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Abstract: Impaired recognition of facial affect has been reported in youths and adults with antisocial behavior. However, few of these studies have examined subjects with the psychiatric disorders associated with antisocial behavior, and there are virtually no data on females. Our goal was to determine if facial affect recognition was impaired in adolescent girls with conduct disorder (CD). Performance on the Ekman Pictures of Facial Affect (POFA) task was compared in 35 girls with CD (mean age of 17.9years±0.95; 38.9% African-American) and 30 girls who had no lifetime history of psychiatric disorder (mean age of 17.6years±0.77; 30% African-American). Forty-five slides representing the six emotions in the POFA were presented one at a time; stimulus duration was 5s. Multivariate analyses indicated that CD vs. control status was not significantly associated with the total number of correct answers nor the number of correct answers for any specific emotion. Effect sizes were all considered small. Within-CD analyses did not demonstrate a significant effect for aggressive antisocial behavior on facial affect recognition. Our findings suggest that girls with CD are not impaired in facial affect recognition. However, we did find that girls with a history of trauma/neglect made a greater number of errors in recognizing fearful faces. Explanations for these findings are discussed and implications for future research presented. [Copyright &y& Elsevier]

Objectives: Conduct disorder (CD) in adolescent girls is a significant problem, but few data exist on the neuropsychological function of girls with this disorder. We investigated whether girls with CD have poorer neuropsychological function than girls without any psychiatric disorder, whether these differences remained significant after adjusting for demographics, and whether psychiatric comorbidity, age at onset of CD symptoms, or aggressive CD behaviors were differentially associated with neuropsychological function within the CD group.Method: Ninety-three girls, ages 15 to 17 years, from the community (52 CD; 41 without any disorder [normal controls]) received a neuropsychological battery examining motor/laterality, general intelligence, language, visuospatial, visual-motor, executive function, and academic achievement domains.Results: Girls with CD had lower general intelligence and poorer performance on visuospatial, executive function, and academic achievement domains. After adjusting for demographic factors, scores in the CD group were worse for general intelligence and in the visuospatial and academic achievement domains. Comorbid substance use disorder was negatively correlated with motor/laterality; no other intra-CD group comparisons were statistically significant.Conclusions: Girls with CD had deficits in several domains of neuropsychological function. Possible explanations for the findings and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The article presents a study on the health care policies used in the U.S. detention facilities. The study was conducted through telephone interviews from 83 juvenile detention facility administration across the U.S. Results showed that policies for admission health screening existed in 99% of facilities and 90% in mental health screening. Most areas had also policies about psychopharmacotherapy and 92% had crisis services. The study concluded that the detention health care policies for adolescents have significant gaps, particularly for mental health care.

Summary: There are few data on the biological correlates of female antisocial behavior. This study compared adrenal androgen and gonadal hormone levels in adolescent girls with conduct disorder (CD) to girls without any psychiatric disorder (NC). We studied 87 girls, (47 CD; 36 NC), ages 15–17 years, obtaining three blood samples, drawn 20min apart between 8 and 9 AM in the first 72h of the onset of menstrual flow. Plasma was assayed for testosterone, estradiol, androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEA-S), sex hormone binding globulin (SHBG), and cortisol; area under the curve (AUC) for each of the three samples was used in the data analysis. We also calculated the Free Testosterone Index, Free Estrogen Index, Index of Hyperandrogenism and cortisol to DHEA ratio. In addition to receiving a full psychiatric interview, each girl completed a self-report questionnaire on general aggression. Main hormone analyses controlled for potentially confounding variables such as psychiatric comorbidity and race. Girls with CD had significantly lower cortisol to DHEA ratios, but did not differ from NC girls on any other hormone variable. Girls with symptoms of aggressive CD had significantly higher mean free testosterone indexes, lower SHBG levels, and lower cortisol to DHEA ratios than girls with non-aggressive CD. Girls with CD scored higher on the aggression questionnaire, but there was no association between general aggression and any hormone variable for the sample. Our data suggest that girls with CD, particularly aggressive CD, have lower cortisol to DHEA ratios, higher levels of free testosterone, and lower levels of SHBG. Clinical and research implications of these findings are discussed. [Copyright &y& Elsevier]

Conduct disorder (CD) is a pernicious mental health disorder afflicting up to 15% of children and adolescents in the United States. This study tested 2 hypotheses: 1) adolescent girls with CD have blunted diurnal secretion of cortisol; and 2) CD plus comorbid internalizing disorders (major depression, anxiety disorders) (CD+INT) is associated with higher diurnal cortisol levels than those in CD-only girls. Diurnal cortisol secretion is blunted in girls with CD, but this is attributed to a lower CAR, not because of lower cortisol levels throughout the rest of the 24 hours. [Extracted from the article]

An abstract of the article "Head to Toe at CHEO: Detecting Suicidal Ideation in Pediatric Inpatients" by Kathleen A. Pajer and colleagues is presented.

The author reflects on the risk factor and biological marker studies in externalizing disorders. She stated that the study of Ashford has showed that prenatal nicotine exposure can produce symptoms of both externalizing and internalizing disorders in offspring. Meanwhile, the study of Beauchaine demonstrates that boys with aggression and conduct problems have lower parasympathetic activity compared to girls with aggression and conduct problems.

The article focuses on cortisol levels and conduct disorder in adolescent mothers. The function of the hypothalamic-pituitary-adrenal (HPA) axis in adolescent antisocial girls. This is important because disturbance of HPA functioning has been found in population of violent adult males and antisocial adolescent males, suggesting that it may be a marker of a physiological disorder associated with antisocial behavior. The hypothesis was made that the girl with conduct disorders have lower cortisol levels that girls without conduct disorders.

Abstract: Purpose: One of the risk factors for poor adult health may be adolescent antisocial behavior, especially in girls. This study was conducted to determine if negative young adult health outcomes in girls who previously had adolescent antisocial behavior could be explained by demographic factors and pre-existing health problems. Methods: This 3-year longitudinal study recruited 93 girls, ages 15–17 years (52 with conduct disorder [CD]; 41 with no psychiatric illness [normal controls; NC]) from the community. Baseline interviews of girls and parents collected demographic, psychiatric, and medical history data. Three annual interviews collected data about medical problems, health care service utilization, and reproductive health. In addition, the final follow-up included a standardized self-report questionnaire about young adult health status. Results: CD and NC groups did not differ in age, racial composition, social class, proportion of smokers, or drug and alcohol experimentation. They were qualitatively different in baseline medical histories. Controlling for age at follow-up and baseline medical problems, the CD group as young adults had worse overall health, more discomfort, higher rates of unhealthy habits, lower rates of healthy behaviors, and more pregnancies at earlier ages. There were no group differences in rates of disorders, injuries, or health care usage. Conclusions: Adolescent girls with CD as young adults have poorer overall health, more discomfort, more health risk behaviors, and earlier onset of adult reproductive behaviors, even when controlling for demographic factors and pre-existing health history. Clinical and research implications are discussed. [Copyright &y& Elsevier]

Summary: Chronic prenatal stress contributes to poor birth outcomes for women and infants. Importantly, poor birth outcomes are most common among minority and low income women. To investigate underlying mechanisms, we tested the hypothesis that chronic stress related to minority or low income status is associated with glucocorticoid resistance as indicated by disruption in the cytokine-glucocorticoid feedback circuit. Home visits were conducted during which 3rd trimester pregnant women completed stress and depression surveys and provided blood for pro- and anti-inflammatory cytokines. Saliva was collected 5 times the preceding day for diurnal cortisol levels. For statistical analyses, women were grouped 3 ways, by race, income, and the presence or absence of either of those risk factors; this last group was labeled high or low general risk. Immune regulation was evaluated by evidence of a functioning negative feedback relationship between cytokines and cortisol. Of 96 participants, 18 were minority, 22 of low income, and 29 either minority or low income (high general risk). Pearson partial correlation identified a significant negative relationship between cortisol area under the curve (AUC) and pro- to anti-inflammatory cytokine ratios in the low general risk women (i.e., Caucasian, higher income) including IFNγ/IL10 (r =−0.73, p <0.0001), IL6/IL10 (r =−0.38, p =0.01), IL1β/IL10 (r =−0.44, p =0.004) and TNFα/IL10 (r =−0.41; p =0.005); no such correlations existed in the high general risk women (i.e., minority, low income) for (IFNγ/IL10: r =−0.25, p =0.43; IL6/IL10: r =0.12, p =0.70; IL1 β/IL10: r =0.05, p =0.87; TNFα/IL10: r =0.10; p =0.75), suggestive of glucocorticoid resistance. Cortisol levels throughout the day also were higher in minority and high general risk groups (p <0.05). Without cytokine glucocorticoid feedback, a pregnant woman's ability to regulate inflammation is limited, potentially contributing to adverse maternal and infant outcomes. [Copyright &y& Elsevier]

Severe antisocial behavior in girls, best exemplified by conduct disorder (CD), is a serious clinical and public health problem. Treatment is difficult, particularly in girls with comorbid internalizing disorders. Identifying biological correlates may help to develop new treatments or diagnostic, prognostic, or treatment response biomarkers. Based on our earlier work and research from others occurring primarily in boys with severe antisocial behavior, it is possible that abnormalities in the hypothalamic pituitary adrenal (HPA) axis circadian cortisol cycle may be associated with female CD. Additionally, research suggests that the presence of comorbid internalizing disorders may be related to differences in cortisol secretion, compared to subjects who only have CD. Our study aimed: 1) to compare the circadian cortisol cycle in 98 girls with CD, 15–16 years of age to 47 girls without any psychiatric disorder (ND) and 2) to compare the cycle in girls with CD and comorbid internalizing disorders (CD + INT) to those without such comorbidity (CD Only). Salivary cortisol was collected over 24 h during weekdays at scheduled times, with protocol adherence measures in place. Unstructured covariance pattern modeling, controlling for effects of age, social class, IQ, and awakening time was used to analyze cortisol data. CD was associated with overall lower cortisol secretion (p = 0.03), but this difference was due to a lower volume of cortisol secreted 30 min after awakening (area under the curve with respect to ground, p = 0.01). Circadian cortisol secretion was no different in the CD+INT group compared to the CD Only group (p = 0.52). Our findings need to be replicated using current consensus guidelines for the assessment of the CAR. We also suggest two new avenues of research in this field. • Research on circadian cortisol secretion in adolescent girls with conduct disorder is lacking. • Girls with conduct disorder showed lower cortisol secretion in the morning after awakening compared to girls with no disorder. • There were no differences in cortisol levels between girls with and without conduct disorder at any other timepoint. • Cortisol levels did not differ at any timepoint between conduct disordered-girls with or without anxiety or depressive disorders. • Effects of neuropsychological function or comorbid oppositional defiant disorder are important topics for future research. [ABSTRACT FROM AUTHOR]

Abstract: Lifetime health disparity between African-American and white females begins with lower birthweight and higher rates of childhood overweight. In adolescence, African-American girls experience earlier menarche. Understanding the origins of these health disparities is a national priority. There is growing literature suggesting that the life course health development model is a useful framework for studying disparities. The purpose of this study was to quantify the influence of explanatory factors from key developmental stages on the age of menarche and to determine how much of the overall race difference in age of menarche they could explain. The factors were maternal age of menarche, birthweight, poverty during early childhood (age 0 through 5 years), and child BMI z-scores at 6 years. The sample, drawn from the US National Longitudinal Surveys of Youth Child–Mother file, consisted of 2337 girls born between 1978 and 1998. Mean age of menarche in months was 144 for African-American girls and 150 for whites. An instrumental variable approach was used to estimate a causal effect of child BMI z-score on age of menarche. The instrumental variables were pre-pregnancy BMI, high gestational weight gain and smoking during pregnancy. We found strong effects of maternal age of menarche, birthweight, and child BMI z-score (−5.23, 95% CI [−7.35,−3.12]) for both African-Americans and whites. Age of menarche declined with increases in exposure to poverty during early childhood for whites. There was no effect of poverty for African-Americans. We used Oaxaca decomposition techniques to determine how much of the overall race difference in age of menarche was attributable to race differences in observable factors and how much was due to race dependent responses. The African-American/white difference in childhood BMI explained about 18% of the overall difference in age of menarche and birthweight differences explained another 11%. [Copyright &y& Elsevier]

The article looks at the connection between decision-making ability and suicidal behavior in youths. Using the Iowa Gambling Task, a psychological test of decision-making skills, the authors researched adolescents with and without a history of suicidal behavior. According to the article, those with past suicide attempts performed considerably worse on the test than the others. The authors conclude clinicians should thus focus more on decision-making abilities in youth suicide prevention.