Children's depression inventory: sex and grade norms for normal children

Trajectories of Annual Number of Sexual Partners from Adolescence to Emerging Adulthood: Individual and Family Predictors

Adolescent sexual development is not the same across the board, and can be seen as both normative as well as risky behavior, depending on factors such as age of onset and number of partners. This longitudinal study identified developmental trajectories of annual number of sexual partners from adolescence to emerging adulthood and their antecedents. From the ages of 16-22, 332 participants (60.8 % females) annually reported their number of sexual partners. Measures of adolescent and family characteristics taken at ages 13-15 were used as predictors. Group-based modeling identified four trajectory groups: the abstainers group (9.1 %), low-increasing group (30.6 %), medium-increasing group (53.0 %), and multiple-partners group (7.3 %). Multinomial logistical regressions indicated that better social competence increased chances of belonging to the multiple-partners group as compared to the abstainers and low-increasing groups, and more substance use predicted membership in the multiple-partners group as compared to the abstainers group. Moreover, females were overrepresented in the low-increasing and medium-increasing groups. These results imply a greater diversity in sexual development than proposed in the literature and highlight the importance of identifying the strengths and competencies associated with healthy sexual development along with the early risk factors.

KNOW-Ped CKD (KoreaN cohort study for outcomes in patients with pediatric CKD): Design and methods

Background

The global prevalence of chronic kidney disease (CKD) is increasing. In children, CKD exhibits unique etiologies and can have serious impacts on children’s growth and development. Therefore, an aggressive approach to preventing the progression of CKD and its complications is imperative. To improve the understanding and management of Asian pediatric patients with CKD, we designed and launched KNOW-Ped CKD (KoreaN cohort study for Outcome in patients With Pediatric Chronic Kidney Disease), a nationwide, prospective, and observational cohort study of pediatric CKD with funding from the Korean government.

Methods/design

From seven major centers, 450 patients <20 years of age with CKD stages I to V are recruited for the comprehensive assessment of clinical findings, structured follow-up, and bio-specimen collection. The primary endpoints include CKD progression, defined as a decline of estimated glomerular filtration rate by 50 %, and a requirement for renal replacement therapy or death. The secondary outcomes include the development of left ventricular hypertrophy or hypertension, impairment of growth, neuropsychological status, behavioral status, kidney growth, and quality of life.

Discussion

With this study, we expect to obtain more information on pediatric CKD, which can be translated to better management for the patients.

Trial registration

NCT02165878 (ClinicalTrials.gov), submitted on June 11, 2014.

Neighborhood Stress, Depressive Symptoms, and Asthma Morbidity in Youth

OBJECTIVE

Living in a dangerous and disadvantaged neighborhood is consistently linked with poor health outcomes; however, few studies have investigated psychosocial mechanisms of this relationship. We hypothesized that a specific facet of depression-anhedonia-would partially explain the relationship between stressful neighborhoods and poor health in youth with asthma.

METHOD

156 youths provided reports on their depressive symptoms, daily asthma symptoms, and peak expiratory flow rate (PEFR). Caregivers provided reports on neighborhood characteristics.

RESULTS

Youth residing in more at-risk neighborhoods experienced more symptoms of depression, greater asthma symptoms (both during the day and night), and marginally lower PEFR. Indirect effect analyses revealed that the relationship between neighborhood stress and youth asthma symptoms was partially explained by a key symptom of depression, anhedonia.

CONCLUSIONS

These findings suggest that the neighborhood-health link is partially explained by symptoms of depression tapping into difficulties experiencing pleasure and motivation.

Light exposure among adolescents with delayed sleep phase disorder: a prospective cohort study

The objective of this study was to compare light exposure and sleep parameters between adolescents with delayed sleep phase disorder (DSPD; n=16, 15.3±1.8 yrs) and unaffected controls (n=22, 13.7±2.4 yrs) using a prospective cohort design. Participants wore wrist actigraphs with photosensors for 14 days. Mean hourly lux levels from 20:00 to 05:00 h and 05:00 to 14:00 h were examined, in addition to the 9-h intervals prior to sleep onset and after sleep offset. Sleep parameters were compared separately, and were also included as covariates within models that analyzed associations with specified light intervals. Additional covariates included group and school night status. Adolescent delayed sleep phase subjects received more evening (p< .02, 22:00-02:00 h) and less morning (p .05, 08:00-09:00 h and 10:00-12:00 h) light than controls, but had less pre-sleep exposure with adjustments for the time of sleep onset (p< .03, 5-7 h prior to onset hour). No differences were identified with respect to the sleep offset interval. Increased total sleep time and later sleep offset times were associated with decreased evening (p< .001 and p= .02, respectively) and morning (p= .01 and p< .001, respectively) light exposure, and later sleep onset times were associated with increased evening exposure (p< .001). Increased total sleep time also correlated with increased exposure during the 9 h before sleep onset (p= .01), and a later sleep onset time corresponded with decreased light exposure during the same interval (p< .001). Outcomes persisted regardless of school night status. In conclusion, light exposure interpretation requires adjustments for sleep timing among adolescents with DSPD. Pre- and post-sleep light exposures do not appear to contribute directly to phase delays. Sensitivity to morning light may be reduced among adolescents with DSPD.

Comorbid Externalising Disorders and Child Anxiety Treatment Outcomes

Examined the effects of comorbid externalising disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], conduct disorder [CD]) on the long-term outcome (7.4 years) of individuals treated for anxiety disorders as youth. Ninety-four anxiety-disordered children (aged 8-13) were provided with a 16-session manual-based cognitive behavioural treatment (CBT). Assessments were completed at pretreatment, posttreatment, 1-year posttreatment (see Kendall, et al., 1997) and for 88 of the original 94 subjects at 7.4-years posttreatment (see Kendall, Safford, Flannery-Schroeder, & Webb, in press). At pretreatment, all participants received principal anxiety diagnoses (generalised anxiety disorder, separation anxiety disorder, social phobia). Nineteen had comorbid externalising disorders (11 ADHD, 7 ODD and 1 CD). These 19 subjects were matched on age (within an average of 3 months), gender and race with 19 previously treated youths who were not comorbid with an externalising disorder. Examining parent- and child-reports, respectively, comparable rates of comorbid versus non-comorbid cases were free of their principal anxiety disorder at the 7.4-year follow-up on all dependent measures. Parents of anxiety-disordered children with a comorbid externalising disorder reported higher levels of child externalising behaviour than did parents of anxiety-disordered children without comorbidity. Comorbid children reported greater self-efficacy in coping with anxiety-provoking situations than did non-comorbid children. Thus, it appears that overall anxiety-disordered children with and without comorbid externalising disorders showed comparable improvements following CBT.

Resiliency in young children whose mothers are living with HIV/AIDS

Resiliency was investigated among well children 6-11 years of age (N = 111) whose mothers are living with AIDS or are HIV symptomatic to determine if mother's HIV status was a risk factor that could effect child resiliency, as well as investigate other factors associated with resiliency. Assessments were conducted with mother and child dyads over four time points (baseline, 6-, 12-, and 18-month follow-ups). Maternal illness was a risk factor for resiliency: as maternal viral load increased, resiliency was found to decrease. Longitudinally, resilient children had lower levels of depressive symptoms (by both mother and child report). Resilient children also reported higher levels of satisfaction with coping self-efficacy. A majority of the children were classified as non-resilient; implications for improving resiliency among children of HIV-positive mothers are discussed.

Relations with parents and with peers, temperament, and trajectories of depressed mood during early adolescence

The present study examined (a) whether groups of children can be empirically identified with distinct longitudinal profiles of depressed mood from late childhood through early adolescence, (b) to what extent these different longitudinal depression profiles are predicted by problematic relations with parents, same-sex peers, and other-sex peers, and (c) what role individuals' temperamental characteristics play in this context. Based on a sample of 414 early adolescents (197 girls), four groups were identified with distinct longitudinal profiles of depressed mood between ages 11 and 14: One group with consistently low levels of depressed mood, another with consistently moderate levels of depressed mood, a third group whose depressed mood increased sharply from late childhood through early adolescence, and a fourth group who already showed clinical-range levels of depressed mood during late childhood and whose depressive feelings increased even slightly more thereafter. Subsequent analyses revealed that rejection by same-sex peers was related to the odds of following an increasing trajectory of depressed mood, but only for girls with a highly reactive temperament. A problematic relationship with parents increased the odds of an elevated trajectory of depressed mood regardless of individual temperament. The theoretical and practical implications of these findings are discussed.

A Longitudinal Look at Parent–Child Diagnostic Agreement in Youth Treated for Anxiety Disorders

This study examined diagnostic agreement between children and their parents for seventy 9- to 13-year-olds (45 boys and 25 girls) who had received cognitive-behavioral treatment for anxiety disorders. Parent-child diagnostic rates and agreements for generalized anxiety disorder, separation anxiety disorder, and social phobia were evaluated at 3 time points: pretreatment, posttreatment, and 7.4-year follow-up. Results indicate that parent-child diagnostic agreement was typically poor to moderate (kappa = -.03 to .64) and that estimates of agreement remained relatively unchanged (a) following treatment and (b) as the children enter adolescence and young adulthood. Parent-daughter agreement was better than parent-son agreement in some cases. Although it remains unclear whether parent or child diagnostic information is most accurate, positive treatment outcome appears to be possible despite poor parent-child diagnostic agreement.

Deviant peer affiliations and depression: confounding or causation?

Data gathered from 2 longitudinal studies (the Christchurch Health and Development study of a birth cohort of 1,265 New Zealand participants studied to 21 years and the Quebec Study of 240 Canadian participants studied to 13 years) was used to examine the linkages between deviant peer affiliations and depression in adolescence. Both studies produced similar conclusions: a) increasing peer affiliations were associated with significant (p < .0001) increases in depressive symptoms; b) the associations between peer affiliations and depression could not be fully explained by confounding factors; and c) peer affiliations and depressive symptoms were linked by a causal chain process in which deviant peer affiliations led to increased externalizing behaviors with the negative consequences of these behaviors leading to depression.

IDENTIFYING PSYCHOSOCIAL DYSFUNCTION IN SCHOOL-AGE CHILDREN: THE PEDIATRIC SYMPTOM CHECKLIST AS A SELF-REPORT MEASURE

The Pediatric Symptom Checklist (PSC) is a brief, well-validated parent-report questionnaire designed to detect psychosocial dysfunction in school-age children during pediatric primary care visits. This study assessed the utility of the PSC when completed by children (PSC-Y) ages 9-14 in a public school when parents are not available (n = 173). The PSC-Y identified 20% of children as having psychosocial problems, a rate similar to other low-income samples. When compared with teacher ratings of attention and behavior problems, the PSC-Y showed a sensitivity of 94% and a specificity of 88%. The PSC-Y correlated significantly with teacher and parent measures of child dysfunction, and with child-reported symptoms of depression and anxiety. Three quarters of the children identified by the PSC-Y were not identified by parents on the PSC. These children had impairment on all other measures, but fewer than one in five had received mental health services, suggesting the PSC-Y identified children with unmet mental health needs. The PSC-Y has the potential to be a rapid, easily administered tool for large-scale mental health screening in schools.

The Montefiore community children's project: a controlled study of cognitive and emotional problems of homeless mothers and children

OBJECTIVES

This study compares the prevalence of emotional, academic, and cognitive impairment in children and mothers living in the community with those living in shelters for the homeless.

METHOD

In New York City, 82 homeless mothers and their 102 children, aged 6 to 11, recruited from family shelters were compared to 115 nonhomeless mothers with 176 children recruited from classmates of the homeless children. Assessments included standardized tests and interviews.

RESULTS

Mothers in shelters for the homeless showed higher rates of depression and anxiety than did nonhomeless mothers. Boys in homeless shelters showed higher rates of serious emotional and behavioral problems. Both boys and girls in homeless shelters showed more academic problems than did nonhomeless children.

CONCLUSION

Study findings suggest a need among homeless children for special attention to academic problems that are not attributable to intellectual deficits in either children or their mothers. Although high rates of emotional and behavioral problems characterized poor children living in both settings, boys in shelters for the homeless may be particularly in need of professional attention.

Competence and memory: integrating psychosocial and cognitive correlates of child depression

Positive and negative peer nominations of multiple competencies and incidental recall of positive and negative self-referential adjectives were measured in relatively depressed and nondepressed fourth-, sixth-, and eighth-grade children (9 to 15 years old). Positive and negative peer evaluations related significantly to children's ability to recall positive and negative self-referential information (respectively), even after controlling for concurrent depressive symptoms. Positive and negative peer evaluations also related strongly to children's self-reported depressive symptoms. Incidental recall of positive and negative information significantly related to self-reported depression. In fact, the relation between recall of negative information and depression significantly increased in the eighth grade. Finally, preliminary support emerged that cognitive processes related to the incidental recall of negative self-descriptive information may mediate the relation between peer evaluations and depression. Implications for further research into the social determinants of cognitive processes and into the social and cognitive determinants of depression are discussed.

Developmental differences in cognitive diatheses for child depression

We studied developmental changes in the relation between cognitive style (i.e., attributional style and cognitive errors) and depression in children. Subjects included 409 fourth-, sixth-, and eighth-grade school children. We hypothesized (1) that evidence congruent with a cognitive diathesis model of depression would emerge with development across middle childhood, (2) that Event x Cognitive Style x Age interactions would be specific to some domains of stressful events but not others, and (3) that interactions would be especially prominent in domains that children regarded as personally important. Hierarchical multiple regressions indicated that cognitive style moderated the relation between events and self-reported depressive symptoms only in later childhood, and that such interactions were specific to certain domains of stressful events and cognitions. The importance of distinguishing among types of stress and cognitions in future tests of diathesis-stress models of childhood depression are discussed. Implications of developmental differences in the psychopathology of child depression also emerge.