Diagnostic Interview For Children Research Articles

Dimensional profiling of psychopathology in children and adolescents based on the K-SADS-PL and an analysis of the construct validity of two ADHD symptom dimensions

Objectives The traditional view on psychiatric disorders as categorical and distinct is being challenged by perspectives emphasizing the relevance of dimensional and transdiagnostic assessment. However, most diagnostic instruments are based on a categorical view with a threshold-approach to disease classification. Methods We here describe algorithms for dimensionalizing the psychopathological ratings of the widely used diagnostic interview for children and adolescents, the Kiddie-Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (K-SADS-PL). We further evaluate the criterion-related construct validity of the dimensionalized attention-deficit/hyperactivity disorder (ADHD) scales using Rasch models in a sample of 590 children (mean age 10.29 (.36), 49% girls). Results The algorithms generate scores of current symptom load, i.e., the sum of clinician-rated symptoms within each disorder assessed with the interview. We found support for counting symptoms of inattention and hyperactivity/impulsivity, respectively, but not for a single combined ADHD scale. Conclusions The algorithms constitute an initial step in creating a framework for clinician-rated dimensional analyses of symptoms derived from the K-SADS-PL, but future studies are needed to further evaluate the construct validity of the remaining scales and the reliability and clinical utility of the method. We believe that our proposed algorithms offer a novel method of dimensional psychopathological assessment, which can be applied in multiple branches of child and adolescent psychiatry.

50.1 Additional, Alternative Avoidant Cluster Symptoms for the Diagnosis of PTSD in Children

This study sought to explore developmentally sensitive avoidant cluster symptoms for children. Abused children (N = 119; mean age = 9.96 years; SD = 1.67) were recruited in a southern state; 65.5% were female, 68.9% were White, and 31.1% were Black. Data were collected in an NIMH study (5-RO1MH49784-04). Informed consent and assent were completed by parents and children. The Abuse Dimensions Inventory (ADI) measures severity of physical and sexual abuse. Data collection for this NIMH study began prior to the release of the DSM-IV, so the Diagnostic Interview for Children and Adolescents—Revised (DICA-R) was utilized for the assessment of PTSD and social anxiety disorder (SAD). The Child Dissociative Checklist (CDC) is a screening measure to access dissociative symptoms based on ratings by caregivers. The CDC mean was 6.93 (SD = 6.54). For the creation of developmentally sensitive, avoidant symptoms, using the DICA-R, if a parent endorsed symptoms that met the criteria for SAD, then the diagnosis of SAD was counted as one avoidant symptom. For dissociation, the CDC was used with a cutoff greater than 12 to establish an alternative avoidant symptom. Of the 119 children, the percentage meeting the threshold set by DSM-III-R was identified for each cluster based on child and parent interviews: Reexperiencing (child: 84.9%; parent: 67.2%); Arousal (child: 84.9%; parent: 66.3%); Avoidance (child: 76.5%; parent: 58.1%); and Positive Diagnosis (child: 62.2%; parent: 31.1%). The percentage of children meeting the threshold of 3, but using the 2 additional symptoms (SAD and CDC) as developmental equivalents for avoidance, was identified based on child and parent interviews: Child PTSD (child: 66.7%; parent: 43.9%); Child PTSD + SAD (child: 78.2%; parent: 53.6%); Child PTSD + CDC (child: 78.0%; parent: 56.0%); Child PTSD + SAD + CDC (child: 89.5%; parent: 75.7%). The developmentally sensitive avoidant criteria resulted in higher rates of PTSD. It is plausible that clinging to a safe parent served the function of reducing distress (reexperiencing and arousal). Similarly, dissociative symptoms may reduce distress. The study limitations included: 1) it was a retrospective analysis of study data that used DSM-III-R criteria; 2) it was conducted in one southern state; and 3) variables used for alternative SAD and dissociative symptoms were available in a subset (N = 66) of the sample.

A Longitudinal Study of Resting-State Connectivity and Response to Psychostimulant Treatment in ADHD.

Psychostimulants are first-line pharmacological treatments for attention deficit hyperactivity disorder (ADHD), although symptom reduction varies widely between patients and these individual differences in treatment response are poorly understood. The authors sought to examine whether the resting-state functional connectivity within and between cingulo-opercular, striato-thalamic, and default mode networks was associated with treatment response to psychostimulant medication, and whether this relationship changed with development. Patients with ADHD (N=110; 196 observations; mean age at first observation, 10.83 years, SD=2.2) and typically developing control subjects (N=142; 330 observations; mean age at first observation, 10.49 years, SD=2.81) underwent functional neuroimaging on up to five occasions during development (age range, 6-17 years). For patients, symptoms were assessed on and off psychostimulant medication (methylphenidate-based treatments: N=132 observations, 67%; amphetamine-based treatments: N=64 observations, 33%) using the Diagnostic Interview for Children and Adolescents for parents. Linear mixed-effects models examined whether resting-state connectivity was associated with treatment response and its interaction with age. Comparisons with typically developing control subjects were performed to contextualize any significant associations. Resting-state connectivity within the cingulo-opercular network was associated with a significant interaction between treatment response and age. Specifically, worse responses to treatment compared with better responses to treatment among patients and compared with typically developing control subjects were associated with an atypical increase in cingulo-opercular connectivity with increasing age from childhood to adolescence. This work delineates how resting-state connectivity may be associated over development with response to psychostimulants in ADHD. Functioning and development within the cingulo-opercular network may warrant further investigation as a contributor to differential response to psychostimulants.

Psychotic like experiences among Nigerian school adolescents: Findings from the Lagos Schools Emotional and Behavioral Health Survey.

This study aimed to explore the presence of psychotic like experience (PLE) symptoms and evaluate for the possible socio-demographic, family, school and mental health variables associated with clinically significant PLE symptoms in Nigeria school adolescent. A total of 9441 adolescents from 47 secondary schools in Lagos Nigeria completed questionnaire detailing sociodemographic, family and school related variables. Mental health was assessed with the Mini International Diagnostic Interview for children and adolescents (MINI-KID). PLE was assessed using the 16-item version of Prodromal Questionnaire (PQ-16). The mean age in years was 15.6 (SD 1.5) and 50.4% were females. The mean PQ-16 score was 2.18 (SD 2.38) with 95% CI 2-15-2.21. A total of 2878 (30.5%) adolescents had no PLE symptoms while 990 (10.5%) had clinically significant PLE symptoms. The most experienced symptoms were "déjà vu" (35.5%) and loss of interest (29.6%). The variables independently associated with clinically significant PLE symptoms were "having no close friend in school" (OR 2.66, 95% CI 2.08-3.41), "often beaten by parents" (OR 1.98, 95% CI 1.67-2.34) "from a polygamous family" (OR 1.80, 95% CI 1.49-2.18), and "diagnosis of depression" (OR 1.33, 95% CI 1.09-1.63). We have shown that PLE symptoms are relatively common in non-help seeking Nigerian school adolescents and that personal and family factors are significantly associated. Longitudinal studies will be needed to chart the path of symptoms and determinants of distress, help seeking and development of psychosis.

Sleep and Daytime Complaints During Manic and Depressive Episodes in Children and Adolescents With Bipolar Disorder.

IntroductionDepressive and manic episodes of bipolar disorder can interact with sleep complaints, followed by a worsened psychiatric condition. The aim of this study was to examine the interaction of sleep disorders with bipolar disorder in youths during depressive and manic episodes.MethodsThe target population was children and adolescents drawn from the Children and Adolescents Affective Disorder Program. Clinical assessment for current psychiatric diagnosis was done by direct clinical interview, Diagnostic Interview for Children and Adolescents (DSM-IV), and best-estimated clinical consensus. We applied sleep questionnaires from which we obtained sleep and daytime complaints during manic and depressive episodes. All statistical tests of significance were done using 2-tailed tests with α = 0.05.ResultsParticipants in this study comprised 29 children (age = 10 ± 3 years, boys = 23) and 43 adolescents (age = 15 ± 2.4 years, boys = 30). Sleep complaints were observed in 66.4% of participants during manic episodes and 52.3% during depressive episodes. 37.9% of patients had sleep complaints in both episodes. Time in bed was longer during depressive episodes than manic episodes (p = 0.01). We found a high prevalence of nocturnal enuresis in depressive episodes in children and adolescents, which was statistically significant compared with manic episodes (p < 0.05). Unrested sleep was higher in adolescents in both episodes, and it was statistically significant during manic episodes (p < 0.05).ConclusionAccording to our analyses, the minority of patients had sleep complaints in both episodes. Our data showed that nocturnal enuresis occurred more frequently during depressive than manic episodes. Further research is necessary to understand the implications of these data.

Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization.

Posttraumatic stress disorder (PTSD) is a mental disorder caused by several distressing events that are related with psychotrauma. It is very frequent in childhood and untreated traumatic stress symptoms in children and adolescents often result in debilitating consequences on development with increased risks for a variety of physical and mental disorders. Ιt has been found that PTSD symptoms are reduced as soon as therapeutic interventions have been applied. The aim of the present review was to summarize the available literature regarding aggravating factors associated with the development of PTSD in children after hospitalization and assessment tools for a quick and reliable screening of children who are at risk for developing PTSD. A review of published papers was conducted until April 10, 2019 to identify articles that discuss the aggravating factors and the assessment tools for PTSD in children after hospitalization published in English, German or Greek language. Search was performed on PubMed with the following combination of key-words: "PTSD" and "children" and "hospitalization", using the filters ''human'' and "Publication date from 30/11/2007 to 09/04/2019" and choosing "all fields'' in PubMed Advanced Search Builder. Of the 115 articles reviewed, 16 relevant articles were included, 10 of them referred to the aggravating factors and the remaining 6 were related to the assessment tools. Significant aggravating factors associated with the development of PTSD were: traumatic injuries and illness/ medical-related hospital admission, previous health problems, Pediatric Intensive Care Unit (PICU) hospitalization, attendance at a hospital for child and adolescent psychiatry, female gender and psychotherapy and initial high Posttraumatic Stress Symptoms (PTSS) in parents. As for assessment tools, it was observed that the Child Trauma Screening Questionnaire (CTSQ)-Heart Rate (HR), the alternative PTSD algorithm (PTSD-AA), the Child Stress Disorders Checklist-Short Form (CSDC-SF), the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) model for PTSD symptom categories, the Posttraumatic Stress Disorder Semi-Structured Interview (PTSDSSI), the Preschool Children's Assessment of Stress Scale (PCASS) and the diagnostic interview for children and adolescents (DICA-P) led to the identification of children who were likely to develope or had already developed PTSD symptoms, in the study population wherein each was implemented. The greatest limitation - but also a significant finding - of this review is the scarceness of published studies on this topic. Overall, there is a variety of aggravating factors associated with the development of PTSD in children after hospitalization. Assessment tools should be able to identify immediately the children who are likely to or have already developed PTSD symptoms.

C-41 Functional Impairments in Girls with Attention-Deficit Hyperactivity Disorder

Abstract Objective ADHD is a neurodevelopmental disorder known to cause functional impairments. Few studies have identified impairments specific to girls with ADHD. The objective of this study was to explore the relationship between ADHD subtypes and measures of functional impairment in girls. Method Participants were chosen from a sample of girls ages 5 – 18 years old, diagnosed with ADHD at an outpatient ADHD clinic at a large children’s hospital (N = 303). Measures included parent and teacher BASC subscales of adaptability, homework problems, and comorbid clinical diagnoses based on the diagnostic interview for children and adolescents-revised parent version (DICA-R). Potential relationships between impairment measures and ADHD subtypes were assessed using multiple and logistic regressions to control for age and socioeconomic status (SES). Results Number of inattentive ADHD symptoms correlates positively with DICA diagnosis of ODD (x2 = 4.008, p = 0.045) and homework problems (r = 0.227, p = 0.0001). Number of combined ADHD symptoms is positively associated with DICA diagnosis of ODD (x2 = 26.812, p = 0.0001) and homework problems (r = 0.171, p = 0.0001) and negatively associated with parent reported social skills (r = 0.092, p = 0.006), adaptability (r = 0.146, p = 0.001) and teacher reported adaptability (r = 0.057, p = 0.01), after controlling for age and SES. Discussion Girls with ADHD exhibit functional impairments in the domains of comorbid diagnoses, homework problems, parent and teacher report of adaptability, and parent report of social skills. Additional research should include self-reports of functional impairment to determine self-perception of impairment.

العلاقة بین الأنشطة الموسیقیة (العزف على آلة البیانو) والتفاعل الاجتماعی لدى الأطفال ذوی اضطراب طیف التوحد

هدف البحث الحالی إلى التعرف على العلاقة بین الأنشطة الموسیقیة (العزف على آلة البیانو) والتفاعل الاجتماعی لدى الأطفال ذوی اضطراب طیف التوحد، حیث تکونت العینة من (5) تلامیذ من ذوی اضطراب التوحد، وکانت الأدوات المستخدمة فى هذا البحث مقیاس التفاعل الاجتماعی إعداد / عبد العزیز الشخص؛ حیث أظهرت النتائج أنه ‌توجد علاقة ارتباطیة دالة إحصائیا بین العزف الموسیقی على ألة البیانو والتفاعل الاجتماعی لدى الأطفال ذوی اضطراب طیف التوحد ،ویوجد فروق بین الممارسین للعزف الموسیقی على آلة البیانو وغیر الممارسین للعزف فى أبعاد مقیاس التفاعل الاجتماعی استمارة المقابلة التشخیصیة للطفل لصالح الممارسین من الأطفال ذوی اضطراب طیف التوحد ،ویوجد فروق بین الممارسین للعزف الموسیقی على آلة البیانو وغیر الممارسین للعزف فى أبعاد مقیاس التفاعل الاجتماعی استمارة تقدیر الوالدین لصالح الممارسین من الأطفال ذوی اضطراب طیف التوحد The aim of current research was to identify relationship between musical activities (playing piano) and social interaction in children with Autism Spectrum Disorder, where sample consisted of (5) students with autism disorder. The tools used in this study were the measure of social interaction prepared by Abdalaziz Alshakhs. The results showed that there is a statistically significant correlation between playing piano and social interaction in children with autism spectrum disorder. There are differences between practitioners of piano and non-practicing playing piano in dimensions of social interaction scale Child Diagnostic Interview for children with Autism Spectrum Disorder, and there are differences between practitioners of piano and non-practicing playing piano in dimensions of Social Interaction Scale Parental Assessment Form for children with autism spectrum disorder

Efficacy of the Aussie Optimism Program: Promoting Pro-social Behavior and Preventing Suicidality in Primary School Students. A Randomised-Controlled Trial.

The efficacy of an enhanced version of the Aussie Optimism Program (AOP) was investigated in a cluster randomized controlled trial. Grade 6 students aged 10–11 years of age (N = 2288) from 63 government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders. Results indicated that Aussie Optimism with teacher training plus coaching was associated with the best outcomes: a significant increase in student-reported pro-social behavior from pre-test to post-test 1 (maintained at post-test 2) and significantly lower incidence rates from suicidal ideation at post-test 2 and follow-up. No significant intervention effects on anxiety and depressive disorders, and total difficulties were reported. These findings suggest that the AOP with teacher training along with coaching may have the potential to positively impact on suicidality and pro-social behavior in the pre-adolescent years.

Behavior Problems and Psychiatric Diagnoses in Girls with Gender Identity Disorder: A Follow-Up Study

ABSTRACTThis study evaluated the presence of clinical range behavior problems and psychiatric diagnoses in 25 girls referred for gender identity disorder (GID) in childhood (mean age: 8.88 years) at the time of follow-up in adolescence or adulthood (mean age: 23.2 years). At follow-up, three (12%) of the girls were judged to have persistent GID based on DSM-IV criteria. With regard to behavior problems at follow-up, 39.1% of the girls had a clinical range score on either the Child Behavior Checklist or Adult Behavior Checklist as rated by their mothers, and 33.3% had a clinical range score on either the Youth Self-Report or the Adult Self-Report. On either the Diagnostic Interview for Children and Adolescents or the Diagnostic Interview Schedule, the girls had, on average, 2.67 diagnoses (range: 0–10); 46% met criteria for three or more diagnoses. From the childhood assessment, five variables were significantly associated with a composite Psychopathology Index (PI) at follow-up: a lower IQ, living in a non-two-parent or reconstituted family, a composite behavior problem index, and poor peer relations. At follow-up, degree of concurrent homoeroticism and a composite index of gender dysphoria were both associated with the composite PI. Girls with GID show a psychiatric vulnerability at the time of follow-up in late adolescence or adulthood, although there was considerable variation in their general well-being.

Posttraumatic Stress Disorder Diagnosis in Young Children With Burns.

The primary aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in young children hospitalized for burns. A secondary aim was to assess partial PTSD in this population. PTSD diagnosis and symptoms were evaluated utilizing both the diagnostic interview for children and adolescents (DICA-P) module and the PTSD semistructured interview and observational report (PTSDSSI). PTSD symptomatology was assessed from parent interviews at 1 month after discharge from a major pediatric burn center. Four of the 42 participants who completed the DICA-P met full criteria for a diagnosis of PTSD (10%).Of the 39 who also completed the PTSDSSI, 1 (3%) met full criteria for PTSD diagnosis on that measure. Twenty-seven percentage of subjects met partial criteria on the DICA-P vs 16% on the PTSDSSI, without impairment. Furthermore, 67% of subjects met DICA-P criteria for the re-experiencing cluster and 54% met the PTSDSSI re-experiencing criteria. Although only a small percentage met full PTSD diagnostic criteria by either measure, a high percentage of young children with burns manifested some posttraumatic symptoms 1 month after discharge. Because PTSDSSI diagnosis is strongly linked to the diagnostic and statistical manual-5 (DSM-5) criteria for "PTSD in children 6 years and younger," these results may offer clues to current diagnoses of PTSD in young children. Future research is needed to improve care by determining the risk factors and course of PTSD to further refine the diagnostic criteria for identifying children most in need of intervention, such as those hospitalized for burn injuries.

ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD)

Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity—not ASD severity—were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.

The relationship between weight status and emotional and behavioral problems in Spanish preschool children.

To examine cross-sectional and longitudinal associations between behavioral problems and weight status, considering body mass index (BMI) z-scores and overweight status, in a community sample of preschoolers. The Strengths and Difficulties Questionnaire and the Diagnostic Interview for Children and Adolescents were administered to 611 parents. Adjusted general linear models and binary logistic regressions were used. Children who were overweight and had a higher BMI were at increased risk of peer problems and attention-deficit/hyperactivity disorder (ADHD) symptoms. Prospective analyses showed that a higher BMI at the age of 3 years was predictive of peer problems at ages 4 and 5 years and hyperactivity and ADHD symptoms at the age of 4 years. This is the first study using a diagnostic-based instrument that shows a relationship between weight status and ADHD symptoms in preschoolers. Overweight children might benefit from screening for behavioral disorders and peer relationship problems.

Quality of Life in Ethiopia's Street Youth at a Rehabilitation Center and the Association With Trauma

Quality of life (QOL) tends to be lower among the homeless than the general population, and traumatic events experienced on the streets have a negative impact on QOL. Low-income countries face a high number of street youth, yet little research has been performed so far on QOL, trauma, and posttraumatic stress disorder (PTSD) among this group. This study aimed at examining the QOL of a sample of Ethiopian street youth within a rehabilitation program and at exploring whether the street youth have experienced traumatic events and show posttraumatic stress symptoms. We interviewed 84 street youths with the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and the Diagnostic Interview for Children and Adolescents (DICA). Mean QOL scores differed significantly between the groups assessed at the beginning and at the end of the program (Cohen's d = 0.48). Eighty-three percent of the Ethiopian street youths had experienced traumatic events, and 25.0% met criteria for PTSD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. QOL did not differ between those with and without PTSD symptoms. These findings show the high rate of traumatic events among Ethiopian street youth and the importance for rehabilitation programs that focus on improving QOL. The results of the study may have cultural limitations.

P.7.a.005 Relationship of olfactory functions and psychopathology in patients with autism spectrum disorders

Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n = 99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity—not ASD severity—were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.

Do attachment representations predict depression and anxiety in psychiatrically hospitalized prepubertal children?

Thirty-six prepubertal inpatients were videotaped completing five stories thematically related to attachment experiences and classified by their attachment representations. Children also completed the Children's Depression Inventory and Diagnostic Interview for Children and Adolescents-Revised. Mothers completed demographic questionnaires. Percentage of secure (B) attachment was only about one tenth of the normative percentage, anxious-ambivalent (C) attachment was between two and three times the normative percentage, and disorganized (D) attachment was almost twice the normative percentage. Both D attachment and the total number of disorganized story responses were associated with negative self-esteem and clinical-range depression. Anxious-avoidant (A) attachment decreased the likelihood, while C and D attachment increased the likelihood, of separation anxiety disorder. Clinical intervention needs to focus on the meaning of parental relationships represented in the child's mind, specifically the negative self-esteem and separation anxiety associated with the lack of felt security provided by the parents.

Are obstetrical, perinatal, and infantile difficulties associated with pediatric bipolar disorder?

Despite increasing acknowledgement of bipolar disorder (BD) in childhood, there is a paucity of literature that has investigated obstetrical, perinatal, and infantile difficulties and their potential link with BD. To this end, we examined difficulties during delivery, immediate post-birth, and infancy and the association with BD in childhood. From two similarly designed, ongoing, longitudinal, case-control family studies of pediatric BD (N = 327 families), we analyzed 338 children and adolescents [mean (± standard deviation) age: 12.00 ± 3.37 years]. We stratified them into three groups: healthy controls (N = 98), BD probands (N = 120), and their non-affected siblings (N = 120). All families were comprehensively assessed with a structured psychiatric diagnostic interview for psychopathology and substance use. Mothers were directly questioned regarding the pregnancy, delivery, and infancy difficulties that occurred with each child using a module from the Diagnostic Interview for Children and Adolescents-Parent Version (DICA-P). Mothers of BD subjects were more likely to report difficulties during infancy than mothers of controls [odds ratio (95% confidence interval) = 6.6 (3.0, 14.6)]. Specifically, children with BD were more likely to have been reported as a stiffened infant [7.2 (1.1, 47.1)] and more likely to have experienced 'other' infantile difficulties [including acting colicky; 4.9 (1.3, 18.8)] compared to controls. We found no significant differences between groups in regards to obstetrical or perinatal difficulties (all p values > 0.05). While our results add to previous literature on obstetrical and perinatal difficulties and BD, they also highlight characteristics in infancy that may be prognostic indicators for pediatric BD.

Differential effects of psychological maltreatment on children of mothers exposed to intimate partner violence

Objective Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV). Method Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations. Results Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in children's psychopathology or functioning in this population. Implications The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs.

Psychometric Properties of the Young Mania Rating Scale for the Identification of Mania Symptoms in Spanish Children and Adolescents with Attention Deficit/Hyperactivity Disorder

Background: Diagnosing mania in children is difficult, due to the high comorbidity and symptom overlap with attention deficit/hyperactivity disorder (ADHD). The detection of manic symptoms in ADHD has important implications for prognosis and choice of treatment. Our objective was to study the utility of the Young Mania Rating Scale (YMRS) for discriminating mania in Spanish children with ADHD. Method: One hundred children and adolescents with ADHD between 8 and 17 years of age were evaluated with a structured diagnostic interview (Diagnostic Interview for Children and Adolescents-IV), the YMRS, the Parent-Young Mania Rating Scale (P-YMRS), the Child Mania Rating Scale-Parent Version (CMRS-P) and the Children’s Global Assessment Scale. Results: The YMRS showed a 1-dimensional structure with good internal consistency and test-retest reliability. The YMRS was associated with the P-YMRS and the CMRS-P. The scores obtained with the YMRS differentiated between ADHD with and without mania. The receiver operating characteristic curve analysis showed good diagnostic efficiency in differentiating mania in ADHD (area under the curve of 0.90). Conclusions: The Spanish version of the YMRS is a valid and reliable instrument for detecting and quantifying the symptoms of mania in children and adolescents with ADHD. The results provide further knowledge about the frequent association between ADHD and manic symptoms in children.

Age at menarche and weight concerns in relation to smoking trajectory and dependence among adolescent girls enrolled in a smoking cessation trial

Many girls adopt dieting and other practices (i.e. cigarette smoking) to control weight during puberty. This analysis explored the relationship between age at menarche and onset of daily smoking, and whether this relationship was influenced by weight concerns among treatment seeking female adolescents. The sample consisted of 71 participants enrolled in a smoking cessation trial (age 15.2 ± 1.3 years; 74.7% European American, baseline BMI 24.7 ± 5.4, age at menarche 11.7 ± 1.3 years, Fagerström Test for Nicotine Dependence score 7.0 ± 1.2). Over 60% of participants reported weight concerns at baseline, based on responses to the Eating Disorders module from the Diagnostic Interview for Children and Adolescents. Linear regression analyses revealed a significant association between age at menarche and age of onset of daily smoking ( β = 0.18 ± 0.09, p = 0.038). Having weight concerns did not modify the relationships between age at menarche and smoking trajectory/severity or abstinence. Findings support previous research showing that early maturation represents a risk factor for substance use. Further study in larger samples that include non-treatment-seeking adolescent female smokers is warranted.