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This study compared the structure of cognitive ability (specifically, verbal/crystallized ["Gc"] and visual-spatial ability ["Gv"]), as measured in the Wechsler Intelligence Scale for Children, in youth with manic symptoms with a nationally representative group of similarly aged youth. Multigroup confirmatory factor analysis found the majority of the estimated parameters were invariant between the groups, although there was a difference in the intercepts for the Similarities subtest and difference in unique variances for the Picture Completion, Comprehension, and Picture Arrangement subtests. Thus, although there are many neurological changes associated with manic symptoms, the structure of verbal/crystallized and visual-spatial abilities appear relatively robust and invariant. As "Gc" and "Gv" are the primary domains on all the Wechsler Intelligence Scales for Children, results also indicate that clinical interpretation of the Wechsler scales may be appropriate to measure cognitive performance in youths with manic symptoms. (Contains 4 tables, 2 figures and 3 notes.)

In this article, four clinicians respond to the following case vignette: A 12-year-old girl with insulin-dependent diabetes presents for treatment of her newly diagnosed bipolar disorder. How would you address the bipolar disorder pharmacologically, and how would the presence of diabetes affect your selection of medication and clinical management?

The fields of child psychology and psychiatry have not yet established the clinical presentation in school of children and adolescents who have been diagnosed as having a depressive disorder. To address this issue, the authors used teacher ratings on scale oriented to the third, revised edition of the "Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R)". Based on "DSM-III-R" diagnoses generated from interviews--using the "Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiological Version" (K-SADS-E)--of parents and children ages 6 to 18 years old (N = 153), the authors formed three groups of children: Depressed, Attention-Deficit/Hyperactivity Disorder, and Control. They then used the "DSM"-oriented scales of Achenbach's "Teacher's Report Form" and the "Child Behavior Checklist," the latter completed by parents, to compare the children in each group. Teacher-parent agreement on the scales was consistent with the results from past studies. Teacher ratings distinguished among the groups almost identically to parent ratings; in particular, the Affective Problems scales significantly differentiated the Depressed group from the other two groups. Furthermore, teachers rated substantial numbers of members of the Depressed group with serious levels of both affective and anxious symptoms. Overall, teacher accuracy in identifying children with depression was 66% on the Affective Problems scales. In addition, the ratings identified two subgroups of the Depressed group: Parent-Identified Only and Teacher/Parent-Identified. Consequently, teachers appear to make clinically relevant ratings of depression in children that may enhance the diagnosis and treatment monitoring of depressive disorders in children and adolescents.

Potential risk factors for conduct problems and depressive symptoms were tested in a cohort of 10- to 12-year-old Ukrainian children (N = 544, 47.6% male). Risk factors examined were child emotional lability, child attention problems, poor mother-child communication, coercive maternal discipline, maternal depression, and low marital satisfaction. Results indicated that poor mother-child communication was related to conduct problems and depressive symptoms for both boys and girls. In addition, conduct problems and depression were associated with attention problems for boys and with low marital satisfaction for girls. Emotional lability was related specifically to conduct problems, and maternal punishment was related specifically to depressive symptoms.

This article examined some of the reasons for confusion and controversy surrounding the frequency of diagnosis of bipolar disorder, especially in prepubertal children. Four case vignettes are used to articulate questions surrounding manifestations of euphoria and grandiosity, informant variance, diagnostic implications of medication-induced behavioral toxicity, and treatment implications of family history. Although extant literature cited addresses some of the issues, specific research is needed for definitive answers.

Examines the prevalence rates for the syndrome and disorder of depression in a psychiatrically referred population of children. (MP)

Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7–15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety. [ABSTRACT FROM AUTHOR]

Recognition of hyperactivity, impulsivity, distractibility, and emotional lability as a clinical syndrome is at the heart of identifying whether there is a discoverer of the condition of attention deficit hyperactivity disorder (ADHD). Just as clinics of children diagnosed with ADHD do not capture a homogeneous group of boys and girls, however, history does not either. What different observers/clinicians have chosen to highlight reflects what is important to them and to the times in which they lived. The child/children described by Heinrich Hoffman (of Fidgety Phil fame) and George Still (who highlighted impulsive aggression as a moral defect), for instance, did not come with a list of criteria (with which even now we cannot always agree) to prove unequivocally that they had ADHD. Who cares! It is sufficient that they recognized the importance of certain co‐occurring behaviors and shared their observations with us such that we can conclude our clinic's children were recognized by good past observers. ADHD‐like children, like the poor, have probably always been with us. [ABSTRACT FROM AUTHOR]

Comorbid externalizing and internalizing disorders are common in offspring of a parent with bipolar I or II disorder. In some cases, the symptoms are harbingers of future bipolar spectrum disorder. Even when they are not, they are likely to be impairing to the child. Clinicians need to be better informed about how the history leading up to mania/hypomania unfolds, and what comorbid disorders are impairing in and of themselves. More information is needed about the parents' psychopathology, course of illness and response to treatment. Until we have data on how to prevent bipolar disorder, the best course of action is to treat the child's current impairing symptoms and render the parent as asymptomatic as possible. [ABSTRACT FROM AUTHOR]

Objective: Irritability is a common and clinically important problem in children and adolescents and a risk factor for later psychopathology and impairment. Irritability can manifest in both tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outburst) forms, and recent studies of adolescents suggest that they predict different outcomes. However, no studies have examined whether tonic and phasic irritability are empirically distinguishable in 6‐year‐old children and whether they have distinct correlates and outcomes. Method: We utilized data from a longitudinal study of an unselected community sample of four hundred fifty‐two 6‐year‐olds followed at 3‐year intervals to age 15. We conducted confirmatory factor analysis (CFA) using relevant items from a diagnostic interview and several parent‐report inventories. Results: The CFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent‐reported temperamental negative affectivity and internalizing and externalizing disorders at age 6 and predicted higher rates of internalizing psychopathology, and suicidal ideation, in adolescence. Phasic irritability was independently associated with concurrent parent‐reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting styles and practices, and externalizing disorders at age 6, and predicted higher rates of externalizing psychopathology in adolescence. Conclusions: Tonic and phasic irritability in 6‐year‐old children appear to be distinguishable constructs with different temperament and parenting correlates and psychopathological outcomes. Distinguishing these components has implications for research on the etiology and pathophysiology of irritability and developing effective treatments. [ABSTRACT FROM AUTHOR]

Background: In recent years, epidemiological and clinical studies have revealed that depressive disorders can present in early childhood. To clarify the validity and prognostic significance of early childhood‐onset depression, we investigated diagnostic and functional outcomes in later childhood and adolescence. Methods: A community sample (N = 516) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. When participants were 9, 12, and 15 years old, children and parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia and measures of symptoms and functioning. Results: In models adjusting for covariates, depressed 3/6‐year‐old children were more likely to experience subsequent episodes of depressive disorders and exhibited significantly higher rates of later anxiety disorder, attention deficit hyperactivity disorder, and suicidality compared to children without depressive disorders at age 3/6. Early childhood depression was also associated with higher levels of mother, but not child, reported depressive symptoms at age 15 compared to children without depressive disorders at age 3/6. Finally, depression at age 3/6 predicted lower levels of global and interpersonal functioning and higher rates of treatment at age 15 compared to children without depressive disorders at age 3/6. Conclusions: Results support the clinical significance of depression in 3/6‐year‐old children, although further studies with larger samples are needed. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of bipolar disorder (BD) increased substantially among youth between the mid‐1990s and mid‐2000s in the United States. This dramatic increase in diagnosis resulted in concern regarding the potential for misdiagnosis of BD among youth. However, the rate of BD diagnosis in the United States had not been evaluated nationally since the mid‐2000s. It was unclear whether changes in diagnostic rates continued to occur. Therefore, the present study aimed to assess the pattern of longitudinal trends in the rate of national inpatient BD diagnosis subsequent to 2004. Methods: Data included a nationally representative dataset of inpatient hospitalizations between 1996 and 2010. De‐identified data were obtained from the National Hospital Discharge Survey (NHDS) conducted annually by the National Center for Health Statistics. Results: The proportion of BD diagnoses relative to all psychiatric diagnoses increased between 1996 and 2004 among children and adolescents. The proportion of BD diagnoses then decreased between 2004 and 2010 among children but continued to increase for adolescents. However, population‐adjusted rates of BD diagnosis per 10,000 individuals in the general population initially increased until the mid‐2000s and then decreased until 2010 for both children and adolescents. Conclusions: Rates of BD diagnosis substantially decreased for youth between the mid‐2000s and 2010. This decline coincided with recommendations for more conservative diagnostic practices due to concerns about overdiagnosis and increasing awareness of the side effects of front‐line medications used to treat BD in youth. Findings provide insight into changing trends in inpatient service utilization for BD in the United States. [ABSTRACT FROM AUTHOR]

Little is known about the effect of natural disasters on children's neural development. Additionally, despite evidence that stress and parenting may both influence the development of neural systems underlying reward and threat processing, few studies have brought together these areas of research. The current investigation examined the effect of parenting styles and hurricane-related stress on the development of neural reactivity to reward and threat in children. Approximately 8 months before and 9 months after Hurricane Sandy, 74 children experiencing high and low levels of hurricane-related stress completed tasks that elicited the reward positivity and error-related negativity, event-related potentials indexing sensitivity to reward and threat, respectively. At the post-Hurricane assessment, children completed a self-report questionnaire to measure promotion- and prevention-focused parenting styles. Among children exposed to high levels of hurricane-related stress, lower levels of promotion-focused, but not prevention-focused, parenting were associated with a reduced post-Sandy reward positivity. In addition, in children with high stress exposure, greater prevention-focused, but not promotion-focused, parenting was associated with a larger error-related negativity after Hurricane Sandy. These findings highlight the need to consider contextual variables such as parenting when examining how exposure to stress alters the development of neural reactivity to reward and threat in children. [ABSTRACT FROM AUTHOR]

Background: Many preschool-age children meet criteria for psychiatric disorders, and rates approach those observed in later childhood and adolescence. However, there is a paucity of longitudinal research examining the outcomes of preschool diagnoses. Methods: Families with a 3-year-old child (N = 559) were recruited from the community. Primary caregivers were interviewed using the Preschool Age Psychiatric Assessment when children were 3 years old (n = 541), and, along with children, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version when children were 9 and 12 years old. Results: Rates of disruptive behavior disorders (DBD) decreased from preschool to middle childhood and early adolescence, whereas rates of attention-deficit/hyperactivity disorder (ADHD) increased. Rates of any psychiatric disorder and depression increased from preschool to early adolescence only. Preschoolers with a diagnosis were over twice as likely to have a diagnosis during later periods. Homotypic continuity was present for anxiety disorders from preschool to middle childhood, for ADHD from preschool to early adolescence, and for DBD through both later time points. There was heterotypic continuity between preschool anxiety and early adolescent depression, and between preschool ADHD and early adolescent DBD. Dimensional symptom scores showed homotypic continuity for all diagnostic categories and showed a number of heterotypic associations as well. Conclusions: Results provide moderate support for the predictive validity of psychiatric disorders in preschoolers. Psychopathology in preschool is a significant risk factor for future psychiatric disorders during middle childhood and early adolescence. [ABSTRACT FROM AUTHOR]

Background Little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of preschool chronic irritability with psychiatric disorders, functional impairment, and service use at age nine in a large community sample. Methods Four hundred and forty-six children were assessed at age three and again at age nine. Child psychopathology and functional impairment were assessed at age three with the Preschool Age Psychiatric Assessment ( PAPA) with parents and at age nine with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K- SADS) with parents and children. Items from the PAPA were used to create a dimensional measure of chronic irritability at age three. At age nine, mothers, fathers, and youth completed the Child Depression Inventory ( CDI) and the Screen for Anxiety Related Disorders ( SCARED). Results Chronic irritability at age three predicted any current and lifetime anxiety disorders at age nine, current and lifetime generalized anxiety disorder, and current separation anxiety, after controlling for baseline anxiety disorders. In addition, preschool irritability predicted increases in anxiety and disruptive behavior disorder symptoms on the K- SADS, and maternal and paternal reports of depressive and anxiety symptoms on the CDI and SCARED. Lastly, preschool irritability predicted greater functional impairment and outpatient treatment use, even after controlling for all psychiatric disorders at baseline. Conclusions Findings underscore the central role of irritability in developmental psychopathology and support the importance of early detection and interventions targeting preschool irritability. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Volatile, aggressive behavior is the chief complaint that brings children to inpatient psychiatric care. These difficulties are increasingly conceptualized as bipolar disorder (BD). The impact of doing so on clinical diagnoses in clinical care is uncertain. Methods: We extracted records from the annual National Hospital Discharge Survey (NHDS) for which a psychiatric diagnosis was primary and examined trends in the rates of hospitalization for BD. Results: Population-adjusted rates of hospital discharges of children with a primary diagnosis of BD increased linearly over survey years. The rate in 1996 was 1.3 per 10,000 U.S. children and climbed to 7.3 per 10,000 U.S. children in 2004. Bipolar disorder related discharges also increased fourfold among adolescents. Adults showed a more modest, though still marked, rise of 56%. Bipolar disorder related hospitalization was more prevalent among female adolescents and adults, while male children had larger risk than female children. Children’s BD diagnoses tended not to specify a prevailing mood state, while depression and psychotic features were the most common codes for adults. Black individuals, especially men, had lower rates of BD diagnoses in early survey years, but more recently their rate of BD related hospitalizations has exceeded other NHDS race groups. Conclusions: Higher rates of inpatient admissions among youth associated with BD may reflect greater appreciation of the importance of affective dysregulation in this patient group or “upcoding” to putatively more severe conditions for reimbursement or administrative reasons. Further study is warranted to examine this shift’s causes and implications for treatments and outcomes. [Copyright &y& Elsevier]

: BackgroundPrior investigations of cross-informant agreement among parents, teachers, and clinicians about externalizing and internalizing problems have not directly addressed agreement about manic symptoms.: MethodsWe identified three groups from a large cohort of youths, aged 8–12 years, treated on an inpatient unit. All 108 participants met criteria for an externalizing disorder, based on a semi-structured diagnostic interview. Of these, 49 did not have manic symptoms endorsed by either the parent or a teacher; 34 had manic symptoms reported by the parent only, and 25 had pervasive manic symptoms (i.e., corroborated by both sources).: ResultsThe “corroborated mania” group consistently showed the most disruptive behavior on the inpatient unit, the worst behavior problems on multiple scales, and the longest admission durations. The “parent-only” group scored in the midrange on all of these measures, with group differences typically representing small to medium effect sizes. The “externalizing only” group consistently scored lowest on all dependent measures, with the differences representing large to extremely large effects when compared with the corroborated mania group and medium effects as compared with the parent-only group.: ConclusionsYouths for whom multiple informants report manic symptoms appear likely to have more severe symptom presentation and more complicated, refractory courses than do youths without manic symptoms. [Copyright &y& Elsevier]

Background: The psychological effects of technological disasters have rarely been studied in children. This study assessed the aftermath of the 1986 Chornobyl disaster in children evacuated to Kyiv from the contaminated zone surrounding the nuclear power facility. Methods: In 1997, we evaluated three hundred 10- to 12-year-old children in Kyiv who were in utero or infants at the time of the disaster and who had resided near Chornobyl (evacuees) and 300 sex-matched homeroom classmates who had never lived in a radiation-contaminated area. Response rates were 92% (evacuees) and 85% (classmates). Data were obtained from children, mothers, and teachers using standard measures of well-being and risk factors for childhood psychopathology. The children also received physical examinations and basic blood tests. Results: The evacuees and classmates perceived their mental health similarly except for Chornobyl-related anxiety symptoms and perceived scholastic competence. No differences were found on the Iowa Conners' Teacher Rating Scale. Although the physical examination and blood test results were normal, the evacuee mothers rated their children's well-being as significantly worse, especially with respect to somatic symptoms on the Children's Somatization Inventory and Child Behavior Checklist. The most important risk factors for these ratings were maternal somatization and Chornobyl-related stress. Conclusions: Given the multiple stressful experiences to which evacuee families were exposed, the small differences in the children's self-reports suggest that there are protective factors in the lives of these children. The trauma experienced by the mothers was reflected in their perceptions of their children's well-being, particularly somatic symptoms, but was not transmitted to the children themselves. [ABSTRACT FROM AUTHOR]

This paper examines the cognitive and neuropsychological functioning of children who were in utero to age 15 months at the time of the Chornobyl disaster and were evacuated to Kyiv from the 30-kilometer zone surrounding the plant. Specifically, we compared 300 evacuee children at ages 10-12 with 300 non-evacuee Kyiv classmates on objective and subjective measures of attention, memory, and school performance. The evacuee children were not significantly different from their classmates on the objective measures (grades; Symbolic Relations subtest of the Detroit Test; forms 1 and 2 of the Visual Search and Attention Test; Benton Form A; Trails A; Underline the Words Test) or on most of the subjective measures (the attention subscale of the Child Behavior Checklist completed by mothers; the attention items of the Iowa Conners Teacher's Rating Scale; mother and child perceptions of school performance). The one exception was that 31.3% of evacuee mothers compared to 7.4 %of classmate mothers indicated that their child had a memory problem. However, this subjective measure of memory problems was not significantly related to neuropsychological or school performance. No significant differences were found in comparisons of evacuees and classmates who were in utero at the time of the explosion, children from Pripyat vs. other villages in the 30-kilometer zone, and children manifesting greater generalized anxiety. For both groups, children with greater Chornobyl-focused anxiety performed significantly worse than children with less Chornobyl-focused anxiety on measures of attention. The results thus fail to confirm two previous reports that relatively more children from areas contaminated by radiation had cognitive deficits compared to controls. Possible reasons for the differences in findings among the studies are discussed. [ABSTRACT FROM AUTHOR]

Read the core debate at: doi: 10.1111/camh.12231; doi: 10.1111/camh.12243; doi: 10.1111/camh.12296; doi: 10.1111/camh.12306 Read more perspectives in this debate at: doi: 10.1111/camh.12318 doi: 10.1111/camh.12317; doi: 10.1111/camh.12316; doi: 10.1111/camh.12313; doi: 10.1111/camh.12310; doi: 10.1111/camh.12314 [ABSTRACT FROM AUTHOR]

In this article, the author comments on an article dealing with the dramatic use of atypical antipsychotics (AAPs). It mentions that the U.S. Food and Drug Administration (FDA) has approved the use of AAPs in the treatment of bipolar disorder, schizophrenia, and other serious mental problems, but not for attention deficit hyperactivity disorder (ADHD) or other childhood behavior problems. It informs that AAP use has increased both alone and in combination with stimulants.

Background: A growing literature indicates that the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) identifies youths with heightened risk for severe psychopathology, comorbidity, and impairment. However, this work has focused on school-age children and adolescents; no studies have examined whether preschool-aged children with the CBCL-DP exhibit a similar constellation of problems. Method: Using a community sample of preschoolers, we compared children with ( N = 61) and without ( N = 488) the CBCL-DP on a broad range of variables assessed using multiple methods. Results: Univariate analyses revealed numerous differences between children with the CBCL-DP and their peers on psychiatric symptomatology, temperament, parenting behavior, and parental personality, psychopathology, and marital functioning. In multivariate analyses, children with the CBCL-DP exhibited greater temperamental negative affectivity and lower effortful control. They also had more depressive and oppositional defiant symptoms, as well as greater functional impairment. Parents of CBCL-DP children reported engaging in more punitive, controlling parenting behavior than parents of non-profile children. Conclusions: In a non-clinical sample of preschoolers, the CBCL-DP is associated with extensive emotional and behavioral dysregulation and maladaptive parenting. [ABSTRACT FROM AUTHOR]

Abstract: Background: The primary purpose of this study was to explore whether age differences in the phenomenology of bipolar disorders from 4 to 17 years of age exist. Methods: Outcome measures included questionnaires pertaining to mood symptoms, psychosocial functioning, and family history of psychiatric illness. Phenomenology was examined in two diagnostic groups: syndromal bipolar disorder (bipolar I or II) and subsyndromal bipolar disorder (bipolar disorder not otherwise specified or cyclothymia) and across six age cohorts: 4–6, 7–8, 9–10, 11–13, and 14–17 years. Analyses examined linear and non-linear age effects on clinician-rated measures of mood and psychosocial functioning. Results: Participants were 535 outpatients (339 males) ages 4–17 years. The proportion diagnosed with comorbid ADHD was significantly lower in the oldest age group. Age groups showed significant moderate decreases in motor activity, aggression, and irritability with age. Many symptoms of depression showed significant increases with age. BP I cases showed much higher manic symptoms, and BP I and BP II cases indicated slightly to moderately higher depressive symptoms, compared to subsyndromal cases. These patterns held after adjusting for comorbid ADHD, and age did not interact with syndrome status. There were also age differences in total scores for measures of mood symptoms and psychosocial functioning. Limitations: Mood ratings were completed based on the same interview that informed the research diagnoses. Also, mood episode at time of interview was not captured. Conclusions: These findings affirm the existence of bipolar disorder from pre-school children through adolescence, with a similar clinical presentation across a wide developmental age span. [Copyright &y& Elsevier]

Objective: Although enuresis is relatively common in early childhood, research exploring its antecedents and implications is surprisingly limited, perhaps because the condition typically remits in middle childhood.Method: We examined the prevalence, predictors, prognostic factors, and outcomes of primary enuresis in a large (N = 559) multi-method, multi-informant prospective study with a community-based sample of children followed from age 3 years to age 9 years.Results: We found that 12.7% of our sample met criteria for lifetime enuresis, suggesting that it is a commonly occurring childhood disorder. Males were more than twice as likely as females to have a lifetime diagnosis. Significant age 3 predictors of developing primary enuresis by age 9 included child anxiety and low positive affectivity, maternal history of anxiety, and low authoritative parenting. In addition, poorer global functioning and more depressive and anxiety symptoms at age 3 years predicted a greater likelihood of persistence through age 9. By age 9 years, 77% of children who had received a diagnosis of primary enuresis were in remission and continent. However, children who had remitted exhibited a higher rate of attention-deficit/hyperactivity disorder (ADHD) and greater ADHD and depressive symptoms at age 9 compared to children with no lifetime history of enuresis.Conclusion: Results of the present study underscore the clinical significance of primary enuresis and demonstrate that it shows both strong antecedent and prospective associations with psychopathology. The findings also highlight the possible role of parenting in the development of enuresis. [ABSTRACT FROM AUTHOR]

Abstract: The present report replicates and extends our previous study using a laboratory assessment of child temperament and behavior to distinguish the affective component, low positive affect (PA), of the broader positive emotionality construct from behavioral inhibition (BI) in a larger, independent sample. Additionally, we examined whether laboratory-assessed traits could be distinguished on parent/teacher-reports of related constructs. Low positive emotionality and BI share the core feature of low approach/engagement and are often not distinguished in the literature, despite presumed differences in underlying motivation. We examined these traits in novel and non-novel laboratory contexts. Similar to previous findings, we found that in novel situations, children with low PA and children with high BI exhibited similar levels of approach, and both groups exhibited lower approach than controls. In contrast, in non-novel situations, children with low PA exhibited significantly lower levels of approach than children with high BI and controls. Finally, we also found external evidence for the distinction between laboratory-defined low PA and high BI on parent- and teacher-reports of child temperament. [Copyright &y& Elsevier]