
    Jeremy C. Kane, Laura K. Murray, Judith Cohen, Shannon Dorsey, Stephanie Skavenski van Wyk, Jennica Galloway Henderson, Mwiya Imasiku, John Mayeya, Paul Bolton.
    Journal of Child Psychology and Psychiatry. September 20, 2016
    Background The effectiveness of mental health interventions such as trauma‐focused cognitive behavioral therapy (TF‐CBT) may vary by client, caregiver, and intervention‐level variables, but few randomized trials in low‐ and middle‐income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF‐CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia. Methods Data were obtained from a completed randomized trial of TF‐CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment. Results Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p < .05; functioning, p < .01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (p < .01), and better functioning in those that identified their father as the primary caretaker (p < .05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (p < .01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment. Conclusions This study suggests that TF‐CBT was effective in reducing trauma symptoms and functional impairment among trauma‐affected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale‐up of TF‐CBT is warranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible.
    September 20, 2016   doi: 10.1111/jcpp.12623   open full text
  • Childhood abuse and reduced cortical thickness in brain regions involved in emotional processing.
    Andrea L. Gold, Margaret A. Sheridan, Matthew Peverill, Daniel S. Busso, Hilary K. Lambert, Sonia Alves, Daniel S. Pine, Katie A. McLaughlin.
    Journal of Child Psychology and Psychiatry. September 20, 2016
    Background Alterations in gray matter development represent a potential pathway through which childhood abuse is associated with psychopathology. Several prior studies find reduced volume and thickness of prefrontal (PFC) and temporal cortex regions in abused compared with nonabused adolescents, although most prior research is based on adults and volume‐based measures. This study tests the hypothesis that child abuse, independent of parental education, predicts reduced cortical thickness in prefrontal and temporal cortices as well as reduced gray mater volume (GMV) in subcortical regions during adolescence. Methods Structural MRI scans were obtained from 21 adolescents exposed to physical and/or sexual abuse and 37 nonabused adolescents (ages 13–20). Abuse was operationalized using dichotomous and continuous measures. We examined associations between abuse and brain structure in several a priori‐defined regions, controlling for parental education, age, sex, race, and total brain volume for subcortical GMV. Significance was evaluated at p < .05 with a false discovery rate correction. Results Child abuse exposure and severity were associated with reduced thickness in ventromedial prefrontal cortex (PFC), right lateral orbitofrontal cortex, right inferior frontal gyrus, bilateral parahippocampal gyrus (PHG), left temporal pole, and bilateral inferior, right middle, and right superior temporal gyri. Neither abuse measure predicted cortical surface area or subcortical GMV. Bilateral PHG thickness was inversely related to externalizing symptoms. Conclusions Child abuse, an experience characterized by a high degree of threat, is associated with reduced cortical thickness in ventromedial and ventrolateral PFC and medial and lateral temporal cortex in adolescence. Reduced PHG thickness may be a mediator linking abuse with externalizing psychopathology, although prospective research is needed to evaluate this possibility.
    September 20, 2016   doi: 10.1111/jcpp.12630   open full text
  • Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health.
    Aaron Reuben, Terrie E. Moffitt, Avshalom Caspi, Daniel W. Belsky, Honalee Harrington, Felix Schroeder, Sean Hogan, Sandhya Ramrakha, Richie Poulton, Andrea Danese.
    Journal of Child Psychology and Psychiatry. September 20, 2016
    Background Adverse childhood experiences (ACEs; e.g. abuse, neglect, and parental loss) have been associated with increased risk for later‐life disease and dysfunction using adults’ retrospective self‐reports of ACEs. Research should test whether associations between ACEs and health outcomes are the same for prospective and retrospective ACE measures. Methods We estimated agreement between ACEs prospectively recorded throughout childhood (by Study staff at Study member ages 3, 5, 7, 9, 11, 13, and 15) and retrospectively recalled in adulthood (by Study members when they reached age 38), in the population‐representative Dunedin cohort (N = 1,037). We related both retrospective and prospective ACE measures to physical, mental, cognitive, and social health at midlife measured through both objective (e.g. biomarkers and neuropsychological tests) and subjective (e.g. self‐reported) means. Results Dunedin and U.S. Centers for Disease Control ACE distributions were similar. Retrospective and prospective measures of adversity showed moderate agreement (r = .47, p < .001; weighted Kappa = .31, 95% CI: .27–.35). Both associated with all midlife outcomes. As compared to prospective ACEs, retrospective ACEs showed stronger associations with life outcomes that were subjectively assessed, and weaker associations with life outcomes that were objectively assessed. Recalled ACEs and poor subjective outcomes were correlated regardless of whether prospectively recorded ACEs were evident. Individuals who recalled more ACEs than had been prospectively recorded were more neurotic than average, and individuals who recalled fewer ACEs than recorded were more agreeable. Conclusions Prospective ACE records confirm associations between childhood adversity and negative life outcomes found previously using retrospective ACE reports. However, more agreeable and neurotic dispositions may, respectively, bias retrospective ACE measures toward underestimating the impact of adversity on objectively measured life outcomes and overestimating the impact of adversity on self‐reported outcomes. Associations between personality factors and the propensity to recall adversity were extremely modest and warrant further investigation. Risk predictions based on retrospective ACE reports should utilize objective outcome measures. Where objective outcome measurements are difficult to obtain, correction factors may be warranted.
    September 20, 2016   doi: 10.1111/jcpp.12621   open full text
  • Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity.
    Margaret H. Sibley, James M. Swanson, L. Eugene Arnold, Lily T. Hechtman, Elizabeth B. Owens, Annamarie Stehli, Howard Abikoff, Stephen P. Hinshaw, Brooke S.G. Molina, John T. Mitchell, Peter S. Jensen, Andrea L. Howard, Kimberley D. Lakes, William E. Pelham,.
    Journal of Child Psychology and Psychiatry. September 19, 2016
    Objective Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5–75%). This study documents how information source (parent vs. self‐report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm‐based) influence reported ADHD persistence rates in adulthood. Method Five hundred seventy‐nine children were diagnosed with DSM‐IV ADHD‐Combined Type at baseline (ages 7.0–9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self‐reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood. Results Persistence rates were higher when using parent rather than self‐reports, structured interviews rather than rating scales (for self‐report but not parent report), and a norm‐based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver‐Operating Characteristics (ROC) analyses revealed that sensitivity and specificity were optimized by combining parent and self‐reports on a rating scale and applying a NB threshold. Conclusion The interview format optimizes young adult self‐reporting when parent reports are not available. However, the combination of parent and self‐reports from rating scales, using an ‘or’ rule and a NB threshold optimized the balance between sensitivity and specificity. With this definition, 60% of the ADHD group demonstrated symptom persistence and 41% met both symptom and impairment criteria in adulthood.
    September 19, 2016   doi: 10.1111/jcpp.12620   open full text
  • Characteristics of socially successful elementary school‐aged children with autism.
    Jill Locke, Justin Williams, Wendy Shih, Connie Kasari.
    Journal of Child Psychology and Psychiatry. September 13, 2016
    Background The extant literature demonstrates that children with autism spectrum disorder (ASD) often have difficulty interacting and socially connecting with typically developing classmates. However, some children with ASD have social outcomes that are consistent with their typically developing counterparts. Little is known about this subgroup of children with ASD. This study examined the stable (unlikely to change) and malleable (changeable) characteristics of socially successful children with ASD. Methods This study used baseline data from three intervention studies performed in public schools in the Southwestern United States. A total of 148 elementary‐aged children with ASD in 130 classrooms in 47 public schools participated. Measures of playground peer engagement and social network salience (inclusion in informal peer groups) were obtained. Results The results demonstrated that a number of malleable factors significantly predicted playground peer engagement (class size, autism symptom severity, peer connections) and social network salience (autism symptom severity, peer connections, received friendships). In addition, age was the only stable factor that significantly predicted social network salience. Interestingly, two malleable (i.e., peer connections and received friendships) and no stable factors (i.e., age, IQ, sex) predicted overall social success (e.g., high playground peer engagement and social network salience) in children with ASD. Conclusions School‐based interventions should address malleable factors such as the number of peer connections and received friendships that predict the best social outcomes for children with ASD.
    September 13, 2016   doi: 10.1111/jcpp.12636   open full text
  • Rumination in dysphoric mothers negatively affects mother–infant interactions.
    Michelle Tester‐Jones, Anke Karl, Edward Watkins, Heather O'Mahen.
    Journal of Child Psychology and Psychiatry. September 12, 2016
    Background Postnatal maternal depressive symptoms are consistently associated with reduced quality of mother–infant interaction. However, there is little research examining the role of maternal cognitive factors (e.g. rumination) in the relationship between depressive symptoms and mother–infant interaction quality. This study investigated the hypotheses that: dysphoric mothers would demonstrate less sensitive behaviour towards their infants compared with nondysphoric mothers; mothers induced to ruminate would be less sensitive towards infants; rumination would moderate the relationship between maternal depressive symptoms and maternal sensitivity and the impact of the rumination induction would increase following a stressor (still face) task. Method Mothers (N = 79; 39 dysphoric and 40 nondysphoric) and their infants were randomised to either a rumination induction or a control condition. Maternal sensitivity in mother–infant interactions was assessed before and after the induction using the CARE Index. In the second interaction task, mothers also completed the still‐face procedure as a stressor. Results Extending previous research, mixed measures ANOVAs demonstrated that dysphoric mothers had reduced quality of interaction with their infant compared with nondysphoric mothers and that mothers in the rumination condition exhibited reduced sensitivity towards their infants relative to mothers in the control condition. Further, maternal sensitivity worsened further after the still‐face procedure in the rumination condition, but not in the control condition. Conclusions This study suggests that the repetitive, internal focus of a ruminative state is causally implicated in mother–infant interaction quality, regardless of the level of depressive symptoms. This research extends understanding of specific mechanisms involved in the quality of the mother–infant relationship.
    September 12, 2016   doi: 10.1111/jcpp.12633   open full text
  • Variation in common preschool sleep problems as an early predictor for depression and anxiety symptom severity across time.
    Diana J. Whalen, Kirsten E. Gilbert, Deanna M. Barch, Joan L. Luby, Andy C. Belden.
    Journal of Child Psychology and Psychiatry. September 12, 2016
    Background Child and adolescent psychopathology has been linked to increased sleep problems, but there has been less investigation of this relationship in younger samples with early‐onset psychopathology. This study examined three specific but commonly observed aspects of sleep behaviors in young children – (i) Sleep onset latency, (ii) Refusal to sleep alone, and (iii) Nighttime awakenings – measured during preschool, and investigated whether these sleep problems predicted anxiety and/or depression across the next 6 years until school age (ages 9–13). Methods Data were analyzed from N = 292 participants from a prospective longitudinal study of preschool‐age children (ages 3–6). At baseline, parent‐reported clinical interviews of psychiatric symptoms, as well as sleep problems were conducted using the Preschool‐Age Psychiatric Assessment (PAPA). Follow‐up clinical interviews were also conducted annually through school age using the Childhood and Adolescent Psychiatric Assessment (CAPA). Results Parent‐reported sleep onset latency and refusal to sleep alone were significant independent predictors of MDD and anxiety severity, but not ADHD severity across time, even after controlling for family income‐to‐needs ratio and maternal internalizing psychopathology. In exploratory analyses using only healthy preschoolers, parent‐reported sleep onset latency and refusal to sleep alone also predicted anxiety severity. Conclusions We demonstrate that specific, yet relatively common sleep problems predict diagnostic severity of depression and anxiety across time, but not ADHD. Increased clinical attention to and screening for sleep onset latency and refusal to sleep alone during preschool may be warranted.
    September 12, 2016   doi: 10.1111/jcpp.12639   open full text
  • Evidence for increased behavioral control by punishment in children with attention‐deficit hyperactivity disorder.
    Emi Furukawa, Brent Alsop, Paula Sowerby, Stephanie Jensen, Gail Tripp.
    Journal of Child Psychology and Psychiatry. September 09, 2016
    Background The behavioral sensitivity of children with ADHD to punishment has received limited theoretical and experimental attention. This study evaluated the effects of punishment on the response allocation of children with ADHD and typically developing children. Method Two hundred and ten children, 145 diagnosed with ADHD, completed an operant task in which they chose between playing two simultaneously available games. Reward was arranged symmetrically across the games under concurrent variable interval schedules. Asymmetric punishment schedules were superimposed; responses on one game were punished four times as often as responses on the other. Results Both groups allocated more of their responses to the less frequently punished alternative. Response bias increased significantly in the ADHD group during later trials, resulting in missed reward trials and reduced earnings. Conclusions Punishment exerted greater control over the response allocation of children with ADHD with increased time on task. Children with ADHD appear more sensitive to the cumulative effects of punishment than typically developing children.
    September 09, 2016   doi: 10.1111/jcpp.12635   open full text
  • Stability of core language skill across the first decade of life in children at biological and social risk.
    Marc H. Bornstein, Chun‐Shin Hahn, Diane L. Putnick.
    Journal of Child Psychology and Psychiatry. September 08, 2016
    Background Command of language is a fundamental skill, a cornerstone of multiple cognitive and socioemotional aspects of development, and a necessary ingredient of successful adjustment and functioning in society. Little is known about the developmental stability of language in at‐risk youth or which biological and social risk factors moderate stability. Methods This four‐wave 10‐year prospective longitudinal study evaluated stability of core language skill in 1,780 children in varying categories of biological and social risk in a multiage, multidomain, multimeasure, and multireporter framework. Results Structural equation modeling supported loadings of diverse age‐appropriate measures of child language on single latent variables of core language skill at 15 and 25 months and 5 and 11 years, respectively. Core language skill was stable over the first decade of life; significant and comparable stability coefficients were obtained for children with diverse biological and social risks, including poor health, welfare status, teen motherhood, ethnicity, gender, birth order, and families that changed in income and maternal education over the study period; stability in language was strong even accounting for child nonverbal intelligence and social competence, maternal education and language, and the family home environment. Conclusions Core language skill varies in stability with age but is robustly stable in children regardless of multiple biological and social risk factors.
    September 08, 2016   doi: 10.1111/jcpp.12632   open full text
  • Hypervigilance‐avoidance in children with anxiety disorders: magnetoencephalographic evidence.
    Ida Wessing, Georg Romer, Markus Junghöfer.
    Journal of Child Psychology and Psychiatry. September 08, 2016
    Background An altered pattern of threat processing is deemed critical for the development of anxiety disorders (AD). According to the hypervigilance‐avoidance hypothesis, AD patients show hypervigilance to threat cues at early stages of processing but avoid threat cues at later stages of processing. Consistently, adults with AD show enhanced neurophysiological responses to threat in early time windows and reduced responses to threat in late time windows. The presence of such a hypervigilance‐avoidance effect and its underlying neural sources remain to be determined in clinically anxious children. Methods Twenty‐three children diagnosed with an AD and 23 healthy control children aged 8–14 years saw faces with angry and neutral expressions while whole‐head magnetoencephalography (MEG) was recorded. Neural sources were estimated based on L2‐Minimum Norm inverse source modeling and analyzed in early, midlatency, and late time windows. Results In visual cortical regions, early threat processing was relatively enhanced in patients compared to controls, whereas this relation was inverted in a late interval. Consistent with the idea of affective regulation, the right dorsolateral prefrontal cortex revealed relatively reduced inhibition of early threat processing but revealed enhanced inhibition at a late interval in patients. Both visual‐sensory and prefrontal effects were correlated with individual trait anxiety. Conclusions These results support the hypothesis of early sensory hypervigilance followed by later avoidance of threat in anxiety disordered children, presumably modulated by early reduced and later enhanced prefrontal inhibition. This neuronal hypervigilance‐avoidance pattern unfolds gradually with increasing trait anxiety, reflecting a progressively biased allocation of attention to threat.
    September 08, 2016   doi: 10.1111/jcpp.12617   open full text
  • Risk and resilience trajectories in war‐exposed children across the first decade of life.
    Galit Halevi, Amir Djalovski, Adva Vengrober, Ruth Feldman.
    Journal of Child Psychology and Psychiatry. August 30, 2016
    Background Although the effects of early‐onset trauma on susceptibility to psychopathology are well‐acknowledged, no study to date has followed risk and resilience trajectories in war‐exposed young children over lengthy periods and charted predictors of individual pathways. Method In this prospective longitudinal study, we followed 232 children, including 148 exposed to repeated wartime trauma and 84 controls, at three time points: early childhood (1.5–5 years), middle childhood (5–8 years), and late childhood (9–11 years). Children were diagnosed at each time point and four trajectories defined: children exhibiting no pathology at any time point, those displaying early pathology that later remitted, those showing initial resilience followed by late pathology, and children presenting chronic pathology across the entire first decade. Maternal behavioral containment during trauma evocation and child social engagement during free play were observed in early childhood and maternal emotional distress self‐reported across time. Results War‐exposed children showed significantly higher rates of psychopathology, with 81% exhibiting pathology at some point during childhood. In middle childhood, exposed children displayed more posttraumatic stress disorders (PTSD), anxiety disorders, and attention‐deficit/hyperactivity disorders (ADHD), and in late childhood more PTSD, conduct/oppositional defiant disorders, and ADHD. War‐exposed children had more comorbid psychopathologies and number of comorbidities increased with age. Notably, war‐exposure increased prevalence of chronic pathology by 24‐fold. Maternal factors, including mother's uncontained style and emotional distress, increased risk for early and chronic psychopathology, whereas reduced child social engagement augmented risk for late pathology. Conclusions Early‐onset chronic stress does not heal naturally, and its effects appear to exacerbate over time, with trauma‐exposed children presenting a more comorbid, chronic, and externalizing profile as they grow older. Our findings demonstrate that responses to trauma are dynamic and variable and pinpoint age‐specific effects of maternal and child factors on risk and resilience trajectories. Results highlight the importance of conducting long‐term follow‐up studies and constructing individually tailored early interventions following trauma exposure.
    August 30, 2016   doi: 10.1111/jcpp.12622   open full text
  • Deficits in error monitoring are associated with externalizing but not internalizing behaviors among children with a history of institutionalization.
    Sonya Troller‐Renfree, Charles A. Nelson, Charles H. Zeanah, Nathan A. Fox.
    Journal of Child Psychology and Psychiatry. August 29, 2016
    Background Children raised in institutions are at increased risk of developing internalizing and externalizing problems. However, not all children raised in institutions develop psychopathology. Deficits in error monitoring may be one risk pathway for children with a history of institutionalization given that these skills are related to both internalizing and externalizing psychiatric disorders. Error monitoring and the neural circuitry that supports it have a protracted developmental time course and are highly susceptible to the effects of adversity. As such, they may play an important moderating role between a history of institutional rearing and subsequent psychopathology. Methods We investigated the impact of psychosocial deprivation on behavioral and neural responses (event‐related potentials: ERPs) to a Flanker task assessing error monitoring and the relations between these measures and psychopathology for 12‐year‐old children in the Bucharest Early Intervention Project (BEIP). The BEIP involves two groups of institutionalized children randomly assigned in infancy to receive either a foster care intervention (FCG) or care as usual (CAUG). Results Children who experienced institutional care, particularly those in the CAUG, showed perturbed behavioral performance and ERPs on the Flanker task. Additionally, an ERP measure of error monitoring [error‐related negativity (ERN)] moderated the relations between time spent in institutions and externalizing and ADHD behaviors. When the amplitude of the ERN was smaller, time spent in institutional care was positively related to ADHD and externalizing behaviors, whereas time spent in institutions was unrelated to externalizing problems when children evidenced a larger ERN. Neural correlates of error monitoring did not moderate the relations between time spent in institutionalized care and internalizing behaviors. Conclusions Exposure to institutional care early in life may affect brain circuitry associated with error monitoring. Perturbations in this neural circuitry in combination with psychosocial deprivation are possibly a risk pathway associated with the development of externalizing and ADHD problems.
    August 29, 2016   doi: 10.1111/jcpp.12604   open full text
  • Computerised attention training for children with intellectual and developmental disabilities: a randomised controlled trial.
    Hannah E. Kirk, Kylie M. Gray, Kirsten Ellis, John Taffe, Kim M. Cornish.
    Journal of Child Psychology and Psychiatry. August 23, 2016
    Background Children with intellectual and developmental disabilities (IDD) experience heightened attention difficulties which have been linked to poorer cognitive, academic and social outcomes. Although, increasing research has focused on the potential of computerised cognitive training in reducing attention problems, limited studies have assessed whether this intervention could be utilised for those with IDD. This study aimed to assess the efficacy of a computerised attention training programme in children with IDD. Methods In a double‐blind randomised controlled trial, children (n = 76; IQ < 75) aged 4–11 years were assigned to an adaptive attention training condition or a nonadaptive control condition. Both conditions were completed at home over a 5‐week period and consisted of 25 sessions, each of 20‐min duration. Outcome measures (baseline, posttraining and 3‐month follow‐up) assessed core attention skills (selective attention, sustained attention and attentional control) and inattentive/hyperactive behaviour. Results Children in the attention training condition showed greater improvement in selective attention performance compared to children in the control condition (SMD = 0.24, 95% CI 0.02, 0.45). These improvements were maintained 3 months after training had ceased (SMD = 0.26, 95% CI 0.04, 0.48). The attention training programme was not effective in promoting improvements in sustained attention, attentional control or inattentive/hyperactive behaviours. Conclusions The findings suggest that attention training may enhance some aspects of attention (selective attention) in children with IDD, but the small to medium effect sizes indicate that further refinement of the training programme is needed to promote larger, more global improvements.
    August 23, 2016   doi: 10.1111/jcpp.12615   open full text
  • Enriching preschool classrooms and home visits with evidence‐based programming: sustained benefits for low‐income children.
    Karen L. Bierman, Brenda S. Heinrichs, Janet A. Welsh, Robert L. Nix, Scott D. Gest.
    Journal of Child Psychology and Psychiatry. August 23, 2016
    Background Growing up in poverty undermines healthy development, producing disparities in the cognitive and social‐emotional skills that support early learning and mental health. Preschool and home‐visiting interventions for low‐income children have the potential to build early cognitive and social‐emotional skills, reducing the disparities in school readiness that perpetuate the cycle of poverty. However, longitudinal research suggests that the gains low‐income children make during preschool interventions often fade at school entry and disappear by early elementary school. Methods In an effort to improve the benefits for low‐income children, the REDI program enriched Head Start preschool classrooms (study one) and home visits (study two) with evidence‐based programming, documenting positive intervention effects in two randomized trials. In this study, REDI participants were followed longitudinally, to evaluate the sustained impact of the classroom and home‐visiting enrichments 3 years later, when children were in second grade. The combined sample included 556 children (55% European American, 25% African American, 19% Latino; 49% male): 288 children received the classroom intervention, 105 children received the classroom intervention plus the home‐visiting intervention, and 173 children received usual practice Head Start. Results The classroom intervention led to sustained benefits in social‐emotional skills, improving second grade classroom participation, student–teacher relationships, social competence, and peer relations. The coordinated home‐visiting intervention produced additional benefits in child mental health (perceived social competence and peer relations) and cognitive skills (reading skills, academic performance). Significant effects ranged from 25% to 48% of a standard deviation, representing important effects of small to moderate magnitude relative to usual practice Head Start. Conclusions Preschool classroom and home‐visiting programs for low‐income children can be improved with the use of evidence‐based programming, reducing disparities and promoting complementary benefits that sustain in elementary school.
    August 23, 2016   doi: 10.1111/jcpp.12618   open full text
  • Familial aggregation of attention‐deficit/hyperactivity disorder.
    Qi Chen, Isabell Brikell, Paul Lichtenstein, Eva Serlachius, Ralf Kuja‐Halkola, Sven Sandin, Henrik Larsson.
    Journal of Child Psychology and Psychiatry. August 22, 2016
    Background Attention‐deficit/hyperactivity disorder (ADHD) aggregates in families. To date, the strength, pattern, and characteristics of the familial aggregation have not been thoroughly assessed in a population‐based family sample. Methods In this cohort study, we identified relative pairs of twins, full and half‐siblings, and full and half cousins from 1,656,943 unique individuals born in Sweden between 1985 and 2006. The relatives of index persons were followed from their third birthday to 31 December 2009 for ADHD diagnosis. Birth year adjusted hazard ratio (HR), that is, the rate of ADHD in relatives of ADHD‐affected index persons compared with the rate of ADHD in relatives of unaffected index persons, was estimated in the different types of relatives using Cox proportional hazards model. Results During the follow‐up, 31,865 individuals were diagnosed with ADHD (male to female ratio was 3.7). The birth year adjusted HRs were as follows: 70.45 for monozygotic twins; 8.44 for dizygotic twins; 8.27 for full siblings; 2.86 for maternal half‐siblings; 2.31 for paternal half‐siblings; 2.24 for full cousins; 1.47 for half cousins. Maternal half‐siblings had significantly higher HR than in paternal half‐siblings. The HR did not seem to be affected by index person's sex. Full siblings of index persons with ADHD diagnosis present at age 18 or older had a higher rate of ADHD (HR: 11.49) than full siblings of index persons with ADHD diagnosis only before age 18 (HR: 4.68). Conclusions Familial aggregation of ADHD increases with increasing genetic relatedness. The familial aggregation is driven by not only genetic factors but also a small amount of shared environmental factors. Persistence of ADHD into adulthood indexes stronger familial aggregation of ADHD.
    August 22, 2016   doi: 10.1111/jcpp.12616   open full text
  • Omega 3/6 fatty acids for reading in children: a randomized, double‐blind, placebo‐controlled trial in 9‐year‐old mainstream schoolchildren in Sweden.
    Mats Johnson, Gunnar Fransson, Sven Östlund, Björn Areskoug, Christopher Gillberg.
    Journal of Child Psychology and Psychiatry. August 22, 2016
    Background Previous research has shown positive effects of Omega 3/6 fatty acids in children with inattention and reading difficulties. We aimed to investigate if Omega 3/6 improved reading ability in mainstream schoolchildren. Methods We performed a 3‐month parallel, randomized, double‐blind, placebo‐controlled trial followed by 3‐month active treatment for all subjects. Mainstream schoolchildren aged 9–10 years were randomized 1:1 to receive three Omega 3/6 capsules twice daily or identical placebo. Assessments were made at baseline, 3 months, and 6 months. The primary outcome measure was the Logos test battery for evaluating reading abilities. The trial is registered with, number NCT02557477. Results The study enrolled 154 children (active n = 78; placebo n = 76), of whom 122 completed the first 3 months (active n = 64; placebo n = 58) and 105 completed the whole study (active/active n = 55; placebo/active n = 50). Outcomes were assessed by per protocol (PP) and intention‐to‐treat (ITT) analyses. Active treatment was superior to placebo at 3 months for improvement in phonologic decoding time (PP active/placebo difference −0.16; 95% CI −0.03, −0.29; effect size (ES) .44; p = .005; and ITT ES .37; p = .036), in visual analysis time (PP active/placebo difference −0.19; 95% CI −0.05, −0.33; ES .49; p = .013; and ITT ES .40; p = .01), and for boys in phonologic decoding time (PP −0.22; 95% CI −0.03, −0.41; ES .62; p = .004). Children with ADHD‐RS scores above the median showed treatment benefits in visual analysis time (PP ES .8, p = .009), reading speed per word (PP ES .61, p = .008), and phonologic decoding time per word (PP ES .85, p = .006). Adverse events were rare and mild, mainly stomach pain/diarrhea (active n = 9, placebo n = 2). Conclusions Compared with placebo, 3 months of Omega 3/6 treatment improved reading ability – specifically the clinically relevant ‘phonologic decoding time’ and ‘visual analysis time’ – in mainstream schoolchildren. In particular, children with attention problems showed treatment benefits.
    August 22, 2016   doi: 10.1111/jcpp.12614   open full text
  • Prenatal unhealthy diet, insulin‐like growth factor 2 gene (IGF2) methylation, and attention deficit hyperactivity disorder symptoms in youth with early‐onset conduct problems.
    Jolien Rijlaarsdam, Charlotte A.M. Cecil, Esther Walton, Maurissa S.C. Mesirow, Caroline L. Relton, Tom R. Gaunt, Wendy McArdle, Edward D. Barker.
    Journal of Child Psychology and Psychiatry. August 18, 2016
    Background Conduct problems (CP) and attention deficit hyperactivity disorder (ADHD) are often comorbid and have each been linked to ‘unhealthy diet’. Early‐life diet also associates with DNA methylation of the insulin‐like growth factor 2 gene (IGF2), involved in fetal and neural development. We investigated the degree to which prenatal high‐fat and ‐sugar diet might relate to ADHD symptoms via IGF2 DNA methylation for early‐onset persistent (EOP) versus low CP youth. Methods Participants were 164 youth with EOP (n = 83) versus low (n = 81) CP drawn from the Avon Longitudinal Study of Parents and Children. We assessed if the interrelationships between high‐fat and ‐sugar diet (prenatal, postnatal), IGF2 methylation (birth and age 7, collected from blood), and ADHD symptoms (age 7–13) differed for EOP versus low CP youth. Results Prenatal ‘unhealthy diet’ was positively associated with IGF2 methylation at birth for both the EOP and low CP youth. For EOP only: (a) higher IGF2 methylation predicted ADHD symptoms; and (b) prenatal ‘unhealthy diet’ was associated with higher ADHD symptoms indirectly via higher IGF2 methylation. Conclusions Preventing ‘unhealthy diet’ in pregnancy might reduce the risk of ADHD symptoms in EOP youth via lower offspring IGF2 methylation.
    August 18, 2016   doi: 10.1111/jcpp.12589   open full text
  • Late childhood interpersonal callousness and conduct problem trajectories interact to predict adult psychopathy.
    Samuel W. Hawes, Amy L. Byrd, Rebecca Waller, Donald R. Lynam, Dustin A. Pardini.
    Journal of Child Psychology and Psychiatry. August 12, 2016
    Background Studies have demonstrated a robust association between interpersonal callousness (IC) and the development of severe and chronic conduct problems (CP) in youth. Although children exhibiting IC are also believed to be at particularly high risk for developing psychopathic personality features in adulthood, there is little longitudinal evidence supporting this assumption, particularly after controlling for co‐occuring CP severity. Methods This study used data collected on a longitudinal cohort of boys (n = 508), with an oversampling of youth exhibiting elevated conduct problems. Analyses examined the unique and interactive association between latent growth curve trajectories of IC and CP assessed bi‐annually from late childhood to early adolescence (~ages 10–13) and features of psychopathy in early adulthood (age ~ 24) assessed using the Psychopathy Checklist – Short Version (PCL:SV; Hart, Cox, & Hare, 1995). Results Growth curve analysis indicated that initial levels of IC and CP in childhood (~age 10 intercept) both uniquely predicted the development of the interpersonal/affective features of adult psychopathy, and boys with a combination of high initial levels of IC and CP were at particularly high risk for developing the impulsive/antisocial features of the disorder. Boys who exhibited systematic increases in CP from late childhood to early adolescence also demonstrated higher adult psychopathy scores, but changes in IC across this developmental period did not significantly add to the prediction of adult psychopathy. Conclusions Findings highlight the importance of developing targeted interventions for boys exhibiting severe IC and CP in childhood, as they appear to be at high risk for developing adult psychopathic features.
    August 12, 2016   doi: 10.1111/jcpp.12598   open full text
  • Complex effects of dyslexia risk factors account for ADHD traits: evidence from two independent samples.
    Sara Mascheretti, Vittoria Trezzi, Roberto Giorda, Michel Boivin, Vickie Plourde, Frank Vitaro, Mara Brendgen, Ginette Dionne, Cecilia Marino.
    Journal of Child Psychology and Psychiatry. August 08, 2016
    Background Developmental dyslexia (DD) and attention deficit/hyperactivity disorder (ADHD) are among the most common neurodevelopmental disorders, whose etiology involves multiple risk factors. DD and ADHD co‐occur in the same individuals much more often than would be expected by chance. Several studies have found significant bivariate heritability, and specific genes associated with either DD or ADHD have been investigated for association in the other disorder. Moreover, there are likely to be gene‐by‐gene and gene‐by‐environment interaction effects (G × G and G × E, respectively) underlying the comorbidity between DD and ADHD. We investigated the pleiotropic effects of 19 SNPs spanning five DD genes (DYX1C1, DCDC2, KIAA0319, ROBO1, and GRIN2B) and seven DD environmental factors (smoke, miscarriage, birth weight, breastfeeding, parental age, socioeconomic status, and parental education) for main, either (a) genetic or (b) environmental, (c) G × G, and (d) G × E upon inattention and hyperactivity/impulsivity. We then attempted replication of these findings in an independent twin cohort. Methods Marker‐trait association was analyzed by implementing the Quantitative Transmission Disequilibrium Test (QTDT). Environmental associations were tested by partial correlations. G × G were investigated by a general linear model equation and a family‐based association test. G × E were analyzed through a general test for G × E in sib pair‐based association analysis of quantitative traits. Results DCDC2‐rs793862 was associated with hyperactivity/impulsivity via G × G (KIAA0319) and G × E (miscarriage). Smoke was significantly correlated with hyperactivity/impulsivity. We replicated the DCDC2 × KIAA0319 interaction upon hyperactivity/impulsivity in the twin cohort. Conclusions DD genetic (DCDC2) and environmental factors (smoke and miscarriage) underlie ADHD traits supporting a potential pleiotropic effect.
    August 08, 2016   doi: 10.1111/jcpp.12612   open full text
  • Research Review: Multi‐informant integration in child and adolescent psychopathology diagnosis.
    Michelle M. Martel, Kristian Markon, Gregory T. Smith.
    Journal of Child Psychology and Psychiatry. August 05, 2016
    Background An empirically based, clinically usable approach to cross‐informant integration in clinical assessment is needed. Although the importance of this ongoing issue is becoming increasingly recognized, little in the way of solid recommendations is currently provided to researchers and clinicians seeking to incorporate multiple informant reports in diagnosis of child psychopathology. The issue is timely because recent developments have created new opportunities for improved handling of this problem. For example, advanced theories of psychopathology and normal and abnormal child development provide theoretical guidance for how integration of multiple informants should be handled for specific disorders and at particular ages. In addition, more sophisticated data analytic approaches are now available, including advanced latent variable models, which allow for complex measurement approaches with consideration of measurement invariance. Findings The increasing availability and mobility of computing devices suggests that it will be increasingly feasible for clinicians to implement more advanced methods rather than being confined to the easily memorized algorithms of the DSM system. Conclusions Development of models of cross‐informant integration for individual disorders based on theory and tests of the incremental validity of more sophisticated cross‐informant integration approaches in comparison to external validation criteria (e.g. longitudinal trajectories and outcomes, treatment response, and behavior genetic etiology) should be a focus of future work.
    August 05, 2016   doi: 10.1111/jcpp.12611   open full text
  • Exposure to parental separation in childhood and later parenting quality as an adult: evidence from a 30‐year longitudinal study.
    Myron D. Friesen, L. John Horwood, David M. Fergusson, Lianne J. Woodward.
    Journal of Child Psychology and Psychiatry. August 02, 2016
    Background Previous research has documented that exposure to parental separation/divorce during childhood can be associated with long‐term consequences into adulthood. This study sought to extend this literature by examining associations between childhood exposure to parental separation/divorce and later parenting behavior as an adult in a New Zealand birth cohort. Methods Data were drawn from the Christchurch Health and Development Study (CHDS), a longitudinal study of a birth cohort of 1,265 children born in 1977 in Christchurch, New Zealand. Information about exposure to parental separation and divorce was gathered annually from birth to 15 years. At the 30‐year follow‐up, all cohort members who had become parents (biological or nonbiological) were assessed on several parenting dimensions (sensitivity, warmth, overreactivity, inconsistency, quality of child management, and physical punishment). Results The analyses showed that exposure to more frequent parental separation in childhood and adolescence was associated with lower levels of parental sensitivity and warmth, greater overreactivity, and an increased use of physical punishment as a parent, after controlling for a wide range of family socioeconomic and psychosocial factors, and individual child characteristics. Conclusions The findings suggest that as exposure to parental separation increases, so does the likelihood of experiencing multiple developmental challenges in childhood and adolescence. As an adult, these life‐course experiences can have small but significant associations with the quality of parenting behavior.
    August 02, 2016   doi: 10.1111/jcpp.12610   open full text
  • Cognitive and adaptive advantages of growth hormone treatment in children with Prader‐Willi syndrome.
    Elisabeth M. Dykens, Elizabeth Roof, Hailee Hunt‐Hawkins.
    Journal of Child Psychology and Psychiatry. August 02, 2016
    Background People with Prader‐Willi syndrome (PWS) typically have mild to moderate intellectual deficits, compulsivity, hyperphagia, obesity, and growth hormone deficiencies. Growth hormone treatment (GHT) in PWS has well‐established salutatory effects on linear growth and body composition, yet cognitive benefits of GHT, seen in other patient groups, have not been well studied in PWS. Methods Study 1 included 96 children and youth with PWS aged 4–21 years who naturalistically varied in their exposures to GHT. Controlling for socioeconomic status, analyses compared cognitive and adaptive behavior test scores across age‐matched treatment naïve versus growth hormone treated children. Study II assessed if age of treatment initiation or treatment duration was associated with subsequent cognition or adaptive behavior in 127, 4‐ to 21‐year olds with PWS. Study III longitudinally examined cognitive and adaptive behavior in 168 participants who were either consistently on versus off GHT for up to 4–5 years. Results Compared to the treatment naïve group, children receiving GHT had significantly higher Verbal and Composite IQs, and adaptive communication and daily living skills. Children who began treatment before 12 months of age had higher Nonverbal and Composite IQs than children who began treatment between 1 and 5 years of age. Longitudinally, the groups differed in their intercepts, but not slopes, with each group showing stable IQ and adaptive behavior scores over time. Conclusions Cognitive and adaptive advantages should be considered an ancillary benefit and additional justification for GHT in people with PWS. Future efforts need to target apparent socioeconomic inequities in accessing GHT in the PWS population.
    August 02, 2016   doi: 10.1111/jcpp.12601   open full text
  • Understanding definitions of minimally verbal across instruments: evidence for subgroups within minimally verbal children and adolescents with autism spectrum disorder.
    Vanessa Hus Bal, Terry Katz, Somer L. Bishop, Kate Krasileva.
    Journal of Child Psychology and Psychiatry. July 30, 2016
    Background Minimally verbal (MV) children with autism spectrum disorder (ASD) are often assumed to be profoundly cognitively impaired and excluded from analyses due to challenges completing standardized testing protocols. A literature aimed at increasing understanding of this subgroup is emerging; however, the many methods used to define MV status make it difficult to compare studies. Understanding how different instruments and definitions used to identify MV children affect sample composition is critical to advance research on this understudied clinical population. Method The MV status of 1,470 school‐aged children was defined using five instruments commonly used in ASD research. MV sample composition was compared across instruments. Analyses examined the proportion of overlap across MV subgroups and the extent to which child characteristics varied across MV subgroups defined using different definitions or combinations of measures. Results A total of 257 children were classified as MV on at least one instrument. Proportion of overlap between definitions ranged from 3% to 100%. The stringency of definition (i.e. few‐to‐no vs. some words) was associated with differences in cognitive and adaptive functioning; more stringent definitions yielded greater consistency of MV status across instruments. Cognitive abilities ranged from profoundly impaired to average intelligence; 16% had NVIQ ≥ 70. Approximately half exhibited verbal skills commensurate with nonverbal cognitive ability, whereas half had verbal abilities significantly lower than their estimated NVIQ. Conclusions Future studies of MV children must carefully consider the methods used to identify their sample, acknowledging that definitions including children with ‘some words’ may yield larger samples with a wider range of language and cognitive abilities. Broadly defined MV samples may be particularly important to delineate factors interfering with language development in the subgroup of children whose expressive impairments are considerably below their estimated nonverbal cognitive abilities.
    July 30, 2016   doi: 10.1111/jcpp.12609   open full text
  • The latent structure of Acute Stress Disorder symptoms in trauma‐exposed children and adolescents.
    Anna McKinnon, Richard Meiser‐Stedman, Peter Watson, Clare Dixon, Nancy Kassam‐Adams, Anke Ehlers, Flaura Winston, Patrick Smith, William Yule, Tim Dalgleish.
    Journal of Child Psychology and Psychiatry. July 30, 2016
    Background The revision of Acute Stress Disorder (ASD) in the DSM‐5 (DSM‐5, 2013) proposes a cluster‐free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined. Methods We used Confirmatory Factor Analysis (combined with multigroup invariance tests) to explore the latent structure of ASD symptoms in a trauma‐exposed sample of children and young people (N = 594). The DSM‐5 structure was compared with the previous DSM‐IV conceptualization (4‐factor), and two alternative models proposed in the literature (3‐factor; 5‐factor). Model fit was examined using goodness‐of‐fit indices. We also established DSM‐5 ASD prevalence rates relative to DSM‐IV ASD, and the ability of these models to classify children impaired by their symptoms. Results Based on both the Bayesian Information Criterion, the interfactor correlations and invariance testing, the 3‐factor model best accounted for the profile of ASD symptoms. DSM‐5 ASD led to slightly higher prevalence rates than DSM‐IV ASD and performed similarly to DSM‐IV with respect to categorising children impaired by their symptoms. Modifying the DSM‐5 ASD algorithm to a 3+ or 4+ symptom requirement was the strongest predictor of impairment. Conclusions These findings suggest that a uni‐factorial general‐distress model is not the optimal model of capturing the latent structure of ASD symptom profiles in youth and that modifying the current DSM‐5 9+ symptom algorithm could potentially lead to a more developmentally sensitive conceptualization.
    July 30, 2016   doi: 10.1111/jcpp.12597   open full text
  • Response time variability under slow and fast‐incentive conditions in children with ASD, ADHD and ASD+ADHD.
    Charlotte Tye, Katherine A. Johnson, Simon P. Kelly, Philip Asherson, Jonna Kuntsi, Karen L. Ashwood, Bahare Azadi, Patrick Bolton, Gráinne McLoughlin.
    Journal of Child Psychology and Psychiatry. July 28, 2016
    Background Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) show significant behavioural and genetic overlap. Both ADHD and ASD are characterised by poor performance on a range of cognitive tasks. In particular, increased response time variability (RTV) is a promising indicator of risk for both ADHD and ASD. However, it is not clear whether different indices of RTV and changes to RTV according to task conditions are able to discriminate between the two disorders. Methods Children with ASD (n = 19), ADHD (n = 18), ASD + ADHD (n = 29) and typically developing controls (TDC; n = 26) performed a four‐choice RT task with slow‐baseline and fast‐incentive conditions. Performance was characterised by mean RT (MRT), standard deviation of RT (SD‐RT), coefficient of variation (CV) and ex‐Gaussian distribution measures of Mu, Sigma and Tau. Results In the slow‐baseline condition, categorical diagnoses and trait measures converged to indicate that children with ADHD‐only and ASD + ADHD demonstrated increased MRT, SD‐RT, CV and Tau compared to TDC and ASD‐only. Importantly, greater improvement in MRT, SD‐RT and Tau was demonstrated in ADHD and ASD + ADHD from slow‐baseline to fast‐incentive conditions compared to TDC and ASD‐only. Conclusions Slower and more variable RTs are markers of ADHD compared to ASD and typically developing controls during slow and less rewarding conditions. Energetic factors and rewards improve task performance to a greater extent in children with ADHD compared to children with ASD. These findings suggest that RTV can be distinguished in ASD, ADHD and ASD + ADHD based on the indices of variability used and the conditions in which they are elicited. Further work identifying neural processes underlying increased RTV is warranted, in order to elucidate disorder‐specific and disorder‐convergent aetiological pathways.
    July 28, 2016   doi: 10.1111/jcpp.12608   open full text
  • Randomized controlled trial of a book‐sharing intervention in a deprived South African community: effects on carer–infant interactions, and their relation to infant cognitive and socioemotional outcome.
    Lynne Murray, Leonardo De Pascalis, Mark Tomlinson, Zahir Vally, Harold Dadomo, Brenda MacLachlan, Charlotte Woodward, Peter J. Cooper.
    Journal of Child Psychology and Psychiatry. July 28, 2016
    Background Consistent with evidence from high‐income countries (HICs), we previously showed that, in an informal peri‐urban settlement in a low‐middle income country, training parents in book sharing with their infants benefitted infant language and attention (Vally, Murray, Tomlinson, & Cooper, ). Here, we investigated whether these benefits were explained by improvements in carer–infant interactions in both book‐sharing and non‐book‐sharing contexts. We also explored whether infant socioemotional development benefitted from book sharing. Methods We conducted a randomized controlled trial in Khayelitsha, South Africa. Carers of 14–16‐month‐old infants were randomized to 8 weeks’ training in book sharing (n = 49) or a wait‐list control group (n = 42). In addition to the cognitive measures reported previously, independent assessments were made at base line and follow‐up of carer–infant interactions during book sharing and toy play. Assessments were also made, at follow‐up only, of infant prosocial behaviour in a ‘help task’, and of infant imitation of doll characters’ nonsocial actions and an interpersonal interaction. Eighty‐two carer–infant pairs (90%) were assessed at follow‐up. (Trial registration ISRCTN39953901). Results Carers who received the training showed significant improvements in book‐sharing interactions (sensitivity, elaborations, reciprocity), and, to a smaller extent, in toy‐play interactions (sensitivity). Infants in the intervention group showed a significantly higher rate of prosocial behaviour, and tended to show more frequent imitation of the interpersonal interaction. Improvements in carer behaviour during book sharing, but not during toy play, mediated intervention effects on all infant cognitive outcomes, and tended to mediate intervention effects on infant interpersonal imitation. Conclusions Training in book sharing, a simple, inexpensive intervention that has been shown to benefit infant cognitive development in a low‐middle income country, also shows promise for improving infant socioemotional outcomes in this context. Benefits are mediated by improvements in carer–infant interactions, particularly in book‐sharing contexts.
    July 28, 2016   doi: 10.1111/jcpp.12605   open full text
  • The course of early disinhibited social engagement among post‐institutionalized adopted children.
    Jamie M. Lawler, Kalsea J. Koss, Colleen M. Doyle, Megan R. Gunnar.
    Journal of Child Psychology and Psychiatry. July 27, 2016
    Background Approximately 20% of post‐institutionalized (PI) children exhibit disinhibited social engagement (DSE) or the propensity to approach and engage strangers. There is little longitudinal research examining changes in DSE after adoption, or methods of identifying children with persistent behaviors. Methods DSE was assessed observationally four times during the first 2 years postadoption in PI children 16–36 months at adoption (n = 68) relative to same‐age nonadopted children (n = 52). At age 5, a validated interview determined which PI children met criteria for Disinhibited Social Engagement Disorder (DSED). Results DSE trajectories initially increased and then stabilized. PIs had higher DSE levels initially and a steeper increase rate than NAs. When separated into physical and nonphysical DSE components, group differences arose in initial physical DSE and the rate of change of nonphysical DSE. DSE rate of increase predicted DSED diagnosis, as did longer institutional duration and poorer institutional care. Conclusions The rate of increase in DSE postadoption, rather than the level observed at adoption, is predictive of disordered social engagement by age 5 years.
    July 27, 2016   doi: 10.1111/jcpp.12606   open full text
  • No relationship between prenatal androgen exposure and autistic traits: convergent evidence from studies of children with congenital adrenal hyperplasia and of amniotic testosterone concentrations in typically developing children.
    Karson T. F. Kung, Debra Spencer, Vickie Pasterski, Sharon Neufeld, Vivette Glover, Thomas G. O'Connor, Peter C. Hindmarsh, Ieuan A. Hughes, Carlo L. Acerini, Melissa Hines.
    Journal of Child Psychology and Psychiatry. July 27, 2016
    Background There is a marked male preponderance in autism spectrum conditions. The extreme male brain theory and the fetal androgen theory of autism suggest that elevated prenatal testosterone exposure is a key contributor to autistic traits. The current paper reports findings from two separate studies that test this hypothesis. Methods A parent‐report questionnaire, the Childhood Autism Spectrum Test (CAST), was employed to measure autistic traits in both studies. The first study examined autistic traits in young children with congenital adrenal hyperplasia (CAH), a condition causing unusually high concentrations of testosterone prenatally in girls. Eighty one children with CAH (43 girls) and 72 unaffected relatives (41 girls), aged 4–11 years, were assessed. The second study examined autistic traits in relation to amniotic testosterone in 92 typically developing children (48 girls), aged 3–5 years. Results Findings from neither study supported the association between prenatal androgen (testosterone) exposure and autistic traits. Specifically, young girls with and without CAH did not differ significantly in CAST scores and amniotic testosterone concentrations were not significantly associated with CAST scores in boys, girls, or the whole sample. Conclusions These studies do not support a relationship between prenatal testosterone exposure and autistic traits. These findings augment prior research suggesting no consistent relationship between early androgen exposure and autistic traits.
    July 27, 2016   doi: 10.1111/jcpp.12602   open full text
  • Attentional avoidance of fearful facial expressions following early life stress is associated with impaired social functioning.
    Kathryn L. Humphreys, Katharina Kircanski, Natalie L. Colich, Ian H. Gotlib.
    Journal of Child Psychology and Psychiatry. July 26, 2016
    Background Early life stress is associated with poorer social functioning. Attentional biases in response to threat‐related cues, linked to both early experience and psychopathology, may explain this association. To date, however, no study has examined attentional biases to fearful facial expressions as a function of early life stress or examined these biases as a potential mediator of the relation between early life stress and social problems. Methods In a sample of 154 children (ages 9–13 years) we examined the associations among interpersonal early life stressors (i.e., birth through age 6 years), attentional biases to emotional facial expressions using a dot‐probe task, and social functioning on the Child Behavior Checklist. Results High levels of early life stress were associated with both greater levels of social problems and an attentional bias away from fearful facial expressions, even after accounting for stressors occurring in later childhood. No biases were found for happy or sad facial expressions as a function of early life stress. Finally, attentional biases to fearful faces mediated the association between early life stress and social problems. Conclusions Attentional avoidance of fearful facial expressions, evidenced by a bias away from these stimuli, may be a developmental response to early adversity and link the experience of early life stress to poorer social functioning.
    July 26, 2016   doi: 10.1111/jcpp.12607   open full text
  • Altered neural response to rejection‐related words in children exposed to maltreatment.
    Vanessa B. Puetz, Essi Viding, Amy Palmer, Philip A. Kelly, Rachael Lickley, Iakovina Koutoufa, Catherine L. Sebastian, Eamon J. McCrory.
    Journal of Child Psychology and Psychiatry. July 26, 2016
    Background Children exposed to maltreatment show neural sensitivity to facial cues signalling threat. However, little is known about how maltreatment influences the processing of social threat cues more broadly, and whether atypical processing of social threat cues relates to psychiatric risk. Methods Forty‐one 10‐ to 14‐year‐old children underwent a social rejection‐themed emotional Stroop task during functional magnetic resonance imaging: 21 children with a documented history of maltreatment (11 F) and 19 comparison children with no maltreatment history (11 F). Groups were matched on age, pubertal status, gender, IQ, socioeconomic status, ethnicity and reading ability. Classic colour Stroop stimuli were also administered in the same paradigm to investigate potential differences in general cognitive control. Results Compared with their peers, children who had experienced maltreatment showed reduced activation in the Rejection versus Neutral condition, across circuitry previously implicated in abuse‐related posttraumatic stress disorder (PTSD), including the left anterior insula, extending into left ventrolateral prefrontal cortex/orbitofrontal cortex; left amygdala; left inferior parietal cortex (STS); and bilateral visual association cortex, encompassing the cuneus and lingual gyrus. No group differences in neural or behavioural responses were found for the classic colour Stroop conditions. Significant negative associations between activity in bilateral cuneus and STS during the rejection‐themed Stroop and higher self‐reported PTSD symptomatology, including dissociation, were observed in children exposed to maltreatment. Conclusion Our findings indicate a pattern of altered neural response to social rejection cues in maltreated children. Compared to their peers, these children displayed relative hypoactivation to rejection cues in regions previously associated with PTSD, potentially reflecting an avoidant coping response. It is suggested that such atypical processing of social threat may index latent vulnerability to future psychopathology in general and PTSD in particular.
    July 26, 2016   doi: 10.1111/jcpp.12595   open full text
  • Attention bias modification for youth with social anxiety disorder.
    Lee Pergamin‐Hight, Daniel S. Pine, Nathan A. Fox, Yair Bar‐Haim.
    Journal of Child Psychology and Psychiatry. July 20, 2016
    Background Attention bias modification treatment (ABMT) targets threat‐related attention biases in anxiety disorders. Most clinical trials of ABMT have focused on adults or small samples of youth. The current randomized controlled trial (RCT) examines ABMT efficacy in youth with social anxiety disorder (SAD) and tests possible moderators of treatment outcomes. Method Sixty‐seven youth with SAD were randomly assigned to ABMT or attention control training (ACT) conditions. Anxiety severity was measured at baseline, posttreatment, and 3‐month follow‐up. name and identifier: Attention bias modification treatment for children with social anxiety, NCT01397032; Results Both ABMT and ACT induced significant reductions in clinician and self‐rated social anxiety (ps < .001). An additional reduction was observed at the 3‐month follow‐up in clinician‐rated anxiety symptoms (p = .03). Moderation effects were nonsignificant for the clinician‐rated anxiety outcome, but age moderated self‐reported anxiety. Older but not younger children, showed significant reduction in anxiety following ABMT relative to ACT (p < .001). Individual differences in attention control also moderated ABMT's effect on self‐reported anxiety (p = .05). Children rated by their parents as lower on attention control benefited more from ABMT than those rated higher on attention control. Baseline attention bias did not moderate anxiety (p = .17). Conclusions Despite significant reductions in social anxiety, no specific evidence for ABMT was found relative to a control condition. Age and attention control moderated ABMT effects on self‐reported SAD symptoms, with clinical effects for older relative to younger children and for those with lower attention control. These results highlight the need to consider developmental influences in the implementation of ABMT protocols.
    July 20, 2016   doi: 10.1111/jcpp.12599   open full text
  • Effect of a universal anxiety prevention programme (FRIENDS) on children's academic performance: results from a randomised controlled trial.
    Elena Skryabina, Gordon Taylor, Paul Stallard.
    Journal of Child Psychology and Psychiatry. July 18, 2016
    Background Evaluations of school‐based anxiety prevention programmes have reported improvements in psychological functioning although little is known about their effect upon educational outcomes. Methods One thousand three hundred and sixty‐two children from 40 primary schools in England took part in the randomised controlled trial, Preventing Anxiety in Children through Education in Schools. The trial investigated the effectiveness of a universal school‐based cognitive behaviour therapy prevention programme, FRIENDS, delivered by health care staff or school staff compared with usual personal, social, health and education (PSHE) lessons. Self‐report psychological outcomes and educational attainment on national standardised attainment tests in reading, writing and maths were collected 12 months postintervention. Analysis was performed at individual level using multivariable mixed effect models controlling for gender, type of intervention and school effect. Registered trial: ISRCTN: 23563048. Results At 12 months, anxiety reduced in the health‐led FRIENDS group compared to school‐led FRIENDS and PSHE. There were no between‐group differences in academic performance regardless of gender, deprivation, ethnicity and additional educational needs. Conclusions School‐based mental health interventions should assess psychological and educational outcomes. Further research should directly compare the effects of interventions led by health and school staff.
    July 18, 2016   doi: 10.1111/jcpp.12593   open full text
  • Associations between the parent–child relationship and adolescent self‐worth: a genetically informed study of twin parents and their adolescent children.
    Tom A. McAdams, Fruhling V. Rijsdijk, Jurgita Narusyte, Jody M. Ganiban, David Reiss, Erica Spotts, Jenae M. Neiderhiser, Paul Lichtenstein, Thalia C. Eley.
    Journal of Child Psychology and Psychiatry. July 18, 2016
    Background Low self‐worth during adolescence predicts a range of emotional and behavioural problems. As such, identifying potential sources of influence on self‐worth is important. Aspects of the parent–child relationship are often associated with adolescent self‐worth but to date it is unclear whether such associations may be attributable to familial confounding (e.g. genetic relatedness). We set out to clarify the nature of relationships between parental expressed affection and adolescent self‐worth, and parent–child closeness and adolescent self‐worth. Methods We used data from the Twin and Offspring Study in Sweden, a children‐of‐twins sample comprising 909 adult twin pairs with adolescent children. Using these data we were able to apply structural equation models with which we could examine whether associations remained after accounting for genetic transmission. Results Results demonstrated that parent–child closeness and parental‐expressed affection were both phenotypically associated with adolescent self‐worth. Associations could not be attributed to genetic relatedness between parent and child. Conclusions Parent–child closeness and parental affection are associated with adolescent self‐worth above and beyond effects attributable to genetic relatedness. Data were cross‐sectional, so the direction of effects cannot be confirmed but findings support the notion that positive parent–child relationships increase adolescent self‐worth.
    July 18, 2016   doi: 10.1111/jcpp.12600   open full text
  • Deactivation in anterior cingulate cortex during facial processing in young individuals with high familial risk and early development of depression: fMRI findings from the Scottish Bipolar Family Study.
    Stella W.Y. Chan, Jessika E. Sussmann, Liana Romaniuk, Tiffany Stewart, Stephen M. Lawrie, Jeremy Hall, Andrew M. McIntosh, Heather C. Whalley.
    Journal of Child Psychology and Psychiatry. July 15, 2016
    Background Studies have identified perturbations in facial processing in bipolar disorder and major depressive disorder (MDD), but their relationship to genetic risk and early development of illness is unclear. Methods The Scottish Bipolar Family Study is a prospective longitudinal investigation examining young individuals (age 16–25) at familial risk of mood disorder. Participants underwent functional MRI using an implicit facial processing task employing angry and neutral faces. An explicit facial expression recognition task was completed outside the scanner. Clinical outcomes obtained 2 years after the scan were used to categorise participants into controls (n = 54), high‐risk individuals who had developed MDD (HR MDD; n = 30) and high‐risk individuals who remained well (HR Well, n = 43). Results All groups demonstrated activation patterns typically observed during facial processing, including activation of the amygdala, hippocampus, fusiform gyrus and middle frontal regions. Notably, the HR MDD group showed reduced activation of the anterior cingulate gyrus versus both the control and HR Well group for angry faces, and versus the HR Well group for neutral faces. Outside the scanner, the HR MDD group was less accurate in recognising fearful expressions than the HR Well group. Conclusions Here, we demonstrate functional abnormalities of the anterior cingulate cortex alongside facial emotional recognition deficits in high‐risk individuals in the early stages of depression compared with both controls and at‐risk individuals who remained well. These neural changes were associated with a current or future diagnosis of MDD and were not simply associated with increased familial risk.
    July 15, 2016   doi: 10.1111/jcpp.12591   open full text
  • Attentional bias training in girls at risk for depression.
    Joelle LeMoult, Jutta Joormann, Katharina Kircanski, Ian H. Gotlib.
    Journal of Child Psychology and Psychiatry. July 08, 2016
    Background This study examined, for the first time, whether attentional biases can be modified in adolescents at risk for depression. Methods The final sample consisted of 41 girls at familial risk for depression, who were randomly assigned to receive six sessions (864 trials) of real or sham attention bias training [Real attentional bias training (ABT) vs. Sham ABT]. Participants who received Real ABT completed a modified dot‐probe task designed to train attention toward positive and away from negative facial expressions; in contrast, girls who received Sham ABT completed the standard dot‐probe task. Attentional biases, self‐reported mood, and psychophysiological responses to stress were measured at pre‐ and post‐training assessments. Results As expected, girls who received Real ABT, but not those who received Sham ABT, exhibited significant increases from pre‐ to post‐training in their attention toward happy faces and away from sad faces. Moreover, adolescents who received Real ABT were buffered against the negative outcomes experienced by adolescents who received Sham ABT. Specifically, only adolescents who received Sham ABT experienced an increase in negative mood and a pre‐ to post‐training increase in heart rate in anticipation of the stressor. Conclusions The current findings provide the first experimental evidence that attentional biases can be modified in youth at risk for depression and further suggest that ABT modulates the heightened response to stress that is otherwise experienced by high‐risk adolescents.
    July 08, 2016   doi: 10.1111/jcpp.12587   open full text
  • Patterns of expressed emotion in adolescent eating disorders.
    Renee D. Rienecke, Leslie Sim, James Lock, Daniel Le Grange.
    Journal of Child Psychology and Psychiatry. July 05, 2016
    Background This goal of this study was to understand the patterns of expressed emotions (EEs) in adolescent eating disorders. As such, this study compared EE among families of adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and a psychiatric control group, major depressive disorder (MDD). This study also examined the influence of family status (intact vs. nonintact) and the presence of siblings on EE. Methods Two‐hundred and fifteen adolescents (ages 12–19) and their families were recruited for this study including 121 adolescents with AN, 54 adolescents with BN, and 40 adolescents with MDD. Adolescents with at least one parent completed the Standardized Clinical Family Interview. Adolescents completed structured diagnostic interviews to assess eligibility for the study, as well as a standardized questionnaire to assess depression. Results Analyses revealed that fathers showed higher levels of critical comments to adolescents with BN or MDD than those with AN, whereas mothers made more critical comments toward patients with BN. Mothers made the least number of positive remarks toward patients with MDD. In terms of the influence of family status, fathers from intact families showed more expressions of warmth and were less critical than fathers from nonintact families, whereas mothers from intact families were less critical but also made fewer positive remarks than mothers from nonintact families. The presence of siblings appeared to reduce mothers’ expression of warmth and emotional overinvolvement. Conclusions Unique patterns of EE were found to characterize AN, BN, and MDD. Family status and the presence of siblings exert an influence on EE that should be taken into consideration in future research.
    July 05, 2016   doi: 10.1111/jcpp.12594   open full text
  • Callous–unemotional traits affect adolescents' perception of collaboration.
    Christine Fawcett, Victoria Wesevich, Erik Truedsson, Cecilia Wåhlstedt, Gustaf Gredebäck.
    Journal of Child Psychology and Psychiatry. July 01, 2016
    Background How is the perception of collaboration influenced by individual characteristics, in particular high levels of callous–unemotional (CU) traits? CU traits are associated with low empathy and endorsement of negative social goals such as dominance and forced respect. Thus, it is possible that they could relate to difficulties in interpreting that others are collaborating based on a shared goal. Methods In the current study, a community sample of 15‐ to 16‐year olds participated in an eye tracking task measuring whether they expect that others engaged in an action sequence are collaborating, depending on the emotion they display toward each other. Positive emotion would indicate that they share a goal, while negative emotion would indicate that they hold individual goals. Results When the actors showed positive emotion toward each other, expectations of collaboration varied with CU traits. The higher adolescents were on CU traits, the less likely they were to expect collaboration. When the actors showed negative emotion toward each other, CU traits did not influence expectations of collaboration. Conclusions The findings suggest that CU traits are associated with difficulty in perceiving positive social interactions, which could further contribute to the behavioral and emotional problems common to those with high CU traits.
    July 01, 2016   doi: 10.1111/jcpp.12588   open full text
  • Common infections with polyomaviruses and herpesviruses and neuropsychological development at 4 years of age, the Rhea birth cohort in Crete, Greece.
    Marianna Karachaliou, Leda Chatzi, Theano Roumeliotaki, Mariza Kampouri, Andriani Kyriklaki, Katerina Koutra, Georgia Chalkiadaki, Angelika Michel, Eftichia Stiakaki, Manolis Kogevinas, Michael Pawlita, Tim Waterboer, Silvia Sanjose.
    Journal of Child Psychology and Psychiatry. June 23, 2016
    Background Viral infections of the central nervous system may have detrimental effects for the developing brain, but the effects of less virulent common infections are unclear. We aim to investigate the impact of common viral infections of early childhood on neuropsychological performance of children at age four. Methods We used cross‐sectional data on 674 children participating at the 4 years of age follow‐up of the Rhea birth cohort in Crete, Greece. Blood levels of IgG antibodies to 10 polyomaviruses (BKPyV, JCPyV, KIPyV, WUPyV, HPyV6, HPyV7, TSPyV, MCPyV, HPyV9, and HPyV10) and four herpesviruses [Epstein–Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus‐1 (HSV‐1), and herpes simplex virus‐2 (HSV‐2)] were measured using multiplex serology. Child's neuropsychological development at age four was assessed using the McCarthy Scales of Children's Abilities, the Attention‐Deficit Hyperactivity Disorder Test (ADHDT), and the Strengths and Difficulties Questionnaire (SDQ). Multiple linear regression models were used to explore the associations. Results Seroprevalence to polyomaviruses ranged from 21% for HPyV9 to 82% for HPyV10. Seroprevalence for EBV was 53%, for CMV 26%, for HSV‐1 3.6%, and for HSV‐2 1.5%. Children seropositive to ≥8 polyomaviruses had lower score in ADHDT inattention subscale [β = −1.28 (95% CI: −2.56, −0.001)] and lower score in SDQ hyperactivity–inattention subscale [β = −.99 (95% CI: −1.60, −0.37)] versus children seropositive to ≤3 polyomaviruses. Seropositivity to BKPyV, a potential neurotropic virus, was associated with higher score in ADHDT inattention subscale [β = .87 (95% CI: 0.03, 1.71)]. Conclusions These findings suggest that acquisition of polyomaviruses during development may influence behavioral outcomes in early childhood.
    June 23, 2016   doi: 10.1111/jcpp.12582   open full text
  • Frequent daytime naps predict vocabulary growth in early childhood.
    Klára Horváth, Kim Plunkett.
    Journal of Child Psychology and Psychiatry. June 20, 2016
    Background The facilitating role of sleep for language learning is well‐attested in adults and to a lesser extent in infants and toddlers. However, the longitudinal relationship between sleep patterns and early vocabulary development is not well understood. Methods This study investigates how measures of sleep are related to the development of vocabulary size in infants and toddlers. Day and night‐time sleeping patterns of infants and toddlers were compared with their concurrent and subsequent vocabulary development. Sleep assessments were conducted using a sleep diary specifically designed to facilitate accurate parental report. Sleep measures were used as predictors in a multilevel growth curve analysis of vocabulary development. Results The number of daytime naps was positively associated with both predicted expressive (p = .062) and receptive vocabulary growth (p = .006), whereas the length of night‐time sleep was negatively associated with rate of predicted expressive vocabulary growth (p = .045). Sleep efficiency was also positively associated with both predicted receptive (p = .001) and expressive vocabulary growth (p = .068). Conclusions These results point to a longitudinal relationship between sleep and language development, with a particular emphasis on the importance of napping at this age.
    June 20, 2016   doi: 10.1111/jcpp.12583   open full text
  • Mapping the structural organization of the brain in conduct disorder: replication of findings in two independent samples.
    Graeme Fairchild, Nicola Toschi, Kate Sully, Edmund J.S. Sonuga‐Barke, Cindy C. Hagan, Stefano Diciotti, Ian M. Goodyer, Andrew J. Calder, Luca Passamonti.
    Journal of Child Psychology and Psychiatry. June 15, 2016
    Background Neuroimaging methods that allow researchers to investigate structural covariance between brain regions are increasingly being used to study psychiatric disorders. Structural covariance analyses are particularly well suited for studying disorders with putative neurodevelopmental origins as they appear sensitive to changes in the synchronized maturation of different brain regions. We assessed interregional correlations in cortical thickness as a measure of structural covariance, and applied this method to investigate the coordinated development of different brain regions in conduct disorder (CD). We also assessed whether structural covariance measures could differentiate between the childhood‐onset (CO‐CD) and adolescence‐onset (AO‐CD) subtypes of CD, which may differ in terms of etiology and adult outcomes. Methods We examined interregional correlations in cortical thickness in male youths with CO‐CD or AO‐CD relative to healthy controls (HCs) in two independent datasets. The age range in the Cambridge sample was 16–21 years (mean: 18.0), whereas the age range of the Southampton sample was 13–18 years (mean: 16.7). We used FreeSurfer to perform segmentations and applied structural covariance methods to the resulting parcellations. Results In both samples, CO‐CD participants displayed a strikingly higher number of significant cross‐cortical correlations compared to HC or AO‐CD participants, whereas AO‐CD participants presented fewer significant correlations than HCs. Group differences in the strength of the interregional correlations were observed in both samples, and each set of results remained significant when controlling for IQ and comorbid attention‐deficit/hyperactivity disorder symptoms. Conclusions This study provides new evidence for quantitative differences in structural brain organization between the CO‐CD and AO‐CD subtypes, and supports the hypothesis that both subtypes of CD have neurodevelopmental origins.
    June 15, 2016   doi: 10.1111/jcpp.12581   open full text
  • The impact of experimental sleep restriction on affective functioning in social and nonsocial contexts among adolescents.
    Dana L. McMakin, Ronald E. Dahl, Daniel J. Buysse, Jennifer C. Cousins, Erika E. Forbes, Jennifer S. Silk, Greg J. Siegle, Peter L. Franzen.
    Journal of Child Psychology and Psychiatry. June 15, 2016
    Background Short sleep duration is highly prevalent in adolescence, and it prospectively predicts problems with emotional adjustment and psychiatric health. To move beyond epidemiological associations and inform models of developmental psychopathology, we experimentally restricted sleep to observe impacts on affective functioning. Based on the importance of social contexts to adolescent emotional experiences, we also examined the impact of restricted sleep on socioaffective functioning in an ecologically valid peer interaction task. Methods In Study 1, adolescents (ages 11.5–15.0, n = 48) were randomly assigned to two nights of polysomnography‐monitored sleep restriction (4 hr in bed) or extension (10 hr in bed). One week later, they completed the other sleep manipulation. Affective functioning was assessed by self‐report and pupil response to standardized affective sounds. Study 2 used a similar protocol and invited adolescents (ages 12–15.0, n = 16) to the sleep laboratory along with 2–4 friends to observe affective behavior in a social context primed for peer conflict. Mixed effects models were used to evaluate the effect of sleep condition on affective outcomes. Results Study 1 demonstrated increased negative affect following sleep restriction, relative to extension, on self‐report (p = .02) and pupil measures (p = .01). Study 2 replicated these effects (both p = .04) and demonstrated greater negative affective behavior in a peer social context (p = .01). Exploratory analyses for positive affect showed reductions as assessed by self‐report (p = .005), but not pupil (p = .81), in Study 1; and no significant effects in Study 2 (self‐report, p = .14; pupil, p = .29; positive affective behavior, p = .43). Conclusions Experimental sleep restriction in adolescence impacts negative affective functioning as evidenced by self‐report and pupil reactivity, as well as observed behavior in a social context primed for peer conflict. Implications for the impact of short sleep on developmental trajectories of emotional adjustment and psychiatric health, and opportunities for early intervention, are briefly discussed.
    June 15, 2016   doi: 10.1111/jcpp.12568   open full text
  • Attention bias in the developmental unfolding of post‐traumatic stress symptoms in young children at risk.
    Margaret J. Briggs‐Gowan, Damion Grasso, Yair Bar‐Haim, Joel Voss, Kimberly J. McCarthy, Daniel S. Pine, Lauren S. Wakschlag.
    Journal of Child Psychology and Psychiatry. June 14, 2016
    Background Threat‐related attention bias relates to anxiety and posttraumatic stress symptoms in adults and adolescents, but few longitudinal studies examine such associations in young children. This study examines prospective relations among attention bias, trauma exposure, and anxiety and trauma symptoms in a sample previously reported to manifest cross‐sectional associations between attention bias and observed anxiety at preschool age. Methods Young children [mean (MN) = 5.0, ±0.7 years, n = 208] from a community‐based sample completed the dot‐probe task to assess their attention biases in response to angry faces. At baseline (T1) and at follow‐up approximately 9 months later (T2), anxiety and trauma exposure (i.e. violent and noninterpersonal events) and symptoms were assessed by maternal report. Results Neither attention bias nor baseline or recent trauma exposure predicted later anxiety. In contrast, attention bias toward threat and recent trauma exposure significantly predicted later trauma symptoms. There was evidence of symptom specificity such that attention bias toward threat significantly predicted hyperarousal and dissociation, but not avoidance or re‐experiencing symptoms. Finally, moderation analyses indicated that the relationship between attention bias and trauma symptoms may differ according to children's experiences of probable abuse. Conclusions Attention profiles and trauma exposure may increase the risk that young children will develop trauma symptoms. Individual differences in these attentional patterns and children's exposure history may impact outcomes among high‐risk children with potential implications for intervention.
    June 14, 2016   doi: 10.1111/jcpp.12577   open full text
  • Early severe institutional deprivation is associated with a persistent variant of adult attention‐deficit/hyperactivity disorder: clinical presentation, developmental continuities and life circumstances in the English and Romanian Adoptees study.
    Mark Kennedy, Jana Kreppner, Nicky Knights, Robert Kumsta, Barbara Maughan, Dennis Golm, Michael Rutter, Wolff Schlotz, Edmund J.S. Sonuga‐Barke.
    Journal of Child Psychology and Psychiatry. June 06, 2016
    Background Early‐life institutional deprivation is associated with attention‐deficit/hyperactivity disorder (ADHD) later in childhood and adolescence. In this article, we examine, for the first time, the persistence of deprivation‐related ADHD into young adulthood in a sample of individuals adopted as young children by UK families after periods in extremely depriving Romanian orphanages. Methods We estimated rates of ADHD at age 15 years and in young adulthood (ages 22–25 years) in individuals at low (LoDep; nondeprived UK adoptees and Romanian adoptees with less than 6‐month institutional exposure) and high deprivation‐related risk (HiDep; Romanian adoptees with more than 6‐month exposure). Estimates were based on parent report using DSM‐5 childhood symptom and impairment criteria. At age 15, data were available for 108 LoDep and 86 HiDep cases, while in young adulthood, the numbers were 83 and 60, respectively. Data on education and employment status, IQ, co‐occurring symptoms of young adult disinhibited social engagement (DSE), autism spectrum disorder (ASD), cognitive impairment, conduct disorder (CD), callous‐unemotional (CU) traits, anxiety, depression and quality of life (QoL) were also collected. Results ADHD rates in the LoDep group were similar to the general population in adolescence (5.6%) and adulthood (3.8%). HiDep individuals were, respectively, nearly four (19%) and over seven (29.3%) times more likely to meet criteria, than LoDep. Nine ‘onset’ young adult cases emerged, but these had a prior childhood history of elevated ADHD behaviours at ages 6, 11 and 15 years. Young adult ADHD was equally common in males and females, was predominantly inattentive in presentation and co‐occurred with high levels of ASD, DSE and CU features. ADHD was associated with high unemployment and low educational attainment. Conclusion We provide the first evidence of a strong persistence into adulthood of a distinctively complex and impairing deprivation‐related variant of ADHD. Our results confirm the powerful association of early experience with later development in a way that suggests a role for deep‐seated alterations to brain structure and function.
    June 06, 2016   doi: 10.1111/jcpp.12576   open full text
  • Discrimination of amygdala response predicts future separation anxiety in youth with early deprivation.
    Shulamite A. Green, Bonnie Goff, Dylan G. Gee, Laurel Gabard‐Durnam, Jessica Flannery, Eva H. Telzer, Kathryn L. Humphreys, Jennifer Louie, Nim Tottenham.
    Journal of Child Psychology and Psychiatry. June 04, 2016
    Background Significant disruption in caregiving is associated with increased internalizing symptoms, most notably heightened separation anxiety symptoms during childhood. It is also associated with altered functional development of the amygdala, a neurobiological correlate of anxious behavior. However, much less is known about how functional alterations of amygdala predict individual differences in anxiety. Here, we probed amygdala function following institutional caregiving using very subtle social‐affective stimuli (trustworthy and untrustworthy faces), which typically result in large differences in amygdala signal, and change in separation anxiety behaviors over a 2‐year period. We hypothesized that the degree of differentiation of amygdala signal to trustworthy versus untrustworthy face stimuli would predict separation anxiety symptoms. Methods Seventy‐four youths mean (SD) age = 9.7 years (2.64) with and without previous institutional care, who were all living in families at the time of testing, participated in an fMRI task designed to examine differential amygdala response to trustworthy versus untrustworthy faces. Parents reported on their children's separation anxiety symptoms at the time of scan and again 2 years later. Results Previous institutional care was associated with diminished amygdala signal differences and behavioral differences to the contrast of untrustworthy and trustworthy faces. Diminished differentiation of these stimuli types predicted more severe separation anxiety symptoms 2 years later. Older age at adoption was associated with diminished differentiation of amygdala responses. Conclusions A history of institutional care is associated with reduced differential amygdala responses to social‐affective cues of trustworthiness that are typically exhibited by comparison samples. Individual differences in the degree of amygdala differential responding to these cues predict the severity of separation anxiety symptoms over a 2‐year period. These findings provide a biological mechanism to explain the associations between early caregiving adversity and individual differences in internalizing symptomology during development, thereby contributing to individualized predictions of future clinical outcomes.
    June 04, 2016   doi: 10.1111/jcpp.12578   open full text
  • Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children.
    Stephen P. Becker, Amanda R. Withrow, Laura Stoppelbein, Aaron M. Luebbe, Paula J. Fite, Leilani Greening.
    Journal of Child Psychology and Psychiatry. June 01, 2016
    Background Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school‐aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self‐esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. Methods We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. Results White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent‐ and child self‐reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. Conclusions This multi‐informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology.
    June 01, 2016   doi: 10.1111/jcpp.12580   open full text
  • What is the biological reality of gene–environment interaction estimates? An assessment of bias in developmental models.
    Sarah R. Moore, Felix Thoemmes.
    Journal of Child Psychology and Psychiatry. May 31, 2016
    Background Standard models used to test gene–environment interaction (G × E) hypotheses make the causal assumption that there are no unobserved variables that could be biasing the interaction estimate. Whether this assumption can be met in nonexperimental studies is unclear because the interactive biological pathways from genetic polymorphisms and environments to behavior, and the confounders that can be introduced along these pathways, are often not delineated. This is problematic in the context of studies focused on caregiver–child dyads, in which common genes and environments induce gene–environment correlation. To address the impact of sources of bias in G × E models specifically assessing the interaction between child genotype and caregiver behavior, we provide a causal framework that integrates biological and statistical concepts of G × E, and assess the magnitude of bias introduced by various confounding pathways in different causal circumstances. Methods A simulation assessed the magnitude of bias introduced by four types of confounding pathways in different causal models. Unadjusted and adjusted statistical models were then applied to the simulated data to assess the efficacy of these procedures to capture unbiased G × E estimates. Finally, the simulation was run under null effects of the genotype to assess the impact of biasing sources on the false‐positive rate. Results Common environmental pathways between caregiver and child inflated G × E estimates and raised the false‐positive rate. Evocative effects of the child also inflated G × E estimates. Conclusions Gene–environment interaction studies should be approached with consideration to the causal pathways at play and the confounding opportunities along these pathways to facilitate the inclusion of adequate statistical controls and correct inferences from study findings. Bridging biological and statistical concepts of G × E can significantly improve research design and the communication of how a G × E process fits into a broader developmental framework.
    May 31, 2016   doi: 10.1111/jcpp.12579   open full text
  • The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study.
    Courtenay Frazier Norbury, Debbie Gooch, Charlotte Wray, Gillian Baird, Tony Charman, Emily Simonoff, George Vamvakas, Andrew Pickles.
    Journal of Child Psychology and Psychiatry. May 16, 2016
    Background Diagnosis of ‘specific’ language impairment traditionally required nonverbal IQ to be within normal limits, often resulting in restricted access to clinical services for children with lower NVIQ. Changes to DSM‐5 criteria for language disorder removed this NVIQ requirement. This study sought to delineate the impact of varying NVIQ criteria on prevalence, clinical presentation and functional impact of language disorder in the first UK population study of language impairment at school entry. Methods A population‐based survey design with sample weighting procedures was used to estimate population prevalence. We surveyed state‐maintained reception classrooms (n = 161 or 61% of eligible schools) in Surrey, England. From a total population of 12,398 children (ages 4–5 years), 7,267 (59%) were screened. A stratified subsample (n = 529) received comprehensive assessment of language, NVIQ, social, emotional and behavioural problems, and academic attainment. Results The total population prevalence estimate of language disorder was 9.92% (95% CI 7.38, 13.20). The prevalence of language disorder of unknown origin was estimated to be 7.58% (95% CI 5.33, 10.66), while the prevalence of language impairment associated with intellectual disability and/or existing medical diagnosis was 2.34% (95% CI 1.40, 3.91). Children with language disorder displayed elevated symptoms of social, emotional and behavioural problems relative to peers, F(1, 466) = 7.88, p = .05, and 88% did not make expected academic progress. There were no differences between those with average and low‐average NVIQ scores in severity of language deficit, social, emotional and behavioural problems, or educational attainment. In contrast, children with language impairments associated with known medical diagnosis and/or intellectual disability displayed more severe deficits on multiple measures. Conclusions At school entry, approximately two children in every class of 30 pupils will experience language disorder severe enough to hinder academic progress. Access to specialist clinical services should not depend on NVIQ.
    May 16, 2016   doi: 10.1111/jcpp.12573   open full text
  • Research Review: Changes in the prevalence and symptom severity of child post‐traumatic stress disorder in the year following trauma – a meta‐analytic study.
    Rachel M. Hiller, Richard Meiser‐Stedman, Pasco Fearon, Sarah Lobo, Anna McKinnon, Abigail Fraser, Sarah L. Halligan.
    Journal of Child Psychology and Psychiatry. May 12, 2016
    Background Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at‐risk youth. We used a meta‐analytic approach to examine longitudinal changes in youth PTSD prevalence and symptoms over the first 12 months posttrauma. Methods We conducted a systematic review to identify longitudinal studies of PTSD in young people (5–18 years old), excluding treatment trials. The search yielded 27 peer‐reviewed studies and one unpublished dataset for analysis of pooled prevalence estimates, relative prevalence reduction and standardised mean symptom change. Key moderators were also explored, including age, proportion of boys in the sample, initial prevalence of PTSD and PTSD measurement type. Results Analyses demonstrated moderate declines in PTSD prevalence and symptom severity over the first 3–6 months posttrauma. From 1 to 6 months posttrauma, the prevalence of PTSD reduced by approximately 50%. Symptoms also showed moderate decline, particularly across the first 3 months posttrauma. There was little evidence of further change in prevalence or symptom severity after 6 months, suggesting that it is unlikely a child would lose a PTSD diagnosis without intervention beyond this point. Conclusions The current findings provide key information about the likelihood of posttrauma recovery in the absence of intervention and have important implications for our understanding of child and adolescent PTSD. Results are discussed with reference to the timing of PTSD screening and the potential role of early interventions. Findings particularly highlight the importance of future research to develop our understanding of what factors prevent the action of normal recovery from the ‘acute’ posttrauma period.
    May 12, 2016   doi: 10.1111/jcpp.12566   open full text
  • Nutritional supplementation to reduce child aggression: a randomized, stratified, single‐blind, factorial trial.
    Adrian Raine, Rose A. Cheney, Ringo Ho, Jill Portnoy, Jianghong Liu, Liana Soyfer, Joseph Hibbeln, Therese S. Richmond.
    Journal of Child Psychology and Psychiatry. May 11, 2016
    Background While some studies suggest that nutritional supplementation may reduce aggressive behavior in children, they have not examined whether its efficacy may be enhanced in conjunction with other treatment approaches. This study tests the hypothesis that a nutritional supplementation of omega‐3, multivitamins, and minerals over 3 months, combined with cognitive behavior therapy, will reduce childhood aggression. Methods In this randomized, single‐blind, stratified, factorial trial, a high‐risk community sample of 290 children aged 11–12 years were randomized into Nutrition only, cognitive behavioral therapy (CBT) only, Nutrition + CBT, and Control groups. The primary outcome measures of child‐ and parent‐reported aggressive and antisocial behavior were collected at 0 months (baseline), 3 months (end of treatment), 6 months (3 months posttreatment), and 12 months (9 months posttreatment). The trial (‘Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)’ was registered at at Results For child self‐reports, children in the Nutrition only group showed reduced externalizing behavior compared to Controls at 3 months. At 6 months, the Nutrition + CBT group scored lower on externalizing behavior compared to both CBT only and Control groups. Findings were more in evidence for an Aggressive‐Reactive form of antisocial behavior than for a Callous‐Proactive form. Effect sizes were in the small‐to‐medium range (d = −.33 to −.37). Group differences were not sustained 9 months posttreatment, and no other effects were significant. Conclusions Findings provide some limited support for the efficacy of omega‐3, vitamin, and mineral supplementation in reducing aggressive behavior in children, and represent the first evaluation of nutritional supplements in conjunction with CBT.
    May 11, 2016   doi: 10.1111/jcpp.12565   open full text
  • School mobility during childhood predicts psychotic symptoms in late adolescence.
    Catherine Winsper, Dieter Wolke, Alex Bryson, Andrew Thompson, Swaran P. Singh.
    Journal of Child Psychology and Psychiatry. May 10, 2016
    Background Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence and the trajectories via which this risk manifests remain unexplored. Methods Psychotic symptoms in 4,720 adolescents aged 18 were ascertained by trained psychologists using the Psychosis‐Like Symptoms Interview. Mothers reported on sociodemographic factors (i.e., family adversity, ethnicity and urbanicity) from pregnancy to 4 years; child's involvement in bullying at age 6–7 years; residential mobility at 11 years and school mobility at 11–12 years. Young people reported on their friendships at 8 years, and antisocial behaviour and cannabis use at 15 years. Results School mobility across childhood significantly predicted psychotic symptoms at 18 years (adjusted odds ratio = 2.15; 95% confidence intervals = 1.06, 4.40). Within path analysis, school mobility (β = .183, p = .035), involvement in bullying (β = .133, p = .013), antisocial behaviour (β = .052, p = .004), cannabis use (β = .254, p = .020) and female sex (β = .420, p < .001) significantly predicted psychotic symptoms. Residential mobility (β = .375, p < .001), involvement in bullying (β = .120, p = .022) and poor friendships (β = .038, p = .014) significantly predicted school mobility. Residential mobility indirectly increased the risk of psychotic symptoms via school mobility (β = .069, p = .041). Conclusions Children who move schools often are more likely to have experienced peer problems. School mobility, in turn, appears to be a robust marker for psychotic symptoms in late adolescence. Clinicians and teachers should consider school mobility as an important risk indicator for both peer problems and psychopathology.
    May 10, 2016   doi: 10.1111/jcpp.12572   open full text
  • Developmental changes in electroencephalographic frontal asymmetry in young children at risk for depression.
    Brandon L. Goldstein, Stewart A. Shankman, Autumn Kujawa, Dana C. Torpey‐Newman, Thomas M. Olino, Daniel N. Klein.
    Journal of Child Psychology and Psychiatry. May 03, 2016
    Background A number of studies have reported that depression is associated with lower relative left frontal activity in the alpha band (i.e. frontal asymmetry, or FA), as measured by electroencephalogram. FA has also been hypothesized to be a vulnerability marker for depression. If this is the case, FA should be evident in offspring of depressed mothers, a group at elevated risk for depression. However, the results of previous offspring studies have been inconsistent and none of these studies has considered whether the relationship between FA and risk changes over development in children. Method We assessed FA twice, at ages 3 and 6, in 253 never depressed children from a community sample. Maternal history of depressive disorders was determined by a diagnostic interview completed by the mothers at the first assessment. Results There was a significant interaction between maternal depression and offspring age at assessment, indicating that FA exhibits different developmental trajectories depending on level of familial risk for depression. Offspring of depressed mothers exhibited a decreasing relative left FA over the course of early childhood, while offspring of nondepressed mothers exhibited relatively similar, symmetrical, levels of frontal alpha activity at both assessment points. Conclusions These results suggest that changes in FA from early to middle childhood distinguish those at risk for depression and that cross‐sectional assessment of FA may have limited value in understanding risk. These results highlight the importance of considering development in understanding the role of FA in depression.
    May 03, 2016   doi: 10.1111/jcpp.12567   open full text
  • Factors differentiating callous‐unemotional children with and without conduct problems.
    Tina D. Wall, Paul J. Frick, Kostas A. Fanti, Eva R. Kimonis, Alexandros Lordos.
    Journal of Child Psychology and Psychiatry. May 02, 2016
    Background Callous‐unemotional (CU) traits are a risk factor for a severe, aggressive, and persistent pattern of conduct problems (CP). This study investigated characteristics that might differentiate children with elevated CU traits with and without CP in an effort to identify factors that may reduce the risk for CP in children with limited prosocial emotions. Methods Utilizing a sample of 1,366 children from Cyprus, five groups were identified for further study based on latent profile analysis: low‐risk (67.2%), high‐CP/low‐CU (7.9%), high‐CU (9.4%), moderate‐CP/CU (8.4%), and high‐CP/CU (7.2%). The identified groups were compared on behavioral and social measures. Results There were significant main effects of group for: impulsivity and executive functioning; parenting; and connectedness to school. The high‐CU group had significantly lower hyperactivity‐impulsivity and executive functioning deficits, significantly higher self‐regulation, and their mothers reported more maternal involvement and positive parenting than those in the high‐CP/CU group. Also, the high‐CU group showed more school connectedness than those in the high‐CP/CU group. Conclusions These findings highlight several factors in the child and in his or her social environment that are associated with CU traits in the absence of serious CP and that may suggest targets for intervention for youth who may lack prosocial emotions.
    May 02, 2016   doi: 10.1111/jcpp.12569   open full text
  • Autonomic arousal in children of parents with and without social anxiety disorder: a high‐risk study.
    Milica Nikolić, Wieke Vente, Cristina Colonnesi, Susan M. Bögels.
    Journal of Child Psychology and Psychiatry. May 02, 2016
    Objective Autonomic hyperarousal in social situations is considered a genetic vulnerability factor for social anxiety disorder (SAD), but so far it is unstudied in children at risk for developing SAD. We examined autonomic activity during socially stressful tasks in children of mothers and fathers with and without lifetime SAD to reveal possible biological mechanisms of intergenerational transmission of SAD. Methods One hundred ten children aged 4.5 years were asked to sing a song in front of an audience and watch back their performance in the presence of that audience. Heart rate (HR), heart rate variability (HRV), electrodermal activity (EDA), and blushing (cheek blood flow and temperature) were measured in anticipation of, during, and after the tasks. Both parents’ lifetime SAD status was assessed, and both parents reported about their own and their child's social anxiety symptoms. Results Children of parents with lifetime SAD blushed more during the socially challenging tasks than children of parents without SAD. Moreover, children of parents with more social anxiety symptoms showed increased EDA throughout the tasks. Finally, more blushing, increased EDA, and reduced HRV were associated with greater child social anxiety. Conclusions This study adds to the current knowledge on the intergenerational transmission of SAD by providing evidence that children at risk for SAD are characterized by excessive blushing in socially challenging situations. The findings also demonstrate that heightened autonomic activity is a characteristic of social anxiety already during early childhood. Hence, autonomic hyperarousal, and blushing in particular, is likely to play an etiological role in the development of SAD.
    May 02, 2016   doi: 10.1111/jcpp.12563   open full text
  • Association between immigrant background and ADHD: a nationwide population‐based case–control study.
    Venla Lehti, Roshan Chudal, Auli Suominen, Mika Gissler, Andre Sourander.
    Journal of Child Psychology and Psychiatry. May 02, 2016
    Background Information about psychiatric disorders among those with immigrant parents is important for early detection and service development. The aim of this study is to examine the association between parental immigration and the diagnosis of attention‐deficit hyperactivity disorder (ADHD) in offspring in Finland. Methods This matched case–control study was based on a national birth cohort. The sample included all singletons who were born in Finland in 1991–2005 and diagnosed with ADHD by the year 2011 (n = 10,409) and their matched controls (n = 39,124). Nationwide registers were used to identify participants and to gather information on the parents' country of birth and native language. Conditional logistic regression analyses were conducted using maternal and paternal migration status and region of birth as well as time since maternal migration as exposure factors. Results The likelihood of being diagnosed with ADHD was significantly increased among children of two immigrant parents [adjusted odds ratio (aOR) 4.7, 95% CI 3.4–6.6] and children of an immigrant father (aOR 1.9, 95% CI 1.6–2.2). The likelihood of receiving an ADHD diagnosis was equal among children whose mother was a recent immigrant when she gave birth and those whose mother had stayed in Finland at least for a year before birth. The association between parental migration and ADHD diagnosis was strongest among fathers born in sub‐Saharan Africa or Latin America and among mothers born in sub‐Saharan Africa or North Africa and Middle East. Children, whose parents were born in countries with low Human Development Index (HDI), were more often diagnosed with ADHD. Conclusions The increased likelihood of ADHD diagnosis among children of immigrants indicates increased exposure to environmental risk factors, differences in the use of health services, or challenges in diagnosing immigrants' children.
    May 02, 2016   doi: 10.1111/jcpp.12570   open full text
  • The long‐term effectiveness of a selective, personality‐targeted prevention program in reducing alcohol use and related harms: a cluster randomized controlled trial.
    Nicola C. Newton, Patricia J. Conrod, Tim Slade, Natacha Carragher, Katrina E. Champion, Emma L. Barrett, Erin V. Kelly, Natasha K. Nair, Lexine Stapinski, Maree Teesson.
    Journal of Child Psychology and Psychiatry. April 19, 2016
    Background This study investigated the long‐term effectiveness of Preventure, a selective personality‐targeted prevention program, in reducing the uptake of alcohol, harmful use of alcohol, and alcohol‐related harms over a 3‐year period. Methods A cluster randomized controlled trial was conducted to assess the effectiveness of Preventure. Schools were block randomized to one of two groups: the Preventure group (n = 7 schools) and the Control group (n = 7 schools). Only students screening as high‐risk on one of four personality profiles (anxiety sensitivity, negative thinking, impulsivity, and sensation seeking) were included in the analysis. All students were assessed at five time points over a 3‐year period: baseline; immediately after the intervention; and 12, 24, and 36 months after baseline. Students were assessed on frequency of drinking, binge drinking, and alcohol‐related harms. Two‐part latent growth models were used to analyze intervention effects, which included all students with data available at each time point. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000026820; Results A total of 438 high‐risk adolescents (mean age, 13.4 years; SD = 0.47) from 14 Australian schools were recruited to the study and completed baseline assessments. Relative to high‐risk Control students, high‐risk Preventure students displayed significantly reduced growth in their likelihood to consume alcohol [b = −0.225 (0.061); p < .001], to binge drink [b = −0.305 (.096); p = 0.001], and to experience alcohol‐related harms [b = −0.255 (0.096); p = .008] over 36 months. Conclusions Findings from this study support the use of selective personality‐targeted preventive interventions in reducing the uptake of alcohol, alcohol misuse, and related harms over the long term. This trial is the first to demonstrate the effects of a selective alcohol prevention program over a 3‐year period and the first to demonstrate the effects of a selective preventive intervention in Australia.
    April 19, 2016   doi: 10.1111/jcpp.12558   open full text
  • Synchrony of physiological activity during mother–child interaction: moderation by maternal history of major depressive disorder.
    Mary L. Woody, Cope Feurer, Effua E. Sosoo, Paul D. Hastings, Brandon E. Gibb.
    Journal of Child Psychology and Psychiatry. April 19, 2016
    Background Family environment plays an important role in the intergenerational transmission of major depressive disorder (MDD), but less is known about how day‐to‐day mother–child interactions may be disrupted in families with a history of MDD. Disruptions in mother–child synchrony, the dynamic and convergent exchange of physiological and behavioral cues during interactions, may be one important risk factor. Although maternal MDD is associated with a lack of mother–child synchrony at the behavioral level, no studies have examined the impact of maternal MDD on physiological synchrony. Therefore, this study examined whether maternal history of MDD moderates mother–child physiological synchrony [measured via respiratory sinus arrhythmia (RSA)] during positive and negative discussions. Method Children aged 7–11 years and mothers with either a history of MDD during the child's lifetime (n = 44) or no lifetime diagnosis of any mood disorder (n = 50) completed positive and negative discussion tasks while RSA was continuously recorded for both child and mother. Results Results indicated significant between‐dyad and within‐dyad group differences in physiological synchrony during positive and negative discussions. Between‐dyad analyses revealed evidence of synchrony only among never depressed dyads, among whom higher average mother RSA during both discussions was associated with higher average child RSA. Within‐dyad analyses revealed that never depressed dyads displayed positive synchrony (RSA concordance), whereas dyads with a history of maternal MDD displayed negative synchrony (RSA discordance) during the negative discussion and that the degree of negative synchrony exhibited during the negative discussion was associated with mothers' and children's levels of sadness. Conclusions These results provide preliminary evidence that physiological synchrony is disrupted in families with a history of maternal MDD and may be a potential risk factor for the intergenerational transmission of depression.
    April 19, 2016   doi: 10.1111/jcpp.12562   open full text
  • Use of machine learning to improve autism screening and diagnostic instruments: effectiveness, efficiency, and multi‐instrument fusion.
    Daniel Bone, Somer L. Bishop, Matthew P. Black, Matthew S. Goodwin, Catherine Lord, Shrikanth S. Narayanan.
    Journal of Child Psychology and Psychiatry. April 19, 2016
    Background Machine learning (ML) provides novel opportunities for human behavior research and clinical translation, yet its application can have noted pitfalls (Bone et al., 2015). In this work, we fastidiously utilize ML to derive autism spectrum disorder (ASD) instrument algorithms in an attempt to improve upon widely used ASD screening and diagnostic tools. Methods The data consisted of Autism Diagnostic Interview‐Revised (ADI‐R) and Social Responsiveness Scale (SRS) scores for 1,264 verbal individuals with ASD and 462 verbal individuals with non‐ASD developmental or psychiatric disorders, split at age 10. Algorithms were created via a robust ML classifier, support vector machine, while targeting best‐estimate clinical diagnosis of ASD versus non‐ASD. Parameter settings were tuned in multiple levels of cross‐validation. Results The created algorithms were more effective (higher performing) than the current algorithms, were tunable (sensitivity and specificity can be differentially weighted), and were more efficient (achieving near‐peak performance with five or fewer codes). Results from ML‐based fusion of ADI‐R and SRS are reported. We present a screener algorithm for below (above) age 10 that reached 89.2% (86.7%) sensitivity and 59.0% (53.4%) specificity with only five behavioral codes. Conclusions ML is useful for creating robust, customizable instrument algorithms. In a unique dataset comprised of controls with other difficulties, our findings highlight the limitations of current caregiver‐report instruments and indicate possible avenues for improving ASD screening and diagnostic tools.
    April 19, 2016   doi: 10.1111/jcpp.12559   open full text
  • Structural brain correlates of adolescent resilience.
    Keith B. Burt, Robert Whelan, Patricia J. Conrod, Tobias Banaschewski, Gareth J. Barker, Arun L.W. Bokde, Uli Bromberg, Christian Büchel, Mira Fauth‐Bühler, Herta Flor, André Galinowski, Juergen Gallinat, Penny Gowland, Andreas Heinz, Bernd Ittermann, Karl Mann, Frauke Nees, Dimitri Papadopoulos‐Orfanos, Tomas Paus, Zdenka Pausova, Luise Poustka, Marcella Rietschel, Trevor W. Robbins, Michael N. Smolka, Andreas Ströhle, Gunter Schumann, Hugh Garavan,.
    Journal of Child Psychology and Psychiatry. April 15, 2016
    Background Despite calls for integration of neurobiological methods into research on youth resilience (high competence despite high adversity), we know little about structural brain correlates of resilient functioning. The aim of the current study was to test for brain regions uniquely associated with positive functioning in the context of adversity, using detailed phenotypic classification. Methods 1,870 European adolescents (Mage = 14.56 years, SDage = 0.44 years, 51.5% female) underwent MRI scanning and completed behavioral and psychological measures of stressful life events, academic competence, social competence, rule‐abiding conduct, personality, and alcohol use. Results The interaction of competence and adversity identified two regions centered on the right middle and superior frontal gyri; grey matter volumes in these regions were larger in adolescents experiencing adversity who showed positive adaptation. Differences in these regions among competence/adversity subgroups were maintained after controlling for several covariates and were robust to alternative operationalization decisions for key constructs. Conclusions We demonstrate structural brain correlates of adolescent resilience, and suggest that right prefrontal structures are implicated in adaptive functioning for youth who have experienced adversity.
    April 15, 2016   doi: 10.1111/jcpp.12552   open full text
  • Behavioral sensitivity to changing reinforcement contingencies in attention‐deficit hyperactivity disorder.
    Brent Alsop, Emi Furukawa, Paula Sowerby, Stephanie Jensen, Cara Moffat, Gail Tripp.
    Journal of Child Psychology and Psychiatry. April 15, 2016
    Background Altered sensitivity to positive reinforcement has been hypothesized to contribute to the symptoms of attention‐deficit hyperactivity disorder (ADHD). In this study, we evaluated the ability of children with and without ADHD to adapt their behavior to changing reinforcer availability. Method Of one hundred sixty‐seven children, 97 diagnosed with ADHD completed a signal‐detection task in which correct discriminations between two stimuli were associated with different frequencies of reinforcement. The response alternative associated with the higher rate of reinforcement switched twice during the task without warning. For a subset of participants, this was followed by trials for which no reinforcement was delivered, irrespective of performance. Results Children in both groups developed an initial bias toward the more frequently reinforced response alternative. When the response alternative associated with the higher rate of reinforcement switched, the children's response allocation (bias) followed suit, but this effect was significantly smaller for children with ADHD. When reinforcement was discontinued, only children in the control group modified their response pattern. Conclusions Children with ADHD adjust their behavioral responses to changing reinforcer availability less than typically developing children, when reinforcement is intermittent and the association between an action and its consequences is uncertain. This may explain the difficulty children with ADHD have adapting their behavior to new situations, with different reinforcement contingencies, in daily life.
    April 15, 2016   doi: 10.1111/jcpp.12561   open full text
  • Dysfunctional representation of expected value is associated with reinforcement‐based decision‐making deficits in adolescents with conduct problems.
    Stuart F. White, Patrick M. Tyler, Anna K. Erway, Mary L. Botkin, Venkata Kolli, Harma Meffert, Kayla Pope, James R. Blair.
    Journal of Child Psychology and Psychiatry. April 08, 2016
    Background Previous work has shown that patients with conduct problems (CP) show impairments in reinforcement‐based decision‐making. However, studies with patients have not previously demonstrated any relationships between impairment in any of the neurocomputations underpinning reinforcement‐based decision‐making and specific symptom sets [e.g. level of CP and/or callous‐unemotional (CU) traits]. Methods Seventy‐two youths [20 female, mean age = 13.81 (SD = 2.14), mean IQ = 102.34 (SD = 10.99)] from a residential treatment program and the community completed a passive avoidance task while undergoing functional MRI. Results Greater levels of CP were associated with poorer task performance. Reduced representation of expected values (EV) when making avoidance responses within bilateral anterior insula cortex/inferior frontal gyrus (AIC/iFG) and striatum was associated with greater levels of CP but not CU traits. Conclusions The current data indicate that difficulties in the use of value information to motivate decisions to avoid suboptimal choices are associated with increased levels of CP (though not severity of CU traits). Moreover, they account for the behavioral deficits observed during reinforcement‐based decision‐making in youth with CP. In short, an individual's relative failure to utilize value information within AIC/iFG to avoid bad choices is associated with elevated levels of CP.
    April 08, 2016   doi: 10.1111/jcpp.12557   open full text
  • Parental death during childhood and depression in young adults – a national cohort study.
    Lisa Berg, Mikael Rostila, Anders Hjern.
    Journal of Child Psychology and Psychiatry. April 05, 2016
    Background There are few prospective, population‐based studies on childhood parental death and psychiatric disorders in adulthood, and previous findings are inconclusive. This study investigated the association between parental death from natural and external (suicides, accidents or homicides) causes before 18 years and the risk of clinical depression in young adults, in relation to age at loss and gender of both child and parent. Methods In this register‐based study, a national cohort born in Sweden during 1973–1982 (n = 862,554) was followed with regard to hospital admissions and outpatient care for depression during 2006–2013. Multivariate Cox proportional hazards models were used to estimate the impact of parental death, taking sociodemographic and parental psychosocial covariates into account. Results Maternal death from natural causes was associated with a hazard ratio (HR) of outpatient care for depression of 1.19 [95% confidence interval (CI), 1.02–1.40] in men and 1.15 (1.01–1.31) in women, after adjustment for sociodemographic confounders, with similar effect sizes for paternal natural death. Death from external causes consistently had higher effect size compared with natural deaths, in particular in relation to risk of hospital admissions for depression where they were as high as HR 3.23 (2.38–4.38) for men, and 1.79 (1.30–2.47) for women after a loss of a mother. Losing a parent in preschool age, compared with losing a parent as a teenager, was associated with higher risks of both hospitalization (p = .006) and outpatient care (p = .001) for depression. Conclusions This study indicates that parental loss to death from natural causes during childhood is associated with a small increased risk of long‐term consequences for psychological health. Children who lose their parents to death from external causes, that is suicides, accidents or homicides, and children losing a parent in young ages are, however, at particular risk and should be given priority in preventive interventions after parental loss.
    April 05, 2016   doi: 10.1111/jcpp.12560   open full text
  • Can school counselors deliver cognitive‐behavioral treatment for social anxiety effectively? A randomized controlled trial.
    Carrie Masia Warner, Daniela Colognori, Chad Brice, Kathleen Herzig, Laura Mufson, Chelsea Lynch, Philip T. Reiss, Eva Petkova, Jeremy Fox, Dominic C. Moceri, Julie Ryan, Rachel G. Klein.
    Journal of Child Psychology and Psychiatry. March 22, 2016
    Background Social anxiety disorder (SAD) typically onsets in adolescence and is associated with multiple impairments. Despite promising clinical interventions, most socially anxious adolescents remain untreated. To address this clinical neglect, we developed a school‐based, 12‐week group intervention for youth with SAD, Skills for Academic and Social Success (SASS). When implemented by psychologists, SASS has been found effective. To promote dissemination and optimize treatment access, we tested whether school counselors could be effective treatment providers. Method We randomized 138, ninth through 11th graders with SAD to one of three conditions: (a) SASS delivered by school counselors (C‐SASS), (b) SASS delivered by psychologists (P‐SASS), or (c) a control condition, Skills for Life (SFL), a nonspecific counseling program. Blind, independent, evaluations were conducted with parents and adolescents at baseline, post‐intervention, and 5 months beyond treatment completion. We hypothesized that C‐SASS and P‐SASS would be superior to the control, immediately after treatment and at follow‐up. No prediction was made about the relative efficacy of C‐SASS and P‐SASS. Results Compared to controls, adolescents treated with C‐SASS or P‐SASS experienced significantly greater improvement and reductions of anxiety at the end of treatment and follow‐up. There were no significant differences between SASS delivered by school counselors and psychologists. Conclusion With training, school counselors are effective treatment providers to adolescents with social anxiety, yielding benefits comparable to those obtained by specialized psychologists. Questions remain regarding means to maintain counselors’ practice standards without external support.
    March 22, 2016   doi: 10.1111/jcpp.12550   open full text
  • A randomized controlled trial of cognitive behavioral therapy for ADHD in medication‐treated adolescents.
    Susan E. Sprich, Steven A. Safren, Daniel Finkelstein, Jocelyn E. Remmert, Paul Hammerness.
    Journal of Child Psychology and Psychiatry. March 17, 2016
    Objective To test cognitive behavioral therapy (CBT) for persistent attention‐deficit hyperactivity disorder (ADHD) symptoms in a sample of medication‐treated adolescents. Methods Forty‐six adolescents (ages 14–18), with clinically significant ADHD symptoms despite stable medication treatment were randomly assigned to receive CBT for ADHD or wait list control in a cross‐over design. Twenty‐four were randomized to CBT, 22 to wait list, and 15 crossed‐over from wait list to CBT. A blind independent evaluator (IE) rated symptom severity on the ADHD Current Symptom Scale, by adolescent and parent report, and rated each subject using the Clinical Global Impression Severity Scale (CGI), a global measure of distress and impairment. These assessments were performed at baseline, 4‐months (post‐CBT or post wait list), and 8‐months (post‐treatment for those originally assigned to the wait list condition and 4‐month follow‐up for those originally assigned to CBT). Trial Registration: Results Using all available data, mixed effects modeling, and pooling for the wait list cross‐over, participants who received CBT received a mean score 10.93 lower on the IE‐rated parent assessment of symptom severity (95% CI: −12.93, −8.93; p < .0001), 5.24 lower on the IE‐rated adolescent assessment of symptom severity (95% CI: −7.21, −3.28; p < .0001), and 1.17 lower IE‐rated CGI (95% CI: −1.39, −.94; p < .0001). Results were consistent across 100 multiple imputations (all p < .0001). There was a greater proportion of responders after CBT by parent (50% vs. 18%, p = .00) and adolescent (58% vs. 18% p = .02) report. Conclusions This study demonstrates initial efficacy of CBT for adolescents with ADHD who continued to exhibit persistent symptoms despite medications.
    March 17, 2016   doi: 10.1111/jcpp.12549   open full text
  • Longitudinal effects of prenatal exposure to air pollutants on self‐regulatory capacities and social competence.
    Amy E. Margolis, Julie B. Herbstman, Katie S. Davis, Valerie K. Thomas, Deliang Tang, Ya Wang, Shuang Wang, Frederica P. Perera, Bradley S. Peterson, Virginia A. Rauh.
    Journal of Child Psychology and Psychiatry. March 17, 2016
    Background We evaluated the influence of prenatal exposure to widespread urban air pollutants on the development of self‐regulation and social competence in a longitudinal prospective cohort of children born to nonsmoking minority women in New York City. Methods Air pollutant exposure was estimated categorically by level of polycyclic aromatic hydrocarbon (PAH)‐DNA adducts in maternal blood collected at delivery, providing a biomarker of maternal exposure to PAH over a 2‐ to 3‐month period. Deficient emotional self‐regulation (DESR) was defined as moderate elevations on three specific scales of the child behavior checklist (anxious/depressed, aggressive behavior, and attention problems). We used generalized estimating equations to assess the influence of prenatal exposure to PAH on DESR in children at 3–5, 7, 9, and 11 years of age, adjusted for gender and race/ethnicity. Next, we assessed the association of prenatal exposure to PAH with social competence, as measured by the social responsiveness scale (SRS), the association of impaired self‐regulation with social competence, and whether impairment in self‐regulation mediated the association of prenatal exposure to PAH with social competence. Results We detected a significant interaction (at p = .05) of exposure with time, in which the developmental trajectory of self‐regulatory capacity was delayed in the exposed children. Multiple linear regression revealed a positive association between presence of PAH‐DNA adducts and problems with social competence (p < .04), level of dysregulation and problems with social competence (p < .0001), and evidence that self‐regulation mediates the association of prenatal exposure to PAH with social competence (p < .0007). Conclusions These data suggest that prenatal exposure to PAH produces long‐lasting effects on self‐regulatory capacities across early and middle childhood, and that these deficits point to emerging social problems with real‐world consequences for high‐risk adolescent behaviors in this minority urban cohort.
    March 17, 2016   doi: 10.1111/jcpp.12548   open full text
  • Research Review: Environmental exposures, neurodevelopment, and child mental health – new paradigms for the study of brain and behavioral effects.
    Virginia A. Rauh, Amy E. Margolis.
    Journal of Child Psychology and Psychiatry. March 14, 2016
    Background Environmental exposures play a critical role in the genesis of some child mental health problems. Methods We open with a discussion of children's vulnerability to neurotoxic substances, changes in the distribution of toxic exposures, and cooccurrence of social and physical exposures. We address trends in prevalence of mental health disorders, and approaches to the definition of disorders that are sensitive to the subtle effects of toxic exposures. We suggest broadening outcomes to include dimensional measures of autism spectrum disorders, attention‐deficit hyperactivity disorder, and child learning capacity, as well as direct assessment of brain function. Findings We consider the impact of two important exposures on children's mental health: lead and pesticides. We argue that longitudinal research designs may capture the cascading effects of exposures across biological systems and the full‐range of neuropsychological endpoints. Neuroimaging is a valuable tool for observing brain maturation under varying environmental conditions. A dimensional approach to measurement may be sensitive to subtle subclinical toxic effects, permitting the development of exposure‐related profiles and testing of complex functional relationships between brain and behavior. Questions about the neurotoxic effects of chemicals become more pressing when viewed through the lens of environmental justice. Conclusions Reduction in the burden of child mental health disorders will require longitudinal study of neurotoxic exposures, incorporating dimensional approaches to outcome assessment, and measures of brain function. Research that seeks to identify links between toxic exposures and mental health outcomes has enormous public health and societal value.
    March 14, 2016   doi: 10.1111/jcpp.12537   open full text
  • Preterm birth is associated with atypical social orienting in infancy detected using eye tracking.
    Emma J. Telford, Sue Fletcher‐Watson, Karri Gillespie‐Smith, Rozalia Pataky, Sarah Sparrow, Ian C. Murray, Anne O'Hare, James P. Boardman.
    Journal of Child Psychology and Psychiatry. March 02, 2016
    Background Preterm birth is closely associated with neurocognitive impairment in childhood including increased risk for social difficulties. Eye tracking objectively assesses eye‐gaze behaviour in response to visual stimuli, which permits inference about underlying cognitive processes. We tested the hypothesis that social orienting in infancy is altered by preterm birth. Methods Fifty preterm infants with mean (range) gestational age (GA) at birth of 29+1 (23+2–33+0) weeks and 50 term infants with mean (range) GA at birth 40+2 (37+0–42+3) weeks underwent eye tracking at median age of 7 months. Infants were presented with three categories of social stimuli of increasing complexity. Time to first fixate (TFF) and looking time (LT) on areas of interest (AoIs) were recorded using remote eye tracking. Results Preterm infants consistently fixated for a shorter time on social content than term infants across all three tasks: face‐scanning (fixation to eyes minus mouth 0.61s vs. 1.47s, p = .013); face pop‐out task (fixation to face 0.8s vs. 1.34s, p = .023); and social preferential looking (1.16s vs. 1.5s p = .02). Time given to AoIs containing social content as a proportion of LT at the whole stimulus was lower in preterm infants across all three tasks. These results were not explained by differences in overall looking time between the groups. Conclusions Eye tracking provides early evidence of atypical cognition after preterm birth, and may be a useful tool for stratifying infants at risk of impairment for early interventions designed to improve outcome.
    March 02, 2016   doi: 10.1111/jcpp.12546   open full text
  • Does comorbid anxiety counteract emotion recognition deficits in conduct disorder?
    Roxanna M.L. Short, Edmund J.S. Sonuga‐Barke, Wendy J. Adams, Graeme Fairchild.
    Journal of Child Psychology and Psychiatry. March 02, 2016
    Background Previous research has reported altered emotion recognition in both conduct disorder (CD) and anxiety disorders (ADs) – but these effects appear to be of different kinds. Adolescents with CD often show a generalised pattern of deficits, while those with ADs show hypersensitivity to specific negative emotions. Although these conditions often cooccur, little is known regarding emotion recognition performance in comorbid CD+ADs. Here, we test the hypothesis that in the comorbid case, anxiety‐related emotion hypersensitivity counteracts the emotion recognition deficits typically observed in CD. Method We compared facial emotion recognition across four groups of adolescents aged 12–18 years: those with CD alone (n = 28), ADs alone (n = 23), cooccurring CD+ADs (n = 20) and typically developing controls (n = 28). The emotion recognition task we used systematically manipulated the emotional intensity of facial expressions as well as fixation location (eye, nose or mouth region). Results Conduct disorder was associated with a generalised impairment in emotion recognition; however, this may have been modulated by group differences in IQ. AD was associated with increased sensitivity to low‐intensity happiness, disgust and sadness. In general, the comorbid CD+ADs group performed similarly to typically developing controls. Conclusions Although CD alone was associated with emotion recognition impairments, ADs and comorbid CD+ADs were associated with normal or enhanced emotion recognition performance. The presence of comorbid ADs appeared to counteract the effects of CD, suggesting a potentially protective role, although future research should examine the contribution of IQ and gender to these effects.
    March 02, 2016   doi: 10.1111/jcpp.12544   open full text
  • Behavioral outcomes of picky eating in childhood: a prospective study in the general population.
    Sebastian Cardona Cano, Hans W. Hoek, Daphne Hoeken, Lisanne M. Barse, Vincent W.V. Jaddoe, Frank C. Verhulst, Henning Tiemeier.
    Journal of Child Psychology and Psychiatry. February 19, 2016
    Background Picky eaters in the general population form a heterogeneous group. It is important to differentiate between children with transient picky eating (PE) and persistent PE behavior when adverse outcomes are studied. We analyzed four PE trajectories to determine the associations with child mental health prospectively. Methods From a population‐based cohort, 3,748 participants were assessed for PE at 1.5, 3, and 6 years of age using maternal reports. Four trajectories were defined: persistent (PE at all ages); remitting (PE before 6 years only); late‐onset (PE at 6 years only); and never (no PE at any assessment). Child's problem behaviors were assessed with the Teacher's Report Form at 7 years of age. We examined associations between picky eating trajectories and emotional problems, behavioral problems and pervasive developmental problems using logistic regressions. Analyses were adjusted for child, parental, and socioeconomic confounders. We also adjusted for maternal‐reported baseline problem behavior at age 1.5 years; the never picky eating group was used as reference. Results Persisting PE predicted pervasive developmental problems at age 7 years (OR = 2.00, 95% CI: 1.10–3.63). The association remained when adjusted for baseline pervasive developmental problems at 1.5 years (OR = 1.96, 95% CI: 1.10–3.51). Persistent PE was not associated with behavioral (OR = 0.92, 95% CI: 0.53–1.60) or emotional problems (OR = 1.24, 95% CI: 0.74–2.07). Other PE trajectories were not related to child behavioral or emotional problems. Conclusions Persistent PE may be a symptom or sign of pervasive developmental problems, but is not predictive of other behavioral problems. Remitting PE was not associated with adverse mental health outcomes, which further indicates that it may be part of normal development.
    February 19, 2016   doi: 10.1111/jcpp.12530   open full text
  • Extended‐release guanfacine hydrochloride in 6–17‐year olds with ADHD: a randomised‐withdrawal maintenance of efficacy study.
    Jeffrey H. Newcorn, Valerie Harpin, Michael Huss, Andrew Lyne, Vanja Sikirica, Mats Johnson, Josep Antoni Ramos‐Quiroga, Judy Stralen, Benoit Dutray, Sasha Sreckovic, Ralph Bloomfield, Brigitte Robertson.
    Journal of Child Psychology and Psychiatry. February 12, 2016
    Background Extended‐release guanfacine hydrochloride (GXR), a selective α2A‐adrenergic agonist, is a nonstimulant medication for attention‐deficit/hyperactivity disorder (ADHD). This phase 3, double‐blind, placebo‐controlled, randomised‐withdrawal study evaluated the long‐term maintenance of GXR efficacy in children/adolescents with ADHD. Methods Children/adolescents (6–17 years) with ADHD received open‐label GXR (1–7 mg/day). After 13 weeks, responders were randomised to GXR or placebo in the 26‐week, double‐blind, randomised‐withdrawal phase (RWP). The primary endpoint was the percentage of treatment failure (≥50% increase in ADHD Rating Scale version IV total score and ≥2‐point increase in Clinical Global Impression‐Severity compared with RWP baseline, at two consecutive visits). The key secondary endpoint was time to treatment failure (TTF). Trial registration identifier NCT01081145; EudraCT 2009‐018161‐12. Results A total of 528 participants enrolled; 316 (59.8%) entered the RWP. Treatment failure occurred in 49.3% of the GXR and 64.9% of the placebo group (p = 0.006). TTF was significantly longer in GXR versus placebo (p = 0.003). GXR was well tolerated. Conclusions Guanfacine hydrochloride demonstrated long‐term maintenance of efficacy compared with placebo in children/adolescents with ADHD. Implications of the placebo substitution design and findings with different ADHD medications are discussed. Phase 3, double‐blind, placebo‐controlled, randomized‐withdrawal study evaluating the long‐term maintenance of GXR efficacy in children/adolescents with ADHD.
    February 12, 2016   doi: 10.1111/jcpp.12492   open full text
  • Aberrant local striatal functional connectivity in attention‐deficit/hyperactivity disorder.
    Daniel Rhein, Marianne Oldehinkel, Christian F. Beckmann, Jaap Oosterlaan, Dirk Heslenfeld, Catharina A. Hartman, Pieter J. Hoekstra, Barbara Franke, Roshan Cools, Jan K. Buitelaar, Maarten Mennes.
    Journal of Child Psychology and Psychiatry. February 12, 2016
    Background Task‐based and resting‐state functional Magnetic Resonance Imaging (fMRI) studies report attention‐deficit/hyperactivity disorder (ADHD)‐related alterations in brain regions implicated in cortico‐striatal networks. We assessed whether ADHD is associated with changes in the brain's global cortico‐striatal functional architecture, or whether ADHD‐related alterations are limited to local, intrastriatal functional connections. Methods We included a cohort of adolescents with ADHD (N = 181) and healthy controls (N = 140) and assessed functional connectivity of nucleus accumbens, caudate nucleus, anterior putamen, and posterior putamen. To assess global cortico‐striatal functional architecture we computed whole‐brain functional connectivity by including all regions of interest in one multivariate analysis. We assessed local striatal functional connectivity using partial correlations between the time series of the striatal regions. Results Diagnostic status did not influence global cortico‐striatal functional architecture. However, compared to controls, participants with ADHD exhibited significantly increased local functional connectivity between anterior and posterior putamen (p = .0003; ADHD: z = .30, controls: z = .24). Results were not affected by medication use or comorbid oppositional defiant disorder and conduct disorder. Conclusions Our results do not support hypotheses that ADHD is associated with alterations in cortico‐striatal networks, but suggest changes in local striatal functional connectivity. We interpret our findings as aberrant development of local functional connectivity of the putamen, potentially leading to decreased functional segregation between anterior and posterior putamen in ADHD.
    February 12, 2016   doi: 10.1111/jcpp.12529   open full text
  • Evaluating differences in Pavlovian fear acquisition and extinction as predictors of outcome from cognitive behavioural therapy for anxious children.
    Allison M. Waters, Daniel S. Pine.
    Journal of Child Psychology and Psychiatry. February 12, 2016
    Background Extinction is a key theoretical model of exposure‐based treatments, such as cognitive behavioural therapy (CBT). This study examined whether individual differences in physiological responses and subjective stimulus evaluations as indices of fear extinction predicted response to CBT. Methods Thirty‐two nonanxious comparisons and 44 anxious, 7‐to‐13‐year‐old children completed a Pavlovian conditioning and extinction task. Anxious children then completed group‐based CBT. Skin conductance responses (SCRs) as well as subjective arousal and valence evaluations were measured in response to a conditioned stimulus paired with an aversive tone (CS+) and another conditioned stimulus presented alone (CS−). Both stimuli were presented alone during extinction. Diagnostic and symptom measures were completed before and after treatment. Results Like nonanxious comparisons, treatment responders did not acquire conditioned negative stimulus evaluations and displayed elevated SCRs that declined significantly across extinction trials. Nonresponders, by contrast, showed elevated negative stimulus evaluations of both CSs that were sensitive to extinction trials but showed no change in SCRs during extinction. Change in physiological but not evaluative indices of fear extinction predicted better treatment outcomes. Conclusions Individual differences in evaluative and physiological indices of fear extinction might moderate response to CBT.
    February 12, 2016   doi: 10.1111/jcpp.12522   open full text
  • Actigraph measures discriminate pediatric bipolar disorder from attention‐deficit/hyperactivity disorder and typically developing controls.
    Gianni L. Faedda, Kyoko Ohashi, Mariely Hernandez, Cynthia E. McGreenery, Marie C. Grant, Argelinda Baroni, Ann Polcari, Martin H. Teicher.
    Journal of Child Psychology and Psychiatry. January 22, 2016
    Background Distinguishing pediatric bipolar disorder (BD) from attention‐deficit hyperactivity disorder (ADHD) can be challenging. Hyperactivity is a core feature of both disorders, but severely disturbed sleep and circadian dysregulation are more characteristic of BD, at least in adults. We tested the hypothesis that objective measures of activity, sleep, and circadian rhythms would help differentiate pediatric subjects with BD from ADHD and typically developing controls. Methods Unmedicated youths (N = 155, 97 males, age 5–18) were diagnosed using DSM‐IV criteria with Kiddie‐SADS PL/E. BD youths (n = 48) were compared to typically developing controls (n = 42) and children with ADHD (n = 44) or ADHD plus comorbid depressive disorders (n = 21). Three‐to‐five days of minute‐to‐minute belt‐worn actigraph data (Ambulatory Monitoring Inc.), collected during the school week, were processed to yield 28 metrics per subject, and assessed for group differences with analysis of covariance. Cross‐validated machine learning algorithms were used to determine the predictive accuracy of a four‐parameter model, with measures reflecting sleep, hyperactivity, and circadian dysregulation, plus Indic's bipolar vulnerability index (VI). Results There were prominent group differences in several activity measures, notably mean 5 lowest hours of activity, skewness of diurnal activity, relative circadian amplitude, and VI. A predictive support vector machine model discriminated bipolar from non‐bipolar with mean accuracy of 83.1 ± 5.4%, ROC area of 0.781 ± 0.071, kappa of 0.587 ± 0.136, specificity of 91.7 ± 5.3%, and sensitivity of 64.4 ± 13.6%. Conclusions Objective measures of sleep, circadian rhythmicity, and hyperactivity were abnormal in BD. Wearable sensor technology may provide bio‐behavioral markers that can help differentiate children with BD from ADHD and healthy controls.
    January 22, 2016   doi: 10.1111/jcpp.12520   open full text
  • Subdimensions of social‐communication impairment in autism spectrum disorder.
    Somer L. Bishop, Karoline Alexandra Havdahl, Marisela Huerta, Catherine Lord.
    Journal of Child Psychology and Psychiatry. January 08, 2016
    Background More refined dimensions of social‐communication impairment are needed to elucidate the clinical and biological boundaries of autism spectrum disorders (ASD) and other childhood onset psychiatric disorders associated with social difficulties, as well as to facilitate investigations in treatment and long‐term outcomes of these disorders. Methods This study was intended to identify separable dimensions of clinician‐observed social‐communication impairments by examining scores on a widely used autism diagnostic instrument. Participants included verbally fluent children ages 3–13 years, who were given a clinical diagnosis of ASD (n = 120) or non‐ASD (i.e. ADHD, language disorder, intellectual disability, mood or anxiety disorder; n = 118) following a comprehensive diagnostic assessment. Exploratory and confirmatory factor analysis examined the factor structure of algorithm items from the Autism Diagnostic Observation Schedule (ADOS), Module 3. Results Results indicated that a three‐factor model consisting of repetitive behaviors and two separate social‐communication behavior factors had superior fit compared to a two‐factor model that included repetitive behaviors and one social‐communication behavior factor. In the three‐factor model, impairments in ‘Basic Social‐Communication’ behaviors (e.g. eye contact, facial expressions, gestures) were separated from impairments in ‘Interaction quality.’ Confirmatory factor analysis in an independent sample of children in the Simons Simplex Collection (SSC) further supported the division of social‐communication impairments into these two factors. Scores in Interaction Quality were significantly associated with nonverbal IQ and male sex in the ASD group, and with age in the non‐ASD group, while scores in basic social communication were not significantly associated with any of these child characteristics in either diagnostic group. Conclusions Efforts to conceptualize level, or severity, of social‐communication impairment in children with neurodevelopmental disorders might be facilitated by separating the most basic (or proximal) social‐communication impairments from those that could arise from a range of other phenotypic variables. Identification of social‐communication subdimensions also highlights potential avenues for measuring different types of social‐communication impairments for different purposes (e.g. for differential diagnosis vs. response to treatment).
    January 08, 2016   doi: 10.1111/jcpp.12510   open full text
  • Attention‐deficit/hyperactivity disorder and sluggish cognitive tempo throughout childhood: temporal invariance and stability from preschool through ninth grade.
    Daniel R. Leopold, Micaela E. Christopher, G. Leonard Burns, Stephen P. Becker, Richard K. Olson, Erik G. Willcutt.
    Journal of Child Psychology and Psychiatry. January 08, 2016
    Background Although multiple cross‐sectional studies have shown symptoms of sluggish cognitive tempo (SCT) and attention‐deficit/hyperactivity disorder (ADHD) to be statistically distinct, studies have yet to examine the temporal stability and measurement invariance of SCT in a longitudinal sample. To date, only six studies have assessed SCT longitudinally, with the longest study examining SCT over a 2‐year period. The overall goals of this study were to assess the 10‐year longitudinal stability and interfactor relationships of ADHD and SCT symptoms among a community sample of children. Methods Confirmatory factor analysis was used to assess the temporal invariance of ADHD and SCT symptoms in a large population‐based longitudinal sample (International Longitudinal Twin Study of Early Reading Development) that included children assessed at preschool and after kindergarten, first, second, fourth, and ninth grades (n = 489). Latent autoregressive models were then estimated to assess the stability of these constructs. Results Results demonstrated invariance of item loadings and intercepts from preschool through ninth grades, as well as invariance of interfactor correlations. Results further indicated that both ADHD and SCT are highly stable across these years of development, that these symptom dimensions are related but also separable, and that hyperactivity/impulsivity and SCT are both more strongly correlated with inattention than with each other and show differential developmental trajectories. Specifically, even in the presence of latent simplex analyses providing support for the developmental stability of these dimensions, linear comparisons indicated that that mean levels of hyperactivity/impulsivity decreased with time, inattentive ratings were generally stable, and SCT tended to increase slightly across development. Conclusions This study adds to the current literature by being the first to systematically assess and demonstrate the temporal invariance and stability of ADHD and SCT across a span of 10 years.
    January 08, 2016   doi: 10.1111/jcpp.12505   open full text
  • Latent class profiles of depressive symptoms from early to middle childhood: predictors, outcomes, and gender effects.
    Diana J. Whalen, Joan L. Luby, Rebecca Tilman, Anissa Mike, Deanna Barch, Andy C. Belden.
    Journal of Child Psychology and Psychiatry. January 08, 2016
    Background There has been little available data to inform the predictors and outcomes of latent class trajectories of depressive symptoms beginning during preschool and continuing throughout school age. Further, the extant literature in this domain has been limited by the use of parent report checklists of nonspecific ‘internalizing’ psychopathology rather than diagnostic interviews for depression. Methods To address these gaps in the literature, this study applied growth mixture modeling to depressive symptom severity endorsed by children and/or their caregivers (N = 348) during a structured clinical interview in a 10‐year longitudinal dataset spanning from preschool into late school age. Results Three distinct trajectories of depressive symptom severity were found in boys and girls. For boys, but not girls, the high depression severity latent class increased in depressive symptoms from preschool through school age, followed by a decline in depressive symptom severity during later school age. For girls, the high depression severity latent class remained stable across time. Early childhood social adversity, familial history of affective disorder, preschool‐onset ODD/CD, and school age functional impairment differentiated high‐risk trajectory classes among both boys and girls. Conclusions Extending the literature on trajectories of depressive symptoms to the preschool period, these findings incorporate structured clinical interviews of depressive symptom severity and indicate gender differences as well as psychosocial predictors and functional outcomes among children in high severity latent classes. The findings from this study suggest that increased attention to screening for depressive symptoms in early childhood is of significant public health importance.
    January 08, 2016   doi: 10.1111/jcpp.12518   open full text
  • Symptoms of autism spectrum disorder and anxiety: shared familial transmission and cross‐assortative mating.
    Jorieke Duvekot, Jan Ende, John N. Constantino, Frank C. Verhulst, Kirstin Greaves‐Lord.
    Journal of Child Psychology and Psychiatry. December 30, 2015
    Background In order to shed more light on the frequent co‐occurrence of Autism Spectrum Disorder (ASD) and anxiety in children, the aims of the study were (a) to examine whether ASD and anxiety share familial transmission indicated by cross‐symptom associations between parental and children's symptoms (e.g., parental anxiety predicting children's ASD) in addition to associations for similar symptoms; (b) to investigate the possibility that cross‐assortative mating (i.e., whether ASD symptoms in one parent are positively associated with anxiety symptoms in the other parent) increases the risk for both ASD and anxiety in children. Method In 231 families of clinically referred children, parents rated both their own and the other parent's ASD and anxiety symptoms and one parent those of the index child and siblings (n = 447, aged 2.5–18 years). ASD symptoms were assessed using the Social Responsiveness Scale (SRS‐2) and anxiety symptoms using the Achenbach System of Empirically Based Assessment (ASEBA) instruments. Results Parental ASD and anxiety symptoms predicted similar symptoms in children, dependent on the informant type. Additionally, parental anxiety symptoms across both self‐report and informant‐report predicted children's ASD symptoms and maternal self‐reported ASD symptoms predicted children's anxiety symptoms. ASD and anxiety symptoms were correlated within parents, but we found only one cross‐symptom association between parents. Conclusions Cross‐symptom associations between parental and children's ASD and anxiety symptoms suggest shared familial transmission of ASD and anxiety, but further research is needed to clarify the underlying mechanisms. Cross‐assortative mating does not seem a likely explanation for the co‐occurrence of ASD and anxiety in children.
    December 30, 2015   doi: 10.1111/jcpp.12508   open full text
  • Is there an association between eating behaviour and attention‐deficit/hyperactivity disorder symptoms in preschool children?
    Vasiliki Leventakou, Nadia Micali, Vaggelis Georgiou, Katerina Sarri, Katerina Koutra, Stella Koinaki, Maria Vassilaki, Manolis Kogevinas, Leda Chatzi.
    Journal of Child Psychology and Psychiatry. December 26, 2015
    Background There is some evidence that aberrant eating behaviours and obesity co‐occur with attention‐deficit/hyperactivity disorder (ADHD) symptoms. The present study is the first that aims to investigate the association between eating behaviours and ADHD symptoms in early childhood in a population‐based cohort. Methods We included 471 preschool children from the Rhea mother–child cohort in Crete, Greece. Parents completed the Children's Eating Behaviour Questionnaire to assess children's eating behaviour and the 36‐item ADHD test (ADHDT) to evaluate ADHD symptoms at 4 years of age. Multivariable linear regression models were used to examine the association of eating behaviours with ADHD symptoms. Results Regarding children's food approach eating behaviours, we observed a positive association between food responsiveness and total ADHD index, as well as impulsivity, inattention and hyperactivity subscale, separately. Similarly, there was a significant positive association between emotional overeating and ADHD symptoms. With regard to children's food avoidant behaviours, food fussiness was found to be significantly associated with the impulsivity subscale. A dose–response association between the food approach behaviours and ADHD symptoms was also observed. Children on the medium and highest tertile of the food responsiveness subscale had increased scores on the ADHD total scale, as compared to those on the lowest tertile. As regards emotional overeating, children in the highest tertile of the scale had higher scores on ADHD total and hyperactivity. Conclusions Our findings provide evidence that food approach eating behaviours such as food responsiveness and emotional overeating are associated with the increased ADHD symptoms in preschool children. Future studies to better understand this overlap will enhance potential interventions.
    December 26, 2015   doi: 10.1111/jcpp.12504   open full text
  • Childhood peer network characteristics: genetic influences and links with early mental health trajectories.
    Eszter Szekely, Irene Pappa, James D. Wilson, Shankar Bhamidi, Vincent W. Jaddoe, Frank C. Verhulst, Henning Tiemeier, Philip Shaw.
    Journal of Child Psychology and Psychiatry. December 22, 2015
    Background Peer relationships are important for children's mental health, yet little is known of their etiological underpinnings. Here, we explore the genetic influences on childhood peer network characteristics in three different networks defined by rejection, acceptance, and prosocial behavior. We further examine the impact of early externalizing and internalizing trajectories on these same peer network characteristics. Methods Participants were 1,288 children from the Dutch ‘Generation R’ birth cohort. At age 7, we mapped out children's classroom peer networks for peer rejection, acceptance, and prosocial behavior using mutual peer nominations. In each network, genetic influences were estimated for children's degree centrality, closeness centrality and link reciprocity from DNA using Genome‐wide Complex Trait Analysis. Preschool externalizing and internalizing trajectories were computed using parental ratings at ages 1.5, 3, and 5 years. Results Of the three network properties examined, closeness centrality emerged as significantly heritable across all networks. Preschool externalizing problems predicted unfavorable positions within peer rejection networks and having fewer mutual friendships. In contrast, children with preschool‐internalizing problems were not actively rejected by their peers, but were less well‐connected within their social support network. Conclusions Our finding of significant heritability for closeness centrality should be taken as preliminary evidence that requires replication. Nevertheless, it can orient us to the role of genes in shaping a child's position within peer networks. Additionally, social network perspectives offer rich insights into how early life mental health trajectories impact a child's later functioning within peer networks.
    December 22, 2015   doi: 10.1111/jcpp.12493   open full text
  • Implicit cognition about self‐injury predicts actual self‐injurious behavior: results from a longitudinal study of adolescents.
    Catherine R. Glenn, Evan M. Kleiman, Christine B. Cha, Matthew K. Nock, Mitchell J. Prinstein.
    Journal of Child Psychology and Psychiatry. December 18, 2015
    Background The implicit association hypothesis of nonsuicidal self‐injury (NSSI) proposes that individuals who engage in self‐injury develop, over time, strong associations between themselves and NSSI, and their identification with this behavior guides their future selection of NSSI to cope. Prior research has established a relationship between implicit NSSI associations (using an Implicit Association Test for Self‐Injury) and engagement in NSSI. However, previous studies have been small and cross‐sectional, and thus underpowered to examine the nature of this association and the extent to which implicit associations predict the persistence of NSSI. Methods This study builds on previous research in a prospective, longitudinal examination of implicit self‐identification with NSSI in a large sample of middle school students. NSSI behavior and implicit NSSI associations were assessed annually in school at three time points. Results Adolescents who engaged in NSSI exhibited stronger implicit self‐identification with NSSI than adolescents who did not engage in NSSI. Moreover, implicit NSSI identification was stronger among adolescents who engaged in cutting, frequent NSSI, and recent NSSI. A reciprocal association was observed between NSSI frequency and implicit NSSI identification over 1 year. Notably, implicit NSSI identification uniquely and prospectively predicted engagement in NSSI over the subsequent year. Conclusions Implicit self‐identification with NSSI may track both trait‐ and state‐related changes in the behavior and, importantly, may help predict continued engagement in NSSI.
    December 18, 2015   doi: 10.1111/jcpp.12500   open full text
  • Different brain responses during empathy in autism spectrum disorders versus conduct disorder and callous‐unemotional traits.
    Eduard T. Klapwijk, Moji Aghajani, Olivier F. Colins, Godfried M. Marijnissen, Arne Popma, Natasja D. J. Lang, Nic J. A. Wee, Robert R. J. M. Vermeiren.
    Journal of Child Psychology and Psychiatry. December 17, 2015
    Background Deficits in empathy are reported in autism spectrum disorders (ASD) and also underlie antisocial behavior of individuals with conduct disorder and callous‐unemotional traits (CD/CU+). Many studies suggest that individuals with ASD are typically impaired in cognitive aspects of empathy, and individuals with CD/CU+ typically in affective aspects. In the current study, we compared the neural correlates of cognitive and affective aspects of empathy between youth with ASD and youth with CD/CU+. Methods Functional magnetic resonance imaging (fMRI) was used to assess boys with ASD (N = 23), boys with CD/CU+ (N = 23), and typically developing (TD) boys (N = 33), aged 15–19 years. Angry and fearful faces were presented and participants were asked to either infer the emotional state from the face (other‐task; emotion recognition) or to judge their own emotional response to the face (self‐task; emotional resonance). Results During emotion recognition, boys with ASD showed reduced responses compared to the other groups in the ventromedial prefrontal cortex (vmPFC). During emotional resonance, the CD/CU+ and ASD groups showed reduced amygdala responses compared to the TD controls, boys with ASD showed reduced responses in bilateral hippocampus, and the CD/CU+ boys showed reduced responses in the inferior frontal gyrus (IFG) and anterior insula (AI). Conclusion Results suggest differential abnormal brain responses associated with specific aspects of empathic functioning in ASD and CD/CU+. Decreased amygdala responses in ASD and CD/CU+ might point to impaired emotion processing in both disorders, whereas reduced vmPFC responses suggest problems in processing cognitive aspects of empathy in ASD. Reduced IFG/AI responses, finally, suggest decreased emotional resonance in CD/CU+.
    December 17, 2015   doi: 10.1111/jcpp.12498   open full text
  • Language profiles and literacy outcomes of children with resolving, emerging, or persisting language impairments.
    Margaret J. Snowling, Fiona J. Duff, Hannah M. Nash, Charles Hulme.
    Journal of Child Psychology and Psychiatry. December 17, 2015
    Background Children with language impairment (LI) show heterogeneity in development. We tracked children from pre‐school to middle childhood to characterize three developmental trajectories: resolving, persisting and emerging LI. Methods We analyzed data from children identified as having preschool LI, or being at family risk of dyslexia, together with typically developing controls at three time points: t1 (age 3;09), t3 (5;08) and t5 (8;01). Language measures are reported at t1, t3 and t5, and literacy abilities at t3 and t5. A research diagnosis of LI (irrespective of recruitment group) was validated at t1 by a composite language score derived from measures of receptive and expressive grammar and vocabulary; a score falling 1SD below the mean of the typical language group on comparable measures at t3 and t5 was used to determine whether a child had LI at later time points and then to classify LIs as resolving, persisting or emerging. Results Persisting preschool LIs were more severe and pervasive than resolving LIs. Language and literacy outcomes were relatively poor for those with persisting LI, and relatively good for those with resolving LI. A significant proportion of children with average language abilities in preschool had LIs that emerged in middle childhood – a high proportion of these children were at family risk of dyslexia. There were more boys in the persisting and resolving LI groups. Children with early LIs which resolved by the start of formal literacy instruction tended to have good literacy outcomes; children with late‐emerging difficulties that persisted developed reading difficulties. Conclusions Children with late‐emerging LI are relatively common and are hard to detect in the preschool years. Our findings show that children whose LIs persist to the point of formal literacy instruction frequently experience reading difficulties.
    December 17, 2015   doi: 10.1111/jcpp.12497   open full text
  • Predicting dyslexia using prereading skills: the role of sensorimotor and cognitive abilities.
    Julia M. Carroll, Jonathan Solity, Laura R. Shapiro.
    Journal of Child Psychology and Psychiatry. December 12, 2015
    Background It is well established that phonological awareness, print knowledge and rapid naming predict later reading difficulties. However, additional auditory, visual and motor difficulties have also been observed in dyslexic children. It is examined to what extent these difficulties can be used to predict later literacy difficulties. Method An unselected sample of 267 children at school entry completed a wide battery of tasks associated with dyslexia. Their reading was tested 2, 3 and 4 years later and poor readers were identified (n = 42). Logistic regression and multiple case study approaches were used to examine the predictive validity of different tasks. Results As expected, print knowledge, verbal short‐term memory, phonological awareness and rapid naming were good predictors of later poor reading. Deficits in visual search and in auditory processing were also present in a large minority of the poor readers. Almost all poor readers showed deficits in at least one area at school entry, but there was no single deficit that characterised the majority of poor readers. Conclusions Results are in line with Pennington's () multiple deficits view of dyslexia. They indicate that the causes of poor reading outcome are multiple, interacting and probabilistic, rather than deterministic.
    December 12, 2015   doi: 10.1111/jcpp.12488   open full text
  • Restrictive educational placements increase adolescent risks for students with early‐starting conduct problems.
    Christopher J. Powers, Karen L. Bierman, Donna L. Coffman.
    Journal of Child Psychology and Psychiatry. December 11, 2015
    Background Students with early‐starting conduct problems often do poorly in school; they are disproportionately placed in restrictive educational placements outside of mainstream classrooms. Although intended to benefit students, research suggests that restrictive placements may exacerbate the maladjustment of youth with conduct problems. Mixed findings, small samples, and flawed designs limit the utility of existing research. Methods This study examined the impact of restrictive educational placements on three adolescent outcomes (high school noncompletion, conduct disorder, depressive symptoms) in a sample of 861 students with early‐starting conduct problems followed longitudinally from kindergarten (age 5–6). Causal modeling with propensity scores was used to adjust for confounding factors associated with restrictive placements. Analyses explored the timing of placement (elementary vs. secondary school) and moderation of impact by initial problem severity. Results Restrictive educational placement in secondary school (but not in elementary school) was iatrogenic, increasing the risk of high school noncompletion and the severity of adolescent conduct disorder. Negative effects were amplified for students with conduct problem behavior with less cognitive impairment. Conclusions To avoid harm to students and to society, schools must find alternatives to restrictive placements for students with conduct problems in secondary school, particularly when these students do not have cognitive impairments that might warrant specialized educational supports.
    December 11, 2015   doi: 10.1111/jcpp.12487   open full text
  • Parenting behavior at 2 years predicts school‐age performance at 7 years in very preterm children.
    Karli Treyvaud, Lex W. Doyle, Katherine J. Lee, Alexandra Ure, Terrie E. Inder, Rod W. Hunt, Peter J. Anderson.
    Journal of Child Psychology and Psychiatry. November 29, 2015
    Background Parenting influences child development, but it is unclear whether early parenting behavior can influence school‐age outcomes in very preterm (VPT) children, and/or if certain groups of VPT children may be more affected by early parenting behavior. These research questions were examined. Methods Participants were 147 children born <30 weeks’ gestation or birth weight <1250 g and their primary caregiver. At term corrected age (CA), magnetic resonance imaging (MRI) was used to determine presence and severity of brain abnormality and medical data collected. High medical risk was defined as the presence of at least one of sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, moderate to severe white matter abnormality on MRI, or postnatal corticosteroids. At 2 years CA, parent–child interaction was assessed, and at 7 years CA, general intelligence (IQ), language, executive function, academic skills, and social‐emotional functioning were assessed. Results Higher levels of parent–child synchrony, and parent facilitation, sensitivity and positive affect at 2 years were associated with better child outcomes at 7 years, while higher levels of intrusiveness and negative affect were associated with poorer outcomes. Many of these relationships remained after controlling for early child cognitive development. Interactions between child medical risk (higher/lower) and parenting were limited to child reading, math, and executive functioning outcomes, with stronger relationships for lower medical risk children. Conclusions The contribution of early parenting to VPT children's school‐age performance is significant, with stronger effects for lower medical risk children in some outcomes. These findings support the premise that parenting strategies should be included in the NICU and early interventions programs for VPT infants.
    November 29, 2015   doi: 10.1111/jcpp.12489   open full text
  • Parental autonomy granting and child perceived control: effects on the everyday emotional experience of anxious youth.
    Kristy Benoit Allen, Jennifer S. Silk, Suzanne Meller, Patricia Z. Tan, Cecile D. Ladouceur, Lisa B. Sheeber, Erika E. Forbes, Ronald E. Dahl, Greg J. Siegle, Dana L. McMakin, Neal D. Ryan.
    Journal of Child Psychology and Psychiatry. November 09, 2015
    Background Childhood anxiety is associated with low levels of parental autonomy granting and child perceived control, elevated child emotional reactivity and deficits in child emotion regulation. In early childhood, low levels of parental autonomy granting are thought to decrease child perceived control, which in turn leads to increases in child negative emotion. Later in development, perceived control may become a more stable, trait‐like characteristic that amplifies the relationship between parental autonomy granting and child negative emotion. The purpose of this study was to test mediation and moderation models linking parental autonomy granting and child perceived control with child emotional reactivity and emotion regulation in anxious youth. Methods Clinically anxious youth (N = 106) and their primary caregivers were assessed prior to beginning treatment. Children were administered a structured diagnostic interview and participated in a parent–child interaction task that was behaviorally coded for parental autonomy granting. Children completed an ecological momentary assessment protocol during which they reported on perceived control, emotional reactivity (anxiety and physiological arousal) and emotion regulation strategy use in response to daily negative life events. Results The relationship between parental autonomy granting and both child emotional reactivity and emotion regulation strategy use was moderated by child perceived control: the highest levels of self‐reported physiological responding and the lowest levels of acceptance in response to negative events occurred in children low in perceived control with parents high in autonomy granting. Evidence for a mediational model was not found. In addition, child perceived control over negative life events was related to less anxious reactivity and greater use of both problem solving and cognitive restructuring as emotion regulation strategies. Conclusion Both parental autonomy granting and child perceived control play important roles in the everyday emotional experience of clinically anxious children.
    November 09, 2015   doi: 10.1111/jcpp.12482   open full text
  • Positive parenting and children's prosocial behavior in eight countries.
    Concetta Pastorelli, Jennifer E. Lansford, Bernadette Paula Luengo Kanacri, Patrick S. Malone, Laura Di Giunta, Dario Bacchini, Anna Silvia Bombi, Arnaldo Zelli, Maria Concetta Miranda, Marc H. Bornstein, Sombat Tapanya, Liliana Maria Uribe Tirado, Liane Pena Alampay, Suha M. Al‐Hassan, Lei Chang, Kirby Deater‐Deckard, Kenneth A. Dodge, Paul Oburu, Ann T. Skinner, Emma Sorbring.
    Journal of Child Psychology and Psychiatry. October 28, 2015
    Background Research supports the beneficial role of prosocial behaviors on children's adjustment and successful youth development. Empirical studies point to reciprocal relations between negative parenting and children's maladjustment, but reciprocal relations between positive parenting and children's prosocial behavior are understudied. In this study reciprocal relations between two different dimensions of positive parenting (quality of the mother–child relationship and the use of balanced positive discipline) and children's prosocial behavior were examined in Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Methods Mother–child dyads (N = 1105) provided data over 2 years in two waves (Mage of child in wave 1 = 9.31 years, SD = 0.73; 50% female). Results A model of reciprocal relations between parenting dimensions, but not among parenting and children's prosocial behavior, emerged. In particular, children with higher levels of prosocial behavior at age 9 elicited higher levels of mother–child relationship quality in the following year. Conclusions Findings yielded similar relations across countries, evidencing that being prosocial in late childhood contributes to some degree to the enhancement of a nurturing and involved mother–child relationship in countries that vary widely on sociodemographic profiles and psychological characteristics. Policy and intervention implications of this study are discussed.
    October 28, 2015   doi: 10.1111/jcpp.12477   open full text
  • Oppositional defiant disorder dimensions and subtypes among detained male adolescent offenders.
    Marcel Aebi, Steffen Barra, Cornelia Bessler, Hans‐Christoph Steinhausen, Susanne Walitza, Belinda Plattner.
    Journal of Child Psychology and Psychiatry. October 23, 2015
    Background In adolescent offenders, oppositional defiant disorder (ODD) and its dimensions/subtypes have been frequently ignored due to the stronger focus on criminal behaviours. The revised criteria of the DSM‐5 now allow diagnosing ODD in older youths independent of conduct disorder (CD). This study aimed at analysing ODD dimensions/subtypes and their relation to suicidality, comorbid psychiatric disorders, and criminal behaviours after release from detention in a sample of detained male adolescents. Methods Suicidality and psychiatric disorders (including ODD symptoms) were assessed in a consecutive sample of 158 male adolescents (Mage = 16.89 years) from the Zurich Juvenile Detention Centre. Based on previous research findings, an irritable ODD dimension and a defiant/vindictive ODD dimension based on ODD symptoms were defined. Latent Class Analysis (LCA) was used to identify distinct subtypes of adolescent offenders according to their ODD symptom profiles. Logistic regression and Cox regression were used to analyse the relations of ODD dimensions/ODD subtypes to comorbid psychopathology and criminal reoffenses from official data. Results The ODD‐irritable dimension, but not the ODD defiant/vindictive dimension predicted comorbid anxiety, suicidality and violent reoffending. LCA identified four subtypes, namely, a no‐ODD subtype, a severe ODD subtype and two moderate ODD subtypes with either defiant or irritable symptoms. The irritable ODD subtype and the severe ODD subtype were related to suicidality and comorbid affective/anxiety disorders. The irritable ODD subtype was the strongest predictor of criminal (violent) reoffending even when controlling for CD. Conclusions The present findings confirm the presence of ODD dimensions/subtypes in a highly disturbed adolescent offender sample. Irritable youths were at risk of suicide and persistent criminal behaviours. Due to the severe consequences of irritability, a standardized assessment approach and a specific treatment is needed in prison to prevent suicide among the detainees and further harm to the society. As defined in the DSM‐5, the present findings confirm the validity of ODD and ODD dimensions/subtypes as a diagnostic category among older youths.
    October 23, 2015   doi: 10.1111/jcpp.12473   open full text
  • Phonological awareness and reading in boys with fragile X syndrome.
    Suzanne M. Adlof, Jessica Klusek, Svetlana V. Shinkareva, Marissa L. Robinson, Jane E. Roberts.
    Journal of Child Psychology and Psychiatry. June 03, 2014
    Background Reading delays are well documented in children with fragile X syndrome (FXS), but few studies have examined linguistic precursors of reading in this population. This study examined the longitudinal development of phonological awareness and its relationship with basic reading in boys with FXS. Individual differences in genetic, social‐behavioral and environmental factors were also investigated as predictors of phonological awareness. Methods Participants included 54 boys with FXS and 53 typically developing (TD) mental age‐matched peers who completed assessments of phonological awareness, nonverbal intelligence, and reading annually for up to 4 years. FMRP level and autism symptomatology were also measured within the FXS group. Hierarchical linear modeling was used to examine change in phonological awareness over time and its predictors. Linear regression was used to examine phonological awareness as a predictor of word reading. Results Boys with FXS exhibited slower growth than TD peers in phonological awareness only when nonverbal cognitive abilities were not controlled. The rate of change in phonological awareness decreased significantly after age 10 in boys with FXS. Phonological awareness accounted for 18% unique variance in basic reading ability after controlling for nonverbal cognition, with similar relationships across groups. Conclusion Phonological awareness skills in the boys with FXS were commensurate with their nonverbal cognitive abilities, with similar relationships between phonological awareness and reading as observed in the TD mental age‐matched peers. More research is needed to examine potential causal relationships between phonological awareness, other language skills, and reading abilities in individuals with FXS and other neurodevelopmental disorders.
    June 03, 2014   doi: 10.1111/jcpp.12267   open full text
  • Reward anticipation and processing of social versus nonsocial stimuli in children with and without autism spectrum disorders.
    Katherine K.M. Stavropoulos, Leslie J. Carver.
    Journal of Child Psychology and Psychiatry. May 30, 2014
    Background How children respond to social and nonsocial rewards has important implications for both typical and atypical social‐cognitive development. Individuals with autism spectrum disorders (ASD) are thought to process rewards differently than typically developing (TD) individuals. However, there is little direct evidence to support this claim. Methods Two event‐related potentials were measured. The stimulus preceding negativity (SPN) was utilized to measure reward anticipation, and the feedback related negativity (FRN) was utilized to measure reward processing. Participants were 6‐ to 8‐year‐olds with (N = 20) and without (N = 23) ASD. Children were presented with rewards accompanied by incidental face or nonface stimuli. Nonface stimuli were composed of scrambled face elements in the shape of arrows, controlling for low‐level visual properties. Results Children with ASD showed smaller responses while anticipating and processing rewards accompanied by social stimuli than TD children. Anticipation and processing of rewards accompanied by nonsocial stimuli was intact in children with ASD. Conclusions This is the first study to measure both reward anticipation and processing in ASD while controlling for reward properties. The findings provide evidence that children with autism have reward anticipation and processing deficits for social stimuli only. Our results suggest that while typically developing children find social stimuli more salient than nonsocial stimuli, children with ASD may have the opposite preference.
    May 30, 2014   doi: 10.1111/jcpp.12270   open full text
  • Infancy predictors of hyperkinetic and pervasive developmental disorders at ages 5–7 years: results from the Copenhagen Child Cohort CCC2000.
    Hanne Elberling, Allan Linneberg, Else Marie Olsen, Tine Houmann, Charlotte Ulrikka Rask, Robert Goodman, Anne Mette Skovgaard.
    Journal of Child Psychology and Psychiatry. May 30, 2014
    Background Epidemiological studies infancy predictors of mental disorders are scarce. Methods The study is part of a longitudinal birth‐cohort study, The Copenhagen Child Cohort CCC2000. Infant mental health and development and mother‐infant relations were assessed by community health nurses from birth to age 10 months. Data on the perinatal period were obtained from Danish National Registers. Mental health outcome at age 5–7 years was investigated in 1,585 children who were assessed by the Developmental and Well‐Being Assessment (DAWBA) and diagnosed according to the ICD‐10. Results Predictors of autism spectrum disorders were problems of oral‐motor development OR 5.02 (95% CI: 1.63–15.42) and overall development OR 4.24 (95% CI: 1.35–13.33). A deviant pattern of activity and interests were predictive of autism spectrum disorder, OR 5.34 (95% CI 1.45–19.70) and hyperkinetic disorder, OR 4.71 (95% CI: 1.28–17.39). Hyperkinetic disorder was furthermore predicted by mother‐infant relationship problems, OR 8.07 (95% CI: 2.90–22.47). The significant associations between infant developmental problems and autism spectrum disorders persisted in multiple logistic regression analyses controlled for maternal psychological problems and mother‐infant relationship problems, OR 3.21 (95% CI: 1.09–9.45). Mother‐infant relationship problems remained strongly associated to hyperkinetic disorders in the multivariate analyses controlled for child development problems and maternal psychological problems, OR 5.20 (95% CI: 1.55–17.47). No significant infancy predictors were found regarding emotional and behavioural disorders at age 5–7 years. Conclusion Predictors of autism spectrum/pervasive developmental disorders and hyperkinetic disorders at child age 5–7 years were identified between birth and child age 10 months in community health settings. The study results suggest potential areas of early preventive intervention, which have to be further explored regarding the psychometric qualities of the identification of infants at risk, and concerning methods to handle and intervene towards these children in the general child health surveillance.
    May 30, 2014   doi: 10.1111/jcpp.12256   open full text
  • Heterogeneity and plasticity in the development of language: a 17‐year follow‐up of children referred early for possible autism.
    Andrew Pickles, Deborah K. Anderson, Catherine Lord.
    Journal of Child Psychology and Psychiatry. May 30, 2014
    Background Delayed, abnormal language is a common feature of autism and language therapy often a significant component of recommended treatment. However, as with other disorders with a language component, we know surprisingly little about the language trajectories and how varied these might be across different children. Thus, we know little about how and when language problems might resolve, whether there are periods of relative stability or lack of change and what periods might offer more favourable circumstances for intervention. Methods Expressive and receptive language was measured on six occasions between age 2 and 19 on a cohort of 192 children initially referred for autism. Latent class growth models were fitted to characterize the patterns of heterogeneous development. Results Latent class growth analysis identified seven classes. Between age 6 and 19, all classes tracked in parallel. Between ages 2 and 6, development was more heterogeneous with considerable variation in relative progress. In all groups, receptive and expressive language developed very largely in tandem. Conclusions The results confirmed previous analysis of children with specific language impairment where progress beyond age 6 was remarkably uniform. Greater variation was evident before this age with some groups making clearly better or worse progress compared to others. While this developmental heterogeneity may simply be a reflection of variation in preexisting and unchanging biological disposition, it may also reflect, at least in part, greater sensitivity in the early years to environments that are more or less supportive of language development. These findings contribute to the case for the importance of early intervention.
    May 30, 2014   doi: 10.1111/jcpp.12269   open full text
  • Dimensions of manic symptoms in youth: psychosocial impairment and cognitive performance in the IMAGEN sample.
    Argyris Stringaris, Natalie Ryan‐Castellanos, Tobias Banaschewski, Gareth J. Barker, Arun L. Bokde, Uli Bromberg, Christian Büchel, Mira Fauth‐Bühler, Herta Flor, Vincent Frouin, Juergen Gallinat, Hugh Garavan, Penny Gowland, Andreas Heinz, Bernd Itterman, Claire Lawrence, Frauke Nees, Marie‐Laure Paillere‐Martinot, Tomas Paus, Zdenka Pausova, Marcella Rietschel, Michael N. Smolka, Gunter Schumann, Robert Goodman, Patricia Conrod,.
    Journal of Child Psychology and Psychiatry. May 28, 2014
    Background It has been reported that mania may be associated with superior cognitive performance. In this study, we test the hypothesis that manic symptoms in youth separate along two correlated dimensions and that a symptom constellation of high energy and cheerfulness is associated with superior cognitive performance. Method We studied 1755 participants of the IMAGEN study, of average age 14.4 years (SD = 0.43), 50.7% girls. Manic symptoms were assessed using the Development and Wellbeing Assessment by interviewing parents and young people. Cognition was assessed using the Wechsler Intelligence Scale For Children (WISC‐IV) and a response inhibition task. Results Manic symptoms in youth formed two correlated dimensions: one termed exuberance, characterized by high energy and cheerfulness and one of undercontrol with distractibility, irritability and risk‐taking behavior. Only the undercontrol, but not the exuberant dimension, was independently associated with measures of psychosocial impairment. In multivariate regression models, the exuberant, but not the undercontrolled, dimension was positively and significantly associated with verbal IQ by both parent‐ and self‐report; conversely, the undercontrolled, but not the exuberant, dimension was associated with poor performance in a response inhibition task. Conclusions Our findings suggest that manic symptoms in youth may form dimensions with distinct correlates. The results are in keeping with previous findings about superior performance associated with mania. Further research is required to study etiological differences between these symptom dimensions and their implications for clinical practice.
    May 28, 2014   doi: 10.1111/jcpp.12255   open full text
  • Reading and language intervention for children at risk of dyslexia: a randomised controlled trial.
    Fiona J. Duff, Charles Hulme, Katy Grainger, Samantha J. Hardwick, Jeremy N.V. Miles, Margaret J. Snowling.
    Journal of Child Psychology and Psychiatry. May 17, 2014
    Background Intervention studies for children at risk of dyslexia have typically been delivered preschool, and show short‐term effects on letter knowledge and phoneme awareness, with little transfer to literacy. Methods This randomised controlled trial evaluated the effectiveness of a reading and language intervention for 6‐year‐old children identified by research criteria as being at risk of dyslexia (n = 56), and their school‐identified peers (n = 89). An Experimental group received two 9‐week blocks of daily intervention delivered by trained teaching assistants; the Control group received 9 weeks of typical classroom instruction, followed by 9 weeks of intervention. Results Following mixed effects regression models and path analyses, small‐to‐moderate effects were shown on letter knowledge, phoneme awareness and taught vocabulary. However, these were fragile and short lived, and there was no reliable effect on the primary outcome of word‐level reading. Conclusions This new intervention was theoretically motivated and based on previous successful interventions, yet failed to show reliable effects on language and literacy measures following a rigorous evaluation. We suggest that the intervention may have been too short to yield improvements in oral language; and that literacy instruction in and beyond the classroom may have weakened training effects. We argue that reporting of null results makes an important contribution in terms of raising standards both of trial reporting and educational practice.
    May 17, 2014   doi: 10.1111/jcpp.12257   open full text
  • Social withdrawal in children moderates the association between parenting styles and the children's own socioemotional development.
    Maryam Zarra‐Nezhad, Noona Kiuru, Kaisa Aunola, Mansour Zarra‐Nezhad, Timo Ahonen, Anna‐Maija Poikkeus, Marja‐Kristiina Lerkkanen, Jari‐Erik Nurmi.
    Journal of Child Psychology and Psychiatry. May 15, 2014
    Background Social withdrawal in early childhood is a risk factor for later socioemotional difficulties. This study examined the joint effects of children's social withdrawal and mothers' and fathers' parenting styles on children's socioemotional development. Based on diatheses‐stress, vantage sensitivity, and differential susceptibility models, socially withdrawn children were assumed to be more prone to parental influences than others. Methods Teachers rated 314 children on prosocial skills, and internalizing and externalizing behaviors at three points in time between grades 1–3. Mothers (n = 279) and fathers (n = 182) filled in questionnaires measuring their affection, and their behavioral and psychological control at the same points in time. Teacher reports on children's level of social withdrawal were obtained at the end of kindergarten. Results Panel analysis showed that particularly those children who showed signs of social withdrawal were vulnerable to the negative effects of low maternal affection in terms of externalizing behavior. Moreover, among these children, mothers' and fathers' psychological control predicted high levels of internalizing problem but, at the same time, mothers' psychological control predicted also a high level of prosocial behavior and low levels of externalizing problem. Conclusions The results supported the diathesis–stress model more than the differential susceptibility model. For example, socially withdrawn children were found to be particularly vulnerable to the negative effects of low maternal affection. Although maternal psychological control had positive effects on the prosocial skills of socially withdrawn children, and reduced the amount of externalizing problems, it was at the same time associated with an increase in their internalizing problems. In this way, socially withdrawn children seem to be at risk of pleasing their mothers at the cost of their own well‐being.
    May 15, 2014   doi: 10.1111/jcpp.12251   open full text
  • Characteristics of suicidal ideation that predict the transition to future suicide attempts in adolescents.
    Regina Miranda, Ana Ortin, Michelle Scott, David Shaffer.
    Journal of Child Psychology and Psychiatry. May 15, 2014
    Background The present study sought to examine characteristics of suicidal ideation (SI) that predict a future suicide attempt (SA), beyond psychiatric diagnosis and previous SA history. Methods Participants were 506 adolescents (307 female) who completed the Columbia Suicide Screen (CSS) and selected modules from the Diagnostic Interview Schedule for Children (C‐DISC 2.3) as part of a two‐stage high school screening and who were followed up 4–6 years later to assess for a SA since baseline. At baseline, participants who endorsed SI on the CSS responded to four questions regarding currency, frequency, seriousness, and duration of their SI. A subsample of 122 adolescents who endorsed SI at baseline also completed a detailed interview about their most recent SI. Results Thinking about suicide often (OR = 3.5, 95% CI = 1.7–7.2), seriously (OR = 3.1, 95% CI = 1.4–6.7), and for a long time (OR = 2.3, 95% CI = 1.1–5.2) were associated with a future SA, adjusting for sex, the presence of a mood, anxiety, and substance use diagnosis, and baseline SA history. However, only SI frequency was significantly associated with higher odds of a future SA (OR = 3.6, 95% CI = 1.4–9.1) when also adjusting for currency, seriousness, and duration. Among ideators interviewed further about their most recent SI, ideating 1 hr or more (vs. less than 1 hr) was associated with a future SA (OR = 3.6, 95% CI = 1.0–12.7), adjusting for sex, depressive symptoms, previous SA history, and other baseline SI characteristics, and it was also associated with making a future SA earlier. Conclusions Assessments of SI in adolescents should take special care to inquire about frequency of their SI, along with length of their most recent SI.
    May 15, 2014   doi: 10.1111/jcpp.12245   open full text
  • Aberrant resting‐state functional connectivity in limbic and salience networks in treatment‐naïve clinically depressed adolescents.
    Justine Nienke Pannekoek, S.J.A. Werff, Paul H.F. Meens, Bianca G. Bulk, Dietsje D. Jolles, Ilya M. Veer, Natasja D.J. Lang, Serge A.R.B. Rombouts, Nic J.A. Wee, Robert R.J.M. Vermeiren.
    Journal of Child Psychology and Psychiatry. May 15, 2014
    Background Depression is prevalent and typically has its onset in adolescence. Resting‐state fMRI could help create a better understanding of the underlying neurobiological mechanisms during this critical period. In this study, resting‐state functional connectivity (RSFC) is examined using seed regions‐of‐interest (ROIs) associated with three networks: the limbic network, the default mode network (DMN) and the salience network. Methods Twenty‐six treatment‐naïve, clinically depressed adolescents of whom 18 had comorbid anxiety, and 26 pair‐wise matched healthy controls underwent resting‐state fMRI. The three networks were investigated using a seed‐based ROI approach with seeds in the bilateral amygdala (limbic network), bilateral dorsal anterior cingulate cortex (dACC; salience network) and bilateral posterior cingulate cortex (default mode network). Results Compared to healthy controls, clinically depressed adolescents showed increased RSFC of the left amygdala with right parietal cortical areas, and decreased right amygdala RSFC with left frontal cortical areas including the ACC, as well as with right occipito‐parietal areas. The bilateral dACC showed decreased RSFC with the right middle frontal gyrus, frontal pole, and inferior frontal gyrus in clinically depressed adolescents. No abnormalities in DMN RSFC were found, and differences in RSFC did not correlate with clinical measures. Conclusions The aberrant RSFC of the amygdala network and the dACC network may be related to altered emotion processing and regulation in depressed adolescents. Our results provide new insights into RSFC in clinically depressed adolescents and future models on adolescent depression may include abnormalities in the connectivity of salience network.
    May 15, 2014   doi: 10.1111/jcpp.12266   open full text
  • Predictors of the onset of depression in young children: a multi‐method, multi‐informant longitudinal study from ages 3 to 6.
    Sara J. Bufferd, Lea R. Dougherty, Thomas M. Olino, Margaret W. Dyson, Rebecca S. Laptook, Gabrielle A. Carlson, Daniel N. Klein.
    Journal of Child Psychology and Psychiatry. May 15, 2014
    Background Despite growing interest in depression in young children, little is known about which variables predict the onset of depression in early childhood. We examined a range of predictors of the onset of depression diagnoses in a multi‐method, multi‐informant longitudinal study of a large community sample of young children from ages 3 to 6. Methods Predictors of the onset of depression at age 6 were drawn from five domains assessed when children were 3 years old: child psychopathology (assessed using a parent diagnostic interview), observed child temperament, teacher ratings of peer functioning, parental psychopathology (assessed using a diagnostic interview), and psychosocial environment (observed parental hostility, parent‐reported family stressors, parental education). Results A number of variables predicted the onset of depression by age 6, including child history of anxiety disorders, child temperamental low inhibitory control, poor peer functioning, parental history of mood, anxiety, and substance use disorders, early and recent stressful life events, and less parental education. Conclusions Predictors of the onset of depression in early childhood tend to be similar to those identified in older youth and adults, and support the feasibility of identifying children in greatest need for early intervention.
    May 15, 2014   doi: 10.1111/jcpp.12252   open full text
  • Prenatal depression and 5‐HTTLPR interact to predict dysregulation from 3 to 36 months – A differential susceptibility model.
    Vanessa Babineau, Cathryn Gordon Green, Alexis Jolicoeur‐Martineau, Klaus Minde, Roberto Sassi, Martin St‐André, Normand Carrey, Leslie Atkinson, Michael Meaney, Ashley Wazana.
    Journal of Child Psychology and Psychiatry. May 15, 2014
    Background Childhood dysregulation, which reflects deficits in the capacity to regulate or control one's thoughts, emotions and behaviours, is associated with psychopathology throughout childhood and into adulthood. Exposures to adversity during the prenatal period, including prenatal depression, can influence the development of dysregulation, and a number of candidate genes have been suggested as moderators of prenatal exposure, including polymorphisms in the promoter region of the serotonin transporter gene (5‐HTTLPR). We examined whether prenatal depression and child 5‐HTTLPR interact to predict childhood dysregulation. Method Sample of N = 213 mother–child pairs from the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) project. Mothers reported the IBQ‐R at 3 and 6 months, and the ECBQ at 18 and 36 months, from which measures of dysregulation were extracted. Mothers' self‐reported symptoms of depression on the CES‐D at 24–36 weeks of gestation, and at 6, 12, 24 and 36 months postnatal. 5‐HTTLPR genotype was extracted from buccal swabs. Mixed‐model and confirmatory analyses were conducted. Results Prenatal depression and 5‐HTTLPR interacted to predict dysregulation from 3 to 36 months, within a model of strong differential susceptibility. Conclusion Children with S or LG alleles, when exposed to prenatal depression, have higher levels of dysregulation, and when exposed to lower or little prenatal depression, have higher capacity for regulation. Our findings support efforts to identify, support and treat prenatal depression.
    May 15, 2014   doi: 10.1111/jcpp.12246   open full text
  • Cost‐effectiveness of classroom‐based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial‐based analysis.
    Rob Anderson, Obioha C. Ukoumunne, Kapil Sayal, Rhiannon Phillips, John A. Taylor, Melissa Spears, Ricardo Araya, Glyn Lewis, Abigail Millings, Alan A. Montgomery, Paul Stallard.
    Journal of Child Psychology and Psychiatry. May 12, 2014
    Background A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age‐appropriate CBT programme in school classrooms. The cost‐effectiveness of the programme for preventing low mood and depression for all participants from a health and social care sector perspective needs to be determined. Methods A trial‐based cost‐effectiveness analysis based on a cluster‐randomized controlled trial (trial registration – ISRCTN 19083628) comparing classroom‐based CBT with usual school provision of Personal Social and Health Education. Per‐student cost of intervention was estimated from programme records. The study was undertaken in eight mixed‐sex UK secondary schools, and included 3,357 school children aged 12 to 16 years (in the two trial arms evaluated in the cost‐effectiveness analysis). The main outcome measures were individual self‐reported data on care costs, Quality‐Adjusted Life‐Years (QALYs, based on the EQ‐5D health‐related quality‐of‐life instrument) and symptoms of depression (Short Mood and Feelings Questionnaire) at baseline, 6 and 12 months. Results Although there was lower quality‐adjusted life‐years over 12 months (−.05 QALYs per person, 95% confidence interval −.09 to −.005, p = .03) with CBT, this is a ‘clinically’ negligible difference, which was not found in the complete case analyses. There was little evidence of any between‐arm differences in SMFQ scores (0.19, 95% CI −0.57 to 0.95, p = .62), or costs (£142, 95% CI −£132 to £415, p = .31) per person for CBT versus usual school provision. Conclusions Our analysis suggests that the universal provision of classroom‐based CBT is unlikely to be either more effective or less costly than usual school provision.
    May 12, 2014   doi: 10.1111/jcpp.12248   open full text
  • ADHD and risky sexual behavior in adolescents: Conduct problems and substance use as mediators of risk.
    Dustin E. Sarver, Michael R. McCart, Ashli J. Sheidow, Elizabeth J. Letourneau.
    Journal of Child Psychology and Psychiatry. May 12, 2014
    Background Recent studies have linked attention‐deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. Methods ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross‐sectional sample of adolescents (N = 115; mean age = 14.9 years) involved in the juvenile justice system. Results Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow‐up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive, but not inattentive, symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. Conclusions The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD.
    May 12, 2014   doi: 10.1111/jcpp.12249   open full text
  • Children's relative age in class and use of medication for ADHD: a Danish Nationwide Study.
    Anton Pottegård, Jesper Hallas, Hernández‐Díaz, Helga Zoëga.
    Journal of Child Psychology and Psychiatry. May 12, 2014
    Background Previous studies from North America and Iceland have shown that the youngest children within a grade are up to twice as likely to be diagnosed and treated for attention‐deficit/hyperactivity disorder (ADHD) compared with their older classmates. We aimed to investigate whether younger age in class is associated with an increased probability of being prescribed medication for ADHD among school‐aged children in Denmark. Methods We followed all Danish children between 2000 and 2012 from 1st through 6th grade (7–12 years). Among children who started school on their age‐assigned grade level, we estimated the prevalence proportion ratio (PPR) of receiving ADHD medication between the youngest children in class (born in October–December) and the oldest in class (born in January–March), specified by grade level, calendar year and gender. As a sensitivity analysis, we added children not on their age‐assigned grade level to the main calculations. Results We identified 932,032 eligible children for the main analysis, of whom 17.3% were among the youngest and 26.5% among the oldest in class. In total, 1.2% eligible children filled at least one prescription for ADHD medication in 2000–2012. The average PPR over the study period was 1.08 (95% CI, 1.04–1.12) and remained stable across subgroups and sensitivity analyses. Overall, 40% of children born October–December had entered school a year after their age‐assigned grade level. Conclusions Contrary to previous study results, we observed almost no relative age effect on medication use for ADHD among children in Denmark. We postulate that this may be due to the high proportion of relatively young children held back by 1 year in the Danish school system and/or a generally low prevalence of ADHD medication use in the country.
    May 12, 2014   doi: 10.1111/jcpp.12243   open full text
  • Rule breaking mediates the developmental association between GABRA2 and adolescent substance abuse.
    Elisa M. Trucco, Sandra Villafuerte, Mary M. Heitzeg, Margit Burmeister, Robert A. Zucker.
    Journal of Child Psychology and Psychiatry. May 09, 2014
    Background This study's primary aim was to examine age‐specific associations between GABRA2, rule breaking, problematic alcohol use, and substance abuse symptomatology. The secondary aim was to examine the extent to which rule breaking mediates the GABRA2‐substance abuse relationship. Methods A sample (n = 518) of primarily male (70.9%) and White (88.8%) adolescents from the Michigan Longitudinal Study was assessed from ages 11–18. Age‐specific effects of GABRA2 on rule breaking, problematic alcohol use, and substance abuse symptomatology were examined using nested path models. The role of rule breaking as a mediator in the association between GABRA2 and substance abuse outcomes was tested using prospective cross‐lagged path models. Results GABRA2 is significantly (p < 0.05) associated with rule breaking in mid‐ to late‐adolescence, but not substance abuse symptomatology across adolescence. GABRA2 effects on problematic alcohol use and substance abuse symptomatology operate largely (45.3% and 71.1%, respectively, p < 0.05) via rule breaking in midadolescence. Conclusions GABRA2 represents an early risk factor for an externalizing pathway to the development of problematic alcohol and drug use.
    May 09, 2014   doi: 10.1111/jcpp.12244   open full text
  • Development of children at risk for adverse outcomes participating in early intervention in developing countries: a randomized controlled trial.
    Jan L. Wallander, Carla M. Bann, Fred J. Biasini, Shivaprasad S. Goudar, Omrana Pasha, Elwyn Chomba, Elizabeth McClure, Waldemar A. Carlo.
    Journal of Child Psychology and Psychiatry. May 09, 2014
    Background Previous research has indicated positive effects of early developmental intervention (EDI) on the development of children in developing countries. Few studies, however, have examined longitudinally when differential treatment effects may be observed and whether differential outcomes are associated with exposure to different risk factors and country of implementation. Also, birth asphyxia as a risk condition has not been well studied. To address these limitations, we conducted a randomized controlled trial to test the hypothesis that there will be differential developmental trajectories favoring those who receive EDI versus a health education intervention in children in rural areas of India, Pakistan, and Zambia. Methods Children with and without birth asphyxia were randomized to EDI or control intervention, which was implemented by parents who received training in biweekly home visits initiated before child age 1 month and continuing until 36 months. Development was assessed in 376 children at ages 12, 24, and 36 months using the Bayley Scales of Infant Development and Ages & Stages Questionnaire administered by evaluators blind to intervention assignment and risk condition. Results Longitudinal mixed model analysis indicated that EDI resulted in better development over 36 months in cognitive abilities, regardless of risk condition, maternal resources, child gender, or country. Psychomotor development and parent‐reported general development showed similar trends as for cognitive abilities, but were not statistically different between intervention conditions. Developmental differences were observed first at 36 months of age. Conclusion Early developmental intervention has promise for improving development in children across developing countries when exposed to various risk conditions. EDI should be one prominent approach used to begin to address long‐term outcomes and intergenerational transmission of poverty.
    May 09, 2014   doi: 10.1111/jcpp.12247   open full text
  • The serotonin transporter gene polymorphism 5‐HTTLPR moderates the effects of stress on attention‐deficit/hyperactivity disorder.
    Dennis Meer, Catharina A. Hartman, Jennifer Richards, Janita B. Bralten, Barbara Franke, Jaap Oosterlaan, Dirk J. Heslenfeld, Stephen V. Faraone, Jan K. Buitelaar, Pieter J. Hoekstra.
    Journal of Child Psychology and Psychiatry. May 02, 2014
    Introduction The role of the serotonin transporter gene polymorphism 5‐HTTLPR in attention‐deficit/hyperactivity disorder (ADHD) is unclear. Heterogeneity of findings may be explained by gene–environment interactions (GxE), as it has been suggested that S‐allele carriers are more reactive to psychosocial stress than L‐allele homozygotes. This study aimed to investigate whether 5‐HTTLPR genotype moderates the effects of stress on ADHD in a multisite prospective ADHD cohort study. Methods 5‐HTTLPR genotype, as well as the number of stressful life events in the past 5 years and ongoing long‐term difficulties, was determined in 671 adolescents and young adults with ADHD, their siblings, and healthy controls (57.4% male, average age 17.3 years). Linear mixed models, accounting for family relatedness, were applied to investigate the effects of genotype, experienced stress, and their interaction on ADHD severity at time point T2, while controlling for ADHD severity at T1 (mean follow‐up time 5.9 years) and for comorbid internalizing problems at T2. Results The interaction between genotype and stress significantly predicted ADHD severity at T2 (p = .006), which was driven by the effect on hyperactivity–impulsivity (p = .004). Probing of the interaction effect made clear that S‐allele carriers had a significantly more positive correlation between stress and ADHD severity than L‐allele homozygotes. Conclusion The results show that the interaction between 5‐HTTLPR and stress is a mechanism involved particularly in the hyperactivity/impulsivity dimension of ADHD, and that this is independent of comorbid internalizing problems. Further research into the neurobiological mechanisms underlying this interaction effect is warranted.
    May 02, 2014   doi: 10.1111/jcpp.12240   open full text
  • A diffusion modeling approach to understanding contextual cueing effects in children with ADHD.
    Alexander Weigard, Cynthia Huang‐Pollock.
    Journal of Child Psychology and Psychiatry. May 02, 2014
    Background Strong theoretical models suggest implicit learning deficits may exist among children with Attention Deficit Hyperactivity Disorder (ADHD). Method We examine implicit contextual cueing (CC) effects among children with ADHD (n = 72) and non‐ADHD Controls (n = 36). Results Using Ratcliff's drift diffusion model, we found that among Controls, the CC effect is due to improvements in attentional guidance and to reductions in response threshold. Children with ADHD did not show a CC effect; although they were able to use implicitly acquired information to deploy attentional focus, they had more difficulty adjusting their response thresholds. Conclusions Improvements in attentional guidance and reductions in response threshold together underlie the CC effect. Results are consistent with neurocognitive models of ADHD that posit subcortical dysfunction but intact spatial attention, and encourage the use of alternative data analytic methods when dealing with reaction time data.
    May 02, 2014   doi: 10.1111/jcpp.12250   open full text
  • Different clinical courses of children exposed to a single incident of psychological trauma: a 30‐month prospective follow‐up study.
    Soon‐Beom Hong, George J. Youssef, Sook‐Hyung Song, Nam‐Hee Choi, Jeong Ryu, Brett McDermott, Vanessa Cobham, Subin Park, Jae‐Won Kim, Min‐Sup Shin, Hee‐Jeong Yoo, Soo‐Churl Cho, Bung‐Nyun Kim.
    Journal of Child Psychology and Psychiatry. April 30, 2014
    Background We investigated the distinct longitudinal trajectories of posttraumatic stress symptoms in a sample of 167 children, who witnessed death of two mothers of their schoolmates. Methods The cohort was followed‐up at 2 days (T1), 2 months (T2), 6 months (T3), and 30 months (T4) after the traumatic event. The children's posttraumatic stress symptoms (T1–T4), depression (T1, T3 and T4), state anxiety (T1, T3 and T4), and quality of life (T4) were assessed, along with parental stress related to child rearing (T4). Different trajectory patterns of the children's posttraumatic stress symptoms were identified using growth mixture modeling (GMM). Results Four different patterns of symptom change were identified, which were consistent with the prototypical model, and were named Recovery (19.9%), Resilience (72.7%), Chronic Dysfunction (1.8%), and Delayed Reactions (5.6%). Significant differences were found in depression and anxiety scores, children's quality of life, and parental rearing stress according to the distinct longitudinal trajectories of posttraumatic stress symptoms. Conclusions The present study suggests that individual differences should be taken into account in the clinical course and outcome of children exposed to psychological trauma. The two most common trajectories were the Resilience and the Recovery types, together suggesting that over 90% of children were evidenced with a favorable 30‐month outcome. The latent classes were associated with significant mean differences in depression and anxiety scores, supporting the clinical validity of the distinct trajectories.
    April 30, 2014   doi: 10.1111/jcpp.12241   open full text
  • Developmental association of prosocial behaviour with aggression, anxiety and depression from infancy to preadolescence.
    Amélie Nantel‐Vivier, Robert O. Pihl, Sylvana Côté, Richard E. Tremblay.
    Journal of Child Psychology and Psychiatry. April 25, 2014
    Background Research on associations between children's prosocial behaviour and mental health has provided mixed evidence. The present study sought to describe and predict the joint development of prosocial behaviour with externalizing and internalizing problems (physical aggression, anxiety and depression) from 2 to 11 years of age. Method Data were drawn from the National Longitudinal Survey of Children and Youth (NLSCY). Biennial prosocial behaviour, physical aggression, anxiety and depression maternal ratings were sought for 10,700 children aged 0 to 9 years at the first assessment point. Results While a negative association was observed between prosociality and physical aggression, more complex associations emerged with internalizing problems. Being a boy decreased the likelihood of membership in the high prosocial trajectory. Maternal depression increased the likelihood of moderate aggression, but also of joint high prosociality/low aggression. Low family income predicted the joint development of high prosociality with high physical aggression and high depression. Conclusions Individual differences exist in the association of prosocial behaviour with mental health. While high prosociality tends to co‐occur with low levels of mental health problems, high prosociality and internalizing/externalizing problems can co‐occur in subgroups of children. Child, mother and family characteristics are predictive of individual differences in prosocial behaviour and mental health development. Mechanisms underlying these associations warrant future investigations.
    April 25, 2014   doi: 10.1111/jcpp.12235   open full text
  • Increase in child behavior problems among urban Brazilian 4‐year olds: 1993 and 2004 Pelotas birth cohorts.
    Alicia Matijasevich, Elizabeth Murray, Alan Stein, Luciana Anselmi, Ana M. Menezes, Iná S. Santos, Aluísio J.D. Barros, Denise P. Gigante, Fernando C. Barros, Cesar G. Victora.
    Journal of Child Psychology and Psychiatry. April 16, 2014
    Background There are an increasing number of reports on time trends in child and adolescent psychological problems but none from low‐ and middle‐income countries, and very few covering the preschool period. The aim was to investigate changes in preschool behavioral/emotional problems in two birth cohorts from a middle‐income country born 11 years apart. Methods We analyzed data from the 1993 and 2004 Pelotas birth cohort studies from Brazil. A subsample of 4‐year olds from the 1993 cohort (634) and all 4‐year olds from the 2004 cohort (3750) were assessed for behavioral/emotional problems through maternal report using the Child Behavior Checklist (CBCL). Response rates in these two population‐based cohorts were above 90%. Results We found a significant increase in CBCL total problems, internalizing and externalizing mean scores over the 11‐year period. For 1993 and 2004 Pelotas cohorts, respectively, CBCL mean values (SE) total problems scores were 27.9 (0.8) and 34.7 (0.3); for internalizing scores, 5.7 (0.2) and 6.3 (0.1) and for externalizing scores, 12.4 (0.4) and 15.5 (0.1). After adjusting for confounding variables, the largest increase from 1993 to 2004 was identified in the aggressive behavior syndrome score (Cohen's d = .50), followed by the externalizing problem score (Cohen's d = .40) and CBCL total problem score (Cohen's d = .36), respectively. The rise in child psychological problems was more marked in children from families with fewer assets and with less educated mothers. Conclusions Our findings provide evidence for a substantial increase in preschool behavioral problems among children in Brazil over an 11‐year period.
    April 16, 2014   doi: 10.1111/jcpp.12236   open full text
  • Inhibitory control and delay aversion in unaffected preschoolers with a positive family history of attention deficit hyperactivity disorder.
    Ursula Pauli‐Pott, Alisa Roller, Monika Heinzel‐Gutenbrunner, Tanja Mingebach, Silke Dalir, Katja Becker.
    Journal of Child Psychology and Psychiatry. March 27, 2014
    Background From current theories on the etiology of attention deficit hyperactivity disorder (ADHD), it can be inferred that delay aversion (DA) and deficits in inhibitory control (IC) constitute basic deficits or endophenotypes of the disorder that already occur in the preschool period. This implies an occurrence of the characteristics in unaffected preschoolers with a positive family history of ADHD. Thus, it is hypothesized that preschoolers who are not affected by ADHD but who have first‐degree relatives who suffer, or have suffered, from ADHD show deficits in IC and heightened DA in comparison to preschoolers from the general population. Methods Thirty unaffected preschoolers with a positive family history of ADHD were compared with 30 control children matched with respect to age in months, gender, intelligence, and maternal education level. The groups also did not differ in terms of maternal depressive symptoms and the number of psychosocial family risks. A set of age‐appropriate neuropsychological tasks on executive IC (e.g. Puppet Says, Day‐Night, relying on Go‐NoGo and interference paradigms) and DA (e.g. Snack Delay, Gift Wrap, relying on delay of gratification paradigm) was conducted. Results Unaffected preschoolers showed significantly higher DA than control children (t(29) = −2.57, p < .008). The result did not change when subclinical ADHD symptoms and symptoms of oppositional defiant disorder were controlled for (F(1,29) = 5.21, p < .031). Differences in IC did not reach statistical significance. Conclusion The results are compatible with the assumption that DA constitutes a familial vulnerability marker that can be validly assessed in the preschool period. As this is the first study to address this issue in preschoolers, more research is needed to confirm and further analyze the significance of DA assessments specifically at this developmental stage.
    March 27, 2014   doi: 10.1111/jcpp.12230   open full text
  • Sensory subtypes in children with autism spectrum disorder: latent profile transition analysis using a national survey of sensory features.
    Karla K. Ausderau, Melissa Furlong, John Sideris, John Bulluck, Lauren M. Little, Linda R. Watson, Brian A. Boyd, Aysenil Belger, Virginia A. Dickie, Grace T. Baranek.
    Journal of Child Psychology and Psychiatry. March 27, 2014
    Background Sensory features are highly prevalent and heterogeneous among children with ASD. There is a need to identify homogenous groups of children with ASD based on sensory features (i.e. sensory subtypes) to inform research and treatment. Methods Sensory subtypes and their stability over 1 year were identified through latent profile transition analysis (LPTA) among a national sample of children with ASD. Data were collected from caregivers of children with ASD ages 2–12 years at two time points (Time 1 N = 1294; Time 2 N = 884). Results Four sensory subtypes (Mild; Sensitive‐Distressed; Attenuated‐Preoccupied; Extreme‐Mixed) were identified, which were supported by fit indices from the LPTA as well as current theoretical models that inform clinical practice. The Mild and Extreme‐Mixed subtypes reflected quantitatively different sensory profiles, while the Sensitive‐Distressed and Attenuated‐Preoccupied subtypes reflected qualitatively different profiles. Further, subtypes reflected differential child (i.e. gender, developmental age, chronological age, autism severity) and family (i.e. income, mother's education) characteristics. Ninety‐one percent of participants remained stable in their subtypes over 1 year. Conclusions Characterizing the nature of homogenous sensory subtypes may facilitate assessment and intervention, as well as potentially inform biological mechanisms.
    March 27, 2014   doi: 10.1111/jcpp.12219   open full text
  • Relative immaturity and ADHD: findings from nationwide registers, parent‐ and self‐reports.
    Linda Halldner, Annika Tillander, Cecilia Lundholm, Marcus Boman, Niklas Långström, Henrik Larsson, Paul Lichtenstein.
    Journal of Child Psychology and Psychiatry. March 26, 2014
    Background We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment. Methods We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case–control designs to study 6–69 year‐old individuals in Sweden from July 2005 to December 2009 (Cohort 1). Cohort 1 included 56,263 individuals diagnosed with ADHD or ever used prescribed ADHD‐specific medication. Complementary population‐representative cohorts provided DSM‐IV ADHD symptom ratings; parent‐reported for 10,760 9‐year‐old twins born 1995–2000 from the CATSS study (Cohort 2) and self‐reported for 6,970 adult twins age 20–47 years born 1959–1970 from the STAGE study (Cohort 3). We calculated odds ratios (OR:s) for ADHD across age for individuals born in November/December compared to January/February (Cohort 1). ADHD symptoms in Cohorts 2 and 3 were studied as a function of calendar birth month. Results ADHD diagnoses and medication treatment were both significantly more common in individuals born in November/December versus January/February; peaking at ages 6 (OR: 1.8; 95% CI: 1.5–2.2) and 7 years (OR: 1.6; 95% CI: 1.3–1.8) in the Patient and Prescribed Drug Registers, respectively. We found no corresponding differences in parent‐ or self‐reported ADHD symptoms by calendar birth month. Conclusion Relative immaturity compared to class mates might contribute to ADHD diagnosis and pharmacotherapy despite absence of parallel findings in reported ADHD symptom loads by relative immaturity. Increased clinical awareness of this phenomenon may be warranted to decrease risk for imprecise diagnostics and treatment. We speculate that flexibility regarding age at school start according to individual maturity could reduce developmentally inappropriate demands on children and improve the precision of ADHD diagnostic practice and pharmacological treatment.
    March 26, 2014   doi: 10.1111/jcpp.12229   open full text
  • Classes of oppositional‐defiant behavior: concurrent and predictive validity.
    Robert R. Althoff, Ana V. Kuny‐Slock, Frank C. Verhulst, James J. Hudziak, Jan Ende.
    Journal of Child Psychology and Psychiatry. March 26, 2014
    Background Oppositional defiant disorder (ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. Methods Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid‐Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid‐Holland Study. Results Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. Conclusions Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior.
    March 26, 2014   doi: 10.1111/jcpp.12233   open full text
  • Heart rate variability during social interactions in children with and without psychopathology: a meta‐analysis.
    Sara Shahrestani, Elizabeth M. Stewart, Daniel S. Quintana, Ian B. Hickie, Adam J. Guastella.
    Journal of Child Psychology and Psychiatry. March 18, 2014
    Background The inability to regulate autonomic activity during social interactions is believed to contribute to social and emotional dysregulation in children. Research has employed heart rate variability (HRV) during both socially engaging and socially disengaging dyadic tasks between children and adults to assess this. Methods We conducted a meta‐analysis including evidence from 18 studies comprising 1,544 children who were categorized as either healthy or at risk/diagnosed with psychopathology. Within these groups, we assessed the impact of social engagement and disengagement tasks on HRV. Results Results showed that social engagement tasks left HRV unaltered to a baseline. Social disengagement, however, was associated with decreases in HRV. In a task that included disengagement and then engagement, HRV was reduced during disengagement but was then restored during the reunion phase (engagement). Children at risk or with a diagnosis for psychopathology, however, failed to show any change in HRV during dyadic social interaction tasks. This was despite a social stressor, the Trier Social Stress Test, causing significantly reduced HRV in both groups. Conclusions This meta‐analysis provides support to suggest HRV may provide a worthwhile context specific marker for the effective regulation of dyadic social interactions in children.
    March 18, 2014   doi: 10.1111/jcpp.12226   open full text
  • Pupillary reactivity to emotional stimuli in children of depressed and anxious mothers.
    Katie L. Burkhouse, Greg J. Siegle, Brandon E. Gibb.
    Journal of Child Psychology and Psychiatry. March 17, 2014
    Background The primary aim of this study was to examine differences in physiological reactivity (measured via pupillometry) to emotional stimuli between children of depressed versus nondepressed mothers. A second goal was to examine differences in pupil dilation to emotional stimuli between children of anxious versus nonanxious mothers. Method Participants included 117 mother–child pairs drawn from the community. Children were between the ages of 8 and 14. Pupil dilation was assessed using an eye‐tracker while participants viewed angry, happy, or sad faces. Results Children of mothers with a history of major depression (MDD) exhibited increased pupil dilation to sad, but not happy or angry, faces compared with children of nondepressed mothers. Second, we found that children of anxious mothers exhibited increased pupil dilation to angry, but not happy or sad, faces compared to youth of nonanxious mothers. Conclusions The current findings add to the growing body of research suggesting that differences in physiological reactivity to depression‐ and anxiety‐relevant cues may represent an important mechanism in the intergenerational transmission of MDD and anxiety.
    March 17, 2014   doi: 10.1111/jcpp.12225   open full text
  • Improving child and parenting outcomes following paediatric acquired brain injury: a randomised controlled trial of Stepping Stones Triple P plus Acceptance and Commitment Therapy.
    Felicity L. Brown, Koa Whittingham, Roslyn N. Boyd, Lynne McKinlay, Kate Sofronoff.
    Journal of Child Psychology and Psychiatry. March 17, 2014
    Background Persistent behavioural difficulties are common following paediatric acquired brain injury (ABI). Parents and families also experience heightened stress, psychological symptoms and burden, and there is evidence of a reciprocal relationship between parent and child functioning, which may be mediated by the adoption of maladaptive parenting practices. Despite this, there is currently a paucity of research in family interventions in this population. The aim of this study was to determine the efficacy of Stepping Stones Triple P: Positive Parenting Program (SSTP), with an Acceptance and Commitment Therapy (ACT) workshop, in improving child outcomes and parenting practices following paediatric ABI. Methods Fifty‐nine parents of children (mean age 7 years, SD 3 years, 1 month; 35 males, 24 females) with ABI (Traumatic injuries 58%, Tumour 17%, Encephalitis or meningitis 15%, Cardiovascular accident 7%, Hypoxia 3%) who were evidencing at least mild behaviour problems were randomly assigned to treatment or care‐as‐usual conditions over 10 weeks. Mixed‐model repeated‐measures linear regression analyses were conducted to compare conditions from pre‐ to postintervention on child behavioural and emotional functioning (Eyberg Child Behavior Inventory, Strengths and Difficulties Questionnaire) and dysfunctional parenting style (Parenting Scale). Assessment of maintenance of change was conducted at a 6‐month follow‐up. The trial was registered on Australian New Zealand Clinical Trials Registry (ID: ACTRN12610001051033, Results Significant time‐by‐condition interactions were identified on number and intensity of child behaviour problems, child emotional symptoms and parenting laxness and overreactivity, indicating significant improvements in the treatment condition, with medium‐to‐large effect sizes. Most improvements were maintained at 6 months. Conclusions Group parenting interventions incorporating Triple P and ACT may be efficacious in improving child and parenting outcomes following paediatric ABI.
    March 17, 2014   doi: 10.1111/jcpp.12227   open full text
  • Working memory training in young children with ADHD: a randomized placebo‐controlled trial.
    Martine Dongen‐Boomsma, Madelon A. Vollebregt, Jan K. Buitelaar, Dorine Slaats‐Willemse.
    Journal of Child Psychology and Psychiatry. March 15, 2014
    Background Until now, working memory training has not reached sufficient evidence as effective treatment for ADHD core symptoms in children with ADHD; for young children with ADHD, no studies are available. To this end, a triple‐blind, randomized, placebo‐controlled study was designed to assess the efficacy of Cogmed Working Memory Training (CWMT) in young children with ADHD. Methods Fifty‐one children (5–7 years) with a DSM‐IV‐TR diagnosis of ADHD (without current psychotropic medication) were randomly assigned to the active (adaptive) or placebo (nonadaptive) training condition for 25 sessions during 5 weeks. The compliance criterion (>20 sessions) was met for 47 children. The primary outcome measure concerned the core behavioural symptoms of ADHD, measured with the ADHD Rating Scale IV (ADHD‐RS). Secondary outcome measures were neurocognitive functioning, daily executive functioning, and global clinical functioning. The influence of the increase in difficulty level (Index‐Improvement) for the treatment group was also analysed. Clinical trial registration information – ‘Working Memory Training in Young ADHD Children’;; NCT00819611. Results A significant improvement in favour of the active condition was found on a verbal working memory task (p = .041; adapted Digit Span WISC‐III, backward condition). However, it did not survive correction for multiple testing. No significant treatment effect on any of the primary or other secondary outcome measurements was found. The Index‐Improvement significantly contributed to ADHD‐RS and the Behavior Rating Inventory of Executive Function, both rated by the teacher, but revealed no significant group difference. Conclusions This study failed to find robust evidence for benefits of CMWT over the placebo training on behavioural symptoms, neurocognitive, daily executive, and global clinical functioning in young children with ADHD.
    March 15, 2014   doi: 10.1111/jcpp.12218   open full text
  • Depressive comorbidity in preschool anxiety disorder.
    Kai Klitzing, Lars O. White, Yvonne Otto, Sandra Fuchs, Helen L. Egger, Annette M. Klein.
    Journal of Child Psychology and Psychiatry. March 14, 2014
    Background The threshold for clinical relevance of preschool anxiety has recently come under increasing scrutiny in view of large variations in prevalence estimates. We studied the impact of presence/absence of additional depressive comorbidity (symptoms and/or diagnosis) on preschoolers with anxiety disorders in relation to clinical phenomenology, family, and peer problems compared to healthy controls. Method A population of 1738 preschoolers were screened and oversampled for internalizing symptoms from community sites, yielding a sample of 236 children. Results Using a multi‐informant approach (mother, father, teacher, child), we found evidence that children with anxiety disorders and depressive comorbidity display a greater internalizing symptom‐load, more peer problems and live in families with more psychosocial impairment (poor family functioning, family adversity, maternal mental health problems). The pure anxiety group was merely dissociable from controls with regard to internalizing symptoms and family adversity. Conclusion The presence of depressive comorbidity in anxiety disorders may mark the transition to a more detrimental and impairing disorder at preschool age.
    March 14, 2014   doi: 10.1111/jcpp.12222   open full text
  • Annual Research Review: Reaction time variability in ADHD and autism spectrum disorders: measurement and mechanisms of a proposed trans‐diagnostic phenotype.
    Sarah L. Karalunas, Hilde M. Geurts, Kerstin Konrad, Stephan Bender, Joel T. Nigg.
    Journal of Child Psychology and Psychiatry. March 13, 2014
    Background Intraindividual variability in reaction time (RT) has received extensive discussion as an indicator of cognitive performance, a putative intermediate phenotype of many clinical disorders, and a possible trans‐diagnostic phenotype that may elucidate shared risk factors for mechanisms of psychiatric illnesses. Scope and Methodology Using the examples of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD), we discuss RT variability. We first present a new meta‐analysis of RT variability in ASD with and without comorbid ADHD. We then discuss potential mechanisms that may account for RT variability and statistical models that disentangle the cognitive processes affecting RTs. We then report a second meta‐analysis comparing ADHD and non‐ADHD children on diffusion model parameters. We consider how findings inform the search for neural correlates of RT variability. Findings Results suggest that RT variability is increased in ASD only when children with comorbid ADHD are included in the sample. Furthermore, RT variability in ADHD is explained by moderate to large increases (d = 0.63–0.99) in the ex‐Gaussian parameter τ and the diffusion parameter drift rate, as well as by smaller differences (d = 0.32) in the diffusion parameter of nondecision time. The former may suggest problems in state regulation or arousal and difficulty detecting signal from noise, whereas the latter may reflect contributions from deficits in motor organization or output. The neuroimaging literature converges with this multicomponent interpretation and also highlights the role of top‐down control circuits. Conclusion We underscore the importance of considering the interactions between top‐down control, state regulation (e.g. arousal), and motor preparation when interpreting RT variability and conclude that decomposition of the RT signal provides superior interpretive power and suggests mechanisms convergent with those implicated using other cognitive paradigms. We conclude with specific recommendations for the field for next steps in the study of RT variability in neurodevelopmental disorders.
    March 13, 2014   doi: 10.1111/jcpp.12217   open full text
  • Who is afraid of math? Two sources of genetic variance for mathematical anxiety.
    Zhe Wang, Sara Ann Hart, Yulia Kovas, Sarah Lukowski, Brooke Soden, Lee A. Thompson, Robert Plomin, Grainne McLoughlin, Christopher W. Bartlett, Ian M. Lyons, Stephen A. Petrill.
    Journal of Child Psychology and Psychiatry. March 10, 2014
    Background Emerging work suggests that academic achievement may be influenced by the management of affect as well as through efficient information processing of task demands. In particular, mathematical anxiety has attracted recent attention because of its damaging psychological effects and potential associations with mathematical problem solving and achievement. This study investigated the genetic and environmental factors contributing to the observed differences in the anxiety people feel when confronted with mathematical tasks. In addition, the genetic and environmental mechanisms that link mathematical anxiety with math cognition and general anxiety were also explored. Methods Univariate and multivariate quantitative genetic models were conducted in a sample of 514 12‐year‐old twin siblings. Results Genetic factors accounted for roughly 40% of the variation in mathematical anxiety, with the remaining being accounted for by child‐specific environmental factors. Multivariate genetic analyses suggested that mathematical anxiety was influenced by the genetic and nonfamilial environmental risk factors associated with general anxiety and additional independent genetic influences associated with math‐based problem solving. Conclusions The development of mathematical anxiety may involve not only exposure to negative experiences with mathematics, but also likely involves genetic risks related to both anxiety and math cognition. These results suggest that integrating cognitive and affective domains may be particularly important for mathematics and may extend to other areas of academic achievement.
    March 10, 2014   doi: 10.1111/jcpp.12224   open full text
  • Annual Research Review: Child and adolescent mental health interventions: a review of progress in economic studies across different disorders.
    Jennifer Beecham.
    Journal of Child Psychology and Psychiatry. February 28, 2014
    Background Resources for supporting children and adolescents with psychiatric disorders continue to be scarce. Economics research can identify current patterns of expenditure, and help inform allocation of treatment and support resources between competing needs or uses. Scope and methods The aim was to identify the costs of supporting children and adolescents, the economic impacts of childhood psychiatric disorders in adulthood and any new evidence on the cost‐effectiveness of interventions. An electronic search of databases (including PubMed, Medline and Psychinfo) identified peer‐reviewed journal articles published between 2005 and 2012. Findings Sixty‐seven papers provided data on support and treatment costs now or in the future, or cost‐effectiveness analyses of services. Half the articles came from the United States. Most articles focussed on autism spectrum disorder (ASD; 23 articles), attention deficit hyperactivity disorder (ADHD; n = 15), conduct disorder (CD; n = 7), and anxiety or depression (n = 8). Conclusion Only 14 studies used a cost perspective wider than health care; most included education costs (n = 11), but only five included costs to the justice system. The number of studies estimating costs to the family has increased, particularly for children with autism spectrum disorder (ASD). In the United Kingdom, support costs for children and adolescents with conduct disorder (CD) appear to be lower than for those with attention deficit hyperactivity disorder (ADHD), although for the United States, the opposite may be true. Support costs for children and adolescents with ASD may be higher than both CD and ADHD. However, there were many differences between the samples and the methods employed making comparisons between studies difficult. Outcomes in adulthood include negative impacts on (mental) health, quality of life, public sector services, employment status and income. The evidence base is improving for child and adolescent psychiatric disorders, although only one full cost‐effectiveness analysis was identified since the previous review published in 2012. However, we still do not know enough about the economic implications of support and treatment for specific disorders.
    February 28, 2014   doi: 10.1111/jcpp.12216   open full text
  • Prevalence and predictors of PTSD and depression among adolescent victims of the Spring 2011 tornado outbreak.
    Zachary W. Adams, Jennifer A. Sumner, Carla Kmett Danielson, Jenna L. McCauley, Heidi S. Resnick, Kirstin Grös, Lisa A. Paul, Kyleen E. Welsh, Kenneth J. Ruggiero.
    Journal of Child Psychology and Psychiatry. February 28, 2014
    Background Relatively few studies have examined prevalence and predictors of posttraumatic stress disorder (PTSD) or major depressive episode (MDE) in disaster‐affected adolescents. Fewer still have administered diagnostic measures or studied samples exposed to tornadoes, a common type of disaster. Further, methodologic problems limit the generalizability of previous findings. This study addressed prevalence estimates and risk factors for PTSD and MDE among adolescents exposed to the Spring 2011 tornado outbreak in Alabama and Joplin, Missouri. Methods A large (N = 2000), population‐based sample of adolescents and caregivers, recruited randomly from tornado‐affected communities, participated in structured telephone interviews. PTSD and MDE prevalence were estimated for the overall sample, by gender, and by age. Hierarchical logistic regression was used to identify risk factors for PTSD and MDE. Results Overall, 6.7% of adolescents met diagnostic criteria for PTSD and 7.5% of adolescents met diagnostic criteria for MDE since the tornado. Girls were significantly more likely than boys to meet diagnostic criteria for MDE, and older adolescents were more likely than younger adolescents to report MDE since the tornado. Female gender, prior trauma exposure, and an injured family member were associated with greater risk for PTSD and MDE. Specific incident characteristics (loss of services, concern about others’ safety) were associated with greater PTSD risk; prior disaster exposure was associated with lower MDE risk. Conclusions However, most adolescents were resilient following tornado exposure, roughly 1 in 15 developed PTSD, 1 in 13 developed MDE, and many more endorsed subclinical mental health problems. Information regarding specific risk factors can guide early screening, prevention, and intervention efforts in disaster‐affected communities.
    February 28, 2014   doi: 10.1111/jcpp.12220   open full text
  • Double disadvantage: The influence of childhood maltreatment and community violence exposure on adolescent mental health.
    Charlotte A.M. Cecil, Essi Viding, Edward D. Barker, Jo Guiney, Eamon J. McCrory.
    Journal of Child Psychology and Psychiatry. February 24, 2014
    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.
    February 24, 2014   doi: 10.1111/jcpp.12213   open full text
  • Research Review: Two pathways toward impulsive action: an integrative risk model for bulimic behavior in youth.
    Carolyn M. Pearson, Elizabeth N. Riley, Heather A. Davis, Gregory T. Smith.
    Journal of Child Psychology and Psychiatry. February 21, 2014
    Background This study provides an integrative review of existing risk factors and models for bulimia nervosa (BN) in young girls. We offer a new model for BN that describes two pathways of risk that may lead to the initial impulsive act of binge eating and purging in children and adolescents. Scope We conducted a selective literature review, focusing on existing and new risk processes for BN in this select population. Findings We identify two ways in which girls increase their risk to begin engaging in the impulsive behavior of binge eating and purging. The first is state‐based: the experience of negative mood, in girls attempting to restrain eating, leads to the depletion of self‐control and thus increased risk for loss of control eating. The second is personality‐based: elevations on the trait of negative urgency, or the tendency to act rashly when distressed, increase risk, particularly in conjunction with high‐risk psychosocial learning. We then briefly discuss how these behaviors are reinforced, putting girls at further risk for developing BN. Conclusions We highlight several areas in which further inquiry is necessary, and we discuss the clinical implications of the new risk model we described.
    February 21, 2014   doi: 10.1111/jcpp.12214   open full text
  • Research Review: The role of diet in the treatment of attention‐deficit/hyperactivity disorder – an appraisal of the evidence on efficacy and recommendations on the design of future studies.
    Jim Stevenson, Jan Buitelaar, Samuele Cortese, Maite Ferrin, Eric Konofal, Michel Lecendreux, Emily Simonoff, Ian C. K. Wong, Edmund Sonuga‐Barke,.
    Journal of Child Psychology and Psychiatry. February 19, 2014
    Background The efficacy of three dietary treatments for ADHD has been repeatedly tested in randomized controlled trials (RCTs). These interventions are restricted elimination diets (RED), artificial food colour elimination (AFCE) and supplementation with free fatty acids (SFFA). There have been three systematic reviews and associated meta‐analyses of the RCTs for each of these treatments. Scope The aim of this review is to critically appraise the studies on the dietary treatments of ADHD, to compare the various meta‐analyses of their efficacy that have been published and to identify where the design of such RCTs could be improved and where further investigations are needed. Findings The meta‐analyses differ in the inclusion and exclusion criteria applied to potentially eligible studies. The range of average effect sizes in standard deviation units is RED (0.29–1.2), AFCE (0.18–0.42) and SFFA (0.17–0.31). The methodology of many of the trials on which the meta‐analyses are based is weak. Conclusions Nevertheless, there is evidence from well‐conducted studies for a small effect of SFFA. Restricted elimination diets may be beneficial, but large‐scale studies are needed on unselected children, using blind assessment and including assessment of long‐term outcome. Artificial food colour elimination is a potentially valuable treatment but its effect size remains uncertain, as does the type of child for whom it is likely to be efficacious. There are additional dietary supplements that have been used with children with ADHD. A systematic search identified 11 RCTs that investigated the effects of these food supplements. Despite positive results for some individual trials, more studies are required before conclusions can be reached on the value in reducing ADHD symptoms of any of these additional supplements.
    February 19, 2014   doi: 10.1111/jcpp.12215   open full text
  • Longitudinal patterns of repetitive behavior in toddlers with autism.
    Jason J. Wolff, Kelly N. Botteron, Stephen R. Dager, Jed T. Elison, Annette M. Estes, Hongbin Gu, Heather C. Hazlett, Juhi Pandey, Sarah J. Paterson, Robert T. Schultz, Lonnie Zwaigenbaum, Joseph Piven,.
    Journal of Child Psychology and Psychiatry. February 19, 2014
    Background Recent evidence suggests that restricted and repetitive behaviors may differentiate children who develop autism spectrum disorder (ASD) by late infancy. How these core symptoms manifest early in life, particularly among infants at high risk for the disorder, is not well characterized. Methods Prospective, longitudinal parent‐report data (Repetitive Behavior Scales‐Revised) were collected for 190 high‐risk toddlers and 60 low‐risk controls from 12 to 24 months of age. Forty‐one high‐risk children were classified with ASD at age 2. Profiles of repetitive behavior were compared between groups using generalized estimating equations. Results Longitudinal profiles for children diagnosed with ASD differed significantly from high‐ and low‐risk children without the disorder on all measures of repetitive behavior. High‐risk toddlers without ASD were intermediate to low risk and ASD positive counterparts. Toddlers with ASD showed significantly higher rates of repetitive behavior across subtypes at the 12‐month time point. Repetitive behaviors were significantly correlated with adaptive behavior and socialization scores among children with ASD at 24 months of age, but were largely unrelated to measures of general cognitive ability. Conclusions These findings suggest that as early as 12 months of age, a broad range of repetitive behaviors are highly elevated in children who go on to develop ASD. While some degree of repetitive behavior is elemental to typical early development, the extent of these behaviors among children who develop ASD appears highly atypical.
    February 19, 2014   doi: 10.1111/jcpp.12207   open full text
  • Risk‐taking and sensation‐seeking propensity in postinstitutionalized early adolescents.
    Michelle M. Loman, Anna E. Johnson, Karina Quevedo, Theresa L. Lafavor, Megan R. Gunnar.
    Journal of Child Psychology and Psychiatry. February 19, 2014
    Background Youth with histories of institutional/orphanage care are at increased risk for externalizing and internalizing problems during childhood and adolescence. Although these problems have been well described, the related adolescent behaviors of risk‐taking and sensation‐seeking have not yet been explored in this population. This study examined risk‐taking and sensation‐seeking propensity, and associations with conduct problems and depressive symptoms, in early adolescents who were adopted as young children from institutional care. Methods Risk‐taking and sensation‐seeking propensities of 12‐ and 13‐year‐old postinstitutionalized (PI; n = 54) adolescents were compared with two groups: youth who were internationally adopted early from foster care (PFC; n = 44) and nonadopted youth (NA; n = 58). Participants were recruited to equally represent pre/early‐ and mid/late‐pubertal stages within each group. Participants completed the youth version of the Balloon Analogue Risk Task (Lejuez et al., ) and the Sensation‐Seeking Scale for Children (Russo et al., ). Parents completed clinical ratings of participants' conduct problems and depressive symptoms. Results PI adolescents demonstrated lower risk‐taking than PFC and NA peers. Pre/early‐pubertal PI youth showed lower sensation‐seeking, while mid/late‐pubertal PI youth did not differ from other groups. PI adolescents had higher levels of conduct problems but did not differ from the other youth in depressive symptoms. In PI youth only, conduct problems were negatively correlated with risk‐taking and positively correlated with sensation‐seeking, while depressive symptoms were negatively correlated with both risk‐taking and sensation‐seeking. Conclusions Early institutional care is associated with less risk‐taking and sensation‐seeking during adolescence. The deprived environment of an institution likely contributes to PI youth having a preference for safe choices, which may only be partially reversed with puberty. Whether this reflects hyporesponsiveness to rewards and how it relates to psychopathology are discussed.
    February 19, 2014   doi: 10.1111/jcpp.12208   open full text
  • Annual Research Review: Current limitations and future directions in MRI studies of child‐ and adult‐onset developmental psychopathologies.
    Guillermo Horga, Tejal Kaur, Bradley S. Peterson.
    Journal of Child Psychology and Psychiatry. January 20, 2014
    Background The widespread use of Magnetic Resonance Imaging (MRI) in the study of child‐ and adult‐onset developmental psychopathologies has generated many investigations that have measured brain structure and function in vivo throughout development, often generating great excitement over our ability to visualize the living, developing brain using the attractive, even seductive images that these studies produce. Often lost in this excitement is the recognition that brain imaging generally, and MRI in particular, is simply a technology, one that does not fundamentally differ from any other technology, be it a blood test, a genotyping assay, a biochemical assay, or behavioral test. No technology alone can generate valid scientific findings. Rather, it is only technology coupled with a strong experimental design that can generate valid and reproducible findings that lead to new insights into the mechanisms of disease and therapeutic response. Methods In this review we discuss selected studies to illustrate the most common and important limitations of MRI study designs as most commonly implemented thus far, as well as the misunderstanding that the interpretations of findings from those studies can create for our theories of developmental psychopathologies. Results Common limitations of MRI study designs are in large part responsible thus far for the generally poor reproducibility of findings across studies, poor generalizability to the larger population, failure to identify developmental trajectories, inability to distinguish causes from effects of illness, and poor ability to infer causal mechanisms in most MRI studies of developmental psychopathologies. For each of these limitations in study design and the difficulties they entail for the interpretation of findings, we discuss various approaches that numerous laboratories are now taking to address those difficulties, which have in common the yoking of brain imaging technologies to studies with inherently stronger designs that permit more valid and more powerful causal inferences. Those study designs include epidemiological, longitudinal, high‐risk, clinical trials, and multimodal imaging studies. Conclusions We highlight several studies that have yoked brain imaging technologies to these stronger designs to illustrate how doing so can aid our understanding of disease mechanisms and in the foreseeable future can improve clinical diagnosis, prevention, and treatment planning for developmental psychopathologies.
    January 20, 2014   doi: 10.1111/jcpp.12185   open full text
  • Annual Research Review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age.
    Sonia Livingstone, Peter K. Smith.
    Journal of Child Psychology and Psychiatry. January 20, 2014
    Aims and scope The usage of mobile phones and the internet by young people has increased rapidly in the past decade, approaching saturation by middle childhood in developed countries. Besides many benefits, online content, contact or conduct can be associated with risk of harm; most research has examined whether aggressive or sexual harms result from this. We examine the nature and prevalence of such risks, and evaluate the evidence regarding the factors that increase or protect against harm resulting from such risks, so as to inform the academic and practitioner knowledge base. We also identify the conceptual and methodological challenges encountered in this relatively new body of research, and highlight the pressing research gaps. Methods Given the pace of change in the market for communication technologies, we review research published since 2008. Following a thorough bibliographic search of literature from the key disciplines (psychology, sociology, education, media studies and computing sciences), the review concentrates on recent, high quality empirical studies, contextualizing these within an overview of the field. Findings Risks of cyberbullying, contact with strangers, sexual messaging (‘sexting’) and pornography generally affect fewer than one in five adolescents. Prevalence estimates vary according to definition and measurement, but do not appear to be rising substantially with increasing access to mobile and online technologies, possibly because these technologies pose no additional risk to offline behaviour, or because any risks are offset by a commensurate growth in safety awareness and initiatives. While not all online risks result in self‐reported harm, a range of adverse emotional and psychosocial consequences is revealed by longitudinal studies. Useful for identifying which children are more vulnerable than others, evidence reveals several risk factors: personality factors (sensation‐seeking, low self‐esteem, psychological difficulties), social factors (lack of parental support, peer norms) and digital factors (online practices, digital skills, specific online sites). Conclusions Mobile and online risks are increasingly intertwined with pre‐existing (offline) risks in children's lives. Research gaps, as well as implications for practitioners, are identified. The challenge is now to examine the relations among different risks, and to build on the risk and protective factors identified to design effective interventions.
    January 20, 2014   doi: 10.1111/jcpp.12197   open full text
  • Longitudinal trajectories of peer relations in children with specific language impairment.
    Pearl L. H. Mok, Andrew Pickles, Kevin Durkin, Gina Conti‐Ramsden.
    Journal of Child Psychology and Psychiatry. January 11, 2014
    Background Peer relations is a vulnerable area of functioning in children with specific language impairment (SLI), but little is known about the developmental trajectories of individuals. Methods Peer problems were investigated over a 9‐year period (from 7 to 16 years of age) in 171 children with a history of SLI. Discrete factor growth modelling was used to chart developmental trajectories. Multinomial logistic regression analysis was conducted to investigate factors associated with group membership. Results Four distinct developmental trajectories were identified: low‐level/no problems in peer relations (22.2% of participants), childhood‐limited problems (12.3%), childhood‐onset persistent problems (39.2%) and adolescent‐onset problems (26.3%). Risk of poor trajectories of peer relations was greater for those children with pragmatic language difficulties. Prosocial behaviour was the factor most strongly associated with trajectory group membership. Overall, the more prosocial children with better pragmatic language skills and lower levels of emotional problems had less difficulty in developing peer relations. Conclusions Analysis of developmental trajectories enriches our understanding of social development. A sizeable minority in the present sample sustained positive relations through childhood and adolescence, and others overcame early difficulties to achieve low levels of problems by their early teens; the majority, however, showed childhood‐onset persistent or adolescent‐onset problems.
    January 11, 2014   doi: 10.1111/jcpp.12190   open full text
  • Mothers' early depressive symptoms and children's first‐grade adjustment: a transactional analysis of child withdrawal as a mediator.
    Ni Yan, Theodore Dix.
    Journal of Child Psychology and Psychiatry. December 28, 2013
    Background The depression‐inhibition hypothesis suggests that mothers' depressive symptoms undermine development because they lead children to withdraw from social contact. To test this, this study examined whether poor first‐grade adjustment among children of mothers with depressive symptoms is mediated by the emergence of child withdrawal in early development. Method Based on 1,364 dyads, four waves of data spanning from 24 months to first grade (7 years) were used to examine paths by which children's withdrawal mediates relations between mothers' early depressive symptoms and three first‐grade outcomes: social competence, academic performance, and externalizing behavior problems. Results Structural equation modeling revealed three principal paths. First, direct relations were observed: Mothers' depressive symptoms predicted early child withdrawal and increases in child withdrawal over time, which predicted poor first‐grade adjustment. Second, reciprocal relations were observed: Mothers' depressive symptoms predicted child withdrawal, which predicted increases in depressive symptoms. Third, relations via mother–child mutual responsiveness were observed: Depression‐related increases in child withdrawal predicted declines in mutual responsiveness, which predicted poor first‐grade adjustment. Conclusion The findings suggest that, due to its interdependence with maternal depression and low mother–child mutual responsiveness over time, child withdrawal may play an important role in the poor first‐grade adjustment of children whose mothers are high in depressive symptoms.
    December 28, 2013   doi: 10.1111/jcpp.12189   open full text
  • Annual Research Review: The neuroinflammation hypothesis for stress and psychopathology in children – developmental psychoneuroimmunology.
    Thomas G. O'Connor, Jan A. Moynihan, Mary T. Caserta.
    Journal of Child Psychology and Psychiatry. December 23, 2013
    Abstract Experimental animal and adult human data suggest that stress exposure is associated with alterations in immune system function that may underlie increased susceptibility to disease and behavioral disorders. The implications of these data for child psychology and psychiatry are not yet clear. The current review seeks to distil and translate the relevant animal and adult human work to children to advance a developmental model of psychoneuroimmunology. In addition to reviewing key specific findings, we consider biological/conceptual models and technical aspects of psychoneuroimmunology work in pediatric populations, and outline the rationales and advantages of integrating hypotheses concerning neuroinflammation in developmental studies of psychopathology.
    December 23, 2013   doi: 10.1111/jcpp.12187   open full text
  • Pathways to self‐harmful behaviors in young women with and without ADHD: A longitudinal examination of mediating factors.
    Erika N. Swanson, Elizabeth B. Owens, Stephen P. Hinshaw.
    Journal of Child Psychology and Psychiatry. December 23, 2013
    Background Rates of suicide attempts and nonsuicidal self‐injury [(NSSI); e.g., cutting, burning] peak in adolescence and early adulthood; females and individuals with psychiatric symptoms and diagnoses appear to be at particular risk. Hinshaw et al. [Journal of Consulting and Clinical Psychology, (), 80, 1041] reported that young women with histories of childhood ADHD diagnoses reported higher rates of suicide attempts and NSSI than nondiagnosed, comparison women. Methods Via analyses of an ongoing longitudinal investigation, our aims are to examine, with respect to both aspects of self‐harmful behavior, (a) ADHD subtype differences and effects of diagnostic persistence (vs. transient and nondiagnosed classifications) and (b) potential mediating effects of impulsivity and comorbid psychopathology, ascertained during adolescence. Results Young adult women with a childhood diagnosis of ADHD‐Combined type were at highest risk for suicide attempts as well as the most varied and severe forms of NSSI compared with those with ADHD‐Inattentive type and those in the comparison group; participants with a persistent ADHD diagnosis were at higher risk than those with a transient diagnosis or those never meeting criteria for ADHD. Mediator analyses revealed that, during adolescence, an objective measure of impulsivity plus comorbid externalizing symptoms were simultaneous, partial mediators of the childhood ADHD‐young adult NSSI linkage. Adolescent internalizing symptoms emerged as a partial mediator of the childhood ADHD‐young adult suicide attempt linkage. Conclusions ADHD in females, especially when featuring childhood impulsivity and especially with persistent symptomatology, carries high risk for self‐harm. Psychiatric comorbidity and response inhibition are important mediators of this clinically important longitudinal association. We discuss limitations and implications for prevention and intervention.
    December 23, 2013   doi: 10.1111/jcpp.12193   open full text
  • The prevention program for externalizing problem behavior (PEP) improves child behavior by reducing negative parenting: analysis of mediating processes in a randomized controlled trial.
    Charlotte Hanisch, Christopher Hautmann, Julia Plück, Ilka Eichelberger, Manfred Döpfner.
    Journal of Child Psychology and Psychiatry. December 23, 2013
    Background Our indicated Prevention program for preschool children with Externalizing Problem behavior (PEP) demonstrated improved parenting and child problem behavior in a randomized controlled efficacy trial and in a study with an effectiveness design. The aim of the present analysis of data from the randomized controlled trial was to identify the mediating processes that account for these positive treatment effects. We hypothesized that a decrease in negative parenting and increases in positive parenting and parental warmth would mediate the relationship between treatment and child improvement. Method Parents of 155 children were randomly assigned to the PEP intervention group (n = 91) or a nontreated control group (n = 64). Parents rated their child's problem behavior and their own parenting practices before and after PEP training. Parental warmth was assessed during standardized play situations. Four mediation models were tested using structural equation modeling. Trial registration number ISRCTN12686222; Results Changes in child externalizing problem behavior were most strongly mediated by reductions of negative parenting in difficult parenting situations. Increases in positive parenting also served as a mediator. Changes in parental warmth, parents' feeling of self‐efficacy, and parental mental health did not play a mediating role in the association between PEP treatment and child behavior. Conclusions In our program, the most important component was to teach parents how to reduce dysfunctional parenting strategies in conflict situations.
    December 23, 2013   doi: 10.1111/jcpp.12177   open full text
  • Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders.
    Deborah K. Anderson, Jessie W. Liang, Catherine Lord.
    Journal of Child Psychology and Psychiatry. December 09, 2013
    Background The range of outcomes for young adults with Autism Spectrum Disorders (ASD) and the early childhood factors associated with this diversity have implications for clinicians and scientists. Methods This prospective study provided a unique opportunity to predict outcome 17 years later for a relatively large sample of children diagnosed with ASD at 2 years old. Diagnostic and psychometric instruments were administered between 2 and 19 with data from 2, 3, and 19 included in this study. Clinicians administered tests without knowledge of previous assessments whenever possible. Caregivers provided additional information through questionnaires. Results Significant intellectual disabilities at 19 were predicted by age 2 about 85% of the time from VIQ and NVIQ scores together, though prediction of young adult outcome for youths with average or higher intelligence was more complex. By 19, 9% of participants had largely overcome core difficulties associated with ASD and no longer retained a diagnosis. These youths with Very Positive Outcomes were more likely to have participated in treatment and had a greater reduction in repetitive behaviors between age 2 and 3 compared to other Cognitively Able youths (VIQ ≥70) with ASD. Very Positive Outcome youths did not differ phenotypically from Cognitively Able ASD individuals at 2 but both groups differed from Cognitively Less Able individuals (VIQ <70). Conclusion Those most at risk for intellectual disabilities and ASD can be reliably identified at an early age to receive comprehensive treatment. Findings also suggest that some cognitively able children with ASD who participate in early intervention have very positive outcomes, although replication with randomized, larger samples is needed. In order to improve understanding of very positive outcomes in ASD, future research will need to identify how variations in child characteristics and environmental factors contribute to the nature and timing of growth across individuals and areas of development.
    December 09, 2013   doi: 10.1111/jcpp.12178   open full text
  • Annual Research Review: The neurobehavioral development of multiple memory systems – implications for childhood and adolescent psychiatric disorders.
    Jarid Goodman, Rachel Marsh, Bradley S. Peterson, Mark G. Packard.
    Journal of Child Psychology and Psychiatry. November 29, 2013
    Extensive evidence indicates that mammalian memory is organized into multiple brains systems, including a ‘cognitive’ memory system that depends on the hippocampus and a stimulus‐response ‘habit’ memory system that depends on the dorsolateral striatum. Dorsal striatal‐dependent habit memory may in part influence the development and expression of some human psychopathologies, particularly those characterized by strong habit‐like behavioral features. The present review considers this hypothesis as it pertains to psychopathologies that typically emerge during childhood and adolescence. These disorders include Tourette syndrome, attention‐deficit/hyperactivity disorder, obsessive–compulsive disorder, eating disorders, and autism spectrum disorders. Human and nonhuman animal research shows that the typical development of memory systems comprises the early maturation of striatal‐dependent habit memory and the relatively late maturation of hippocampal‐dependent cognitive memory. We speculate that the differing rates of development of these memory systems may in part contribute to the early emergence of habit‐like symptoms in childhood and adolescence. In addition, abnormalities in hippocampal and striatal brain regions have been observed consistently in youth with these disorders, suggesting that the aberrant development of memory systems may also contribute to the emergence of habit‐like symptoms as core pathological features of these illnesses. Considering these disorders within the context of multiple memory systems may help elucidate the pathogenesis of habit‐like symptoms in childhood and adolescence, and lead to novel treatments that lessen the habit‐like behavioral features of these disorders.
    November 29, 2013   doi: 10.1111/jcpp.12169   open full text
  • Annual Research Review: Towards a developmental neuroscience of atypical social cognition.
    Francesca Happé, Uta Frith.
    Journal of Child Psychology and Psychiatry. November 28, 2013
    Abstract As a starting point for our review we use a developmental timeline, starting from birth and divided into major developmental epochs defined by key milestones of social cognition in typical development. For each epoch, we highlight those developmental disorders that diverge from the normal developmental pattern, what is known about these key milestones in the major disorders affecting social cognition, and any available research on the neural basis of these differences. We relate behavioural observations to four major networks of the social brain, that is, Amygdala, Mentalizing, Emotion and Mirror networks. We focus on those developmental disorders that are characterized primarily by social atypicality, such as autism spectrum disorder, social anxiety and a variety of genetically defined syndromes. The processes and aspects of social cognition we highlight are sketched in a putative network diagram, and include: agent identification, emotion processing and empathy, mental state attribution, self‐processing and social hierarchy mapping involving social ‘policing’ and in‐group/out‐group categorization. Developmental disorders reveal some dissociable deficits in different components of this map of social cognition. This broad review across disorders, ages and aspects of social cognition leads us to some key questions: How can we best distinguish primary from secondary social disorders? Is social cognition especially vulnerable to developmental disorder, or surprisingly robust? Are cascading notions of social development, in which early functions are essential stepping stones or building bricks for later abilities, necessarily correct?
    November 28, 2013   doi: 10.1111/jcpp.12162   open full text
  • The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence.
    Ginny Russell, Tamsin Ford, Rachel Rosenberg, Susan Kelly.
    Journal of Child Psychology and Psychiatry. November 26, 2013
    Background Studies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link. Method Secondary analysis of a UK birth cohort (the Millennium Cohort Study, N = 19,519) was used to model the association of ADHD with socioeconomic disadvantage and assess evidence for several potential explanatory pathways. The case definition of ADHD was a parent‐report of whether ADHD had been identified by a medical doctor or health professional when children were 7 years old. Results ADHD was associated with a range of indicators of social and economic disadvantage including poverty, housing tenure, maternal education, income, lone parenthood and younger motherhood. There was no evidence to suggest childhood ADHD was a causal factor of socioeconomic disadvantage: income did not decrease for parents of children with ADHD compared to controls over the 7‐year study period. No clinical bias towards labelling ADHD in low SES groups was detected. There was evidence to suggest that parent attachment/family conflict mediated the relationship between ADHD and SES. Conclusion Although genetic and neurological determinants may be the primary predictors of difficulties with activity level and attention, aetiology appears to be influenced by socioeconomic situation.
    November 26, 2013   doi: 10.1111/jcpp.12170   open full text
  • Does EEG‐neurofeedback improve neurocognitive functioning in children with attention‐deficit/hyperactivity disorder? A systematic review and a double‐blind placebo‐controlled study.
    Madelon A Vollebregt, Martine Dongen‐Boomsma, Jan K Buitelaar, Dorine Slaats‐Willemse.
    Journal of Child Psychology and Psychiatry. October 30, 2013
    Background The number of placebo‐controlled randomized studies relating to EEG‐neurofeedback and its effect on neurocognition in attention‐deficient/hyperactivity disorder (ADHD) is limited. For this reason, a double blind, randomized, placebo‐controlled study was designed to assess the effects of EEG‐neurofeedback on neurocognitive functioning in children with ADHD, and a systematic review on this topic was performed. Methods Forty‐one children (8–15 years) with a DSM‐IV‐TR diagnosis of ADHD were randomly allocated to EEG‐neurofeedback or placebo‐neurofeedback treatment for 30 sessions, twice a week. Children were stratified by age, electrophysiological state of arousal, and medication use. Neurocognitive tests of attention, executive functioning, working memory, and time processing were administered before and after treatment. Researchers, teachers, children and their parents, with the exception of the neurofeedback‐therapist, were all blind to treatment assignment. Outcome measures were the changes in neurocognitive performance before and after treatment. Clinical trial registration: NCT00723684. Results No significant treatment effect on any of the neurocognitive variables was found. A systematic review of the current literature also did not find any systematic beneficial effect of EEG‐neurofeedback on neurocognitive functioning. Conclusion Overall, the existing literature and this study fail to support any benefit of neurofeedback on neurocognitive functioning in ADHD, possibly due to small sample sizes and other study limitations.
    October 30, 2013   doi: 10.1111/jcpp.12143   open full text
  • Annual Research Review: A developmental psychopathology approach to understanding callous‐unemotional traits in children and adolescents with serious conduct problems.
    Paul J. Frick, James V. Ray, Laura C. Thornton, Rachel E. Kahn.
    Journal of Child Psychology and Psychiatry. October 09, 2013
    Recent research has suggested that the presence of significant levels of callous‐unemotional (CU) traits designates a clinically important and etiologically distinct subgroup of children and adolescents with serious conduct problems. Based on this research, CU traits have been included in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM‐5; American Psychiatric Association, 2013) – as a specifier for the diagnosis of conduct disorder. In this review, we attempt to understand CU traits within a developmental psychopathological framework. Specifically, we summarize research on the normal development of the prosocial emotions of empathy and guilt (i.e., conscience) and we illustrate how the development of CU traits can be viewed as the normal development of conscience gone awry. Furthermore, we review research on the stability of CU traits across different developmental periods and highlight factors that can influence this stability. Finally, we highlight the implications of this developmental psychopathological framework for future etiological research, for assessment and diagnostic classification, and for treatment of children with serious conduct problems.
    October 09, 2013   doi: 10.1111/jcpp.12152   open full text
  • Serotonin transporter‐linked polymorphic region (5‐HTTLPR) genotype and stressful life events interact to predict preschool‐onset depression: a replication and developmental extension.
    Ryan Bogdan, Arpana Agrawal, Michael S Gaffrey, Rebecca Tillman, Joan L Luby.
    Journal of Child Psychology and Psychiatry. October 04, 2013
    Background Scientific enthusiasm about gene × environment interactions, spurred by the 5‐HTTLPR (serotonin transporter‐linked polymorphic region) × SLEs (stressful life events) interaction predicting depression, have recently been tempered by sober realizations of small effects and meta‐analyses reaching opposing conclusions. These mixed findings highlight the need for further research. Converging evidence suggests that the effects of 5‐HTTLPR genotype may be neurodevelopmental in origin, but we are not aware of empirical studies that have investigated whether the 5‐HTTLPR genotype × SLE interaction predicts preschool‐onset depression (PO‐MDD), the earliest validated form of depression. Methods Children (n = 234) aged 3–5 were recruited for a longitudinal study designed to examine PO‐MDD. In a comprehensive baseline assessment, the child's primary caregivers completed questionnaires and were interviewed about their child's behaviors, psychiatric symptoms, and exposure to SLEs. Results A 5‐HTTLPR × SLEs interaction emerged, such that children homozygous for the short allele were more susceptible to depression in the context of elevated SLE than long allele carriers. In contrast, at low SLE exposure, short allele homozygotes had fewer depressive symptoms. The data were best fit by a plasticity model with a substantial reduction in fit by diathesis‐stress models. Conclusions Extending studies in adult and adolescent populations, these data suggest that 5‐HTTLPR genotype may provide plasticity to environmental influence, for better or worse. Specifically, children homozygous for the short allele were more susceptible to the depressogenic effects of SLEs but benefitted, in the form of reduced depressive symptoms, in the context of relatively benign environmental conditions (i.e. relatively low SLE exposure). These data highlight the importance of examining gene × environment interactions across development, environment, and outcome but should be interpreted cautiously given the small sample size.
    October 04, 2013   doi: 10.1111/jcpp.12142   open full text
  • Family income in early childhood and subsequent attention deficit/hyperactivity disorder: a quasi‐experimental study.
    Henrik Larsson, Amir Sariaslan, Niklas Långström, Brian D'Onofrio, Paul Lichtenstein.
    Journal of Child Psychology and Psychiatry. September 23, 2013
    Background Studies have found negative associations between socioeconomic position and attention deficit/hyperactivity disorder (ADHD), but it remains unclear if this association is causal. The aim of this study was to determine the extent to which the association between family income in early childhood and subsequent ADHD depends on measured and unmeasured selection factors. Methods A total of 811,803 individuals born in Sweden between 1992 and 2000 were included in this nationwide population‐based cohort study. Diagnosis of ADHD was assessed via the Swedish national Patient Register and the Swedish Prescribed Drug Register. Annual family income during offspring's first 5 years in life was collected prospectively from the Swedish Integrated Database for Labour Market Research and divided into quartiles by (lower) family disposable income. We predicted ADHD from family income while controlling for covariates and also comparing differently exposed cousins and siblings to control for unmeasured familial confounding. Results The crude analyses suggested that children exposed to lower income levels were at increased risk for ADHD (HRQuartile1 = 2.52; 95% CI, 2.42–2.63; HRQuartile2 = 1.52; 95% CI, 1.45–1.58; HRQuartile3 = 1.20; 95% CI, 1.14–1.15). This dose‐dependent association decreased after adjustment for measured covariates (HRQuartile1 = 2.09; 95% CI, 2.00–2.19; HRQuartile2 = 1.36; 95% CI, 1.30–1.42; HRQuartile3 = 1.13; 95% CI, 1.08–1.18). Although the association was attenuated in cousin comparisons (HRQuartile1 = 1.61; 95% CI, 1.40–1.84; HRQuartile2 = 1.28; 95% CI, 1.12–1.45; HRQuartile3 = 1.14; 95% CI, 1.01–1.28) and sibling comparison models (HRQuartile1 = 1.37; 95% CI, 1.07–1.75; HRQuartile2 = 1.37; 95% CI, 1.12–1.68; HRQuartile3 = 1.23; 95% CI, 1.04–1.45), it remained statistically significant across all levels of decreased disposable family income. Conclusions Our results indicated that low family income in early childhood was associated with increased likelihood of ADHD. The link remained even after controlling for unmeasured selection factors, highlighting family income in early childhood as a marker of causal factors for ADHD.
    September 23, 2013   doi: 10.1111/jcpp.12140   open full text
  • Schooling and variation in the COMT gene: the devil is in the details.
    Daniel Campbell, Johanna Bick, Carolyn M. Yrigollen, Maria Lee, Antony Joseph, Joseph T. Chang, Elena L. Grigorenko,.
    Journal of Child Psychology and Psychiatry. August 19, 2013
    Background Schooling is considered one of the major contributors to the development of intelligence within societies and individuals. Genetic variation might modulate the impact of schooling and explain, at least partially, the presence of individual differences in classrooms. Method We studied a sample of 1,502 children (mean age = 11.7 years) from Zambia. Approximately 57% of these children were enrolled in school, and the rest were not. To quantify genetic variation, we investigated a number of common polymorphisms in the catechol‐O‐methyltransferase (COMT) gene that controls the production of the protein thought to account for >60% of the dopamine degradation in the prefrontal cortex. Results Haplotype analyses generated results ranging from the presence to absence of significant interactions between a number of COMT haplotypes and indicators of schooling (i.e., in‐ vs. out‐of‐school and grade completed) in the prediction of nonverbal intelligence, depending on the parameter specification. However, an investigation of the distribution of corresponding p‐values suggested that these positive results were false. Conclusions Convincing evidence that the variation in the COMT gene is associated with individual differences in nonverbal intelligence either directly or through interactions with schooling was not found. p‐values produced by the method of testing for haplotype effects employed here may be sensitive to parameter settings, invalid under default settings, and should be checked for validity through simulation.
    August 19, 2013   doi: 10.1111/jcpp.12120   open full text
  • Offending behaviours of child and adolescent firesetters over a 10‐year follow‐up.
    Ian Lambie, Julia Ioane, Isabel Randell, Fred Seymour.
    Journal of Child Psychology and Psychiatry. August 09, 2013
    Background To assess the postintervention arson recidivism and other offending rates of a group of 182 firesetting children and adolescents referred to the New Zealand Fire Awareness and Intervention Program (FAIP) over a follow‐up period of 10 years. To investigate predictors of offending behaviour as well as variables associated with previous involvement in firesetting behaviour and offending severity. Method Data collected at the time of the FAIP intervention was provided by the New Zealand Fire Service and the offence histories of the sample were accessed from the New Zealand Police database (NIA). Data were analyzed using both descriptive and inferential statistics. Results Although the arson recidivism rate was low (2%), rates of general offending were high, with 59% of the sample having committed an offence during the follow‐up period. Fifteen percent of the sample was classified as severe offenders, 40% as moderate and 4% as minor. Of offenders, 12.6% had been imprisoned during the follow‐up period. Offending was predicted by experience of abuse and a previous firesetting behaviour at the time of the FAIP intervention. Living with both parents at the time of intervention decreased the probability of an individual engaging in future offending behaviour. The presence of family stress and a diagnosis of Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD/ADHD) were associated with previous firesetting behaviour. In addition, involvement with family violence (as a perpetrator, complainant or victim) was associated with more severe offending behaviour. Conclusions In light of existing research, the findings of this study indicate that many firesetters are at risk for future offending and that identification of high‐risk individuals is therefore an important consideration for any organization involved with firesetters. To minimize this risk, there is a need for a collaborative, multiagency approach to firesetting behaviour involving comprehensive risk assessment and appropriate referral for at‐risk individuals.
    August 09, 2013   doi: 10.1111/jcpp.12126   open full text
  • Parental social anxiety disorder prospectively predicts toddlers' fear/avoidance in a social referencing paradigm.
    Evin Aktar, Mirjana Majdandžić, Wieke Vente, Susan M. Bögels.
    Journal of Child Psychology and Psychiatry. August 02, 2013
    Background Anxiety runs in families. Observational learning of anxious behavior from parents with anxiety disorders plays an important role in the intergenerational transmission of anxiety. We investigated the link between parental anxiety (parental lifetime anxiety disorders and expressed parental anxiety) and toddler fear/avoidance during social referencing (SR) situations. Method Toddlers (N = 117) participated with both parents (with lifetime social anxiety disorder, other nonsocial anxiety disorders, lifetime comorbid social and other anxiety disorders, or without anxiety disorders) in a longitudinal study. Behavioral inhibition (BI) was measured at 12 months via observational tasks. At 30 months, children were confronted with a stranger and a remote‐control robot in SR situations, separately with each parent. Children's fear and avoidance, and parents' expressions of anxiety, encouragement, and overcontrol were observed. Results Toddlers of parents with lifetime social anxiety disorder (alone and comorbid with other anxiety disorders) showed more fear/avoidance in SR situations than toddlers of parents without anxiety disorders, while the effect of other anxiety disorders alone was not significant. Although expressed parental anxiety at 30 months in SR situations did not significantly predict toddlers' fear/avoidance, higher levels of expressed anxiety at 12 months in SR situations by parents with comorbid social and other anxiety disorders predicted higher levels of fear/avoidance. BI at 12 months predicted toddlers' fear/avoidance only with mothers, but not with fathers. Conclusions Parental lifetime social anxiety disorders may be a stronger predictor of children's fear/avoidance than parents' expressions of anxiety in SR situations in toddlerhood. End of infancy may be a sensitive time for learning of anxiety from parents with comorbid lifetime social and nonsocial anxiety disorders in SR situations. Fathers are as important as mothers in the transmission of anxiety via SR. Furthermore, children may act relatively free of their early temperament in SR situations with fathers.
    August 02, 2013   doi: 10.1111/jcpp.12121   open full text
  • Gene × smoking interactions on human brain gene expression: finding common mechanisms in adolescents and adults.
    Samuel L. Wolock, Andrew Yates, Stephen A. Petrill, Jason W. Bohland, Clancy Blair, Ning Li, Raghu Machiraju, Kun Huang, Christopher W. Bartlett.
    Journal of Child Psychology and Psychiatry. August 02, 2013
    Background Numerous studies have examined gene × environment interactions (G × E) in cognitive and behavioral domains. However, these studies have been limited in that they have not been able to directly assess differential patterns of gene expression in the human brain. Here, we assessed G × E interactions using two publically available datasets to assess if DNA variation is associated with post‐mortem brain gene expression changes based on smoking behavior, a biobehavioral construct that is part of a complex system of genetic and environmental influences. Methods We conducted an expression quantitative trait locus (eQTL) study on two independent human brain gene expression datasets assessing G × E for selected psychiatric genes and smoking status. We employed linear regression to model the significance of the Gene × Smoking interaction term, followed by meta‐analysis across datasets. Results Overall, we observed that the effect of DNA variation on gene expression is moderated by smoking status. Expression of 16 genes was significantly associated with single nucleotide polymorphisms that demonstrated G × E effects. The strongest finding (p = 1.9 × 10−11) was neurexin 3‐alpha (NRXN3), a synaptic cell–cell adhesion molecule involved in maintenance of neural connections (such as the maintenance of smoking behavior). Other significant G × E associations include four glutamate genes. Conclusions This is one of the first studies to demonstrate G × E effects within the human brain. In particular, this study implicated NRXN3 in the maintenance of smoking. The effect of smoking on NRXN3 expression and downstream behavior is different based upon SNP genotype, indicating that DNA profiles based on SNPs could be useful in understanding the effects of smoking behaviors. These results suggest that better measurement of psychiatric conditions, and the environment in post‐mortem brain studies may yield an important avenue for understanding the biological mechanisms of G × E interactions in psychiatry.
    August 02, 2013   doi: 10.1111/jcpp.12119   open full text
  • Familial confounding of the association between maternal smoking during pregnancy and ADHD in offspring.
    Charlotte Skoglund, Qi Chen, Brian M D′Onofrio, Paul Lichtenstein, Henrik Larsson.
    Journal of Child Psychology and Psychiatry. July 30, 2013
    Background Maternal Smoking During Pregnancy (SDP) has consistently been associated with increased risk of attention‐deficit/hyperactivity disorder (ADHD) in offspring, but recent studies indicate that this association might be due to unmeasured familial confounding. Methods A total of 813,030 individuals born in Sweden between 1992 and 2000 were included in this nationwide population‐based cohort study. Data on maternal SDP and ADHD diagnosis were obtained from national registers and patients were followed up from the age of 3 to the end of 2009. Hazard Ratios (HRs) were estimated using stratified Cox regression models. Cousin and sibling data were used to control for unmeasured familial confounding. Results At the population level maternal SDP predicted ADHD in offspring (HRModerateSDP = 1.89; HRHighSDP = 2.50). This estimate gradually attenuated toward the null when adjusting for measured confounders (HRModerateSDP = 1.62; HRHighSDP = 2.04), unmeasured confounders shared within the extended family (i.e., cousin comparison) (HRModerateSDP = 1.45; HRHighSDP = 1.69), and unmeasured confounders within the nuclear family (i.e., sibling comparison) (HRModerateSDP = 0.88; HRHighSDP = 0.84). Conclusions Our results suggest that the association between maternal SDP and offspring ADHD are due to unmeasured familial confounding.
    July 30, 2013   doi: 10.1111/jcpp.12124   open full text
  • Sleep restriction worsens mood and emotion regulation in adolescents.
    Katherine T. Baum, Anjali Desai, Julie Field, Lauren E. Miller, Joseph Rausch, Dean W. Beebe.
    Journal of Child Psychology and Psychiatry. July 30, 2013
    Background The relationship between inadequate sleep and mood has been well‐established in adults and is supported primarily by correlational data in younger populations. Given that adolescents often experience shortened sleep on school nights, we sought to better understand the effect of experimentally induced chronic sleep restriction on adolescents’ mood and mood regulation. Methods Fifty healthy adolescents, ages 14–17, completed a 3‐week sleep manipulation protocol involving a baseline week, followed by a sleep restriction (SR) condition (6.5 hr in bed per night for five nights) and healthy sleep duration (HS) condition (10 hr in bed per night for five nights). The study used a randomized, counterbalanced, crossover experimental design. Participants’ sleep was monitored at home via self‐report and actigraphy. At the end of each condition, participants and their parents completed questionnaires of mood and mood regulation. To assess for expectancy effects, we also analyzed parent and teen ratings of hyperactivity/impulsivity, which prior research suggests is not sensitive to SR in adolescents. Wilcoxon Signed Rank tests compared questionnaire outcomes across the two conditions. Results Participants averaged 2.5 more hours of sleep per night during HS relative to SR. Compared with HS, adolescents rated themselves as significantly more tense/anxious, angry/hostile, confused, and fatigued, and as less vigorous (p = .001–.01) during SR. Parents and adolescents also reported greater oppositionality/irritability and poorer emotional regulation during SR compared with HS (p < .05). There were no cross‐condition differences in depression or hyperactivity/impulsivity (p > .05). Conclusions Findings complement prior correlational study results to show that after only a few days of shortened sleep, at a level of severity that is experienced regularly by millions of adolescents on school nights, adolescents have worsened mood and decreased ability to regulate negative emotions.
    July 30, 2013   doi: 10.1111/jcpp.12125   open full text
  • Exploring anxiety symptoms in a large‐scale twin study of children with autism spectrum disorders, their co‐twins and controls.
    Victoria Hallett, Angelica Ronald, Emma Colvert, Catherine Ames, Emma Woodhouse, Stephanie Lietz, Tracy Garnett, Nicola Gillan, Fruhling Rijsdijk, Lawrence Scahill, Patrick Bolton, Francesca Happé.
    Journal of Child Psychology and Psychiatry. July 30, 2013
    Background Although many children with autism spectrum disorders (ASDs) experience difficulties with anxiety, the manifestation of these difficulties remains unresolved. The current study assessed anxiety in a large population‐based twin sample, aged 10–15 years. Phenotypic analyses were used to explore anxiety symptoms in children with ASDs, their unaffected co‐twins and a control sample. Methods Participants included 146 families from the Twins Early Development Study (TEDS) where one or both children had a suspected ASD. Eighty control families were also included. The Revised Child Anxiety and Depression scale (Chorpita, Yim, Moffitt, Umemoto & Francis, 2000) was completed (self‐ and parent‐report), along with diagnostic and cognitive tests. Children were categorized into four groups (a) ASD (b) Broader Autism Phenotype (BAP: mainly co‐twins of children with ASDs, with high subclinical autistic traits) (c) unaffected co‐twins (with neither ASDs nor BAP) (d) controls. Results Children in the ASD and BAP groups scored significantly higher than controls for all parent‐rated (although not child‐rated) anxiety subscales. There were no significant differences between the ASD and BAP groups for any of the parent‐rated anxiety subscales. Compared with controls, unaffected co‐twins showed significantly heightened Social Anxiety, Generalized Anxiety, and Panic symptoms. Significant associations were observed between certain anxiety subscales and both IQ and ASD symptoms. For example, greater parent‐rated Social Anxiety was associated with higher IQ and increased social and communicative impairments. Significant interrater correlations were observed for anxiety reports in children with ASDs (r = .27–.54; p < .01), their unaffected co‐twins (r = .32–.63; p < .01) and controls (r = .23–.43; p < .01) suggesting that children in this sample with and without ASD symptoms were able to report on their anxiety symptoms with some accuracy. Conclusions These findings support previous reports of heightened anxiety in children with ASDs, at least on parent‐reported measures. Unaffected co‐twins of children with ASDs also showed increased anxiety, generating questions about the potential etiological overlap between ASDs and anxiety. Progress in this area now depends on more refined anxiety measurement in ASDs and continued investigation of interrater differences.
    July 30, 2013   doi: 10.1111/jcpp.12068   open full text
  • Increased freezing and decreased positive affect in postinstitutionalized children.
    Sarah Stellern, Elisa Esposito, Shanna Mliner, Katherine Pears, Megan Gunnar.
    Journal of Child Psychology and Psychiatry. July 30, 2013
    Background Early neglect is associated with increased risk of internalizing disorders in humans and with increased fear behavior in animals. When children are adopted out of orphanages in which they experienced institutional neglect, anxiety and depressive disorders often are not seen until adolescence. What has not been examined is whether even young children adopted from institutional care exhibit heightened fear or behavioral inhibition. Method Children adopted between 15 and 35 months from institutional care were examined twice during their first year postadoption and compared with children of the same age reared in their birth families. A modified version of the Laboratory Temperament Assessment Battery for Preschoolers was used with the children being exposed to two mechanical toys designed to be highly arousing and fear eliciting. Because children in institutions tend to exhibit low levels of positive affect, the children were also examined during exposure to two positive stimuli. Sessions were videotaped and coded by observers blind to the study purpose. Results Postinstitutionalized children froze more in fear vignettes and were less positive in both fear and positive vignettes than nonadopted children. Group differences did not diminish significantly from the first session to the next, 6 months later. Conclusions Children exposed to early institutional neglect exhibit emotional biases that are consistent with their previously demonstrated risk for the development of internalizing disorders.
    July 30, 2013   doi: 10.1111/jcpp.12123   open full text
  • Preschool predictors of childhood anxiety disorders: a prospective community study.
    Lars Wichstrøm, Jay Belsky, Turid Suzanne Berg‐Nielsen.
    Journal of Child Psychology and Psychiatry. July 15, 2013
    Background Anxiety disorders are often present at preschool age. Research on older children and studies contrasting preschoolers with high versus low behavioral inhibition (BI) highlight several risk factors, but these have not been investigated in community samples of young children. Child, parent, and peer factors at age 4 were therefore examined as potential predictors of anxiety disorders at age 6. Methods Two birth cohorts of 4‐year olds living in the city of Trondheim, Norway, were screened for emotional and behavioral problems. A subsample oversampled for emotional and behavioral problems were drawn to take part in the study; 82.1% consented. Parents of 1000 children were interviewed with the Preschool Age Psychiatric Assessment and provided ratings of children's BI, victimization by peers and their own anxiety symptoms. Assessments of attachment and parent–child interaction were based on observation. Preschool teachers rated children's social competence. Children were reassessed after 2 years (N = 797). Results High scores on BI, attention‐deficient/hyperactivity disorder, parental anxiety, and peer victimization, along with low scores on social skills at age 4 collectively predicted anxiety disorders at age 6 after controlling for initial anxiety and other disorders. The effect of parental anxiety did only apply to children with high levels of BI. No effects of age‐4 anxiety, gender, parenting, parental SES, divorce, peer acceptance, or attachment emerged. Conclusions Behavioral inhibition, parental anxiety, and peer victimization function as risk factors whereas high social competence may protect against anxiety disorders in young children.
    July 15, 2013   doi: 10.1111/jcpp.12116   open full text
  • Cognitive and behavioral indicators of ADHD symptoms prior to school age.
    Anne Bernard Arnett, Beatriz MacDonald, Bruce F. Pennington.
    Journal of Child Psychology and Psychiatry. July 15, 2013
    Background Previous research on the etiology of ADHD symptoms suggests that neuropsychological differences may be present as early as birth; however, the diagnosis is typically not given until school age. This study aimed to (a) identify early behavioral and cognitive markers of later significant parent and/or teacher ratings of ADHD symptomology, (b) examine sex differences in these predictors, and (c) describe the developmental trajectories of comorbid symptoms in school‐aged children. Methods 1,106 children and at least one parent enrolled in the NICHD Study of Early Child Care and Youth Development were followed from 1 month of age through 6th grade. Effect size calculations, discriminant function analysis, and growth curve analyses were conducted to address the three aims. Results Children with high‐ versus low‐ADHD symptomology at 3rd grade could be distinguished using cognitive and behavioral measures as early as 15 months (females) and 24 months (males). Sensitivity and specificity were modest at 15, 24, and 26 months. Growth curves revealed significant differences between high‐ and low‐ADHD groups in comorbid symptoms at kindergarten and significantly different slopes for externalizing, social skills, and academic skills ratings across elementary school. There were few gender differences on cognitive and behavioral variables within the high‐ADHD group. Conclusions Cognitive and behavioral markers of ADHD symptoms are present in children prior to entry into formal schooling, but current behavioral screeners are not developmentally sensitive to these differences in infancy and toddlerhood.
    July 15, 2013   doi: 10.1111/jcpp.12104   open full text
  • Cognitive and language skills in adults with autism: a 40‐year follow‐up.
    Patricia Howlin, Sarah Savage, Philippa Moss, Althea Tempier, Michael Rutter.
    Journal of Child Psychology and Psychiatry. July 15, 2013
    Background It is well established that very few individuals with autism spectrum disorders (ASD) and an IQ below 70 are able to live independently as adults. However, even amongst children with an IQ in the normal range, outcome is very variable. Childhood factors that predict later stability, improvement or decline in cognitive functioning remain uncertain and, in particular, very little is known about trajectories in later adulthood. Method Changes in cognitive and language ability from childhood to adulthood were assessed in 60 individuals with autism, all of whom had an IQ in the average range as children. Mean age in childhood = 6 years (range 2–13 years); mean age in adulthood = 44 years (range 29–64 years). Trajectories of change and factors related to current cognitive abilities were explored. Results For the majority of participants (N = 45, 75%), who were testable both as children and adults, IQ remained very stable and language also improved over time. However, 15 individuals could not be assessed on standard tests as adults and their developmental level could be estimated only on the Vineland Adaptive Behavior Scales. Almost all these adults (apart from one who had suffered a major stroke) showed severe aggressive or self‐injurious behaviours; none had ever developed language above a 3‐year level, and seven had developed epilepsy. Conclusions For most individuals with autism who had an IQ in the average range (i.e. ≥70) as children, childhood IQ proved a reliable predictor of cognitive functioning well into mid‐ to‐ later adulthood. However, a significant minority was no longer testable on standard tests as adults. Their current very low levels of functional ability were generally associated with severe behavioural disturbance and persisting and severe language impairment; 50% of these individuals had also developed epilepsy, pointing to the role of organic brain dysfunction. Implications for early intervention are discussed.
    July 15, 2013   doi: 10.1111/jcpp.12115   open full text
  • Internal working models and adjustment of physically abused children: the mediating role of self‐regulatory abilities.
    Amy L. Hawkins, Mary E. Haskett.
    Journal of Child Psychology and Psychiatry. July 15, 2013
    Background Abused children's internal working models (IWM) of relationships are known to relate to their socioemotional adjustment, but mechanisms through which negative representations increase vulnerability to maladjustment have not been explored. We sought to expand the understanding of individual differences in IWM of abused children and investigate the mediating role of self‐regulation in links between IWM and adjustment. Methods Cluster analysis was used to subgroup 74 physically abused children based on their IWM. Internal working models were identified by children's representations, as measured by a narrative story stem task. Self‐regulation was assessed by teacher report and a behavioral task, and adjustment was measured by teacher report. Results Cluster analyses indicated two subgroups of abused children with distinct patterns of IWMs. Cluster membership predicted internalizing and externalizing problems. Associations between cluster membership and adjustment were mediated by children's regulation, as measured by teacher reports of many aspects of regulation. There was no support for mediation when regulation was measured by a behavioral task that tapped more narrow facets of regulation. Conclusions Abused children exhibit clinically relevant individual differences in their IWMs; these models are linked to adjustment in the school setting, possibly through children's self‐regulation.
    July 15, 2013   doi: 10.1111/jcpp.12118   open full text
  • The interacting effect of the BDNF Val66Met polymorphism and stressful life events on adolescent depression is not an artifact of gene–environment correlation: evidence from a longitudinal twin study.
    Jie Chen, Xinying Li, Matt McGue.
    Journal of Child Psychology and Psychiatry. July 12, 2013
    Background Confounding introduced by gene–environment correlation (rGE) may prevent one from observing a true gene–environment interaction (G × E) effect on psychopathology. The present study investigated the interacting effect of the BDNF Val66Met polymorphism and stressful life events (SLEs) on adolescent depression while controlling for the rGE by two means: separating pure environmental factors (independent SLEs) from the environmental factors under partial genetic control (dependent SLEs) and adopting a prospective longitudinal design. Methods A total of 780 pairs of Chinese twins, aged 11–17 years (mean = 13.6, SD = 1.8) at intake, were followed up twice. Self‐reported depression symptoms at Time 1 and Time 2 were assessed by the Children's Depression Inventory (CDI). SLEs occurring between Time 1 and Time 2 were assessed by a self‐reported checklist. SLEs were differentiated into independent and dependent ones and were validated by heritability analyses using twin design. The interacting effects between the BDNF Val66Met polymorphism and numbers of SLEs (total SLEs and independent SLEs) on intraindividual change of depression symptoms were examined. Results After controlling for sex, age, age square, and Time 1 depression, both total SLEs × BDNF Val66Met genotype and independent SLEs × BDNF Val66Met genotype significantly predicted Time 2 depression. Val allele carriers (Val/Val and Val/Met) were more susceptible to the detrimental effects of stress. Conclusions There is a true G × E effect underlying the observed interaction between BDNF Val66Met polymorphism and environmental stress on depression.
    July 12, 2013   doi: 10.1111/jcpp.12099   open full text
  • Research Review: Evaluating and reformulating the developmental taxonomic theory of antisocial behaviour.
    Graeme Fairchild, Stephanie H.M. Goozen, Andrew J. Calder, Ian M. Goodyer.
    Journal of Child Psychology and Psychiatry. July 04, 2013
    Background The developmental taxonomic theory proposes that there are two subtypes of antisocial behaviour. The first is a neurodevelopmental disorder which emerges in early childhood and follows a life‐course persistent course, whereas the second emerges in adolescence, remits in early adulthood and reflects peer processes such as mimicry of antisocial peers. The aim of this review was to evaluate the developmental taxonomic theory in the light of recent empirical research. Methods We conducted a comprehensive literature review comparing these subtypes of antisocial behaviour based on searches on PubMed and other scientific databases covering the period from 1993 to 2013. We focused on research encompassing psychiatric epidemiology, personality assessment, neuropsychology, neuroendocrinology, genetics, and structural and functional neuroimaging. Sixty one empirical studies were identified that investigated one of these forms of antisocial behaviour separately or explicitly compared childhood‐onset and adolescence‐onset forms of antisocial behaviour. Results Empirical research provides support for the hypothesis that life‐course persistent antisocial behaviour is a neurodevelopmental disorder which emerges in the transactions between individual vulnerabilities and environmental adversity. In contrast to the developmental taxonomic theory, however, empirical findings suggest that severe antisocial behaviour that emerges in adolescence frequently has a negative prognosis and is rarely limited to the adolescent period. In addition, both forms of antisocial behaviour are associated with emotion processing deficits, changes in brain structure and function, alterations in cortisol secretion, and atypical personality traits (such as increased callous‐unemotional traits). Conclusions We conclude that the developmental taxonomic theory is in need of revision, as differences between life‐course persistent and adolescence‐onset forms of antisocial behaviour appear to be quantitative, rather than qualitative, in nature. In addition, evidence is accumulating that adolescence‐onset antisocial behaviour may also be a neurodevelopmental disorder. To account for the similarities between these groups, despite the differences in their age‐of‐onset, we propose that the quality of the child's early environment moderates the relationship between individual vulnerabilities and the age‐of‐onset of antisocial behaviour.
    July 04, 2013   doi: 10.1111/jcpp.12102   open full text
  • Child anxiety and parenting in England and Italy: the moderating role of maternal warmth.
    Alessandra Raudino, Lynne Murray, Corinne Turner, Eirini Tsampala, Adriana Lis, Leonardo Pascalis, Peter J. Cooper.
    Journal of Child Psychology and Psychiatry. July 04, 2013
    Background Parenting factors have been implicated in the aetiology and maintenance of child anxiety. Most research has been correlational with little experimental or longitudinal work. Cross‐cultural comparison could be illuminating. A comparison of Italian and British children and their mothers was conducted. Methods A sample of 8‐ to 10‐year old children, 60 Italian and 49 English, completed the Spence Child Anxiety Scale. Mothers also completed two questionnaires of parenting: the Skills of Daily Living Checklist (assessing maternal autonomy granting) and the Parent–Child Interaction Questionnaire (assessing maternal intrusiveness). Parenting was assessed in two video‐recorded blindly rated mother–child interaction tasks, the ‘belt‐buckling tasks and the ‘etch‐a‐sketch’, providing objective indices of overcontrol, warmth, lack of autonomy granting, and overprotection. Results There were no differences between the children in overall anxiety and specific forms of anxiety. Parenting, however, was markedly different for the two countries. Compared to English mothers, on the two questionnaires, Italian mothers were significantly less autonomy granting and more intrusive; and in terms of the observed indices, a significantly greater proportion of the Italian mothers displayed a high level of both overprotection and overcontrol, and a low level of autonomy granting. Notably, Italian mothers evidenced significantly more warmth than English mothers; and maternal warmth was found to moderate the impact of self‐reported maternal intrusiveness on the level of both overall child anxiety and the level of child separation anxiety; and it also moderated the relationship between both observed maternal intrusiveness and overall child anxiety and observed maternal overprotectiveness and child separation anxiety. Conclusions Although, compared to the British mothers, the Italian mothers were more likely to evidence high levels of parenting behaviours previously found to be anxiogenic, the high levels of warmth displayed by these mothers to their children appears to have neutralised the adverse impact of these behaviours.
    July 04, 2013   doi: 10.1111/jcpp.12105   open full text
  • Gene variants associated with antisocial behaviour: a latent variable approach.
    Mary Jane Bentley, Haiqun Lin, Thomas V. Fernandez, Maria Lee, Carolyn M. Yrigollen, Andrew J. Pakstis, Liliya Katsovich, David L. Olds, Elena L. Grigorenko, James F. Leckman.
    Journal of Child Psychology and Psychiatry. July 03, 2013
    Objective The aim of this study was to determine if a latent variable approach might be useful in identifying shared variance across genetic risk alleles that is associated with antisocial behaviour at age 15 years. Methods Using a conventional latent variable approach, we derived an antisocial phenotype in 328 adolescents utilizing data from a 15‐year follow‐up of a randomized trial of a prenatal and infancy nurse‐home visitation programme in Elmira, New York. We then investigated, via a novel latent variable approach, 450 informative genetic polymorphisms in 71 genes previously associated with antisocial behaviour, drug use, affiliative behaviours and stress response in 241 consenting individuals for whom DNA was available. Haplotype and Pathway analyses were also performed. Results Eight single‐nucleotide polymorphisms (SNPs) from eight genes contributed to the latent genetic variable that in turn accounted for 16.0% of the variance within the latent antisocial phenotype. The number of risk alleles was linearly related to the latent antisocial variable scores. Haplotypes that included the putative risk alleles for all eight genes were also associated with higher latent antisocial variable scores. In addition, 33 SNPs from 63 of the remaining genes were also significant when added to the final model. Many of these genes interact on a molecular level, forming molecular networks. The results support a role for genes related to dopamine, norepinephrine, serotonin, glutamate, opioid and cholinergic signalling as well as stress response pathways in mediating susceptibility to antisocial behaviour. Conclusions This preliminary study supports use of relevant behavioural indicators and latent variable approaches to study the potential ‘co‐action’ of gene variants associated with antisocial behaviour. It also underscores the cumulative relevance of common genetic variants for understanding the aetiology of complex behaviour. If replicated in future studies, this approach may allow the identification of a ‘shared’ variance across genetic risk alleles associated with complex neuropsychiatric dimensional phenotypes using relatively small numbers of well‐characterized research participants.
    July 03, 2013   doi: 10.1111/jcpp.12109   open full text
  • Candidate gene associations with withdrawn behavior.
    David H. Rubin, Robert R. Althoff, Erik A. Ehli, Gareth E. Davies, David C. Rettew, Eileen T. Crehan, John T. Walkup, James J. Hudziak.
    Journal of Child Psychology and Psychiatry. June 28, 2013
    Background Social withdrawal is a core neuropsychiatric phenomenon in developmental psychopathology. Its presence predicts psychopathology across many domains, including depression, psychosis, autism, anxiety, and suicide. Withdrawn behavior is highly heritable, persistent, and characteristically worsens without intervention. To date, few studies have successfully identified genetic associations with withdrawn behavior, despite the abundance of evidence of its heritability. This may be due to reliance of categorical over dimensional measures of the behaviorally inhibited phenotype. The aim of this study is to identify associations between known psychiatric candidate genes and a dimensionally derived measure of withdrawn behavior. Methods Genetic information was collected on 20 single‐nucleotide polymorphisms (SNPs) from a custom‐designed SNP chip and TAQMAN arrays of 4 variable number of tandem repeat (VNTR) genes for 551 individuals from 187 families. Linear mixed modeling was employed to examine the relationship between genotypes of interest and Child Behavior Checklist (CBCL) Withdrawn Behavior Subscale Score (WBS) while controlling for gender and age through multiple linear regressions. Results Withdrawn behavior was highly associated with polymorphism rs6314 of the serotonin receptor 2A (HTR2A) [p = .009, estimate = 0.310 (bootstrap 95% CI 0.155–0.448), bootstrap p = .001] and rs1800544 of the alpha 2‐adrenergic (ADRA2A) [p = .001, estimate = −0.310 (bootstrap 95% CI −0.479 to −0.126), bootstrap p = .001] genes after correction for gender and age. The association between withdrawn behavior and ADRA2A was stronger for younger children. Conclusions HTR2A and ADRA2A genes are associated with withdrawn behavior. This reinforces the role of catecholaminergic genes in the heritability of withdrawn behavior.
    June 28, 2013   doi: 10.1111/jcpp.12108   open full text
  • Gene–environment interactions in genome‐wide association studies: current approaches and new directions.
    Stacey J. Winham, Joanna M. Biernacka.
    Journal of Child Psychology and Psychiatry. June 28, 2013
    Background Complex psychiatric traits have long been thought to be the result of a combination of genetic and environmental factors, and gene–environment interactions are thought to play a crucial role in behavioral phenotypes and the susceptibility and progression of psychiatric disorders. Candidate gene studies to investigate hypothesized gene–environment interactions are now fairly common in human genetic research, and with the shift toward genome‐wide association studies, genome‐wide gene–environment interaction studies are beginning to emerge. Methods We summarize the basic ideas behind gene–environment interaction, and provide an overview of possible study designs and traditional analysis methods in the context of genome‐wide analysis. We then discuss novel approaches beyond the traditional strategy of analyzing the interaction between the environmental factor and each polymorphism individually. Results Two‐step filtering approaches that reduce the number of polymorphisms tested for interactions can substantially increase the power of genome‐wide gene–environment studies. New analytical methods including data‐mining approaches, and gene‐level and pathway‐level analyses, also have the capacity to improve our understanding of how complex genetic and environmental factors interact to influence psychologic and psychiatric traits. Such methods, however, have not yet been utilized much in behavioral and mental health research. Conclusions Although methods to investigate gene–environment interactions are available, there is a need for further development and extension of these methods to identify gene–environment interactions in the context of genome‐wide association studies. These novel approaches need to be applied in studies of psychology and psychiatry.
    June 28, 2013   doi: 10.1111/jcpp.12114   open full text
  • Maternal depression and co‐occurring antisocial behaviour: testing maternal hostility and warmth as mediators of risk for offspring psychopathology.
    Ruth Sellers, Gordon T. Harold, Kit Elam, Kimberly A. Rhoades, Robert Potter, Becky Mars, Nick Craddock, Anita Thapar, Stephan Collishaw.
    Journal of Child Psychology and Psychiatry. June 27, 2013
    Background Disruption in the parent–child relationship is a commonly hypothesized risk factor through which maternal depression may increase risk for offspring psychopathology. However, maternal depression is commonly accompanied by other psychopathology, including antisocial behaviour. Few studies have examined the role of co‐occurring psychopathology in depressed mothers. Using a longitudinal study of offspring of mothers with recurrent depression, we aimed to test whether maternal warmth/hostility mediated links between maternal depression severity and child outcomes, and how far direct and indirect pathways were robust to controls for co‐occurring maternal antisocial behaviour. Methods Mothers with a history of recurrent major depressive disorder and their adolescent offspring (9–17 years at baseline) were assessed three times between 2007 and 2010. Mothers completed questionnaires assessing their own depression severity and antisocial behaviour at Time 1 (T1). The parent–child relationship was assessed using parent‐rated questionnaire and interviewer‐rated 5‐min speech sample at Time 2 (T2). Offspring symptoms of depression and disruptive behaviours were assessed using the Child and Adolescent Psychiatric Assessment at Time 3 (T3). Results Maternal hostility and warmth, respectively, mediated the association between maternal depression severity and risk for offspring psychopathology. However, the effects were attenuated when maternal antisocial behaviour was included in the analysis. In tests of the full theoretical model, maternal antisocial behaviour predicted both maternal hostility and low warmth, maternal hostility predicted offspring disruptive behaviour disorder symptoms, but not depression, and maternal warmth was not associated with either child outcome. Conclusions Parenting interventions aimed at reducing hostility may be beneficial for preventing or reducing adolescent disruptive behaviours in offspring of depressed mothers, especially when depressed mothers report co‐occurring antisocial behaviour.
    June 27, 2013   doi: 10.1111/jcpp.12111   open full text
  • Childhood psychopathology in children of women with eating disorders: understanding risk mechanisms.
    Nadia Micali, Daniel Stahl, Janet Treasure, Emily Simonoff.
    Journal of Child Psychology and Psychiatry. June 27, 2013
    Background Very few studies have investigated psychopathology in children of mothers with eating disorders (ED). We aimed to determine the effect of maternal ED on childhood psychopathology in a large population‐based cohort and investigate relevant risk pathways using structural equation modeling (SEM). Methods Data on emotional and behavioral problems at 3½ years were obtained prospectively on 8,622 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Children of exposed women who self‐reported lifetime anorexia nervosa (AN, N = 193) or bulimia nervosa (BN, N = 158) in pregnancy were compared with children of unexposed women (N = 8,271) using linear and logistic regression models. SEM was used to determine best‐fitting risk models by child gender. Results There was evidence that girls of AN women were more likely to have emotional, conduct, and hyperactivity disorders [Odds Ratio (OR): 1.7 (95% Confidence Intervals 1.0–3.0); OR: 2.2 (1.2–4.0); OR: 1.8 (1.1–3.1), respectively] and boys of AN women to have emotional disorders compared with unexposed [OR: 2.0(1.2–3.4)]. Girls of women with BN were more likely to show hyperactivity [OR: 1.7 (1.0–3.1)]; and boys to show emotional and conduct disorders compared with unexposed [OR: 2.2 (1.2–3.9); OR: 2.4 (1.4–4.2), respectively]. SEM models showed that pregnancy anxiety and depression mediated the effect of maternal ED on child psychopathology. Conclusions Maternal ED are associated with different childhood psychopathology outcomes in boys and girls. Pregnancy anxiety and depression and active ED symptoms are important mediators of risk and are preventable; the direct effect of maternal lifetime ED was small.
    June 27, 2013   doi: 10.1111/jcpp.12112   open full text
  • Preschool language profiles of children at family risk of dyslexia: continuities with specific language impairment.
    Hannah M. Nash, Charles Hulme, Debbie Gooch, Margaret J. Snowling.
    Journal of Child Psychology and Psychiatry. June 18, 2013
    Background Children at family risk of dyslexia have been reported to show phonological deficits as well as broader language delays in the preschool years. Method The preschool language skills of 112 children at family risk of dyslexia (FR) at ages 3½ and 4½ were compared with those of children with SLI and typically developing (TD) controls. Results Children at FR showed two different profiles: one third of the group resembled the children with SLI and scored poorly across multiple domains of language including phonology. As a group, the remaining children had difficulties on tasks tapping phonological skills at T1 and T2. At the individual level, we confirmed that some FR children had both phonological and broader oral language difficulties (compared with TD controls), some had only phonological difficulties and some appeared to be developing typically. Conclusions We have highlighted the early overlap between family risk of dyslexia and SLI. A family history of dyslexia carries an increased risk for SLI and the two disorders both show an increased incidence of phonological deficits which appear to a proximal risk factor for developing a reading impairment.
    June 18, 2013   doi: 10.1111/jcpp.12091   open full text
  • Predicting outcomes following cognitive behaviour therapy in child anxiety disorders: the influence of genetic, demographic and clinical information.
    Jennifer L. Hudson, Kathryn J. Lester, Cathryn M. Lewis, Maria Tropeano, Cathy Creswell, David A. Collier, Peter Cooper, Heidi J. Lyneham, Talia Morris, Ronald M. Rapee, Susanna Roberts, Jennifer A. Donald, Thalia C. Eley.
    Journal of Child Psychology and Psychiatry. June 18, 2013
    Background Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; 5HTTLPR and marker rs6330 in Nerve Growth Factor gene; NGF is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety disorders. The aim of this study was to explore one potential means of extending the translational reach of G × E data in a way that may be clinically informative. We describe a ‘risk‐index’ approach combining genetic, demographic and clinical data and test its ability to predict diagnostic outcome following CBT in anxious children. Method DNA and clinical data were collected from 384 children with a primary anxiety disorder undergoing CBT. We tested our risk model in five cross‐validation training sets. Results In predicting treatment outcome, six variables had a minimum mean beta value of 0.5:5HTTLPR, NGF rs6330, gender, primary anxiety severity, comorbid mood disorder and comorbid externalising disorder. A risk index (range 0–8) constructed from these variables had moderate a predictive ability (AUC = .62–.69) in this study. Children scoring high on this index (5–8) were approximately three times as likely to retain their primary anxiety disorder at follow‐up as compared with those children scoring 2 or less. Conclusion Significant genetic, demographic and clinical predictors of outcome following CBT for anxiety‐disordered children were identified. Combining these predictors within a risk index could be used to identify which children are less likely to be diagnosis‐free following CBT alone and require longer or enhanced treatment. The ‘risk‐index’ approach represents one means of harnessing the translational potential of G × E data.
    June 18, 2013   doi: 10.1111/jcpp.12092   open full text
  • Evidence for interplay between genes and parenting on infant temperament in the first year of life: monoamine oxidase A polymorphism moderates effects of maternal sensitivity on infant anger proneness.
    Andrew Pickles, Jonathan Hill, Gerome Breen, John Quinn, Kate Abbott, Helen Jones, Helen Sharp.
    Journal of Child Psychology and Psychiatry. June 06, 2013
    Background The low expression polymorphism of the MAOA gene in interaction with adverse environments (G × E) is associated with antisocial behaviour disorders. These have their origins in early life, but it is not known whether MAOA G × E occurs in infants. We therefore examined whether MAOA G × E predicts infant anger proneness, a temperamental dimension associated with later antisocial behaviour disorders. In contrast to previous studies, we examined MAOA G × E prospectively using an observational measure of a key aspect of the infant environment, maternal sensitivity, at a specified developmental time point. Methods In a stratified epidemiological cohort recruited during pregnancy, we ascertained MAOA status (low vs. high expression alleles) from the saliva of 193 infants, and examined specific predictions to maternal report of infant temperament at 14 months from maternal sensitivity assessed at 29 weeks of age. Results Analyses, weighted to provide general population estimates, indicated a robust interaction between MAOA status and maternal sensitivity in the prediction of infant anger proneness (p = .003) which became stronger once possible confounders for maternal sensitivity were included in the model (p = .0001). The interaction terms were similar in males (p = .010) and females (p = .016), but the effects were different as a consequence of an additional sex of infant by maternal sensitivity interaction. Conclusions This prospective study provides the first evidence of moderation by the MAOA gene of effects of parenting on infant anger proneness, an important early risk for the development of disruptive and aggressive behaviour disorders.
    June 06, 2013   doi: 10.1111/jcpp.12081   open full text
  • Group trauma‐focused cognitive‐behavioural therapy with former child soldiers and other war‐affected boys in the DR Congo: a randomised controlled trial.
    John McMullen, Paul O'Callaghan, Ciaran Shannon, Alastair Black, John Eakin.
    Journal of Child Psychology and Psychiatry. June 06, 2013
    Background The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group‐based mental health or psychosocial intervention has been evaluated in a randomised controlled trial for psychologically distressed former child soldiers. Method A randomised controlled trial involving 50 boys, aged 13–17, including former child soldiers (n = 39) and other war‐affected boys (n = 11). They were randomly assigned to an intervention group, or wait‐list control group. The intervention group received a 15‐session, group‐based, culturally adapted Trauma‐Focused Cognitive–Behavioural Therapy (TF‐CBT) intervention. Assessment interviews were completed at baseline, postintervention and 3‐month follow‐up (intervention group). Results Analysis of Covariance (ANCOVA) demonstrated that, in comparison to the wait‐list control group, the TF‐CBT intervention group had highly significant reductions in posttraumatic stress symptoms, overall psychosocial distress, depression or anxiety‐like symptoms, conduct problems and a significant increase in prosocial behaviour (p < .001 for all). Effect sizes were higher when former child soldier scores were separated for sub‐analysis. Three‐month follow‐up of the intervention group found that treatment gains were maintained. Conclusions A culturally modified, group‐based TF‐CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child soldiers and other war‐affected boys.
    June 06, 2013   doi: 10.1111/jcpp.12094   open full text
  • Research Review: The role of cytokines in depression in adolescents: a systematic review.
    Natalie T. Mills, James G. Scott, Naomi R. Wray, Sarah Cohen‐Woods, Bernhard T. Baune.
    Journal of Child Psychology and Psychiatry. June 04, 2013
    Background While cytokines have been implicated in the pathophysiology of depression in adults, the potential role in younger age groups such as adolescents is less clear. This article therefore reviews the literature (a) to explore the relationship between cytokines and depression in adolescents, and (b) to examine how cytokines may be related to adolescent depression in the context of other neurobiological theories of depression. Method A systematic review of the scientific literature on the subject was conducted in February 2013, searching the Web of Knowledge, PubMed (Medline), PsycInfo and Cochrane electronic databases. Results Eighteen studies were identified measuring both depression or depressive symptoms and cytokines or immune markers in adolescents. Adolescents with depression show age‐specific characteristics of the immune and inflammatory system, specifically in NK cell activity and in pro‐inflammatory cytokines (such as IL‐1β and TNF‐α). In addition, the role of cytokines in adolescent depression is influenced by neurodevelopment, hormonal changes, stress and trauma. Conclusions There may be differences in the neurobiology of adolescent major depressive disorder (MDD) compared with adult MDD. Increased understanding of the role of cytokines in adolescent MDD may lead to improved outcomes in the treatment of adolescent depression.
    June 04, 2013   doi: 10.1111/jcpp.12080   open full text
  • Sweating under pressure: skin conductance level reactivity moderates the association between peer victimization and externalizing behavior.
    Kim D. Gregson, Kelly M. Tu, Stephen A. Erath.
    Journal of Child Psychology and Psychiatry. June 04, 2013
    Background This study examined whether the association between peer victimization and externalizing behavior may be illuminated by individual differences in skin conductance level reactivity (SCLR) in the context of peer stress. Methods Participants included 123 fifth and sixth graders (Mean age = 12.03 years, 50% females; 42% ethnic minorities). SCLR was assessed in the context of an ecologically relevant, lab‐based peer‐evaluative stress experience in preadolescence. Results As hypothesized, self‐reported peer victimization was linked with parent‐ and teacher‐reported externalizing behavior, and SCLR consistently moderated these associations. Peer victimization was associated with parent‐ and teacher‐reported externalizing behavior among preadolescents who exhibited lower SCLR, but not among preadolescents who exhibited higher SCLR. Conclusions Results suggest that promoting engagement with peer stress experiences and enhancing inhibitory control are potential intervention targets that may reduce externalizing behavior in the context of peer victimization (or reduce peer victimization among preadolescents who exhibit externalizing behavior).
    June 04, 2013   doi: 10.1111/jcpp.12086   open full text
  • Evidence for shared genetic risk between ADHD symptoms and reduced mathematics ability: a twin study.
    Corina U. Greven, Yulia Kovas, Erik G. Willcutt, Stephen A. Petrill, Robert Plomin.
    Journal of Child Psychology and Psychiatry. June 03, 2013
    Background Attention‐deficit/hyperactivity disorder (ADHD) symptoms and mathematics ability are associated, but little is known about the genetic and environmental influences underlying this association. Methods Data came from more than 6,000 twelve‐year‐old twin pairs from the UK population‐representative Twins Early Development Study. Parents rated each twin's behaviour using a DSM‐IV‐based 18‐item questionnaire of inattentive and hyperactive–impulsive ADHD symptoms. Mathematics tests based on the UK National Curriculum were completed by each twin. The twins also completed standardised tests of reading and general cognitive ability. Multivariate twin model fitting was applied. Results Inattentive and hyperactive–impulsive ADHD symptoms were highly heritable (67% and 73% respectively). Mathematics ability was moderately heritable (46%). Mathematics ability and inattentiveness showed a significantly greater phenotypic correlation (rp = −.26) and genetic correlation (rA = −.41) than mathematics ability and hyperactivity–impulsivity (rp = −.18; rA = −.22). The genetic correlation between inattentiveness and mathematics ability was largely independent from hyperactivity‐impulsivity, and was only partially accounted for by genetic influences related to reading and general cognitive ability. Conclusions Results revealed the novel finding that mathematics ability shows significantly stronger phenotypic and genetic associations with inattentiveness than with hyperactivity–impulsivity. Genetic associations between inattentiveness and mathematics ability could only partially be accounted for by hyperactivity–impulsivity, reading and general cognitive ability. Results suggest that mathematics ability is associated with ADHD symptoms largely because it shares genetic risk factors with inattentiveness, and provide further evidence for considering inattentiveness and hyperactivity–impulsivity separately. DNA markers for ADHD symptoms (especially inattentiveness) may also be candidate risk factors for mathematics ability and vice versa.
    June 03, 2013   doi: 10.1111/jcpp.12090   open full text
  • Genetic contributions to continuity and change in attachment security: a prospective, longitudinal investigation from infancy to young adulthood.
    K. Lee Raby, Dante Cicchetti, Elizabeth A. Carlson, Byron Egeland, W. Andrew Collins.
    Journal of Child Psychology and Psychiatry. June 03, 2013
    Background Longitudinal research has demonstrated that individual differences in attachment security show only modest continuity from infancy to adulthood. Recent findings based on retrospective reports suggest that individuals' genetic variation may moderate the developmental associations between early attachment–relevant relationship experiences and adult attachment security. The purpose of this study was to use a prospective, longitudinal design to investigate genetic contributions to continuity and changes in attachment security from infancy to young adulthood in a higher risk sample. Methods Infant attachment security was assessed using the Strange Situation Procedure at 12 and 18 months. Adults' general attachment representations were assessed using the Adult Attachment Interview at ages 19 and 26. Romantic attachment representations were assessed with the Current Relationship Interview (CRI) at ages 20–21 and ages 26–28. Individuals were genotyped for variants within the oxytocin receptor (OXTR), dopamine D4 receptor (DRD4), and serotonin transporter linked polymorphic region (5‐HTTLPR) . Results The continuity of attachment security from infancy into young adulthood was consistently moderated by OXTR genetic variation. Infant attachment security predicted the security of adults' general and romantic attachment representations only for individuals with the OXTR G/G genotype. This interaction was significant when predicting adult attachment security as measured by the Adult Attachment Interview at ages 19 and 26 and the CRI at ages 26–28. Dopamine D4 receptor and 5‐HTTLPR genetic variation did not consistently moderate the longitudinal associations between attachment security during infancy and adulthood. Conclusions This study provides initial longitudinal evidence for genetic contributions to continuity and change in attachment security from infancy to young adulthood. Genetic variation related to the oxytocin system may moderate the stability of attachment security across development.
    June 03, 2013   doi: 10.1111/jcpp.12093   open full text
  • Asthma and attention‐deficit/hyperactivity disorder: a nationwide population‐based prospective cohort study.
    Mu‐Hong Chen, Tung‐Ping Su, Ying‐Sheue Chen, Ju‐Wei Hsu, Kai‐Lin Huang, Wen‐Han Chang, Tzeng‐Ji Chen, Ya‐Mei Bai.
    Journal of Child Psychology and Psychiatry. June 03, 2013
    Background Previous cross‐sectional studies have suggested an association between asthma and attention‐deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population‐based prospective case–control cohort study (1:4, age‐/gender‐matched), we hypothesized that asthma in infanthood or early childhood would increase the risk of ADHD in later life. Methods In all, 2,294 children with asthma and 9,176 controls aged between 0 and 3 years in 2000 were included in our study. Cases of ADHD that occurred to the end of follow‐up (31 December 2010) were identified. Results Children with asthma had a higher incidence of developing ADHD (7% vs. 4.6%, p < .001) than control cohort during the follow‐up period. After adjusting for age at enrollment, gender, level of urbanization, and comorbid allergic diseases (allergic rhinitis and atopic dermatitis), children with asthma had an elevated risk (HR: 1.31, 95% CI: 1.07–1.59) of developing ADHD compared with control group. Discussion Our prospective study supported a temporal relationship between asthma and ADHD. Asthma in very early life increased the risk of developing ADHD during the school years. Further studies are required to investigate whether the prompt treatment of asthma and comorbid allergic diseases could prevent the development of ADHD or decrease ADHD symptoms.
    June 03, 2013   doi: 10.1111/jcpp.12087   open full text
  • The British Chinese Adoption Study: orphanage care, adoption and mid‐life outcomes.
    Alan Rushton, Margaret Grant, Julia Feast, John Simmonds.
    Journal of Child Psychology and Psychiatry. June 03, 2013
    Background While studies of ex‐orphanage care show adverse effects on development, the longer‐term impact on mid‐life psychosocial functioning and physical health has not been established. Methods Orphanage records provided baseline data on a sample of 100 Hong Kong Chinese girls who were subsequently adopted into the UK. A mid‐life follow‐up using standardised questionnaires and face‐to‐face interviews assessed current circumstances, life satisfaction and mental and physical health outcomes. Comparisons were made with age‐matched UK‐born adopted and nonadopted women. Results Half the group spent between 1 and 2 years in orphanages, average age at adoptive placement was 23 months and 72% participated in the follow‐up. Despite this poor early start, mid‐life outcomes were commensurate with the comparison groups in terms of mental and physical health measures. Serious psychiatric and social difficulties were largely absent. Although the timing and extent of exposure to orphanage care did not influence outcome, participants' reports of poorer quality adoptive family experience and a negative view of their adoption were significantly associated with poorer mental health outcomes (difference in means = 0.76, 95% CI 1.33–0.19, p = .01; difference in means = 1.2, 95% CI 0.68–1.73, p = .01, respectively). Conclusions Moderately depriving orphanage care did not predict enduring adverse consequences in mid‐life but subsequent poor adoption experience was associated with outcome.
    June 03, 2013   doi: 10.1111/jcpp.12088   open full text
  • Maternal warmth and directiveness jointly moderate the etiology of childhood conduct problems.
    S. Alexandra Burt, Ashlea M. Klahr, Michael C. Neale, Kelly L. Klump.
    Journal of Child Psychology and Psychiatry. June 03, 2013
    Background Prior studies exploring gene–environment interactions (GxE) in the development of youth conduct problems (CP) have focused almost exclusively on single‐risk experiences, despite research indicating that the presence of other risk factors and or the absence of protective factors can accentuate the influence of a given risk factor on CP. The goal of the current study was to fill this gap in the literature, evaluating whether risky and protective aspects of parenting might combine to jointly moderate the etiology of CP. Methods The sample consisted of 500 child twin pairs from the Michigan State University Twin Registry (MSUTR). Child CP was assessed using multiple informant reports. Maternal warmth and directiveness were assessed via videotaped dyadic interactions between mothers and each of their twins. Results Biometric GxE analyses revealed that directiveness and warmth did appear to jointly moderate the etiology of CP. In particular, shared environmental influences were accentuated by colder, less directive or ‘less engaged’ mothering, whereas genetic influences were strongest when the child was experiencing warmer, more directive or ‘more authoritative’ mothering. Conclusions Such findings serve to highlight the synergistic effects of risky and protective experiences on child outcomes. They also provide additional empirical support for the bioecological form of GxE, which postulates that, in some cases, genetic influences may be most strongly expressed in the presence of low‐risk environments.
    June 03, 2013   doi: 10.1111/jcpp.12095   open full text
  • Executive function in children and adolescents with posttraumatic stress disorder 4 and 12 months after the Sichuan earthquake in China.
    Rui Yang, Yu‐Tao Xiang, Lan Shuai, Ying Qian, Kelly Y.C. Lai, Gabor S. Ungvari, Helen F.K. Chiu, Yu‐Feng Wang.
    Journal of Child Psychology and Psychiatry. June 03, 2013
    Background While several studies have found executive function deficits in adults and maltreated children with posttraumatic stress disorder (PTSD), there are few data on executive function in children and adolescents with PTSD related to natural disasters. The objective of this study was to test executive function changes over time in children and adolescents with PTSD after a magnitude 8.0 earthquake in Sichuan, China. Method A sample of 34 children and adolescents with diagnosed PTSD following the Sichuan earthquake and 66 matched controls exposed to the same earthquake but without PTSD participated in the study. Executive function was assessed using a battery of interviewer‐rated neuropsychological tests and the guardian‐rated Behavior Rating Scale of Executive Function (BRIEF) at 4‐ and 12‐month after the earthquake. Results Children and adolescents with PTSD performed similar to controls in executive function at 4‐months after the earthquake. Both groups improved significantly in similar domains of cognition during the following 8 months. The PTSD group exhibited daily deficits in emotional control compared with the controls at the 4‐month assessment, but the differences disappeared during the following 8 months. Conclusions Children and adolescents with PTSD related to a natural disaster have deficits only in the emotional control domain of executive function compared with controls exposed to the same disaster, but even these deficits did not persist.
    June 03, 2013   doi: 10.1111/jcpp.12089   open full text
  • Expanding the environment: gene × school‐level SES interaction on reading comprehension.
    Sara A. Hart, Brooke Soden, Wendy Johnson, Christopher Schatschneider, Jeanette Taylor.
    Journal of Child Psychology and Psychiatry. June 01, 2013
    Background Influential work has explored the role of family socioeconomic status (SES) as an environmental moderator of genetic and environmental influences on cognitive outcomes. This work has provided evidence that socioeconomic circumstances differentially impact the heritability of cognitive abilities, generally supporting the bioecological model in that genetic influences are greater at higher levels of family SES. The present work expanded consideration of the environment, using school‐level SES as a moderator of reading comprehension. Methods The sample included 577 pairs of twins from the Florida Twin Project on Reading, Behavior and Environment. Reading comprehension was measured by the Florida Comprehensive Achievement Test (FCAT) Reading in third or fourth grade. School‐level SES was measured by the mean Free and Reduced Lunch Status (FRLS) of the schoolmates of the twins. Results The best‐fitting univariate G × E moderation model indicated greater genetic influences on reading comprehension when fewer schoolmates qualified for FRLS (i.e., ‘higher’ school‐level SES). There was also an indication of moderation of the shared environment; there were greater shared environmental influences on reading comprehension at higher school‐level SES. Conclusions The results supported the bioecological model; greater genetic variance was found in school environments in which student populations experienced less poverty. In general, ‘higher’ school‐level SES allowed genetic and probably shared environmental variance to contribute as sources of individual differences in reading comprehension outcomes. Poverty suppresses these influences.
    June 01, 2013   doi: 10.1111/jcpp.12083   open full text
  • Diagnosing Autism Spectrum Disorder: who will get a DSM‐5 diagnosis?
    Rachel G. Kent, Sarah J. Carrington, Ann Couteur, Judith Gould, Lorna Wing, Jarymke Maljaars, Ilse Noens, Ina Berckelaer‐Onnes, Susan R. Leekam.
    Journal of Child Psychology and Psychiatry. May 23, 2013
    Background Introduction of proposed criteria for DSM‐5 Autism Spectrum Disorder (ASD) has raised concerns that some individuals currently meeting diagnostic criteria for Pervasive Developmental Disorder (PDD; DSM‐IV‐TR/ICD‐10) will not qualify for a diagnosis under the proposed changes. To date, reports of sensitivity and specificity of the new criteria have been inconsistent across studies. No study has yet considered how changes at the ‘sub domain’ level might affect overall sensitivity and specificity, and few have included individuals of different ages and ability levels. Methods A set of DSM‐5 ASD algorithms were developed using items from the Diagnostic Interview for Social and Communication Disorders (DISCO). The number of items required for each DSM‐5 subdomain was defined either according to criteria specified by DSM‐5 (Initial Algorithm), a statistical approach (Youden J Algorithm), or to minimise the number of false positives while maximising sensitivity (Modified Algorithm). The algorithms were designed, tested and compared in two independent samples (Sample 1, N = 82; Sample 2, N = 115), while sensitivity was assessed across age and ability levels in an additional dataset of individuals with an ICD‐10 PDD diagnosis (Sample 3, N = 190). Results Sensitivity was highest in the Initial Algorithm, which had the poorest specificity. Although Youden J had excellent specificity, sensitivity was significantly lower than in the Modified Algorithm, which had both good sensitivity and specificity. Relaxing the domain A rules improved sensitivity of the Youden J Algorithm, but it remained less sensitive than the Modified Algorithm. Moreover, this was the only algorithm with variable sensitivity across age. All versions of the algorithm performed well across ability level. Conclusions This study demonstrates that good levels of both sensitivity and specificity can be achieved for a diagnostic algorithm adhering to the DSM‐5 criteria that is suitable across age and ability level.
    May 23, 2013   doi: 10.1111/jcpp.12085   open full text
  • Atypical mismatch negativity to distressful voices associated with conduct disorder symptoms.
    An‐Yi Hung, Jyrki Ahveninen, Yawei Cheng.
    Journal of Child Psychology and Psychiatry. May 23, 2013
    Background Although a general consensus holds that emotional reactivity in youth with conduct disorder (CD) symptoms arises as one of the main causes of successive aggression, it remains to be determined whether automatic emotional processing is altered in this population. Methods We measured auditory event‐related potentials (ERP) in 20 young offenders and 20 controls, screened for DSM‐IV criteria of CD and evaluated using the youth version of Hare Psychopathy Checklist (PCL:YV), State‐Trait Anxiety Inventory (STAI) and Barrett Impulsiveness Scale (BIS‐11). In an oddball design, sadly or fearfully spoken ‘deviant’ syllables were randomly presented within a train of emotionally neutral ‘standard’ syllables. Results In young offenders meeting with CD criteria, the ERP component mismatch negativity (MMN), presumed to reflect preattentive auditory change detection, was significantly stronger for fearful than sad syllables. No MMN differences for fearful versus sad syllables were observed in controls. Analyses of nonvocal deviants, matched spectrally with the fearful and sad sounds, supported our interpretation that the MMN abnormalities in juvenile offenders were related to the emotional content of sounds, instead of purely acoustic factors. Further, in the young offenders with CD symptoms, strong MMN amplitudes to fearful syllables were associated with high impulsive tendencies (PCL:YV, Factor 2). Higher trait and state anxiety, assessed by STAI, were positively correlated with P3a amplitudes to fearful and sad syllables, respectively. The differences in group‐interaction MMN/P3a patterns to emotional syllables and nonvocal sounds could be speculated to suggest that there is a distinct processing route for preattentive processing of species‐specific emotional information in human auditory cortices. Conclusions Our results suggest that youths with CD symptoms may process distressful voices in an atypical fashion already at the preattentive level. This auditory processing abnormality correlated with increased impulsivity and anxiety. Our results may help to shed light on the neural mechanisms of aggression.
    May 23, 2013   doi: 10.1111/jcpp.12076   open full text
  • Pragmatic deficits and social impairment in children with ADHD.
    Ekaterina Staikova, Hilary Gomes, Vivien Tartter, Allyssa McCabe, Jeffrey M. Halperin.
    Journal of Child Psychology and Psychiatry. May 18, 2013
    Background Impaired social functioning has been well documented in individuals with attention‐deficit/hyperactivity disorder (ADHD). Existing treatments for ADHD are effective for managing core symptoms, but have limited effectiveness at improving social skills, suggesting that social deficits in ADHD may not be directly related to core symptoms of the disorder. Language problems are also common in ADHD, with accumulating evidence of pragmatic language difficulties. Pragmatic deficits are associated with social impairment in several neurodevelopmental disorders. This study systematically examined pragmatic language functioning in children with ADHD and whether social impairment in ADHD is mediated by pragmatic deficits. Method Sixty‐three children (28 ADHD; 35 typically developing), ages 7–11 years, underwent a comprehensive assessment of pragmatic language, including parent ratings, standardized tests, and a narrative task. Parents also rated children's social skills on the Social Skills Improvement System. Results Children with ADHD had poorer pragmatic language skills relative to peers across all measures, even after controlling for general language abilities. Furthermore, pragmatic abilities as measured by parent ratings, mediated the relation between ADHD and social skills. Conclusions Pragmatic language skills are impaired in many children with ADHD and may partially account for high rates of social impairment. Implications for treatment and possible prevention of social problems in children with ADHD are discussed.
    May 18, 2013   doi: 10.1111/jcpp.12082   open full text
  • Motivational incentives and methylphenidate enhance electrophysiological correlates of error monitoring in children with attention deficit/hyperactivity disorder.
    Madeleine J. Groom, Elizabeth B. Liddle, Gaia Scerif, Peter F. Liddle, Martin J. Batty, Mario Liotti, Chris P. Hollis.
    Journal of Child Psychology and Psychiatry. May 13, 2013
    Background Children with attention deficit hyperactivity disorder (ADHD) are characterised by developmentally inappropriate levels of hyperactivity, impulsivity and/or inattention and are particularly impaired when performing tasks that require a high level of cognitive control. Methylphenidate (MPH) and motivational incentives may help improve cognitive control by enhancing the ability to monitor response accuracy and regulate performance accordingly. Methods Twenty‐eight children with DSM‐IV ADHD (combined type) aged 9–15 years and pairwise‐matched typically developing children (CTRL) performed a go/no‐go task in which the incentives attached to performance on no‐go trials were manipulated. The ADHD group performed the task off and on their usual dose of MPH. CTRL children performed the task twice but were never medicated. EEG data were recorded simultaneously and two electrophysiological indices of error monitoring, the error‐related negativity (ERN) and error positivity (Pe) were measured. Amplitudes of each ERP were compared between diagnostic groups (CTRL, ADHD), medication days (Off MPH, On MPH) and motivational conditions (baseline – low incentive, reward, response cost). Results Error rates were lower in the reward and response cost conditions compared with baseline across diagnostic groups and medication days. ERN and Pe amplitudes were significantly reduced in ADHD compared with CTRL, and were significantly enhanced by MPH. Incentives significantly increased ERN and Pe amplitudes in the ADHD group but had no effect in CTRL. The effects of incentives did not interact with the effects of MPH on either ERP. Effect sizes were computed and revealed larger effects of MPH than incentives on ERN and Pe amplitudes. Conclusions The findings reveal independent effects of motivational incentives and MPH on two electrophysiological markers of error monitoring in children with ADHD, suggesting that each may be important tools for enhancing or restoring cognitive control in these children.
    May 13, 2013   doi: 10.1111/jcpp.12069   open full text
  • Social communication disorder outside autism? A diagnostic classification approach to delineating pragmatic language impairment, high functioning autism and specific language impairment.
    Jenny Gibson, Catherine Adams, Elaine Lockton, Jonathan Green.
    Journal of Child Psychology and Psychiatry. May 03, 2013
    Background Developmental disorders of language and communication present considerable diagnostic challenges due to overlapping of symptomatology and uncertain aetiology. We aimed to further elucidate the behavioural and linguistic profile associated with impairments of social communication occurring outside of an autism diagnosis. Methods Six to eleven year olds diagnosed with pragmatic language impairment (PLI), high functioning autism (HFA) or specific language impairment (SLI) were compared on measures of social interaction with peers (PI), restricted and repetitive behaviours/interests (RRBIs) and language ability. Odds ratios (OR) from a multinomial logistic regression were used to determine the importance of each measure to diagnostic grouping. MANOVA was used to investigate differences in subscale scores for the PI measure. Results Greater degrees of PI difficulties (OR = 1.22, 95% CI = 1.05–1.41), RRBI (OR = 1.23, 95% CI = 1.06–1.42) and expressive language ability (OR = 1.16, 95% CI = 1.03–1.30) discriminated HFA from PLI. PLI was differentiated from SLI by elevated PI difficulties (OR = 0.82, 95% CI = 0.70–0.96) and higher expressive language ability (OR = 0.88, 95% CI = 0.77–0.98), but indistinguishable from SLI using RRBI (OR = 1.01, 95% CI=0.94–1.09). A significant effect of group on PI subscales was observed (θ = 1.38, F(4, 56) = 19.26, p < .01) and PLI and HFA groups shared a similar PI subscale profile. Conclusions Results provide empirical support for a conceptualisation of PLI as a developmental impairment distinguishable from HFA by absence of RRBIs and by the presence of expressive language difficulties. PI difficulties appear elevated in PLI compared with SLI, but may be less pervasive than in HFA. Findings are discussed with reference to the proposed new category of ‘social communication disorder’ in DSM‐5.
    May 03, 2013   doi: 10.1111/jcpp.12079   open full text
  • Children's callous‐unemotional traits moderate links between their positive relationships with parents at preschool age and externalizing behavior problems at early school age.
    Grazyna Kochanska, Sanghag Kim, Lea J. Boldt, Jeung Eun Yoon.
    Journal of Child Psychology and Psychiatry. May 03, 2013
    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 52 months. Both parents rated children's CU traits at 67 months and their externalizing behavior problems (Oppositional Defiant Disorder and Conduct Disorder) at 67, 80, and 100 months. 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.
    May 03, 2013   doi: 10.1111/jcpp.12084   open full text
  • Executive functions in girls with and without childhood ADHD: developmental trajectories and associations with symptom change.
    Meghan Miller, Fred Loya, Stephen P. Hinshaw.
    Journal of Child Psychology and Psychiatry. April 19, 2013
    Background We prospectively followed an ethnically and socioeconomically diverse sample of girls with attention‐deficit/hyperactivity disorder (ADHD) (n = 140) and a matched comparison sample (n = 88) from childhood through young adulthood to evaluate developmental trajectories of executive functions (EF) and associations between EF trajectories and dimensional measures of ADHD symptoms. We hypothesized that (a) EF trajectories would be similar in girls both with and without childhood ADHD, with the ADHD group showing greater impairment across time; and (b) changes in EF abilities would predict changes in ADHD symptoms across time, consistent with the theory that ADHD symptom reductions partially result from prefrontally mediated EF development. Method Latent growth curve models were used to evaluate development of sustained attention, response inhibition, working memory, and global EF abilities, and associations between EF trajectories and ADHD symptom trajectories. Results Girls with childhood‐diagnosed ADHD showed greater improvement across development on measures of sustained attention and global EF, but similar rates of improvement on measures of working memory and response inhibition. Changes in the global EF measure predicted changes in both inattentive and hyperactive‐impulsive symptoms across time, whereas changes in response inhibition predicted changes in hyperactive‐impulsive symptoms; associations between changes in other EF variables and symptoms were not significant. Conclusions Findings suggest variability in patterns of EF improvement over time in females with ADHD histories and indicate that EF development may play a role in symptom change.
    April 19, 2013   doi: 10.1111/jcpp.12074   open full text
  • Relation of symptom‐induced impairment with other illness parameters in clinic‐referred youth.
    Kenneth D. Gadow, Aaron J. Kaat, Luc Lecavalier.
    Journal of Child Psychology and Psychiatry. April 16, 2013
    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 (cut‐off) 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 cut‐off for specific disorders did not meet symptom cut‐off. Conversely, most youth who met symptom cut‐off were impaired. Symptom cut‐off evidenced greater convergence with impairment cut‐off than combined symptom + impairment cut‐offs. 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 cut‐off, symptom cut‐off, or combined symptom + impairment cut‐off. 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.
    April 16, 2013   doi: 10.1111/jcpp.12077   open full text
  • Executive function as a mediator in the link between attention‐deficit/hyperactivity disorder and social problems.
    Wan‐Ling Tseng, Susan Shur‐Fen Gau.
    Journal of Child Psychology and Psychiatry. April 10, 2013
    Background Cognitive processes and mechanisms underlying the strong link between attention‐deficit/hyperactivity disorder (ADHD) and social problems remain unclear. Limited knowledge also exists regarding a subgroup of youth with ADHD who do not have social problems. This study investigated the extent to which executive function (EF) mediated the association between ADHD and social problems and compared ADHD symptoms, comorbidities, and EF among ADHD youth with and without social problems and controls. Methods The sample consisted of 279 youth with ADHD and 173 controls without ADHD (11–17 years of age) in Taiwan. Among youth with ADHD, two subgroups were further identified: 70 ADHD youth with social problems and 31 ADHD youth without social problems. EF was assessed with four subtests from the Cambridge Neuropsychological Test Automated Battery (Spatial span, Spatial working memory, Intra‐dimensional/extra‐dimensional shifts, Stockings of Cambridge). Social problems were assessed by mother and child reports. Results Executive function measures in working memory and planning mediated the effect of ADHD on social problems, independent of age, gender, and IQ. The two ADHD groups with and without social problems did not differ in ADHD severity or comorbidities; however, ADHD youth without social problems performed better on certain measures of EF such as working memory, planning, and response inhibition. Conclusions These findings suggest that deficits in some aspects of EF may account for social problems often experienced by youth with ADHD.
    April 10, 2013   doi: 10.1111/jcpp.12072   open full text
  • The sleeper effect of intimate partner violence exposure: long‐term consequences on young children's aggressive behavior.
    Megan R. Holmes.
    Journal of Child Psychology and Psychiatry. March 29, 2013
    Background Children who have been exposed to intimate partner violence (IPV) experience a wide variety of short‐term social adjustment and emotional difficulties, including externalizing behavioral problems such as aggression. While children are affected by IPV at all ages, little is known about the long‐term consequences of IPV exposure at younger ages. Because early experiences provide the foundation for later development, children exposed to IPV as an infant or toddler may experience worse negative outcomes over time than children never exposed. Methods Using the National Survey of Child and Adolescent Well‐Being (NSCAW), latent growth curve modeling was conducted to examine whether early IPV exposure occurring between birth and age three (n = 107), compared with no exposure (n = 339), affects the development of aggressive behavior over 5 years. This modeling allowed for empirical exploration of developmental trajectories, and considered whether initial social development trajectories and change over time vary according to early IPV exposure. Results Children who were exposed to more frequent early IPV did not have significantly different aggressive behavior problems initially than children who were never exposed. However, over time, the more frequently children were exposed between birth and 3 years, the more aggressive behavior problems were exhibited by age eight. Conclusions Results indicate a long‐term negative behavioral effect on children who have been exposed to IPV at an early age. An initial assessment directly following exposure to IPV may not be able to identify behavior problems in young children. Because the negative effects of early IPV exposure are delayed until the child is of school age, early intervention is necessary for reducing the risk of later aggressive behavior.
    March 29, 2013   doi: 10.1111/jcpp.12071   open full text
  • Malnutrition in the first year of life and personality at age 40.
    Janina R. Galler, Cyralene P. Bryce, Miriam L. Zichlin, Deborah P. Waber, Natalie Exner, Garrett M. Fitzmaurice, Paul T. Costa.
    Journal of Child Psychology and Psychiatry. March 12, 2013
    Background Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods Using the NEO‐PI‐R personality inventory, we compared personality profiles at 37–43 years of age (M 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate‐to‐severe protein‐energy malnutrition (PEM) in the first year of life (n = 77) with healthy controls, who were former classmates of the index cases and were matched for age, gender, and handedness in childhood (n = 57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented up to 12 years of age, and study participants were followed longitudinally from childhood to 40 years. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. Results At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness, and Conscientiousness than did the healthy controls. At the subdomain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Conclusions Malnutrition limited to the first year of life with good health and nutrition documented up to 12 years of age is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes.
    March 12, 2013   doi: 10.1111/jcpp.12066   open full text
  • Empathic responsiveness in amygdala and anterior cingulate cortex in youths with psychopathic traits.
    Abigail A. Marsh, Elizabeth C. Finger, Katherine A. Fowler, Christopher J. Adalio, Ilana T. N. Jurkowitz, Julia C. Schechter, Daniel S. Pine, Jean Decety, R. J. R. Blair.
    Journal of Child Psychology and Psychiatry. March 12, 2013
    Background Psychopathic traits are associated with increases in antisocial behaviors such as aggression and are characterized by reduced empathy for others' distress. This suggests that psychopathic traits may also impair empathic pain sensitivity. However, whether psychopathic traits affect responses to the pain of others versus the self has not been previously assessed. Method We used whole‐brain functional magnetic resonance imaging to measure neural activation in 14 adolescents with oppositional defiant disorder or conduct disorder and psychopathic traits, as well as 21 healthy controls matched on age, gender, and intelligence. Activation in structures associated with empathic pain perception was assessed as adolescents viewed photographs of pain‐inducing injuries. Adolescents imagined either that the body in each photograph was their own or that it belonged to another person. Behavioral and neuroimaging data were analyzed using random‐effects analysis of variance. Results Youths with psychopathic traits showed reduced activity within regions associated with empathic pain as the depicted pain increased. These regions included rostral anterior cingulate cortex, ventral striatum (putamen), and amygdala. Reductions in amygdala activity particularly occurred when the injury was perceived as occurring to another. Empathic pain responses within both amygdala and rostral anterior cingulate cortex were negatively correlated with the severity of psychopathic traits as indexed by PCL:YV scores. Conclusions Youths with psychopathic traits show less responsiveness in regions implicated in the affective response to another's pain as the perceived intensity of this pain increases. Moreover, this reduced responsiveness appears to predict symptom severity.
    March 12, 2013   doi: 10.1111/jcpp.12063   open full text
  • Concurrent and prospective effects of psychopathic traits on affective and cognitive empathy in a community sample of late adolescents.
    Bart H. J. Brouns, Minet Annette de Wied, Loes Keijsers, Susan Branje, Stephanie H. M. van Goozen, Wim H. J. Meeus.
    Journal of Child Psychology and Psychiatry. March 01, 2013
    Background A deficit in affective rather than cognitive empathy is thought to be central to psychopathic traits. However, empirical evidence for empathy deficits in adolescents with psychopathic traits is limited. We investigated the concurrent and prospective effects of psychopathic traits on affective and cognitive trait empathy in late adolescence. Methods A community sample of 107 males and 126 females who were approximately 16‐year olds at Time 1 participated in four annual waves. Sex‐specific classes of adolescents' psychopathic traits were created using Latent Class Analyses. Subsequently, we investigated class differences in level and development of empathy. Results For both sexes, Latent Class Analyses produced two classes: one class with low and one with moderate levels of psychopathic traits. Consistent with our hypothesis, for both sexes, adolescents with moderate levels of psychopathic traits reported lower mean levels of affective empathy than adolescents with low levels of psychopathic traits. In addition, female adolescents with moderate psychopathic traits reported lower mean levels of cognitive empathy. Male adolescents showed a trend in this direction. No differences between classes were found in development of empathy, which increased over years. Conclusions This is the first study to show that male and female adolescents with higher levels of psychopathic traits have lower levels of affective empathy not only concurrently but also prospectively over a 3‐year period. Females additionally showed a similar pattern on cognitive empathy. In this community sample, developmental results suggest that adolescents with higher levels of psychopathic traits have relative rather than absolute empathy deficits.
    March 01, 2013   doi: 10.1111/jcpp.12052   open full text
  • Bisphenol A in relation to behavior and learning of school‐age children.
    Soon‐Beom Hong, Yun‐Chul Hong, Jae‐Won Kim, Eun‐Jin Park, Min‐Sup Shin, Boong‐Nyun Kim, Hee‐Jeong Yoo, In‐Hee Cho, Soo‐Young Bhang, Soo‐Churl Cho.
    Journal of Child Psychology and Psychiatry. February 28, 2013
    Background Bisphenol A (BPA) has been shown to affect brain and behavior in rodents and nonhuman primates, but there are few studies focusing on its relationship to human neurobehavior. We aimed to investigate the relationship between environmental exposure to BPA and childhood neurobehavior. MethodsUrinary BPA concentrations and behavioral and learning characteristics were assessed in a general population of 1,089 children, aged 8–11 years. The main outcome measures were the Child Behavior Checklist (CBCL) and the Learning Disability Evaluation Scale (LDES). Results Urinary levels of BPA were positively associated with the CBCL total problems score and negatively associated with the learning quotient from the LDES. The linear association with the CBCL anxiety/depression score and the quadratic association with the LDES listening score were significant after correction for multiple comparisons. Conclusions Environmental exposure to BPA might be associated with childhood behavioral and learning development. The results suggest possible nonmonotonic relationships.
    February 28, 2013   doi: 10.1111/jcpp.12050   open full text
  • Economic impact of childhood psychiatric disorder on public sector services in Britain: estimates from national survey data.
    Tom Snell, Martin Knapp, Andrew Healey, Sacha Guglani, Sara Evans‐Lacko, Jose‐Luis Fernandez, Howard Meltzer, Tamsin Ford.
    Journal of Child Psychology and Psychiatry. February 27, 2013
    Background Approximately one in ten children aged 5–15 in Britain has a conduct, hyperactivity or emotional disorder. Methods The British Child and Adolescent Mental Health Surveys (BCAMHS) identified children aged 5–15 with a psychiatric disorder, and their use of health, education and social care services. Service costs were estimated for each child and weighted to estimate the overall economic impact at national level. Results Additional health, social care and education costs associated with child psychiatric disorders totalled £1.47bn in 2008. The lion's share of the costs falls to frontline education and special education services. Conclusions There are huge costs to the public sector associated with child psychiatric disorder, particularly the education system. There is a pressing need to explore ways to reduce these costs while improving health and well‐being.
    February 27, 2013   doi: 10.1111/jcpp.12055   open full text
  • Siblings versus parents and friends: longitudinal linkages to adolescent externalizing problems.
    Ivy N. Defoe, Loes Keijsers, Skyler T. Hawk, Susan Branje, Judith Semon Dubas, Kirsten Buist, Tom Frijns, Marcel Aken, Hans M. Koot, Pol A. C. Lier, Wim Meeus.
    Journal of Child Psychology and Psychiatry. February 12, 2013
    Background It is well documented that friends' externalizing problems and negative parent–child interactions predict externalizing problems in adolescence, but relatively little is known about the role of siblings. This four‐wave, multi‐informant study investigated linkages of siblings' externalizing problems and sibling–adolescent negative interactions on adolescents' externalizing problems, while examining and controlling for similar linkages with friends and parents. Methods Questionnaire data on externalizing problems and negative interactions were annually collected from 497 Dutch adolescents (M = 13.03 years, SD = 0.52, at baseline), as well as their siblings, mothers, fathers, and friends. Results Cross‐lagged panel analyses revealed modest unique longitudinal paths from sibling externalizing problems to adolescent externalizing problems, for male and female adolescents, and for same‐sex and mixed‐sex sibling dyads, but only from older to younger siblings. Moreover, these paths were above and beyond significant paths from mother–adolescent negative interaction and friend externalizing problems to adolescent externalizing problems, 1 year later. No cross‐lagged paths existed between sibling–adolescent negative interaction and adolescent externalizing problems. Conclusions Taken together, it appears that especially older sibling externalizing problems may be a unique social risk factor for adolescent externalizing problems, equal in strength to significant parents' and friends' risk factors.
    February 12, 2013   doi: 10.1111/jcpp.12049   open full text
  • Parent‐ and self‐reported dimensions of oppositionality in youth: construct validity, concurrent validity, and the prediction of criminal outcomes in adulthood.
    Marcel Aebi, Belinda Plattner, Christa Winkler Metzke, Cornelia Bessler, Hans‐Christoph Steinhausen.
    Journal of Child Psychology and Psychiatry. January 28, 2013
    Background:  Different dimensions of oppositional defiant disorder (ODD) have been found as valid predictors of further mental health problems and antisocial behaviors in youth. The present study aimed at testing the construct, concurrent, and predictive validity of ODD dimensions derived from parent‐ and self‐report measures. Method:  Confirmatory factor analyses were performed to test a three‐dimensional model (ODD‐irritability, ODD‐headstrong, and ODD‐hurtful) and a two‐dimensional model (ODD‐irritability, ODD‐headstrong/hurtful) based on items of the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR) collected in a Swiss community study of 1,031 adolescents (519 boys, 512 girls) aged between 10.7 and 17.9 (M = 13.85, SD = 1.63) years. Logistic regression analyses were applied to predict scores in the clinical range of concurrent CBCL/YSR‐anxiety/depression, CBCL/YSR‐attention problems, and CBCL/YSR‐delinquent behavior and depression as measured by the Center for Epidemiological Studies Depression Scale (CES‐D) as well as to predict the presence of adult criminal convictions. Results:  CFA findings were in favor of a three‐dimensional model rather than a two‐dimensional model of ODD. The CBCL/YSR‐ODD‐irritability scale was related to concurrent self‐reported depression, but also to attention problems and delinquent behavior. CBCL/YSR‐ODD‐hurtful and less strongly also the combined YSR‐headstrong/hurtful scale predicted adult criminal outcomes. Conclusions:  As proposed by the DSM‐5 workgroup, different ODD‐dimensions were confirmed by the present study. ODD‐irritability predicts psychiatric comorbidity and ODD‐hurtful symptoms should be specifically considered in youth at risk for criminal outcomes.
    January 28, 2013   doi: 10.1111/jcpp.12039   open full text
  • Detained adolescent females’ multiple mental health and adjustment problem outcomes in young adulthood.
    E. van der Molen, R.R.J.M. Vermeiren, A.A. Krabbendam, A.T.F. Beekman, T.A.H. Doreleijers, L.M.C. Jansen.
    Journal of Child Psychology and Psychiatry. January 23, 2013
    Background:  Although prior studies have shown that detained females are marked by significant adverse circumstances, little is known about their adult outcomes. Method:  Prospective follow‐up study of 184 (80.4% of original sample of 229) detained adolescent females who were reassessed 4.5 (SD = 0.6) years later in young adulthood (mean age = 20.0, SD = 1.4) on mental health and adjustment outcomes. Associations between these outcomes and detained females’ behavior problems and offense history were examined. Results:  In the total sample, 59.0% had one or more mental health problems at follow‐up, whereas 96.2% were facing at least one adjustment problem. Subjects with a personality disorder (PD) reported more adjustment problems compared to subjects without PD. Mental health and adjustment problems in young adulthood were predicted by detained adolescent females’ behavior problems and offense history. Conclusion:  Detained adolescent females suffered from multiple mental health and adjustment problems in young adulthood. Females who developed PD were most impaired. Results of this study underline the compelling need for continued and gender‐specific interventions. The identification of predictors during detention for poor adult outcomes can serve as targets for intervention.
    January 23, 2013   doi: 10.1111/jcpp.12044   open full text
  • Early sensory over‐responsivity in toddlers with autism spectrum disorders as a predictor of family impairment and parenting stress.
    A. Ben‐Sasson, T. W. Soto, F. Martínez‐Pedraza, A. S. Carter.
    Journal of Child Psychology and Psychiatry. January 21, 2013
    Background:  Sensory over‐responsivity (SOR) affects many individuals with autism spectrum disorders (ASD), often leading to stressful encounters during daily routines. Methods:  This study describes the associations between early SOR symptoms and the longitudinal course of restrictions in family life activities and parenting stress across three time‐points in families raising a child with ASD (n = 174). Covariates were child diagnostic severity, emotional problems, and maternal affective symptoms. At time 1 mean chronological age was 28.5 months. Children were administered the Autism Diagnostic Observation Schedule (ADOS) and Mullen Scales of Early Learning (MSEL). Parents completed the Infant Toddler Sensory Profile (ITSP), Infant‐Toddler Social Emotional Assessment (ITSEA), Beck Anxiety Index (BAI), and the Center for Epidemiologic Studies Depression Inventory (CES‐D) at time 1; and the Parenting Stress Index (PSI) and Family Life Impairment Scale (FLIS) at the three annual time‐points. Results:  Latent Growth Curve Models indicated that higher SOR scores on the ITSP at time 1 were associated with higher initial levels of family life impairment and parenting stress and with a smaller magnitude of change over time. These associations were independent of severity of ADOS social‐communication symptoms, MSEL composite score, ITSEA externalizing and anxiety symptoms, and maternal affective symptoms as measured by the BAI and CES‐D. On average FLIS and PSI did not change over time, however, there was significant individual variability. Concurrently, SOR at time 1 explained 39–45% of the variance in family stress and impairment variables. Conclusions:  An evaluation of SOR should be integrated into the assessment of toddlers with ASD considering their role in family life impairment and stress.
    January 21, 2013   doi: 10.1111/jcpp.12035   open full text
  • Differential susceptibility to prevention: GABAergic, dopaminergic, and multilocus effects.
    Gene H. Brody, Yi‐fu Chen, Steven R. H. Beach.
    Journal of Child Psychology and Psychiatry. January 07, 2013
    Background:  Randomized prevention trials provide a unique opportunity to test hypotheses about the interaction of genetic predispositions with contextual processes to create variations in phenotypes over time. Methods:  Using two longitudinal, randomized prevention trials, molecular genetic and alcohol use outcome data were gathered from more than 900 youths to determine whether prevention program participation would, across 2 years, moderate genetic risk for increased alcohol use conferred by the dopaminergic and GABAergic systems. Results:  We found that (a) variance in dopaminergic (DRD2, DRD4, ANKK1) and GABAergic (GABRG1, GABRA2) genes forecast increases in alcohol use across 2 years, and (b) youths at genetic risk who were assigned to the control condition displayed greater increases in alcohol use across 2 years than did youths at genetic risk who were assigned to the prevention condition or youths without genetic risk who were assigned to either condition. Conclusions:  This study is unique in combining data from two large prevention trials to test hypotheses regarding genetic main effects and gene × prevention interactions. Focusing on gene systems purported to confer risk for alcohol use and abuse, the study demonstrated that participation in efficacious prevention programs can moderate genetic risk. The results also support the differential susceptibility hypothesis that some youths, for genetic reasons, are more susceptible than others to both positive and negative contextual influences.
    January 07, 2013   doi: 10.1111/jcpp.12042   open full text
  • Error‐related brain activity in young children: associations with parental anxiety and child temperamental negative emotionality.
    Dana C. Torpey, Greg Hajcak, Jiyon Kim, Autumn J. Kujawa, Margaret W. Dyson, Thomas M. Olino, Daniel N. Klein.
    Journal of Child Psychology and Psychiatry. January 07, 2013
    Background:  There is increasing interest in error‐related brain activity in anxiety disorders. The error‐related negativity (ERN) is a negative deflection in the event‐related potential approximately 50 ms after errors compared to correct responses. Recent studies suggest that the ERN may be a biomarker for anxiety, as it is positively associated with anxiety disorders and traits in adults and older youth. However, it is not known if the ERN in young children is related to risk for anxiety disorders. We addressed this by examining the association of six‐year olds' ERNs with two established risk factors for anxiety: parental anxiety disorder and child temperamental negative emotionality (NE). Method:  The ERN was assessed using a Go/No‐Go task in a community sample of 413 six‐year olds. In a prior assessment at age 3, child temperament was evaluated using a laboratory observational measure and parental psychopathology was assessed using semi‐structured diagnostic interviews. Results:  Children of mothers with anxiety disorders and children with greater temperamental NE (particularly fearfulness) exhibited significantly smaller ERNs than their peers. Paternal psychopathology, maternal mood and substance use disorders, and child positive emotionality were not associated with children's ERNs. Conclusion:  Both maternal anxiety disorders and child NE (particularly fearfulness) were significantly associated with children's ERNs. However, the direction of these associations was opposite to the relations between ERNs and anxiety in older youth and adults. These results suggest that there may be a difference between risk and disorder status in the relation of error‐related brain activity to anxiety between early childhood and late childhood/ early adolescence.
    January 07, 2013   doi: 10.1111/jcpp.12041   open full text
  • A novel differential susceptibility gene: CHRNA4 and moderation of the effect of maltreatment on child personality.
    Rachael G. Grazioplene, Colin G. DeYoung, Fred A. Rogosch, Dante Cicchetti.
    Journal of Child Psychology and Psychiatry. December 13, 2012
    Background:  The differential susceptibility hypothesis states that some genetic variants that confer risk in adverse environments are beneficial in normal or nurturing environments. The cholinergic system is promising as a source of susceptibility genes because of its involvement in learning and neural plasticity. The cholinergic receptor gene CHRNA4 has been linked to characteristics related to the personality traits Neuroticism and Openness/Intellect. Methods:  The effects of interaction between CHRNA4 genotype and maltreatment status on child personality were examined in a well matched sample of 339 maltreated and 275 non‐maltreated children (aged 8–13 years). Results:  Variation in CHRNA4 interacted with childhood maltreatment to predict personality in a manner indicating differential susceptibility. The interaction of CHRNA4 and maltreatment status predicted Neuroticism and Openness/Intellect. Maltreated children with the rs1044396 T/T genotype scored highest on Neuroticism and showed no effect of genotype on Openness/Intellect. Non‐maltreated children with this genotype scored lowest on Neuroticism and highest on Openness/Intellect. Conclusion:  Variation in CHRNA4 appears to contribute to personality by affecting degree of developmental sensitivity to both normal and adverse environments.
    December 13, 2012   doi: 10.1111/jcpp.12031   open full text