1
|
Chavannes P, Gignac M. The Child Behavior Check List Usefulness in Screening for Severe Psychopathology in Youth: A Narrative Literature Review. J Atten Disord 2024; 28:608-613. [PMID: 38389275 DOI: 10.1177/10870547241228826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This article will review the use of the CBCL to diagnose youth with psychopathological disorders focusing on: ADHD, Mood Disorders, Autism Spectrum disorders, and Disruptive Disorders. METHOD Using a narrative review approach, we investigate the usefulness of the CBCL as a screening tool to detect childhood onset psychopathology across different diagnostic syndromes. RESULTS The available literature supports the use of the CBCL for ADHD screening and as a measure of ADHD severity. While some studies support a specific profile linked with childhood bipolar disorder, replication studies for this profile found mixed results. The CBCL was also found to be useful in screening for patients presenting with Autism Spectrum Disorders, Conduct Disorder, and Childhood Bipolar Disorder all of which presents with more severely impaired scores. CONCLUSION The CBCL holds promise as a screening tool for childhood psychopathology.
Collapse
|
2
|
Faraone SV, Newcorn JH, Wozniak J, Joshi G, Coffey B, Uchida M, Wilens T, Surman C, Spencer TJ. In Memoriam: Professor Joseph Biederman's Contributions to Child and Adolescent Psychiatry. J Atten Disord 2024; 28:550-582. [PMID: 38334088 PMCID: PMC10947509 DOI: 10.1177/10870547231225818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To provide an overview of Joe Biederman's contributions to child and adolescent psychiatry. METHOD Nine colleagues described his contributions to: psychopharmacology, comorbidity and genetics, pediatric bipolar disorder, autism spectrum disorders, Tourette's and tic disorders, clinical and neuro biomarkers for pediatric mood disorders, executive functioning, and adult ADHD. RESULTS Joe Biederman left us with many concrete indicators of his contributions to child and adolescent psychiatry. He set up the world's first pediatric psychopharmacology clinic and clinical research program in child adolescent psychiatry. As a young faculty member he began a research program that led to many awards and eventual promotion to full professor at Harvard Medical School. He was for many years the most highly cited researcher in ADHD. He achieved this while maintaining a full clinical load and was widely respected for his clinical acumen. CONCLUSION The world is a better place because Joe Biederman was here.
Collapse
Affiliation(s)
| | | | - Janet Wozniak
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Gagan Joshi
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Mai Uchida
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy Wilens
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Craig Surman
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Thomas J. Spencer
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
DiSalvo M, Vater CH, Green A, Woodworth KY, Farrell A, Biederman J, Faraone S. Further Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis. Scand J Child Adolesc Psychiatr Psychol 2023; 11:44-59. [PMID: 37273800 PMCID: PMC10236377 DOI: 10.2478/sjcapp-2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Background Previous research has found that a unique profile of the Child Behavior Checklist comprising of aggregate elevations of the Attention, Anxiety/Depression and Aggression scales (A-A-A profile, CBCL-Bipolar (BP) profile, CBCL-Dysregulation profile (DP); henceforth CBCL-BP/DP profile) is associated with a clinical diagnosis of pediatric bipolar (BP) disorder. Objective The main aim of the study is to evaluate the strength of the association between the CBCL-BP/DP profile and the clinical diagnosis of pediatric BP disorder through a meta-analysis. Methods A literature search was performed to identify studies that examined the association between a positive CBCL-BP/DP profile and a clinical diagnosis of pediatric BP disorder. The meta-analyses first examined studies assessing the rates of a positive CBCL-BP/DP profile in youth with BP disorder versus those with 1) ADHD, anxiety/depression, or disruptive behavior disorders (DBDs), and 2) non-bipolar controls. The second analysis evaluated studies examining the rates of pediatric BP disorder in youth with and without a positive CBCL-BP/DP profile. Results Eighteen articles met our inclusion and exclusion criteria, and fifteen articles had adequate data for meta-analysis. Results showed that BP youth were at significantly increased odds of having a positive CBCL-BP/DP profile compared to those with other psychiatric disorders (i.e., ADHD, anxiety/depression, or DBDs) (pooled OR=4.34, 95% CI=2.82, 8.27; p<0.001) and healthy control groups (pooled OR=34.77, 95% CI=2.87, 420.95; p=0.005). Further, meta-analysis results showed that youth with a positive CBCL-BP/DP profile were at significantly increased odds of having a BP disorder diagnosis compared to those without (pooled OR=4.25, 95% CI=2.12, 8.52; p<0.001). Conclusion Our systematic review and meta-analysis of the extant literature provides strong support for the association between the CBCL-BP/DP profile and pediatric BP disorder.
Collapse
Affiliation(s)
- Maura DiSalvo
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Chloe Hutt Vater
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Allison Green
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
- Department of Psychological and Brain Sciences, Indiana University, Indiana, United States
| | - K. Yvonne Woodworth
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Abigail Farrell
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
- Department of Psychology, University of Houston, Houston, United States
| | - Joseph Biederman
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, United States
- Boston Department of Psychiatry, Massachusetts General Hospital, Boston, United States
| | - Stephen Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, United States
| |
Collapse
|
4
|
Davico C, Marcotulli D, Cudia VF, Arletti L, Ghiggia A, Svevi B, Faraoni C, Amianto F, Ricci F, Vitiello B. Emotional Dysregulation and Adaptive Functioning in Preschoolers With Autism Spectrum Disorder or Other Neurodevelopmental Disorders. Front Psychiatry 2022; 13:846146. [PMID: 35479499 PMCID: PMC9035819 DOI: 10.3389/fpsyt.2022.846146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/28/2022] [Indexed: 11/22/2022] Open
Abstract
AIM Emotional dysregulation (ED), defined by deficits in the ability to monitor and modulate the valence, intensity, and expression of emotions, is typically expressed with irritability, tantrums, mood fluctuations, and self-harm in young children with autism spectrum disorder (ASD). Although ED does not represent a diagnostic feature of ASD, its manifestations are an important contributor to functional impairment and clinical referral. This study aims to examine the relationship between ED and adaptive functioning in preschoolers clinically referred for ASD or other neurodevelopmental disorders. METHODS A sample of 100 children (74% males, mean age 39.4 ± 12.3 months), consecutively referred to a university clinic for neurodevelopmental disorders, received clinical assessments of psychopathology with the CBCL and the Autism Diagnostic Interview-Revised, of ED- with the CBCL-Attention, Anxious/Depressed, and Aggression index (CBCL-AAA), of autism symptom severity with the ADOS-2 Calibrated Severity Score (ADOS-CSS), and of global developmental/cognitive delay (GDD) with the WPPSI-IV or other age-appropriate standardized scales. Adaptive functioning was measured with the ABAS-II. Sixty-five children met DSM-5 criteria for ASD. Multivariate regression models were applied to evaluate the relative contribution of ED, ASD severity and GDD to the ABAS-II general (GAC), conceptual (CAD), social (SAD), and practical (PAD) adaptive functioning domains. RESULTS Overall (n = 100), lower adaptive functioning was associated with higher CBCL-AAA (p = 0.003), higher ADOS-CSS (p < 0.001), and presence of GDD (p = 0.023). In the ASD group (n = 65), worse CAD was predicted by GDD (p = 0.016), and worse SAD and PAD by higher ADOS-CSS (p = 0.032) and ED (p = 0.002). No sex differences were detected in the study variables. CONCLUSION Together with the severity of global developmental delay and of autism symptoms, ED is a significant contributor to impairment in adaptive functioning among young children with a neurodevelopmental disorder and, in particular, with ASD. ED could represent a specific target for early interventions aimed at enhancing adaptive functioning in early childhood.
Collapse
Affiliation(s)
- Chiara Davico
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Daniele Marcotulli
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Valentina Francesca Cudia
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Luca Arletti
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | - Barbara Svevi
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Chiara Faraoni
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | | | - Federica Ricci
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Benedetto Vitiello
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| |
Collapse
|
5
|
Kelberman C, Biederman J, Green A, Spera V, Maiello M, Uchida M. Differentiating bipolar disorder from unipolar depression in youth: A systematic literature review of neuroimaging research studies. Psychiatry Res Neuroimaging 2021; 307:111201. [PMID: 33046342 PMCID: PMC8021005 DOI: 10.1016/j.pscychresns.2020.111201] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 01/14/2023]
Abstract
Differentiating bipolar disorder from unipolar depression is one of the most difficult clinical questions posed in pediatric psychiatric practices, as misdiagnosis can lead to severe repercussions for the affected child. This study aimed to examine the existing literature that investigates brain differences between bipolar and unipolar mood disorders in children directly, across all neuroimaging modalities. We performed a systematic literature search through PubMed, PsycINFO, Embase, and Medline databases with defined inclusion and exclusion criteria. Nine research studies were included in the systematic qualitative review, including three structural MRI studies, five functional MRI studies, and one MR spectroscopy study. Relevant variables were extracted and brain differences between bipolar and unipolar mood disorders in children as well as healthy controls were qualitatively analyzed. Across the nine studies, our review included 228 subjects diagnosed with bipolar disorder, 268 diagnosed with major depressive disorder, and 299 healthy controls. Six of the reviewed studies differentiated between bipolar and unipolar mood disorders. Differentiation was most commonly found in the anterior cingulate cortex (ACC), insula, and dorsal striatum (putamen and caudate) brain areas. Despite its importance, the current neuroimaging literature on this topic is scarce and presents minimal generalizability.
Collapse
Affiliation(s)
- Caroline Kelberman
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Joseph Biederman
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States
| | - Allison Green
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Vincenza Spera
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56100, Italy
| | - Marco Maiello
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa 56100, Italy
| | - Mai Uchida
- Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA 02114, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States.
| |
Collapse
|
6
|
Schiweck C, Arteaga-Henriquez G, Aichholzer M, Edwin Thanarajah S, Vargas-Cáceres S, Matura S, Grimm O, Haavik J, Kittel-Schneider S, Ramos-Quiroga JA, Faraone SV, Reif A. Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 124:100-123. [PMID: 33515607 DOI: 10.1016/j.neubiorev.2021.01.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 12/17/2022]
Abstract
Attention-deficit / hyperactivity disorder (ADHD) and Bipolar Disorder (BD) are common mental disorders with a high degree of comorbidity. However, no systematic review with meta-analysis has aimed to quantify the degree of comorbidity between both disorders. To this end we performed a systematic search of the literature in October 2020. In a meta-analysis of 71 studies with 646,766 participants from 18 countries, it was found that about one in thirteen adults with ADHD was also diagnosed with BD (7.95 %; 95 % CI: 5.31-11.06), and nearly one in six adults with BD had ADHD (17.11 %; 95 % CI: 13.05-21.59 %). Substantial heterogeneity of comorbidity rates was present, highlighting the importance of contextual factors: Heterogeneity could partially be explained by diagnostic system, sample size and geographical location. Age of BD onset occurred earlier in patients with comorbid ADHD (3.96 years; 95 % CI: 2.65-5.26, p < 0.001). Cultural and methodological differences deserve attention for evaluating diagnostic criteria and clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide optimal care for both disorders.
Collapse
Affiliation(s)
- Carmen Schiweck
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany.
| | - Gara Arteaga-Henriquez
- Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Mareike Aichholzer
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| | - Sharmili Edwin Thanarajah
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany; Max-Planck-Institute for Metabolism Research, Cologne, Germany
| | - Sebastian Vargas-Cáceres
- Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Silke Matura
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| | - Oliver Grimm
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway; Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital, University of Würzburg, Würzburg, Germany
| | - Josep Antoni Ramos-Quiroga
- Department for Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Andreas Reif
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt- Goethe University, Germany
| |
Collapse
|
7
|
Elmaghrabi S, Nahmias MJ, Adamo N, Di Martino A, Somandepalli K, Patel V, McLaughlin A, De Sanctis V, Castellanos FX. Is Increased Response Time Variability Related to Deficient Emotional Self-Regulation in Children With ADHD? J Atten Disord 2020; 24:1045-1056. [PMID: 30047295 DOI: 10.1177/1087054718788950] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: Elevated response time intrasubject variability (RT-ISV) characterizes ADHD. Deficient emotional self-regulation (DESR), defined by summating Child Behavior Checklist Anxious/Depressed, Aggressive, and Attention subscale scores, has been associated with worse outcome in ADHD. To determine if DESR is differentially associated with elevated RT-ISV, we examined RT-ISV in children with ADHD with and without DESR and in typically developing children (TDC). Method: We contrasted RT-ISV during a 6-min Eriksen Flanker Task in 31 children with ADHD without DESR, 34 with ADHD with DESR, and 65 TDC. Results: Regardless of DESR, children with ADHD showed significantly greater RT-ISV than TDC (p < .001). The ADHD subgroups, defined by presence or absence of DESR, did not differ from each other. Conclusion: Increased RT-ISV characterizes ADHD regardless of comorbid DESR. Alongside similar findings in children and adults with ADHD, these results suggest that RT-ISV is related to cognitive rather than emotional dysregulation in ADHD.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Francisco X Castellanos
- Hassenfeld Children's Hospital at NYU Langone, New York City, USA.,The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| |
Collapse
|
8
|
Tonacci A, Billeci L, Calderoni S, Levantini V, Masi G, Milone A, Pisano S, Muratori P. Sympathetic arousal in children with oppositional defiant disorder and its relation to emotional dysregulation. J Affect Disord 2019; 257:207-213. [PMID: 31301625 DOI: 10.1016/j.jad.2019.07.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/07/2019] [Accepted: 07/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Emotional dysregulation (ED) is a trans-nosographical condition characterized by mood instability, severe irritability, aggression, temper outburst, and hyper-arousal. Pathophysiology of emotional dysregulation and its potential biomarkers are an emerging field of interest. A Child Behaviour Checklist (CBCL) profile, defined as Dysregulation Profile (DP), has been correlated to ED in youth. We examined the association between the CBCL-DP and indices of sympathetic arousal in children with Oppositional Defiant Disorder (ODD) and healthy controls. METHOD The current study sought to compare the arousal level measured via electrodermal activity in response to emotional stimuli in three non-overlapping groups of children: (1) ODD+CBCL-DP (n = 28), (2) ODD without CBCL-DP (n = 35), and (3) typically developing controls (n = 25). RESULTS Analyses revealed a distinct electrodermal activity profile in the three groups. Specifically, children with ODD+CBCL-DP presented higher levels of sympathetic arousal for anger and sadness stimuli compared to the other two groups. LIMITATIONS The relatively small sample and the lack of assessing causality limit the generalizability of this study which results need to be replicated in larger, different samples. CONCLUSION The CBCL-DP was associated to higher levels of arousal for negative emotions, consistently with previous reports in individuals with depression and anxiety. Further work may identify potential longitudinal relationships between this profile and clinical outcomes.
Collapse
Affiliation(s)
- Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy, (CNR), Via Moruzzi 1, 56124, Pisa, Italy
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy, (CNR), Via Moruzzi 1, 56124, Pisa, Italy.
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valentina Levantini
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Gabriele Masi
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Simone Pisano
- Department of Neuroscience, AORN Santobono-Pausilipon, Naples, Italy
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| |
Collapse
|
9
|
Biederman J, Chan J, Faraone SV, Woodworth KY, Spencer TJ, Wozniak JR. A Familial Risk Analysis of Emotional Dysregulation: A Controlled Study. J Atten Disord 2018. [PMID: 26220788 DOI: 10.1177/1087054715596576] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Children with deficits in emotional regulation operationalized by scores on the Child Behavior Checklist (CBCL) Attention Problems, Aggressive Behavior, and Anxious-Depressed subscales are more likely than others to manifest adverse outcomes. However, the transmission of this profile has not been well studied. The main aim of this study was to investigate the familiality of this profile. METHOD Participants were youth probands with bipolar I (BP-I) disorder ( N = 140), ADHD ( N = 83), and controls ( N = 117) and their siblings. Based on the CBCL emotional dysregulation profile, we classified children with severe emotional dysregulation (aggregate cut-off score ≥210) and emotional dysregulation (aggregate cut-off score ≥ 180 and <210). RESULTS Emotional dysregulation profile scores correlated positively between probands and siblings. CONCLUSION Youth with emotional dysregulation are at increased risk to have siblings with similar deficits, suggesting that emotional dysregulation runs in families.
Collapse
Affiliation(s)
- Joseph Biederman
- 1 Massachusetts General Hospital, Boston, USA.,2 Harvard Medical School, Boston, MA, USA
| | - James Chan
- 1 Massachusetts General Hospital, Boston, USA
| | - Stephen V Faraone
- 3 SUNY Upstate Medical University, Syracuse, NY, USA.,4 University of Bergen, Norway
| | | | - Thomas J Spencer
- 1 Massachusetts General Hospital, Boston, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Janet R Wozniak
- 1 Massachusetts General Hospital, Boston, USA.,2 Harvard Medical School, Boston, MA, USA
| |
Collapse
|
10
|
Smith DL, Gozal D, Hunter SJ, Kheirandish-Gozal L. Parent-Reported Behavioral and Psychiatric Problems Mediate the Relationship between Sleep-Disordered Breathing and Cognitive Deficits in School-Aged Children. Front Neurol 2017; 8:410. [PMID: 28848496 PMCID: PMC5554505 DOI: 10.3389/fneur.2017.00410] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/28/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Numerous studies over the past several decades have illustrated that children who suffer from sleep-disordered breathing (SDB) are at greater risk for cognitive, behavioral, and psychiatric problems. Although behavioral problems have been proposed as a potential mediator between SDB and cognitive functioning, these relationships have not been critically examined. METHODS This analysis is based on a community-based cohort of 1,115 children who underwent overnight polysomnography, and cognitive and behavioral phenotyping. Structural model of the relationships between SDB, behavior, and cognition, and two recently developed mediation approaches based on propensity score weighting and resampling were used to assess the mediational role of parent-reported behavior and psychiatric problems in the relationship between SDB and cognitive functioning. Multiple models utilizing two different SDB definitions further explored direct effects of SDB on cognition as well as indirect effects through behavioral pathology. All models were adjusted for age, sex, race, BMI z-score, and asthma status. RESULTS Indirect effects of SDB through behavior problems were significant in all mediation models, while direct effects of SDB on cognition were not. The findings were consistent across different mediation procedures and remained essentially unaltered when different criteria for SDB, behavior, and cognition were used. CONCLUSION Potential effects of SDB on cognitive functioning appear to occur through behavioral problems that are detectable in this pediatric population. Thus, early attentional or behavioral pathology may be implicated in the cognitive functioning deficits associated with SDB, and may present an early morbidity-related susceptibility biomarker.
Collapse
Affiliation(s)
- Dale L. Smith
- Public Health Sciences, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
- Olivet Nazarene University, Bourbonnais, IL, United States
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
| | - Scott J. Hunter
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
| | - Leila Kheirandish-Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
| |
Collapse
|
11
|
Papachristou E, Oldehinkel AJ, Ormel J, Raven D, Hartman CA, Frangou S, Reichenberg A. The predictive value of childhood subthreshold manic symptoms for adolescent and adult psychiatric outcomes. J Affect Disord 2017; 212:86-92. [PMID: 28157551 DOI: 10.1016/j.jad.2017.01.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Childhood subthreshold manic symptoms may represent a state of developmental vulnerability to Bipolar Disorder (BD) and may also be associated with other adverse psychiatric outcomes. To test this hypothesis we examined the structure and predictive value of childhood subthreshold manic symptoms for common psychiatric disorders presenting by early adulthood. METHODS Subthreshold manic symptoms at age 11 years and lifetime clinical outcomes by age 19 years were ascertained in the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective Dutch community cohort. We used latent class analysis to identify subthreshold manic symptom profiles at baseline. The association between class membership and subsequent clinical diagnoses of BD (comprising BD-I, BD-II, mania and hypomania), depressive, anxiety and substance abuse disorders was determined using Cox proportional-hazard ratio (HR) models. RESULTS At age 11 years, we identified a normative (n=916; 47%), a mildly symptomatic (n=843; 43%) and a highly symptomatic class (n=198; 10%). Referenced to the normative class, the sex- and age-adjusted risk of new-onset BD by the age of 19 years was significantly increased in the mildly (HR=2.01, 95%CI 1.13-3.59) and highly symptomatic classes (HR=5.02, 95%CI 2.48-10.16). These estimates remained significant after further adjustments for cognitive and family function, parental socioeconomic status, parental psychiatric morbidity, and comorbid disorders at baseline (p-value for linear trend across classes<0.01). Class membership did not show significant associations with incident depressive, anxiety and substance abuse disorders in the fully adjusted regression models. LIMITATIONS The period of risk for adult-onset BD extends beyond the observational period of the study. CONCLUSIONS Elevated childhood subthreshold manic symptoms are associated with increased risk of BD by early adulthood and are therefore a potentially useful phenotype for the early identification of at-risk individuals.
Collapse
Affiliation(s)
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Johan Ormel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Dennis Raven
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
12
|
Bianchi V, Brambilla P, Garzitto M, Colombo P, Fornasari L, Bellina M, Bonivento C, Tesei A, Piccin S, Conte S, Perna G, Frigerio A, Castiglioni I, Fabbro F, Molteni M, Nobile M. Latent classes of emotional and behavioural problems in epidemiological and referred samples and their relations to DSM-IV diagnoses. Eur Child Adolesc Psychiatry 2017; 26:549-557. [PMID: 27844161 PMCID: PMC5394137 DOI: 10.1007/s00787-016-0918-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 11/07/2016] [Indexed: 12/05/2022]
Abstract
Researchers' interest have recently moved toward the identification of recurrent psychopathological profiles characterized by concurrent elevations on different behavioural and emotional traits. This new strategy turned to be useful in terms of diagnosis and outcome prediction. We used a person-centred statistical approach to examine whether different groups could be identified in a referred sample and in a general-population sample of children and adolescents, and we investigated their relation to DSM-IV diagnoses. A latent class analysis (LCA) was performed on the Child Behaviour Checklist (CBCL) syndrome scales of the referred sample (N = 1225), of the general-population sample (N = 3418), and of the total sample. Models estimating 1-class through 5-class solutions were compared and agreement in the classification of subjects was evaluated. Chi square analyses, a logistic regression, and a multinomial logistic regression analysis were used to investigate the relations between classes and diagnoses. In the two samples and in the total sample, the best-fitting models were 4-class solutions. The identified classes were Internalizing Problems (15.68%), Severe Dysregulated (7.82%), Attention/Hyperactivity (10.19%), and Low Problems (66.32%). Subsequent analyses indicated a significant relationship between diagnoses and classes as well as a main association between the severe dysregulated class and comorbidity. Our data suggested the presence of four different psychopathological profiles related to different outcomes in terms of psychopathological diagnoses. In particular, our results underline the presence of a profile characterized by severe emotional and behavioural dysregulation that is mostly associated with the presence of multiple diagnosis.
Collapse
Affiliation(s)
- Valentina Bianchi
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy. .,Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy.
| | - Paolo Brambilla
- 0000 0004 1757 2822grid.4708.bDepartment of Neurosciences and Mental Health, Psychiatric Clinic, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy ,0000 0000 9206 2401grid.267308.8Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX USA
| | - Marco Garzitto
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Pordenone, Italy
| | - Paola Colombo
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Livia Fornasari
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Pordenone, Italy
| | - Monica Bellina
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Carolina Bonivento
- 0000 0001 2113 062Xgrid.5390.fDepartment of Experimental and Clinical Medicine, University of Udine, Udine, Italy ,0000 0001 2113 062Xgrid.5390.fInterUniversity Center for Behavioral Neurosciences (ICBN), University of Udine, Udine, Italy
| | - Alessandra Tesei
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Sara Piccin
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Pordenone, Italy
| | - Stefania Conte
- 0000 0001 2174 1754grid.7563.7Department of Psychology, University of Milano-Bicocca, Milan, Italy ,NeuroMI, Milan Center for Neuroscience, Milan, Italy
| | | | - Alessandra Frigerio
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Isabella Castiglioni
- 0000 0001 1940 4177grid.5326.2Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy
| | - Franco Fabbro
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Pordenone, Italy
| | - Massimo Molteni
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Maria Nobile
- grid.420417.4Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy ,Hermanas Hospitalarias, FoRiPsi, Albese con Cassano, Italy
| |
Collapse
|
13
|
Dölitzsch C, Kölch M, Fegert JM, Schmeck K, Schmid M. Ability of the Child Behavior Checklist-Dysregulation Profile and the Youth Self Report-Dysregulation Profile to identify serious psychopathology and association with correlated problems in high-risk children and adolescents. J Affect Disord 2016; 205:327-334. [PMID: 27566452 DOI: 10.1016/j.jad.2016.08.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/20/2016] [Accepted: 08/14/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current analyses examined whether the dysregulation profile (DP) 1) could be used to identify children and adolescents at high risk for complex and serious psychopathology and 2) was correlated to other emotional and behavioral problems (such as delinquent behavior or suicide ideation). DP was assessed using both the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR) in a residential care sample. METHODS Children and adolescents (N=374) aged 10-18 years living in residential care in Switzerland completed the YSR, and their professional caregivers completed the CBCL. Participants meeting criteria for DP (T-score ≥67 on the anxious/depressed, attention problems, and aggressive behavior scales of the YSR/CBCL) were compared against those who did not for the presence of complex psychopathology (defined as the presence of both emotional and behavioral disorders), and also for the prevalence of several psychiatric diagnoses, suicidal ideation, traumatic experiences, delinquent behaviors, and problems related to quality of life. RESULTS The diagnostic criteria for CBCL-DP and YSR-DP were met by just 44 (11.8%) and 25 (6.7%) of participants. Only eight participants (2.1%) met the criteria on both instruments. Further analyses were conducted separately for the CBCL-DP and YSR-DP groups. DP was associated with complex psychopathology in only 34.4% of cases according to CBCL and in 60% of cases according to YSR. YSR-DP was somewhat more likely to be associated with psychiatric disorders and associated problems than was the CBCL-DP. LIMITATIONS Because of the relatively small overlap between the CBCL-DP and YSR-DP, analyses were conducted largely with different samples, likely contributing to the different results. CONCLUSIONS Despite a high rate of psychopathology in the population studied, both the YSR-DP and the CBCL-DP were able to detect only a small proportion of those with complex psychiatric disorders. This result questions the validity of YSR-DP and the CBCL-DP in detecting subjects with complex and serious psychopathology. It is possible that different screening instruments may be more effective.
Collapse
Affiliation(s)
- Claudia Dölitzsch
- University Hospital of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
| | - Michael Kölch
- Medical School Brandenburg, Department of Child and Adolescent Psychiatry, Germany
| | - Jörg M Fegert
- University Hospital of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany
| | - Klaus Schmeck
- University Hospital of Basel, Department of Child and Adolescent Psychiatry, Switzerland
| | - Marc Schmid
- University Hospital of Basel, Department of Child and Adolescent Psychiatry, Switzerland
| |
Collapse
|
14
|
Caporino NE, Herres J, Kendall PC, Wolk CB. Dysregulation in Youth with Anxiety Disorders: Relationship to Acute and 7- to 19- Year Follow-Up Outcomes of Cognitive-Behavioral Therapy. Child Psychiatry Hum Dev 2016; 47:539-47. [PMID: 26384978 PMCID: PMC4798924 DOI: 10.1007/s10578-015-0587-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study evaluated the impact of dysregulation across cognitive, affective, and behavioral domains on acute and 7- to 19-year follow-up outcomes of cognitive-behavioral therapy (CBT) for anxiety, and explored dysregulation as a predictor of psychopathology and impairment in young adulthood among individuals who received anxiety treatment as youth. Participants (N = 64; 50 % female, 83 % non-Hispanic White) from two randomized clinical trials completed a follow-up assessment 7-19 years later. Latent profile analysis identified dysregulation based on Anxious/Depressed, Attention Problems, and Aggressive Behavior scores on the Child Behavior Checklist. Although pretreatment dysregulation was not related to acute or follow-up outcomes for anxiety diagnoses that were the focus of treatment, dysregulation predicted an array of non-targeted psychopathology at follow-up. Among youth with a principal anxiety disorder, the effects of CBT (Coping Cat) appear to be robust against broad impairments in self-regulation. However, youth with a pretreatment dysregulation profile likely need follow-up to monitor for the emergence of other disorders.
Collapse
Affiliation(s)
- Nicole E Caporino
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA.
| | - Joanna Herres
- Department of Couple and Family Therapy, Drexel University, Philadelphia, Pennsylvania
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | | |
Collapse
|
15
|
Papachristou E, Schulz K, Newcorn J, Bédard ACV, Halperin JM, Frangou S. Comparative Evaluation of Child Behavior Checklist-Derived Scales in Children Clinically Referred for Emotional and Behavioral Dysregulation. Front Psychiatry 2016; 7:146. [PMID: 27605916 PMCID: PMC4995201 DOI: 10.3389/fpsyt.2016.00146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/08/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We recently developed the Child Behavior Checklist-Mania Scale (CBCL-MS), a novel and short instrument for the assessment of mania-like symptoms in children and adolescents derived from the CBCL item pool and have demonstrated its construct validity and temporal stability in a longitudinal general population sample. OBJECTIVE The aim of this study was to evaluate the construct validity of the 19-item CBCL-MS in a clinical sample and to compare its discriminatory ability to that of the 40-item CBCL-dysregulation profile (CBCL-DP) and the 34-item CBCL-Externalizing Scale. METHODS The study sample comprised 202 children, aged 7-12 years, diagnosed with DSM-defined attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), and mood and anxiety disorders based on the Diagnostic Interview Schedule for Children. The construct validity of the CBCL-MS was tested by means of a confirmatory factor analysis. Receiver operating characteristics (ROC) curves and logistic regression analyses adjusted for sex and age were used to assess the discriminatory ability relative to that of the CBCL-DP and the CBCL-Externalizing Scale. RESULTS The CBCL-MS had excellent construct validity (comparative fit index = 0.97; Tucker-Lewis index = 0.96; root mean square error of approximation = 0.04). Despite similar overall performance across scales, the clinical range scores of the CBCL-DP and the CBCL-Externalizing Scale were associated with higher odds for ODD and CD, while the clinical range scores of the CBCL-MS were associated with higher odds for mood disorders. The concordance rate among the children who scored within the clinical range of each scale was over 90%. CONCLUSION CBCL-MS has good construct validity in general population and clinical samples and is therefore suitable for both clinical practice and research.
Collapse
Affiliation(s)
- Efstathios Papachristou
- Department of Primary Care and Population Health, University College London (UCL) , London , UK
| | - Kurt Schulz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Jeffrey Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Anne-Claude V Bédard
- Ontario Institute for Studies in Education, University of Toronto , Toronto, ON , Canada
| | - Jeffrey M Halperin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychology, Queens College, New York, NY, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| |
Collapse
|
16
|
Lemaire M, El-Hage W, Frangou S. Increased affective reactivity to neutral stimuli and decreased maintenance of affective responses in bipolar disorder. Eur Psychiatry 2015; 30:852-60. [PMID: 26443053 DOI: 10.1016/j.eurpsy.2015.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/11/2015] [Accepted: 07/12/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Affective dysregulation is a core feature of bipolar disorder (BD) and a significant predictor of clinical and functional outcome. Affective dysregulation can arise from abnormalities in multiple processes. This study addresses the knowledge gap regarding the precise nature of the processes that may be dysregulated in BD and their relationship to the clinical expression of the disorder. METHODS Patients with BD (n=45) who were either in remission or in a depressive or manic state and healthy individuals (n=101) were compared in terms of the intensity, duration and physiological response (measured using inter-beat intervals and skin conductance) to affective and neutral pictures during passive viewing and during experiential suppression. RESULTS Compared to healthy individuals, patients with BD evidenced increased affective reactivity to neutral pictures and reduced maintenance of subjective affective responses to all pictures. This pattern was present irrespective of clinical state but was more pronounced in symptomatic patients, regardless of polarity. Patients, regardless of symptomatic status, were comparable to healthy individuals in terms of physiological arousal and voluntary control of affective responses. CONCLUSION Our study demonstrates that increased affective reactivity to neutral stimuli and decreased maintenance of affective responses are key dimensions of affective dysregulation in BD.
Collapse
Affiliation(s)
- M Lemaire
- UMR Inserm U930, University François-Rabelais, Tours, France; CHRU Tours, Department of Child Psychiatry, Tours, France
| | - W El-Hage
- UMR Inserm U930, University François-Rabelais, Tours, France; CHRU Tours, Department of Adult Psychiatry (CPU), Tours, France
| | - S Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, USA.
| |
Collapse
|
17
|
Schei J, Nøvik TS, Thomsen PH, Indredavik MS, Jozefiak T. Improved quality of life among adolescents with attention-deficit/hyperactivity disorder is mediated by protective factors: a cross sectional survey. BMC Psychiatry 2015; 15:108. [PMID: 25948117 PMCID: PMC4429327 DOI: 10.1186/s12888-015-0491-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 04/27/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the role of protective factors as mediators and/or moderators of the relationship between coexisting emotional and conduct problems and quality of life (QoL) among adolescents with attention-deficit/hyperactivity disorder (ADHD). METHODS The sample consisted of 194 adolescents with ADHD. Participants completed measures of individual competencies, family cohesion and social support, and QoL. Coexisting emotional and conduct problems were assessed using the Strength and Difficulties Questionnaire. RESULTS Individual competencies and social support mediated the association between emotional and conduct problems and QoL. Family cohesion was associated with both emotional and conduct problems. No moderating effects of protective factors and coexisting problems were found. CONCLUSIONS The assessment of individual competencies, social resources, and family cohesion may identify potential treatment goals for adolescents with ADHD and coexisting problems, and may contribute to improvements in QoL.
Collapse
Affiliation(s)
- Jorun Schei
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.
| | - Torunn Stene Nøvik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital Trondheim University Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway.
| | - Per Hove Thomsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.
- Psychiatric Hospital for Children and Adolescents, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark.
| | - Marit S Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital Trondheim University Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway.
| | - Thomas Jozefiak
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Pb 8905 MTFS, 7491, Trondheim, Norway.
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital Trondheim University Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway.
| |
Collapse
|
18
|
Chen MH, Chen YS, Hsu JW, Huang KL, Li CT, Lin WC, Chang WH, Chen TJ, Pan TL, Su TP, Bai YM. Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study. Bipolar Disord 2015; 17:315-22. [PMID: 25295997 DOI: 10.1111/bdi.12266] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/23/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Previous studies have found that attention-deficit hyperactivity disorder (ADHD) in childhood and adolescence is associated with an increased risk of major depression and bipolar disorder in later life. However, the effect of ADHD comorbidity on the diagnostic conversion to bipolar disorder among patients with major depression is still uncertain. METHODS Using the Taiwan National Health Insurance Research Database, 58,023 subjects < 30 years of age who had major depression with (n = 1,193) or without (n = 56,830) ADHD comorbidity between the years 2000 and 2008 were enrolled in our study. Subjects who developed bipolar disorder during the follow-up to the end of 2011 were identified. RESULTS Adolescents and young adults who had major depression with ADHD comorbidity had an increased incidence of subsequent bipolar disorder (18.9% versus 11.2%, p < 0.001) compared to those without ADHD. Cox regression analysis showed that ADHD comorbidity was an independent risk factor (hazard ratio = 1.50, 95% confidence interval 1.30-1.72) predicting subsequent bipolar disorder among those with major depression, adjusting for demographic data and psychiatric comorbidities. CONCLUSIONS Patients with comorbid diagnoses of major depression and ADHD had an increased risk of diagnostic conversion to bipolar disorder compared to those who had major depression alone. Further studies would be required to validate this finding and to investigate the possible underlying mechanisms.
Collapse
Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Rolim-Neto ML, Alves Silva E, Teixeira Júnior AG, de Sousa Cartaxo J, Rolim Lima NN, Nascimento VB, Vieira dos Santos MDS, Lima da Silva CG, Romero de Sousa SI, da Silva Costa L, Nascimento Neto PJ. Bipolar disorder incidence between children and adolescents: A brief communication. J Affect Disord 2015; 172:171-4. [PMID: 25451413 DOI: 10.1016/j.jad.2014.09.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 09/24/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Bipolar affective disorder is one of most injurious psychiatric diseases, not, rarely leading patient for suicide, and its prevalence keeps increasing worldwide, notably on low and, middle-income countries. For children living in northeast Brazil, extreme social conditions constitute, an environment of special vulnerability. OBJECTIVE Here we show that bipolar disorder incidence, between children and adolescents in this Brazilian region increased 34.2% from 2005 to 2014 and, in, the same area and age group, deaths provoked by self-caused injuries also became progressively, greater. RESULTS According to DATASUS, the Brazilian national databank for public health, information, in the last five years, we observed an increase of Bipolar Disorder incidence rates under, 19 year-old of about 34.2% in the northeast region of Brazil, while the increase for Brazilian general, population was 12.4%. If considered only patients under 10, this number is even greater, of 47.2%. Content of Table 2 shows this disproportion, while comparing the advance of bipolar disorder, morbidity indices nationwide and worldwide. CONCLUSION Children living in Brazil's northeast, region are in a condition of extreme social disadvantage, what can be determinant for the recent and, sequential increase of bipolar disorder prevalence and the mortality in this age-group due to suicide, one of possible reflections of untreated mood disorders. For protecting these children is important to, identify the factors which prevent these illnesses and promote resilience for these young people.
Collapse
Affiliation(s)
- Modesto Leite Rolim-Neto
- Department of Medicine, Faculty of Medicine, Federal University of Cariri, UFCA, Barbalha, Ceara, Brazil.
| | - Elizabeth Alves Silva
- Postgraduate Program in Health Sciences, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
| | | | - Jesus de Sousa Cartaxo
- Postgraduate Program in Health Sciences, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
| | - Nádia Nara Rolim Lima
- Postgraduate Program in Health Sciences, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
| | - Vânia Barbosa Nascimento
- Postgraduate Program in Health Sciences, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil
| | - Maria do Socorro Vieira dos Santos
- Postgraduate Program in Health Sciences, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil; Department of Medicine, Faculty of Medicine, Federal University of Cariri, UFCA, Barbalha, Ceara, Brazil
| | - Cláudio Gleidiston Lima da Silva
- Postgraduate Program in Health Sciences, Faculty of Medicine of ABC, Santo André, São Paulo, Brazil; Department of Medicine, Faculty of Medicine, Federal University of Cariri, UFCA, Barbalha, Ceara, Brazil
| | | | - Lucas da Silva Costa
- Department of Medicine, Faculty of Medicine, Federal University of Cariri, UFCA, Barbalha, Ceara, Brazil
| | | |
Collapse
|
20
|
Child behaviour checklist emotional dysregulation profiles in youth with disruptive behaviour disorders: clinical correlates and treatment implications. Psychiatry Res 2015; 225:191-196. [PMID: 25480545 DOI: 10.1016/j.psychres.2014.11.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/05/2014] [Accepted: 11/09/2014] [Indexed: 11/23/2022]
Abstract
Two Child Behaviour Checklist (CBCL) profiles were correlated to poor self-regulation, Deficient Emotional Self-Regulation (DESR) (elevation between 1 and 2 Standard Deviations (SD) in Anxiety/Depression, Aggression, Attention subscales), and Dysregulation Profile (DP) (elevation of 2 Standard Deviations or more). We explored youths with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) whether these profiles are associated with specific clinical features. The sample included 57 patients with DESR profile and 41 with DP profile, ages 9 to 15 years, all assigned to a non-pharmacological Multimodal Treatment Program. No differences resulted between groups in demographic features, diagnosis ratio, and comorbidities with Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), and Anxiety Disorder. The DP group was associated with higher scores in Withdrawn, Social Problem, Thought, Rule Breaking, and Somatic CBCL subscales, and higher scores in Narcissism and Impulsivity (but not Callous-Unemotional (CU)), according to the Antisocial Process Screening Device (APSD). After treatment, patients with DESR improved their personality traits (Narcissistic and Callous-Unemotional, but not Impulsivity), while changes in CBCL scales were modest. Patients with DP improved scales of Attention, Aggression, Anxiety-Depression, Rule Breaking, Withdrawal, Social Problem and Thought, while personality features did not change. These results suggest diagnostic implications of CBCL profiles, and indications for targeted treatment strategies.
Collapse
|
21
|
Basten M, van der Ende J, Tiemeier H, Althoff RR, Rijlaarsdam J, Jaddoe VWV, Hofman A, Hudziak JJ, Verhulst FC, White T. Nonverbal intelligence in young children with dysregulation: the Generation R Study. Eur Child Adolesc Psychiatry 2014; 23:1061-70. [PMID: 24802760 DOI: 10.1007/s00787-014-0551-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 04/15/2014] [Indexed: 10/25/2022]
Abstract
Children meeting the Child Behavior Checklist Dysregulation Profile (CBCL-DP) suffer from high levels of co-occurring internalizing and externalizing problems. Little is known about the cognitive abilities of these children with CBCL-DP. We examined the relationship between CBCL-DP and nonverbal intelligence. Parents of 6,131 children from a population-based birth cohort, aged 5 through 7 years, reported problem behavior on the CBCL/1.5-5. The CBCL-DP was derived using latent profile analysis on the CBCL/1.5-5 syndrome scales. Nonverbal intelligence was assessed using the Snijders Oomen Nonverbal Intelligence Test 2.5-7-Revised. We examined the relationship between CBCL-DP and nonverbal intelligence using linear regression. Analyses were adjusted for parental intelligence, parental psychiatric symptoms, socio-economic status, and perinatal factors. In a subsample with diagnostic interview data, we tested if the results were independent of the presence of attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders (ASD). The results showed that children meeting the CBCL-DP (n = 110, 1.8%) had a 11.0 point lower nonverbal intelligence level than children without problems and 7.2-7.3 points lower nonverbal intelligence level than children meeting other profiles of problem behavior (all p values <0.001). After adjustment for covariates, children with CBCL-DP scored 8.3 points lower than children without problems (p < 0.001). The presence of ADHD or ASD did not account for the lower nonverbal intelligence in children with CBCL-DP. In conclusion, we found that children with CBCL-DP have a considerable lower nonverbal intelligence score. The CBCL-DP and nonverbal intelligence may share a common neurodevelopmental etiology.
Collapse
Affiliation(s)
- Maartje Basten
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Uchida M, Davis J, Wozniak J. Familiality and Indicators of Risk for Bipolar Disorder in Youth with Attention-Deficit/Hyperactivity Disorder. Psychiatr Ann 2014. [DOI: 10.3928/00485713-20140908-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
23
|
Uchida M, Faraone SV, Martelon M, Kenworthy T, Woodworth KY, Spencer T, Wozniak J, Biederman J. Further evidence that severe scores in the aggression/anxiety-depression/attention subscales of child behavior checklist (severe dysregulation profile) can screen for bipolar disorder symptomatology: a conditional probability analysis. J Affect Disord 2014; 165:81-6. [PMID: 24882182 PMCID: PMC4066999 DOI: 10.1016/j.jad.2014.04.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 04/11/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous work shows that children with high scores (2SD, combined score≥210) on the Attention Problems, Aggressive Behavior, and Anxious-Depressed (A-A-A) subscales of the Child Behavior Checklist (CBCL) are more likely than other children to meet criteria for bipolar (BP)-I disorder. However, the utility of this profile as a screening tool has remained unclear. METHODS We compared 140 patients with pediatric BP-I disorder, 83 with attention deficit hyperactivity disorder (ADHD), and 114 control subjects. We defined the CBCL-Severe Dysregulation profile as an aggregate cutoff score of ≥210 on the A-A-A scales. Patients were assessed with structured diagnostic interviews and functional measures. RESULTS Patients with BP-I disorder were significantly more likely than both control subjects (Odds Ratio [OR]: 173.2; 95% Confidence Interval [CI], 21.2 to 1413.8; P<0.001) and those with ADHD (OR: 14.6; 95% CI, 6.2 to 34.3; P<0.001) to have a positive CBCL-Severe Dysregulation profile. Receiver Operating Characteristics analyses showed that the area under the curve for this profile comparing children with BP-I disorder against control subjects and those with ADHD was 99% and 85%, respectively. The corresponding positive predictive values for this profile were 99% and 92% with false positive rates of <0.2% and 8% for the comparisons with control subjects and patients with ADHD, respectively. LIMITATIONS Non-clinician raters administered structured diagnostic interviews, and the sample was referred and largely Caucasian. CONCLUSIONS The CBCL-Severe Dysregulation profile can be useful as a screen for BP-I disorder in children in clinical practice.
Collapse
Affiliation(s)
- Mai Uchida
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - MaryKate Martelon
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Tara Kenworthy
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - K Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Thomas Spencer
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Janet Wozniak
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
24
|
Genetic associations between the symptoms of attention-deficit/hyperactivity disorder and emotional lability in child and adolescent twins. J Am Acad Child Adolesc Psychiatry 2014; 53:209-220.e4. [PMID: 24472255 DOI: 10.1016/j.jaac.2013.11.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 09/10/2013] [Accepted: 11/21/2013] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Emotional lability is recognized as an associated feature of attention-deficit/hyperactivity disorder (ADHD). However, the degree of phenotypic and etiologic overlap between emotional lability and the ADHD dimensions of hyperactivity-impulsivity and inattention remains unclear. The present study examines these associations in a large, community twin sample. METHOD Structural equation models were fit to data from 1,920 child and adolescent twin pairs (age range, 5-18 years). Symptoms of hyperactivity-impulsivity (HI) and inattention (IA) were assessed using a modified version of the DuPaul rating scale, completed by parents. Symptoms of emotional lability (EL) were assessed using the parent-rated Conners 10-item scale. RESULTS There were moderate to strong phenotypic correlations between HI, IA, and EL. Multivariate twin modeling revealed that a common pathway model best accounted for the covariance among these dimensions, represented by a highly heritable latent factor. Ad hoc analyses confirmed that all additive genetic influences on HI, IA, and EL were shared, and identified a significantly stronger association of EL with the latent ADHD factor in older than in younger individuals. CONCLUSIONS Emotional lability was phenotypically and genetically associated with hyperactivity-impulsivity and inattention in children and adolescents. The finding that a single, heritable, latent factor accounted for covariation among these phenotypes indicates that their co-occurrence is primarily the result of overlapping genetic effects. These data support the hypothesis that emotional lability is etiologically relevant to the core ADHD phenotype, and that it should be targeted in assessment and treatment in clinical practice.
Collapse
|