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Warner EN, Ammerman RT, Glauser TA, Pestian JP, Agasthya G, Strawn JR. Developmental Epidemiology of Pediatric Anxiety Disorders. Child Adolesc Psychiatr Clin N Am 2023; 32:511-530. [PMID: 37201964 DOI: 10.1016/j.chc.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
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Affiliation(s)
- Emily N Warner
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati.
| | - Robert T Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John P Pestian
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Greeshma Agasthya
- Oak Ridge National Laboratory, Computational Sciences and Engineering Division, Advanced Computing for Health Sciences Section
| | - Jeffrey R Strawn
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Mutluer T, Gorker I, Akdemir D, Ozdemir DF, Ozel OO, Vural P, Tufan AE, Karacetin G, Arman AR, Fis NP, Demirci E, Ozmen S, Hesapcioglu ST, Oztop D, Tural U, Aktepe E, Aksu H, Ardic UA, Basgul S, Bilac O, Coskun M, Celik GG, Demirkaya SK, Dursun OB, Durukan I, Fidan T, Gokcen C, Gormez V, Gundogdu OY, Herguner S, Kandemir H, Kilic BG, Kilincaslan A, Nasiroglu S, Sapmaz SY, Sahin N, Tahiroglu AY, Toros F, Unal F, Yazici IP, Yazici KU, Isik U, Ercan ES. Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study. Soc Psychiatry Psychiatr Epidemiol 2022:10.1007/s00127-022-02396-7. [PMID: 36526939 PMCID: PMC9758023 DOI: 10.1007/s00127-022-02396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. METHODS This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. RESULTS The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. CONCLUSION Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.
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Affiliation(s)
- T. Mutluer
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Koç University School of Medicine, Istanbul, Turkey
| | - I. Gorker
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Trakya University, Edirne, Turkey
| | - D. Akdemir
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - D. Foto Ozdemir
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - O. Ozcan Ozel
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Inonu University, Malatya, Turkey
| | - P. Vural
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Uludag University, Bursa, Turkey
| | - A. E. Tufan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University, Bolu, Turkey
| | - G. Karacetin
- Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | - A. Rodopman Arman
- Department of Child and Adolescent Psychiatry, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
| | - N. Perdahli Fis
- Department of Child and Adolescent Psychiatry, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
| | - E. Demirci
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Erciyes University, Kayseri, Turkey
| | - S. Ozmen
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Erciyes University, Kayseri, Turkey
| | - S. Tural Hesapcioglu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Karadeniz Technical University, Trabzon, Turkey
| | - D. Oztop
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara University, Ankara, Turkey
| | - U. Tural
- Faculty of Medicine, Department of Psychiatry, Kocaeli University, Kocaeli, Turkey
| | - E. Aktepe
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Isparta, Turkey
| | - H. Aksu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - U. Akyol Ardic
- Child and Adolescent Psychiatry, Denizli State Hospital, Denizli, Turkey
| | - S. Basgul
- Department of Psychology, Hasan Kalyoncu University, Istanbul, Turkey
| | - O. Bilac
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Manisa, Turkey
| | - M. Coskun
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul, Turkey
| | - G. G. Celik
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Cukurova University, Adana, Turkey
| | | | - O. B. Dursun
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Turkey
| | - I. Durukan
- Gulhane Faculty of Medicine, Department of Child and Adolescent Psychiatry, University of Health Sciences, Ankara, Turkey
| | - T. Fidan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Osmangazi University, Eskisehir, Turkey
| | - C. Gokcen
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - V. Gormez
- Department of Child and Adolescent Psychiatry, Bezmi Alem University, Istanbul, Turkey
| | - O. Yildiz Gundogdu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli University, Kocaeli, Turkey
| | - S. Herguner
- Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Necmettin Erbakan University, Konya, Turkey
| | - H. Kandemir
- Medical School, Department of Child and Adolescent Psychiatry, Harran University, Sanliurfa, Turkey
| | - B. Gunay Kilic
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara University, Ankara, Turkey
| | - A. Kilincaslan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul, Turkey
| | - S. Nasiroglu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Akdeniz University, Antalya, Turkey
| | - S. Yalin Sapmaz
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Celal Bayar University, Manisa, Turkey
| | - N. Sahin
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mugla Sitki Kocman University, Mugla, Turkey
| | - A. Y. Tahiroglu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Cukurova University, Adana, Turkey
| | - F. Toros
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin University, Mersin, Turkey
| | - F. Unal
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - I. Percinel Yazici
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Firat University, Elazig, Turkey
| | - K. U. Yazici
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Firat University, Elazig, Turkey
| | - U. Isik
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Isparta, Turkey
| | - E. S. Ercan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
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Krause KR, Edbrooke-Childs J, Singleton R, Wolpert M. Are We Comparing Apples with Oranges? Assessing Improvement Across Symptoms, Functioning, and Goal Progress for Adolescent Anxiety and Depression. Child Psychiatry Hum Dev 2022; 53:737-753. [PMID: 33826029 PMCID: PMC9287244 DOI: 10.1007/s10578-021-01149-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 12/16/2022]
Abstract
Strategies for comparing routinely collected outcome data across services or systems include focusing on a common indicator (e.g., symptom change) or aggregating results from different measures or outcomes into a comparable core metric. The implications of either approach for judging treatment success are not fully understood. This study drew on naturalistic outcome data from 1641 adolescents with moderate or severe anxiety and/or depression symptoms who received routine specialist care across 60 mental health services in England. The study compared rates of meaningful improvement between the domains of internalizing symptoms, functioning, and progress towards self-defined goals. Consistent cross-domain improvement was observed in only 15.6% of cases. Close to one in four (24.0%) young people with reliably improved symptoms reported no reliable improvement in functioning. Inversely, one in three (34.8%) young people reported meaningful goal progress but no reliable symptom improvement. Monitoring systems that focus exclusively on symptom change risk over- or under-estimating actual impact, while aggregating different outcomes into a single metric can mask informative differences in the number and type of outcomes showing improvement. A move towards harmonized outcome measurement approaches across multiple domains is needed to ensure fair and meaningful comparisons.
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Affiliation(s)
- Karolin Rose Krause
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK.
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK.
| | - Julian Edbrooke-Childs
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK
| | - Rosie Singleton
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK
| | - Miranda Wolpert
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Wellcome Trust, 215 Euston Rd, Bloomsbury, London, NW1 2BE, UK
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Guilé JM, Zavaglia E, Berthiaume C, Bergeron L. Prevalence and comorbidity of borderline personality traits in the Quebec general population aged 12-14 years. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2053-2062. [PMID: 33745001 DOI: 10.1007/s00127-021-02067-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The early identification of borderline personality traits (BPT) in adolescents helps to prevent their progression. Data are available for the clinical population, but little has been published on the general population, especially regarding age and sex distribution in adolescence. Even less is known about the comorbidity of BPT with other mental disorders. METHODS We estimated the prevalence of BPT, by sex, age, and comorbidity, in a sample of adolescents aged 12-14 years (n = 799) from the Quebec Mental Health Survey. A complex sampling design was used to ensure representativeness. BPT was assessed with the abbreviated-diagnostic interview for borderlines-revised, with the adolescent as an informant. Reliability coefficients were above 0.80. Several levels of severity were explored using an independent criterion, defined by impairment according to the Columbia impairment scale. RESULTS The overall prevalence of BPT was 6.3%. Prevalence estimates for the most impaired were 3.2% for the entire sample and 1.3% for 12-year-olds. Prevalence increased significantly with age for most impairment levels but did not differ significantly between the sexes. In adolescents, BPT displayed moderate-to-strong comorbidity with anxiety (AD) and insomnia disorders, and very strong comorbidity with depressive (DD), attention deficit hyperactivity (ADHD), and oppositional defiant/conduct disorders (ODD/CD). CONCLUSION We, therefore, make two clinical recommendations for child psychiatry practice: (1) with respect to the lower rate of male adolescents attending BPT Health Programs, increase BPT screening in male adolescents; (2) evaluate BPT when children with ADHD or ODD/CD develop AD or DD during adolescence.
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Affiliation(s)
- Jean Marc Guilé
- Child and Adolescent Psychiatry Services, Amiens-Picardie University Medical Centre , Amiens, France. .,Psychiatry Residency Program, Department of Psychiatry, University of Picardie-Jules Verne, Amiens, France. .,Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Elissa Zavaglia
- Department of Psychology, Montreal University, Montreal, QC, Canada.,Research Centre, Hôpital en Santé Mentale Rivières-Des-Prairies, CIUSSS du Nord-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Claude Berthiaume
- Research Centre, Hôpital en Santé Mentale Rivières-Des-Prairies, CIUSSS du Nord-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Lise Bergeron
- Department of Psychology, Montreal University, Montreal, QC, Canada
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Castagna PJ, Waschbusch DA. The Importance of Assessing Impairment Associated With Limited Prosocial Emotions. Behav Ther 2021; 52:1237-1250. [PMID: 34452676 DOI: 10.1016/j.beth.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
Limited prosocial emotions (LPE) are characterized by a lack of remorse or guilt, callousness/lack of empathy, being unconcerned about performance, and shallow/deficient affect. While previous research has largely focused on the presence or absence of LPE in youth, there is considerable evidence that symptom presence/absence and symptom impairment are separable dimensions, where impairment often is found to play a significant, unique role in assessing child psychopathology. The current study utilized a newly developed questionnaire with the purpose of exploring its psychometric properties and better understand the dual and potentially differential role LPE symptom presence and LPE-related impairment have in youth. Mothers (n = 265) of children (Mage = 8.04, SD = 2.07) completed questionnaires assessing LPE impairment, LPE symptoms, externalizing disorder symptoms, and functional impairment. Results demonstrated strong support for the psychometric properties of the newly developed measure of LPE impairment. Importantly, LPE-related impairment uniquely predicted all impairment domains above-and-beyond the effects of LPE symptoms, oppositional defiant disorder, and CD symptoms (as well as child age and sex covariates). Moreover, youth in the top 25th percentile on both LPE symptoms and LPE-related impairment (compared to youth only in the top 25th percentile in LPE symptoms) had greater mean externalizing symptoms and functional impairment. The preliminary evidence provided suggests researchers and clinicians may benefit from assessing both LPE symptoms and LPE-related impairment when attempting to identify youth with high levels of conduct problem symptoms and/or psychosocial impairment. Future research should aim to replicate and expand our findings to other clinical populations.
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Ullah F, Kaelber DC. Using Large Aggregated De-Identified Electronic Health Record Data to Determine the Prevalence of Common Chronic Diseases in Pediatric Patients Who Visited Primary Care Clinics. Acad Pediatr 2021; 21:1084-1093. [PMID: 34022428 PMCID: PMC8637401 DOI: 10.1016/j.acap.2021.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE We used de-identified clinical data from multiple health care systems using different electronic health records (EHRs) to 1) quantify the prevalence of common pediatric chronic diseases, 2) investigate patent characteristics associated with common pediatric chronic diseases, and 3) compare the results of our methodology to determine chronic disease prevalence with traditional approaches. METHODS We used a HIPAA-compliant and de-identified web application (Explorys; IBM Watson Health Explorys Inc.) to identify patients 17 years old or younger from multiple health care systems in the US who were seen in primary care clinics between 2016-2018 to determine the most common chronic conditions in this age group. The prevalence of chronic conditions was compared between different age groups, genders, races/ethnicities, and insurance; odds ratios and confidence intervals were calculated and reported. RESULTS The top 6 chronic conditions identified by prevalence were: obesity/overweight (36.7%), eczema (15.8%), asthma (12.7%), food allergies (4.7%), attention deficit-hyperactivity disorder (4.09%) and hypertension (4.07%). Chronic conditions were generally more prevalent among relatively older pediatric patients, males, and African-American and multiracial groups. CONCLUSIONS Approximately 40% of children and adolescents have at least one chronic disease. Obesity/overweight, eczema, and asthma are the most common chronic diseases of childhood, in the US, among those seeking care in health care systems with EHRs. The work compiled herein demonstrates that aggregated, standardized, normalized and de-identified population-level EHR data can provide both sufficient insight and statistical power to calculate the prevalence of chronic diseases and the odds ratio of various risk factors.
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Affiliation(s)
- Farhan Ullah
- Center for Internal Medicine and Pediatrics, Center for Clinical Informatics Research and Education, The MetroHealth System (F Ullah, DC Kaelber), Cleveland, Ohio.
| | - David C. Kaelber
- Center for Internal Medicine and Pediatrics, Center for
Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH,
United States;,Departments of Internal Medicine, Pediatrics, and
Population and Quantitative Health Sciences, Case Western Reserve University,
Cleveland, OH, United States
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Bares CB, Silberg J, Kendler KS, Maes HH. Common Liabilities in Internalizing Symptoms and Cigarette Use in Adolescence. Nicotine Tob Res 2021; 23:1248-1253. [PMID: 33241318 PMCID: PMC8186420 DOI: 10.1093/ntr/ntaa237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Substance use and mood disorders account for about 10% of the global burden of disease and, among adolescents, are a significant source of disability. The present study examined whether additive genetic or shared environmental factors influenced the covariance of internalizing symptoms and cigarette use during adolescence when both of these problems begin to increase. AIMS AND METHODS We used data (n = 1230 pairs of twins) from the Virginia Twin Study of Adolescent Behavioral Development (mean age = 15.3) to decompose the variance of internalizing symptoms, cigarette initiation, and quantity of cigarettes smoked in a variance decomposition model that included a beta coefficient to allow for estimates of cigarette initiation to influence quantity of cigarettes smoked. RESULTS In biometric models we were able to equate all parameter estimates by sex. After identifying the best fitting model, parameter estimates were calculated and the significance of overlapping paths between internalizing symptoms and cigarette initiation were tested. After accounting for the genetic architecture of cigarette initiation and quantity smoked, the covariance between internalizing symptoms and cigarette use was accounted for by sex-specific shared and unique environmental factors. CONCLUSIONS Among adolescents, the overlap in risk factors between internalizing symptoms and cigarette use is because of non-genetic, environmental factors. Further exploration of the environmental sources of variance involved in the onset of adolescents internalizing symptoms and cigarette use is warranted. IMPLICATIONS We find that during adolescence common environmental factors influence the association between internalizing symptoms and cigarette use. Correlated vulnerabilities because of environmental sources between internalizing and cigarette use may be open to intervention and likely will influence the progression of internalizing and cigarette use.
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Affiliation(s)
| | - Judy Silberg
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Hermine H Maes
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
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Bares C, Lopez-Quintero C. Shared Environmental Influences on Electronic Cigarette Use Among Adolescent and Young Adult Females. Nicotine Tob Res 2021; 23:1425-1430. [PMID: 33539519 DOI: 10.1093/ntr/ntab022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Electronic cigarettes are now the most commonly used form of tobacco product among youth in the United States. Current evidence suggests that although e-cigarettes are perceived as less harmful and preferred over combustible cigarettes by adolescents, adolescents who try e-cigarettes are at greater risk of transitioning to combustible cigarettes. The genetic and environmental contributions to liability for e-cigarette use have not yet been examined using a behavioral genetic design. METHODS Behavioral genetic models of lifetime and current e-cigarette use and friends who use e-cigarettes were examined among female monozygotic and dizygotic twins. RESULTS A total of 41 female twin pairs (65.9% monozygotic twins; age = 19.7, SD = 1.6) with complete data on the study variables were included in the present analyses. The majority of the sample (68.1%) had at least some friends who use e-cigarettes. Additive genetic effects on e-cigarette use were not present, but the shared environment explained 98.7% of the variance in lifetime e-cigarette use, 96.6% in current e-cigarette use, and 94.9% in affiliation with friends who use e-cigarettes. CONCLUSION This first study on the behavioral genetics of e-cigarette use among adolescents and young adults suggest that environmental factors shared by twins within a family seem to play a predominant role in the initial stages of e-cigarette use, a finding that is consistent with what has been found for tobacco. The findings emphasize the importance of continuing population-based tobacco control interventions to reduce the burden of e-cigarette use among adolescents. IMPLICATIONS The shared environment significantly influences the initiation and regular use of electronic cigarettes and affiliation with friends who use electronic cigarettes among adolescent and young adult females. These findings underscore the importance of formulating preventive interventions that mitigate the social effects of familial influences on e-cigarette use through social skills training, education on harms of e-cigarettes for young people, or altering social norms regarding initiation of novel tobacco products.
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Affiliation(s)
- Cristina Bares
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
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Adamo N, Hodsoll J, Asherson P, Buitelaar JK, Kuntsi J. Ex-Gaussian, Frequency and Reward Analyses Reveal Specificity of Reaction Time Fluctuations to ADHD and Not Autism Traits. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:557-567. [PMID: 30027330 PMCID: PMC6397137 DOI: 10.1007/s10802-018-0457-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Both attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have been linked to increased reaction time variability (RTV), a marker of attentional fluctuation. Here we test whether specificity to either trait emerges when we examine (1) detailed ex-Gaussian and frequency RTV subcomponents, (2) effects while controlling for the other trait and (3) improvement in the RTV measures following rewards or a faster event rate. 1110 children aged 7-10 years from a population-based sample completed a Go/No-Go task under three conditions (slow, fast and incentives). We measured RTV with standard deviation of RT (SDRT), ex-Gaussian distribution measures (Sigma and Tau), RT fluctuations in cycles of ~14-90 s in all conditions (Slow-4 and Slow-5), and RT fluctuations in cycles of 2-14 s in the fast condition (Slow-2 and Slow-3). Parent-rated ADHD and ASD traits were obtained. All refined RTV components were linked to ADHD traits only and not to ASD traits, while Sigma did not relate to either trait. Although both ADHD and ASD social-communication traits were associated with SDRT, the association with social-communication impairments disappeared when controlling for ADHD traits. A reward-induced improvement in RTV measures, indicating malleability, emerged in relation to ADHD traits but not ASD traits. Under closer inspection, specificity emerges of high RTV to ADHD traits. For the clinician, our findings indicate that attentional fluctuation in children with high ASD traits may be due to co-occurring ADHD traits and emphasise how the effectiveness of rewards does not generalise from ADHD to ASD traits.
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Affiliation(s)
- Nicoletta Adamo
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park (PO80), London, SE5 8AF, UK
| | - John Hodsoll
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park (PO20), London, SE5 8AF, UK
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park (PO80), London, SE5 8AF, UK
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Trigon building, Route 200, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park (PO80), London, SE5 8AF, UK.
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Del Giudice T, Tervoort J, Hautmann C, Walter D, Döpfner M. Cross-Cultural Validity of the Child and Adolescent Dispositions Model in a Clinical Sample of Children With Externalizing Behavior Problems. Front Psychol 2020; 11:641. [PMID: 32322227 PMCID: PMC7156638 DOI: 10.3389/fpsyg.2020.00641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 03/17/2020] [Indexed: 12/05/2022] Open
Abstract
Background: The Child and Adolescent Dispositions Scale—parent rating (CADS-P) explores three emotional dispositions that may enlarge the probability of future externalizing problem behavior. The English version has proven its psychometric quality within a population-based sample of children and adolescents. The presents study investigates the German version of the CADS-P by examining a clinically referred sample of children with externalizing behavior problems. Methods:The sample included 132 children aged 4–11 years with a diagnosis of attention- deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD). The factor structure of the CADS-P was evaluated using exploratory (EFA) and confirmatory factor analyses (CFA). Reliability was estimated using internal consistency (Cronbach's alpha). Validity was assessed through linear regression analyses, with symptoms of externalizing [conduct disorder (CD), ODD, ADHD] and internalizing behavior problems (anxiety, depression) as criterion variables and the three CADS-P factor scores as predictors. Results:After eliminating eight items due to insufficient psychometric properties, EFA and CFA supported a three-factor solution for the German CADS-P. Cronbach's alpha coefficient exceeded α = 0.70 for all subscales. Mostly, as predicted, the CADS-P dimensions were associated with symptoms of ODD/CD and ADHD and symptoms of anxiety and depression. Conclusions:The present study provides evidence for the cross-cultural validity of the CADS- P in a non-English-Speaking country. Results show that the German version of the CADS-P is a reliable and valid parent questionnaire for assessing prosociality, negative emotionality and daring as emotional dispositions that may enlarge the probability to develop externalizing problem behavior. Trial Registration: The study was approved by the review board of the Medical Faculty of the University of Cologne (ID 09-123) and was pre-registered at ClinicalTrials.gov (ID: NCT01350986).
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Affiliation(s)
- Teresa Del Giudice
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, Cologne, Germany
- *Correspondence: Teresa Del Giudice
| | - Janina Tervoort
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
| | - Christopher Hautmann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, Cologne, Germany
| | - Daniel Walter
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), University Hospital Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
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Tistarelli N, Fagnani C, Troianiello M, Stazi MA, Adriani W. The nature and nurture of ADHD and its comorbidities: A narrative review on twin studies. Neurosci Biobehav Rev 2019; 109:63-77. [PMID: 31838192 DOI: 10.1016/j.neubiorev.2019.12.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 12/26/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children worldwide, and also the recognition of its persistence into adulthood is increasing. While ADHD in childhood is highly heritable and mostly driven by familial factors, during adulthood it appears to show a lower heritability, even if there is not total agreement on this yet. This disorder often co-occurs with many other conditions, which also vary across the different stages of development, and several studies have used the twin design to investigate these comorbidities, giving valuable insights into the origins of the observed co-occurrence. This review aims to summarize the main results of twin research, according to the following domains: individual traits, cognitive impairment, behavioral manifestations, clinical conditions and psychosocial risk factors. Individual features seem to play a role in this symptomatology and include personality traits such as negative emotionality, personality disorders and temperamental dimensions with a predominance of novelty seeking. At a lower level, ADHD is associated with both functional and anatomic brain characteristics. ADHD is also associated with some forms of cognitive impairment, such as sluggish cognitive tempo, and learning disabilities, with a specific predisposition to reading disability. In addition, ADHD is strongly associated with externalizing disorders such as conduct disorder and oppositional defiant disorder, and some behavioral outcomes, particularly substance use and abuse both in adolescence and adulthood. Moreover, ADHD symptoms often overlap with other psychological disorders, namely affective and internalizing disorders, as well as autism spectrum disorder and autistic-like traits in a wider sense. Notably, a genetic overlap has been found between asthma and ADHD, particularly with respect to hyperactivity/impulsivity dimensions. ADHD also appears to represent a risk factor for disordered eating, and, more specifically, for binge eating and bulimia nervosa. Finally, among psychosocial factors, an association has been proposed between childhood maltreatment and ADHD symptoms.
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Affiliation(s)
- Naomi Tistarelli
- Department of Brain & Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Corrado Fagnani
- Center "Behavioral Sciences and Mental Health", Istituto Superiore di Sanità, Rome, Italy
| | | | - Maria Antonietta Stazi
- Center "Behavioral Sciences and Mental Health", Istituto Superiore di Sanità, Rome, Italy
| | - Walter Adriani
- Center "Behavioral Sciences and Mental Health", Istituto Superiore di Sanità, Rome, Italy.
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Moore AA, Lapato DM, Brotman MA, Leibenluft E, Aggen SH, Hettema JM, York TP, Silberg JL, Roberson-Nay R. Heritability, stability, and prevalence of tonic and phasic irritability as indicators of disruptive mood dysregulation disorder. J Child Psychol Psychiatry 2019; 60:1032-1041. [PMID: 30994196 PMCID: PMC6692198 DOI: 10.1111/jcpp.13062] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Little is known about genetic and environmental influences on the components of disruptive mood dysregulation disorder (DMDD), tonic irritability (i.e., irritable mood) and phasic irritability (i.e., temper outbursts). This study examined prevalence, stability, and heritability of tonic irritability, phasic irritability, and a DMDD proxy (pDMDD) based on DSM-5 criteria. METHODS pDMDD was derived using data from clinical interviews of parents and their twins (N = 1,431 twin pairs), ages 8-17, participating in Waves 1 and 2 of the Virginia Twin Study of Adolescent Behavioral Development. Biometrical modeling was used to compare a common pathway model (CPM) and an independent pathway model (IPM), and heritability estimates were obtained for pDMDD using the symptoms of irritable mood (tonic irritability; DMDD Criterion D), intense temper outbursts (phasic irritability; DMDD Criterion A), and frequent temper outbursts (phasic irritability; DMDD Criterion C). RESULTS Lifetime prevalence of pDMDD was 7.46%. The stability of DMDD symptoms and the pDMDD phenotype across approximately one year were moderate (.30-.69). A CPM was a better fit to the data than an IPM. Phasic irritability loaded strongly onto the pDMDD latent factor (.89-.96) whereas tonic irritability did not (.28). Genetic influences accounted for approximately 59% of the variance in the latent pDMDD phenotype, with the remaining 41% of the variance due to unique environmental effects. The heritability of tonic irritability (54%) was slightly lower than that of frequent and intense temper (components of phasic irritability; 61% and 63%, respectively). CONCLUSIONS Compared to tonic irritability, phasic irritability appears to be slightly more stable and heritable, as well as a stronger indicator of the latent factor. Furthermore, environmental experiences appear to play a substantial role in the development of irritability and DMDD, and researchers should seek to elucidate these mechanisms in future work.
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Affiliation(s)
- Ashlee A. Moore
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA
| | - Dana M. Lapato
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institutes of Mental Health, National Institutes of Health Department of Health and Human Services, Bethesda, MD
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institutes of Mental Health, National Institutes of Health Department of Health and Human Services, Bethesda, MD
| | - Steven H. Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - John M. Hettema
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Timothy P. York
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
| | - Judy L. Silberg
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
| | - Roxann Roberson-Nay
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
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Reilly EE, Brown TA, Gray EK, Kaye WH, Menzel JE. Exploring the cooccurrence of behavioural phenotypes for avoidant/restrictive food intake disorder in a partial hospitalization sample. EUROPEAN EATING DISORDERS REVIEW 2019; 27:429-435. [DOI: 10.1002/erv.2670] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/14/2019] [Accepted: 02/11/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Erin E. Reilly
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Tiffany A. Brown
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Emily K. Gray
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Walter H. Kaye
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Jessie E. Menzel
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
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Ramy H, El Sheikh M, Sultan M, Bassim R, Eid M, Ali R, El Missiry M. Risk factors influencing severity of attention deficit hyperactivity disorder in a sample of preparatory school students in Cairo. Clin Child Psychol Psychiatry 2018; 23:542-555. [PMID: 29451009 DOI: 10.1177/1359104518755218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. Severity of symptoms is associated with more behavioral problems, poor academic performance, and persistence of symptoms into adulthood. METHODS To examine the clinical and social correlates that may be identified as risk factors associated with ADHD severity in a sample of adolescent ADHD school students. A total of 925 students were recruited from two public and two private schools from eastern Cairo. They were interviewed using Conners-Wells Adolescent Self-Report-short version (CASS-S); students scoring more than 65 were further interviewed with Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version (K-SADS-PL) to confirm the diagnosis, then Conners-Wells Adolescent Self-Report-long version (CASS-L) to assess severity and Wechsler Intelligence Scale for Children (WISC) to ascertain intellectual ability. RESULTS About 10.3% of cases were severe, 5.7% were moderate, and 83.9% were mild. Severity was significantly associated with female gender, psychiatric comorbidity, family problems, conduct symptoms, and poor anger management. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ( DSM-IV) hyperactive-impulsive type was the only predictive factor of ADHD severity. CONCLUSIONS The diagnosis of hyperactive-impulsive subtype may predict the severity of ADHD symptoms.
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Affiliation(s)
- Hisham Ramy
- Institute of Psychiatry, Ain Shams University, Egypt
| | | | - Marwa Sultan
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Rasha Bassim
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Maissa Eid
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Ramy Ali
- Institute of Psychiatry, Ain Shams University, Egypt
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Bishry Z, Ramy HA, El-Shahawi HH, El-Sheikh MM, El-Missiry AA, El-Missiry MA. Screening for ADHD in a Sample of Egyptian Adolescent School Students. J Atten Disord 2018; 22:58-65. [PMID: 24891559 DOI: 10.1177/1087054714533190] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To screen for ADHD in a sample of Egyptian adolescent students, and study the distribution of different subtypes of ADHD, associated comorbidities, and sociodemographic correlates. METHOD A total of 925 adolescents were randomly selected and screened by the Conners-Wells' Adolescent Self-Report Scale-Short form (CASS:S), and potential cases were further assessed by the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime versions (K-SADS-PL). RESULTS A total of 87 students (9.4%) had potential ADHD diagnosis with evident preponderance in boys (13.8%, n = 58) than in girls (5.8%, n = 29) with a ratio of 2:1 ( p = .000, χ2 = 17.328). The hyperactive-impulsive subtype comprised the majority of cases (54.7%, n = 41). Psychiatric comorbidity was invariably present (85.1%, n = 74). Nearly half the cases had poor academic achievement (43.7%, n = 34). Positive correlates included family history of psychiatric disorders, the order of birth, and parental disharmony. CONCLUSION ADHD is prevalent in Egyptian adolescents and is associated with high psychiatric comorbidity and a pronounced effect on academic performance.
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Affiliation(s)
- Zienab Bishry
- 1 Instititute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Hisham A Ramy
- 1 Instititute of Psychiatry, Ain Shams University, Cairo, Egypt
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Social Origins of Developmental Risk for Mental and Physical Illness. J Neurosci 2017; 37:10783-10791. [PMID: 29118206 DOI: 10.1523/jneurosci.1822-17.2017] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 12/19/2022] Open
Abstract
Adversity in early childhood exerts an enduring impact on mental and physical health, academic achievement, lifetime productivity, and the probability of interfacing with the criminal justice system. More science is needed to understand how the brain is affected by early life stress (ELS), which produces excessive activation of stress response systems broadly throughout the child's body (toxic stress). Our research examines the importance of sex, timing and type of stress exposure, and critical periods for intervention in various brain systems across species. Neglect (the absence of sensitive and responsive caregiving) or disrupted interaction with offspring induces robust, lasting consequences in mice, monkeys, and humans. Complementary assessment of internalizing disorders and brain imaging in children suggests that early adversity can interfere with white matter development in key brain regions, which may increase risk for emotional difficulties in the long term. Neural circuits that are most plastic during ELS exposure in monkeys sustain the greatest change in gene expression, offering a mechanism whereby stress timing might lead to markedly different long-term behaviors. Rodent models reveal that disrupted maternal-infant interactions yield metabolic and behavioral outcomes often differing by sex. Moreover, ELS may further accelerate or delay critical periods of development, which reflect GABA circuit maturation, BDNF, and circadian Clock genes. Such factors are associated with several mental disorders and may contribute to a premature closure of plastic windows for intervention following ELS. Together, complementary cross-species studies are elucidating principles of adaptation to adversity in early childhood with molecular, cellular, and whole organism resolution.
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Homman LE, Edwards AC, Cho SB, Dick DM, Kendler KS. Gender and Direction of Effect of Alcohol Problems and Internalizing Symptoms in a Longitudinal Sample of College Students. Subst Use Misuse 2017; 52:429-438. [PMID: 27849409 PMCID: PMC5601307 DOI: 10.1080/10826084.2016.1233983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Alcohol problems and internalizing symptoms are consistently found to be associated but how they relate to each other is unclear. OBJECTIVE The present study aimed to address limitations in the literature of comorbidity of alcohol problems and internalizing symptoms by investigating the direction of effect between the phenotypes and possible gender differences in college students. METHOD We utilized data from a large longitudinal study of college students from the United States (N = 2607). Three waves of questionnaire-based data were collected over the first two years of college (in 2011-2013). Cross-lagged models were applied to examine the possible direction of effect of internalizing symptoms and alcohol problems. Possible effects of gender were investigated using multigroup modeling. RESULTS There were significant correlations between alcohol problems and internalizing symptoms. A direction of effect was found between alcohol problems and internalizing symptoms but differed between genders. A unidirectional relationship varying with age was identified for males where alcohol problems initially predicted internalizing symptoms followed by internalizing symptoms predicting alcohol problems. For females, a unidirectional relationship existed wherein alcohol problems predicted internalizing symptoms. Conclusions/Importance: We conclude that the relationship between alcohol problems and internalizing symptoms is complex and differ between genders. In males, both phenotypes are predictive of each other, while in females the relationship is driven by alcohol problems. Importantly, our study examines a population-based sample, revealing that the observed relationships between alcohol problems and internalizing symptoms are not limited to individuals with clinically diagnosed mental health or substance use problems.
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Affiliation(s)
- Lina E. Homman
- Institute of Clinical Sciences, Block B. Queens University Belfast. Royal Victoria Hospital. Belfast, BT12 6BA, Northern Ireland, UK
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University. PO Box 980126, Richmond, VA, USA, 23298-0126
| | - Seung Bin Cho
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University. PO Box 980126, Richmond, VA, USA, 23298-0126
- Departments of Psychology and African American Studies, Virginia Commonwealth University, PO Box 842509, Richmond, VA 23284-2509
| | - Danielle M. Dick
- Departments of Psychology and African American Studies, Virginia Commonwealth University, PO Box 842509, Richmond, VA 23284-2509
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University. PO Box 980126, Richmond, VA, USA, 23298-0126
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Sorvo R, Koponen T, Viholainen H, Aro T, Räikkönen E, Peura P, Dowker A, Aro M. Math anxiety and its relationship with basic arithmetic skills among primary school children. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2017; 87:309-327. [PMID: 28258597 DOI: 10.1111/bjep.12151] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/05/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children have been found to report and demonstrate math anxiety as early as the first grade. However, previous results concerning the relationship between math anxiety and performance are contradictory, with some studies establishing a correlation between them while others do not. These contradictory results might be related to varying operationalizations of math anxiety. AIMS In this study, we aimed to examine the prevalence of math anxiety and its relationship with basic arithmetic skills in primary school children, with explicit focus on two aspects of math anxiety: anxiety about failure in mathematics and anxiety in math-related situations. SAMPLE The participants comprised 1,327 children at grades 2-5. METHODS Math anxiety was assessed using six items, and basic arithmetic skills were assessed using three assessment tasks. RESULTS Around one-third of the participants reported anxiety about being unable to do math, one-fifth about having to answer teachers' questions, and one tenth about having to do math. Confirmatory factor analysis indicated that anxiety about math-related situations and anxiety about failure in mathematics are separable aspects of math anxiety. Structural equation modelling suggested that anxiety about math-related situations was more strongly associated with arithmetic fluency than anxiety about failure. Anxiety about math-related situations was most common among second graders and least common among fifth graders. CONCLUSIONS As math anxiety, particularly about math-related situations, was related to arithmetic fluency even as early as the second grade, children's negative feelings and math anxiety should be identified and addressed from the early primary school years.
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Affiliation(s)
- Riikka Sorvo
- Department of Education, University of Jyväskylä, Finland
| | - Tuire Koponen
- Department of Education, University of Jyväskylä, Finland.,Niilo Mäki Institute, University of Jyväskylä, Finland
| | | | - Tuija Aro
- Niilo Mäki Institute, University of Jyväskylä, Finland.,Department of Psychology, University of Jyväskylä, Finland
| | | | - Pilvi Peura
- Department of Education, University of Jyväskylä, Finland
| | - Ann Dowker
- Department of Experimental Psychology, University of Oxford, UK
| | - Mikko Aro
- Department of Education, University of Jyväskylä, Finland
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Perera F, Nolte ELR, Wang Y, Margolis AE, Calafat AM, Wang S, Garcia W, Hoepner LA, Peterson BS, Rauh V, Herbstman J. Bisphenol A exposure and symptoms of anxiety and depression among inner city children at 10-12 years of age. ENVIRONMENTAL RESEARCH 2016; 151:195-202. [PMID: 27497082 PMCID: PMC5071142 DOI: 10.1016/j.envres.2016.07.028] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/28/2016] [Accepted: 07/19/2016] [Indexed: 05/09/2023]
Abstract
BACKGROUND Experimental and epidemiological studies suggest that gestational exposure to Bisphenol A (BPA), an ubiquitous endocrine disrupting chemical, may lead to neurobehavioral problems in childhood; however, not all results have been consistent. We previously reported a positive association between prenatal BPA exposure and symptoms of anxiety/depression reported by the mother at child age 7-9 years in boys, but not girls. OBJECTIVES Here, in the same birth cohort, we investigated the association of prenatal BPA exposure with symptoms of depression and anxiety self-reported by the 10-12 year olds, hypothesizing that we would observe sex-specific differences in anxiety and depressive symptoms. METHODS African-American and Dominican women living in Northern Manhattan and their children were followed from mother's pregnancy through children's age 10-12 years. BPA was quantified in maternal urine collected during the third trimester of pregnancy and in child urine collected at ages 3 and 5 years. Children were evaluated using the Revised Children's Manifest Anxiety Scale (RCMAS) and Children's Depression Rating Scale (CDRS). We compared the children in the highest tertile of BPA concentration to those in the lower two tertiles. Associations between behavior and prenatal (maternal) BPA concentration or postnatal (child) BPA concentration were assessed in regression models stratified by sex. RESULTS Significant positive associations between prenatal BPA and symptoms of depression and anxiety were observed among boys. Postnatal BPA exposure was not significantly associated with outcomes. There was substantial co-occurrence of anxiety and depressive symptoms in this sample. CONCLUSION These results provide evidence that prenatal BPA exposure is associated with more symptoms of anxiety and depression in boys but not in girls at age 10-12 years.
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Affiliation(s)
- Frederica Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA.
| | - Emily L Roen Nolte
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Ya Wang
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Amy E Margolis
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Division of Child & Adolescent Psychiatry and the Center for Developmental Neuropsychiatry, Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F17, Atlanta, GA 30341, USA
| | - Shuang Wang
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Wanda Garcia
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; The Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Avenue, New York, NY 10032, USA
| | - Lori A Hoepner
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles and Keck School of Medicine at the University of Southern California, USA
| | - Virginia Rauh
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; The Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Avenue, New York, NY 10032, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
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Bares CB, Kendler KS, Maes HHM. Racial differences in heritability of cigarette smoking in adolescents and young adults. Drug Alcohol Depend 2016; 166:75-84. [PMID: 27427414 PMCID: PMC4983522 DOI: 10.1016/j.drugalcdep.2016.06.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although epidemiologic studies suggest low levels of cigarette use among African American adolescents relative to White U.S. adolescents, it is not known whether this may be due to racial differences in the relative contribution of genes and environment to cigarette use initiation and progression to regular use. METHODS Using data from White (n=2665) and African American (n=809) twins and full siblings sampled in the National Longitudinal Study of Adolescents, we fitted age-, sex- and race-specific variance decomposition models to estimate the magnitude of genetic and environmental effects on cigarette use initiation and cigarette use quantity in Whites and African Americans across adolescence and adulthood. We employ a causal-contingent-common pathway model to estimate the amount of variance explained in quantity of cigarettes smoked contingent on cigarette use initiation. RESULTS African Americans had lower cigarette use prevalence from adolescence through adulthood, and used cigarettes less heavily than Whites. Race-specific causal-contingent-common pathway models indicate that racial differences in genetic and environmental contributions to cigarette use initiation and cigarette use quantities are not present in adolescence but appear in young adulthood. Additive genetic factors were an important risk factor for cigarette use initiation for White but not African American young adults and adults. CONCLUSIONS Genetic and environmental contributions for cigarette use are similar by race in adolescence. In adulthood, genes have a stronger influence for cigarette use among White adolescents while the influence of the environment is minimal. For African Americans, both genetic and environmental influences are important in young adulthood and adulthood.
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Affiliation(s)
- Cristina B. Bares
- 1080 S. University, School of Social Work, The University of Michigan, Ann Arbor, MI 48109
| | - Kenneth S. Kendler
- 800 E. Leigh Street, Department of Psychiatry and Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298-0126
| | - Hermine H. M. Maes
- 800 E. Leigh Street, Department of Human and Molecular Genetics and Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298-0126
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van Geelen SM, Hagquist C. Are the time trends in adolescent psychosomatic problems related to functional impairment in daily life? A 23-year study among 20,000 15-16year olds in Sweden. J Psychosom Res 2016; 87:50-6. [PMID: 27411752 DOI: 10.1016/j.jpsychores.2016.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/26/2016] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Worldwide there are frequent reports on increasing psychosomatic problems, anxiety, emotional distress, conduct problems, and depression among adolescents. Recently, it was contended that secular studies on such aspects of adolescent mental health can only be evaluated adequately when data on symptom prevalence are analyzed together with data on functional impairment. Still, this has not yet been done in epidemiological time-trend studies on any aspect of adolescent mental health. Therefore, this study aims to investigate if, and to what extent, changes in adolescents' symptoms of psychosomatic problems are affected when data on functional impairment are taken into account simultaneously. METHODS A repeated cross-sectional population study relating self-reported symptoms of psychosomatic problems to functional impairment; covering the time-period 1988-2011 and including 19.823 adolescents 15-16years old in eight cohorts in one geographically defined population (Värmland, Sweden). RESULTS The proportion of adolescents with psychosomatic problems had increased significantly from 1988 to 2005/2008. In all cohorts the proportion of girls with psychosomatic problems was significantly higher than the proportion of boys reporting symptoms. Over the same period, there was a corresponding significant increase of the proportion of participants with symptoms of psychosomatic problems in combination with functional impairment. Adding functional impairment to the measure of psychosomatic problems decreased the prevalence rates, while the shapes of the trend-curves stayed congruent in form. CONCLUSION The long-term pattern of increasing psychosomatic problems among adolescents remains evident, even when taking functional impairment data into account. Previously observed trends of a deteriorating adolescent mental health are thus consistent with this study.
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Affiliation(s)
- Stefan M van Geelen
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, 65188 Karlstad, Sweden; Division of Pediatrics, University Medical Center Utrecht, The Netherlands.
| | - Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Sweden
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Demmer DH, Hooley M, Sheen J, McGillivray JA, Lum JAG. Sex Differences in the Prevalence of Oppositional Defiant Disorder During Middle Childhood: a Meta-Analysis. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 45:313-325. [DOI: 10.1007/s10802-016-0170-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Silberg J, Moore AA, Rutter M. Age of onset and the subclassification of conduct/dissocial disorder. J Child Psychol Psychiatry 2015; 56:826-833. [PMID: 25359313 PMCID: PMC4417077 DOI: 10.1111/jcpp.12353] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Conduct Disorder (CD) is a markedly heterogeneous psychiatric condition. Moffitt (1993) proposed that subclassification of CD should be according to age of onset. Our goals were to compare childhood-onset and adolescent-onset CD in terms of differences in phenotypic risk factors, genetic analyses, and factors associated with the persistence of antisocial behavior into young adulthood. METHODS The data are from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and Young Adult Follow-Up (YAFU). Childhood-onset CD was defined as CD beginning at or before age 11. Adolescent-onset CD was defined as having CD onset between ages 14 and 17. These subgroups were compared on ADHD, young adult antisocial behavior (ASB), family dysfunction, and parental depression. Genetic analyses compare childhood-onset and adolescent-onset CD, as well as their cooccurrence with ADHD and ASB. Finally, predictors of persistence were examined. RESULTS Childhood-onset CD was significantly associated with ADHD, ASB, family dysfunction, and parental depression. Adolescent-onset CD was marginally associated with parental depression (p = .05) but not with any of the other risk factors. Univariate genetic models showed that both childhood-onset and adolescent-onset CD involve a large genetic liability accounting for 62% and 65% of the variance, respectively. A common genetic factor (as well as an ADHD-specific factor) accounted for the cooccurrence of childhood-onset CD and ADHD. The cooccurrence of childhood-onset CD and ASB are reflected by a common genetic factor with genetic specific effects on ASB. There was no etiological link between adolescent-onset CD and either ADHD or ASB. Both ADHD and family dysfunction were significantly associated with the persistence of antisocial behavior into young adulthood. CONCLUSIONS Phenotypic findings differentiated between childhood-onset and adolescent-onset CD. ADHD and family dysfunction predicted persistence of antisocial behavior into young adulthood.
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Affiliation(s)
- Judy Silberg
- Department of Human and Molecular Genetics, Virginia
Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University,
Richmond, VA
| | - Ashlee A. Moore
- Center for Clinical and Translational Research, Virginia
Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University,
Richmond, VA, USA
| | - Michael Rutter
- MRC Social, Genetic and Developmental Psychiatry Research
Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College,
London, UK
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Genome-Wide Meta-Analysis of Longitudinal Alcohol Consumption Across Youth and Early Adulthood. Twin Res Hum Genet 2015; 18:335-47. [PMID: 26081443 DOI: 10.1017/thg.2015.36] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The public health burden of alcohol is unevenly distributed across the life course, with levels of use, abuse, and dependence increasing across adolescence and peaking in early adulthood. Here, we leverage this temporal patterning to search for common genetic variants predicting developmental trajectories of alcohol consumption. Comparable psychiatric evaluations measuring alcohol consumption were collected in three longitudinal community samples (N=2,126, obs=12,166). Consumption-repeated measurements spanning adolescence and early adulthood were analyzed using linear mixed models, estimating individual consumption trajectories, which were then tested for association with Illumina 660W-Quad genotype data (866,099 SNPs after imputation and QC). Association results were combined across samples using standard meta-analysis methods. Four meta-analysis associations satisfied our pre-determined genome-wide significance criterion (FDR<0.1) and six others met our 'suggestive' criterion (FDR<0.2). Genome-wide significant associations were highly biological plausible, including associations within GABA transporter 1, SLC6A1 (solute carrier family 6, member 1), and exonic hits in LOC100129340 (mitofusin-1-like). Pathway analyses elaborated single marker results, indicating significant enriched associations to intuitive biological mechanisms, including neurotransmission, xenobiotic pharmacodynamics, and nuclear hormone receptors (NHR). These findings underscore the value of combining longitudinal behavioral data and genome-wide genotype information in order to study developmental patterns and improve statistical power in genomic studies.
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Gillespie NA, Eaves LJ, Maes H, Silberg JL. Testing Models for the Contributions of Genes and Environment to Developmental Change in Adolescent Depression. Behav Genet 2015; 45:382-93. [PMID: 25894924 DOI: 10.1007/s10519-015-9715-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 03/09/2015] [Indexed: 11/27/2022]
Abstract
We tested two models to identify the genetic and environmental processes underlying longitudinal changes in depression among adolescents. The first assumes that observed changes in covariance structure result from the unfolding of inherent, random individual differences in the overall levels and rates of change in depression over time (random growth curves). The second assumes that observed changes are due to time-specific random effects (innovations) accumulating over time (autoregressive effects). We found little evidence of age-specific genetic effects or persistent genetic innovations. Instead, genetic effects are consistent with a gradual unfolding in the liability to depression and rates of change with increasing age. Likewise, the environment also creates significant individual differences in overall levels of depression and rates of change. However, there are also time-specific environmental experiences that persist with fidelity. The implications of these differing genetic and environmental mechanisms in the etiology of depression are considered.
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Affiliation(s)
- Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Richmond, VA, USA,
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Mallett CA, Kirven J. Comorbid Adolescent Difficulties: Social Work Prevention of Delinquency and Serious Youthful Offending. JOURNAL OF EVIDENCE-INFORMED SOCIAL WORK 2015; 12:509-23. [PMID: 25844994 DOI: 10.1080/15433714.2014.942020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A majority of adolescents who are formally involved with the juvenile courts and detained or incarcerated are dealing with past or present maltreatment victimization, learning disabilities, and/or mental health/substance abuse difficulties. Addressing these problems and traumas is an integral part of preventing delinquency and breaking a youthful offender's recidivist cycle, a pattern that often predicts adult offending and incarceration. Fortunately, there are effective programs across the social work profession that decrease or may even eliminate delinquent behaviors, both for low-level and more serious youthful offenders. Unfortunately, the use of these social work preventative programs is not consistent or extensive within the juvenile justice system.
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Sobhani M, Baker L, Martins B, Tuvblad C, Aziz-Zadeh L. Psychopathic traits modulate microstructural integrity of right uncinate fasciculus in a community population. NEUROIMAGE-CLINICAL 2015; 8:32-8. [PMID: 26106525 PMCID: PMC4473285 DOI: 10.1016/j.nicl.2015.03.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 11/29/2022]
Abstract
Individuals with psychopathy possess emotional and behavioral abnormalities. Two neural regions, involved in behavioral control and emotion regulation, are often implicated: amygdala and ventromedial prefrontal cortex (VMPFC). Recently, in studies using adult criminal populations, reductions in microstructural integrity of the white matter connections (i.e., uncinate fasciculus (UF)) between these two neural regions have been discovered in criminals with psychopathy, supporting the notion of neural dysfunction in the amygdala-VMPFC circuit. Here, a young adult, community sample is used to assess whether psychopathic traits modulate microstructural integrity of UF, and whether this relationship is dependent upon levels of trait anxiety, which is sometimes used to distinguish subtypes of psychopathy. Results reveal a negative association between psychopathic traits and microstructural integrity of UF, supporting previous findings. However, no moderation of the relationship by trait anxiety was discovered. Findings provide further support for the notion of altered amygdala-VMPFC connectivity in association with higher psychopathic traits.
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Affiliation(s)
- Mona Sobhani
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA ; Brain and Creativity Institute, Los Angeles, CA, USA
| | - Laura Baker
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | | | - Catherine Tuvblad
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Lisa Aziz-Zadeh
- Brain and Creativity Institute, Los Angeles, CA, USA ; Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
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Kovess V, Carta MG, Pez O, Bitfoi A, Koç C, Goelitz D, Kuijpers R, Lesinskiene S, Mihova Z, Otten R. The School Children Mental Health in Europe (SCMHE) Project: Design and First Results. Clin Pract Epidemiol Ment Health 2015; 11:113-23. [PMID: 25834631 PMCID: PMC4378028 DOI: 10.2174/1745017901511010113] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/03/2014] [Accepted: 10/05/2014] [Indexed: 11/22/2022]
Abstract
Background : The School Children Mental Health in Europe (SCMHE) project aims to build up a set of indicators to collect and monitor children's mental health in an efficient and comparable methodology across the EU countries. It concerns primary schools children aged 6 to 11 years a range where few data are available whereas school interventions are promising. Methods : Three informants were used: parents, teachers and children. In selecting instruments language, instruments were selected according to the easiness to translate them: SDQ (Strengths and Difficulties Questionnaire) for parents and teachers and DI (Dominic Interactive). A two-step procedure was used: schools randomization then six children by class in each grade. Results : 9084 children from seven countries (Italy, Netherlands, Germany, Romania, Bulgaria, Lithuania, and Turkey) completed the Dominic Interactive in their own language. 6563 teachers and 6031 parents completed their questionnaire, and a total of 5574 interviews have been completed by the 3 informants. The participation rate of the children with parents in the participating schools was about 66.4%. As expected teachers report more externalised problems and less internalised problems than parents. Children report more internalised problems than parents and teachers. Boys have consistently more externalised problems than girls and this is the reverse for internalised problems. Combining the diverse informants and impairment levels children with problems requiring some sort of mental health care were about 9.9%: 76% did not see any mental health professional: 78.7% In Eastern countries 63.1% in Western Europe.
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Affiliation(s)
- Viviane Kovess
- EHESP Rennes, Sorbonne Paris Cite, EA 4057 Paris Descartes University, Paris, France
| | - Mauro Giovanni Carta
- Centro di Psichiatria di Consulenza e Psicosomatica Azienda Ospedaliero Universitaria di Cagliari
| | - Ondine Pez
- EHESP Rennes, Sorbonne Paris Cite, EA 4057 Paris Descartes University, Paris, France
| | - Adina Bitfoi
- The Romanian League for Mental Health, Bucharest, Romania
| | - Ceren Koç
- Yeniden Health and Education Society, Istanbul, Turkey
| | - Dietmar Goelitz
- Institute of Psychology, University of Koblenz-Landau (Campus Koblenz), Koblenz, Germany
| | - Rowella Kuijpers
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Sigita Lesinskiene
- Clinic of Psychiatry, Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | | | - Roy Otten
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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Dimensions of Oppositional Defiant Disorder in young children: heterotypic continuity with anxiety and depression. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 42:937-51. [PMID: 24497230 DOI: 10.1007/s10802-014-9853-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There are distinct dimensions of Oppositional Defiant Disorder (ODD) that have been associated with symptoms of other disorders (heterotypic continuity). The present study compared the heterotypic continuity of a two-factor (Pitt-2) model and the three-factor model incorporated into DSM-5 with symptoms of anxiety and depression. Participants were a diverse community sample of 796 children (38.8 % minority, 49.1 % boys) assessed at ages 4, 5 and 6 years. Symptoms were assessed with the dimensional scales of the Diagnostic Interview Schedule for Children-Young Child version and the Child Symptom Inventory. Dimensions of both the two- and three-factor DSM-5 models were associated with later symptoms of anxiety and depression. The association, however, was weak when accounting for initial levels of internalizing symptoms: thus there was little evidence for the unique contributions of ODD dimensions to symptoms of subsequent internalizing disorders for either model.
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30
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Rijlaarsdam J, Stevens GWJM, van der Ende J, Hofman A, Jaddoe VWV, Verhulst FC, Tiemeier H. Prevalence of DSM-IV disorders in a population-based sample of 5- to 8-year-old children: the impact of impairment criteria. Eur Child Adolesc Psychiatry 2015; 24:1339-48. [PMID: 25715995 PMCID: PMC4628613 DOI: 10.1007/s00787-015-0684-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 01/24/2015] [Indexed: 12/01/2022]
Abstract
This study determined the impact of impairment criteria on the prevalence and patterns of comorbidity of child DSM-IV disorders. The validity of these impairment criteria was tested against different measures of mental health care referral and utilization. We interviewed parents of 1,154 children aged 5-8 years in-depth using the Diagnostic Interview Schedule for Children in Rotterdam, the Netherlands, to establish DSM-IV diagnosis. These children were randomly selected or oversampled based on Child Behavior Checklist ratings from a large population-based study (N = 6,172). Referral data were extracted from the psychiatric interview as well as from a follow-up questionnaire. The results showed an overall prevalence of DSM-IV disorders of 31.1 % when impairment was not considered. This rate declined to 22.9 % when mild impairment was required and declined even further, to 10.3 %, for more severe levels of impairment. Similarly, the overall comorbidity rate declined from 8.5 to 6.7 and 2.7 % when mild and severe impairment were required, respectively. Virtually all children who attained symptom thresholds for a specific disorder, and had been referred to a mental health care professional because of the associated symptoms, also had mild impairment. The requirement of severe impairment criteria significantly increased diagnostic thresholds, but for most disorders, this definition captured only half of the clinically referred cases. In conclusion, prevalence was highly dependent upon the criteria used to define impairment. If severe impairment is made a diagnostic requirement, many children with psychiatric symptoms and mild impairment seeking mental health care will be undiagnosed and possibly untreated.
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Affiliation(s)
- Jolien Rijlaarsdam
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands ,Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gonneke W. J. M. Stevens
- Interdisciplinary Social Sciences, Faculty of Social Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands ,Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands ,Department of Paediatrics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank C. Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands. .,Department of Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Barclay NL, Gehrman PR, Gregory AM, Eaves LJ, Silberg JL. The heritability of insomnia progression during childhood/adolescence: results from a longitudinal twin study. Sleep 2015; 38:109-18. [PMID: 25325458 PMCID: PMC4262942 DOI: 10.5665/sleep.4334] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/23/2014] [Indexed: 10/24/2022] Open
Abstract
STUDY OBJECTIVES To determine prevalence and heritability of insomnia during middle/late childhood and adolescence; examine longitudinal associations in insomnia over time; and assess the extent to which genetic and environmental factors on insomnia remain stable, or whether new factors come into play, across this developmental period. DESIGN Longitudinal twin study. SETTING Academic medical center. PATIENTS OR PARTICIPANTS There were 739 complete monozygotic twin pairs (52%) and 672 complete dizygotic twin pairs (48%) initially enrolled and were followed up at three additional time points (waves). Mode ages at each wave were 8, 10, 14, and 15 y (ages ranged from 8-18 y). INTERVENTIONS None. MEASUREMENTS AND RESULTS Clinical ratings of insomnia symptoms were assessed using the Child and Adolescent Psychiatric Assessment (CAPA) by trained clinicians, and rated according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R criteria for presence of 'clinically significant insomnia', over four sequential waves. Insomnia symptoms were prevalent but significantly decreased across the four waves (ranging from 16.6% to 31.2%). 'Clinically significant insomnia' was moderately heritable at all waves (h² range = 14% to 38%), and the remaining source of variance was the nonshared environment. Multivariate models indicated that genetic influences at wave 1 contributed to insomnia at all subsequent waves, and that new genetic influences came into play at wave 2, which further contributed to stability of symptoms. Nonshared environmental influences were time-specific. CONCLUSION Insomnia is prevalent in childhood and adolescence, and is moderately heritable. The progression of insomnia across this developmental time period is influenced by stable as well as new genetic factors that come into play at wave 2 (modal age 10 y). Molecular genetic studies should now identify genes related to insomnia progression during childhood and adolescence.
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Affiliation(s)
- Nicola L. Barclay
- Northumbria Centre for Sleep Research, Department of Psychology, Northumbria University, UK
| | - Philip R. Gehrman
- Department of Psychiatry and Penn Sleep Centre, University of Pennsylvania, Philadelphia, PA
| | | | - Lindon J. Eaves
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA
| | - Judy L. Silberg
- Virginia Commonwealth University School of Medicine, Richmond, VA
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Timimi S. No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished. Int J Clin Health Psychol 2014. [DOI: 10.1016/j.ijchp.2014.03.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Douglas J, Scott J. A systematic review of gender-specific rates of unipolar and bipolar disorders in community studies of pre-pubertal children. Bipolar Disord 2014; 16:5-15. [PMID: 24305108 DOI: 10.1111/bdi.12155] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 07/20/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Gender-specific rates of unipolar and bipolar disorders are well established for cases with post-pubertal onset. However, there is less certainty about these rates in pre-pubertal children. We undertook a systematic review of community studies that report gender-specific rates for unipolar and bipolar disorders in young children, particularly cases of major depression and mania. METHOD Computer databases (Medline, EMBASE, Index to Theses, and PsychInfo) were searched for non-clinical observational studies using recognized diagnostic criteria to identify unipolar and bipolar disorders in children aged ≤ 12 years. A meta-analysis was undertaken to calculate pooled odds ratios (ORs) for caseness for major depression by gender. The limited data on bipolar disorder were summarized. RESULTS Analysis of 12 studies (>15,000 children), indicated that the community prevalence of unipolar disorders was higher in boys (1.3%) than in girls (0.8%). Rates of major depression were low (0.61%), but boys were significantly more likely to meet diagnostic criteria than girls (OR = 1.61; 95% confidence interval: 1.11-2.35). Five studies, assessing >5,000 children, identified only one case with a probable diagnosis of mania. CONCLUSIONS This systematic review suggests that boys aged ≤ 12 years are significantly more likely to experience major depression than girls. However, in younger children, community rates of major depression are low, and it is frequently suggested (but not proven) that most cases are comorbid. The absence of mania suggests either that childhood bipolar phenotypes do not resemble post-pubertal onset cases or that there are problems of case ascertainment.
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Affiliation(s)
- Jessica Douglas
- Department of Paediatric Clinical Psychology, Children's Services, Addenbrooke's Hospital, Cambridge, UK; Institute of Neuroscience, University of Newcastle, Newcastle, UK
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Bendiksen B, Aase H, Svensson E, Friis S, Myhre AM, Reichborn-Kjennerud T, Zeiner P. Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder. Scand J Child Adolesc Psychiatr Psychol 2014. [DOI: 10.21307/sjcapp-2014-014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Stringaris A, Goodman R. The value of measuring impact alongside symptoms in children and adolescents: a longitudinal assessment in a community sample. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 41:1109-20. [PMID: 23677767 PMCID: PMC3755220 DOI: 10.1007/s10802-013-9744-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The impact that psychiatric symptoms have on the lives of young people is central to clinical practice and classification. However, there is relatively little research on impact and its association with symptoms. This paper examines how well impact can be measured and how it relates to psychiatric outcomes. On four separate occasions over 3 years, symptoms and impact were assessed in a UK epidemiological sample (n = 4,479; 51.5 % boys) using the Strengths and Difficulties Questionnaire (SDQ) as reported by parents, youths and teachers. Disorders were ascertained using the Development and Well-Being Assessment. An impact scale made of items about distress and impairment demonstrated considerable internal consistency, cross-informant correlations, and longitudinal stability by all reporting sources. Impact at baseline was a strong predictor of psychiatric disorder 3 years later after accounting for psychiatric disorders and symptoms measured at baseline: odds ratio OR = 2.10, 95 % Confidence Interval (CI) [1.50, 2.94] according to parent-rated impact and OR = 1.71, CI [1.08, 2.72] according to teacher-rated impact. Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline. Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders. More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.
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Affiliation(s)
- Argyris Stringaris
- King’s College London, Institute of Psychiatry, PO 85, Denmark Hill, London, SE5 8AF UK
| | - Robert Goodman
- King’s College London, Institute of Psychiatry, PO 85, Denmark Hill, London, SE5 8AF UK
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ADad 10: the impairment in Anxiety Disorders among adolescents in a rural community population in India. Indian J Pediatr 2013; 80 Suppl 2:S181-5. [PMID: 24043515 DOI: 10.1007/s12098-013-1213-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES There is significant paucity of studies on the impairment associated with Anxiety Disorders (AD) among adolescents. This study focuses on the prevalence and pattern of impairment as well as impairment in the context of severity of AD, co-morbidities, suicide, age and gender in this population. METHODS In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime to collect the required data. Descriptive statistics and Chi-square tests were done to evaluate the prevalence and profile of impairment, compare the impairment among different types of AD, severity of AD, number of co-morbidities, age and gender on impairment, effect of impairment on the need for suicide prevention. RESULTS Impairment in adolescents with AD was a rule, noted in 94.4%. Irrespective of the type of AD diagnosed, impairment at home was significant in adolescents with AD. The presentation of impairment among different Anxiety Disorders was different with different functional settings. Severity of AD and the number of co-morbidities was related to the impairment. Need for suicide related interventions were not different in those with and without impairment. Age and gender did not influence the presence of impairment. CONCLUSIONS Anxiety Disorders among adolescents in India result in significant functional impairment. Clinically, in this population assessment of impairment is required. Community policies and plans should have special management strategy to address impairment in adolescents with Anxiety Disorders.
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Gadow KD, Kaat AJ, Lecavalier L. Relation of symptom-induced impairment with other illness parameters in clinic-referred youth. J Child Psychol Psychiatry 2013; 54:1198-207. [PMID: 23586345 DOI: 10.1111/jcpp.12077] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2013] [Indexed: 01/06/2023]
Abstract
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.
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Affiliation(s)
- Kenneth D Gadow
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, NY, USA
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Liu SK, Chien YL, Shang CY, Lin CH, Liu YC, Gau SSF. Psychometric properties of the Chinese version of Strength and Difficulties Questionnaire. Compr Psychiatry 2013; 54:720-30. [PMID: 23433222 DOI: 10.1016/j.comppsych.2013.01.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 01/10/2013] [Accepted: 01/14/2013] [Indexed: 11/26/2022] Open
Abstract
This study aimed to establish the norms and to examine the psychometric properties of the Chinese version of the Strengths and Difficulties Questionnaire (SDQ). Sample included a representative sample of 3534 students (grades 1 to 8) from one city and one suburb each in Northern and Southern Taiwan by using a multistage sampling method and 211 psychiatric outpatients diagnosed with attention-deficit hyperactivity disorder (ADHD), aged 6 to 15, consecutively recruited from a medical center in Taipei. All the parents and teachers and participants with grade 4 or higher completed the SDQ. Parents and teachers also completed the Child Behavior Checklist and the measures about inattention, hyperactivity, and oppositional symptoms. Similar to Western studies, principal component analyses confirmed the five psychological dimensions of the SDQ for the parent, teacher, and student forms. The three forms of the Chinese SDQ showed satisfactory test-retest reliability, internal consistency, concurrent validity, and discriminant validity. All the subscales of the three forms of the Chinese SDQ clearly distinguished clinical participants with ADHD from school-based participants. Like Western studies, our findings indicate that the Chinese SDQ demonstrates a reliable and valid instrument for measuring internalizing, externalizing, and prosocial behaviors in Taiwanese child and adolescent population.
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Affiliation(s)
- Shih-Kai Liu
- Department of Child and Adolescent Psychiatry, Taoyuan Mental Hospital, Tao-Yuan, Taiwan
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Genes, environments, and developmental research: methods for a multi-site study of early substance abuse. Twin Res Hum Genet 2013; 16:505-15. [PMID: 23461817 DOI: 10.1017/thg.2013.6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The importance of including developmental and environmental measures in genetic studies of human pathology is widely acknowledged, but few empirical studies have been published. Barriers include the need for longitudinal studies that cover relevant developmental stages and for samples large enough to deal with the challenge of testing gene-environment-development interaction. A solution to some of these problems is to bring together existing data sets that have the necessary characteristics. As part of the National Institute on Drug Abuse-funded Gene-Environment-Development Initiative, our goal is to identify exactly which genes, which environments, and which developmental transitions together predict the development of drug use and misuse. Four data sets were used of which common characteristics include (1) general population samples, including males and females; (2) repeated measures across adolescence and young adulthood; (3) assessment of nicotine, alcohol, and cannabis use and addiction; (4) measures of family and environmental risk; and (5) consent for genotyping DNA from blood or saliva. After quality controls, 2,962 individuals provided over 15,000 total observations. In the first gene-environment analyses, of alcohol misuse and stressful life events, some significant gene-environment and gene-development effects were identified. We conclude that in some circumstances, already collected data sets can be combined for gene-environment and gene-development analyses. This greatly reduces the cost and time needed for this type of research. However, care must be taken to ensure careful matching across studies and variables.
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Cleverley K, Bennett K, Duku E. Effects of functional impairment on internalizing symptom trajectories in adolescence: A longitudinal, growth curve modelling study. J Adolesc 2013; 36:45-53. [DOI: 10.1016/j.adolescence.2012.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 08/31/2012] [Accepted: 09/05/2012] [Indexed: 11/25/2022]
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Copeland WE, Shanahan L, Erkanli A, Costello EJ, Angold A. Indirect comorbidity in childhood and adolescence. Front Psychiatry 2013; 4:144. [PMID: 24204349 PMCID: PMC3816229 DOI: 10.3389/fpsyt.2013.00144] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/21/2013] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Comorbidity between psychiatric disorders is common, but pairwise associations between two disorders may be explained by the presence of other diagnoses that are associated with both disorders or "indirect" comorbidity. MATERIALS AND METHODS Comorbidities of common childhood psychiatric disorders were tested in three community samples of children ages 6-17 (8931 observations of 2965 subjects). Psychiatric disorder status in all three samples was assessed with the Child and Adolescent Psychiatric Assessment. Indirect comorbidity was defined as A-B associations that decreased from significance to non-significance after adjusting for other disorders. RESULTS All tested childhood psychiatric disorders were positively associated in bivariate analyses. After adjusting for comorbidities, many associations involving a behavioral disorder and an emotional disorder were attenuated suggesting indirect comorbidity. Generalized anxiety and depressive disorders displayed a very high level of overlap (adjusted OR = 37.9). All analyses were rerun with depressive disorders grouped with generalized anxiety disorder in a single "distress disorders" category. In these revised models, all associations between and emotional disorder and a behavior disorder met our criteria for indirect comorbidity except for the association of oppositional defiant disorder with distress disorders (OR = 11.3). Follow-up analyses suggested that the indirect associations were primarily accounted for by oppositional defiant disorder and the distress disorder category. There was little evidence of either sex differences or differences by developmental period. CONCLUSION After accounting for the overlap between depressive disorders with generalized anxiety disorder, direct comorbidity between emotional and behavioral disorders was uncommon. When there was evidence of indirect comorbidity, ODD, and distress disorders were the key intermediary diagnoses accounting for the apparent associations.
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Taylor J, Allan N, Mikolajewski AJ, Hart SA. Common genetic and nonshared environmental factors contribute to the association between socioemotional dispositions and the externalizing factor in children. J Child Psychol Psychiatry 2013; 54:67-76. [PMID: 23017065 PMCID: PMC3527638 DOI: 10.1111/j.1469-7610.2012.02621.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Childhood behavioral disorders including conduct disorder (CD), oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD) often co-occur. Prior twin research shows that common sets of genetic and environmental factors are associated with these various disorders and they form a latent factor called Externalizing. The developmental propensity model posits that CD develops in part from socioemotional dispositions of prosociality, negative emotionality, and daring; and recent research has supported the expected genetic and environmental associations between these dispositions and CD. This study examined the developmental propensity model in relation to the broader Externalizing factor that represents the covariance among behavior disorders in children. METHODS Parents of 686 six- to twelve-year-old twin pairs rated them on symptoms of CD, ADHD, and ODD using the disruptive behavior disorder scale and on prosociality, negative emotionality, and daring using the child and adolescent dispositions scale. A latent factor multivariate Cholesky model was used with each disposition latent factor comprised of respective questionnaire items and the Externalizing factor comprised of symptom dimensions of CD, ADHD inattention, ADHD hyperactivity/impulsivity, and ODD. RESULTS Results supported the hypothesis that the socioemotional dispositions and the Externalizing factor have genetic factors in common, but there was not a single genetic factor associated with all of the constructs. As expected, nonshared environment factors were shared by the dispositions and externalizing factor but, again, no single nonshared environmental factor was common to all constructs. A shared environmental factor was associated with both negative emotionality and externalizing. CONCLUSIONS The developmental propensity model was supported and appears to extend to the broader externalizing spectrum of childhood disorders. Socioemotional dispositions of prosociality, negative emotionality, and (to a lesser extent) daring may contribute to the covariation among behavioral disorders and perhaps to their comorbid expression through common sets of primarily genetic but also environmental factors.
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Affiliation(s)
- Jeanette Taylor
- Department of Psychology, Florida State University, Tallahassee, FL 32306-4301, USA.
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Shenk CE, Dorn LD, Kolko DJ, Susman EJ, Noll JG, Bukstein OG. Predicting Treatment Response for Oppositional Defiant and Conduct Disorder Using Pre-treatment Adrenal and Gonadal Hormones. JOURNAL OF CHILD AND FAMILY STUDIES 2012; 21:973-981. [PMID: 27429540 PMCID: PMC4943761 DOI: 10.1007/s10826-011-9557-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Variations in adrenal and gonadal hormone profiles have been linked to increased rates of oppositional defiant disorder (ODD) and conduct disorder (CD). These relationships suggest that certain hormone profiles may be related to how well children respond to psychological treatments for ODD and CD. The current study assessed whether pre-treatment profiles of adrenal and gonadal hormones predicted response to psychological treatment of ODD and CD. One hundred five children, 6 - 11 years old, participating in a randomized, clinical trial provided samples for cortisol, testosterone, dehydroepiandrosterone, and androstenedione. Diagnostic interviews of ODD and CD were administered up to three years post-treatment to track treatment response. Group-based trajectory modeling identified two trajectories of treatment response: 1) a High-response trajectory where children demonstrated lower rates of an ODD or CD diagnosis throughout follow-up, and 2) a Low-response trajectory where children demonstrated higher rates of an ODD or CD diagnosis throughout follow-up. Hierarchical logistic regression predicting treatment response demonstrated that children with higher pre-treatment concentrations of testosterone were four times more likely to be in the Low-response trajectory. No other significant relationship existed between pre-treatment hormone profiles and treatment response. These results suggest that higher concentrations of testosterone are related to how well children diagnosed with ODD or CD respond to psychological treatment over the course of three years.
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Affiliation(s)
- Chad E. Shenk
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 3015, Cincinnati, OH 45229
| | - Lorah D. Dorn
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 3015, Cincinnati, OH 45229
| | - David J. Kolko
- Western Psychiatric Institute & Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Jennie G. Noll
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 3015, Cincinnati, OH 45229
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Lamers F, Burstein M, He JP, Avenevoli S, Angst J, Merikangas KR. Structure of major depressive disorder in adolescents and adults in the US general population. Br J Psychiatry 2012; 201:143-50. [PMID: 22700082 PMCID: PMC3409428 DOI: 10.1192/bjp.bp.111.098079] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 11/04/2011] [Accepted: 02/13/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although techniques such as latent class analysis have been used to derive empirically based subtypes of depression in adult samples, there is limited information on subtypes of depression in youth. AIMS To identify empirically based subtypes of depression in a nationally representative sample of US adolescents, and to test the comparability of subtypes of depression in adolescents with those derived from a nationally representative sample of adults. METHOD Respondents included 912 adolescents and 805 adults with a 12-month major depressive disorder, selected from the National Comorbidity Survey Adolescent Supplement and the National Comorbidity Survey Replication samples respectively. Latent class analysis was used to identify subtypes of depression across samples. Sociodemographic and clinical correlates of derived subtypes were also examined to establish their validity. RESULTS Three subtypes of depression were identified among adolescents, whereas four subtypes were identified among adults. Two of these subtypes displayed similar diagnostic profiles across adolescent and adult samples (P = 0.43); these subtypes were labelled 'severe typical' (adults 45%, adolescents 35%) and 'atypical' (adults 16%, adolescents 26%). The latter subtype was characterised by increased appetite and weight gain. CONCLUSIONS The structure of depression observed in adolescents is highly similar to the structure observed in adults. Longitudinal research is necessary to evaluate the stability of these subtypes of depression across development.
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Affiliation(s)
- Femke Lamers
- National Institutes of Health, National Institute of Mental Health, 35 Convent Drive, Bethesda, MD 20892-3720, USA
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The Course of Childhood Anxiety Symptoms: Developmental Trajectories and Child-Related Factors in Normal Children. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 41:81-95. [DOI: 10.1007/s10802-012-9669-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lau JYF, Hilbert K, Goodman R, Gregory AM, Pine DS, Viding EM, Eley TC. Investigating the genetic and environmental bases of biases in threat recognition and avoidance in children with anxiety problems. BIOLOGY OF MOOD & ANXIETY DISORDERS 2012; 2:12. [PMID: 22788754 PMCID: PMC3487968 DOI: 10.1186/2045-5380-2-12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 05/21/2012] [Indexed: 12/03/2022]
Abstract
Background Adults with anxiety show biased categorization and avoidance of threats. Such biases may emerge through complex interplay between genetics and environments, occurring early in life. Research on threat biases in children has focuses on a restricted range of biases, with insufficient focus on genetic and environmental origins. Here, we explore differences between children with and without anxiety problems in under-studied areas of threat bias. We focused both on associations with anxious phenotype and the underlying gene-environmental correlates for two specific processes: the categorisation of threat faces and avoidance learning. Method Two-hundred and fifty 10-year old MZ and DZ twin pairs (500 individuals) completed tasks assessing accuracy in the labelling of threatening facial expressions and in the acquisition of avoidant responses to a card associated with a masked threatening face. To assess whether participants met criteria for an anxiety disorder, parents of twins completed a self-guided computerized version of the Development and Well-being Assessment (DAWBA). Comparison of MZ and DZ twin correlations using model-fitting were used to compute estimates of genetic, shared and non-shared environmental effects. Results Of the 500 twins assessed, 25 (5%) met diagnostic criteria for a current anxiety disorder. Children with anxiety disorders were more accurate in their ability to recognize disgust faces than those without anxiety disorders, but were commensurate on identifying other threatening face emotions (angry, fearful, sad). Children with anxiety disorders but also more strongly avoided selecting a conditioned stimulus than non-anxious children. While recognition of socially threatening faces was moderately heritable, avoidant responses were heavily influenced by the non-shared environment. Conclusion These data add to other findings on threat biases in anxious children. Specifically, we found biases in the labelling of some negative-valence faces and in the acquisition of avoidant responses. While non-shared environmental effects explained all of the variance on threat avoidance, some of this may be due to measurement error.
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Affiliation(s)
- Jennifer Y F Lau
- Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford, OX1 3UD, UK.
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Pitfalls of the psychotherapy of twins with eating disorders. Eat Weight Disord 2012; 17:e140-3. [PMID: 23010785 DOI: 10.1007/bf03325339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AIM Scientific literature is limited on problems related to the psychotherapy of twins, especially eating disorders. This paper discusses the therapeutic difficulties encountered with two anorexic and one bulimic sets of twins. METHOD AND RESULTS The three case reports show that the symbiotic tendency of twins is a frequent phenomenon, which may be a special resistance against change, and can serve as a factor maintaining the pathological state. In many cases, the parental behaviour strengthens the symbiosis of the twins, instead of helping the individuation. CONCLUSION The integration of individual and family therapeutic interventions is proposed. The separation-individuation process of the twins can be stimulated by individual sessions with each of the twins, or separate sessions during family therapy (i.e., sessions with the parents and with one of the twins). In this case, the best strategy would be to have the individual and family therapies conducted by the same therapist.
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How do we optimally conceptualize the heterogeneity within antisocial behavior? An argument for aggressive versus non-aggressive behavioral dimensions. Clin Psychol Rev 2012; 32:263-79. [DOI: 10.1016/j.cpr.2012.02.006] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 02/24/2012] [Accepted: 02/24/2012] [Indexed: 11/23/2022]
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Silberg JL, Maes H, Eaves LJ. Unraveling the effect of genes and environment in the transmission of parental antisocial behavior to children's conduct disturbance, depression and hyperactivity. J Child Psychol Psychiatry 2012; 53:668-77. [PMID: 22141405 PMCID: PMC3319001 DOI: 10.1111/j.1469-7610.2011.02494.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND A critical issue in devising effective interventions for the treatment of children's behavioral and emotional problems identifying genuine family environmental factors that place children at risk. In most twin and family studies, environmental factors are confounded with both direct genetic risk from parents and the indirect effect of genes influencing parents' ability to provide an optimal rearing environment. The present study was undertaken to determine whether parental psychopathology, specifically parental antisocial behavior (ASP), is a genuine environmental risk factor for juvenile conduct disturbance, depression and hyperactivity, or whether the association between parental ASP and children's behavioral and emotional problems can be explained as a secondary consequence of the intergenerational transmission of genetic factors. METHODS An extended children of twins design comprised of data collected on 2,674 adult female and male twins, their spouses, and 2,454 of their children was used to test whether genetic and/or family environmental factors best accounted for the association between parental antisocial behavior and children's behavioral problems. An age-matched sample of 2,826 juvenile twin pairs from the Virginia Twin Study of Adolescent Behavioral Development was also included to examine developmental differences in gene expression by partitioning child-specific transmissible effects from those effects that persist into adulthood. The fit of alternative models was evaluated using the statistical program Mx. RESULTS We found distinct patterns of transmission between parental antisocial behavior and juvenile conduct, depression and hyperactivity. Genetic and family environmental factors accounted for the resemblance between parents' ASP and children's conduct disturbance. Family environmental factors alone explained the association between child depression and parental ASP, and the impact of parental ASP on hyperactivity was entirely genetic. CONCLUSIONS These findings underscore differences in the contribution of genetic and environmental factors on the patterns of association between parental antisocial behavior and juvenile psychopathology, having important clinical implications for the prevention and amelioration of child behavioral and emotional problems.
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Affiliation(s)
- Judy L Silberg
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298–0003, USA.
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Depressive disorders in school children of suburban India: an epidemiological study. Soc Psychiatry Psychiatr Epidemiol 2012; 47:783-8. [PMID: 21533600 DOI: 10.1007/s00127-011-0383-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Accepted: 04/10/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE There is a dearth of research on the prevalence of depressive disorders in children from suburban and rural areas in the Indian subcontinent. Therefore, the present study was aimed at assessing the prevalence of depressive disorders and the associated risk factors in the primary and secondary school children in suburban India. METHODS This was a cross-sectional, school-based epidemiological study involving 1,851 children from standard I to VII age group. Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), a semi-structured interview was used to diagnose depression in this sample. RESULTS Using K-SADS-PL, prevalence of depressive disorder was 3.13% (n = 58); major depressive disorder was diagnosed in 15 (0.81%), dysthymia in 28 (1.51%) and depressive disorder NOS in 15 (0.81%). Age (OR 1.396, CI 1.121-1.738), class attendance (OR 0.251, CI 0.103-0.613), family history of psychiatric illness (OR 0.204, CI 0.069-0.605) and birth complications (OR 0.128, CI 0.029-0.558) emerged as significant predictors of depression; the model explained 24.1-32.3% of the variance in this sample. CONCLUSION The present study confirms the findings from previous studies that childhood depression is a distinct diagnostic entity affecting a significant number of children and adolescents.
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