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Background: Theorists and researchers have demonstrated multiple trajectories of symptoms following disasters (Ecology and Society, 13, 2008, 9), highlighting the importance of obtaining more knowledge about exposed youth who demonstrate resilience as well as those who suffer chronic difficulties. This paper examines trajectories of posttraumatic stress disorder (PTSD) symptoms following exposure to hurricanes and the Deepwater Horizon Oil Spill to increase understanding of resilience and chronic reactions to both natural and technological disasters. Methods: A multiwave longitudinal design was used to follow N = 4,619 youth who were evaluated for PTSD symptoms, hurricane exposure, and oil spill exposure/stress at four time points over a period of 4 years. Trajectories were identified with cluster analyses and multilevel modeling. Results: Individual trajectories were statistically identified consistent with theory. The largest group exhibited stable-low symptoms (52%), a second group showed steep declines following initial symptoms (21%), a third group exhibited increasing symptoms (18%), and a fourth group showed stable-high symptoms (9%). Both hurricane exposure and oil spill stress predicted trajectories and overall levels of PTSD symptoms. Conclusions: Results identified an effect of oil spill stress and hurricane exposure on symptom levels and trajectories of exposed youth. Results provide prospective data to support theories of multiple symptom trajectories following disasters and reinforce the importance of research that utilizes a developmental perspective to consider the long-term effects of disasters in youth. Findings highlight the importance of identifying symptoms and predictors of resilience as well as factors that contribute to resilience. [ABSTRACT FROM AUTHOR]

Deficits in time perception (the ability to judge the duration of time intervals) have been found in children with both attention-deficit/hyperactivity disorder (ADHD) and dyslexia. This paper investigates time perception, phonological skills and executive functions in children with dyslexia and/or ADHD symptoms (AS). Children with dyslexia-only ( n = 17), AS-only ( n = 17), comorbid dyslexia+AS ( n = 25), and typically developing controls ( n = 42), matched for age and non-verbal ability, were assessed on measures of phonological skills, executive function and time perception (duration discrimination and time reproduction). Children with dyslexia were impaired on measures of phonological skill and duration discrimination compared to children without dyslexia (though problems on duration discrimination appeared to be attributable to mild symptoms of inattention in this group). In contrast, children with AS exhibited impairments on measures of both time perception and executive function compared to children without AS. Children with dyslexia+AS showed an additive combination of the deficits associated with dyslexia-only and AS-only. Dyslexia and AS appear to be associated with distinct patterns of cognitive deficit, which are present in combination in children with dyslexia+AS. [ABSTRACT FROM AUTHOR]

Background: While the current knowledge base on the mental health effects of displacement is mainly limited to refugees residing in industrialised countries, this paper examines the impact of war-induced displacement and related risk factors on the mental health of Eastern Congolese adolescents, and compares currently internally displaced adolescents to returnees and non-displaced peers. Methods: Data were collected from a community sample of 819 adolescents aged 13 to 21 years, attending one of 10 selected schools across the Ituri district in the Democratic Republic of Congo. Respondents completed culturally adapted self-report measures of posttraumatic stress symptoms (using the Impact of Event Scale - Revised) and internalising and externalising behaviour problems (by means of the Hopkins Symptoms Checklist - 37 for Adolescents). Associated factors studied were age, sex, parental death, exposure to war-related violence and daily stressors. Results: Internally displaced persons (IDPs) reported highest mean scores for the IES-R and the HSCL-37A internalising scale, followed by returnees, while non-displaced adolescents scored significantly lower. However, ANCOVA tests showed that posttraumatic stress and internalising symptoms were mainly associated with traumatic exposure and daily stressors and not with displacement status. Externalising problem scores were associated with traumatic exposure, daily stressors and displacement. Remarkably, death of father was associated with fewer externalising problems. Sex was differently associated with internalising and externalising problems through traumatic and daily stressors. Conclusions: As IDPs are highly exposed to violence and daily stressors, they report most psychological distress, when compared to returnees and non-displaced peers. The distinct mental health outcomes for returned youngsters illustrate how enhancing current socio-economic living conditions of war-affected adolescents could stimulate resilient outcomes, despite former trauma or displacement. [ABSTRACT FROM AUTHOR]

Background: We propose and evaluate a contribution to the conceptualization and assessment of personality functioning based on social domains and mentalizing hypotheses. Social domains are distinct social contexts, such as with acquaintances and friends, with differentiated expectations regarding participants' behaviours and social attributions. The capacity to organize social participation according to these expectations requires the ability, we suggest, to modulate mentalizing processes domain by domain. Drawing on evidence that social domain organization is impaired in borderline personality disorder (BPD) and that hypermentalizing, a heightened interpretation of others' motives, thoughts or emotions, is elevated in adolescent BPD, we hypothesized that hypermentalizing levels in adolescents will vary by social domain and that elevated BPD features will be associated with impairment of this domain organization of hypermentalizing. Methods: Measures including the borderline personality features scale for children (BPFSC) and the movie for the assessment of social cognition (MASC) were administered to 171 adolescents aged 12–17 recruited from public schools and community organizations in a large metropolitan area in southwestern United States. Mean hypermentalizing scores were computed for adolescent interpretations of sequences in the MASC focusing on the social domains of acquaintance, friends and romantic interactions. Results: There was a progressive increase in hypermentalizing scores across the acquaintance, friends and romantic interactions (repeated measures ANOVA, p <.001, all pairwise comparisons, p ≤.02), which was markedly reduced in the presence of elevated BPD features (interaction term, p =.007). Conclusions: Hypermentalizing is organized according to social domain and this organization is impaired in the presence of elevated BPD features. The findings are consistent with the proposal that personality functioning entails a social domains organization of hypermentalizing, which is impaired in personality dysfunction. Identifying mentalizing processes domain by domain has the potential to create a personalized focus for the treatment of adolescents with personality difficulties. [ABSTRACT FROM AUTHOR]

Background: Daily skin‐to‐skin contact (SSC) during early infancy fosters the long‐term development of children born preterm. This is the first randomized controlled trial assessing the potential beneficial effects of daily SSC on executive functioning and socio‐emotional behavior of children born full‐term. Whether children of mothers who experienced prenatal stress and anxiety benefitted more from SSC was also explored. Methods: Pregnant women (N = 116) were randomly assigned to a SSC or care‐as‐usual (CAU) condition. Women in the SSC condition were instructed to perform one hour of SSC daily from birth until postnatal week five. Prenatal stress was measured with questionnaires on general and pregnancy‐specific stress and anxiety completed by the mothers in gestational week 37. At child age three, mothers filled in questionnaires on children's executive functioning, and externalizing and internalizing behavior. Analyses were performed in an intention‐to‐treat (ITT), per‐protocol, and dose–response approach. Netherlands Trial Register: NL5591. Results : In the ITT approach, fewer internalizing (95% CI = 0.11–1.00, U = 2148.50, r =.24, p =.001) and externalizing (95% CI = 0.04–2.62, t = 2.04, d = 0.38, p =.04) problems were reported in the SSC condition compared to the CAU condition. Multivariate analyses of variance did not show group differences on executive functioning. Additional analyses of covariance showed no moderations by maternal prenatal stress. Conclusions: Current findings indicate that early daily SSC in full‐term infants may foster children's behavioral development. Future replications, including behavioral observations of child behavior to complement maternal reports, are warranted. [ABSTRACT FROM AUTHOR]

Background: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents' ratings of their offspring's mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents' reports are essential for clinical assessment of their offspring, they reflect parents' perceptions of the offspring. Consequently, clinical assessment also requires self‐reports from the offspring themselves. To test effects of individual differences, society, and culture on youths' self‐ratings of their problems and strengths, we analyzed Youth Self‐Report (YSR) scores for 39,849 11–17 year olds in 38 societies. Methods: Indigenous researchers obtained YSR self‐ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. Results: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. Conclusions: Like parents' ratings, youths' self‐ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self‐rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths' self‐reports should thus not be minimized by societal/cultural differences, which—while important—can be taken into account with appropriate norms, as can gender and age differences. [ABSTRACT FROM AUTHOR]

Background: Empathic concern is an important component of children's social competence. Yet, little is known about the role of the development of concern for others during infancy as a predictor of social competence in early childhood. Methods: Israeli infants (N = 165, 50% girls) were observed five times, from 3 to 36 months. Empathic concern was assessed at ages 3–18 months using observations, and four components of social competence were assessed at 36 months using observations and teacher reports. Results: Four groups with distinct developmental trajectories of empathic concern from 3 to 18 months were identified: early‐onset (starting high and increasing), low‐empathy (starting low with minimal increase), rising (starting low and increasing considerably), and a very small group with a negative slope (decreasing). The first three trajectories differed on aspects of social competence at 36 months. Early‐onset children continued to exhibit the highest empathic concern. Both the early‐onset and rising groups had greater affective knowledge than the low‐empathy group. Moreover, the rising group had better peer relations compared with low‐empathy trajectory children. Conclusions: Children who exhibit high levels of empathy early in infancy are likely to show high social competence later on. However, even when initial empathy levels are low, subsequent growth in empathy from 3 to 18 months can occur, with positive consequences for children's social competence at 36 months. Only children with low initial empathic concern and minimal growth across infancy are at increased risk of having poorer socioemotional capabilities in early childhood. [ABSTRACT FROM AUTHOR]

Background: Attention‐deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Neuroanatomic heterogeneity limits our understanding of ADHD's etiology. This study aimed to parse heterogeneity of ADHD and to determine whether patient subgroups could be discerned based on subcortical brain volumes. Methods: Using the large ENIGMA‐ADHD Working Group dataset, four subsamples of 993 boys with and without ADHD and to subsamples of 653 adult men, 400 girls, and 447 women were included in analyses. We applied exploratory factor analysis (EFA) to seven subcortical volumes in order to constrain the complexity of the input variables and ensure more stable clustering results. Factor scores derived from the EFA were used to build networks. A community detection (CD) algorithm clustered participants into subgroups based on the networks. Results: Exploratory factor analysis revealed three factors (basal ganglia, limbic system, and thalamus) in boys and men with and without ADHD. Factor structures for girls and women differed from those in males. Given sample size considerations, we concentrated subsequent analyses on males. Male participants could be separated into four communities, of which one was absent in healthy men. Significant case–control differences of subcortical volumes were observed within communities in boys, often with stronger effect sizes compared to the entire sample. As in the entire sample, none were observed in men. Affected men in two of the communities presented comorbidities more frequently than those in other communities. There were no significant differences in ADHD symptom severity, IQ, and medication use between communities in either boys or men. Conclusions: Our results indicate that neuroanatomic heterogeneity in subcortical volumes exists, irrespective of ADHD diagnosis. Effect sizes of case–control differences appear more pronounced at least in some of the subgroups. [ABSTRACT FROM AUTHOR]

Background: Postnatal maternal depressive symptoms are consistently associated with reduced quality of mother- infant interaction. However, there is little research examining the role of maternal cognitive factors (e.g. rumination) in the relationship between depressive symptoms and mother-infant interaction quality. This study investigated the hypotheses that: dysphoric mothers would demonstrate less sensitive behaviour towards their infants compared with nondysphoric mothers; mothers induced to ruminate would be less sensitive towards infants; rumination would moderate the relationship between maternal depressive symptoms and maternal sensitivity and the impact of the rumination induction would increase following a stressor (still face) task. Method: Mothers (N = 79; 39 dysphoric and 40 nondysphoric) and their infants were randomised to either a rumination induction or a control condition. Maternal sensitivity in mother-infant interactions was assessed before and after the induction using the CARE Index. In the second interaction task, mothers also completed the still-face procedure as a stressor. Results: Extending previous research, mixed measures ANOVAs demonstrated that dysphoric mothers had reduced quality of interaction with their infant compared with nondysphoric mothers and that mothers in the rumination condition exhibited reduced sensitivity towards their infants relative to mothers in the control condition. Further, maternal sensitivity worsened further after the still-face procedure in the rumination condition, but not in the control condition. Conclusions: This study suggests that the repetitive, internal focus of a ruminative state is causally implicated in mother-infant interaction quality, regardless of the level of depressive symptoms. This research extends understanding of specific mechanisms involved in the quality of the mother-infant relationship. [ABSTRACT FROM AUTHOR]

Background: The extant literature demonstrates that children with autism spectrum disorder (ASD) often have difficulty interacting and socially connecting with typically developing classmates. However, some children with ASD have social outcomes that are consistent with their typically developing counterparts. Little is known about this subgroup of children with ASD. This study examined the stable (unlikely to change) and malleable (changeable) characteristics of socially successful children with ASD. Methods: This study used baseline data from three intervention studies performed in public schools in the Southwestern United States. A total of 148 elementary-aged children with ASD in 130 classrooms in 47 public schools participated. Measures of playground peer engagement and social network salience (inclusion in informal peer groups) were obtained. Results: The results demonstrated that a number of malleable factors significantly predicted playground peer engagement (class size, autism symptom severity, peer connections) and social network salience (autism symptom severity, peer connections, received friendships). In addition, age was the only stable factor that significantly predicted social network salience. Interestingly, two malleable (i.e., peer connections and received friendships) and no stable factors (i.e., age, IQ, sex) predicted overall social success (e.g., high playground peer engagement and social network salience) in children with ASD. Conclusions: School-based interventions should address malleable factors such as the number of peer connections and received friendships that predict the best social outcomes for children with ASD. [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) show significant behavioural and genetic overlap. Both ADHD and ASD are characterised by poor performance on a range of cognitive tasks. In particular, increased response time variability (RTV) is a promising indicator of risk for both ADHD and ASD. However, it is not clear whether different indices of RTV and changes to RTV according to task conditions are able to discriminate between the two disorders. Methods: Children with ASD (n = 19), ADHD (n = 18), ASD + ADHD (n = 29) and typically developing controls (TDC; n = 26) performed a four-choice RT task with slow-baseline and fastincentive conditions. Performance was characterised by mean RT (MRT), standard deviation of RT (SD-RT), coefficient of variation (CV) and ex-Gaussian distribution measures of Mu, Sigma and Tau. Results: In the slow-baseline condition, categorical diagnoses and trait measures converged to indicate that children with ADHD-only and ASD + ADHD demonstrated increased MRT, SD-RT, CV and Tau compared to TDC and ASD-only. Importantly, greater improvement in MRT, SD-RT and Tau was demonstrated in ADHD and ASD + ADHD from slow-baseline to fast-incentive conditions compared to TDC and ASD-only. Conclusions: Slower and more variable RTs are markers of ADHD compared to ASD and typically developing controls during slow and less rewarding conditions. Energetic factors and rewards improve task performance to a greater extent in children with ADHD compared to children with ASD. These findings suggest that RTV can be distinguished in ASD, ADHD and ASD + ADHD based on the indices of variability used and the conditions in which they are elicited. Further work identifying neural processes underlying increased RTV is warranted, in order to elucidate disorder-specific and disorder-convergent aetiological pathways. [ABSTRACT FROM AUTHOR]

Background: This goal of this study was to understand the patterns of expressed emotions (EEs) in adolescent eating disorders. As such, this study compared EE among families of adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and a psychiatric control group, major depressive disorder (MDD). This study also examined the influence of family status (intact vs. nonintact) and the presence of siblings on EE. Methods: Two-hundred and fifteen adolescents (ages 12-19) and their families were recruited for this study including 121 adolescents with AN, 54 adolescents with BN, and 40 adolescents with MDD. Adolescents with at least one parent completed the Standardized Clinical Family Interview. Adolescents completed structured diagnostic interviews to assess eligibility for the study, as well as a standardized questionnaire to assess depression. Results: Analyses revealed that fathers showed higher levels of critical comments to adolescents with BN or MDD than those with AN, whereas mothers made more critical comments toward patients with BN. Mothers made the least number of positive remarks toward patients with MDD. In terms of the influence of family status, fathers from intact families showed more expressions of warmth and were less critical than fathers from nonintact families, whereas mothers from intact families were less critical but also made fewer positive remarks than mothers from nonintact families. The presence of siblings appeared to reduce mothers' expression of warmth and emotional overinvolvement. Conclusions: Unique patterns of EE were found to characterize AN, BN, and MDD. Family status and the presence of siblings exert an influence on EE that should be taken into consideration in future research. [ABSTRACT FROM AUTHOR]

Background: Children raised in institutions are at increased risk of developing internalizing and externalizing problems. However, not all children raised in institutions develop psychopathology. Deficits in error monitoring may be one risk pathway for children with a history of institutionalization given that these skills are related to both internalizing and externalizing psychiatric disorders. Error monitoring and the neural circuitry that supports it have a protracted developmental time course and are highly susceptible to the effects of adversity. As such, they may play an important moderating role between a history of institutional rearing and subsequent psychopathology. Methods: We investigated the impact of psychosocial deprivation on behavioral and neural responses (event-related potentials: ERPs) to a Flanker task assessing error monitoring and the relations between these measures and psychopathology for 12-year-old children in the Bucharest Early Intervention Project (BEIP). The BEIP involves two groups of institutionalized children randomly assigned in infancy to receive either a foster care intervention (FCG) or care as usual (CAUG). Results: Children who experienced institutional care, particularly those in the CAUG, showed perturbed behavioral performance and ERPs on the Flanker task. Additionally, an ERP measure of error monitoring [error-related negativity (ERN)] moderated the relations between time spent in institutions and externalizing and ADHD behaviors. When the amplitude of the ERN was smaller, time spent in institutional care was positively related to ADHD and externalizing behaviors, whereas time spent in institutions was unrelated to externalizing problems when children evidenced a larger ERN. Neural correlates of error monitoring did not moderate the relations between time spent in institutionalized care and internalizing behaviors. Conclusions: Exposure to institutional care early in life may affect brain circuitry associated with error monitoring. Perturbations in this neural circuitry in combination with psychosocial deprivation are possibly a risk pathway associated with the development of externalizing and ADHD problems. [ABSTRACT FROM AUTHOR]

Background This study investigated the long-term effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of alcohol, harmful use of alcohol, and alcohol-related harms over a 3-year period. Methods A cluster randomized controlled trial was conducted to assess the effectiveness of Preventure. Schools were block randomized to one of two groups: the Preventure group ( n = 7 schools) and the Control group ( n = 7 schools). Only students screening as high-risk on one of four personality profiles (anxiety sensitivity, negative thinking, impulsivity, and sensation seeking) were included in the analysis. All students were assessed at five time points over a 3-year period: baseline; immediately after the intervention; and 12, 24, and 36 months after baseline. Students were assessed on frequency of drinking, binge drinking, and alcohol-related harms. Two-part latent growth models were used to analyze intervention effects, which included all students with data available at each time point. This trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12612000026820; ). Results A total of 438 high-risk adolescents (mean age, 13.4 years; SD = 0.47) from 14 Australian schools were recruited to the study and completed baseline assessments. Relative to high-risk Control students, high-risk Preventure students displayed significantly reduced growth in their likelihood to consume alcohol [ b = −0.225 (0.061); p < .001], to binge drink [ b = −0.305 (.096); p = 0.001], and to experience alcohol-related harms [ b = −0.255 (0.096); p = .008] over 36 months. Conclusions Findings from this study support the use of selective personality-targeted preventive interventions in reducing the uptake of alcohol, alcohol misuse, and related harms over the long term. This trial is the first to demonstrate the effects of a selective alcohol prevention program over a 3-year period and the first to demonstrate the effects of a selective preventive intervention in Australia. [ABSTRACT FROM AUTHOR]

Background Neuroimaging methods that allow researchers to investigate structural covariance between brain regions are increasingly being used to study psychiatric disorders. Structural covariance analyses are particularly well suited for studying disorders with putative neurodevelopmental origins as they appear sensitive to changes in the synchronized maturation of different brain regions. We assessed interregional correlations in cortical thickness as a measure of structural covariance, and applied this method to investigate the coordinated development of different brain regions in conduct disorder ( CD). We also assessed whether structural covariance measures could differentiate between the childhood-onset ( CO- CD) and adolescence-onset ( AO- CD) subtypes of CD, which may differ in terms of etiology and adult outcomes. Methods We examined interregional correlations in cortical thickness in male youths with CO- CD or AO- CD relative to healthy controls ( HCs) in two independent datasets. The age range in the Cambridge sample was 16-21 years (mean: 18.0), whereas the age range of the Southampton sample was 13-18 years (mean: 16.7). We used FreeSurfer to perform segmentations and applied structural covariance methods to the resulting parcellations. Results In both samples, CO- CD participants displayed a strikingly higher number of significant cross-cortical correlations compared to HC or AO- CD participants, whereas AO- CD participants presented fewer significant correlations than HCs. Group differences in the strength of the interregional correlations were observed in both samples, and each set of results remained significant when controlling for IQ and comorbid attention-deficit/hyperactivity disorder symptoms. Conclusions This study provides new evidence for quantitative differences in structural brain organization between the CO- CD and AO- CD subtypes, and supports the hypothesis that both subtypes of CD have neurodevelopmental origins. [ABSTRACT FROM AUTHOR]

Background It is well established that phonological awareness, print knowledge and rapid naming predict later reading difficulties. However, additional auditory, visual and motor difficulties have also been observed in dyslexic children. It is examined to what extent these difficulties can be used to predict later literacy difficulties. Method An unselected sample of 267 children at school entry completed a wide battery of tasks associated with dyslexia. Their reading was tested 2, 3 and 4 years later and poor readers were identified ( n = 42). Logistic regression and multiple case study approaches were used to examine the predictive validity of different tasks. Results As expected, print knowledge, verbal short-term memory, phonological awareness and rapid naming were good predictors of later poor reading. Deficits in visual search and in auditory processing were also present in a large minority of the poor readers. Almost all poor readers showed deficits in at least one area at school entry, but there was no single deficit that characterised the majority of poor readers. Conclusions Results are in line with Pennington's () multiple deficits view of dyslexia. They indicate that the causes of poor reading outcome are multiple, interacting and probabilistic, rather than deterministic. [ABSTRACT FROM AUTHOR]

Background There is a known strong genetic contribution to aggression in those with ADHD. In a previous investigation of a large population cohort, impaired 'emotional/social cognitive' processing, assessed by questionnaire, was observed to mediate the link between COMT Val158Met and aggression in individuals with ADHD. We set out to replicate and extend this finding in a clinical sample, using task-based and physiological assessments of emotional and cognitive processing. Our aim was to test the hypothesis that directly assessed emotional processing mediates the link between COMT Val158Met and aggression in young people with ADHD. Methods Males aged 10-17 years with ADHD were recruited from UK community clinics ( n = 194). Research diagnostic interviews (parent and child) were used to assess psychopathology and generate DSM- IV Conduct Disorder symptom scores. Participants completed tasks assessing executive function (response inhibition and set shifting), empathy for fear, sadness and happiness, and fear conditioning [measured using skin conductance responses ( SCR) to aversive stimuli]. Results COMT V al allele carriers showed poorer response inhibition ( F = 5.27, p = .02) and set shifting abilities ( F = 6.45, p = .01), reduced fear empathy ( F = 4.33, p = .04) and reduced autonomic responsiveness (lower SCRs) to the conditioned aversive stimulus ( F = 11.74, p = .001). COMT Val158Met did not predict impairments in recognising others' emotions or affective empathy for happiness or sadness. Mediation analysis revealed that impaired fear-related mechanisms indirectly mediated the link between COMT Val158Met and aggression. Conclusion Our findings suggest fear mechanisms as possible targets for psychological interventions to disrupt links between genetic risk and aggressive outcomes in ADHD. Our findings also reveal the potential of hypothesis-driven approaches for identifying neuropsychological mechanisms that mediate genetic risk effects on behaviour and psychopathology. [ABSTRACT FROM AUTHOR]

Background The goal of this study is to investigate differences in executive function ( EF) in children with different levels of disruptive behavior problems ( DBP). Methods Ninety-three children between 7 and 12 years old with DBP were compared to 63 normally developing peers on a battery of EF tasks that varied in the amount of required emotion regulation ('hot' EF). Results Differences in EF were found between DBP and comparison groups as indexed by hot EF tasks. Self-reported emotion scales, in conjunction with physiological recordings of heart rate, confirmed that emotions were elicited during hot EF. Conclusions Results suggest that difficulties in hot EF underlie externalizing problem behaviors in middle childhood. [ABSTRACT FROM AUTHOR]

Background Tourette syndrome ( TS) is a common tic disorder in children and adolescents. There is preliminary evidence that herbal medicine may possess the potential to treat tics. The purpose of this study was to formally evaluate the efficacy and safety of 5-Ling Granule (5- LGr), a proprietary polyherbal product, for the treatment of patients with TS in comparison with tiapride and placebo. Methods In this multisite, double-blind, double-dummy, randomized, placebo-controlled trial, 603 patients with TS aged 5-18 years were randomly assigned to treatment with placebo ( n = 117), tiapride ( n = 123, 200-400 mg/day) or 5- LGr ( n = 363, 15-22.5 g/day) for 8 weeks. The primary outcome was measured using the Yale Global Tic Severity Scale ( YGTSS) and its subscales, total tic Score ( TTS) and tic-related impairment. Incidence of adverse events was compared among the three groups. Results While tics of all patients were reduced over time, 5- LGr and tiapride treatment produced significantly greater improvement on the YGTSS overall scale and subscale for TTS and impairment at endpoint than the placebo. Seventy-four percentage of patients in the 5- LGr arm and 68.3% in the tiapride arm had clinical response and these rates of response were significantly higher than those on placebo (44.0%, p < .001). The incidence of overall adverse events was significantly fewer for patients on placebo and 5- LGr compared to tiapride (11.2% and 13.8% vs. 26.0%, p = .002); in particular physical tiredness, dizziness and sleep disturbance. Conclusions The clinical efficacy of 5- LGr is comparable to tiapride in reducing tics. Its safety profile is better than tiapride. 5- LGr can be considered a safe and effective therapy for TS (Trial registration: : NCT01501695). [ABSTRACT FROM AUTHOR]

Background: An integrative multidisciplinary approach is required to elucidate the multiple factors that shape neurodevelopmental trajectories of mental disorders. The Philadelphia Neurodevelopmental Cohort (PNC), funded by the National Institute of Mental Health Grand Opportunity (GO) mechanism of the American Recovery and Reinvestment Act, was designed to characterize clinical and neurobehavioral phenotypes of genotyped youths. Data generated, which are recently available through the NIMH Database of Genotypes and Phenotypes (dbGaP), have garnered considerable interest. We provide an overview of PNC recruitment and clinical assessment methods to allow informed use and interpretation of the PNC resource by the scientific community. We also evaluate the structure of the assessment tools and their criterion validity. Methods: Participants were recruited from a large pool of youths (n = 13,958) previously identified and genotyped at The Children's Hospital of Philadelphia. A comprehensive computerized tool for structured evaluation of psychopathology domains (GOASSESS) was constructed. We administered GOASSESS to all participants and used factor analysis to evaluate its structure. Results: A total of 9,498 youths (aged 8-21; mean age = 14.2; European American = 55.8%; African American = 32.9%; Other = 11.4%) were enrolled. Factor analysis revealed a strong general psychopathology factor, and specific 'anxious-misery', 'fear', and 'behavior' factors. The 'behavior' factor had a small negative correlation (0.21) with overall accuracy of neurocognitive performance, particularly in tests of executive and complex reasoning. Being female had a high association with the 'anxious-misery' and low association with the 'behavior' factors. The psychosis spectrum was also best characterized by a general factor and three specific factors: ideas about 'special abilities/ persecution,' 'unusual thoughts/perceptions', and 'negative/disorganized' symptoms. Conclusions: The PNC assessment mechanism yielded psychopathology data with strong factorial validity in a large diverse community cohort of genotyped youths. Factor scores should be useful for dimensional integration with other modalities (neuroimaging, genomics). Thus, PNC public domain resources can advance understanding of complex interrelationships among genes, cognition, brain, and behavior involved in neurodevelopment of common mental disorders. Keywords: Community cohort, children, adolescents, young adults, psychopathology, mood, anxiety, behavior, psychosis, comorbidity, structure, genomics, neuroimaging, neurocognition, public domain. [ABSTRACT FROM AUTHOR]

Background The behavioural symptoms of autism spectrum disorder ( ASD) are thought to reflect underlying cognitive deficits/differences. The findings in the literature are somewhat mixed regarding the cognitive features of ASD. This study attempted to address this issue by investigating a range of cognitive deficits and the prevalence of multiple cognitive atypicalities in a large population-based sample comprising children with ASD, their unaffected co-twins, and typically developing comparison children. Methods Participants included families from the Twins Early Development Study ( TEDS) where one or both children met diagnostic criteria for ASD. Overall, 181 adolescents with a diagnosis of ASD and 73 unaffected co-twins were included, plus an additional 160 comparison control participants. An extensive cognitive battery was administered to measure IQ, central coherence, executive function, and theory of mind ability. Results Differences between groups ( ASD, co-twin, control) are reported on tasks assessing theory of mind, executive function, and central coherence. The ASD group performed atypically in significantly more cognitive tasks than the unaffected co-twin and control groups. Nearly a third of the ASD group presented with multiple cognitive atypicalities. Conclusions Multiple cognitive atypicalities appear to be a characteristic, but not universal feature, of ASD. Further work is needed to investigate whether specific cognitive atypicalities, either alone or together, are related to specific behaviours characteristic of ASD. [ABSTRACT FROM AUTHOR]

Background With rates of autism diagnosis continuing to rise, there is an urgent need for effective and efficient service delivery models. Pivotal Response Treatment ( PRT) is considered an established treatment for autism spectrum disorder ( ASD); however, there have been few well-controlled studies with adequate sample size. The aim of this study was to conduct a randomized controlled trial to evaluate PRT parent training group ( PRTG) for targeting language deficits in young children with ASD. Methods Fifty-three children with autism and significant language delay between 2 and 6 years old were randomized to PRTG ( N = 27) or psychoeducation group ( PEG; N = 26) for 12 weeks. The PRTG taught parents behavioral techniques to facilitate language development. The PEG taught general information about ASD (clinical trial NCT01881750; ). Results Analysis of child utterances during the structured laboratory observation (primary outcome) indicated that, compared with children in the PEG, children in the PRTG demonstrated greater improvement in frequency of utterances ( F(2, 43) = 3.53, p = .038, d = 0.42). Results indicated that parents were able to learn PRT in a group format, as the majority of parents in the PRTG (84%) met fidelity of implementation criteria after 12 weeks. Children also demonstrated greater improvement in adaptive communication skills (Vineland- II) following PRTG and baseline Mullen visual reception scores predicted treatment response to PRTG. Conclusions This is the first randomized controlled trial of group-delivered PRT and one of the largest experimental investigations of the PRT model to date. The findings suggest that specific instruction in PRT results in greater skill acquisition for both parents and children, especially in functional and adaptive communication skills. Further research in PRT is warranted to replicate the observed results and address other core ASD symptoms. [ABSTRACT FROM AUTHOR]

Background Attention-Deficit/Hyperactivity Disorder ( ADHD) is a risk factor for substance use disorders ( SUDs) and nicotine dependence ( ND). Neurocognitive deficits may predict the increased risk of developing SUDs and nicotine dependence. Methods This study comprised three groups derived from the Dutch part of the International Multicenter ADHD Genetics ( IMAGE) study: ADHD probands ( n = 294), unaffected siblings ( n = 161), and controls ( n = 214). At baseline (age = 12.2), a range of neurocognitive functions was assessed including executive functions (inhibition, working memory, timing), measures of motor functioning (motor timing and tracking) and IQ. After a mean follow-up of 4.2 years, SUDs and ND were assessed. Results None of the neurocognitive functions predicted later SUDs or ND in ADHD probands, even after controlling for medication use and conduct disorder. Slower response inhibition predicted later nicotine dependence in unaffected siblings ( OR = 2.06, 95% CI = 1.22-3.48), and lower IQ predicted increased risk for SUDs in controls ( OR = 1.96, 95% CI = 1.12-3.44). Conclusions Cold executive functions, motor functioning, and IQ did not predict the elevated risk of SUDs and ND in ADHD. Future studies should target 'hot' executive functions such as reward processing as risk factors for SUDs or ND. [ABSTRACT FROM AUTHOR]

Background Deficits in facial emotion processing, reported in attention-deficit/hyperactivity disorder ( ADHD), have been linked to both early perceptual and later attentional components of event-related potentials ( ERPs). However, the neural underpinnings of vocal emotion processing deficits in ADHD have yet to be characterised. Here, we report the first ERP study of vocal affective prosody processing in ADHD. Methods Event-related potentials of 6-11-year-old children with ADHD ( n = 25) and typically developing controls ( n = 25) were recorded as they completed a task measuring recognition of vocal prosodic stimuli (angry, happy and neutral). Audiometric assessments were conducted to screen for hearing impairments. Results Children with ADHD were less accurate than controls at recognising vocal anger. Relative to controls, they displayed enhanced N100 and attenuated P300 components to vocal anger. The P300 effect was reduced, but remained significant, after controlling for N100 effects by rebaselining. Only the N100 effect was significant when children with ADHD and comorbid conduct disorder ( n = 10) were excluded. Conclusion This study provides the first evidence linking ADHD to atypical neural activity during the early perceptual stages of vocal anger processing. These effects may reflect preattentive hyper-vigilance to vocal anger in ADHD. [ABSTRACT FROM AUTHOR]

Background Both genetic and environmental factors have been implicated in the etiology of attention-deficit/hyperactivity disorder ( ADHD). We had previously suggested that exposure to maternal smoking during pregnancy ( MSDP) may be a valid basis for delineating a distinct subtype of ADHD, where children exposed to MSDP present with a more severe clinical picture. Here, we examine the psychopathology of parents in this group, to better understand the etiology of ADHD. Methods Using the Family Interview for Genetic Studies in a sample of 514 families of children with ADHD, we collected data pertaining to lifetime parental psychopathology. Families were stratified based on maternal smoking during the complete gestational period. The frequency of different disorders was compared using the χ2 statistic. Results In the group where mothers smoked during pregnancy, both parents were significantly more likely to have antisocial personality disorder, and problems with alcohol and drug abuse. Mothers had a significantly higher frequency of major depressive disorder ( MDD), while fathers showed a trend for both MDD and bipolar disorder. Conclusions Based on the pattern of psychopathology in parents of children exposed to MSDP, as well as earlier reports of the severe clinical, behavioral, and cognitive phenotype in these children, combined with the large body of epidemiological evidence, we propose that these children present a distinct subtype of ADHD with comorbid conduct disorder. Furthermore, we propose that MSDP may be a proxy measure to help delineate this subtype. [ABSTRACT FROM AUTHOR]

Background This study examined the effects of atomoxetine ( ATX) and OROS methylphenidate ( MPH) on laboratory measures of inhibitory control and attention in youth with attention-deficit/hyperactivity disorder ( ADHD). It was hypothesized that performance would be improved by both treatments, but response profiles would differ because the medications work via different mechanisms. Methods One hundred and two youth (77 male; mean age = 10.5 ± 2.7 years) with ADHD received ATX (1.4 ± 0.5 mg/kg) and MPH (52.4 ± 16.6 mg) in a randomized, double-blind, crossover design. Medication was titrated in 4-6-week blocks separated by a 2-week placebo washout. Inhibitory control and attention measures were obtained at baseline, following washout, and at the end of each treatment using Conners' Continuous Performance Test II ( CPT- II), which provided age-adjusted T-scores for reaction time ( RT), reaction time variability ( RT variability), and errors. Repeated-measures analyses of variance were performed, with Time (premedication, postmedication) and Treatment type ( ATX, MPH) entered as within-subject factors. Data from the two treatment blocks were checked for order effects and combined if order effects were not present. Clinical trial registration: Clinicaltrials.gov: NCT00183391. Results Main effects for Time on RT ( p = .03), RTSD ( p = .001), and omission errors ( p = .01) were significant. A significant Drug × Time interaction indicated that MPH improved RT, RTSD, and omission errors more than ATX ( p < .05). Changes in performance with treatment did not correlate with changes in ADHD symptoms. Conclusions MPH has greater effects than ATX on CPT measures of sustained attention in youth with ADHD. However, the dissociation of cognitive and behavioral change with treatment indicates that CPT measures cannot be considered proxies for symptomatic improvement. Further research on the dissociation of cognitive and behavioral endpoints for ADHD is indicated. [ABSTRACT FROM AUTHOR]

Introduction The role of the serotonin transporter gene polymorphism 5- HTTLPR in attention-deficit/hyperactivity disorder ( ADHD) is unclear. Heterogeneity of findings may be explained by gene-environment interactions ( Gx E), as it has been suggested that S-allele carriers are more reactive to psychosocial stress than L-allele homozygotes. This study aimed to investigate whether 5- HTTLPR genotype moderates the effects of stress on ADHD in a multisite prospective ADHD cohort study. Methods 5- HTTLPR genotype, as well as the number of stressful life events in the past 5 years and ongoing long-term difficulties, was determined in 671 adolescents and young adults with ADHD, their siblings, and healthy controls (57.4% male, average age 17.3 years). Linear mixed models, accounting for family relatedness, were applied to investigate the effects of genotype, experienced stress, and their interaction on ADHD severity at time point T2, while controlling for ADHD severity at T1 (mean follow-up time 5.9 years) and for comorbid internalizing problems at T2. Results The interaction between genotype and stress significantly predicted ADHD severity at T2 ( p = .006), which was driven by the effect on hyperactivity-impulsivity ( p = .004). Probing of the interaction effect made clear that S-allele carriers had a significantly more positive correlation between stress and ADHD severity than L-allele homozygotes. Conclusion The results show that the interaction between 5- HTTLPR and stress is a mechanism involved particularly in the hyperactivity/impulsivity dimension of ADHD, and that this is independent of comorbid internalizing problems. Further research into the neurobiological mechanisms underlying this interaction effect is warranted. [ABSTRACT FROM AUTHOR]

Background There are an increasing number of reports on time trends in child and adolescent psychological problems but none from low- and middle-income countries, and very few covering the preschool period. The aim was to investigate changes in preschool behavioral/emotional problems in two birth cohorts from a middle-income country born 11 years apart. Methods We analyzed data from the 1993 and 2004 Pelotas birth cohort studies from Brazil. A subsample of 4-year olds from the 1993 cohort (634) and all 4-year olds from the 2004 cohort (3750) were assessed for behavioral/emotional problems through maternal report using the Child Behavior Checklist ( CBCL). Response rates in these two population-based cohorts were above 90%. Results We found a significant increase in CBCL total problems, internalizing and externalizing mean scores over the 11-year period. For 1993 and 2004 Pelotas cohorts, respectively, CBCL mean values ( SE) total problems scores were 27.9 (0.8) and 34.7 (0.3); for internalizing scores, 5.7 (0.2) and 6.3 (0.1) and for externalizing scores, 12.4 (0.4) and 15.5 (0.1). After adjusting for confounding variables, the largest increase from 1993 to 2004 was identified in the aggressive behavior syndrome score (Cohen's d = .50), followed by the externalizing problem score (Cohen's d = .40) and CBCL total problem score (Cohen's d = .36), respectively. The rise in child psychological problems was more marked in children from families with fewer assets and with less educated mothers. Conclusions Our findings provide evidence for a substantial increase in preschool behavioral problems among children in Brazil over an 11-year period. [ABSTRACT FROM AUTHOR]

Background Youth with histories of institutional/orphanage care are at increased risk for externalizing and internalizing problems during childhood and adolescence. Although these problems have been well described, the related adolescent behaviors of risk-taking and sensation-seeking have not yet been explored in this population. This study examined risk-taking and sensation-seeking propensity, and associations with conduct problems and depressive symptoms, in early adolescents who were adopted as young children from institutional care. Methods Risk-taking and sensation-seeking propensities of 12- and 13-year-old postinstitutionalized ( PI; n = 54) adolescents were compared with two groups: youth who were internationally adopted early from foster care ( PFC; n = 44) and nonadopted youth ( NA; n = 58). Participants were recruited to equally represent pre/early- and mid/late-pubertal stages within each group. Participants completed the youth version of the Balloon Analogue Risk Task (Lejuez et al., ) and the Sensation-Seeking Scale for Children (Russo et al., ). Parents completed clinical ratings of participants' conduct problems and depressive symptoms. Results PI adolescents demonstrated lower risk-taking than PFC and NA peers. Pre/early-pubertal PI youth showed lower sensation-seeking, while mid/late-pubertal PI youth did not differ from other groups. PI adolescents had higher levels of conduct problems but did not differ from the other youth in depressive symptoms. In PI youth only, conduct problems were negatively correlated with risk-taking and positively correlated with sensation-seeking, while depressive symptoms were negatively correlated with both risk-taking and sensation-seeking. Conclusions Early institutional care is associated with less risk-taking and sensation-seeking during adolescence. The deprived environment of an institution likely contributes to PI youth having a preference for safe choices, which may only be partially reversed with puberty. Whether this reflects hyporesponsiveness to rewards and how it relates to psychopathology are discussed. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit/hyperactivity disorder (ADHD) and childhood-onset psychosis (COP) are chronic, heterogeneous disorders with symptoms that frequently co-occur, but the etiology of their comorbidity is unknown. Studies of each disorder indicate that both ADHD and COP are associated with a range of neuropsychological weaknesses, but few neuropsychological studies have directly compared groups with ADHD and COP. Methods: Groups with ADHD only (32 F, 48 M), COP only (5 F, 5 M), ADHD + COP (9 F, 21 M), and a control group with neither disorder (25 F, 44 M) completed a neuropsychological battery that included measures of verbal working memory, response inhibition, response speed and variability, and selective attention. Results: All three clinical groups exhibited significantly lower performance versus the control group on all neuropsychological measures, whereas the only significant difference between the clinical groups was a significantly larger weakness in verbal working memory in the groups with COP. Conclusions: The frequent co-occurrence between COP and ADHD may reflect shared neuropsychological weaknesses that are most pronounced on measures of working memory and response variability. [ABSTRACT FROM AUTHOR]

Background: Pathological Demand Avoidance (PDA) is a term increasingly used in the United Kingdom to describe children who obsessively resist everyday demands, going to extreme lengths to avoid these. There is debate about its relationship with both autism spectrum disorder (ASD) and oppositional defiant disorder (ODD). Unlike ASD, children with PDA are said to use socially manipulative avoidance strategies; and unlike ODD, they resort to extreme, embarrassing or age-inappropriate behaviour. To date, there has been little research into PDA, and it remains contentious. Currently, there are no questionnaire instruments available to aid consistency in description. This study reports the development and preliminary validation of the 'Extreme Demand Avoidance Questionnaire' (EDA-Q), designed to quantify PDA traits based on parent-reported information. Methods: The validation study involved data from 326 parents of children aged 5-17 allocated to six groups based on information reported by parents about received diagnoses and behavioural difficulties: (a) typically developing children (N = 102), (b) children with ASD without disruptive behaviour (N = 36), (c) children with ASD with disruptive behaviour (N = 48), (d) children for whom PDA was suspected by parents (irrespective of other diagnoses) (N = 67), (e) children who had, according to parents, been identified as having PDA by a health professional, irrespective of other diagnoses (N = 50), and (6) disruptive behaviour or behavioural problems without suspected/identified ASD or PDA (N = 23). Results: Although the Strengths and Difficulties Questionnaire (SDQ) did not differentiate PDA from those with ASD plus disruptive behaviour; score on the EDA-Q was significantly higher in PDA than all comparison groups. ROC analysis indicated good sensitivity (.80) and specificity (.85). Across all case groups, females scored higher than males on the EDA-Q. Separate cut-off scores were identified for older and younger age-groups. Conclusions: Our findings highlight the potential utility of the EDA-Q to assist the identification of this unusual profile for future research. [ABSTRACT FROM AUTHOR]

Background Rates of suicide attempts and nonsuicidal self-injury [( NSSI); e.g., cutting, burning] peak in adolescence and early adulthood; females and individuals with psychiatric symptoms and diagnoses appear to be at particular risk. Hinshaw et al. [ Journal of Consulting and Clinical Psychology, (), 80, 1041] reported that young women with histories of childhood ADHD diagnoses reported higher rates of suicide attempts and NSSI than nondiagnosed, comparison women. Methods Via analyses of an ongoing longitudinal investigation, our aims are to examine, with respect to both aspects of self-harmful behavior, (a) ADHD subtype differences and effects of diagnostic persistence (vs. transient and nondiagnosed classifications) and (b) potential mediating effects of impulsivity and comorbid psychopathology, ascertained during adolescence. Results Young adult women with a childhood diagnosis of ADHD-Combined type were at highest risk for suicide attempts as well as the most varied and severe forms of NSSI compared with those with ADHD-Inattentive type and those in the comparison group; participants with a persistent ADHD diagnosis were at higher risk than those with a transient diagnosis or those never meeting criteria for ADHD. Mediator analyses revealed that, during adolescence, an objective measure of impulsivity plus comorbid externalizing symptoms were simultaneous, partial mediators of the childhood ADHD-young adult NSSI linkage. Adolescent internalizing symptoms emerged as a partial mediator of the childhood ADHD-young adult suicide attempt linkage. Conclusions ADHD in females, especially when featuring childhood impulsivity and especially with persistent symptomatology, carries high risk for self-harm. Psychiatric comorbidity and response inhibition are important mediators of this clinically important longitudinal association. We discuss limitations and implications for prevention and intervention. [ABSTRACT FROM AUTHOR]

Background Low heart rate predicts externalising and delinquent behaviour in adults, adolescents and school-age children. In younger children the evidence is less clear. Moreover, the specificity of the relation between the autonomic nervous system and different forms of externalising behaviour is uncertain. We investigated the longitudinal relation between resting mean heart rate and different externalising behaviours. Methods In 412 children of the Generation R Study, we measured resting mean heart rate at 14 months. At 3 years, child problem behaviour was assessed by the mother with the Child Behavior Checklist. In a gift delay task, we observed whether children were compliant and whether they lied about their noncompliance. The association of heart rate with behaviour was contrasted with the effect of harsh parenting. Results In our main analysis, we examined the association between heart rate and reported and observed child behaviour. For comparison, the association of heart rate with behaviour was contrasted with the effect of harsh parenting. Mean heart rate was positively associated with Anxious/Depressed scale scores (β = .1, 95% CI = 0.01; 0.2, p = .04), but not with Aggressive Behaviour (β = .02; 95% CI = −0.1; 0.1, p = .8) nor Attention Problem scale scores (β = .08, 95% CI = −0.3; 0.5, p = .8). We could not demonstrate an association between mean heart rate and noncompliance during the gift delay task (OR = 1.14, 95% CI = 0.9; 1.1, p = .2), but lower heart rate predicted higher odds of the child lying (OR = 0.56, 95% CI = 0.3; 0.9, p = .03). In contrast, harsh parenting was associated with mother-reported Aggressive Behaviour (β = .7, 95% CI = 0.4; 0.9, p < .001) and Attention Problems (β = .2, 95% CI = 0.1; 0.3, p < .001), but not with observed lying (OR = 1.03, 95% CI = 0.8; 1.4, p = .8). Conclusions Lower resting mean heart rate at age 14 months predicts low anxiety symptoms and higher odds of lying at age 3 years. Low resting mean heart rate may be less an indicator of early childhood aggression than of fearless behaviour. [ABSTRACT FROM AUTHOR]

Background Comorbidity among developmental disorders such as dyslexia, language impairment, attention deficit/hyperactivity disorder and developmental coordination disorder is common. This study explores comorbid weaknesses in preschool children at family risk of dyslexia with and without language impairment and considers the role that comorbidity plays in determining children's outcomes. Method The preschool attention, executive function and motor skills of 112 children at family risk for dyslexia, 29 of whom also met criteria for language impairment, were assessed at ages 3½ and 4½ years. The performance of these children was compared to the performance of children with language impairment and typically developing controls. Results Weaknesses in attention, executive function and motor skills were associated with language impairment rather than family risk status. Individual differences in language and executive function are strongly related during the preschool period, and preschool motor skills predicted unique variance (4%) in early reading skills over and above children's language ability. Conclusion Comorbidity between developmental disorders can be observed in the preschool years: children with language impairment have significant and persistent weaknesses in motor skills and executive function compared to those without language impairment. Children's early language and motor skills are predictors of children's later reading skills. [ABSTRACT FROM AUTHOR]

Background While several studies have found executive function deficits in adults and maltreated children with posttraumatic stress disorder ( PTSD), there are few data on executive function in children and adolescents with PTSD related to natural disasters. The objective of this study was to test executive function changes over time in children and adolescents with PTSD after a magnitude 8.0 earthquake in Sichuan, China. Method A sample of 34 children and adolescents with diagnosed PTSD following the Sichuan earthquake and 66 matched controls exposed to the same earthquake but without PTSD participated in the study. Executive function was assessed using a battery of interviewer-rated neuropsychological tests and the guardian-rated Behavior Rating Scale of Executive Function ( BRIEF) at 4- and 12-month after the earthquake. Results Children and adolescents with PTSD performed similar to controls in executive function at 4-months after the earthquake. Both groups improved significantly in similar domains of cognition during the following 8 months. The PTSD group exhibited daily deficits in emotional control compared with the controls at the 4-month assessment, but the differences disappeared during the following 8 months. Conclusions Children and adolescents with PTSD related to a natural disaster have deficits only in the emotional control domain of executive function compared with controls exposed to the same disaster, but even these deficits did not persist. [ABSTRACT FROM AUTHOR]

Background Children at family risk of dyslexia have been reported to show phonological deficits as well as broader language delays in the preschool years. Method The preschool language skills of 112 children at family risk of dyslexia ( FR) at ages 3½ and 4½ were compared with those of children with SLI and typically developing ( TD) controls. Results Children at FR showed two different profiles: one third of the group resembled the children with SLI and scored poorly across multiple domains of language including phonology. As a group, the remaining children had difficulties on tasks tapping phonological skills at T1 and T2. At the individual level, we confirmed that some FR children had both phonological and broader oral language difficulties (compared with TD controls), some had only phonological difficulties and some appeared to be developing typically. Conclusions We have highlighted the early overlap between family risk of dyslexia and SLI. A family history of dyslexia carries an increased risk for SLI and the two disorders both show an increased incidence of phonological deficits which appear to a proximal risk factor for developing a reading impairment. [ABSTRACT FROM AUTHOR]

Background: Twin studies in children reveal that familial aggregation of anxiety disorders is due to both genetic and environmental factors. Cognitive biases for threat information are considered a robust characteristic of childhood anxiety. However, little is known regarding the underlying aetiology of such biases and their role in anxiety disorders. Method: A face version of the dot-probe task measuring attentional biases for negative (anger, fear, sad, disgust) and positive (happy) facial expressions was completed by 600, 8-year-old twins; the largest study of its kind. Twin correlations for attentional bias scores were compared to estimate genetic and environmental effects. Parent-report diagnostic interviews identified children with an anxiety disorder. Indices of inferred genetic and familial risk for anxiety disorders were created for each child. Data were analysed using a series of logistic regressions. Results: Anxious children showed greater attentional avoidance of negative faces than nonanxious children; t (548) = 2.55, p < .05. Attentional avoidance was not under genetic or shared environmental influence. Risk for anxiety disorders was predicted by familial factors. Both attentional avoidance and inferred familial risk were significant but independent predictors of anxiety disorders (ORs = .65 and 3.64, respectively). Conclusions: Anxiety-related attentional biases and familial risk play important but independent roles in childhood anxiety disorders. If replicated, these findings indicate that links between genetic risk and anxiety disorders lie outside the domain of attentional processes. [ABSTRACT FROM AUTHOR]

Background: Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating whether parental symptoms in early childhood may explain any observed intrauterine effect. Methods: This study was conducted in two cohorts (Generation R, n = 2,280 and ALSPAC, n = 3,442). Pregnant women and their partners completed questionnaires to assess symptoms of depression and anxiety. Child attention problems were measured in Generation R at age 3 with the Child Behavior Checklist, and in ALSPAC at age 4 with the Strengths and Difficulties Questionnaire. Results: In both cohorts, antenatal maternal symptoms of depression (Generation R: OR 1.23, 95% CI 1.05-1.43; ALSPAC: OR 1.33, 95% CI 1.19-1.48) and anxiety (Generation R: OR 1.24, 95% CI 1.06-1.46; ALSPAC: OR 1.32, 95% CI 1.19-1.47) were associated with a higher risk of child attention problems. In ALSPAC, paternal depression was also associated with a higher risk of child attention problems (OR 1.11, 95% CI 1.00-1.24). After adjusting for maternal symptoms after giving birth, antenatal maternal depression and anxiety were no longer associated with child attention problems in Generation R. Moreover, there was little statistical evidence that antenatal maternal and paternal depression and anxiety had a substantially different effect on attention problems of the child. Conclusions: The apparent intrauterine effect of maternal depression and anxiety on offspring-behavioural problems may be partly explained by residual confounding. There was little evidence of a difference between the strength of associations of maternal and paternal symptoms during pregnancy with offspring-attention problems. That maternal symptoms after childbirth were also associated with offspring-behavioural problems may indicate a contribution of genetic influences to the association. [ABSTRACT FROM AUTHOR]

Background: Intraindividual variability in reaction times (RT variability) has garnered increasing interest as an indicator of cognitive and neurobiological dysfunction in children with attention deficit hyperactivity disorder (ADHD). Recent theory and research has emphasized specific low-frequency patterns of RT variability. However, whether group differences are specific to low frequencies is not well examined. Method: Two studies are presented. The first is a quantitative review of seven previously published studies that have examined patterns of RT variability in ADHD. The second provides new data from a substantially larger sample of children than in prior studies ( NControl = 42; NADHD = 123). The children completed a choice RT task as part of a traditional go/stop task. Fast-Fourier transform analyses were applied to assess patterns of variability. Results: Quantitative review of previous studies indicated that children with ADHD demonstrate more low-frequency variability than non-ADHD controls (Hedge's g = .39; 95% CI: .16-.62), but an equivalent excess variability in a faster frequency comparison band ( g = .36; 95% CI: .03-.69), with a trivial and nonsignificant difference between ESs in each band. New data replicated results of the quantitative review with nearly identical effects in the low-frequency ( g = .39; 95% CI: .05-.75) and faster frequency comparison bands ( g = .40; 95% CI: .04-.74) and no evidence of diagnosis × frequency interaction ( p = .954). Conclusions: Results suggest that theories of RT variability in ADHD that focus on low-frequency variability will need to be modified to account for the presence of variability at a broader range of frequencies. [ABSTRACT FROM AUTHOR]

Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a rare event, did they lose the full diagnosis, but still suffer significant social and communication impairments or did they lose all symptoms of ASD and function socially within the normal range? Methods: The present study documents a group of these optimal outcome individuals (OO group, n = 34) by comparing their functioning on standardized measures to age, sex, and nonverbal IQ matched individuals with high-functioning autism (HFA group, n = 44) or typical development (TD group, n = 34). For this study, 'optimal outcome' requires losing all symptoms of ASD in addition to the diagnosis, and functioning within the nonautistic range of social interaction and communication. Domains explored include language, face recognition, socialization, communication, and autism symptoms. Results: Optimal outcome and TD groups' mean scores did not differ on socialization, communication, face recognition, or most language subscales, although three OO individuals showed below-average scores on face recognition. Early in their development, the OO group displayed milder symptoms than the HFA group in the social domain, but had equally severe difficulties with communication and repetitive behaviors. Conclusions: Although possible deficits in more subtle aspects of social interaction or cognition are not ruled out, the results substantiate the possibility of OO from autism spectrum disorders and demonstrate an overall level of functioning within normal limits for this group. [ABSTRACT FROM AUTHOR]

Background: Fluctuations in attention-deficit hyperactivity disorder (ADHD) symptoms related to regulatory deficits in arousal states are themselves characterized by circadian rhythms. Although cortisol is an important circadian arousal-related marker, studies focusing on across-the-day cortisol variations in ADHD are scarce. There is no study with multiple measurements to take into account interday and intraday variability. Methods: Salivary cortisol was sampled five times a day (awakening, 30 min after awakening, noon, 4 p.m., 8 p.m.) across five consecutive days in 33 children with ADHD (22 with and 11 without oppositional defiant disorder; ODD) and 33 class- and sex-matched controls (aged 6-12). The cortisol awakening response (increase from awakening to 30 min after awakening) and the diurnal cortisol profile (across-the-day variations) were compared for ADHD with ODD (ADHD + ODD) and without ODD (ADHD) subgroups and the control group. Results: The cortisol awakening response was not significantly different between groups. However, longitudinal analyses to evaluate cortisol profiles across the day revealed a significant Group × Time effect ( p < .001). More specifically, compared to each other, the ADHD subgroup showed a flatter slope with relative morning hypo-arousal and evening hyperarousal, whereas the ADHD + ODD subgroup showed a steeper slope with relative morning hyperarousal and evening hypo-arousal ( p < .001). Conclusions: Findings support time-related arousal disruptions in children with ADHD associated with the presence or absence of ODD comorbidity. We recommend research on cortisol in larger samples for a better understanding of arousal mechanisms involved in ADHD not only with and without ODD but also with other comorbidities which may have implications for timing of arousal-based treatments. [ABSTRACT FROM AUTHOR]

Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world. Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children ( M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M = 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression. Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans. Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children. [ABSTRACT FROM AUTHOR]

Background: Accurate identification of nonverbal emotional cues is essential to successful social interactions, yet most research is limited to emotional face expression labeling. Little research focuses on the processing of emotional prosody, or tone of verbal speech, in clinical populations. Methods: Using the Diagnostic Analysis of Nonverbal Accuracy, the current study examined whether youths with pediatric-onset bipolar disorder (BD) and/or those with chronic and severe irritability (i.e. the severe mood dysregulation phenotype) are impaired in their ability to identify the emotional prosody of a spoken sentence with neutral content. Results: Youths with severe mood dysregulation ( n = 67) performed more poorly than healthy comparison children ( n = 57), even when the sample was limited to unmedicated patients. Medicated BD youths ( n = 52) exhibited impairment relative to healthy comparison children. No interactions between group and emotion were observed, suggesting that emotional prosody labeling problems may represent a general deficit in chronically irritable youths and in medicated youths with BD. Conclusion: In concert with previously documented facial emotion labeling deficits, difficulties ascertaining the correct emotional tone of a spoken sentence may contribute to emotion dysregulation in chronically irritable children, and possibly also in youths with BD. [ABSTRACT FROM AUTHOR]

Background: We assessed trajectories of children's internalizing symptoms as predicted by interactions among maternal internalizing symptoms, respiratory sinus arrhythmia (RSA) and child sex. Method: An ethnically and socioeconomically diverse sample of children ( n = 251) participated during three study waves. Children's mean ages were 8.23 years ( SD = 0.72) at T1, 9.31 years ( SD = 0.79) at T2 and 10.28 years ( SD = 0.99) at T3. Results: Multiple-indicator multilevel latent growth analyses showed maternal internalizing symptoms interacted with child RSA and sex to predict children's internalizing symptoms. Girls with higher RSA whose mothers had lower levels of internalizing symptoms showed the steepest decline in internalizing symptoms across time. Girls with lower RSA whose mothers had higher levels of internalizing symptoms showed the highest levels of internalizing symptoms at T3, whereas boys with higher RSA whose mothers had higher levels of internalizing symptoms showed the highest levels of internalizing symptoms at T3. Conclusions: Findings build on this scant literature and support the importance of individual differences in children's physiological regulation in the prediction of psychopathology otherwise associated with familial risk. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is associated with heightened risk for depression; however, not all individuals who experience maltreatment develop depression. Previous research indicates that maltreatment contributes to an attention bias for emotional cues, and that depressed individuals show attention bias for sad cues. Method: The present study examined attention patterns for sad, depression-relevant cues in children with and without experience of maltreatment. We also explored whether individual differences in physiological reactivity and emotion regulation in response to a sad emotional state predict heightened attention to sad cues associated with depression. Results: Children who experienced high levels of maltreatment showed an increase in attention bias for sad faces throughout the course of the study, such that they showed biased attention for sad faces following the initiation of a sad emotional state. Maltreated children who had high levels of trait rumination showed an attention bias toward sad faces across all time points. Conclusions: These data suggest that maltreated children show heightened attention for depression-relevant cues in certain contexts (e.g. after experience of a sad emotional state). Additionally, maltreated children who tend to engage in rumination show a relatively stable pattern of heightened attention for depression-relevant cues. These patterns may identify which maltreated children are most likely to exhibit biased attention for sad cues and be at heightened risk for depression. [ABSTRACT FROM AUTHOR]

Background: Purpose of this study was to systematically examine combined use of the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) for children under age 4 using newly developed and revised diagnostic algorithms. Methods: Single and combined use of the ADI-R and ADOS algorithms were compared to clinical best estimate diagnoses for 435 children with autism spectrum disorders (ASD), 113 children with nonspectrum disorders, and 47 children with typical development from 12 to 47 months of age. Sequential strategies to reach a diagnostic decision by prioritizing administrations of instruments were also evaluated. Results: Well-balanced sensitivities and specificities above 80% were obtained for ASD diagnoses using both instruments. Specificities significantly improved when both instruments were used compared to one. Scores that can be used to systematically prioritize administrations of instruments were identified. Conclusions: The ADI-R and ADOS make independent, additive contributions to more accurate diagnostic decisions for clinicians evaluating toddlers and young preschoolers with ASD. Sequential assessment strategies using the scores identified may be appropriate for some children. [ABSTRACT FROM AUTHOR]

Background: Infants, toddlers and preschoolers are the highest risk group for burn injury. However, to date this population has been largely neglected. This study examined the prevalence, onset, comorbidity and recovery patterns of posttrauma reactions in young children with burns. Methods: Parents of 130 unintentionally burned children (1-6 years) participated in the study. The Diagnostic Infant Preschool Assessment was conducted with parents at 1 and 6 months postinjury. Results: The majority of children were resilient. However, 35% were diagnosed with at least one psychological disorder, there was a high rate of comorbidity with posttraumatic stress disorder, and 8% of children did not experience recovery in distress levels over the course of 6 months. Conclusions: These outcomes are likely to have serious repercussions for a young child's medical and psychosocial recovery as well as their normal developmental trajectories. It is recommended that screening, prevention and early intervention resources are incorporated into paediatric health care settings to optimise children's psychological adjustment following burn injury. [ABSTRACT FROM AUTHOR]

Background: Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial. Methods: A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC ( n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment. Results: Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17, p = .006). The intervention had no effect on internalizing disorders in boys (OR = 0.47, p = .150). At 42 months, girls in FC were more likely to have secure attachment than girls in CAU (OR = 12.5, p < .001), but no difference was observed in boys (OR = 2.0, p = .205). Greater attachment security predicted lower rates of internalizing disorders in both sexes. Development of attachment security fully mediated intervention effects on internalizing disorders in girls. Conclusion: Placement into FC facilitated the development of secure attachment and prevented the onset of internalizing disorders in institutionalized girls. The differential effects of FC on attachment security in boys and girls explained gender differences in the intervention effects on psychopathology. Findings provide evidence for the critical role of disrupted attachment in the etiology of internalizing disorders in children exposed to institutionalization. [ABSTRACT FROM AUTHOR]

Background: Although impaired sensory processing accompanies various clinical conditions, the question of its status as an independent disorder remains open. Our goal was to delineate the comorbidity (or lack thereof) between childhood psychopathology and sensory over-responsivity (SOR) in middle childhood using phenotypic and behavior-genetic analyses. Method: Participants ( N = 970) were drawn from the Wisconsin Twin Project, a population-based sample of twins and their families. Mothers completed a sensory responsivity checklist when their offspring were on average 7 years old, followed by a diagnostic interview (Diagnostic Interview Schedule for Children; DISC) within 6-12 months. We examined the incidence of DISC diagnoses - attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, agoraphobia, general anxiety, obsessive-compulsive disorder, panic disorder, separation anxiety, social phobia, specific phobia, depression, enuresis, trichtollomaniatics, selective mutism, and pica - among children with SOR, and vice versa. Children with autism or pervasive developmental disorders were excluded from the present study. In addition, we examined parent-reported physical health diagnoses among nondiagnosed children and three groups of children with SOR and/or DISC diagnoses. Biometric models explored common underlying genetic and environmental influences on symptoms of SOR and psychopathology. Results: A majority of individuals who screened positive for SOR did not qualify for a DISC diagnosis (58.2%), and vice versa (68.3%). Children who screened positive for SOR only and typical children had similar rates of physical health problems. Turning to a dimensional approach, multivariate twin models demonstrated that modest covariation between SOR and DISC symptoms could be entirely accounted for by common underlying genetic effects. Conclusions: Our results suggest that SOR occurs independently of recognized childhood psychiatric diagnoses but is also a relatively frequent comorbid condition with recognized diagnoses. Genetic sources of this comorbidity are implicated. [ABSTRACT FROM AUTHOR]

Background and methods: In two birth cohort studies with genetic, sensitive parenting, and attachment data of more than 1,000 infants in total, we tested main and interaction effects of candidate genes involved in the dopamine, serotonin, and oxytocin systems ( DRD4, DRD2, COMT, 5-HTT, OXTR) on attachment security and disorganization. Parenting was assessed using observational rating scales for parental sensitivity (), and infant attachment was assessed with the Strange Situation Procedure. Results: We found no consistent additive genetic associations for attachment security and attachment disorganization. However, specific tests revealed evidence for a codominant risk model for COMT Val158Met, consistent across both samples. Children with the Val/Met genotype showed higher disorganization scores (combined effect size d = .22, CI = .10-.34, p < .001). Gene-by-environment interaction effects were not replicable across the two samples. Conclusions: This unexpected finding might be explained by a broader range of plasticity in heterozygotes, which may increase susceptibility to environmental influences or to dysregulation of emotional arousal. This study is unique in combining the two largest attachment cohorts with molecular genetic and observed rearing environment data to date. [ABSTRACT FROM AUTHOR]