Search

Objective: To explore the scope of diagnosed eating disorders among Medicaid-insured youth in California, and to describe the demographic characteristics of this population in a repeated annual cross-sectional study design., Method: California Medicaid claims data were extracted for youth aged 7 to 18 years between January 2014 and December 2016. Participants included all youth who received an eating disorder diagnosis at any point in the study period (N = 8,075). Additional analyses compared youth with eating disorders who were continuously enrolled across all 3 years (n = 4,500) to random subsamples of continuously enrolled youth diagnosed with a mood or anxiety disorder (n = 4,128), a disruptive behavior disorder (n = 4,599), or a psychotic disorder (n = 4,290)., Results: About one-half of youth with eating disorders were Latinx (58.5%, n = 2,634) and indicated Spanish as their preferred language (48.9%, n = 2,199). About one-half (51%, n = 2,301) of eating disorder diagnoses were unspecified. Latinx ethnicity and Spanish language were significantly more frequent among youth with eating disorders than among those with other disorders (F 11.97 , F 362.75 , p values <.0005)., Conclusion: The first examination of publicly insured youth with eating disorders revealed a highly diverse group of individuals among whom Latinx youth were particularly prevalent. However, past-year national prevalence estimates suggest that most eating disorder cases were undiagnosed., Plain Language Summary: Eating disorders affect approximately 10% of the US population and lead to serious mental health and medical problems. This study used California Medicaid claims data from 2014 to 2016 to characterize the population of youth aged 7 to 18 years with diagnosed with an eating disorder (N = 8,075). The authors found the prevalence of eating disorders among youth aged 13 to 18 years was about 0.20% across all 3 years of the study, which is far below the expected prevalence and suggests that most eating disorders in youth go undiagnosed. About half of eating disorder diagnoses provided to youth with Medicaid insurance are unspecified, which may hinder receipt of appropriate treatment. Of youth with an eating disorder, about half were Latinx and reported Spanish as their preferred language. The authors also found differences in the prevalences of eating disorder diagnoses when analyzing youth by age, sex, and ethnicity. These results suggest that more standardized screening and assessment is needed to improve eating disorders detection and diagnosis, particularly for minoritized youth., (Copyright © 2023 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children's drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process., (© 2020 Family Process Institute.)

Parents of children with oppositional defiant disorder (ODD) experience greater stress in parenting and more parental depressive symptoms. The study examined the longitudinal and bidirectional associations between three dimensions of parenting stress (i.e., parental distress, parent-child dysfunctional interaction, and difficult child) and parental depressive symptoms from a sample of Chinese parents of children with or without ODD. The sample included 256 parents of children with ODD and 265 parents of children without ODD, along with children's teachers. Using a three wave, cross-lagged design, results showed that parents of children with ODD suffered higher levels of parenting stress across three dimensions. For both groups, the links between parental depressive symptoms and subsequent parental distress and difficult child were unidirectional, whereas the relation between parental depressive symptoms and parent-child dysfunctional interaction was bidirectional. Multi-group analysis found that there was no significant difference in the relations between parenting stress and depressive symptoms between the ODD and non-ODD groups. The findings indicated that children with ODD require comprehensive services to address the stress of their parents. The study also provided support for the dynamic and longitudinal relations between specific dimensions of parenting stress and depressive symptoms among parents of children with or without ODD.

North American Indigenous (i.e., American Indian and Canadian First Nations) youth experience inequities in rates of substance abuse and dependence. Despite this, few longitudinal studies examine the developmental course of substance use disorders (SUD) among community-based samples of Indigenous youth. The purpose of the study was to examine onset and predictors of nicotine dependence, alcohol use disorders, marijuana use disorders, any SUD, and multiple SUDs across the entire span of adolescence among a longitudinal sample (N = 744) of reservation/reserve Indigenous youth in the upper-Midwest of the United States and Ontario, Canada. Using discrete time survival analysis, the results show that rates of meeting criteria for SUDs by late adolescence were 22% for nicotine, 43% for alcohol, and 35% for marijuana. Peak periods of risk for new nicotine dependence and marijuana use disorder cases occurred around 14 years of age, whereas peak periods of risk for new alcohol use disorder cases emerged slightly later around 16 years of age. We found high rates of SUD comorbidity, and the cumulative probability of developing two or more SUDs during adolescence was 31%. Internalizing disorders increased the odds of nicotine dependence and multiple SUDs, while externalizing disorders increased the odds of all outcomes except nicotine dependence. Gender, age, and per capita family income were inconsistently associated with SUD onset. The findings are embedded within broader substance use patterns identified among Indigenous youth, and prevention, intervention, and treatment implications are discussed.

Research suggests that callous unemotional (CU) traits are associated with poor emotion recognition due to impairments in attention to relevant emotional cues. To further investigate the mechanisms that underlie CU traits, this study focused on the relationship between levels of CU and children's attention to, and recognition of, facial emotions. Participants were 7- to 10-year-old Italian boys, 35 with a diagnosis of Disruptive Behavior Disorder (age: M = 8.93, SD = 1.35), and 23 healthy male controls (age: M = 8.86, SD = 1.35). Children viewed standardized emotional faces (happiness, sadness, fear, disgust, anger, and neutral) while eye-tracking technology was used to evaluate scan paths for each area of interest (eyes, face, mouth), and for each emotion. CU traits were assessed using parent and teacher ratings on the Antisocial Process Screening Device. In the whole sample, elevated levels of CU traits were associated with a lower ability to recognize sadness, a lower number of fixations, and a lower average length of each fixation, specifically to the eye area of sad faces. In children with Disruptive Behavior Disorder diagnoses, high levels of CU traits were associated with lower duration of fixations to the eye-region on the eye area of sad faces, which in turns predicted lower levels of sadness recognition. The findings confirm that poor emotion recognition is associated with impairments in attention to critical information about other people's emotions. The clinical implications are discussed., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Parents of children with oppositional defiant disorder (ODD) experience considerable stress and challenges in parenting. Based on a 2-year, 3-wave longitudinal study of children with ODD (N = 243, mean age = 9.47 years, SD = 1.53; 72.8% boys) and their parents in Mainland China, our study examined the relation between 3 dimensions of parenting stress (i.e., Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child) and their children's ODD symptoms. Using cross-lagged panel models, we tested the bidirectional relation between parenting stress and children's ODD symptoms. We found evidence for both parent-driven and child-driven effects. Specifically, Parent-Child Dysfunctional Interaction (PCDI) at T2 positively predicted children's ODD symptoms at T3. Moreover, children's ODD symptoms at T1 positively predicted parental perceptions of Difficult Child and PCDI at T2. Further, children's ODD symptoms at T2 positively predicted all 3 dimensions of parenting stress at T3. Further, multiple-group path analysis by child's gender suggested that PCDI had a significant negative relation with girls' (but not boys') ODD symptoms from T1 to T2 and had a significant positive relation with boys' (but not girls) ODD symptoms from T2 to T3. These findings provided support for the dynamic relations among parenting stress, parent-child interaction, and children's ODD symptoms and highlighted the different effects of child gender in the parent-child interaction process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Background: Oppositional defiant disorder (ODD) is a behavioral disorder that mainly refers to a recurrent pattern of disobedient, defiant, negativistic and hostile behaviors toward authority figures. Previous studies have showed associations of serotonin transporter (5-HTT) and monoamine oxidase A (MAOA) with behavioral and psychiatric disorders. The purposes of this study were to investigate the potential association of 5-HTT gene promoter polymorphism (5-HTTLPR) and MAOA gene polymorphism with susceptibility to ODD in a Han Chinese school population., Methods: The 5-HTTLPR gene polymorphism and the MAOA gene polymorphism were genotyped in a case-control study of 257 Han Chinese children (123 ODD and 134 healthy controls)., Results: There was significant difference in the allele distribution of 5-HTTLPR (χ 2  = 7.849, P = 0.005) between the ODD and control groups. Further, there were significant differences in genotype (χ 2  = 5.168, P = 0.023) and allele distributions (χ 2  = 10.336, P = 0.001) of the MAOA gene polymorphism that is variable-number tandem repeat (MAOA-uVNTR) between two groups. Moreover, there were significant differences in genotype (χ 2  = 4.624, P = 0.032) and allele distributions (χ 2  = 9.248, P = 0.002) of MAOA-uVNTR only in the male ODD and healthy groups., Conclusions: Our results suggest that 5-HTTLPR and MAOA-uVNTR gene variants may contribute to susceptibility to ODD. Further, MAOA-uVNTR gene polymorphism may play a role in susceptibility to ODD only in male children.

Objective: This study examined the prevalence and correlates of anxiety disorders in Chinese children with ADHD., Method: Overall, 120 children with ADHD aged 6 to 12 years were recruited, and the parent version of computerized Diagnostic Interview Schedule for Children-Version 4 was administrated to their primary caretakers., Results: The prevalence rate of anxiety disorders was 27.5%, which is consistent with the reports of previous Asian and Western studies. Among the children with ADHD and anxiety disorders, more than 50% of them also had comorbid oppositional defiant disorder or conduct disorder (ODD/CD), which yielded an adjusted odds ratio of 3.0 in multivariable analysis for anxiety disorder, with comorbid ODD/CD. In addition, anxiety disorders were positively associated with inattention symptoms in children with both disorders., Conclusion: Clinicians should perform screening and careful assessment for anxiety symptoms in children with ADHD, particularly those suffering from comorbid ODD/CD.

The current study examined differences in working memory (WM) between monolingual and bilingual Hispanic/Latino preschoolers with disruptive behavior disorders (DBDs). A total of 149 children (M age  = 5.10 years, SD = 0.53; 76% male) with elevated levels of DBDs, as indicated by their parents or teachers, were recruited to participate in an 8-week summer program prior to the start of kindergarten (Summer Treatment Program for Pre-Kindergarteners). Prior to the start of treatment, parents completed several measures about their children's behavior and executive function, and children were administered two subtests of the Automated Working Memory Assessment to examine their current WM capabilities. After controlling for demographic variables (i.e., age, sex, socioeconomic status, IQ, and diagnostic status), no significant differences were observed between bilingual and monolingual children in verbal WM performance (β = .03, p > .05). However, children who were bilingual did perform better than monolinguals on spatial WM tasks (β = .23, p < .01). Finally, parent reports of WM corroborated these findings such that bilingual children were reported as having fewer WM problems by parents (β = -.19, p < .05) and teachers (β = -.22, p < .05). Whereas WM deficits are often found among children with DBDs, the current findings suggest that bilingualism may serve as a protective factor for preschoolers with DBDs., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To examine the validity of sluggish cognitive tempo (SCT) and ADHD-inattention (ADHD-IN) symptoms in children from Chile., Method: Mothers and teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (ADHD-HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection (teachers only) in 652 Chilean children (55% boys) aged 6 to 14 years., Results: For both mother and teacher ratings, the eight SCT symptoms and nine ADHD-IN symptoms showed substantial loadings on their respective factors (convergent validity) along with loadings close to zero on the alternative factor (discriminant validity). ADHD-IN showed a uniquely stronger relationship than SCT with ADHD-HI and ODD whereas SCT showed a uniquely stronger relationship than ADHD-IN with anxiety and depression. Although ADHD-IN uniquely predicted academic impairment and social difficulties, SCT did not., Conclusion: This study provides the first evidence for the validity of SCT among children outside of North America or Western Europe.

Background: Children with chronic non-episodic irritability were frequently diagnosed as suffering from pediatric bipolar disorder. Therefore in DSM-5 a new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) was included for such children., Aims: This study aimed to identify DMDD in children and adolescents in Indian child and adolescent psychiatry clinic and elicit its phenomenology and co-morbidities., Methods: Children of 6-16 years, presenting with irritability for more than one year were assessed using DSM 5 diagnostic criteria to make a diagnosis of DMDD. Severity of irritability was assessed using Affective Reactivity index (ARI). Co-morbidities were screened on Kiddie Schedule for Affective Disorders and Schizophrenia present and lifetime version (KSADS-PL) and diagnosed as per DSM-IV TR criteria. Overall behavioral problems were assessed on Conner's parent symptom questionnaire (CPSQ) and impairment in functioning on children's global assessment of functioning scale(C-GAS)., Results: 21 subjects were diagnosed with DMDD. Majority of the subjects (15, 71.4%) were in the age group 6-12 years (mean age11.1±2.9 years) and were males (16, 76.2%). Most common presenting complaints were, frequent irritability and anger outbursts in 21 (100%) and inattention towards studies in 20 (95.2%) subjects. Most of the subjects (18, 85.7%) had moderate to severe irritability. 13 (61.9%) subjects had co-morbidities. Mean CGAS was 46.1±6.9., Conclusion: DMDD can be diagnosed in Indian children using DSM 5 criteria. Such children presented with complaints of irritability and problems in studies. They commonly had co-morbidities and had moderate impairment of functioning., (Copyright © 2016. Published by Elsevier B.V.)

The factor structure and potential uniform differential item functioning (DIF) among gender and three racial/ethnic groups of adolescents (African American, Latino, White) were evaluated for attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) symptom scores of the DISC Predictive Scales (DPS; Leung et al., 2005; Lucas et al., 2001). Primary caregivers reported on DSM-IV ADHD, CD, and ODD symptoms for a probability sample of 4,491 children from three geographical regions who took part in the Healthy Passages study (mean age = 12.60 years, SD = 0.66). Confirmatory factor analysis indicated that the expected 3-factor structure was tenable for the data. Multiple indicators multiple causes (MIMIC) modeling revealed uniform DIF for three ADHD and 9 ODD item scores, but not for any of the CD item scores. Uniform DIF was observed predominantly as a function of child race/ethnicity, but minimally as a function of child gender. On the positive side, uniform DIF had little impact on latent mean differences of ADHD, CD, and ODD symptomatology among gender and racial/ethnic groups. Implications of the findings for researchers and practitioners are discussed., ((c) 2015 APA, all rights reserved).)

Race/ethnic disparities in utilization of children's mental health care have been well documented and are particularly concerning given the long-term risks of untreated mental health problems (Institute of Medicine, 2003; Kessler et al. Am J Psychiatry 152:10026-1032, 1995). Research investigating the higher rates of unmet need among race/ethnic minority youths has focused primarily on policy, fiscal, and individual child or family factors that can influence service access and use. Alternatively, this study examines provider behavior as a potential influence on race/ethnic disparities in mental health care. The goal of the study was to examine whether patient (family) race/ethnicity influences physician diagnostic and treatment decision-making for childhood disruptive behavior problems. The study utilized an internet-based video vignette with corresponding survey of 371 randomly selected physicians from across the USA representing specialties likely to treat these patients (pediatricians, family physicians, general and child psychiatrists). Participants viewed a video vignette in which only race/ethnicity of the mother randomly varied (non-Hispanic White, Hispanic, and African American) and then responded to questions about diagnosis and recommended treatments. Physicians assigned diagnoses such as oppositional defiant disorder (48 %) and attention deficit disorder (63 %) to the child, but there were no differences in diagnosis based on race/ethnicity. The majority of respondents recommended psychosocial treatment (98 %) and/or psychoactive medication treatment (60 %), but there were no significant differences based on race/ethnicity. Thus, in this study using mock patient stimuli and controlling for other factors, such as insurance coverage, we did not find major differences in physician diagnostic or treatment decision-making based on patient race/ethnicity.

Background: The relationship between behavioral problems and obesity in early childhood in Latinos is largely unknown., Methods: Cross-sectional anthropometric and behavioral data of children at three years of age were gathered from a cohort of 174 children of Latina mothers at two San Francisco hospitals. Child behaviors were assessed using the preschool Child Behavior Checklist (CBCL/1½-5). Logistic regression was used to analyze the association between behavior and obesity., Results: At three years, 27.7% were obese. There were no associations between affective (OR = 1.89; 95% confidence interval [CI] 0.42-8.59), anxiety (OR = 1.86; 95% CI 0.53-6.47), pervasive developmental (OR = 0.42; 95% CI 0.13-1.36), attention deficit hyperactivity (OR = 0.58; 95% CI 0.12-2.76), or oppositional defiant (OR = 6.49; 95% CI 0.65-64.49) problems and obesity., Conclusions: Though psychological problems and obesity are associated among older children and adolescents, there was no association in Latino three-year olds in a low-income sample.

Purposes: Racial/ethnic differences in mental health service utilization were examined among youth who reported participating in negative externalizing behaviors., Methods: The study utilized merged data from the 2007-2010 National Survey on Drug Use and Health (NSDUH) to examine differences in utilization of inpatient or outpatient mental health services not related to substance or alcohol use by White, Black and Hispanic youth who reported engaging in negative externalizing behaviors ("acting out"). Differences in service utilization in these groups were assessed using logistic regression models., Results: Race/ethnicity was a significant predictor of outpatient mental health service use. Black and Hispanic children were less likely to use outpatient services. Inpatient service use decreased with increasing income. Parental presence in the household increased the likelihood of outpatient service use for minorities., Conclusion: Racial/ethnic minority youth in the United States continue to use outpatient mental health services at lower rates. This may lead to high prevalence of untreated negative externalizing behaviors among minority adolescent groups and, in turn, lead to use of inpatient services from systems such as juvenile justice and foster care. Such severe treatment alternatives can be prevented if timely and culturally tailored outpatient intervention is provided.

Disruptive behavior problems (DBP) represent a growing concern for young women (e.g., Snyder and Sickmund, 2006), but gender-specific investigations have been traditionally underrepresented in this area. The purpose of this study is to examine the associations among gender-relevant risk factors for DBP among 217 African American girls in psychiatric care. African American girls, 12-16 years old (M = 14.6; SD = 1.2), and their primary female caregivers (N = 254) were recruited from outpatient mental health clinics and reported on girls' DBP, heterosexual dating experiences (romantic and sexual), peer relationships, pubertal development, and self-silencing at baseline, 6-, and 12 months. Structural Equation Modeling examined evidence for full versus mediated (via self-silencing) models and the structural relationships (direct and indirect) among key study variables. Results suggest that the full model was a significantly better fit than the mediated model as indicated by a Chi-squared difference test (p < 0.01). In the full model, direct effects of greater romantic dating experiences and lower quality peer relationships at baseline predicted DBP at 12 months. Sexual dating experiences were more strongly linked with DBP at 12 months for early maturing compared to average or later maturing girls. Indirect effects analyses suggested that girls' suppression of relational needs, assessed through a measure of self-silencing, explained the association between peer relationships and DBP. Findings highlight the importance of the relational context for girls' DBP, with treatment implications supporting relationship-based models of care, early intervention, and skill building around negotiating needs with peers and partners.

Background: The study examined the measurement equivalence for teacher ratings across Malaysian Malay, Chinese and Indian children., Methods: Malaysian teachers completed ratings of the ODD symptoms for 574 Malay, 247 Chinese and 98 Indian children., Results: The results supported the equivalences for the configural, metric, and error variances models, and the equivalences for ODD latent variances and mean scores., Discussion: Together, these findings suggest good support for measurement and structural equivalences of the ODD symptoms across these ethnic groups. The theoretical and clinical implications of the findings for cross-cultural equivalence of the ODD symptoms are discussed., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Introduction: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia., Methods: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively., Results: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior., Discussions: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The discourse on Black boys tends to suggest that Black boys are in complete peril. We begin with evidence that Black boys are excelling in certain contexts (i.e., in certain states, in certain schools, and in certain courses). We then discuss the ways in which the narratives used by parents, teachers, and Black boys themselves may serve to further reinforce views that Black boys are beyond hope. Research on Black parents suggests that they tend to view their sons as vulnerable and have lower expectations for sons than for daughters. Studies of teachers show that they tend to view Black boys as unteachable, as social problems, and as scary. Research on Black boys shows that they are sometimes complicit in supporting these narratives by engaging in negative or ste reotypical behavior. We also include recent research that includes counter-narratives of Black boys. We end with suggestions for future research.

To explore behavioral differences as possible cultural factors in presentation of psychiatric comorbidity in two clinically referred, consecutively ascertained samples of youth with Tourette's disorder (TD) from New York and Buenos Aires. Subjects were evaluated between 2002 and 2010 at the Tics and Tourette's Clinical and Research Program at the New York University Child Study Center in New York and the Interdisciplinary Center for Tourette's, Obsessive Compulsive Disorder (OCD) and Associated Disorders (CITTTA)/Institute of Cognitive Psychology (INECO) in Buenos Aires. Demographic, diagnostic, tic severity (Yale Global Tic Severity Scale; YGTSS), clinical (Child Behavior Check List-Parent version; CBCL), and global functioning (Global Assessment of Functioning; GAF) data were compared using descriptive statistics. The sample included 111 subjects ages 6-17 years, who met DSM-IV-TR diagnostic criteria for TD. Findings revealed that the BA sample (n = 35) was significantly older at initial evaluation at the tic specialty clinic, and had higher frequency of oppositional defiant disorder (ODD), mood and non-OCD anxiety disorders than the NY sample (n = 76). There were no differences in gender distribution, age at tic onset or TD diagnosis, tic severity, proportion with current diagnoses of OCD/OC behavior or attention deficit hyperactivity disorder (ADHD), CBCL internalizing, externalizing, or total problems scores, YGTSS scores, or GAF scores. The observed similarities in demographic features, clinical presentation, rates of ADHD and OCD/OCB, and global impairment may reflect similar phenomenology and illness-related characteristics of TD in these referred youth. Differences in age at initial specialty clinic evaluation and rates of ODD, mood and non-OCD anxiety disorders may need further exploration before they may be considered to reflect cultural factors. Because of these limitations (e.g. small sample size), these results can be regarded only as preliminary.

This study examined the cross-racial measurement equivalence of the three Eyberg Child Behavior Inventory Intensity Scale factors, found by Stern and Johnson: Oppositional Defiant Behavior, Attention Difficulties, and Conduct Problems. Cross-racial measurement equivalence was examined between 278 low-income African American and 119 non-Latino White children aged 3 to 6 years. Results did not support configural equivalence of the three subscales between groups. Exploratory factor analyses conducted separately for each racial group showed support for a single factor structure in both groups. Convergent validity of the Intensity Scale was found separately for both groups. Findings suggest the three Intensity Scale factors should not be used to screen or compare treatment outcomes of specific externalizing behavior problems among community samples that include low-income non-Latino White and African American preschoolers.

Background: Prenatal exposure to methylmercury (MeHg) and polychlorinated biphenyls (PCBs) has been associated with impaired performance on attention tasks in previous studies, but the extent to which these cognitive deficits translate into behavioral problems in the classroom and attention deficit/hyperactivity disorder (ADHD) remains unknown. By contrast, lead (Pb) exposure in childhood has been associated with ADHD and disruptive behaviors in several studies., Objectives: In this study we examined the relation of developmental exposure to MeHg, PCBs, and Pb to behavioral problems at school age in Inuit children exposed through their traditional diet., Methods: In a prospective longitudinal study conducted in the Canadian Arctic, exposure to contaminants was measured at birth and at school age. An assessment of child behavior (n = 279; mean age = 11.3 years) was obtained from the child's classroom teacher on the Teacher Report Form (TRF) from the Child Behavior Checklist, and the Disruptive Behavior Disorders Rating Scale (DBD)., Results: Cord blood mercury concentrations were associated with higher TRF symptom scores for attention problems and DBD scores consistent with ADHD. Current blood Pb concentrations were associated with higher TRF symptom scores for externalizing problems and with symptoms of ADHD (hyperactive-impulsive type) based on the DBD., Conclusions: To our knowledge, this study is the first to identify an association between prenatal MeHg and ADHD symptomatology in childhood and the first to replicate previously reported associations between low-level childhood Pb exposure and ADHD in a population exposed to Pb primarily from dietary sources.

The objective of this study is to see whether Immigrant (IM) and Spanish (National) students (SP) need different kinds of help from teachers due to differences in motivation, family expectancies and interests and classroom-motivational-climate perception. A sample of Secondary Students -242 Spanish and 243 Immigrants- completed questionnaires assessing goal orientations and expectancies, family attitudes towards academic work, perception of classroom motivational climate and of its effects, satisfaction, disruptive behavior and achievement. ANOVAs showed differences in many of the motivational variables assessed as well as in family attitudes. In most cases, Immigrant students scored lower than Spanish students in the relevant variables. Regression analyses showed that personal and family differences were related to student's satisfaction, achievement and disruptive behavior. Finally, multi-group analysis of classroom-motivational-climate (CMC) showed similarities and differences in the motivational value attributed by IM and SP to each specific teaching pattern that configure the CMC. IM lower self-esteem could explain these results, whose implications for teaching and research are discussed.

This study presents an evaluation of the diagnostic accuracy and concurrent validity of Direct Behavior Rating Single Item Scales for use in school-based behavior screening of second-grade students. Results indicated that each behavior target was a moderately to highly accurate predictor of behavioral risk. Optimal universal screening cut scores were also identified for each scale, with results supporting reduced false positive rates through the simultaneous use of multiple scales., ((c) 2012 APA, all rights reserved.)

This study evaluated the effects of abuse potential in parents on subsequent coping competence domains in their children, using a model empirically supported in a high-risk community sample by Moreland and Dumas (2007). Data from an ethnically diverse sample of 579 parents enrolled in the PACE (Parenting Our Children to Excellence) program was used to evaluate whether parental child abuse potential assessed at pre-intervention negatively contributed to child affective, achievement, and social coping competence in preschoolers one year later, and whether these associations were moderated by sex or ethnicity. Cross-sectional results indicated that parental child abuse potential was negatively related to child affective and achievement coping competence, after accounting for variance associated with child behavior problems. However, child abuse potential was not predictive of subsequent coping competence in any domain after controlling for previous levels of child coping competence. No moderating effects were found for sex and ethnicity, but results showed main effects of sex and ethnicity in cross-sectional analyses. Clinical implications and future directions are discussed., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

An accumulation of research evidence suggests that early pubertal timing plays a significant role in girls' behavioral and emotional problems. If early pubertal timing is a problematic event, then early developing Black girls should manifest evidence of this crisis because they tend to be the earliest to develop compared to other girls from different racial and ethnic groups. Given the inconsistent findings among studies using samples of Black girls, the present study examined the independent influence of perceived pubertal timing and age of menarche on externalizing behaviors and depressive symptoms in a nationally representative sample of Black girls (412 African American and 195 Caribbean Black; M = 15 years). Path analysis results indicated that perceived pubertal timing effects on externalizing behaviors were moderated by ethnic subgroup. Caribbean Black girls' who perceived their development to be early engaged in more externalizing behaviors than Caribbean Black girls' who perceived their development to be either on-time or late. Age of menarche did not significantly predict Black girls' externalizing behaviors and depressive symptoms. The onset of menarche does not appear to be an important predictor of Black girls' symptoms of externalizing behavior and depression. These findings suggest ethnic subgroup and perceived pubertal timing are promising factors for better understanding the adverse effects of early perceived pubertal timing among Black girls.

The purpose was to describe the social adjustment, academic achievement, and creativity of 127 Taiwanese children with Tourette's Syndrome and a control group of 138 Taiwanese children with typical development and reports of the parents of both groups. The Tourette's Syndrome group had significantly more disruptive behaviors than the controls; most parents reported their children with Tourette's Syndrome had high academic achievement although the children scored significantly lower than controls on the Elaboration subtest of Creative Thinking.

Objective: Children of depressed and/or anxious parents are at increased risk for developing psychiatric disorders. Little research has focused on screening parents bringing their children for psychiatric evaluation, and few studies have included fathers or Hispanic children. This study had the following aims: 1) to identify current symptom rates in parents bringing their children for evaluation; and 2) to determine whether parental symptoms were associated with children's symptoms, diagnoses, and functioning., Method: The sample included 801 mothers, 182 fathers, and 848 children (aged 6 through 17 years). The majority (55.66%) were Hispanic, who attended a child and adolescent psychiatric evaluation service. Parent and child symptoms were assessed via parental reports. Children's diagnoses and functioning were determined by clinicians. Multiple regression analyses were used to determine whether severity of parental symptoms was associated with clinical child variables adjusting for child and parent demographic variables., Results: In all, 18.80% of mothers and 18.42% of fathers reported elevated internalizing symptoms. Maternal symptoms were significantly associated with problems in children's functioning and children's anxiety, depression, and oppositional/conduct diagnoses; but not attention-deficit/hyperactivity disorder. Adjusting for parental and child demographics had a reduction on the effect of maternal symptoms on child depression. Paternal symptoms and functioning were positively associated with children's diagnoses, but the associations were smaller and not significant. Both parents' symptoms were significantly associated with children's internalizing and externalizing symptoms. However, these significant effects were not moderated by marital status or child ethnicity., Conclusions: This study highlights the importance of screening parents when their children receive a psychiatric evaluation. The findings support the development of mental health services that address psychiatric needs of the entire family within one clinical setting., (Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

This study examines the relationship between school discipline and student classroom behavior. A traditional deterrence framework predicts that more severe discipline will reduce misbehavior. In contrast, normative perspectives suggest that compliance depends upon commitment to rules and authority, including perceptions of fairness and legitimacy. Using school and individual-level data from the National Education Longitudinal Study of 1988 and multilevel regression modeling, the author finds support for the normative perspective. Students who perceive school authority as legitimate and teacher–student relations as positive are rated as less disruptive. While perceptions of fairness also predict lower disruptions, the effects are mediated by positive teacher–student relations. Contrary to the deterrence framework, more school rules and higher perceived strictness predicts more, not less, disruptive behavior. In addition, a significant interaction effect suggests that attending schools with more severe punishments may have the unintended consequence of generating defiance among certain youth.

This project describes the dissemination of an evidence-based parenting skills intervention by training social and health workers with little or no mental health background so that they themselves train mothers of children with behavioral problems in impoverished communities in a developing country. The Strengths and Difficulties Questionnaire was completed by mothers to screen for children with behavioral problems and was repeated at the end of the intervention. Pre- and post-tests of knowledge and parenting attitudes were administered to mothers. Mental health workers trained social and health workers in social development centers and dispensaries. Each social and health worker trained mothers of children with behavioral problems under supervision utilizing an Arabic adaptation of the treatment manual for externalizing disorders "Helping Challenging Children" developed by the Integrated Services Taskforce of the World Psychiatric Association Child Mental Health Presidential Programme. A total of 20 workers and 87 mothers participated in the training. The proportion of children who obtained an SDQ total difficulties score in the abnormal range decreased from 54.4 to 19.7% after the training. Whereas 40.2% of mothers used severe corporal punishment with their children before the intervention, this decreased to 6.1% post-intervention. Three-fourths of mothers related that the program helped them develop new parenting skills. This pilot project demonstrated the feasibility of dissemination of a manual-based intervention and training of workers who have little background in mental health to offer effective services to families in impoverished communities who otherwise would have not received them. Successful replication in other developing countries would pave the way to incorporating such programs in national policies given their potential sustainability and cost-effectiveness.

Confirmatory factor analysis was used with a multitrait (attention-deficit/hyperactivity disorder-inattention, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, oppositional defiant disorder toward adults, academic competence, and social competence) by multisource (mothers and fathers) matrix to test the invariance and convergent/discriminant validity of the 5-factor model between mothers' and fathers' ratings of Thai adolescents (Year 1: n = 872; Year 2: n = 903; Year 3: n = 700; Year 4: n = 984) with the Child and Adolescent Disruptive Behavior Inventory (G. L. Burns, T. Taylor, & J. Rusby, 2001). The results showed equality of like-item loadings, intercepts, and residuals, as well as like-factor variances, covariances, and means between mothers' and fathers' ratings within each of the 4 yearly samples. In addition, the between-parent factor correlations showed convergent and discriminant validity with the within-parent factor correlations, showing discriminant validity for each year as well. These results for Thai adolescents and similar results (G. L. Burns et al., 2008) for mothers' and fathers' ratings of Brazilian, Thai, and American children provide broader support for the construct validity of the scale. The confirmatory factor analysis invariance and convergent/discriminant validity procedure with multiple sources is considered to provide a much more sophisticated procedure to evaluate the construct validity of attention-deficit/hyperactivity disorder and oppositional defiant disorder rating scales than a single-source approach.

Connections between adolescents' social information processing (SIP), moral reasoning, and emotion attributions and their reactive and proactive aggressive tendencies were assessed. One hundred mostly African American and Latino 13- to 18-year-olds from a low-socioeconomic-status (SES) urban community and their high school teachers participated. Reactive aggression was uniquely related to expected ease in enacting aggression, lower verbal abilities, and hostile attributional biases, and most of these connections were mediated by adolescents' attention problems. In contrast, proactive aggression was uniquely related to higher verbal abilities and expectations of more positive emotional and material outcomes resulting from aggression. Discussion focused on the utility of assessing both moral and SIP-related cognitions, and on the potential influence of low-SES, high-risk environments on these findings.

The aims of this study were threefold: (1) to compare prevalence of sensory regulation dysfunction based on previously established criteria to rates established with a more representative community sample of 796 4-year-olds; (2) to examine ethnic/racial and gender differences in prevalence according to the different criteria; and (3) to examine the co-occurrence of sensory regulation dysfunction and preschool psychiatric disorders. Prevalence rates ranged from 3.4% (current criteria) to 15.6% (previous criteria). In contrast to previous studies with less representative samples, there were no significant ethnic or racial differences using the current criteria. Boys were more likely to have sensory regulation dysfunction than girls according to all criteria. Depending upon impairment criteria used, 33-63% of children meeting criteria for sensory dysregulation also had a psychiatric disorder; 37-67% had only a sensory dysregulation disorder, indicating that sensory regulation dysfunction exists independent of psychiatric disorder, and is also a significant risk factor for disorder.

Objectives: To examine the psychometric properties of the Chinese version of Swanson, Nolan and Pelham IV Scale (SNAP-IV)-Teacher Form., Methods: The sample included a representative sample of 3,653 first to eighth graders (boys, 52.3%) and 190 children diagnosed with ADHD (aged 6-15). Teachers completed the Chinese versions of the SNAP-IV, and Strengths and Difficulties Questionnaire., Results: The confirmatory factor analysis revealed a four-factor structure (inattention, hyperactivity, impulsivity, and opposition) with an adequate fit (Comparative Fit Index = 0.990; root mean square error of approximation = 0.058). The test-retest reliability (intraclass correlations = 0.60-0.84), internal consistency (alpha = .88-.95), and concurrent validity (Pearson correlations = 0.61-0.84) were satisfactory. Children with both ADHD and oppositional defiant/conduct disorders had the highest scores, followed by children with ADHD only who had intermediate scores and then school-based participants who had the lowest scores., Conclusions: Our findings suggest that the Chinese SNAP-IV-Teacher Form is a reliable and valid instrument for rating ADHD and oppositional symptoms (ClinicalTrials.Gov number, NCT00491361).

African Americans are over-represented in school suspensions, yet little is known about the underlying contributing dynamics. Study 1 reviewed a high school's annual discipline data and 442 students referred for defiance. African Americans were over-represented in referrals for defiance and most students received referrals from one or several teachers. This suggests that defiance referrals are specific to the classroom situation. Examining the situational specificity of referrals, Study 2 used repeated measures and multilevel modeling with a sub-sample of 30 African American students. Attendance, grades, and teacher reports showed that students behaved more defiantly and less cooperatively with teachers perceived as having untrustworthy authority. Predictors of African American student trust in teacher authority included teacher caring and high expectations, offering implications for lowering the discipline gap.

Theoretical models suggest that child behaviors influence parenting behaviors, and specifically that unpleasant child behaviors coerce parents to discontinue engaging in appropriate discipline. This study examined reciprocal relationships between parenting behaviors (supervision, communication, involvement, timid discipline and harsh punishment) and child disruptive disorder symptoms (ADHD, ODD and CD) in a clinic-referred sample of 177 boys. Annual measures, including structured clinical interviews, were obtained from the beginning of the study (when boys were between the ages of 7 to 12) to age 17. Specific reciprocal influence was observed; only timid discipline predicted worsening behavior, namely ODD symptoms, and ODD symptoms predicted increases in timid discipline. Greater influence from child behaviors to parenting practices was found: ODD also predicted poorer communication and decreased involvement, and CD predicted poorer supervision. ADHD was neither predictive of, nor predicted by, parenting behaviors. The results are specifically supportive of a coercive process between child behaviors and parenting behaviors, and generally suggestive of greater influence of child behaviors on parenting behaviors than of parenting behaviors on child behaviors.

The purpose of the study was to examine social functioning and adjustment in peer context in Chinese Canadian and European Canadian children. A sample of elementary school children participated in the study. Data on social functioning, peer acceptance and rejection, and victimization were collected from peer assessments and sociometric nominations. The results indicated that Chinese Canadian children were viewed by peers as less aggressive-disruptive than European Canadian children. Chinese Canadian girls, but not boys, were more shy-sensitive than their European Canadian counterparts. Sociability was associated with peer acceptance, whereas aggression was associated with peer rejection and victimization. Shyness was associated with peer relationship difficulties more evidently in European Canadian children than in Chinese Canadian children. These results indicate the relevance of ethnic background to children's peer social experiences.

This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal self-injury only (NSSI only; n = 30), suicide attempt only (n = 38), and suicide attempt plus NSSI (n = 40). Those who attempted suicide were more likely to have major depressive disorder and/or posttraumatic stress disorder than those who engaged in NSSI only. Those who engaged in any type of DSH were more likely to have features of borderline personality disorder than those who did not engage in DSH. The suicidal ideation levels of those in the NSSI group were similar to those in the NoDSH group. Findings offer empirical support for the importance of distinguishing between suicidal and nonsuicidal self-harm behaviors.

Objective: Most screening instruments for externalizing disorders have been developed and validated in Western children. We developed and validated a brief screening instrument for predicting externalizing disorders in native Dutch children as well as in non-Dutch immigrant children, using predictors that can be easily obtained from teachers., Method: Teachers completed the Strengths and Difficulties Questionnaire for an ethnic diverse sample of 2,185 children ages 6 to 10 years. In a stratified subsample, 254 children and their parents were additionally interviewed regarding psychiatric disorders and sociodemographic data. In this group, stepwise logistic regression was used to derive a score from sex and all items of the Hyperactivity and Conduct Problems Scale of the Strengths and Difficulties Questionnaire, for predicting a best-estimate diagnosis of any externalizing disorder. The accuracy of the score was compared between native Dutch and non-Dutch immigrant children., Results: Ninety-one cases of externalizing disorders were identified. An externalizing disorder could be predicted by the items restless, obeys, lies, and concentrates. Sex and ethnicity did not contribute to a prediction of an externalizing disorder. The area under the receiver operating characteristic was 0.84 (95% confidence interval 0.79-0.89), indicating good discriminatory power with no substantial differences between native Dutch and non-Dutch immigrant children., Conclusions: Externalizing disorders in both native Dutch and non-Dutch immigrant children can be predicted with a scoring rule, based on only four items that can be easily assessed by teachers. Before this internally validated prediction tool can be implemented, external validation in another sample is necessary.

Objective: This study attempts to evaluate whether there are attention deficit/ hyperactivity disorder (ADHD) subtype differences regarding psychiatric features, comorbidity pattern and parenting stress profiles in an Asian population., Methods: A total of 182 ADHD children and their primary caretakers recruited from a university-affiliated hospital were surveyed. Subjects were two groups of preadolescent (6 to 12 years old) ADHD children: children with ADHD-inattentive subtype (n=58) and ADHD-combined subtype (n=124). Various information was collected and compared, including the child's characteristics (current age, gender, number of family members, age at ADHD diagnosis, duration of pharmaceutical intervention, psychiatric comorbidities, and intelligence quotient); the primary caretaker's characteristics, and profiles obtained with the Parenting Stress Index (PSI)., Results: Group comparison showed that these two subtypes were statistically distinguishable from each other in total scores on the PSI, four subscale scores on the PSI, the child's age at diagnosis, and comorbidity profiles (all p<.05). Parents of children of the combined subtype experienced higher parenting stress and felt their children displayed qualities that made it difficult for them to fulfill their parenting roles. School failure (p=.001) and anxiety disorders (p=.022) were significantly more prevalent in the inattentive subtype children, while oppositional defiant disorder was significantly more present in the combined subtype children (p=.000)., Conclusions: Our findings supported the cross-cultural equivalence of the nosological distinction in ADHD subtypes. The need for specific clinical intervention according to the subtype difference was stressed.

The aim of this paper was to describe patterns of marijuana involvement during the middle-school years from the first chance to try marijuana down through the early stages of experiencing health and social problems from marijuana use in a sample of African-American adolescents. A total of 488 urban-dwelling African-American middle-school students were interviewed in sixth, seventh and eighth grades as part of a longitudinal field study. Longitudinal latent class models were used to identify subgroups (classes) of adolescents with similar patterns of marijuana involvement. Three classes were identified; little or no involvement (prevalence 85%, 71%, 55% in sixth, seventh and eighth grade, respectively), marijuana exposure opportunity (12%, 19% and 26%), and marijuana use and problems (2%, 9% and 19%). High levels of aggressive/disruptive behavior exhibited as early as first grade and moderate to high levels of deviant peer affiliation were associated with an increased risk of marijuana exposure opportunities in middle-school. Moderate to high levels of aggressive/disruptive behavior and deviant peer affiliation, moderate to low levels of parent monitoring and high levels of perceived neighborhood disadvantage were associated with an increased risk of marijuana use and problems. Significant interactions with grade provided evidence that the influences of parent monitoring and neighborhood disadvantage decrease through the middle-school years. Although not statistically significant, the magnitude of the effects of deviant peer affiliation on marijuana use and problems increased two-fold from sixth to eighth grade. These findings highlight the importance of marijuana exposure opportunities in the pathway to marijuana use and problems and the potential to intervene on behaviors exhibited as early as first grade. It also underscores the importance of developing interventions that are sensitive to the strong influence of parents at entry into middle-school and the shift to peer influences by the end of middle-school.

The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample of 2041 children aged 6-10 years using the Strengths and Difficulties Questionnaire (SDQ). In the second phase, a subsample of 253 children was psychiatrically examined, while their parents were interviewed. In addition, teachers completed a short questionnaire about 10 DSM-IV items. Prevalence was estimated using the best-estimate diagnosis based on parent, child and teacher information. Projected to the total population, 11% of the children had one or more impairing psychiatric disorders, which did not differ between native and non-native children. In the total group a clear relationship was observed between the prevalence of psychiatric disorders and gender, parental psychopathology, peer problems and school problems, but not among all ethnic groups separately. This study suggests that the prevalence of psychiatric disorders among non-treated minority and native children in low SES inner-city neighborhoods does not materially differ. However, associated mechanisms may be influenced by ethnicity.

Objective: To examine whether data on the clinical profiles of psychiatric service users can inform the claim that Māori in the New Zealand community have an increased rate of bipolar disorder., Method: The standardized recordings of a variety of clinical phenomena previously collected in a New Zealand study of psychiatric service users was extracted for those persons who were diagnosed with a bipolar mental disorder. The individual clinical phenomena were then compared by ethnicity., Results: The most dramatic result was the increased recording of high levels of overactivity or disruptive aggressive behaviour in Māori compared with European in psychiatric service users, despite which, the rates of the disorder did not significantly differ by ethnicity., Conclusion: In the community survey lay raters were deciding on the presence or absence of phenomena including hyperactivity without the contextual knowledge that clinicians use. It is possible that the Composite International Diagnostic Interview decision tree was being fed an excessive amount of that criterion.

Associations between dopamine transporter (DAT1) variable number tandem repeats (VNTR), genotypes, and disruptive behavior were examined in an 8-year longitudinal study of children (n = 183). Half of the children met criteria for attention-deficit/hyperactivity disorder (ADHD) at 4-6 years and half were non-referred comparison children. Consistent with several studies, the non-additive association for the 10-repeat allele was significant for hyperactivity-impulsivity (HI) symptoms. However, consistent with other studies, exploratory analyses of the non-additive association of the 9-repeat allele of DAT1 with HI and oppositional defiant disorder (ODD) symptoms also were significant. The inconsistent association between DAT1 and child behavior problems in this and other samples may reflect joint influence of the 10-repeat and 9-repeat alleles., ((c) 2006 Wiley-Liss, Inc.)

Background: Previous research has reported lower treatment rates for externalizing disorders among non-Western children as compared to Western children. Ethnic differences in parental detection may be an explanation for this discrepancy., Aims: In a cross-sectional study among the four largest ethnic groups in the Netherlands, namely Dutch, Moroccan, Turkish and Surinamese, we examined the influence of ethnicity on parental detection of behavioural disorders., Method: A total of 270 children (aged 6-10 years) and their parents were interviewed regarding psychiatric disorders and socio-demographic data. Sensitivity and specificity were calculated by using standard definitions, with adjustment for parental educational level., Results: Sensitivity to detect any externalizing disorder and ADHD in particular was significantly lower among Moroccan and Surinamese parents when compared to Dutch parents. Sensitivity to detect ADHD tended to be lower among Turkish parents. Specificity to detect any externalizing disorder was higher among Moroccan and Turkish parents. Specificity to detect ADHD was higher among Moroccan parents and tended to be higher among Turkish parents., Conclusions: The detection rate of externalizing disorders is markedly lower among non-Dutch parents than among Dutch parents. This finding emphasizes the importance of taking parents' cultural context into account when appraising their report on possible externalizing disorders in their children.

Objective: Poor parent and teacher awareness for attention-deficit/hyperactivity disorder (ADHD) and the scepticism of many clinicians on the prevalence of the disorder, make Italy an interesting environment in which to verify neuropsychological constructs generated in a predominantly Northern American cultural contest. The aim of the study was to verify, by factor confirmatory analysis, the empirical validity of the DSM constructs underlying the diagnostic criteria for developmental disruptive behaviour disorders in Italian school-age children., Methods: Scores for DSM-IV inattention and hyperactivity/impulsivity, for oppositional defiant disorder (ODD) and for conduct disorder (CD) symptoms in 6-12 years old Italian children were analysed from 1575 parent and 1085 teacher forms of the disruptive behaviour disorders questionnaires collected in four different Italian regions., Results: Reliability indicates high internal consistencies for both parent and teacher rating of inattention, hyperactivity/impulsivity, and oppositionality, but not for conduct problems. In accordance with the literature, a relatively low inter-rater convergent and discriminant validity correlation was observed comparing measures obtained by between parents and teachers. Confirmatory factor analysis of both parent and teacher data showed a better fit for a four-factor model, indicating a factor structure in accordance with the DSM-IV taxonomy. When completed by parents and teachers of clinically assessed ADHD, dyslexic or normal children, the disruptive behavioural disorder questionnaires showed a significant predictive diagnostic value., Conclusion: Although an informant variance higher that dimensional (trait) variance was observed, the study provides support for DSM-IV taxonomy for developmental disruptive disorders, showing construct validity of ADHD. ODD and CD could also be distinguished from each other.

Background: Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year., Methods: This population-based cross-sectional study included all 10th-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity., Results: The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p < 0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p < 0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p < 0.05)., Conclusion: In adolescents from a multicultural city in Norway, relative age within a school year significantly influenced academic performance. In contrast to data from Great Britain, relative age within a school year was not an important risk factor for mental health problems in adolescents in Oslo.

Background: Despite the huge youth population, there is a lack of psychiatric diagnostic instruments with reported psychometric properties in Chinese. This study reports the development of the Chinese version of DISC-IV and examines its test-retest reliability., Method: Seventy-eight parents and 79 youths (mean age 13.1 years) attending child psychiatric clinics were interviewed twice using the Chinese DISC-IV (Diagnostic Interview Schedule for Children-IV) about 22 days apart., Results: The kappa coefficients were good to excellent for obsessive compulsive disorder (OCD) (both youth (Y) and parent (P) versions), major depressive disorder (MDD) (P), attention deficit hyperactivity disorder (ADHD) (P); fair for anxiety disorder (P), oppositional defiant disorder (ODD) (P, Y), MDD (Y); but poor for anxiety disorder (Y) and ADHD (Y). Parent informants had better test-retest reliability than youth informants., Conclusions: The Chinese DISC-IV had comparable test-retest reliability with the original English version.