Diagnostic Interview Schedule Research Articles

Betrayal trauma and somatic symptoms among patients in a medically underserved primary care clinic.

Betrayal Trauma Theory posits that victims of trauma are more prone to developing psychological and physical problems if the traumatic event includes the element of betrayal. We sought to evaluate the impact of betrayal trauma versus nonbetrayal trauma and no trauma exposure on the risk of patients' reporting somatic symptoms in six domains (gastrointestinal, cardiopulmonary, musculoskeletal, pseudoneurological, gynecological, or any symptom). Medically underserved patients (N = 1,350) who presented to a primary care clinic in California completed a structured standardized interview that assessed trauma history (Diagnostic Interview Schedule) and somatization symptoms (Composite International Diagnostic Interview). Using Betrayal Trauma Theory as a guide, respondents were classified into "no trauma," "nonbetrayal trauma," and "betrayal trauma" groups. Compared to "no trauma" patients, patients who experienced nonbetrayal trauma were more likely to endorse all symptom domains (ORs = 1.30-1.50) except gastrointestinal and musculoskeletal; compared to "no trauma" patients, patients who experienced betrayal trauma were more likely to endorse all symptom domains (ORs = 1.61-3.12) except gynecological. Compared to patients who experienced nonbetrayal trauma, exposure to betrayal trauma increased the likelihood of reporting any (OR = 2.25), gastrointestinal (OR = 1.56), and pseudoneurological symptoms (OR = 1.71), as well as symptoms spanning multiple physiological systems (incidence rate ratio = 1.27). Each nonbetrayal trauma increased the likelihood of symptom reporting across all domains (ORs = 1.18-1.40); each betrayal trauma increased the likelihood across all domains (ORs = 1.41-2.31) except gynecological. Both nonbetrayal and betrayal trauma may predispose victims to somatization. Compared to nonbetrayal trauma, betrayal trauma confers a greater magnitude of risk for having a somatic symptom across each symptom domain except gynecological. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Epidemiology of DSM-5 psychiatric disorders in Kenyan youth with low and high psychosis risk

IntroductionThere are few psychiatric epidemiology studies among Kenyan youth and fewer among those at high psychosis risk (HR). MethodsThis study assessed the epidemiology of DSM-5 psychiatric disorders in HR and low-risk (LR) individuals to inform research and mental health services. 567 participants (aged 15–25) in HR (n = 246) and LR (n = 260) groups based on Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen scores. Diagnostic Interview Schedule, version 5 (DIS-5) assessed DSM-5 psychiatric disorder prevalence. Diagnostic comorbidity and demographic relationships were investigated. ResultsA higher prevalence was observed for all DSM-5 disorders in the HR group, significantly for gambling disorder (13% vs. 5.8%), major depressive disorder (9.8% vs. 3.8%), antisocial personality disorder (5.7% vs. 2.3%), general anxiety disorder (4.9% vs. 0.4%), oppositional defiant disorder (3.3% vs. 0.4%), panic disorder (2.8% vs. 0.8%), and anorexia nervosa (2.8% vs. 0%). Gambling disorder was the most prevalent and showed significant gender effects (males>females). DiscussionPsychiatric disorders occur at increased rates among HR compared to LR. Prevalence rates found are lower than in US studies, except for gambling disorder which was highly prevalent. Large-population-based epidemiology studies in Africa are needed to estimate rates, particularly of disorders such as schizophrenia, accurately.

Prevalence of adolescent mental disorders in Kenya, Indonesia, and Viet Nam measured by the National Adolescent Mental Health Surveys (NAMHS): a multi-national cross-sectional study

Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam. As part of the National Adolescent Mental Health Surveys (NAMHS), a multinational cross-sectional study, nationally representative household surveys were conducted in Kenya, Indonesia, and Viet Nam between March and December, 2021. Adolescents aged 10-17 years and their primary caregiver were interviewed from households selected randomly according to sampling frames specifically designed to elicit nationally representative results. Six mental disorders (social phobia, generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder, conduct disorder, and attention-deficit hyperactivity disorder) were assessed with the Diagnostic Interview Schedule for Children, Version 5. Suicidal behaviours and self-harm in the past 12 months were also assessed. Prevalence in the past 12 months and past 4 weeks was calculated for each mental disorder and collectively for any mental disorder (ie, of the six mental disorders assessed). Prevalence of suicidal behaviours (ie, ideation, planning, and attempt) and self-harm in the past 12 months was calculated, along with adjusted odds ratios (aORs) to show the association with prevalence of any mental disorder in the past 12 months. Inverse probability weighting was applied to generate national estimates with corresponding 95% CIs. Final samples consisted of 5155 households (ie, adolescent and primary caregiver pairs) from Kenya, 5664 households from Indonesia, and 5996 households from Viet Nam. In Kenya, 2416 (46·9%) adolescents were male and 2739 (53·1%) were female; in Indonesia, 2803 (49·5%) adolescents were male and 2861 (50·5%) were female; and in Viet Nam, 3151 (52·5%) were male and 2845 (47·4%) were female. Prevalence of any mental disorder in the past 12 months was 12·1% (95% CI 10·9-13·5) in Kenya, 5·5% (4·3-6·9) in Indonesia, and 3·3% (2·7-4·1) in Viet Nam. Prevalence in the past 4 weeks was 9·4% (8·3-10·6) in Kenya, 4·4% (3·4-5·6) in Indonesia, and 2·7% (2·2-3·3) in Viet Nam. The prevalence of suicidal behaviours in the past 12 months was low in all three countries, with suicide ideation ranging from 1·4% in Indonesia (1·0-2·0) and Viet Nam (1·0-1·9) to 4·6% (3·9-5·3) in Kenya, suicide planning ranging from 0·4% in Indonesia (0·3-0·8) and Viet Nam (0·2-0·6) to 2·4% (1·9-2·9) in Kenya, and suicide attempts ranging from 0·2% in Indonesia (0·1-0·4) and Viet Nam (0·1-0·3) to 1·0% (0·7-1·4) in Kenya. The prevalence of self-harm in the past 12 months was also low in all three countries, ranging from 0·9% (0·6-1·3) in Indonesia to 1·2% (0·9-1·7) in Kenya. However, the prevalence of suicidal behaviours and self-harm in the past 12 months was significantly higher among those with any mental disorder in the past 12 months than those without (eg, aORs for suicidal ideation ranged from 7·1 [3·1-15·9] in Indonesia to 14·7 [7·5-28·6] in Viet Nam). NAMHS provides the first national adolescent mental disorders prevalence estimates for Kenya, Indonesia, and Viet Nam. These data can inform mental health and broader health policies in low-income and middle-income countries. The University of Queensland in America (TUQIA) through support from Pivotal Ventures, a Melinda French Gates company.

Abstract P258: Association of Depressive Symptoms With Exceptional Longevity: The Women’s Health Initiative

Introduction: Older women may experience elevated levels of depressive symptoms and are particularly vulnerable to chronic diseases, including CVD, and disability. Yet, few studies have examined associations of depressive symptoms with healthy longevity. We examined the associations of depressive symptoms with survival to ages 90, 95, and 100, and with survival to age 90 with intact mobility and cognitive functioning among older women. Hypothesis: Relative to those without depressive symptoms at baseline, women with elevated depressive symptoms will have (i) lower odds of survival to ages 90, 95, or 100 and (ii) lower odds of surviving to age 90 without mobility and cognitive impairment. Methods: We studied 70,363 women ( M age = 69.9, SD = 3.9; 7.1% Black, 2.5% Hispanic/Latino, 89.6% White) enrolled in the Women’s Health Initiative with potential, due to birth year, to survive to ages 90 and older as of February 2022. Depressive symptoms were assessed at baseline (1993-1998) using an 8-item screening instrument that comprises the 6-item Center for Epidemiologic Studies Depression Scale and 2 items from the Diagnostic Interview Schedule. Depressive symptoms were classified as elevated (vs. not) using an established cut point of ≥0.06 for detecting the presence of depressive disorders. Survival (vs. death) to ages 90, 95, and 100 years was assessed through February 2022. Separate logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for survival to age 90, 95, and 100 and to age 90 without (vs. with) mobility and cognitive impairment, adjusting for age, race/ethnicity, education, marital status, health insurance, financial problems, diet quality, body mass index, physical activity, smoking status, alcohol consumption, history of hypertension, diabetes, stroke, heart failure, myocardial infarction, and cancer, and use of depression medication. Results: A total of 38,607 women survived to age 90 or older during WHI follow-up. After adjustment for covariates, women with elevated depressive symptoms at baseline (compared to women without symptoms) had lower odds of surviving to age 90 (OR, 0.91; 95% CI 0.86-0.96; P = .001), age 95 (OR, 0.87; 95% CI 0.80-0.96; P = .005) and similarly but non-significantly to age 100 (OR, 0.80; 95% CI 0.59-1.06; P = .14). Women with elevated depressive symptoms at baseline (compared to women without symptoms) had lower odds of surviving to age 90 without mobility and cognitive impairment (OR, 0.57; 95% CI 0.51-0.65; P < .001) vs. surviving to age 90 with mobility and cognitive impairment. Conclusions: Baseline depressive symptoms were associated with lower odds of exceptional longevity and survival to age 90 without impairment in mobility and cognitive functioning among WHI women. These findings underscore the adverse long-term impact of depressive symptoms on healthy longevity.

A Preliminary Trial of an Early Surveillance Program for Autism and Developmental Delays within General Practices

AbstractThere are inequities in engagement with established early childhood developmental surveillance programs, eclipsing disadvantaged families. The current study sought to address this by dovetailing developmental surveillance with immunization visits and other opportunistic contacts with children at general practices). While 53 General Practices were recruited, significant COVID-19 disruptions resulted in only 81 children being screened (both parent-administered and GP completed). Of the 81 children, 11 screened positive and all of them along with 5% of screen negatives (i.e. 4 children) received clinician-administered reference-standard assessment for autism and developmental delay (DD) using Autism Diagnostic Observation Schedule (ADOS), Autism Diagnostic Interview Schedule –Revised (ADI-R), and Mullen Scales of Early Learning (MSEL). All children found by reference-standard assessment to have probable autism and/or DD had screened positive during the screening process, and 90.9% of children who screened positive were found by reference-standard assessment to have probable DD or autism. The findings provide early evidence for the feasibility and usefulness of parent completed and GP administered developmental measures during opportunistic contacts with GPs as a promising method to facilitate early identification of DD or autism.

DSM-5 conduct disorder and symptoms in youths at high risk of psychosis in Kenya with DSM-5 mental disorders and substance use: towards integrated management

Little is known about the prevalence of Conduct Disorder (CD) and symptoms of CD in high risk psychosis persons at both clinical and community populations in LMICs and in particular Kenya. This study aimed to document (1) the prevalence of CD diagnosis and symptoms in youth who screened positive for psychosis and (2) the associated mental disorders and substance use in the same cohort in LMIC. The sample size was 536 students who had screened positive on the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) from a population of 9,742 high school, college and university students, but had not converted to a psychotic disorder. We collected data on socio-demographic characteristics and used the following tools: Economic indicators tool; the Diagnostic Interview Schedule (DIS) tool for DSM-5 diagnosis; World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Basic descriptive statistics, chi-square test, Fisher's exact test, Pearson correlation and Poisson regression were conducted. Five percent (5%) of the respondents met the criteria for DSM-5 CD. Indeterminate CD comprised 10.1%. Male gender, all substances except hallucinogens lifetime, obsessive compulsive disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, antisocial personality disorder, oppositional defiant disorder, suicidality, WERCAP screen for bipolar disorder and WERCAP screen for schizophrenia were significantly (p < 0.05) associated with CD. Deceitfulness or theft criteria symptoms showed that CD had no significant gender difference. Criteria symptoms in aggression to people and animals, destruction of property and serious violations of rules were more common among males. Our findings suggest the need to screen for and diagnose CD, mental disorders and substance use in high risk psychosis youths in Kenya. This will inform integrated management.

Family Functioning in Children With ADHD and Subthreshold ADHD: A 3-Year Longitudinal Study

Objective: To compare family functioning over time for elementary school children with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 179) and subthreshold ADHD (ST-ADHD; N = 86), to children without ADHD (Control; N = 212). Method: ADHD was assessed using the Conners 3 ADHD Index and Diagnostic Interview Schedule for Children IV. At baseline, 18-month follow-up and 36-month follow-up, parents completed measures assessing a range of family functioning domains. Results: At baseline, the ADHD group reported higher psychological distress, less parenting self-efficacy, less parenting consistency, and more stressful life events; and both groups reported poorer family quality of life (QoL) and greater parenting anger. Trajectories were largely similar to controls (i.e., stable over time), but unlike controls, ADHD and ST-ADHD groups showed lessening parent-partner support and parenting warmth, respectively; and both groups showed worsening aspects of family QoL. Conclusion: Families of children with ADHD and ST-ADHD report persistently poor or worsening family functioning; highlighting a need for tailored psycho-social supports.

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.

Diagnostic deep learning algorithms that use resting EEG to distinguish major depressive disorder, bipolar disorder, and schizophrenia from each other and from healthy volunteers

BackgroundMood disorders and schizophrenia affect millions worldwide. Currently, diagnosis is primarily determined by reported symptomatology. As symptoms may overlap, misdiagnosis is common, potentially leading to ineffective or destabilizing treatment. Diagnostic biomarkers could significantly improve clinical care by reducing dependence on symptomatic presentation. MethodsWe used deep learning analysis (DLA) of resting electroencephalograph (EEG) to differentiate healthy control (HC) subjects (N = 239), from those with major depressive disorder (MDD) (N = 105), MDD-atypical (MDD-A) (N = 27), MDD-psychotic (MDD-P) (N = 35), bipolar disorder-depressed episode (BD-DE) (N = 71), BD-manic episode (BD-ME) (N = 49), and schizophrenia (SCZ) (N = 122) and also differentiate subjects with mental disorders on a pair-wise basis. DSM-III-R diagnoses were determined and supplemented by computerized Quick Diagnostic Interview Schedule. After EEG preprocessing, robust exact low-resolution electromagnetic tomography (ReLORETA) computed EEG sources for 82 brain regions. 20 % of all subjects were then set aside for independent testing. Feature selection methods were then used for the remaining subjects to identify brain source regions that are discriminating between diagnostic categories. ResultsPair-wise classification accuracies between 90 % and 100 % were obtained using independent test subjects whose data were not used for training purposes. The most frequently selected features across various pairs are in the postcentral, supramarginal, and fusiform gyri, the hypothalamus, and the left cuneus. Brain sites discriminating SCZ from HC were mainly in the left hemisphere while those separating BD-ME from HC were on the right. LimitationsThe use of superseded DSM-III-R diagnostic system and relatively small sample size in some disorder categories that may increase the risk of overestimation. ConclusionsDLA of EEG could be trained to autonomously classify psychiatric disorders with over 90 % accuracy compared to an expert clinical team using standardized operational methods.

A longitudinal follow-up study of Oklahoma City bombing survivors in the first quarter century after the disaster.

This study is one of the longest postdisaster prospective longitudinal studies of disaster-related psychopathology, completed nearly a quarter century after a terrorist bombing, and the longest follow-up study ever conducted using full diagnostic assessment in highly exposed disaster survivors. Oklahoma City bombing survivors (87% injured) were randomly selected from a state survivor registry and interviewed approximately 6 months postdisaster (N = 182; 71% participation) and again nearly 25 years later (N = 103; 72% participation). Interviews were conducted using the Diagnostic Interview Schedule (a structured interview assessing full diagnostic criteria) for panic disorder, generalized anxiety disorder, and substance use disorder at baseline and also for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) at follow-up. The Disaster Supplement assessed disaster trauma exposure and subjective experience. At follow-up, 37% of participants exhibited bombing-related PTSD (34% at baseline) and 36% had MDD (23% at baseline). More new cases of PTSD than MDD developed over time. Nonremission rates were 51% for bombing-related PTSD and 33% for MDD. One-third of participants reported long-term nonemployability. The presence of long-term medical problems among survivors parallels the persistence of psychopathology. Ongoing medical problems might have contributed to psychiatric morbidity. Because no major variables predicted remission from bombing-related PTSD and MDD, all survivors with postdisaster psychopathology likely need access to long-term evaluation and care.

Factors Associated with Anxiety Disorders in Chinese Children with Autism Spectrum Disorder in Hong Kong

Background: Autism Spectrum Disorder (ASD) is a pervasive neurodevelopment disorder characterised by impairment in social communication and presence of restricted, repetitive patterns of behaviour, interests, or activities. A growing body of research has shown that children with ASD experience significantly greater anxiety levels than typically developing children. Anxiety disorders have been found to be one of the most prevalent psychiatric comorbidities in this population of children and are associated with debilitating psychosocial impairment. Objective: This study aimed to examine factors associated with anxiety disorders among Chinese children diagnosed with ASD in Hong Kong. Methods: This cross-sectional study was conducted at a child and adolescent psychiatry outpatient clinic from August 2019 to April 2020. The sample consisted of one hundred thirty-two subjects aged 6 to &lt;12 years who had a diagnosis of ASD. Structured interviews and questionnaires including the Diagnostic Interview Schedule for Children, Parenting Stress Index-Short Form, Parenting Styles and Dimensions Questionnaire and a socio-demographic questionnaire were administered for the assessment of anxiety disorders and their associated factors. Results: Greater qualitative deficits in reciprocal social interaction skills, attention-deficit/hyperactivity disorder and maternal mood disorder were found to be significantly associated with anxiety disorders in children with ASD. Conclusion: Anxiety disorders are prevalent among children with ASD. Early recognition and identification of comorbid anxiety disorders are necessary in the diagnostic process of ASD. This study enriches our understanding of the factors associated with anxiety disorders in this population of children. For future research directions, furthering our understanding on the aetiological pathways, course of illness, and outcome of anxiety disorders in autistic children is highly warranted.

Validation of the Diagnostic Interview Schedule for Children (DISC-5) Tic Disorder and Attention-Deficit/Hyperactivity Disorder Modules

ABSTRACT Effective methods to assess mental disorders in children are necessary for accurate prevalence estimates and to monitor prevalence over time. This study assessed updates of the tic disorder and attention-deficit/hyperactivity disorder (ADHD) modules of the Diagnostic Interview Schedule for Children, Version 5 (DISC-5) that reflect changes in diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (Fifth edition, DSM-5). The DISC-5 tic disorder and ADHD parent- and child-report modules were compared to expert clinical assessment for 100 children aged 6–17 years (40 with tic disorder alone, 17 with tic disorder and ADHD, 9 with ADHD alone, and 34 with neither) for validation. For the tic disorder module, parent-report had high (>90%) sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, while the youth-report had high specificity and PPV, moderate accuracy (81.4%), and lower sensitivity (69.8%) and NPV (67.3%). The ADHD module performed less well: parent-report had high NPV (91.4%), moderate sensitivity (80.8%), and lower specificity (71.6%), PPV (50.0%), and accuracy (74.0%); youth-report had moderate specificity (82.8%) and NPV (88.3%), and lower sensitivity (65.0%), PPV (54.2%), and accuracy (78.6%). Adding teacher-report of ADHD symptoms to DISC-5 parent-report of ADHD increased sensitivity (94.7%) and NPV (97.1%), but decreased specificity (64.2%), PPV (48.7%), and accuracy (72.2%). These findings support the use of the parent-report tic disorder module alone or in combination with the child report module in future research and epidemiologic studies; additional validation studies are warranted for the ADHD module.

Cannabis use and episodic memory performance among adolescents: Moderating effects of depression symptoms and sex.

Cannabis use has been linked to poorer episodic memory. However, little is known about whether depression and sex may interact as potential moderators of this association, particularly among adolescents. The current study addresses this by examining interactions between depression symptoms and sex on the association between cannabis use and episodic memory in a large sample of adolescents. Cross-sectional data from 360 adolescents (M age = 17.38, SD = .75) were analyzed at the final assessment wave of a two-year longitudinal study. We used the Drug Use History Questionnaire to assess for lifetime cannabis use, and the Computerized Diagnostic Interview Schedule for Children, Fourth edition to assess the number of depression symptoms in the past year. Subtests from the Wechsler Memory Scale, Fourth Edition and the California Verbal Learning Test, Second Edition were used to assess episodic memory performance. The effect of the three-way interaction among cannabis use, depression symptoms, and sex did not have a significant impact on episodic memory performance. However, follow-up analyses revealed a significant effect of the two-way interaction of cannabis use and depression symptoms on episodic memory, such that associations between cannabis use and episodic memory were only significant at lower and average levels of depression symptoms. Contrary to our hypotheses, we found that as depression symptoms increased, the negative association between cannabis use and episodic memory diminished. Given the use of a predominantly subsyndromic sample, future studies should attempt to replicate findings among individuals with more severe depression.

A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic.

The lifestyles change of children and adolescents during the COVID-19 pandemic due to antipandemic measures can affect their sleep health. Existing studies have used convenient samples and focused on the initial months of the pandemic, leaving a knowledge gap on changes in young people's sleep patterns under the "new normal" under COVID-19. As part of a territory-wide epidemiological study in Hong Kong, this cross-sectional study recruited primary and secondary school students by stratified random sampling. Sleep parameters were collected using the structured diagnostic interview for sleep patterns and disorders. We investigated the pandemic's effects on sleep parameters by comparing data of participants recruited pre-COVID and those recruited during COVID using multivariate regression, adjusting for age, sex, household income, seasonality, and presence of mental disorders, and the moderators and mediators of the effects. Between September 1, 2019 and June 2, 2021, 791 primary and 442 secondary school students were recruited and analyzed. Primary school and secondary school participants assessed before COVID had a longer sleep latency on school days (95% confidence interval [CI] = 1.0-5.2 minutes, adjusted P-value = .010; and 95% CI= 3.9-13.0 minutes, adjusted P-value = .004, respectively) and nonschool days (95% CI = 1.7-7.2 minutes, adjusted P-value = .005; 95% CI = 3.4-13.7 minutes, adjusted P-value = .014, respectively). Low household income was a moderator for later bedtime (adjusted P-value = .032) and later sleep onset (adjusted P-value = .043) during nonschool days among secondary school students. Changes associated with COVID have a widespread and enduring effect on the sleep health of school-aged students in Hong Kong. Household income plays a role in adolescent sleep health resilience, and the impact of antiepidemic measures on the health gaps of the youth should be considered. Chau SWH, Hussain S, Chan SSM, etal. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic. J Clin Sleep Med. 2023;19(4):749-757.

Pathways to post-traumatic growth and post-traumatic stress following the Canterbury earthquakes in a cohort of 40-year-olds.

To report on post-traumatic growth and post-traumatic stress following the Canterbury earthquakes and to quantify the relationships between exposure to the earthquakes, post-traumatic growth and post-traumatic stress. The Christchurch Health and Development Study is a longitudinal birth cohort study of New Zealanders aged 40 years at the time of latest assessment in 2017. A total of 455 participants were exposed to the Canterbury earthquakes and assessed in 2012 and 2017. Post-traumatic growth was measured in 2017 using the Post-traumatic Growth Inventory. Earthquake-related post-traumatic stress was measured in 2012 using post-traumatic stress disorder items from the Diagnostic Interview Schedule. Post-traumatic growth and post-traumatic stress were modelled using measures of earthquake impact and subjective measures of earthquake consequences (peri-traumatic stress and disruption distress). There was an indirect relationship between earthquake impact and post-traumatic growth. This was mediated via disruption distress. There was also an indirect relationship between earthquake impact and post-traumatic stress. This was mediated via peri-traumatic stress and disruption distress. Post-traumatic growth and post-traumatic stress were not significantly related. Measurement of post-traumatic growth and post-traumatic stress is required for a holistic understanding of disaster consequences. Subjective assessment of distress following disasters is required to predict their psychological effects.

Self-reported mental health outcomes in prenatally cocaine exposed adolescents at 17 years of age

ObjectiveAdverse developmental effects of prenatal cocaine exposure (PCE) are hypothesized to extend into late adolescence, yet few studies have investigated the association between PCE and late adolescent mental health outcomes. We examined the associations between PCE and self-reported mental health symptoms at age 17, controlling for biologic and environmental confounders. We further explored the potential moderating role of sex and the mediating role of earlier drug use by age 15 in the associations. Method327 (162 PCE; 165 non-cocaine exposed, NCE) urban adolescents, primarily African Americans, of low socioeconomic status, were prospectively recruited at birth for a longitudinal study and participated in the current study. We administered the Computerized Diagnostic Interview Schedule for Children-IV to assess their mental health symptoms at age 17. Alcohol, tobacco, and marijuana use by age 15 were assessed using biologic samples and self-reports. Confounders included other prenatal drug exposures, caregiving environment, and childhood maltreatment. ResultsAlthough no overall associations between PCE and mental health outcomes were observed, multivariate logistic regression models indicate girls with PCE were 3.60 times (95% CI = 1.45–8.96, p = .006) more likely to have symptoms of oppositional defiance disorder than girls with NCE. This relationship was partially mediated by marijuana use by age 15. ConclusionContinued studies into emerging adulthood will further elucidate the long-term mental health outcomes associated with PCE.

HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area.

IntroductionAs children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV‐exposed but uninfected (AYAPHEU).MethodsData come from an ongoing longitudinal New York City‐based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12–18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first‐reported suicide attempt. Generalized estimating equations were used to examine associations between first‐reported suicide attempt and socio‐demographic, contextual and psychosocial correlates measured concurrently across six timepoints.ResultsAt enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21–33%) compared to AYAPHEU (16%, CI 10–22%), with an OR of 1.74 (CI 1.04–2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46–4.85), mood (OR 3.62, CI 1.49–8.81) and behaviour disorders (OR 5.05, CI 2.15–11.87) and past‐year arrest (OR 3.05, CI 1.26–7.4), negative life events (OR 1.27, CI 1.11–1.46), city stress (OR 2.28, CI 1.46–3.57), pregnancy (OR 2.28, CI 1.08–4.81) and HIV stigma (OR 2.46, CI 1.27–4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14–0.52), higher personal (OR 0.45, CI 0.26–0.80) and family self‐concept (OR 0.36, CI 0.22–0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years.ConclusionsAYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.

Using Time-out for Child Conduct Problems in the Context of Trauma and Adversity

Exposure to adverse childhood experiences substantially increases the risk of chronic health problems. Originally designed to treat child conduct problems, parent management training programs have been shown to be effective in preventing children from being exposed to further adversity and supporting children's recovery from adversity; however, there are increasing concerns that a core component of these programs, the discipline strategy time-out, may be harmful for children with a history of exposure to adversity. To investigate the comparative benefits and potential harms to children exposed to adversity that are associated with parenting programs that include time-out. This nonrandomized waiting list-controlled clinical study was conducted at a specialist clinic for the treatment of conduct problems in Sydney, Australia. The self-referred sample included children with conduct problems and their caregivers. Eligibility was confirmed through clinician-administered interviews. Data were collected between February 14, 2018, and February 1, 2021. Caregivers participated in a 10-session, social learning-based parent management training program. Caregivers were provided with parenting strategies aimed at encouraging desired behaviors through effective reinforcement and managing misbehavior through consistent limit setting, including the use of time-outs. The primary outcome was the parent-reported Strengths and Difficulties Questionnaire score, and secondary outcomes included subscale scores from the clinician-administered Diagnostic Interview Schedule for Children, Adolescents, and Parents. Multi-informant measures of child adversity were collected using the parent-reported Adverse Life Experiences Scale and the clinician-rated Maltreatment Index. A total of 205 children were included in analysis (156 in the full intervention and 49 in the control condition; 158 boys [77.1%]; mean [SD] age, 5.6 [1.8] years [range, 2-9 years]). Compared with children with low adversity exposure, children with high adversity exposure showed greater reductions in the Strengths and Difficulties Questionnaire score from baseline (mean difference, 3.46 [95% CI, 1.51-5.41]; P < .001) to after treatment (mean difference, 1.49 [95% CI, -0.46 to 3.44]; P = .13) and in the internalizing symptom subscale score (baseline mean difference, 1.00 [95% CI, -2,00 to 0.00]; P = .50; posttreatment mean difference, 0.06 [95% CI, -0.82 to 0.94]; P = .90). No significant differences in the externalizing symptom subscale score were found. In this nonrandomized clinical study, children with high exposure to adversity experienced equivalent, if not greater, benefits associated with parenting programs that include time-out compared with children with low exposure to adversity. Results suggest that time-out was an effective component of parenting programs for children exposed to adversity. anzctr.org.au Identifier: ACTRN12617001472369.

A Prospective Longitudinal Study of Qualitative Disaster Narratives of Highly Trauma-Exposed Survivors of the Oklahoma City Bombing Nearly a Quarter Century Later

Objective: To examine highly trauma-exposed survivors of the 1995 Oklahoma City Murrah Federal Building bombing nearly a quarter century later, focusing on survivors’ immediate personal experiences of it through open-ended narratives. Methods: An original sample of 182 bombing survivors, studied approximately 6 months post bombing, was randomly selected from a state registry of 1,092 bombing survivors, with 71% participation. Of the original 182 bombing survivors, 103 completed the longitudinal follow-up, conducted at a median of 23 years post bombing. Qualitative data for the follow-up study were collected using an expanded version of the Disaster Supplement to the Diagnostic Interview Schedule. Of the original sample, 39 were known to be deceased, 25 could not be located, and 15 declined participation. Results: In all, 12 themes were identified, but just 3 (Locations, Bombing experience, and Initial actions) are detailed here. All survivors were in heavily damaged buildings (about one-half in the Murrah Federal building) or directly outside, and the majority (84%) were injured. They described intense and gruesome experiences of the bombing, difficult efforts to escape to safety and help other survivors, and continuing postbombing experiences once outside. Conclusions: A striking finding was the intensity of the survivors’ memories almost a quarter century after the bombing. Their sensory recollections remained vivid, generally as bright and intense as in earlier reporting periods. It may be that the salience of this extreme event stabilized memories of it yielding such vivid descriptions nearly a quarter century later.

Dissociation and psychopathology in Kenyan survivors of a terrorist bombing.

Dissociation is a serious psychological condition that is characterized as a pathological outcome of trauma-related experience. Thus, dissociation could be expected to develop in survivors of disaster trauma and to be associated with trauma exposure and psychopathology. A sample of 278 disaster-affected Kenyans was assessed 8 to 10 months after the 1998 terrorist bombing of the US Embassy in Nairobi for a study of trauma-related psychopathology and dissociation in the context of personality and culture. Instruments of assessment were the Diagnostic Interview Schedule, the Dissociative Experiences Scale, and the Temperament and Character Inventory. Dissociation appeared to represent a largely nonpathological response to the disaster experience that reflected personality variables and a cultural context. These findings suggest that dissociation encountered in disaster-exposed groups in this cultural setting does not necessarily represent psychopathology, but attention to dissociative responses might help clinicians identify and provide interventions for individuals experiencing distressing intrusive and hyperarousal symptoms.