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Background: The purpose of this study was to determine a score on the Obsessive Compulsive Scale (OCS) from the Child Behavior Checklist (CBCL) to screen for obsessive compulsive disorder (OCD) in children and to rigorously test the specificity and sensitivity of a single cutpoint. Methods: A receiver operating characteristic (ROC) curve analysis was applied to data from 61 patients with clinically determined OCD, 64 clinical controls and 73 general population controls to determine the best sum score on the CBCL-OCS to predict confirmed OCD in children. Using the ROC-determined cutoff, this score was applied to a national sample of CBCL data from 2460 singleton children ages 4–18 and to 20,016 children ages 7–18 from three large general population twin samples to determine the estimated prevalence in the general population. Results: Using a CBCL-OCS score of 5 demonstrated an area under the curve (AUC) of .88 with high sensitivity (92%) and moderate specificity (67%) compared to clinical controls. Compared to the general population controls, the AUC was .96 with high sensitivity (92%) and specificity (89%). In the twin samples, the number of participants with CBCL-OCS scores above this cutpoint was 2.3–7.1%. Conclusions: These findings suggest that the OCS of the CBCL may provide a highly effective way to screen for childhood OCD, and that the prevalence of childhood OCD may have been underestimated, thus prompting the need for further research into screening children for this condition. [ABSTRACT FROM AUTHOR]

This study examines the diagnostic accuracy of the CBCL syndrome AS scales for predicting DSM-IV Attention Deficit-Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder with or without Conduct Disorder (ODD/CD). The sample included 370 children (187 probands and 183 siblings) participating in a family genetic study of attention and aggressive behavior problems. Univariate and stepwise logistic regression analyses were used to derive models for predicting two diagnostic conditions: ADHD and ODD/CD. The Attention Problems syndrome significantly predicted ADHD, and ODD/CD was significantly predicted by the Aggressive Behavior syndrome. Both scales demonstrated good diagnostic accuracy, as assessed through receiver operating characteristics analyses. Cut-point analyses confirmed the utility of low T-scores, 55 on the respective syndromes, for efficiently discriminating cases from noncases. CBCL syndromes display good diagnostic efficiency for assessing common externalizing disorders in children. [ABSTRACT FROM AUTHOR]

The expression psychopathology in general and child psychopathology in particular, is affected by multiple sources of variance. Some of these sources include gender differences, informant differences, and age-related differences. In this paper, we discuss how these sources of variance complicate both research and clinical management. We argue that the current diagnostic system would be aided by the inclusion of a quantitative axis that can take these sources of variance into account. We reason that the fields of genomics and neuroscience are prepared to move the field of developmental psychopathology forward, but need a diagnostic system that allows for these sources of variance to be controlled. We demonstrate how in Conduct Disorder, inclusion of dimensional information would allow the clinician or researcher to demonstrate not only the presence or absence of pathology, but also the degree to which the disorder is manifested in a particular individual. Because dimensional approaches are already used widely as an alternative measure of psychopathology, we argue that there is reason to consider dimensionalizing some aspects of the DSM. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: No clear consensus has been reached yet on how best to characterize children who suffer from pediatric bipolar disorder (PBD). The CBCL-PBD profile on the Child Behavior Checklist (CBCL) has been consistently reported showing deviant findings on the Attention Problems, Aggressive Behavior, and Anxious-Depressed subscales. Aim: To examine the sensitivity and specificity of the proposed CBCL-PBD profile for determining DSM diagnosis of PBD. Methods: We applied receiver operating characteristic (ROC) curve analysis to data from 471 probands from two family studies of attention-deficit hyperactivity disorder and their 410 siblings. Results: The CBCL-PBD score demonstrated an area under the curve (AUC) of 0.97 for probands and 0.82 for siblings for current diagnosis of PBD, suggesting that the CBCL-PBD provided a highly efficient way of identifying subjects with a current diagnosis of PBD in this sample. Conclusions: These findings suggest that the CBCL-PBD may provide a highly efficient way of screening for childhood bipolar disorder. [ABSTRACT FROM AUTHOR]

BACKGROUND: Exercise reduces the odds of sadness and suicidality in bullied students, but the role of the bullying environment on this relationship remains unknown. METHODS: Using combined data from the 2013 and 2015 Youth Risk Behavior Survey (N = 29,207), adjusted logistic regression models estimated odds ratios between exercise, sadness, and suicidal ideation and attempt, stratified by bullying exposure (electronically/at school). RESULTS: Overall, 40.2% of students bullied at school and 48.3% of students bullied electronically reported feeling sad, compared to 22.6% of those not bullied. Bullied students were 2–3 times more likely to report suicidal ideation, and 3–4 times more likely to report suicidal attempt, regardless of bullying context. Students who were bullied at school and exercised 4–7 days per week had lower odds of sadness (adjusted odds ratio [AOR]: 0.64; 95% confidence interval [CI]: 0.51–0.81), suicidal ideation (AOR: 0.66; 95% CI: 0.53–82), and suicidal attempt (AOR: 0.69; 95% CI: 0.48–0.98) compared to those who exercised 0–3 days. There were no protective effects of exercise for students bullied electronically. CONCLUSIONS: Exercise reduced sadness and suicidality in adolescents bullied at school but not for students who were cyberbullied. Bullying environment should be a primary consideration in school mental health treatment and maintenance paradigms. [ABSTRACT FROM AUTHOR]

Background Oppositional defiant disorder ( ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. Methods Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid-Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study. Results Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. Conclusions Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior. [ABSTRACT FROM AUTHOR]

Background Social withdrawal is a core neuropsychiatric phenomenon in developmental psychopathology. Its presence predicts psychopathology across many domains, including depression, psychosis, autism, anxiety, and suicide. Withdrawn behavior is highly heritable, persistent, and characteristically worsens without intervention. To date, few studies have successfully identified genetic associations with withdrawn behavior, despite the abundance of evidence of its heritability. This may be due to reliance of categorical over dimensional measures of the behaviorally inhibited phenotype. The aim of this study is to identify associations between known psychiatric candidate genes and a dimensionally derived measure of withdrawn behavior. Methods Genetic information was collected on 20 single-nucleotide polymorphisms ( SNPs) from a custom-designed SNP chip and TAQMAN arrays of 4 variable number of tandem repeat ( VNTR) genes for 551 individuals from 187 families. Linear mixed modeling was employed to examine the relationship between genotypes of interest and Child Behavior Checklist ( CBCL) Withdrawn Behavior Subscale Score ( WBS) while controlling for gender and age through multiple linear regressions. Results Withdrawn behavior was highly associated with polymorphism of the serotonin receptor 2A ( HTR2A) [ p = .009, estimate = 0.310 (bootstrap 95% CI 0.155-0.448), bootstrap p = .001] and of the alpha 2-adrenergic ( ADRA2A) [ p = .001, estimate = −0.310 (bootstrap 95% CI −0.479 to −0.126), bootstrap p = .001] genes after correction for gender and age. The association between withdrawn behavior and ADRA2A was stronger for younger children. Conclusions HTR2A and ADRA2A genes are associated with withdrawn behavior. This reinforces the role of catecholaminergic genes in the heritability of withdrawn behavior. [ABSTRACT FROM AUTHOR]

We examined associations of disorganized attachment and maternal depressive symptoms with infant autonomic functioning in 450 infant-mother dyads enrolled in the Generation R study. Maternal depressive symptoms were measured 2 months postpartum with the Brief Symptom Inventory. At 14 months, we assessed infant attachment with a slightly shortened Strange Situation and measured infant resting heart rate. Respiratory sinus arrhythmia ( RSA) was calculated using spectral analysis. Higher levels of maternal postnatal depressive symptoms predicted lower resting RSA in disorganized infants ( B = −0.31, SE = 0.15, p = .04, R2 = .05) but not in nondisorganized infants ( B = 0.05, SE = 0.06, p = .36). This effect was buffered in disorganized infants with a secondary secure attachment classification. Disorganized infants were more vulnerable to the effect of maternal postnatal depressive symptoms on the physiological stress systems. [ABSTRACT FROM AUTHOR]

Background: Previous research highlights the significance of a functional polymorphism located in the promoter region (5-HTTLPR) of the serotonin transporter gene in emotional behaviour. This study examined the effect of the 5-HTTLPR polymorphism on emotion processing in a large number of healthy preschoolers. Methods: The 5-HTTLPR genotype was classified in 605 children as homozygous for the short allele (SS), homozygous for the long allele (LL), or heterozygous (LS). Emotion-processing was assessed using age-appropriate computer tasks where children matched happy, sad, angry, and fearful facial expressions preceded by a shape-matching task to assess basic matching ability. Results: We found that young children could differentiate between emotion categories ( F = 12.1, p < .001). The effect of 5-HTTLPR genotype depended on the emotion category presented ( F = 2.3, p = .031). This effect was explained by the finding that SS children were less accurate at recognising fearful faces than LL or LS children ( F = 5.3, p = .005). We did not find any significant differences as a result of 5-HTTLPR genotype for happy, sad or angry expressions ( p > .05). Conclusions: Results indicate that 5-HTTLPR allele status selectively impacts the processing of fearful but not other facial expressions. This pattern is already apparent in very young typically developing children. Results may signal an early vulnerability for affective problems before disorders emerge. [ABSTRACT FROM AUTHOR]

Juvenile bipolar disorder (JBD) has been a subject of significant research and debate. Phenotypic differences between JBD and adult-onset bipolar disorder have led researchers to question whether or not similar neuropathologic mechanisms will be found. While much is known about the genetic and environmental contributions to the adult-onset phenotype, less is known about their contributions to JBD. Here, we review family, twin, adoption, and molecular genetic studies of JBD. Behavioral genetic data suggest both genetic and environmental contributions to JBD, while molecular genetic studies find linkage to age of onset of bipolar disorder to chromosomes 12p, 14q, and 15q. Additionally, changes associated with symptom age of onset have been recently reported in the brain-derived neurotrophic factor (BDNF) and glycogen synthase kinase 3-beta (GSK3-beta) genes. We contend that further progress in discovering the precise genetic and environmental contributions to JBD may depend on advances in phenotypic refinement, an increased appreciation of comorbid conditions, and more investigation of the longitudinal course of the disorder. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a phenotypically heterogeneous and highly heritable syndrome, which commonly co-occurs with other psychiatry disorders. To assess the role of genetic influences in ADHD, we used latent class analysis (LCA) to identify subtypes of ADHD taking into account its comorbidity with separation anxiety, oppositional defiant disorder (ODD), and three major depression symptoms. A structured interview was used to collect diagnostic data from a population sample of 2904 adolescent female twins and their parents. LCA was applied to ADHD, separation anxiety, ODD symptom profiles obtained from the twins' parents, and major depression symptom profiles obtained from the twins' self-report. Odds ratios were used to test for familiality of class membership by examining the effect of zygosity on twin concordance within and between latent classes. Structural equation modeling was used to compute heritabilities for latent class membership. LCA revealed three ADHD categories of clinical interest: an inattentive subtype without comorbidity, a second inattentive subtype with increased number of ODD symptoms, and a combined inattentive/hyperactive-impulsive type with elevated levels of ODD, separation anxiety, and depressive symptoms. LCA also distinguished an ODD class and a separation anxiety class, each without increased levels of other comorbid symptoms; a second ODD class co-occurring with increased separation anxiety and depression symptoms; and a pure depression class. Odds ratios for MZ contrasted with DZ twin concordance for individual latent class membership ranged from 2.5 to 1924. Overall, 66% of MZ pairs, but only 36% of DZ pairs, were assigned to the same latent class, consistent with a genetic hypothesis for latent class membership. Individual class membership was shown to have high heritability ranging from .34-.85. The pattern of latent classes suggested that in the general female adolescent population, there are three highly heritable ADHD subtypes, two of which are comorbid with other disorders. These classes were consistent with a genetic hypothesis for ADHD, with each class potentially reflecting a unique genetic subtype. [ABSTRACT FROM AUTHOR]

Oestradiol is known to play an important role in the developing human brain, although little is known about the entire network of potential regions that might be affected and how these effects may vary from childhood to early adulthood, which in turn can explain sexually differentiated behaviours. In the present study, we examined the relationships between oestradiol, cortico‐amygdalar structural covariance, and cognitive or behavioural measures typically showing sex differences (verbal/spatial skills, anxious‐depressed symptomatology) in 152 children and adolescents (aged 6‐22 years). Cortico‐amygdalar structural covariance shifted from positive to negative across the age range. Oestradiol was found to diminish the impact of age on cortico‐amygdalar covariance for the pre‐supplementary motor area/frontal eye field and retrosplenial cortex (across the age range), as well as for the posterior cingulate cortex (in older children). Moreover, the influence of oestradiol on age‐related cortico‐amygdalar networks was associated with higher word identification and spatial working memory (across the age range), as well as higher reading comprehension (in older children), although it did not impact anxious‐depressed symptoms. There were no significant sex effects on any of the above relationships. These findings confirm the importance of developmental timing on oestradiol‐related effects and hint at the non‐sexually dimorphic role of oestradiol‐related cortico‐amygdalar structural networks in aspects of cognition distinct from emotional processes. [ABSTRACT FROM AUTHOR]