Conduct Disorder Symptoms Research Articles

The multispecifier model for conduct disorder in detained boys: Relations with conduct disorder criteria and etiologically and clinically relevant correlates.

A multispecifier model for subtyping children and adolescents with conduct disorder (CD) has been proposed that, in addition to callous-unemotional (CU) traits, also considers grandiose-manipulative (GM) and daring-impulsive (DI) traits. Yet, concerns have been raised about the potential overlap of these latter two specifiers with existing CD criteria and their limited added value to the prediction of etiologically and clinically relevant correlates. The present study was designed to address these concerns while using data from 286 detained boys with a CD diagnosis (ages 16 to 17 years). In addition to a diagnostic interview, participants completed questionnaires that assessed GM, CU, and DI traits, attention-deficit/hyperactivity disorder (ADHD) symptoms, and external correlates. Findings showed that all three specifiers were weakly to moderately correlated to the CD symptom scores. In support of the CU subtyping scheme, CU traits incrementally contributed to the prediction of various external correlates, beyond the total number of CD symptoms, childhood-onset CD, and ADHD symptoms. Importantly, GM and DI traits also significantly added to the prediction of etiologically (i.e., maternal parenting, empathy, and anxiety) and clinically (i.e., proactive aggression and substance use) relevant correlates beyond CU traits. In conclusion, this study suggests that GM and DI traits, just like CU traits, add to the classification of detained boys with CD and have validity for subtyping CD. Nevertheless, a systematic evaluation of the multispecifier model for CD and related concerns is needed before firm conclusions can be drawn about the utility of having additional specifiers for CD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Comorbidity of Cerebral Palsy and Bipolar Disorder in Two Adolescents: Case Series

AbstractCerebral palsy (CP) is a common condition in children that affects movement and posture due to nonprogressive disruptions during cerebral development. Patients with CP are at a higher risk of developing mental health disorders due to social and physical factors. In total, 28 to 57% of children diagnosed with CP exhibit psychiatric diagnoses or symptoms. The symptoms of intellectual disability and related behavioral disorders that are often associated with CP can be easily confused with the symptoms of a mood disorder. Therefore, there is a possibility of a delay in the diagnostic procedure and the commencement of treatment, which could potentially endanger the mental health of the adolescent and result in long-term complications. By shedding light on diagnosis, treatment, and the follow-up process, this case series, which includes two adolescents with bipolar disorder and CP comorbidity, aims to contribute to the limited literature.

Exploring the relation between REM sleep behavior disorder onset and striatal dopaminergic dysfunction in Parkinson's Disease.

The α-Synuclein Origin and Connectome (SOC) model recently proposed two different Parkinson's Disease (PD) phenotypes clinically based on the relationship between REM sleep behavior disorder (RBD) and motor symptoms' onset: a "body first" phenotype and a "brain first" phenotype in which RBD precedes or may follow the motor onset, respectively. A higher burden of non-motor symptoms as well as a more symmetrical clinical presentation have also been predicted in the body-first phenotype. This point has been poorly assessed through semi-quantitative striatal dopaminergic functional imaging to date. To explore the relation between RBD onset and striatal dysfunction in PD. PD patients were retrospectively enrolled and clinical follow-up data were gathered. Presence and onset of probable RBD were evaluated classifying patients into PD-RBDpre (onset before motor symptoms), PD-RBDpost (onset after motor symptoms) and PD-RBD-. Semi-quantitative 123I-FP-CIT-DAT-SPECT imaging was performed at baseline. Mean putamen and caudate-specific binding ratios (SBR) and asymmetry index (AI) were computed. Fifty-six PD patients were enrolled (10 PD-RBDpre, 19 PD-RBDpost and 27 PD-RBD-). A more symmetrical motor impairment, higher mild cognitive impairment (MCI) prevalence, lower caudate SBR and lower putamen AI were found in PD-RBDpre. A negative trend in MCI prevalence as well as a positive trend in both caudate SBR and putamen AI were found across PD-RBDpre, PD-RBDpost and PD-RBD-. Different patterns of striatal dopaminergic dysfunction and cognitive impairment based on RBD onset were unraveled, supporting the SOC model's predictions.

Self-Rated Symptoms of Oppositional Defiant Disorder and Conduct Disorder: Factor Structure, Reliability, and Validity in a Clinical Sample of Adolescents.

This study examined the psychometric properties of self-rated symptoms of oppositional defiant disorder (ODD) and conduct disorder (CD). We analyzed symptom ratings from a clinical outpatient sample of 658 adolescents aged 11;0-17;11 years diagnosed with ODD/CD and/or attention-deficit hyperactivity disorder. In two steps, we examined the factor structure of ODD models and an additional CD symptom dimension using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Our preferred three-factor CFA and ESEM models (CFI = 0.937-0.975, TLI = 0.926-0.962, RMSEA = 0.049-0.068, SRMR = 0.045-0.070) demonstrated scalar measurement invariance across age groups (≥ 14;0 years) and metric measurement invariance across informants (parents, teachers). With exceptions, the self-rated symptom scales showed acceptable internal consistencies (α = 0.68-0.84). Convergent (r =.27-.65) and divergent validity (r =.13-.41) were supported using Achenbach's Youth Self Report Form. Our results provide implications for using self-rated ODD/CD symptoms in clinical practice and research.

INFLUENCE OF ATTACHMENT DIMENSIONS AND PERCEIVED PARENTAL ACCEPTANCE/REJECTION IN ADOLESCENT PATIENTS ON CONDUCT DISORDER.

The purpose of this study was to examine the differences in attachment dimensions and the perceived parental acceptance / rejection among adolescents with conduct disorder (CD) in comparison to the control group, and the contribution of the attachment dimensions and parental acceptance /rejection to the CD. The group of male and female adolescents with CD (N=97) and a control group of male and female adolescents with no signs of CD (N=97) participated in this study. Attachment and parental acceptance/rejection were determined in the relationship between adolescents and their mothers and fathers by using self-evaluation questionnaires. The results showed that subjects with CD had insecure (avoidance) attachment, perception of lower parental acceptance and higher parental rejection more often compared to controls. Higher levels of complex father rejection predicted CD. The main findings of this study indicated that the subjects with a conduct disorder felt less accepted and more rejected by parents compared to control group subjects. Complex father rejection was shown as a significant predictor of conduct disorder. Parental attachment may affect adolescents' perception of parental acceptance/rejection which may result in an expression of CD symptoms.

Using machine learning to determine a functional classifier of reward responsiveness and its association with adolescent psychiatric symptomatology

Abstract Background Machine learning (ML) has developed classifiers differentiating patient groups despite concerns regarding diagnostic reliability. An alternative strategy, used here, is to develop a functional classifier (hyperplane) (e.g. distinguishing the neural responses to received reward v. received punishment in typically developing (TD) adolescents) and then determine the functional integrity of the response (reward response distance from the hyperplane) in adolescents with externalizing and internalizing conditions and its associations with symptom clusters. Methods Two hundred and ninety nine adolescents (mean age = 15.07 ± 2.30 years, 117 females) were divided into three groups: a training sample of TD adolescents where the Support Vector Machine (SVM) algorithm was applied (N = 65; 32 females), and two test groups– an independent sample of TD adolescents (N = 39; 14 females) and adolescents with a psychiatric diagnosis (major depressive disorder (MDD), generalized anxiety disorder (GAD), attention deficit hyperactivity disorder (ADHD) & conduct disorder (CD); N = 195, 71 females). Results SVM ML analysis identified a hyperplane with accuracy = 80.77%, sensitivity = 78.38% and specificity = 88.99% that implicated feature neural regions associated with reward v. punishment (e.g. nucleus accumbens v. anterior insula cortices). Adolescents with externalizing diagnoses were significantly less likely to show a normative and significantly more likely to show a deficient reward response than the TD samples. Deficient reward response was associated with elevated CD, MDD, and ADHD symptoms. Conclusions Distinguishing the response to reward relative to punishment in TD adolescents via ML indicated notable disruptions in this response in patients with CD and ADHD and associations between reward responsiveness and CD, MDD, and ADHD symptom severity.

Patient characteristics of completion and dropout of mentalization-based treatment for adolescents with conduct disorder.

Conduct disorder (CD) is a severe mental disorder in youth. Yet, providing psychological interventions for adolescents with CD is challenging. This patient group is often characterized by risk factors for therapy dropout such as, e.g., CD symptoms and being in middle adolescence. On the other hand, little is known about characteristics of adolescents with CD who complete treatment. To gain more insight into what might become a successful therapy with adolescents with CD, this study explores baseline characteristics and drop-out occurrence in patients with CD referred to mentalization-based treatment for adolescents with CD (MBT-CD). More specifically, this study aims at identifying clusters of adolescent patients based on age, CD symptom severity and personality pathology at the beginning of treatment which may have come along with a higher or lower dropout occurrence. Following implications of an elbow plot, a 3-means cluster-analysis was conducted on self-report baseline data of N = 32 adolescents with CD (n = 11 dropouts, n = 21 completers) who participated in a feasibility study on MBT-CD. Additionally, in an exploratory stepwise logistic regression, variables were explored as potential predictors of dropout. Cluster 1 consisted of n = 14 adolescents, of whom n = 8 (57%) dropped out. Cluster 2 consisted of n = 5 adolescents of whom 1 (20%) dropped out. Cluster 3 consisted of N = 13 adolescents, of whom only n = 2 (15%) dropped out. Cluster 2 showed descriptively the highest CD symptom severity. While adolescents in Clusters 1 and 3 showed in part similarities in CD symptom severity, personality pathology was descriptively markedly higher in Cluster 1. In the stepwise logistic regression, only intimacy personality pathology was identified as potential predictor for dropout. This study's exploratory findings point to different types of adolescents with CD coming along with different chances for therapists to conduct a (successful) psychotherapy. Herein, low personality functioning in the intimacy domain, rather than CD symptoms as aggressiveness, may play a crucial role. While findings are limited by the small sample size, they may be able to shed increasing light on conducting (successful) psychotherapy with a scarcely researched patient group.

Network structure of REM sleep behavior disorder symptoms in iRBD patients

ObjectiveEmploying the REM Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-HK) to investigate symptoms and their severity in rapid eye movement (REM) sleep behavior disorder (RBD) patients, this study delves into the construct of RBD through the RBDQ-HK and its links to depression and sleep quality. MethodsData from the RBDQ-HK, the Geriatric Depression Scale (GDS), and the Pittsburgh Sleep Quality Index (PSQI) were compiled from individuals with isolated RBD (iRBD) confirmed by polysomnography. We constructed a network analysis of the RBDQ-HK, measured the centrality of each symptom (node), conducted Exploratory Graph Analysis (EGA) to unveil the dimension structure of the questionnaire, and calculated bridge expected influence (BEI) to identifying critical bridge. Multivariate linear regression was also employed to discover relationships between RBDQ-HK dimensions and variables such as PSQI and GDS. ResultsIn our cohort of 455 iRBD patients (299 males), the items in the RBDQ-HK were divided into three dimensions: dream, movement, and SRI/violence. The symptoms identified as most central to RBD were ‘shouting or yelling in sleep’, ‘dream-enacting movements’, and ‘talking during sleep’. The highest (BEI) was ‘violent and aggressive dreams’, which has the potential to bridge three dimensions within the symptom network. Depression was significantly correlated with the movement and dream dimensions of RBD, and sleep quality was predominantly related to the dream dimension score. ConclusionOur findings verify that the principal symptoms of the RBDQ-HK align with the established diagnostic criteria and reveal a three-dimensional structure within RBD symptoms. The relationships between the RBD symptoms, depression, and sleep quality need to be identified for the effective management of RBD patients.

Unique versus shared neural correlates of externalizing psychopathology in late childhood.

Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The activities of daily living partially mediate the relationship between rapid eye movement sleep behavior disorder and depressive symptoms in Parkinson's disease.

A longitudinal study was conducted to investigate whether rapid eye movement sleep behavior disorder affect depression in patients with Parkinson's disease through activities of daily living. A total of 387 Parkinson's disease patients' six-year follow-up data (one follow-up per year) were obtained from the Parkinson's Progression Markers Initiative. To allow causal effects to manifest, this study increased the lag period and divided the data from the six follow-ups into two groups: wave 1 (wave refers to time points), wave 3, and wave 5 as one group, and wave 2, wave 4, and wave6 as the other group. The time interval between two time points in each group was two years. To comprehensively and deeply analyze the dynamic relationships between variables, accurately infer causal relationships, control for individual differences, and detect the stability of these relationships, this study constructed the fixed effects cross-lagged panel model (CLPM), the random effects CLPM (RE-CLPM) model, and the Equating CLPM and Equating RE-CLPM models with applied restriction conditions. Additionally, a reverse path was added to verify the reverse prediction effect. The most suitable data analysis model was selected to explore the relationships between the study variables. Furthermore, the longitudinal mediating effect of daily living activities between rapid eye movement sleep behavior disorder and depression was investigated. In the models, Equating cross-lagged panel model was the best. The lag effect was positive and significant. In wave 1, 3, 5, activities of daily living mediated 11.82% on the path from rapid eye movement sleep behavior disorder to depression; in wave 2, 4, 6, it mediated 13.13%. Therefore, attention should be paid to the treatment of activities of daily living. Longitudinal changes in activities of daily living have indirect effects on the relationship between rapid eye movement sleep behavior disorder and depression, which highlights the importance of changes in activities of daily living ability in Parkinson's disease patients with rapid eye movement sleep behavior disorder.

Differential etiologic associations of heroin use and prescription opioid misuse with psychopathology.

Patterns of association with externalizing and internalizing features differ across heroin use and prescription opioid misuse (POM). The present study examined whether heroin use and POM display differential etiologic overlap with symptoms of conduct disorder (CD), adult antisocial behavior (AAB), and major depressive episodes (MDEs), how aggregating heroin use and POM into a single phenotype may bias results, and explored potential sex differences. Seven thousand one hundred and sixty-four individual twins from the Australian Twin Registry (ATR; 59.81% female; Mage = 30.58 years) reported lifetime heroin use, POM, CD symptoms, AABs, and MDE symptoms within a semi-structured interview. Biometric models decomposed phenotypic variance and covariance into additive genetic, common environmental, and unique environmental effects. The proportion of variance in heroin use attributable to factors shared with CD, AAB, and MDE, respectively, was 41%, 41%, and 0% for men and 26%, 19%, and 42% for women; for POM, the proportions were 33%, 35%, and 20% for men and 15%, 9%, and 13% for women. CD and AAB were more strongly genetically correlated with heroin use among women and with POM among men. MDE was more strongly genetically correlated with POM than with heroin use among men, but more strongly genetically correlated with heroin use than with POM among women. Analyses using an aggregate opioid (mis)use variable were biased toward POM, which was the more prevalent phenotype. Magnitude and source of etiologic influence may differ across forms of opioid (mis)use and sex. Disaggregating heroin use and POM in future opioid research may be warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Maternal and Paternal Parenting and Maltreatment in Relation to Callous-Unemotional Traits in Detained Male Adolescents

This study investigated the relationship between parenting practices, childhood maltreatment (CM), callous-unemotional (CU) traits, and conduct disorder (CD) symptoms among 275 detained adolescent boys (Mage = 16.96). CU traits, and paternal and maternal parenting were assessed via self-report questionnaires. A diagnostic interview was used to assess CD symptoms. Regression analyses revealed that harsh parenting and physical maltreatment were positively associated with CU traits after controlling for CD symptoms, whereas warm parenting was significantly negatively related to CU traits. After controlling for the overlap between parenting and CM, only parenting was significantly positively related to CU traits. Findings, finally, showed that CU traits did not moderate the link between parenting (or CM) and CD symptoms. The study underscores that it is important to consider experiences with parenting practices and CM in detained adolescents with heightened CU traits.

The association between delinquent peer affiliation and disruptive behavior interacts with functional brain correlates of reward sensitivity: a biosocial interaction study in adolescent delinquents.

Affiliating with delinquent peers may stimulate the development of antisocial behavior, especially for adolescents who are sensitive to social rewards. The current study examines whether the association between delinquent peer affiliation (DPA) and disruptive behavior interacts with functional brain correlates of reward sensitivity in early onset male adolescents delinquents. Childhood arrestees (n = 126, mean age = 17.7 [s.d. 1.6]) completed a DPA questionnaire, and participated in an fMRI study in which reward sensitivity was operationalized through responsiveness of the ventral striatum (VS), amygdala, and medial prefrontal cortex (mPFC) during the monetary incentive delay paradigm (reward anticipation and outcome). Symptoms of disruptive behavior disorders (DBD) were assessed through structured psychiatric interviews (Diagnostic Interview Schedule for Children) with adolescents. DPA had a main effect on DBD symptoms. Adolescents with high VS reward responses showed a stronger significant positive association between DPA and DBD symptoms compared to low VS responders. No evidence for an interaction effect was found for the amygdala and mPFC. Post-hoc analyses revealed the positive association between DPA and DBD was only present in males, with a diminishing effect as age increased. We found evidence for a biosocial interaction between DPA and reward sensitivity of the VS in relation to DBD symptom severity. This study provides the first evidence of an interaction effect between a brain mechanism and an environmental factor in relation to DBD symptoms, implying that susceptibility to influences of delinquent peers may intertwine with individual biological differences.

A Machine Learning Approach for Early Identification of Prodromal Parkinson's Disease.

Parkinson's disease (PD) affects approximately 6 million people worldwide. Data analysis of early PD symptoms using machine learning (ML) models may provide an inexpensive, non-invasive, and simple method for the remote diagnosis of early PD. The aim of this project was to analyze voice, computer keystrokes, spiral drawings, and gait data involving PD patients and controls available in public databases using ML models and identify early PD characteristics that are more pronounced than others. An ML model was developed using Random Forest to analyze existing clinical data for PD patients, prodromal PD patients with REM (rapid eye movement) sleep behavior disorder (RBD) symptoms, and non-PD healthy controls. We reviewed and collected data from the UCI (University of California Irvine) Machine Learning Repository, PPMI (Parkinson's Progression Markers Initiative), and Kaggle databases. ML analysis was carried out on voice samples in PD and RBD patients, computer keystroke data, spiral drawings, and gait datasets. The ML prediction model developed may be helpful in improving risk prediction for PD, enabling early intervention and resource prioritization. The ML study suggests that voice analysis is the most robust test, followed by computer keystroke data, spiral drawings, and gait analysis, in that order. Voice is affected even in RBD patients, revealing that it is a sensitive and early measure of prodromal PD. The low accuracy of the analysis indicates that several PD-positive samples may remain undetected and unclassified. Combining all four features, that is, voice analysis, computer keystroke data, spiral drawings, and gait analysis, may improve the overall accuracy.

Alcohol milestones and internalizing, externalizing, and executive function: longitudinal and polygenic score associations.

Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk. Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11-36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones. Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20). Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.

Rates and Predictors of Rapid Eye Movement Sleep Behavior Disorder Symptoms Among Post-9/11 Veterans.

Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), which are prevalent conditions among post-9/11 veterans, increase risks of rapid eye movement (REM) sleep behavior disorder (RBD) and degenerative synucleinopathy. Rates and predictors of RBD symptoms were investigated by screening post-9/11 veterans for RBD with a validated questionnaire. In this cross-sectional analysis, consecutive patients in the Houston Translational Research Center for TBI and Stress Disorders (TRACTS) were screened with the English translation of the RBD Questionnaire-Hong Kong (RBDQ-HK). In addition to data from the standard TRACTS battery, systematic chart review was used to identify known sleep disorders mimicking or manifesting RBD. Of the 119 patients with available RBDQ-HK scores, 71 (60%) and 65 (55%) screened positive for RBD, when a total score ≥21 and a factor 2 score ≥8 were used as cutoff scores, respectively. Univariable analyses with both cutoffs showed consistent associations between a positive RBDQ-HK screen and global sleep quality, number of TBI exposures, and PTSD severity. Multivariable logistic regression with total score ≥21 as a cutoff indicated that PTSD severity (odds ratio=1.06, 95% CI=1.02-1.10) and number of TBIs (odds ratio=1.63, 95% CI=1.16-2.41) were independent predictors of a positive screen, whereas global sleep quality was no longer significant. Multivariable logistic regression with factor 2 score ≥8 as a cutoff showed similar results. Interdisciplinary parasomnia assessment, further validation of RBD screens, and standardized reporting of REM sleep without atonia could provide necessary information on the pathophysiological relationships linking PTSD, TBI, RBD symptoms, and ultimately synucleinopathy risk among post-9/11 veterans.

Examination of quality of life and psychiatric symptoms in childhood Graves' disease.

The aim of our study is to examine the emotional, behavioral problems, and psychiatric symptoms of children diagnosed with Graves' disease (GD), to assess their quality of life, and to compare with control group. The research was planned as a cross-sectional study and included 16 patients with GD (13 female and three male) and 29 healthy children for control group (19 female and 10 male). Sociodemographic form, Pediatric Quality of Life Inventory, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Strengths and Difficulties Questionnaire (SDQ), Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S), and Affective Reactivity Index scale were applied to the children and their families. Eighty one percent of GD group (GG) (n=13, mean age 15.1±2.2) and 66 % of control group (CG) (n=19, 14.6±2.2) were girls. No significant difference was found between GG and CG in terms of quality of life, anxiety, and depression scores. GG had higher scores in affective reactivity index, SDQ-P total score, and T-DSM-IV-S total scores (p values 0.039; 0.009; 0.023, respectively). While no significant difference was detected in the T-DSM-IV-S-inattention and hyperactivity scores, significantly higher scores were detected in oppositional defiance and conduct disorder scores (pvalues 0.172; 0.294; 0.019; 0.027, respectively). In children with GD, irritability, oppositional defiant, and conduct disorder symptoms have been detected. Children with these mental health symptoms experience behavioral and emotional difficulties in their daily lives. It is important to follow up children with GD for possible comorbid psychiatric disorders.

Cognition and Other Non-Motor Symptoms in an At-Risk Cohort for Parkinson's Disease Defined by REM-Sleep Behavior Disorder and Hyposmia.

REM-sleep behavior disorder (RBD) and other non-motor symptoms such as hyposmia were proposed by the Movement Disorder Society as research criteria for prodromal Parkinson's disease (P-PD). Global cognitive deficit was later added. To compare non-motor symptoms, focusing on cognition, between a P-PD group and a matched control group. In this cross-sectional, case-control study, in a first set of analyses, we performed extensive cognitive testing on people with (n = 76) and a control group without (n = 195) probable RBD and hyposmia. Furthermore, we assessed motor and non-motor symptoms related to Parkinson's Disease (PD). After propensity score matching, we compared 62 P-PD with 62 age- and sex-matched controls. In addition, we performed regression analyses on the total sample (n = 271). In a second set of analyses, we used, a.o., the CUPRO to evaluate retrograde procedural memory and visuo-constructive functions. People with P-PD showed significantly poorer performances in global cognition, visuo-constructive and executive functions, mainly in mental flexibility (p < 0.001; p = 0.004; p = 0.003), despite similar educational levels (p = 0.415). We observed significantly more motor and non-motor symptoms (p < 0.001; p = 0.004), higher scores for depression (p = 0.004) and apathy (p < 0.001) as well as lower quality of life (p < 0.001) in P-PD. Our findings confirm that global cognitive, executive, and visuo-constructive deficits define the P-PD group. In addition, depression, apathy, and lower quality of life were more prevalent in P-PD. If replicated in other samples, executive and visuo-constructive deficits should be considered in non-motor P-PD. Determining specific patterns will support early recognition of PD, secondary prevention of complications and the development of neuroprotective treatments.

Emotional and Behavioral Impairment and Comorbid Eating Disorder Symptoms in Adolescents with Obesity: A Cross-Sectional Study.

Background: The current study aims to assess the psychological conditions of Italian adolescents with obesity seeking an in-hospital multidisciplinary body weight reduction program, by exploring their psychological adjustment, emotional states, and co-occurring eating disorder symptoms. Methods: The study involved ninety-two consecutive Italian adolescents with obesity (31 males, 61 females), with a mean age ± SD: 16.4 ± 1.1 years and body mass index (BMI): 38.3 ± 6.04 kg/m2). The Strengths and Difficulties Questionnaire (SDQ), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Eating Attitude Test-26 (EAT-26) were used for the evaluations. Differences between genders, degrees of obesity (Group 1 = BMI SDS 2-2.99 and Group 2: BMI SDS > 3), and those with or without eating disorder symptoms (Group 1: EAT-26 ≤ 20 and Group 2: EAT-26 > 20) were explored. Results: The results showed that females reported higher scores on the Emotional Symptoms, Prosocial Behaviors, Total Difficulties, and Total Impact subscales of the SDQ, the BDI, both subscales of the STAI, and the Bulimia subscales of the EAT-26 than males, independently from the degrees of obesity. Participants with eating disorder symptoms (Group 2: EAT-26 > 20) showed higher scores on the Emotional Symptoms and Total Difficulties subscales of the SDQ, the BDI, and both subscales of the STAI than those of Group 1 (EAT-26 ≤ 20). Conclusions: The study explores the psychological conditions of adolescents with obesity. The results can inform appropriate treatment approaches for the management of obesity in developmental age groups, which not only take into account the medical and physical aspects of obesity, but also the behavioral, emotional, and social difficulties expressed by adolescents, in addition to specific eating disorder symptoms.

Prediction of internalizing and externalizing symptoms in late childhood from attention-deficit/hyperactivity disorder symptoms in early childhood.

Limited analyses based on national samples have assessed whether early attention-deficit/hyperactivity disorder (ADHD) symptoms predict later internalizing and externalizing symptoms in youth and the influence of sex and pubertal timing on subsequent psychiatric symptoms. This study analyzed data (n = 2818) from the Environmental influences on Child Health Outcomes Program national cohort. Analyses used data from early childhood (mean age = 5.3 years) utilizing parent-reported ADHD symptoms to predict rates of internalizing and externalizing symptoms from late childhood/adolescence (mean age = 11.9 years). Within a subsample age at peak height velocity (APHV) acted as a proxy to assess pubertal timing from early childhood (mean age = 5.4 years) to adolescence (mean age = 12.3 years). Early-childhood ADHD symptoms predicted later psychiatric symptoms, including anxiety, depression, aggressive behavior, conduct problems, oppositional defiant disorder, and rule-breaking behavior. Earlier APHV was associated with increased Conduct Disorder symptoms from late childhood to adolescence for females only. A stronger relation between ADHD symptoms and later aggression was observed in females with earlier APHV, whereas this same pattern with aggression, conduct problems and depression was observed in males with later APHV. Clinicians should consider that both young girls and boys with elevated ADHD symptoms, particularly with off-set pubertal timing, may be at risk for later psychiatric symptoms.