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Objective Posttraumatic stress disorder (PTSD) is a debilitating condition that when left untreated can have severe lifelong consequences for psychological, social, and occupational functioning. Initial conceptualizations of PTSD were centered on adult presentations. However, the instantiation of developmentally appropriate PTSD in young children (PTSD-YC) criteria, tailored to preschool (6 years old and younger) children, represents an important step toward identifying more young children experiencing distress. This study explored population-level prevalence of PTSD-YC indexed via an alternative algorithm for DSM-IV PTSD (AA-PTSD). Method Representative population data were used to test whether application of AA-PTSD criteria, relative to the DSM-IV PTSD algorithm, increased identification of 5- to 6-year-old children with clinical needs in both the general population (n = 3,202) and among looked after children (ie, in Britain, foster children are called looked after children [more commonly referred to as children in care].) (n = 137), in whom the risk of mental health issues is greater. Results Notably, no 5- to 6-year-old children in the general population sample were diagnosed with PTSD using adult-based DSM-IV criteria. In contrast, AA-PTSD prevalence was 0.4% overall, rising to 5.4% in trauma-exposed children. In looked after children, overall PTSD prevalence rose from 1.2% when applying adult-based DSM-IV criteria to 14% when using AA-PTSD criteria. Of trauma-exposed looked after children, 2.7% met criteria for DSM-IV PTSD compared with 57.0% when applying AA-PTSD criteria. In both samples, use of the alternative algorithm to index PTSD-YC criteria markedly increased identification of children experiencing functional impairment owing to symptoms. Conclusion Results demonstrate the utility of the PTSD-YC diagnosis beyond at-risk and treatment-seeking samples. Use of PTSD-YC criteria substantially improves identification of 5- to 6-year-old children burdened by PTSD at the population level.

Background: Social anxiety disorder (SAD) aggregates in families. To elucidate intergenerational transmission of risk, we examined whether childhood SAD and symptoms of anxiety were prospectively predicted by stable infant temperamental inhibition, maternal SAD, maternal generalized anxiety disorder (GAD) and maternal parenting behaviours. Methods: We conducted a longitudinal study beginning prenatally with follow‐up at 4, 10, 14 and 58 months postnatally. Mothers were assessed for anxiety disorders prenatally and assigned to one of three groups: SAD (n = 67), GAD (n = 56) and nonanxious controls (n = 94). We assessed infant temperamental inhibition at 4 and 14 months, maternal parenting behaviours at 10 and 58 months, and child anxiety disorders and symptoms at 58 months. Results: Child SAD at 58 months was predicted by prenatal maternal SAD (OR = 23.76, 95% CI = 1.15–60.37), but not by prenatal maternal GAD (OR = 7.44, 95% CI = 0.32–124.49), stable temperamental inhibition or maternal behaviours. Child anxiety symptoms at 58 months were predicted specifically by maternal SAD (but not GAD), and also by concurrent maternal intrusiveness. Stable temperamental inhibition moderated the association between 10‐month maternal encouragement and 58‐month child anxiety symptoms. Conclusions: We found evidence for specificity of risk for child SAD and anxiety symptoms from maternal SAD compared to maternal GAD. Childhood anxiety symptoms were also predicted by an interaction between a lack of maternal encouragement in infancy and stable temperamental inhibition, as well as concurrent maternal intrusiveness. The findings have clinical implications for targeted prevention of child anxiety.

Background Understanding the characteristics of commenters on mental health–related online forums is vital for the development of effective psychological interventions in these communities. The way in which commenters interact can enhance our understanding of their characteristics. Objective Using eating disorder–related (EDR) forums as an example, this study detailed a methodology that aimed to determine subtypes of mental health–related forums and profile their commenters based on the other forums to which they contributed. Methods The researchers identified all public EDR forums (with ≥500 contributing commenters between March 2017 and February 2018) on a large Web-based discussion platform (Reddit). A mixed-methods approach comprising network analysis with community detection, text mining, and manual review identified subtypes of EDR forums. For each subtype, another network analysis with community detection was conducted using the EDR forum commenter overlap between 50 forums on which the commenters also commented. The topics of forums in each detected community were then manually reviewed to identify the shared interests of each subtype of EDR forum commenters. Results Six subtypes of EDR forums were identified, to which 14,024 commenters had contributed. The results focus on 2 subtypes—proeating disorder and thinspiration—and communities of commenters within both subtypes. Within the proeating disorder subtype, 3 communities of commenters were detected that related to the body and eating, mental health, and women, appearance, and mixed topics. With regard to the thinspiration group, 78.17% (849/1086) of commenters had also commented on pornographic forums and 16.66% (181/1086) had contributed to proeating disorder forums. Conclusions The article exemplifies a methodology that provides insight into subtypes of mental health–related forums and the characteristics of their commenters. The findings have implications for future research and Web-based psychological interventions. With the publicly available data and code provided, researchers can easily reproduce the analyses or utilize the methodology to investigate other mental health–related forums.

Background: There has been increasing research interest in parenting by anxious adults; however, little is known about anxiety-subtype effects, or effects of the context in which parenting is assessed. Methods: Two groups of anxious mothers, social phobia (N = 50), generalised anxiety disorder (N = 38), and nonanxious controls (N = 62) were assessed with their 4.9-year-old children in three tasks: two presented threat specifically relevant to each maternal disorder, namely, a social threat task where the child had to give a speech, and a nonsocial threat task where the child had to explore potentially scary objects; the third was a nonthreat task (playing with play dough). Seven parenting dimensions were scored. Effects on parenting of maternal anxiety subgroup and task, and their interactions, were examined, as were effects of earlier child behavioural inhibition and currently manifest anxiety. Results: There were no parenting differences between maternal groups in the nonthreat play-dough task; parenting difficulties in the two anxious groups were principally evident in the disorder-specific challenge. Parenting differences between nonanxious and anxious mothers occurred independently of child characteristics. There was little evidence for particular forms of parenting difficulty being unique to maternal disorder. Conclusions: Anxious mothers’ parenting difficulties emerge when occurring under challenge, especially when this is disorder-specific. These effects should be considered in research and clinical practice.

The article discusses geophagia, which is the practice of eating dirt. The authors note that geophagia is classified in the fourth edition of the "Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)" as an eating disorder subtype, called pica, in which individuals consume things that are not food. Topics include the prevalence of geophagia among animals, such as parrots, deer, and elephants, evolution research investigating whether geophagia is abnormal of adaptive behavior, and the idea that eating dirt may be a way to detoxify the body.

ObjectivesTrichotillomania (TTM) is a psychiatric syndrome characterised by the inability to control repetitive hair pulling. Psychiatric data reveal that TTM is not usually prevalent among all family members of patients, and so far only one case of familial TTM has been reported.MethodsIn this study, we report a case of familial TTM that afflicted four sisters and discuss the importance of genetic factors in this disorder.ResultsThis report suggests that, similar to many other psychiatric disorders, TTM can be detected in other family members and that genetic factors not only have a significant role in the development of such disorders but also in determination of the disorder subtype. This report also shows that the comorbidities in one member of the family might predict the existence of comorbidities in other members. On the basis of response to medication.Conclusionthe authors suggest that a genetic disorder like polymorphism in serotonin receptors or dopamine can cause such a disorder.

Seasonal affective disorder, which is underdiagnosed in the primary care setting, is a mood disorder subtype characterized by episodic major depression that typically develops in winter when daylight hours are short. Patients with SAD experience increased morbidity and decreased quality of life. This article focuses on recognition and management of this condition. Light therapy is the preferred treatment for SAD because it is safe and easy to administer; light therapy may be combined with pharmacologic therapy. Cognitive behavioral therapy (CBT) also has a positive therapeutic effect when combined with light therapy and may help prevent SAD in subsequent seasons.

We utilized a short-term, prospective, behavioral high-risk design with a daily diary methodology for assessing daily life events and symptoms in order to examine whether attributional style and the attributional style × events interaction predicted level, within-day, and across-days variability in the depressive disorder subtype, hopelessness depression, but not other depression symptoms. Nondepressed participants at high or low risk for hopelessness depression symptoms based on their attributional styles for positive and negative events provided daily reports of their positive and negative life events and ratings of their highest, lowest, and average point for the day on 20 symptoms of depression vs. mania for 28 days. In accord with the hopelessness theory, attributionally high-risk participants exhibited higher levels and greater within-day variability and also tended to show greater across-days variability of hopelessness depression symptoms, but not other depression symptoms, than attributionally low-risk participants. Across-days variability of hopelessness depression sympotoms was further predicted by the interaction of attributional style and total events (positive + negative), whereas within-day variability was a function of the main effects of attributional style and total events. Finally, as predicted, hopelessness depression symptoms intercorrelated with each other more highly than they correlated with non-hopelessness depression symptoms. The findings are discussed with respect to their implications for the proposed hopelessness subtype of depression.

Objective: The aim of this study is to evaluate the effect of zinc and omega-3 supplements as adjunctive drugs in the treatment of attention-deficit/hyperactivity disorder (ADHD) of children. Methods: This study is a randomized, double-blind clinical trial conducted on 150 children aged 6–15 years old that diagnosed as new cases of ADHD. Study subjects were evaluated for 8 weeks. Besides of drug of choice (methylphenidate) for the ADHD, patients received placebo in the control group (n = 50), zinc sulfate in second group (n = 50), and omega-3 (n = 50) in third group. Clinical improvement was checking by Conners' Parent and Teacher Rating Scales before and in 2nd, 4th, and 8th week of treatment. Results were analyzed with SPSS version 16 software. Findings: In this study, mean scores of Conners' scale showed significant improvement during treatment in the zinc group compared to control group in children that affected to attention-deficit disorder subtype of ADHD (P = 0.02). Moreover, in omega-3 group, better clinical response was seen than other groups (P < 0.05). However, there was no significant difference between omega-3 group compared to placebo group in the mean scores of Conners' scale (P = 0.89). Conclusion: Zinc supplementation accompanied by the main treatment significantly improves symptom of attention-deficit disorder subtype of ADHD. However, omega-3 supplementation was superior to zinc and placebo in the clinical improvement of ADHD.

Aims Depression is the most common neuropsychiatric disturbance in Parkinson9s disease. Evidence is accumulating that motor subtype may be a critical risk factor for the development of depression throughout the disease and that the gender prevalence seen for common depression may not hold for patients with Parkinson9s disease. Here we set out to analyse a database containing information about motor subtype, gender and depression in a large pool of well-characterised patients with idiopathic Parkinson9s disease. Methods Standardised neurological and psychiatric tests were administered to 224 patients (154 male) suffering from idiopathic Parkinson at the Parkinson Centre Nijmegen (ParC) of the Radboud University Nijmegen Medical Centre (UMCN) in the Netherlands. ParC is an outpatient centre recognised as Centre of Excellence by the National Parkinson Foundation. The data were collected during a 3-day programme for diagnosis and the development of an individual multidisciplinary treatment programme. Data were statistically analysed using SPSS. Results Of the 224 patients, 74 (33%) suffered from the tremor-dominant subtype, 129 (56%) had a bradykinetic/rigidity subtype and 24 (11%) patients were diagnosed as having a postural instability and gait disorder subtype. Overall and for each of the subtypes, there was a significant higher prevalence of males in the group (minimum t(255)=12.9; p=0.000). We therefore corrected subsequent analyses for this difference in prevalence. Duration of illness did not differ between groups. Our statistical analysis further indicated that the prevalence of depression did not differ between male and female in any of the groups both for minor and major depression. Conclusions Our data contained a homogenous set of patients suffering from idiopathic Parkinsons disease in a mild to moderate stage. We could not replicate recent evidence of a predominance of depression in the postural instability and gait disorder subtype in this sample possibly due the stage of the disease. Our data, however, do suggest that contrary to the general population there is an equal prevalence of male and female patients suffering from minor or major depression. These results may suggest that there is a different pathophysiology underlying depression in Parkinson9s diseases independent of subtype.