Child Symptom Inventory Research Articles

Child characteristics associated with outcome for children with autism in a school-based behavioral intervention.

This study examined the extent to which clinical and demographic characteristics predicted outcome for children with autism spectrum disorder. Participants included 152 students with autism spectrum disorder in 53 kindergarten-through-second-grade autism support classrooms in a large urban public school district. Associations between child characteristics (including age, language ability, autism severity, social skills, adaptive behavior, co-occurring psychological symptoms, and restrictive and repetitive behavior) and outcome, as measured by changes in cognitive ability following one academic year of an intervention standardized across the sample were evaluated using linear regression with random effects for classroom. While several scales and subscales had statistically significant bivariate associations with outcome, in adjusted analysis, only age and the presence of symptoms associated with social anxiety, such as social avoidance and social fearfulness, as measured through the Child Symptom Inventory-4, were associated with differences in outcome. The findings regarding the role of social anxiety are new and have important implications for treatment. Disentangling the construct of social anxiety to differentiate between social fearfulness and social motivation has important implications for shifting the focus of early treatment for children with autism spectrum disorder.

Association study of monoamine oxidase-A gene promoter polymorphism (MAOA-uVNTR) with self-reported anxiety and other psychopathological symptoms in a community sample of early adolescents

The polymorphism upstream of the gene for monoamine oxidase A (MAOA-uVNTR) is reported to be an important enzyme involved in human physiology and behavior. With a sample of 228 early-adolescents from a community sample (143 girls) and adjusting for environmental variables, we examined the influence of MAOA-uVNTR alleles on the scores obtained in the Screen for Childhood Anxiety and Related Emotional Disorders and in the Child Symptom Inventory-4. Our results showed that girls with the high-activity MAOA allele had higher scores for generalized and total anxiety than their low-activity peers, whereas boys with the low-activity allele had higher social phobia scores than boys with the high-activity allele. Results for conduct disorder symptoms did not show a significant relationship between the MAOA alleles and the presence of these symptoms. Our findings support a possible association, depending on gender, between the MAOA-uVNTR polymorphism and psychopathological disorders such as anxiety, which affects high rates of children and adolescents.

Variation in the Profile of Anxiety Disorders in Boys with an ASD According to Method and Source of Assessment

To determine any variation that might occur due to the type of assessment and source used to assess them, the prevalence of 7 anxiety disorders were investigated in a sample of 140 boys with an Autism spectrum disorder (ASD) and 50 non-ASD (NASD) boys via the Child and Adolescent Symptom Inventory and the KIDSCID Clinical Interview. Boys with an ASD were significantly more anxious than their NASD peers. Data collected from the boys with an ASD themselves showed differences in the severity and diagnostic criterion of anxiety disorders to data collected from the boys' parents. There were age-related variations to the pattern of anxiety disorder differences across reports from the boys with an ASD and reports from their parents.

Effecacy of painting therapy in reducing aggression in children with conduct disorder

Background: The present study was carried out to examine the effectiveness of painting therapy in reducing aggression in children with conduct disorder. Methods: This study was a semi-experimental research (pretest-posttest with control group design) in which the statistical population consisted of thirty 8-12 year-old children with conduct disorder who were studying in Parsabad city in the academic year of 2013-2014 and were selected through convenience sampling method. Then, they were divided into two equal groups (experimental and control) using sample random sampling. The instruments for data collection consisted of Raven's intelligence test, child symptom inventory-4 and Eysenck aggression inventory. The experimental underwent painting therapy for 12 sessions and every session lasted 40 minutes. The obtained data were analyzed by ANCOVA and t-test for dependent and independent groups. Results: There was not a significant difference between the mean aggression scores of experimental group in the post-test and follow up compared with pre-test. Also, a significant difference was reported between the mean aggression scores of experimental and control groups in post-test and follow up phases (P<0.05). Conclusion: Painting therapy is an effective method in reducing aggression in children with conduct disorder.

Patient characteristics associated with treatment initiation among paediatric patients with Attention-Deficit/Hyperactivity Disorder symptoms in a naturalistic setting in Central Europe and East Asia.

BackgroundCultural views of Attention-Deficit/Hyperactivity Disorder (ADHD), differing healthcare systems and funding mechanisms, and the availability of mental health services can greatly influence the perceptions, diagnosis, and treatment of ADHD. There is, however, lack of information about treatment practice and the treatment decision-making process for ADHD, particularly in non-Western countries. Our study compared characteristics of paediatric patients newly diagnosed with ADHD symptoms who did and who did not initiate treatment, and also examined whether any differences varied by region in Central Europe and East Asia.MethodsData were taken from a 1-year prospective, observational study that included 1,068 paediatric patients newly diagnosed with ADHD symptoms. Clinical severity was measured using the Clinical Global Impression-ADHD-Severity (CGI-ADHD-S) scale and the Child Symptom Inventory-4 (CSI-4) checklist. Logistic regression was used to explore patient characteristics associated with treatment initiation (pharmacotherapy and/or psychotherapy) at baseline for each region.ResultsA total of 74.3% of patients initiated treatment at baseline (78.3% in Central Europe and 69.9% in East Asia). Of these, 48.8% started with both pharmacotherapy and psychotherapy in Central Europe, and only 17.1% did so in East Asia. The level of clinical severity was highest in the combination treatment group in Central Europe, but was highest in the psychotherapy only group in East Asia. In East Asia, treatment initiation was associated with being older, being male, and having a higher CGI-ADHD-S score. In Central Europe, treatment initiation was associated with parental psychological distress, having a higher CSI-4 score, and not being involved in bullying.ConclusionsAlthough factors associated with treatment initiation differed to some extent between Central Europe and East Asia, clinical severity appeared to be one of the most important determinants of treatment initiation in both regions. However, the choice between pharmacotherapy and psychotherapy, either alone or in combination, varied substantially across the regions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0304-x) contains supplementary material, which is available to authorized users.

PO-0931 Pharmacologic Treatment – Part Of The Therapeutic Plan In Adhd Management

Background and aims Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder generally characterised by inattention, distractibility, impulsivity, hyperactivity. Medication does not cure ADHD, but it is used to control the symptoms. The goal of the study was to determine the impact of pharmacologic treatment on symptoms control in ADHD paediatric patients. Methods The efficacy of pharmacologic treatment was assessed in 82 children patients of 5–12 years old diagnosed with ADHD. 33 patients received treatment with atomoxetine, 26 patients underwent treatment with methylphenidate and 23 patients weren’t receiving pharmacological treatment (control group). The ADHD symptoms were screened with parent-rated Child Symptom Inventory-4 (CSI-4) scale at first visit to the doctor and three months after. Results CSI-4 scale scores were statistically analysed. Between-subjects analysis taking as factor the treatment group highlighted a statistical significant difference (p Conclusions Pharmacologic treatment significantly reduced the ADHD symptoms in children on the basis of parent-rate CSI-4 scoring. Medication doesn’t cure, but it has positive impact in the management of ADHD syndrome.

Dimensions of oppositional defiant disorder in young children: model comparisons, gender and longitudinal invariance.

Identifying the latent structure of Oppositional Defiant Disorder (ODD) may have important clinical and research implications. The present study compared existing dimensional models of ODD for model fit and examined the metric and scalar invariance of the best-fitting model. Study participants were a diverse (38.8% minority, 49.1% boys) community sample of 796 children. Parents completed the Child Symptom Inventory and the DISC-YC ODD scales at child ages of 4, 5 and 6-7 years. When comparing single-factor (DSM-IV model), two-factor (oppositional behavior, negative affect), and three-factor models (one with dimensions of oppositional behavior, negative affect, antagonistic behavior; a second with dimensions of irritable, hurtful, and headstrong), the two-factor model showed the best fit. The two-factor model showed configural, metric and scalar invariance across gender and age. Results suggest that, among existing models, ODD is best characterized as two separate dimensions, one behavioral and one affective, which are comparable for both boys and girls in these age groups.

Multi-domain predictors of oppositional defiant disorder symptoms in preschool children: cross-informant differences.

Existing research suggests that parent and teacher reports of children's behavior problems are often discrepant. The current study examined whether contextual (stress and family conflict), parent (depression), parenting (hostility, support, and scaffolding), and child factors (receptive vocabulary; negative affect, NA; effortful control, EC; inhibitory control, IC; attachment; and sensory regulation, SR) are related to parent-teacher reporting discrepancies. Participants included a community sample of 344 4-year-old children. A multi-informant approach was used to assess contextual, parent, parenting, and child factors. Parents and teachers completed the Oppositional Defiant Disorder (ODD) scale of the Child Symptom Inventory. Consistent with previous data, there was poor agreement between parents and teachers (r=.17). After correcting for multiple comparisons, child effortful control, parent hostility, and family conflict were significant predictors of parent-rated symptoms of ODD symptoms but not teacher-rated ODD symptoms. Only family conflict was a significant predictor of discrepancies in parent and teacher ratings.

Dissociative Identity Disorder Among Adolescents: Prevalence in a University Psychiatric Outpatient Unit

The aim of this study was to determine the prevalence of dissociative identity disorder (DID) and other dissociative disorders among adolescent psychiatric outpatients. A total of 116 consecutive outpatients between 11 and 17 years of age who were admitted to the child and adolescent psychiatry clinic of a university hospital for the 1st time were evaluated using the Adolescent Dissociative Experiences Scale, adolescent version of the Child Symptom Inventory-4, Childhood Trauma Questionnaire, and McMaster Family Assessment Device. All patients were invited for an interview with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) administered by 2 senior psychiatrists in a blind fashion. There was excellent interrater reliability between the 2 clinicians on SCID-D diagnoses and scores. Among 73 participants, 33 (45.2%) had a dissociative disorder: 12 (16.4%) had DID, and 21 (28.8%) had dissociative disorder not otherwise specified. There was no difference in gender distribution, childhood trauma, or family dysfunction scores between the dissociative and nondissociative groups. Childhood emotional abuse and family dysfunction correlated with self-reported dissociation. Of the dissociative adolescents, 93.9% had an additional psychiatric disorder. Among them, only separation anxiety disorder was significantly more prevalent than in controls. Although originally designed for adults, the SCID-D is promising for diagnosing dissociative disorders in adolescents, its modest congruence with self-rated dissociation and lack of relationship between diagnosis and childhood trauma and family dysfunction suggest that the prevalence rates obtained with this instrument originally designed for adults must be replicated. The introduction of diagnostic criteria for adolescent DID in revised versions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, would refine the assessment of dissociative disorders in this age group.

Bidirectional influences of anxiety and depression in young children.

Anxiety and depression tend to co-occur in children. Studies indicate that higher levels of anxiety are associated with subsequent higher levels of depression, while depression may inhibit subsequent anxiety. It is important to increase our understanding of the temporal sequencing of these disorders and, particularly, to determine if suppression effects account for the inhibitory association. In addition, further information about these relationships in young children is needed. Participants were a diverse (20.4% Hispanic, 16.7% African American; 49.1% boys) community sample of 796 children with data available at ages 4, 5, and 6-7years. Anxiety and depression symptoms were assessed using the Child Symptom Inventory and symptom count measures from the Diagnostic Interview Schedule for Children-Parent Scale -Young Child version. The results indicated: (a) anxiety and depression were relatively stable over time; (b) anxiety at age 4 and 5 was a significant positive predictor of subsequent depression; (c) while an inhibitory effect of depression on subsequent anxiety was found, that inhibitory effect was due to negative suppression, and higher levels of depression were actually associated with subsequent anxiety; (e) consistent with a significant suppression effect, when depression was included as a predictor, the association between anxiety at ages 4 and 5 and anxiety one year later increases in magnitude. Both anxiety and depression are associated with higher levels of one another in the subsequent year. Implications for prevention are discussed.

Dimensions of Oppositional Defiant Disorder in Young Children: Heterotypic Continuity with Anxiety and Depression

There are distinct dimensions of Oppositional Defiant Disorder (ODD) that have been associated with symptoms of other disorders (heterotypic continuity). The present study compared the heterotypic continuity of a two-factor (Pitt-2) model and the three-factor model incorporated into DSM-5 with symptoms of anxiety and depression. Participants were a diverse community sample of 796 children (38.8 % minority, 49.1 % boys) assessed at ages 4, 5 and 6 years. Symptoms were assessed with the dimensional scales of the Diagnostic Interview Schedule for Children-Young Child version and the Child Symptom Inventory. Dimensions of both the two- and three-factor DSM-5 models were associated with later symptoms of anxiety and depression. The association, however, was weak when accounting for initial levels of internalizing symptoms: thus there was little evidence for the unique contributions of ODD dimensions to symptoms of subsequent internalizing disorders for either model.

Baseline Factors Predicting Placebo Response to Treatment in Children and Adolescents With Autism Spectrum Disorders

The finding of factors that differentially predict the likelihood of response to placebo over that of an active drug could have a significant impact on study design in this population. To identify possible nonspecific, baseline predictors of response to intervention in a large randomized clinical trial of children and adolescents with autism spectrum disorders. Randomized clinical trial of citalopram hydrobromide for children and adolescents with autism spectrum disorders and prominent repetitive behavior. Baseline data at study entry were examined with respect to final outcome to determine if response predictors could be identified. A total of 149 children and adolescents 5 to 17 years of age (mean [SD] age, 9.4 [3.1] years) from 6 academic centers were randomly assigned to citalopram (n = 73) or placebo (n = 76). Participants had autistic disorder, Asperger syndrome, or pervasive developmental disorder, not otherwise specified; had illness severity ratings that were moderate or more than moderate on the Clinical Global Impression-Severity scale; and scored moderate or more than moderate on compulsive behaviors measured with the modified Children's Yale-Brown Obsessive-Compulsive Scale. Twelve weeks of treatment with citalopram (10 mg/5 mL) or placebo. The mean (SD) maximum dose of citalopram was 16.5 (6.5) mg by mouth daily (maximum dose, 20 mg/d). A positive response was defined as having a score of at least much improved on the Clinical Global Impression-Improvement scale at week 12. Baseline measures included demographic (sex, age, weight, and pubertal status), clinical, and family measures. Clinical variables included baseline illness severity ratings (the Aberrant Behavior Checklist, the Child and Adolescent Symptom Inventory, the Vineland Adaptive Behavior Scales, the Repetitive Behavior Scale-Revised, and the Children's Yale-Brown Obsessive-Compulsive Scale). Family measures included the Caregiver Strain Questionnaire. Several baseline predictors of response were identified, and a principal component analysis yielded 3 composite measures (disruptive behavior, autism/mood, and caregiver strain) that significantly predicted response at week 12. Specifically, participants in the placebo group were significantly less likely than participants in the citalopram group to respond at week 12 if they entered the study more symptomatic on each of the 3 composite measures, and they were at least 2 times less likely to be responders. This analysis suggests strategies that may be useful in anticipating and potentially mitigating the nonspecific response in randomized clinical trials of children and adolescents with autism spectrum disorders. clinicaltrials.gov Identifier: NCT00086645.

Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia

PurposeTo assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia.Patients and methodsData for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE.ResultsOf the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE.ConclusionNon-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question.

Reliability, Validity, and Clinical Use of the Dominic Interactive: A DSM-Based, Self-Report Screen for School-Aged Children

As no single informant can be considered the gold standard of child psychopathology, interviewing of children regarding their own symptoms is necessary. Our study focused on the reliability, validity, and clinical use of the Dominic Interactive (DI), a multimedia self-report screen to assess symptoms for the most frequent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, mental disorders in school-aged children. A sample of 585 children aged 6 to 11 years from the community and psychiatric clinics was used to analyze the internal consistency, the test-retest estimate of reliability, and the criterion-related validity of the DI against the referral status. In addition, cross-informant correlation coefficients between this instrument (child report) and the Child Symptom Inventory (parent report) were explored in a subsample of 292 participants. For the total sample, Cronbach alpha coefficients ranged from 0.63 to 0.91. Test-retest kappas varied from 0.42 to 0.62 for categories based on cut-off points, except for specific phobias. Intraclass correlation coefficients ranged from 0.70 to 0.81 for symptom scales. The DI discriminated between referred and non-referred children in psychiatric clinics for all symptom scales. Significant cross-informant correlation coefficients were higher for the externalizing symptoms (0.35 to 0.48) than the internalizing symptoms (0.14 to 0.27). Findings of our study reasonably support adequate psychometric properties of the DI. This instrument offers a developmentally sensitive screening method to obtain unique information from young children about their mental health problems in front-line services, psychiatric clinics, and research settings.

The Effect of Art Therapy based on Painting Therapy in Reducing Symptoms of Separation Anxiety Disorder (SAD) in Elementary School Boys

The purpose of this research is to investigate the effect of art therapy based on painting therapy on 30 children recruited from elementarily School Boys with symptom of separation anxiety disorder who were 7-12 years old. To find and select the main subjects, two steps were taken. At the first step, children obtaining scores higher than cut-off in CHILD SYMPTOM INVENTORY-4 (CSI-4) were selected, and at the second step, for final selection, children were attended in the Structured Diagnostic Interview-based on DSM-IV-TR criteria. The researcher adopted interview/observation and the document analysis for qualitative study and went through the painting therapy by 12 sessions twice per week, and each session lasted 40minutes based on discussion and reviewing from parents and the teacher. An experimental and a pretest-posttest control group design method were applied in this regard. The data were analyzed using descriptive statistics as well as ANCOVA. The finding showed that experimental group did have a significant decrease in the symptoms of SAD while the control group showed no significant difference.

The Effect of Art Therapy Based on Painting Therapy in Reducing Symptoms of Oppositional Defiant Disorder (ODD) in Elementary School Boys

The purpose of this research is to investigate the effect of art therapy based on painting therapy on 30 children recruited from elementarily School Boys with symptom of oppositional defiant disorder who were 7-12 years old. To find and select the main subjects, two steps were taken. At the first step, children obtaining scores higher than cut-off in CHILD SYMPTOM INVENTORY-4 (CSI-4) were selected, and at the second step, for final selection, children were attended in the Structured Diagnostic Interview-based on DSM-IV-TR criteria. The researcher adopted interview/observation and the document analysis for qualitative study and went through the painting therapy by 12 sessions twice per week, and each session lasted 40minutes based on discussion and reviewing from parents and the teacher. An experimental and a pretest-posttest control group design method were applied in this regard. The data were analyzed using descriptive statistics as well as ANCOVA. The finding showed that experimental group did have a significant decrease in the symptoms of odd while the control group showed no significant difference.

The Effect of Visual Arts on Education of Coping Strategies in Annoyed Children

The main goal of this study was investigation of visual arts effect on education of coping strategies in annoyed children. The study design was Semi-experimental. Statistical population included all children 6 to 12 years old (boys and girls) that were Child care homes in Shush and Nasser Khosro at part time. The study samples of present research included 14 annoyed children selected as available samples from two Child care homes (Shush and Nasser Khosro). The questionnaires of Children's Coping Strategies Checklist (CCSC) and Child Symptom Inventory (SCI) were used to collect research data. In addition to descriptive statistics, Independent t-test and dependent t-test were used for data analysis. The results showed using of visual arts is effective on education of coping strategies in annoyed children. Intensity and duration of annoying was determine factor in rate of cooperation and learning in children In general: based on findings: a) visual arts are effective on learning of coping strategies in children. B) Reducing of abnormal behavior and pathologic signs due to increase of children's coping. C) Reducing of abnormal behavior and pathologic signs due to visual arts. Annoyed children will be damaged less if better coping strategies.

The effectiveness of sensory-motor integration with an emphasis on proprioceptive and vestibular senses on the symptoms of attention deficit/ hyperactivity disorder

Introduction: Attention deficit - hyperactivity disorder (ADHD) is a common childhood disorder which should be effectively treated in order to decrease the severity of its symptoms. In the present study, the effects of proprioceptive and vestibular sensory integration were aimed to be determined as a treatment approach for alleviating the symptoms of this disorder. Materials and Methods: In this study a quasi-experimental method with pretest, posttest, and control group was adopted. Participants were thirty-two 6-to-12 year-old students with ADHD studying at the schools of Semnan, Iran. They were randomly selected and assigned to either an experimental (n = 16) or control group (n = 16). The experimental group received a sensory integration intervention program (with an emphasis on Proprioceptive and Vestibular senses) that consisted of 12 sessions, lasting 2 hours each and held two times a week. The Child Symptom Inventory- 4 (CSI-4) was used to evaluate the symptoms of the disorder. The obtained data were statistically analyzed by Shapiro-Wilk test, and also by univariate and multivariate analysis of covariance. Results: According to the reports of teachers, the experimental group had better scores for inattention and hyperactivity than did the control group (P > 0.001). Impulsivity scores, however, was not significantly reduced in the experimental group compared to the control group (P 0.001). Conclusion: The intervention involving sensory- motor integration with an emphasis on proprioceptive and vestibular senses significantly improved attention deficits, hyperactivity and impulsivity in the studied population. Keywords: Sensory-motor integration, Proprioceptive and vestibular senses, Attention deficit, Hyperactivity and impulsivity

Restricted and repetitive behaviors and psychiatric symptoms in youth with autism spectrum disorders

Children with autism spectrum disorders (ASD) are at high risk for co-occurring psychiatric disorders. Previous research has suggested that restricted and repetitive behaviors (RRB) are associated with symptoms of co-occurring psychiatric disorders in individuals with ASD, but this relationship is not well understood. The current study investigated the relationship between RRB and co-occurring psychiatric symptoms, including depressive, anxiety, attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms, while considering the role of level of functioning. Participants were 72 parents of youth diagnosed with an ASD (ages 5–17). They completed the Social Communication Questionnaire (SCQ), the Repetitive Behavior Scale-Revised (RBS-R), an abridged version of the Child Symptom Inventory-4 (CSI-4) and the Conceptual domain of the Adaptive Behavior Assessment System, 2nd Edition (ABAS-II). Results indicated that RRB do predict psychopathology. Ritualistic and sameness behavior is predictive of anxiety, depression and ODD while stereotypy is predictive of ADHD. Restricted interests were a negative predictor of depression. Level of functioning moderated the relationship between self-injurious behavior (SIB) and both anxiety and depressive symptoms as well as the relationship between ritualistic and sameness behavior and depressive symptoms. Understanding the relationship between RRB and psychiatric symptoms could help clarify the presentation of ASD phenotypes as well as etiological variables.

Abstract P248: Assessing for Bi-Directional Relationships between Body Mass Index and Mental Health Symptoms in Girls

Introduction Obesity and mental health problems are increasing in youth; both are often under-treated. The interplay between mental health and body weight development in adolescent girls is not well understood. Hypothesis Bi-directional associations will be established between mental health symptoms (depression and conduct symptoms) and BMI in urban pre-adolescent girls. Methods We examined data from participants in an accelerated longitudinal cohort study of largely disadvantaged urban girls from a single US city (n=2,451; 53% African American). Data were collected annually over 6 years, starting in 2003 when girls were age 8-11. Depression and conduct symptoms (oppositional defiant disorder and conduct disorder symptoms combined) were collected via the validated Child Symptom Inventory (CSI-4) and height and weight were measured. Transitional models assessed for bi-directional associations between mental health symptoms and BMI. Random-effects mixed models identified within-subject and between-subject effects in models examining whether mental health symptoms predicted BMI. All models were adjusted for race, age, and receipt of public assistance, and when applicable, included interaction terms. Results Transitional models showed that prior depression symptoms (β=0.27; p&lt;0.001) predicted an increase in BMI while prior conduct symptoms (β=0.04; p=0.05) showed a small and borderline significant effect on BMI. An increase in prior BMI predicted an increase in depression symptoms (β=0.074, p&lt;0.001) but not conduct symptoms (β=0.028, p=0.125). Mixed models revealed significant between-girl and within-girl effects (β = 0.38 and 0.038, respectively, both with p&lt;0.001) for depression symptoms predicting BMI. Conduct symptoms showed a significant between-girl effect (β=0.51; p=0.045) but a non-significant within-girl effect (β=0.011; p=0.080) when used to predict BMI. Conclusions We identified a clear bi-directional relationship between depression symptoms and BMI in under-privileged girls, and mixed models confirmed that a change in depression score is associated with increased BMI. While an increase in conduct symptoms shows a weak positive association with BMI, the association was not bi-directional. The potential for BMI and depression to each reinforce the other may represent a mechanism for the development of high-risk weight patterns in girls. Early identification of those at risk may facilitate preventive measures for both weight and mental health outcomes.