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Background: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents’ ratings of their offspring’s mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents’ reports are essential for clinical assessment of their offspring, they reflect parents’ perceptions of the offspring. Consequently, clinical assessment also requires self-reports from the offspring themselves. To test effects of individual differences, society, and culture on youths’ self-ratings of their problems and strengths, we analyzed Youth Self-Report (YSR) scores for 39,849 11–17 year olds in 38 societies. Methods: Indigenous researchers obtained YSR self-ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. Results: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. Conclusions: Like parents’ ratings, youths’ self-ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self-rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths’ self-reports should thus not be minimized by societal/cultural differences, which—while important—can be taken into account with appropriate norms, as can gender and age differences.

ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems., European Child & Adolescent Psychiatry, 32 (8), ISSN:1435-165X, ISSN:1018-8827

Previous research has demonstrated the influence of family functioning on developmental outcomes but only a few studies have addressed the normative changes of family functioning during adolescence. While there is evidence that family adaptability is stable, findings regarding the development of family cohesion levels are controversial. The focus on the association of family functioning with parenting behavior has also been quite limited. Some studies have revealed that an authoritative parenting style is connected with better family functioning, but only a small body of research has analyzed the association with the main dimensions of parenting behavior. The current study investigated developmental trajectories of family adaptability and cohesion from adolescence to young adulthood. The impact of sex, number of siblings, marital status, socioeconomic status and parenting behavior was studied in a sample of N = 619 participants from a longitudinal Swiss study at two measurement times. Repeated measures ANOVAs and cross-sectional linear regression models were used to analyze the data. There was a significant developmental decline in perceived family cohesion but no change in adaptability from adolescence to young adulthood. In addition, there was a significant main effect of socioeconomic status on adaptability and of parental divorce on cohesion. Boys experienced a significantly steeper decline in family cohesion than girls. Adaptability and cohesion were predicted by perceived parental acceptance and psychological control at both measurement times while cohesion was also significantly predicted by perceived parental structure. The findings reflect normative developmental processes in the transition period.

Das Psychopathologische Befund-System für Kinder und Jugendliche (CASCAP-2) dient der Erfassung der wichtigsten Merkmale psychischer Störungen im Kindes- und Jugendalter. Mithilfe des CASCAP-2 können über 100 psychopathologische Merkmale klinisch beurteilt werden. Die Diagnostikerin bzw. der Diagnostiker nimmt die Einschätzung auf der Basis einer klinischen Exploration des Kindes bzw. Jugendlichen und der begleitenden Bezugsperson(en) sowie anhand eigener Beobachtungen in der Untersuchungssituation vor. CASCAP-2 besteht aus drei Komponenten: dem Befundbogen, dem Glossar und dem Explorationsleitfaden. Im Glossar werden die einzelnen Merkmale definiert, Beispiele für eine starke Symptomausprägung gegeben und abzugrenzende Merkmale aufgelistet. Der Explorationsleitfaden beinhaltet Beispielfragen und liegt in zwei Versionen vor, eine für die Exploration des Kindes bzw. des Jugendlichen und eine für die Exploration der Bezugsperson(en). Auf dem separat lieferbaren Befundbogen werden die klinischen Beurteilungen dokumentiert. CASCAP-2 ist der Nachfolger des CASCAP-D. Im Befund-System wurden einige psychopathologische Merkmale hinzugefügt. Entsprechend wurden das Glossar und der Befundbogen überarbeitet und der Explorationsleitfaden erweitert. Im Manual wurden weitere empirische Studien ergänzt und es wird ein neues empirisches Skalenmodell vorgestellt. CASCAP-2 ergänzt die kategoriale Diagnostik durch eine phänomenologische Beschreibung psychischer Störungen von Kindern und Jugendlichen auf der Ebene von Einzelsymptomen. Das für die Praxis konzipierte Instrument lässt sich sehr gut in klinische Routineabläufe integrieren.

Perceived parental behaviour has mainly been studied in association with various developmental outcomes in children and adolescents but less is known about the underlying developmental change of parental behavior during adolescence. In the present study, a sample of N = 552 participants aged 11–12 years were assessed at three measurement times during adolescence. Perceived acceptance, psychological control, and structure were measured separately for both parents with the brief Perceived Parental Behavior Inventory (PPBI). Trajectories were analyzed using individual growth curve models. Perceived acceptance did not change over time for either parent and there were no sex differences. In contrast, parental psychological control and structure decreased and showed sex differences during adolescence. The latter effect was stronger in boys. This study documents normative developmental trajectories of perceived parental behaviour during adolescence. The PPBI adequately reflects developmental changes in perceived parental behaviour across adolescence and may represent a useful tool in future studies.

BACKGROUND Treating patients with anorexia nervosa (AN) remains a major challenge. The choice between an inpatient or an outpatient care setting is an essential issue for the patients and for their relatives with major health economic implications. However, health services-related studies are lacking. The present study was a descriptive exploration of time-trends in treatment modes of patients with free and equal access to health services. METHODS The study was based on a nationwide cohort of patients diagnosed for the first time with AN, each followed for 5 years in the registers covering the years 1994-2018. The per patient number of hospital admissions, cumulated number of days of hospitalization and number of outpatient visits during the first 5 years after initial diagnosis were considered. RESULTS The cohort of patients with AN with at least 5 years of follow-up amounted to N = 7,505. A clear trend was observed in the per patient five-year cumulated number of inpatient days, decreasing by 6% per year after adjustment for age at diagnosis, parental mental diagnosis, and family income. The five-year number of hospital admissions after initial diagnosis decreased by 2% per year, while no trend was observed for outpatient visits. CONCLUSIONS The per patient number of hospitalizations and cumulated days of hospitalization during 5 years after diagnosis were reduced for patients initially diagnosed with AN while there was no change in the number of outpatient visits. The factors contributing to these changes of treatment modes over time are in need of further study.

To assess the risk of somatic diseases in connection with anorexia nervosa (AN).This matched cohort study was based on Danish registries of all patients born 1961-2008 with a first-time diagnosis of AN in 1994-2018 at age 8-32 and matched controls without an eating disorder. For 13 somatic disease categories, time from inclusion date to time of first somatic diagnosis, accounting for censoring, was studied by use of time-stratified Cox models.A total of 9985 AN patients born 1961-2008 and 49,351 controls were followed for a median (interquartile range) of 9.0 (4.4-15.7) years. During the first 2 years after entry there was a 60% higher hazard for any somatic disease among patients with AN than among controls, while the ratio from three to 11 years was reduced to 1.18. Regardless of age at diagnosis, the hazard among patients and controls were no different at approximately a decade after diagnosis of AN and the cumulative risk for patients for 12 of 13 disease categories was always higher or no less that for controls. For all disease categories, the hazard ratio (HR) was higher when close to entry. For most disease categories, age at diagnosis of AN did not modify the effect.While around 90% of all individuals had any somatic disease at the end of follow-up, the cumulative incidence over time was higher for patients with AN than for controls. Large HRs were seen in the early years after diagnosis during which patients require extensive medical interventions.Based on Danish registries, a large sample of almost 10,000 patients with AN born 1961-2008 and almost 50,000 matched controls were followed for a median of 9 years. While around 90% of all individuals had any somatic disease at the end of follow-up, the cumulative incidence over time was higher for patients with AN than for controls.

OBJECTIVE Comorbid mental disorders in anorexia nervosa during long-term course require detailed studies. METHOD This matched cohort study was based on nationwide Danish register data of all patients born 1961-2008 with a first-time ICD-10 diagnosis of anorexia nervosa (AN) between 1994 and 2018 at age 8-32 and matched controls taken from all individuals without an eating disorder (ED). For nine categories of non-eating mental disorders, time from date of first AN-diagnosis (inclusion date) to time of first diagnosis, accounting for censoring, was studied by use of time-stratified Cox models. RESULTS A total of 9,985 patients with AN (93.5% females) and 49,351 matched controls were followed for a median (IQR) of 9.0 (4.4-15.7) years. For patients, there was about 25% and 55% risk of receiving any non-ED disorder during the first 2 years and two decades after inclusion, respectively. A hazard ratio (HR) of seven for any non-ED was found for the first 12 months after inclusion, a ratio that reduced to two at five or more years after inclusion. During the first years, large HRs ranging in 6-9 were found for affective, autism spectrum, personality, and obsessive-compulsive disorders with the latter displaying the highest continuous increased risk. The HR at 12 months after inclusion was highest for any non-ED disorder and affective disorders in patients aged 8-13 at diagnosis. DISCUSSION Comorbid mental disorders in AN are most frequently diagnosed in the first years after diagnosis of AN and on longer terms imply a double immediate risk.

Understanding the dysregulation profile (DP) consisting of high scores in aggression, attention problems, and anxious/depressed problems is still limited. The aims of the present study were threefold: (a) to analyze developmental trajectories of DP (b) to identify predictors of these trajectories, and (c) to study the outcome of DP in terms of mental disorders and criminal offenses in young adulthood. A sample of 402 individuals aged 11-14 years at baseline was followed up during adolescence and young adulthood. Latent class growth analysis was used to identify DP based on the youth self-report and the young adult self-report. Self-related cognitions, perceived parental behavior, life events and coping served as predictors, psychiatric diagnoses and criminal convictions in young adulthood as outcomes. There were three developmental trajectories representing high, moderate, and low DP subgroups with 9.2% of participants represented by the high DP subgroup. Among predictors, self-esteem (negative), self-awareness (positive), and high numbers of life events had the most consistent effect on high DP. Affective and anxiety disorders and any mental disorder were significant outcomes of the high DP subgroup in both sexes at the time of young adulthood. This first report on DP based on longitudinal self-reports shows that DP is stable for a sizeable proportion of youth during adolescence and young adulthood. The predictors for DP share some similarity with those predicting psychopathology in general. However, so far there seems to be no heightened risk for the development of crime in the concerned individuals.

As societies become increasingly diverse, mental health professionals need instruments for assessing emotional, behavioral, and social problems in terms of constructs that are supported within and across societies. Building on decades of research findings, multisample alignment confirmatory factor analyses tested an empirically based 8-syndrome model on parent ratings across 30 societies and youth self-ratings across 19 societies. The Child Behavior Checklist for Ages 6–18 and Youth Self-Report for Ages 11–18 were used to measure syndromes descriptively designated as Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior. For both parent ratings (N = 61,703) and self-ratings (N = 29,486), results supported aggregation of problem items into 8 first-order syndromes for all societies (configural invariance), plus the invariance of item loadings (metric invariance) across the majority of societies. Supported across many societies in both parent and self-ratings, the 8 syndromes offer a parsimonious phenotypic taxonomy with clearly operationalized assessment criteria. Mental health professionals in many societies can use the 8 syndromes to assess children and youths for clinical, training, and scientific purposes. © 2018, Copyright © Society of Clinical Child and Adolescent Psychology.

Objective: This study examined the validity of childhood depression diagnoses in the Danish Psychiatric Central Research Register (DPCRR) and identified predictors of validity. Methods: A nationwide random sample of 500 children (6–17 years) diagnosed with depression between 1996 and 2016 was identified in the DPCRR. Psychiatric hospital records were reviewed and rated using an online checklist. The primary outcome was whether depressive symptoms and functional impairment documented in hospital records justified a depressive disorder diagnosis based on ICD-10 or DSM-5 diagnostic criteria. Diagnostic validity was calculated as the positive predictive value. Binary logistic regression analysis was used to identify potential predictors of diagnostic validity, and these were included in a multiple logistic regression. Results: Psychiatric hospital records were available for 393 patients (78.6%). The documentation in the records justified an ICD-10 depressive episode diagnosis in 72.8%, and DSM-5 major depressive disorder in 73.3% of the patients registered with a depression diagnosis. We identified three predictors of diagnostic validity: (i) The validity increased almost linearly from 2000 to 2016 (OR 1.14, 95% CI 1.07–1.20, p

BackgroundA recent genome-wide association study (GWAS) identified 12 independent loci significantly associated with attention-deficit/hyperactivity disorder (ADHD). Polygenic risk scores (PRS), derived from the GWAS, can be used to assess genetic overlap between ADHD and other traits. Using ADHD samples from several international sites, we derived PRS for ADHD from the recent GWAS to test whether genetic variants that contribute to ADHD also influence two cognitive functions that show strong association with ADHD: attention regulation and response inhibition, captured by reaction time variability (RTV) and commission errors (CE).MethodsThe discovery GWAS included 19 099 ADHD cases and 34 194 control participants. The combined target sample included 845 people with ADHD (age: 8–40 years). RTV and CE were available from reaction time and response inhibition tasks. ADHD PRS were calculated from the GWAS using a leave-one-study-out approach. Regression analyses were run to investigate whether ADHD PRS were associated with CE and RTV. Results across sites were combined via random effect meta-analyses.ResultsWhen combining the studies in meta-analyses, results were significant for RTV (R2 = 0.011, β = 0.088, p = 0.02) but not for CE (R2 = 0.011, β = 0.013, p = 0.732). No significant association was found between ADHD PRS and RTV or CE in any sample individually (p > 0.10).ConclusionsWe detected a significant association between PRS for ADHD and RTV (but not CE) in individuals with ADHD, suggesting that common genetic risk variants for ADHD influence attention regulation.

Background Consistent research findings indicate that parents and teachers observe genuinely different Attention Deficit/Hyperactivity Disorder (ADHD) behaviours in their respective settings. Objective To evaluate the utility of information provided by teacher informant assessments (INFAs) of ADHD symptoms, and the implications of aggregation algorithms in combing parents’ information, i.e. using ‘or-rule’ (endorsement by either one informant) versus ‘and-rule’ (endorsement by both informants). Method Teacher ratings on Conners scales and clinical data from parental accounts on 1383 probands and their siblings from the IMAGE study were analysed. The psychometric properties of teacher and combined ratings using the item response theory model (IRT) are presented. Kappa coefficients, intraclass correlations and linear regression were employed. Results First, teacher endorsement of symptoms is located in a narrow part of the trait continuum close to the average levels. Symptoms exhibit comparable perception in the measurement of the trait(s) with similar discrimination ability and information (reliability). Second, the IRT properties of the ‘or-rule’ ratings are predominantly influenced by parent-INFAs; and the ‘and-rule’ ratings predominantly by teacher-INFAs ratings. Third, parent-teacher INFAs agreement was low, both for individual items (κ = 0.01–0.15) and for dimensional scores (r = 0.12–0.16). The ‘or-rule’ captured milder expressions of ADHD symptoms, whereas the ‘and-rule’ indexed greater severity of ADHD. Conclusions Parent and teacher-INFAs provide different kinds of information, while both are useful. Teacher-INFA and the ‘and-rule’ provide a more accurate index of severity than an additive symptom count. Parent-INFA and the ‘or-rule’ are more sensitive for detecting cases with milder ADHD.

Perceived parental behaviour has mainly been studied in association with various developmental outcomes in children and adolescents but less is known about the underlying developmental change of parental behavior during adolescence. In the present study, a sample of N = 552 participants aged 11-12 years were assessed at three measurement times during adolescence. Perceived acceptance, psychological control, and structure were measured separately for both parents with the brief Perceived Parental Behavior Inventory (PPBI). Trajectories were analyzed using individual growth curve models. Perceived acceptance did not change over time for either parent and there were no sex differences. In contrast, parental psychological control and structure decreased and showed sex differences during adolescence. The latter effect was stronger in boys. This study documents normative developmental trajectories of perceived parental behaviour during adolescence. The PPBI adequately reflects developmental changes in perceived parental behaviour across adolescence and may represent a useful tool in future studies.

There are pronounced developmental changes in perceived social support during adolescence. The present study used the newly developed Adolescent Social Support Questionnaire (ASSQ) to examine both the consultation frequency of, and the satisfaction with perceived social support across adolescence in a longitudinal study focusing on nine different familial and non-familial supporters. The sample of N = 857 adolescents was derived from the Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) and included three measurement time points. Overall, there was a decrease in the perceived frequency and satisfaction from adolescents with social support from both parents and grandparents from preadolescence to late adolescence. Best friends and romantic partners were consulted more frequently, and their support was perceived as more satisfying with increasing age. Teachers were contacted more frequently with increasing age, while satisfaction with their support remained stable. In contrast, though contacted less frequently, brothers and other relatives showed no changes in perceived satisfaction with support during adolescence. Parents and best friends were perceived as the most satisfying supporters during adolescence followed by romantic partners in later adolescence. Grandparents were perceived as an important support source but only in preadolescence. There were developmental differences during the various stages of adolescence with regard to the importance placed on each social support source. Both parents remained a very a satisfying support source, although they were consulted less often. Romantic partners and best friends gained importance as supporters in older adolescents, whereas grandparents represented a more important support source for preadolescents. Although teachers were not frequently consulted, they remained a stable and satisfying source of support.

Background Selective mutism (SM) is nowadays considered a relatively rare anxiety disorder characterized by children failing to speak in certain situations. Research on risk factors for SM are limited in comparison to other psychiatric disorders. The aim of this study was to examine several potential risk factors for SM in a large nationwide cohort, namely parental psychopathology, parental age, maternal SES, urbanicity, maternal marital status and parental immigration status. Methods This nested case-control study comprised 860 cases with SM, identified from the Finnish Hospital Discharge Register and 3250 controls matched for sex and age from the Finnish Central Population Register. Conditional logistic regression was used to examine the association between the risk factors and SM. Results If both parents had any psychiatric disorder, this almost tripled their odds of having a child with SM (OR 2.8, 95% CI 2.0–4.0). There were increased rates of all types of psychiatric disorders in the parents of the children with SM, with a wider range of diagnoses among the mothers than fathers. Fathers over 35 years (OR 1.4, 95% CI 1.1–1.8) were significantly more likely to have children with SM. Offspring of a single mother had a 2-fold (OR = 2.0, 95% CI 1.4–3.0) increased odds of SM than mothers who were married or in a relationship. Conclusions Several parental psychiatric disorders were associated with offspring SM. This points towards a shared aetiology of psychiatric disorders. Findings on paternal age and single motherhood help to improve our understanding of risk factors for SM.

This longitudinal study aimed to evaluate a newly developed cumulative measure for substance use problems as predictor of criminal recidivism in youth. Questionnaires-based substance-related behaviors (tobacco, alcohol, cannabis and further drugs), and interview-based psychiatric disorders were assessed in a sample of 142 male adolescent forensic outpatients in Zurich, Switzerland (mean age 16.8 years, SD = 1.4 years). Cox regressions were used to test whether substance use behaviors/disorders were predictors of officially recorded criminal offenses 365 days after the initial assessment. The cumulative substance problem score (SPS) was a valid measure for assessing the risk of criminal recidivism for youth having 2–3 (OR 2.24–2.56) and 4+ problems (OR 3.40–4.37) in comparison to youth with 0–1 problems. Forensic experts and clinicians should comprehensively assess substance use patterns in juvenile offenders and may use the SPS as an indicator for further criminal risks. Additional analysis of the SPS in other forensic samples and cultures would be worthwhile.

Additional file 1: Supplementary Table S1. Inclusion and exclusion criteria of Selective Mutism. Supplementary Table S2. Diagnostic categories and codes for parental psychiatric disorders. Supplementary Table S3. Diagnostic categories and codes for comorbid psychiatric disorders in children. Supplementary Table S4. Covariate testing for maternal psychopathology. Supplementary Table S5. Covariate testing for parental psychopathology. Supplementary Table S6. Covariate testing for paternal age. Supplementary Table S7. Covariate testing for maternal age. Supplementary Table S8. sensitivity analyses for a group without comorbid diagnoses. Supplementary Table S9. Comparison of risk factors in the total SM sample and in SM cases diagnosed since 1998. Supplementary Table S10. Sensitivity analyses for a group without parental diagnoses before 1998. Supplementary Table S11. Sensitivity analyses for a group without parental diagnoses before 1998 and without cases diagnosed only before 1998.

ispartof: Lancet Child and Adolescent Health vol:4 issue:6 pages:1-2 ispartof: location:England status: Published online

Zusammenfassung. Die Dialektisch-Behaviorale Therapie für Adoleszente (DBT-A) zur Behandlung impulsiver und suizidaler Jugendlicher wird seit Februar 2005 in leicht abgeänderter Form ambulant im Kinder- und Jugendpsychiatrischen Dienst Zürich umgesetzt. Diese DBT-A umfasst Einzeltherapie, ein Gruppen- bzw. Skills-Training sowie einen Elternabend und dauert jeweils ein halbes Jahr. Der vorliegende Erfahrungsbericht zeigt die Umsetzung dieses Ansatzes und präsentiert eine Evaluation im Rahmen der klinikinternen Qualitätssicherung. Die insgesamt 43 Teilnehmerinnen des Therapie-Programms waren weibliche Jugendliche im Alter von 14–19 Jahren, die impulsive und selbstschädigende Verhaltensweisen sowie Probleme in der Regulierung ihrer Emotionen und in der zwischenmenschlichen Beziehungsgestaltung aufwiesen. An einem Skills-Training nahmen jeweils 4–6 Jugendliche teil. Unsere mehrheitlich positiven Erfahrungen mit diesem Ansatz in der Therapie wurden durch die Auswertungen der Daten aus der Qualitätssicherung von 19 Teilnehmerinnen bestätigt, welche sowohl Selbst- wie auch Fremdurteile umfassten. Es liegen Hinweise vor, dass die DBT-A mit zu einer Abnahme sowohl verschiedener Indikatoren der allgemeinen als auch der spezifischen Psychopathologie führt.

The prevalence of autumn/winter seasonality in depression has been documented in the longitudinal Zurich cohort study by five comprehensive diagnostic interviews at intervals over more than 20 years (N = 499). Repeated winter major depressive episodes (MDE—unipolar + bipolar) showed a prevalence of 3.44% (5× more women than men), whereas MDE with a single winter episode was much higher (9.96%). A total of 7.52% suffered from autumn/winter seasonality in major and minor depressive mood states. The clinical interviews revealed novel findings: high comorbidity of Social Anxiety Disorder and Agoraphobia within the repeated seasonal MDE group, high incidence of classic diurnal variation of mood (with evening improvement), as well as a high rate of oversensitivity to light, noise, or smell. Nearly twice as many of these individuals as in the other MDE groups manifested the syndrome of atypical depression (DSM-V), which supports the prior description of seasonal affective disorder (SAD) as presenting primarily atypical symptoms (which include hypersomnia and increase in appetite and weight). This long-term database of regular structured interviews provides important confirmation of SAD as a valid diagnosis, predominantly found in women, and with atypical vegetative symptoms.

ObjectivesThis study aims to ascertain whether the differences of prevalence and severity of attention deficit hyperactivity disorder (ADHD) are true or whether children are perceived and rated differently by parent and teacher informant assessments (INFAs) according to gender, age, and co‐occurring disorders, even at equal levels of latent ADHD traits.MethodsUse of latent trait models (for binary responses) to evaluate measurement invariance in children with ADHD and their siblings from the International Multicenter ADHD Gene data.ResultsSubstantial measurement noninvariance between parent and teacher INFAs was detected for seven out of nine inattention (IA) and six out of nine hyperactivity/impulsivity (HI) items; the correlations between parent and teacher INFAs for six IA and four HI items were not significantly different from zero, which suggests that parent and teacher INFAs are essentially rating different kinds of behaviours expressed in different settings, instead of measurement bias. However, age and gender did not affect substantially the endorsement probability of either IA or HI symptom criteria, regardless of INFA. For co‐occurring disorders, teacher INFA ratings were largely unaffected by co‐morbidity; conversely, parental endorsement of HI symptoms is substantially influenced by co‐occurring oppositional defiant disorder.ConclusionsOur findings suggest general robustness of Diagnostic and Statistical Manual of Mental Disorders ADHD diagnostic items in relation to age and gender. Further research on classroom presentations is needed.