Frequency of phobic disorder in a community sample of young adolescents

Obsessive-Compulsive Symptoms: Baseline Prevalence, Comorbidity, and Implications in a Clinically Anxious Pediatric Sample

Subclinical symptoms of obsessive-compulsive disorder (i.e., obsessive compulsive symptoms, or "OCS") cause functional impairment, including for youth without full-syndrome OCD. Further, despite high rates of OCS in youth with anxiety disorders, knowledge of OCS in the context of specific anxiety disorders is limited. The present study seeks to: (1) compare OCS in pediatric patients with anxiety disorders and healthy youth, (2) determine which categorical anxiety disorder(s) associate most with OCS, and (3) determine relationships between OCS with anxiety severity and impairment. Data on OCS, anxiety, and functional impairment were collected from 153 youth with anxiety disorders and 45 healthy controls, ages 7-17 years (M = 11.84, SD = 3.17). Findings indicated that patients had significantly more OCS than healthy controls. Among patients, GAD was a significant predictor of OCS as well as OCD risk. These results suggest that OCS should be a primary diagnostic and treatment consideration for youth who present in clinical settings with GAD.

Father absence and gendered traits in sons and daughters

Research has previously found a number of apparently contradictory patterns in the relationship between ‘father absence’ (having a non-resident father during childhood) and the expression of gender roles, as well as other sexually dimorphic traits such as aggression. In the current study we measured a battery of sexually differentiated traits in relation to family background. 133 men and 558 women from the United States and Australia completed the Bem Sex Role Inventory, the Barrett Impulsivity Scale, the Fear Survey Schedule and the Buss & Perry Aggression Questionnaire. Principal components analysis found two main axes of variation in these traits. Firstly, a general ‘reactivity’ factor, on which aggression, impulsivity, and fear all loaded positively, was weakly associated with father absence in women. Secondly, ‘masculinity’ (consisting of high scores on masculine traits, low fear, and physical and verbal aggression) was not associated with father absence. Participants (except American males) reporting a poor childhood relationship with their parents also had high ‘reactivity’ but not higher ‘masculinity’. We found some evidence of a link between father absence and earlier age of first coitus in American females (although not in Australia), but there was no link with age of menarche in either country. Overall, the current results suggest that previous findings linking gender development with father absence in girls may have arisen from a tendency towards greater externalising and reactive behaviour rather than a change in gender development per se.

Childhood Symptoms of ADHD Overrule Comorbidity in Relation to Psychosocial Outcome at Age 15: A Longitudinal Study

Objective

Neurodevelopmental problems (NDPs) may influence the transition from childhood to adolescence. Our aim was to study long-term psychosocial outcomes of NDPs, focusing on ADHD.

Method

Data was collected through a telephone interview with parents of twins at ages 9 or 12 years. NDP screen-positive children were clinically assessed at age 15; N = 450. Psychosocial outcome concerning peers, school, internalizing problems, antisocial behavior, alcohol misuse, drug misuse, and impaired daily functioning was examined.

Results

Even after controlling for other NDP comorbidity, screen-positivity for ADHD doubled or tripled the odds of later psychosocial problems. When controlling for parental education level, the significant effect of ADHD remained only for antisocial behavior and impaired daily functioning.

Conclusions

Signs of NDPs as well as other psychiatric diagnoses at ages 9 or 12 years are associated with a more problematic adolescence. However, despite the presence of comorbidity, early ADHD symptoms stand out as the most important risk factor for later antisocial development and impaired daily functioning.

The Comprehensive Quality of Life Scale: A Psychometric Evaluation with an Adolescent Sample

The term quality of life (QOL) generally refers to the overall evaluation of an individual's life condition, on both objective and subjective dimensions. Quality of life research has focused on global evaluations of life satisfaction in adults. The life quality of adolescents and the performance of central life domains have largely been ignored. This study describes the psychometric properties of the Comprehensive Quality of Life Scale (ComQol) with an adolescent sample. In line with recent conceptualisations of QOL, ComQol assesses subjective and objective QOL on seven life domains. ComQol was administered along with two other self-report instruments (measuring fear and anxiety) to a sample of 264 school-based adolescents aged between 12 and 18 years. The scale yielded life satisfaction data that lay within the normative range for adults. Test-retest reliability and internal consistency analyses indicated that the scale has adequate reliability. In support of convergent validity, fear and anxiety were generally found to be significantly associated with lower levels of life quality. The present study supports the psychometric adequacy of ComQol as an instrument to measure the life quality of adolescents.

Enhancing management of depression and type 1 diabetes in adolescents and young adults

Anxiety, depression, and eating disorders are higher in adolescents and young adults with diabetes than in their unaffected counterparts worldwide. This descriptive qualitative research paper, using secondary analysis, described the experiences of adolescents and young adults living with depression and Type 1 diabetes. The study showed that depression negatively affected the participants physically, emotionally, and socially and impacted on their relationships. Negative dimensions of self had a flow-on effect for health management. A deeper understanding of these experiences may assist health professionals to enhance the management of affected adolescents and young adults, leading to better health outcomes.

Specific phobia in youth: phenomenology and psychological characteristics

Sociodemographic and psychological characteristics of 62 youth with animal and natural environment types of specific phobia were examined in a treatment-seeking sample. Differences due to age, sex, ethnicity, family structure, and family socioeconomic status were not found between youth with the two types of specific phobia. Moreover, differences were not obtained between the two groups in the clinical severity of their phobias, the perceived dangerousness of the feared outcomes associated with their phobias, the perceived levels of coping with their phobias, or overall fearfulness. However, differences between youth with the two types of specific phobias were found on somatic/anxious symptoms, depressive symptoms, and life satisfaction. In addition, differences were noted on withdrawn, somatic complaints, anxious/depressed symptoms, and social problems as reported by the mothers of these youngsters. Finally, differences in the percent of co-occurring anxiety disorders between youth with the two types of specific phobia were found. On all of the domains in which differences were found, youth with the natural environment type fared more poorly than those with the animal type. These findings converge with those obtained in treatment studies which indicate that youth with the natural environment type are more difficult to treat than youth with the animal type.

Rates and predictors of remission in young women with specific phobia: a prospective community study

This prospective study reports rates and predictors of remission in young women with specific phobia. Data came from a prospective community study, in which German women (aged 18-25 years) completed an extended version of the Anxiety Disorders Interview Schedule (ADIS-IV-L) at two time points. Of the 137 women with specific phobia at baseline, 41.6% were partially remitted and an additional 19.0% were fully remitted at follow-up, defined as absence of any specific fears. A remitting course of specific phobia was predicted by residual protective factors at baseline, especially participants' positive mental health and life satisfaction. Baseline levels of stress, coping skills, cognitive factors, psychopathology, and specific phobia characteristics did not predict remission. Results show that specific phobia in young women rarely takes a stable course at the full diagnostic threshold. The factors that influence remission of specific phobia are different from those that predict the incidence.

Incidence of childhood psychiatric disorders in India

BACKGROUND

Studies on incidence of childhood mental disorders are extremely rare globally and there are none from India. Incidence studies though more difficult and time consuming, provide invaluable information on the pattern and causes of occurrence of mental disorders allowing opportunity for early intervention and primary prevention.

AIM

This study aimed at estimating the incidence of psychiatric disorders in school children.

MATERIALS AND METHODS

A representative sample of school children was assessed through a two stage evaluation process involving teacher's rating (N=963) and parent rating (N=873). Children who scored below the cut-off for psychiatric disorder (N=727) on both the screening instruments were re-contacted six years later. 186 children and their families were personally available for reevaluation. All the children and their parents were re-assessed on Parent Interview Schedule; Strengths and Difficulties Questionnaire: and detailed clinical assessment by a psychiatrist. Psychiatric diagnosis was made as per ICD 10 criteria. Data on children who were found to have psychiatric disorder were compared with those who did not have psychiatric disorders.

RESULTS

20 children out of 186 followed up had psychiatric disorder giving the annual incidence rate of 18/1000/yr. Children who had disorder at follow-up did not differ from those who did not on age, gender and psychological (temperament, parental handling, life stress and IQ) parameters at baseline.

DISCUSSION

Incidence figures cannot be compared due to lack of any comparable studies. Factors associated with occurrence of new cases of psychiatric disorder and implications for future studies are discussed.

Associations of familial risk factors with social fears and social phobia: evidence for the continuum hypothesis in social anxiety disorder?

We examined parental psychopathology and family environment in subthreshold and DSM-IV threshold conditions of social anxiety disorder (SAD) in a representative cohort sample of 1,395 adolescents. Offspring and parental psychopathology was assessed using the DIA-X/M-CIDI; recalled parental rearing and family functioning via questionnaire. Diagnostic interviews in parents were supplemented by family history reports from offspring. The cumulative lifetime incidence was 23.07% for symptomatic SAD, and 18.38 and 7.41% for subthreshold and threshold SAD, respectively. The specific parent-to-offspring association for SAD occurred for threshold SAD only. For subthreshold and threshold SAD similar associations were found with other parental anxiety disorders, depression and substance use disorders. Parental rearing behaviour, but not family functioning, was associated with offspring threshold SAD, and although less strong and less consistent, also with subthreshold SAD. Results suggest a continued graded relationship between familial risk factors and offspring SAD. Parental psychopathology and negative parental styles may be used defining high-risk groups to assign individuals with already subthreshold conditions of SAD to early intervention programs.

Specific phobia

This article describes specific phobia of childhood and its clinical presentation, discusses issues related to the differential diagnosis of specific phobia, considers the issue of comorbidity among phobic and anxiety disorders and developmental trends in the manifestation of fears, summarizes the epidemiology, causes, and course of specific phobia, and presents assessment and treatment issues. Finally, a case study is offered that serves to illuminate the major topics outlined in the article.

Global assessment of psychosocial functioning in child and adolescent psychiatry. A review of three unidimensional scales (CGAS, GAF, GAPD)

Global assessment of functioning represents an important aspect of assessment in clinical practice and research. It can help identify persons in need of psychiatric treatment, have predictive value and measure change over time, including treatment effects. This review examines publications concerning development, psychometric properties and usefulness of three scales for children: Axis-VI in ICD-10 Global Assessment of Psychosocial Disability (GAPD), Children's Global Assessment Scale (CGAS) and Axis-V in DSM-IV Global Assessment of Functioning Scale (GAF). It is based on literature searches in PubMed and PsycInfo (1977-2003), and screening of Scandinavian and English textbooks on child psychiatry. The three scales differ in theoretical guidelines, descriptions of codes/anchor points and psychometric aspects. CGAS has been evaluated in 69 papers and 33 have been published on GAF used for children. The one paper comparing GAPD and CGAS found both scales sufficiently reliable for clinical practice. Reliability of CGAS and GAF has been found to vary from fair to substantial, depending on raters, training and diagnostic groups. International consensus for the use of one scale for global assessment of functioning for children 4-18 years would improve reliability in clinical practice and ease comparisons of studies across countries. A training programme would assist in this.