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Background: The aim was to study the comorbidity of oppositional defiant disorder (ODD) and anxiety disorders (AD) among preschool children of the general population, and to assess the contribution of comorbidity to the child's functional impairment., Method: 622 children were assessed at the ages of 3 and 5, through a diagnostic interview. They were clustered into three diagnostic groups: only ODD, only AD and comorbid ODD+AD., Results: At age 3, ODD was associated with specific phobia, OR = 4.7, 95% CI [1.4, 14.1], and at age 5, with any anxiety disorder, OR=3.9; 95% CI [1.8, 8.4]. ODD at age 3 was predictive of separation anxiety at age 5, OR=4.1; 95% CI [1.2, 14.3]. Comorbid ODD+AD cases showed a higher risk of functional impairment at school and in behavior toward others. Sex and socioeconomic status were not related to the diagnostic group., Conclusions: ODD+AD comorbidity can be identified in preschool children. Early identification of this association is needed to adequately treat the affected children.

Background: Oppositional defiant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents' psychopathology and ODD in preschoolers., Method: A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on children's psychopathology through a diagnostic interview, and on their own psychological state and parenting style through questionnaires., Results: At ages 3 and 5, corporal punishment mediated the relationships between mothers' anxiety-depression and ODD (in girls), between mothers' aggressive behavior and ODD (in boys), and between parents' rule-breaking and ODD both in boys and girls. For both sexes, there was a direct association between mothers' aggressive behavior score and ODD. The association between fathers' psychopathology and ODD was not mediated by the fathers' parenting practices. Fathers' anxiety-depression and aggressive behavior scores were directly associated with ODD., Conclusions: Parents' psychopathology must be explored and, in families where such psychopathology is a relevant variable, parenting practices must be addressed with a view to the prevention and treatment of children's ODD in the preschool years.

Purpose: The goal is to examine the prevalence, comorbidity and impairment of DSM-IV disorders in 3-year-old children from the Spanish general population., Method: A sample of 1,341 3-year-old preschoolers were randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semi-structured interview and functional impairment measures., Results: Prevalence of any diagnosis was 29.9%, the most prevalent disorders being primary insomnia (11.7%) and oppositional defiant disorder (ODD) (6.9%). There were no sex differences in the prevalence. One-third of the families had sought professional help for the child's symptoms, and 9.4% received treatment (4.4% psychological and 2.1% pharmacological). After controlling for other comorbidities, ADHD was significantly associated with ODD, CD, insomnia and social phobia; ODD was associated with CD, separation anxiety, specific phobia and major depression. Diagnostic categories were associated with impairment, family burden, seeking professional help and receiving treatment. A diagnosis was more frequent in children of low socioeconomic status, born outside Spain, from one-parent families, with younger parents and with parents of lower educational level., Conclusions: Psychopathology, comorbidity and associated factors are very frequent from age three, suggesting a need for efforts of detection, prevention and treatment in the different societies.

We provide the first validation data on the Strengths and Difficulties Questionnaire (SDQ(3-4)), a brief screening tool for behavioral and emotional problems, in preschool children. Parents of a community sample of 1341 Spanish 3-year-olds and teachers of a sample of 622 children responded to the SDQ(3-4) and different measures of psychopathology. Confirmatory factor analysis yielded adequate fit of the model to the original structure. Internal consistency (omega coefficient) for total scores was .87 for parents and .91 for teachers. Convergent validity of SDQ(3-4)-parents' reports with Achenbach's taxonomy and diagnostic interview was good, but low for SDQ(3-4)-teachers' reports. The SDQ(3-4) showed predictive accuracy for discriminating use of mental health services and functional impairment. This is the first work presenting empirical evidence of the reliability and validity of the parents' and teachers' SDQ(3-4) for preschoolers. The SDQ(3-4) presents acceptable psychometric properties for use in the identification of preschool children who might have behavioral or emotional problems., (Copyright © 2013 Elsevier Inc. All rights reserved.)

The aim was to examine the potential mediating role of father's and mother's parenting styles in the association between parental psychopathology and antisocial behavior in children, and whether this pathway was moderated by child's sex. Participants included both parents and 338 Spanish outpatient children between 8 and 17 years (56.5% boys). Parenting style had a mediating effect on the studied relationships. Maternal psychopathology was positively associated with antisocial behavior in children, either directly or partially by parenting style, while paternal psychopathology was positively associated with offspring antisocial behavior only through the mediator role of parenting style. Child's sex did not moderate these relationships. Parenting style could be a target for prevention and intervention of antisocial behavior in the offspring of parents with mental health problems.

Unlabelled: The Achenbach System of Empirically Based Assessment (ASEBA) is an example of the efforts to integrate categorical and dimensional assessment methods. The latest editions of the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) included the DSM-Oriented Scales, constructed in rational manner based on the items making up these inventories., Objective: To analyze the psychometric properties of the DSM-Oriented Scales of the CBCL and YSR., Method: A clinical sample of 420 children and adolescents (aged 8-17 years) was assessed with the CBCL and YSR, with a structured diagnostic interview and with measures of functional impairment to study the reliability and validity of the DSM-Oriented Scales., Results: Internal consistency ranged from moderate to good for all the scales except the DSM-Anxiety Problems Scale. Agreement between parents and children ranged between moderate and low values. Kappa coefficients showed moderate agreement in the different symptoms. The DSM-Oriented Scales presented acceptable diagnostic power for DSM-IV disorders and a significant relationship with measures of functional impairment., Conclusion: The DSM-Oriented Scales constitute a useful approach from the dimensional model to the DSM-IV disorders in Spanish clinical population.

There is a need for reliable and well-validated diagnostic measures for studying psychopathology in preschool and young children. The goal is to study the psychometric properties of the Diagnostic Interview for Children and Adolescents for Parents of Preschool and Young Children (DICA-PPYC) in the general population. A sample of 852 Spanish school children, aged 3 to 7 years, were randomly selected and screened for a double phase design. A total of 251 families were interviewed with the DICA-PPYC and 244 participated in a test-retest design. Different measures of psychopathology and functional impairment were also administered. Test-retest agreement with a mean interval of 8.8 days ranged from excellent to slight (kappa from 1 to 0.39) for DSM-IV-TR and from good to fair (kappa from 0.77 to 0.49) for Research Diagnostic Criteria-Preschool Age diagnoses. Attenuation between test and retest was not significant for the prevalence of diagnoses, although it was significant for the number of externalising and total symptoms in the interview. The diagnoses converged moderately with the CBCL and Dominic scores. The presence of diagnoses in the DICA-PPYC significantly differentiated preschoolers and young children who had used mental health services, were more impaired, and presented more severe psychopathology measured by dimensional scales. The DICA-PPYC is a reliable and valid semi-structured interview schedule for preschool and young children, and can serve to advance the knowledge and mental health care of this population., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The goal was to analyze the sex differences in symptoms, comorbidity and functional impairment in outpatient children with Oppositional Defiant Disorder (ODD). A sample of 343 children, aged 8 to 17 years and diagnosed with ODD, were assessed with a semi-structured diagnostic interview and dimensional measures of psychopathology and functional impairment. Boys with ODD more frequently displayed the symptoms "deliberately annoys" and "blames others", presented comorbid ADHD, and had greater functional impairment in school and community contexts; girls presented higher comorbidity with internalizing symptomatology (anxiety, depression and somatic complaints). Given that some clinical differences are apparent in ODD between boys and girls, it is necessary to consider the sex of the patient in order to identify and treat this disorder efficiently and effectively in boys and in girls.

Objective: Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV)., Method: Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations., Results: Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in children's psychopathology or functioning in this population., Implications: The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

This study examined the prevalence, degree of association and differential effect, by sex and age, of conduct disorder symptoms on psychopathology and functioning. Participants included 680 Spanish children and adolescents between 8 and 17 years and their parents, attending to psychiatric outpatient consultation. Data were obtained through structured diagnostic interviews, and other measures of psychopathological outcomes and functional impairment. In general, the prevalence of antisocial behavior did not differ significantly by sex or age. Results indicated a higher frequency for 13-17 year olds, and a greater number of symptoms in boys. Moreover, some symptoms of conduct disorder showed developmental variations. Sex and age differentially affected the expression of some conduct disorder symptoms and their associations with functional impairment and severity of psychopathology. Knowing the different expression of each symptom could help to identify these problems in clinical children and adolescents, contributing to an early detection of population at the highest risk of serious psychopathology and worse prognosis.