Editorial: Identifying the cognitive and physiological underpinning of child psychiatric conditions

Abstract

The February issue11 Articles in this issue (with italicised names below) can be found at: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.2011.53.issue-2/issuetoc. represents several important approaches and domains found in contemporary psychology and psychiatry. First, several studies examined the links between child cognition and child outcomes. These studies are important because they attempt to move beyond broad diagnostic categories to a deeper understanding of their cognitive underpinnings. Shoemaker and colleagues examined the relationship between inhibition and working memory in preschool children with attention-deficit hyperactivity disorder (ADHD), disruptive behavioral disorder (DBD) and ADHD + DBD. The results of their study suggested that, as expected, children with ADHD showed significant inhibition deficits. Interestingly, children with DBD showed inhibition deficits, especially in situations with motivational incentives. Romens and Pollak examined the relationship between child maltreatment, depression, and attention bias. Results indicated that maltreated children displayed increased attention for depression-related stimuli, especially when provided with depression-related cues. The results of this study also suggested that children who ruminated demonstrated heightened and stable patterns of attention to depression-related cues. Rhodes and colleagues conducted a systematic analysis of memory in boys with ADHD and oppositional defiant disorder (ODD). These researchers asserted that combined ADHD+ODD constitutes comorbidity between two distinct conditions, as opposed to different expressions of the same underlying etiology. As noted in their commentary, Jarrold and Hall raised several important issues concerning limitations of the Rhodes et al. study. These were, in turn, addressed by a response by Coghill and Rhodes. The reader is encouraged to consider Rhodes et al., Jarrold & Hall., and Coghill & Rhodes in their totality. Additionally, the current issue presents several papers addressing issues related to autism spectrum disorders (ASD). Kim and Lord examined the combined use of the Autism Diagnostic Interview-Revise (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). Their study suggested that these measures tap additive dimensions of ASD, which leads to more stable and accurate diagnoses. Peters and colleagues examined autism-related features and behaviors in children with Angelman syndrome. This study is important because it examined this issue in children with chromosomal deletions. In particular, children with Class I deletions were more likely to show greater impairments in social affect and more repetitive behaviors than children with Class II deletions. These characteristics also appeared to persist longitudinally. Geluk and colleagues examined the longitudinal association between autistic symptoms and delinquent behavior in childhood arrestees, finding that autistic symptoms are more prevalent in these children compared to the unselected population. This study raises important questions concerning the interpretation of behavior as related to autism or related to delinquency in this population of children. Finally, a set of papers in this issue addressed the relationship between behavioral measures, physiological measures, and complex child outcomes. First, Wetter and El-Sheikh examined growth trajectories on internalizing symptoms in children, as predicted by maternal internalizing behavior and children’s basal respiratory sinus arrhythmia (RSA), which is a measure of parasympathetic nervous system functioning. Results suggested that child physiological measures predict a portion of the substantial individual differences in children with familial risk for psychopathology. Kossowsky and colleagues suggested that separation from mother led to greater sympathetic nervous responsivity in children with separation anxiety disorder compared to controls. Murray and colleagues suggested that anxious mothers are no different from non-anxious mothers under typical conditions. However, mothers with anxiety disorders show difficulties when placed under stress. Tan and colleagues examined emotional reactivity and regulation in anxious versus nonanxious children using a cell phone-based study. What was most interesting about this study, aside from the ecological validity of the design, was the finding that, similar to the Murray et al. study, persons at risk for anxiety demonstrated difficulties in response to challenging events, but appeared to be no different from controls in other conditions. Finally, Kujawa and colleagues studied electrocortical reactivity to emotional faces in young children, and their relationship with parental depression. Children of mothers with a history of depression were more likely to show reduced physiological responses for faces with emotional content, suggesting that this response may be a biomarker for (as opposed to a consequence of) depression. Taken together, the studies contained in this issue demonstrate that child psychology and psychiatry are beginning to systematically integrate cognitive and physiological measures into theory. This is important, not only because of increased explanation of the substantial heterogeneity found in most diagnostic categories, but also because of the potential for developing cognitive or physiological biomarkers that can be employed to better identify, treat, or prevent childhood disorders.