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To improve international needs assessment for child mental health services, it is necessary to employ standardized assessment methods that can be easily administered and scored, can be interpreted by practitioners and researchers with various kinds of training, and that perform similarly across many societies. To this end, we tested the effects of both society and culture on parents' ratings of children's problems. We used hierarchical linear modeling as well as analyses of variance to analyze parents' Child Behavior Checklist ratings of 72,493 6- to 16-year-olds from 45 societies. The 45 societies were nested within 10 culture clusters based on the Global Leadership and Organizational Behavior Effectiveness (GLOBE) taxonomy. Societal differences accounted for 3.8–10.7% of variance in various kinds of problems, while differences between culture clusters (e.g., Anglo vs. Confucian) accounted for 0.1–10.0%. By contrast, differences associated with parents' ratings of individual children accounted for 85.5–93.3% of variance. Averaged across 17 problem scales, society plus culture cluster accounted for about 10% of the variance in parents' ratings of children's problems, whereas individual differences and other possible variables accounted for about 90%. These findings indicate that parents' standardized ratings can be used to assess effects associated with individual differences in child and adolescent psychopathology, over and above differences associated with societies and culture clusters. [ABSTRACT FROM AUTHOR]

The authors talk about dimensional personality disorder diagnosis and the proposal to replace categorical personality disorders with a severity gradient. Topics discussed include the International Classification of Disease (ICD)-11 section for personality disorders, the personality trait model proposed for ICD-11, and the challenges associated with a personality based diagnosis.

Withdrawn/depressed behavior (WD) as defined by the Child Behavior Checklist (CBCL) relates to various outcomes in developmental psychopathology such as depression, pervasive developmental disorders, and suicide. We sought to examine the temperamental characteristics of children who concurrently endorse symptoms of WD. Junior Temperament and Characteristic Inventory (JTCI) and CBCL data were collected from 397 children's parents in a family study in the northeastern United States. Linear mixed models were used to test the relations between WD and temperament dimensions (Novelty Seeking, Harm Avoidance, Reward Dependence, Persistence) on the JTCI, while controlling for age, sex, item overlap, and co-occurring aggression and attention problems. When controlling for definitional artifact and CBCL aggressive behavior and attention scores, high harm avoidance and low reward dependence were both significant predictors of childhood withdrawn behavior. This study marks the first characterization of a temperamental profile associated with WD in children and adolescents. [ABSTRACT FROM AUTHOR]

Food security is a condition achieved when all members of a household have access to adequate food at all times for a healthy, active lifestyle. As of 2014, 14% of households in the United States were food insecure. Previous research has suggested that household food insecurity is associated with numerous adverse medical and psychosocial outcomes across the lifespan. In this narrative review, we examine current research on food insecurity, specifically as it relates to child psychopathology and risk factors thereof: namely, parental mental illness and poor diet and metabolic health. Moreover, we begin to speculate about behavioral and physiological mechanisms by which these conditions may influence one another, and discuss possible interventions through enhanced screening and treatment, parent training, and provision of high quality foods to vulnerable households. Further research is needed to the effects of child and parental mental health on metabolic outcomes in families with food insecurity. [ABSTRACT FROM AUTHOR]

Objective: Children with co-occurring internalizing and externalizing problems have higher levels of impairment and worse outcomes later in life, but it is unclear whether these children can be distinguished validly from children who have problems in a single domain. We used a person-centered statistical approach to examine whether a group of children with co-occurring internalizing and externalizing problems can be identified in a general-population sample of young children. Method: This study included a population-based sample of 6,131 children, aged 5 through 7 years. Mothers (92.6%) reported emotional and behavioral problems using the Child Behavior Checklist/1.5-5 (CBCL). A latent profile analysis was performed on the CBCL syndrome scales. Identified classes were compared on early socioeconomic and parental risk factors using multinomial logistic regression. Results: We identified 4 classes, as follows: a class scoring high on all internalizing and externalizing scales (1.8%); a class with internalizing problems (5.3%); a class with externalizing problems and emotional reactivity (7.3%); and a class without problems (85.6%). The first class, with co-occurring problems, was associated with higher levels of maternal and paternal affective symptoms and hostility than the other 3 classes. Conclusions: The class with co-occurring internalizing and externalizing problems appears to be highly similar to the CBCL Dysregulation Profile described in older children. This empirically based dysregulation profile offers a promise to the study of the development of poor self-regulation. [ABSTRACT FROM AUTHOR]

The article reports on the result of the study conducted, which investigates the relation of empirically defined temperament phenotypes with psychopathology and wellness in children. The inquiry was done through Juvenile Temperament and Character Inventory Assessment, as well as an evaluation of wellness and psychopathology using the Child Behavior Checklist, among a number of juveniles from the northeastern area of the U.S. A latent profile analysis in the study revealed that there was a strong link between the steady class, higher functioning and lower levels of psychopathology, whereas the disengaged class showed the opposite associations. The study concluded that temperament may be illuminative in identifying children with the same traits.

Juvenile bipolar disorder (JBD) has been a subject of significant research and debate. Phenotypic differences between JBD and adult-onset bipolar disorder have led researchers to question whether or not similar neuropathologic mechanisms will be found. While much is known about the genetic and environmental contributions to the adult-onset phenotype, less is known about their contributions to JBD. Here, we review family, twin, adoption, and molecular genetic studies of JBD. Behavioral genetic data suggest both genetic and environmental contributions to JBD, while molecular genetic studies find linkage to age of onset of bipolar disorder to chromosomes 12p, 14q, and 15q. Additionally, changes associated with symptom age of onset have been recently reported in the brain-derived neurotrophic factor (BDNF) and glycogen synthase kinase 3-beta (GSK3-beta) genes. We contend that further progress in discovering the precise genetic and environmental contributions to JBD may depend on advances in phenotypic refinement, an increased appreciation of comorbid conditions, and more investigation of the longitudinal course of the disorder. [ABSTRACT FROM AUTHOR]

Background: No clear consensus has been reached yet on how best to characterize children who suffer from pediatric bipolar disorder (PBD). The CBCL-PBD profile on the Child Behavior Checklist (CBCL) has been consistently reported showing deviant findings on the Attention Problems, Aggressive Behavior, and Anxious-Depressed subscales. Aim: To examine the sensitivity and specificity of the proposed CBCL-PBD profile for determining DSM diagnosis of PBD. Methods: We applied receiver operating characteristic (ROC) curve analysis to data from 471 probands from two family studies of attention-deficit hyperactivity disorder and their 410 siblings. Results: The CBCL-PBD score demonstrated an area under the curve (AUC) of 0.97 for probands and 0.82 for siblings for current diagnosis of PBD, suggesting that the CBCL-PBD provided a highly efficient way of identifying subjects with a current diagnosis of PBD in this sample. Conclusions: These findings suggest that the CBCL-PBD may provide a highly efficient way of screening for childhood bipolar disorder. [ABSTRACT FROM AUTHOR]

Background: No consensus has been reached yet on how best to characterize children with juvenile bipolar disorder (JBD). Several groups have shown that children on the attention problems (AP), aggressive behavior (AGG), and anxious-depressed (AD) syndromes of the Child Behavior Checklist (CBCL) are likely to meet criteria for DSM-JBD. We aimed to use a large population-based twin sample to evaluate the prevalence and genetic architecture of the CBCL-JBD (deviant on AP, AGG, and AD) phenotype and compare these data to children who are deviant on just the CBCL-AP syndrome. Methods: Structural equation modeling (SEM) was applied to CBCL data from 5418, 3562, and 1971 Dutch twin pairs at ages 7, 10, and 12 years. Results: The CBCL-JBD phenotype occurs in ∼1% of children at each age. Among the children who meet criteria for the CBCL-AP phenotype (∼ 5%), between 13 and 20% also meet criteria for CBCL-JBD. The best SEM for CBCL-JBD includes additive genetic, shared and unique environmental factors. The best SEM for CBCL-AP includes dominant and additive genetic and unique environmental factors. Conclusions: These data suggest that CBCL-JBD is common, and even more common among children who have severe attention problems. CBCL-JBD shows familial aggregation due to both genetic and shared environmental factors. [Copyright &y& Elsevier]

Self-injurious thoughts and behaviors (SITB) among preteen children have risen to the attention of researchers, practitioners, and policymakers. To shed light on potential treatment/prevention targets, we sought to identify empirically derived emotional and behavioral problem profiles of preteens with SITB, and to determine whether these profiles differ by age, gender and society. Caregivers of 46,719 children aged 6 to 12 years from 42 societies across the world completed the Child Behavior Checklist for ages 6-18 (CBCL/6-18). There were 1,656 children whose caregivers indicated that their child experienced SITB. We conducted a latent profile analysis (LPA) using scores from eight CBCL/6-18 problem scales to derive problem profiles of children with SITB. Multilevel modelling was used to estimate differences in the profiles by SITB, society, sex, and age. A 4-profile model provided the best fit to the data, with profiles reflecting low problems (39.7%), mild problems (42.6%), moderate problems (15.4%), and rule-breaking/thought problems (2.3%). The low problems profile had CBCL problem scale scores nearly indistinguishable from those of children without SITB. Children in the rule-breaking/thought problems group were mostly female, whereas children in the other profile groups were mostly male. Children with the rule-breaking/thought problems profile also were most likely to have both suicidal thoughts and self-harm behaviors. In this study, authors analyzed emotional and behavioral profile of preteens who experienced self-injurious thoughts and behaviors (SITB). Caregivers of over 46,000 children aged 6-12 from 42 countries completed the Child Behavior Checklist. The authors found that most preteens with SITB had low levels of other mental health problems. This study highlights the needs to screen all children for SITBs, not just those who have have significant mental health problems. Problem profiles of preteens with SITB are heterogeneous, with most having relatively low levels of other psychopathology. Selectively screening only children with clinically significant mental health problems for suicidal thoughts and self-harm behaviors (eg, asking about suicidal thoughts only among children with depression) risks missing many children experiencing SITB. [ABSTRACT FROM AUTHOR]

The article provides an overview of the topics discussed in the issue of the journal on child and adolescent psychiatry. The first feature provides a road map through each month's pages by summarizing several of its key articles. The second feature aims to tie this information with research being published in related fields by summarizing recent articles that may be off the path of the reader. Building on the tradition of including relevant abstracts from other journals throughout the issue each month, a rotating contributing editor will select a relevant topic and summarize studies outside clinical child and adolescent psychiatry research.

The article discusses the role of parents in preventing childhood depression and examines the role of gene-environment interplay. According to the author, the presence of a healthy and involved parents in the home can guard at-risk children from later psychopathology. It states that greater understanding of gene-environment interplay could shape human appreciation of the etiology of child and adolescent psychiatric illness, which increases the role of parental family and other environment interventions.

The expression psychopathology in general and child psychopathology in particular, is affected by multiple sources of variance. Some of these sources include gender differences, informant differences, and age-related differences. In this paper, we discuss how these sources of variance complicate both research and clinical management. We argue that the current diagnostic system would be aided by the inclusion of a quantitative axis that can take these sources of variance into account. We reason that the fields of genomics and neuroscience are prepared to move the field of developmental psychopathology forward, but need a diagnostic system that allows for these sources of variance to be controlled. We demonstrate how in Conduct Disorder, inclusion of dimensional information would allow the clinician or researcher to demonstrate not only the presence or absence of pathology, but also the degree to which the disorder is manifested in a particular individual. Because dimensional approaches are already used widely as an alternative measure of psychopathology, we argue that there is reason to consider dimensionalizing some aspects of the DSM. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: We used latent class analysis (LCA) to examine the prevalence and characteristics of the Dysregulation Profile (DP) based on data from the Youth Self-Report (YSR). The DP comprises elevated scores on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndromes and thus reflects significant problems in self-regulation of affect, attention, and behavior.Method: We examined YSR data for 38,070 adolescents (48.1% male) in 34 societies. Participants ranged in age from 11 to 16 years. Researchers in 31 societies used translations of the YSR (not in Jamaica, Australia, or the United States).Results: The various statistical indices for good LCA model fit (entropy, bootstrapped parametric likelihood ratio test, adjusted Bayesian Information Criterion, and probability of correct assignment) were not always consistent but generally supported a DP class in every society. However, prevalence of the DP ranged from 1% to 26% and the T score syndrome profile for the DP class in many societies featured elevations on all scales. In every society, the DP class had significantly higher scores than the pooled non-DP classes on all 3 DP syndromes, with large d values.Conclusion: Because model fit, the number of classes, and the prevalence of the DP class varied across societies, and because the DP "3-peak" profile was relatively uncommon, results for the DP based on adolescents' ratings in 34 societies must be considered as mixed. [ABSTRACT FROM AUTHOR]

The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology and were shaped by a variety of other considerations, which may explain the aforementioned shortcomings. The Hierarchical Taxonomy Of Psychopathology (HiTOP) model has emerged as a research effort to address these problems. It constructs psychopathological syndromes and their components/subtypes based on the observed covariation of symptoms, grouping related symptoms together and thus reducing heterogeneity. It also combines co-occurring syndromes into spectra, thereby mapping out comorbidity. Moreover, it characterizes these phenomena dimensionally, which addresses boundary problems and diagnostic instability. Here, we review the development of the HiTOP and the relevant evidence. The new classification already covers most forms of psychopathology. Dimensional measures have been developed to assess many of the identified components, syndromes, and spectra. Several domains of this model are ready for clinical and research applications. The HiTOP promises to improve research and clinical practice by addressing the aforementioned shortcomings of traditional nosologies. It also provides an effective way to summarize and convey information on risk factors, etiology, pathophysiology, phenomenology, illness course, and treatment response. This can greatly improve the utility of the diagnosis of mental disorders. The new classification remains a work in progress. However, it is developing rapidly and is poised to advance mental health research and care significantly as the relevant science matures. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Abstract: Recent functional connectivity studies have demonstrated that, in resting humans, activity in a dorsally-situated neocortical network is inversely associated with activity in the amygdalae. Similarly, in human neuroimaging studies, aspects of emotion regulation have been associated with increased activity in dorsolateral, dorsomedial, orbital and ventromedial prefrontal regions, as well as concomitant decreases in amygdalar activity. These findings indicate the presence of two countervailing systems in the human brain that are reciprocally related: a dorsally-situated cognitive control network, and a ventrally-situated limbic network. We investigated the extent to which this functional reciprocity between limbic and dorsal neocortical regions is recapitulated from a purely structural standpoint. Specifically, we hypothesized that amygdalar volume would be related to cerebral cortical thickness in cortical regions implicated in aspects of emotion regulation. In 297 typically developing youths (162 females, 135 males; 572 MRIs), the relationship between cortical thickness and amygdalar volume was characterized. Amygdalar volume was found to be inversely associated with thickness in bilateral dorsolateral and dorsomedial prefrontal, inferior parietal, as well as bilateral orbital and ventromedial prefrontal cortices. Our findings are in line with previous work demonstrating that a predominantly dorsally-centered neocortical network is reciprocally related to core limbic structures such as the amygdalae. Future research may benefit from investigating the extent to which such cortical-limbic morphometric relations are qualified by the presence of mood and anxiety psychopathology. [Copyright &y& Elsevier]