Search

Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of children met criteria for BPD and 6% for BPD-not specified. ADHD children with bipolar spectrum disorder had greater comorbidity with disruptive behavior disorders and scored higher on the Young Mania Rating Scales and on the Child Behavior Checklist (CBCL) Scales of rule-breaking behavior, externalizing problems, and total problems; however, significance on the CBCL Scales was lost when controlling for disruptive behavior disorders. Conclusion: BPD is frequently associated with ADHD; it has important implications for prognosis and choice of treatment. Differences on the CBCL Scales could be explained by the comorbidity with disruptive behavior disorders rather than by a specific manic profile. (Contains 3 tables and 2 figures.)

Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semi-structured interview and questionnaires on psychopathology, temperament and executive functioning completed by parents and teachers. Results: Using categorical and dimensional symptoms of ODD it was possible to confirm, cross-informant and cross-method, distinct dimensions for defining the structure of ODD: one made up of irritable and headstrong and the other of negative affect, oppositional behaviour and antagonistic behaviour. Specific associations with DSM-IV disorders were found, and irritable was associated with anxiety disorders, whereas headstrong was associated with disruptive disorders, including aggressive and non-aggressive CD symptoms. Also, negative affect was associated with anxiety disorders and non-aggressive CD symptoms, oppositional behaviour with disruptive disorders and aggressive CD symptoms, and antagonistic behaviours with disruptive disorders and, in boys, with mood disorders. The dimensions correlated with specific scales of psychopathology, temperament and executive functioning. Conclusions: Oppositional defiant disorder is a heterogeneous disorder from preschool age. Different dimensions, with moderate to acceptable reliability and convergent and discriminant validity with other psychological constructs, can be identified early in life. (Contains 5 tables and 1 figure.)

The aim was to examine the potential mediating role of father's and mother's parenting styles in the association between parental psychopathology and antisocial behavior in children, and whether this pathway was moderated by child's sex. Participants included both parents and 338 Spanish outpatient children between 8 and 17 years (56.5% boys). Parenting style had a mediating effect on the studied relationships. Maternal psychopathology was positively associated with antisocial behavior in children, either directly or partially by parenting style, while paternal psychopathology was positively associated with offspring antisocial behavior only through the mediator role of parenting style. Child's sex did not moderate these relationships. Parenting style could be a target for prevention and intervention of antisocial behavior in the offspring of parents with mental health problems.

Objectives: The current study examined the independent effects of mothers' childhood abuse (CA) and intimate partner violence (IPV) on psychopathology and functional impairment in children; and the potential moderating and mediating role of individual and family factors in these relationships. Additionally, this study explored the potential cumulative effects of both maternal CA and IPV on children's outcomes. Method: The sample included 547 Spanish children and adolescents aged between 8 and 17 years, and their parents, who had accessed mental health services. The assessment was based on structured interviews with the children and their parents. Statistical analyses were carried out through hierarchical multiple, negative-binomial and logistic regressions, and Structural Equation Models. Results: Children whose mothers experienced CA and those whose mothers suffered physical IPV showed increased DSM-IV disruptive disorders and externalizing behavior problems, respectively. Children who directly observed physical IPV and also suffered physical punishment by parents showed increased internalizing problems. IPV had effects, either direct or indirect by physical punishment, on children's externalizing problems. Cumulative effect analyses indicated that the prevalence of disruptive disorders was highest in children whose mothers had suffered both CA and IPV. Conclusion: Spanish children whose mothers have suffered CA, IPV or both, are at high risk of serious conduct problems, whereas children exposed to IPV and who were also physically abused are at greater risk of internalizing problems. Physical punishment of children contributes in part to explain externalizing problems of IPV-exposed children. These findings indicate potential targets of assessment and intervention for families seeking help in mental health services. (Contains 4 tables and 2 figures.)

Objective: Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV). Method: Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations. Results: Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in children's psychopathology or functioning in this population. Implications: The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs. (Contains 4 tables.)

There are discrepancies about whether children who witness and suffer domestic violence (DV) have similar outcomes in terms of psychopathology. This work examines the relationship between different types of exposure to DV and child psychopathology and functional impairment. One hundred and forty-four Spanish children aged from 4 to 17 years and exposed to DV were evaluated using a diagnostic interview and other instruments of psychopathology and functional impairment. The participants were classified in three groups according to the degree of exposure: witness (n = 72), involved (n = 52), and victim (n = 20). According to mothers' self-reports and mother-child combined information, DV equally affects psychopathology and functional impairment regardless of the degree of the exposure. Children's self-reports showed a linear trend to present greater psychopathology as a victim than as a witness. The differential effect of exposure to DV measured in this study depended on the informant, which underlines the importance of obtaining information from the children exposed to violence at home. (Contains 5 tables.)

This study examined the prevalence, degree of association and differential effect, by sex and age, of conduct disorder symptoms on psychopathology and functioning. Participants included 680 Spanish children and adolescents between 8 and 17 years and their parents, attending to psychiatric outpatient consultation. Data were obtained through structured diagnostic interviews, and other measures of psychopathological outcomes and functional impairment. In general, the prevalence of antisocial behavior did not differ significantly by sex or age. Results indicated a higher frequency for 13-17 year olds, and a greater number of symptoms in boys. Moreover, some symptoms of conduct disorder showed developmental variations. Sex and age differentially affected the expression of some conduct disorder symptoms and their associations with functional impairment and severity of psychopathology. Knowing the different expression of each symptom could help to identify these problems in clinical children and adolescents, contributing to an early detection of population at the highest risk of serious psychopathology and worse prognosis.

Background: We studied the symptomatology of conduct/oppositional defiant disorder and major depression/dysthymic disorder in "pure" and comorbid presentations. Method: The sample comprised 382 children of 8 to 17 years of age attending for psychiatric outpatient consultation. Ninety-two had depressive disorders without conduct disorders, 165 conduct disorder or oppositional defiant disorder without depressive disorders and 125 had both. Results: In general, there were few differences in the distributions of the symptoms of shared disorders between the pure and the comorbid groups. Comorbidity accentuated depressive and emotional symptoms and functional impairment. After controlling for the presence of other disorders and severity of symptoms, comorbid children were more globally impaired than the pure conduct group and more impaired than the pure depressive group in school, the home, and in relationships with other people. Conclusions: The clinical presentations of "pure" and comorbid depressive and conduct disorders are similar. Differences found in phenomenology and in functional impairment between the groups have implications for treatment planning and for nosology.

This longitudinal study aims to define the developmental trajectories of social cognition (SC) in a community sample (N = 378) assessed from preschool (3 years old) to preadolescence (12 years old). Parents and teachers reported on a SC measure at ages 5, 10, and 12. We tested the existence of different trajectories and whether they discriminated outcomes in early adolescence. The data were collected from different sources, the children, the parents, and teachers, by means of different methods. Using Growth Mixture Modeling (GMM), we identified three distinct social cognition trajectories: persistently mild difficulties reported by parents and teachers (7.9% of the children), stable low problems reported by parents and increased difficulties reported by teachers (10.5% of the sample), and stable low problems reported by both informants for most of the participants (81.5%). Comparison of the psychological outcomes between classes using regression models showed that the two trajectories including children with any level of problems differ from the normative one as regards their association with psychological problems, daily functioning, and variables, such as aggressive behavior and callousness. The two non-normative trajectories also differ from each other in terms of the personal characteristics of the adolescents included in them. Adolescents in the increasing problematic class in the school have a tougher and more problematic style of social relating, while children with persistent and non-context-dependent difficulties are more anxious. These results might help to better detect and design specific interventions for children with deficits in SC that might respond to different personal characteristics leading to different outcomes. [ABSTRACT FROM AUTHOR]

Maternal internalizing symptoms have been linked with child internalizing symptoms, but paternal internalizing difficulties have received little attention. Our aims were to prospectively analyse the simultaneous effect of maternal and paternal internalizing symptoms on child internalizing difficulties, examining gender differences, and to verify the mediating effect of parenting practices and child irritability. The sample included 470 families assessed at child ages 3, 6, 8, and 11. Multi‐group structural equation modelling was performed with Mplus8.2. Complete equivalence was found between boys and girls for all paths. Maternal internalizing symptoms at age 3 had an indirect effect on child internalizing symptoms at age 11, via irritability at age 8. Paternal internalizing symptoms at age 3 were not associated with any of the variables under study. Maternal internalizing symptoms and child irritability are targets for intervention in order to prevent child internalizing difficulties. [ABSTRACT FROM AUTHOR]

The objective was to obtain developmental trajectories combining callous-unemotional traits and the number of stressful life-events between ages 3 and 9 years and to ascertain their association with the polymorphism rs53576 at the Oxytocin Receptor gene (OXTR). A total of 377 children were assessed yearly from ages 3 to 9 years. Latent class growth analysis for parallel processes was used to identify distinct trajectories for callous-unemotional traits (assessed using the Inventory of Callous-Unemotional Traits, ICU) and number of stressful life-events, and then the influence of being an A allele carrier on class membership was included with OXTR genotypes as a binary time-invariant predictor, following a 3-step approach. A 3-class model showed the highest entropy (.859) and adequate posterior probabilities of class membership (≥.884). Class 1 (n = 226, 59.9%) included children with low and stable ICU scores and low and descending stressful life-events; class 2 (n = 127, 33.7%) included children with high and ascending ICU scores and low and slightly descending stressful life-events; and class 3 (n = 24, 6.4%) included children with persistently high profiles both for ICU scores and stressful life-events. Carrying an A allele (genotypes GA/AA) increased the odds of pertaining to class 3 (high and persistent ICU scores and stressful life-events) as opposed to class 2 (OR = 4.27, p = 0.034) or class 1 (OR = 3.81, p = 0.042). The results suggest the importance of considering callous-unemotional traits and stressful life-events in conjunction. In addition, the genetic variability of OXTR (rs53576) may help to understand individual differences in early development. [ABSTRACT FROM AUTHOR]

Introduction: School victimization by peers is an important social problem with serious short- and long-term consequences poorly studied at preschool ages, which can lead to school bullying without timely intervention. Longitudinal data was used to determine the prevalence of warning signs of preschool peer victimization and its individual and family risk factors. Methods: Data was obtained from 577 community preschoolers. School victimization was measured using the Strengths and Difficulties Questionnaire (SDQ) administered to parents and teachers of children at ages 4 and 5. Risk factors for the child (demographics, conduct and emotional problems, aggressiveness) and the family (maternal problems during pregnancy and early development, parenting styles, adaptive functioning and parents’ problems) were previously recorded at 3 years old. Results: Combined information from parents and teachers showed that 4.2% of preschoolers presented warning signs of victimization at ages 4 and 5. Low socioeconomic status, poor emotional control, early problems making friends and low level of parenting education in social norms at age 3 predicted later victimization at ages 4 and 5 (AUC = .78). Conclusion: Peer victimization affects a considerable percentage of preschoolers. Early detection may help to reduce the risk of escalation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study examines the relationships between perceived parental acceptance and children's behavioral problems (externalizing and internalizing) from a multi-informant perspective. Using mothers, fathers, and children as sources of information, we explore the informant effect and incremental validity. The sample was composed of 681 participants (227 children, 227 fathers, and 227 mothers). Children's (40% boys) ages ranged from 9 to 17 years (M D 12.52, SD D 1.81). Parents and children completed both the Parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and the check list of the Achenbach System of Empirically Based Assessment (ASEBA). Statistical analyses were based on the correlated uniqueness multitrait-multimethod matrix (model MTMM) by structural equations and different hierarchical regression analyses. Results showed a significant informant effect and a different incremental validity related to which combination of sources was considered. A multi-informant perspective rather than a single one increased the predictive value. Our results suggest that mother-father or child-father combinations seem to be the best way to optimize the multi-informant method in order to predict children's behavioral problems based on perceived parental acceptance. [ABSTRACT FROM AUTHOR]

Objective To examine cross-sectional and longitudinal associations between behavioral problems and weight status, considering body mass index (BMI) z-scores and overweight status, in a community sample of preschoolers. Methods The Strengths and Difficulties Questionnaire and the Diagnostic Interview for Children and Adolescents were administered to 611 parents. Adjusted general linear models and binary logistic regressions were used. Results Children who were overweight and had a higher BMI were at increased risk of peer problems and attention-deficit/hyperactivity disorder (ADHD) symptoms. Prospective analyses showed that a higher BMI at the age of 3 years was predictive of peer problems at ages 4 and 5 years and hyperactivity and ADHD symptoms at the age of 4 years. Conclusion This is the first study using a diagnostic- based instrument that shows a relationship between weight status and ADHD symptoms in preschoolers. Overweight children might benefit from screening for behavioral disorders and peer relationship problems. [ABSTRACT FROM AUTHOR]

Parenting practices should be assessed and taken into account at an early age, since it is well documented that they are strongly related to children's development. This study provides data on the psychometric properties of a Spanish version of the Alabama Parenting Questionnaire for Preschool children (APQ-Pr). A community sample of 622 (310 boys and 312 girls) 3 year-old children and their parents, participated in the study. Data were obtained from parents' reports and correspond to a semi-structured diagnostic interview and self-report questionnaires evaluating parenting and children's psychological states. Confirmatory factor analysis supported a three-factor solution: positive parenting, inconsistent parenting and punitive parenting. These scales scores showed moderate to good internal consistence (omega values ranged from .54 to .86). Inconsistent parenting scores achieved the strongest associations with external measures of psychopathology, especially for externalizing and conduct problems, as well as for functional impairment, the poorest associations being for the positive parenting scores. Results support the validity of the Spanish APQ-Pr, which is potentially a useful measure for the study of parenting practices regarding preschool children and their relation to conduct problems. [ABSTRACT FROM AUTHOR]

Psychological maltreatment (PM) is an extremely heterogeneous phenomenon that includes several subtypes. The aim of this work is to explore whether the accumulation of different subtypes of PM has a greater impact on the child's psychopathology and functional impairment. One hundred and sixty-eight children and adolescents aged between 4 and 17 whose mothers had been exposed to intimate partner violence (IPV) participated. Psychopathology was assessed through a rating scale and a diagnostic interview. Polynomial contrasts by means of Generalized Estimated Equations explored linear and quadratic trends. The greater the number of PM subtypes suffered by children, the greater the adverse effects in psychopathology and functioning. When a child suffers four PM subtypes, the number of DSM disorders is, on average, twice as high compared with children who are suffering only one PM subtype. Linear trends were mainly found in internalizing problems. The importance of accurately assessing characteristics and severity of PM, and design efficient programs of prevention and treatment, is highlighted. [ABSTRACT FROM AUTHOR]

This work examines the moderator effect of sex and age on the relationship between different types of exposure to intimate partner violence (IPV) and child psychopathology and functional impairment. One hundred and sixty-six Spanish children aged 4 -17 years exposed to intimate partner violence were assessed using a diagnostic interview and other instruments for the measurement of psychopathology and functional impairment. Participants were classified in three groups according to the degree of exposure: witness ( N = 77), involved ( N = 63) and victim ( N = 26). According to mothers' self-reports and mother-child combined information, boy victims of IPV showed more mood disorders than involved or witness boys. There were no other moderator effects of either sex or age. The effect of exposure to intimate partner violence among children was not dependent, in general, on the child's sex or age, and this has important implications for the assessment, treatment, and prevention of children's exposure to IPV. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports rates of psychopathology in a population of 9- and 13-yr olds from a Spanish slum. Two cohorts of all the children born in 1989 and in 1993 and registered in the census of a municipality in 2001 were assessed over a 3-yr period with structured diagnostic interviews and functional measures. In the first year of the study 79 (53.7%) children of the adolescent 13-yr-old population and 72 (59.5%) of the pre-adolescent 9-yr-old population participated. Between 30% and 60% of preadolescents and between 30% and 50% of adolescents presented some mental disorder. Anxiety and disruptive behavior disorders were the most frequent disorders in both cohorts. For both genders, the highest risk for any psychopathology was at 10yr. We found that, psychopathology and functional impairment decreased with age, and that the psychopathology of children in a peripheral slum of a big city is 3 times higher than the median of the general population. This information should be useful for administrators providing services for children from the most disadvantaged segment of the population. [Copyright &y& Elsevier]

We provide the first validation data on the Spanish version of the Brief Problem Monitor-Parent form (BPM-P), a recently developed abbreviated version of the 120-item Child Behavior Checklist for Ages 6 to 18 (CBCL/6-18) in young schoolchildren. Parents of a community sample of 521 children aged 6-8 answered the CBCL/6-18 yearly, and the 19 BPM-P items were examined; parents also provided different measures of psychopathology. Confirmatory factor analysis of the expected 3-factor model (attention, externalizing, and internalizing) showed adequate fit (root mean square error of approximation, RMSEA ≤ .057), and measurement invariance across sex and age was observed. Internal consistency for the derived scores was satisfactory (ω ≥ .83). Concurrent validity with the equivalent scale scores of the original full CBCL/6-18 (r ≥ .84) and convergent validity with parents' ratings of the Strengths and Difficulties Questionnaire scores (r ≥ .52) were good. BPM-P scores at age 7 showed good predictive accuracy for discriminating the use of mental health services (OR ≥ 1.12), functional impairment (B ≤ -1.25), and the presence of the corresponding disorders diagnosed with an independent clinical interview, both cross-sectionally at age 7 and longitudinally at age 8 (OR ≥ 1.24). The BPM-P provides reliable and valid scores as a very brief follow-up and screening tool for assessing behavioral and emotional problems in young schoolchildren. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Reinforcement Sensitivity Theory has been applied to childhood psychopathology and the development of different types of personality in recent years. Few studies have reported evidence of the reliability/validity of specific measures based on this theory. The aim of this study was to assess the psychometric properties of the measures obtained through the Spanish version of the Sensitivity to Punishment and Sensitivity to Reward Questionnaire for Children (SPSRQ-C) in a community sample of N = 478 children aged 6. Confirmatory Factor Analysis showed that the three-factor model was the best solution with indexes of moderate to good fit. Resulting factors were F1 sensitivity-to-punishment, F2 impulsivity/fun-seeking and drive and F3 reward-responsivity. High correlations were achieved between empirical SPSRQ-C factors and external measures: a) F1 largely correlated with anxiety–depression and internalizing problems, shyness and negative affectivity; b) F2 was strongly related to externalizing problems (attention-aggressive), activity level and surgency; and c) F3 achieved the highest correlations with externalizing problems. These results highlight the validity of the SPSRQ-C measures to be used with young children from the general population. Availability of accurate measures of response to punishment and reward is especially valuable in educational and therapeutic plans that include discipline and incentives as contingencies [ABSTRACT FROM AUTHOR]