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The current study aimed at testing and developing alternative short versions of autism spectrum quotient (AQ-10) (adult [self-report], adult [parent-report], adolescent, and child versions) for use in Hong Kong. First, the various versions of AQ-10 developed in the United Kingdom (the AQ-10-UK) were applied to Hong Kong Chinese samples and demonstrated satisfactory discriminative power (AUCs 0.77-0.94). Second, the Hong Kong Chinese versions of AQ-10 (AQ-10-HK) were developed, using the same methodology as in the original UK study. There were some changes in the choice of items and cut-offs. The AQ-10-HK demonstrated slightly greater discriminative power (AUCs 0.88-0.97) to that of the AQ-10-UK, but the differences in AUCs were not statistically significant. Compared to the corresponding full-length versions, both the UK and HK short forms did not seem to lose any significant discriminative power. Yet, the various versions of AQ, be they the full-length or AQ-10, appeared to consistently exhibit slightly smaller AUCs with the Hong Kong Chinese samples than with the UK samples. So, this study found both cross-cultural similarities and differences. The AQ-10-HK was recommended for local practice to maximize the advantage gained. Yet, for international multi-site research collaboration, involving the UK and HK, the original AQ-10-UK can be used for direct comparison of data.

Children with autism commonly suffer from comorbid functional gastrointestinal disorders (FGID) and anxiety. The raised prevalence of both conditions in autism suggests complex reciprocal relationships, which are seldom explored in non-treatment-seeking FGID. The relationships between subtypes of FGID and anxiety are also unclear. This study recruited boys with autism and age-matched typically developing (TD) boys, aged 4-11 years, who were not actively seeking help for gastrointestinal problems. Their parents completed the Rome IV Diagnostic Questionnaires for Pediatric FGID. Four groups of children with and without autism/FGID were identified and compared on their anxiety level using the Spence children's anxiety scale. In 69 boys with autism and 69 age-matched TD boys, FGID were identified in 22 and 16 boys, respectively. ANCOVA demonstrated a significant interaction effect of autism and FGID on anxiety (F[1, 129] = 5.43, p = 0.021), while conditional logistic regression identified an interaction effect of autism and anxiety on the odds of FGID (OR 1.038, 95% CI 1.002-1.075, p = 0.038). Explorative post hoc analysis showed higher anxiety in functional nausea and vomiting disorder (p = 0.033) and functional abdominal pain disorder (p = 0.029) among boys with autism than TD boys with the same respective subtypes of FGID. In summary, among prepubertal boys with autism, the presence of FGID that are non-treatment-seeking in nature, has a significantly stronger association with higher levels of anxiety than TD boys. The strength of association may be more prominent in subtypes of FGID. Possible pathomechanisms including the underlying microbiota spectra and inflammatory paths should be explored in future studies. LAY SUMMARY: Anxiety and gastrointestinal problems are common symptoms in autism. Given that gut health could be linked to emotions, their association in young boys with autism was studied. The presence of nausea vomiting, or abdominal pain were associated with raised anxiety among boys with autism, yet this was not observed in typically developing boys. This suggests that anxiety among autistic children could be partly explained by the presence of FGID.

This study examines the psychometric properties of the Autism Diagnostic Interview-Revised (ADI-R) in the context of DSM-5 in a sample of Chinese children. Using re-mapped ADI-R items and algorithms matched to DSM-5 criteria, and administering to children with autism spectrum disorder (ASD) with and without intellectual disability, attention-deficit hyperactivity disorder, and typically developing, it evidenced high sensitivity and specificity. However, similar to DSM-IV algorithm, the DSM-5 algorithms were better at classifying ASD among children with intellectual disability than among those without intellectual disability. With the DSM-5's recognition of the spectrum nature of ASD, the performance of the ADI-R can be improved by having finer gradations in the ADI-R scoring and adding more items on the restricted and repetitve behavior domain.

Background: To cope with the rising demand for psychological treatment, evidence-based low-intensity cognitive behavioural therapy (LiCBT) delivered by trained para-professionals was introduced internationally. Aims: This pilot study aimed at examining the effectiveness of LiCBT in Hong Kong. Method: This study was of an uncontrolled pre- and post-treatment design, testing LiCBT at a local community mental health centre in Hong Kong. Two hundred and eighty-five Chinese adult help-seekers to the centre attended two or more sessions of LiCBT delivered by trained para-professionals. These participants also rated their depression and anxiety on the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Scale-7 (GAD-7), respectively, at pre- and post-treatment. Results: Comparison of the pre- and post-treatment PHQ-9 and GAD-7 scores of 285 participants indicated significant improvements in depression and anxiety with large effect sizes (depression: d = 0.87; anxiety: d = 0.95). For those participants reaching the clinical level of either depression and/or anxiety at pre-treatment (n = 229, 80.4%), they reported even larger effect sizes (depression: d = 1.00; anxiety: d = 1.15). The recovery rate was 55.9% with a reliable improvement rate of 63.9%. An average of 5.6 sessions was offered to the participants with each session spanning a mean of 42 minutes. The baseline clinical conditions and participants’ educational level were predictive of post-treatment recovery. Conclusions: The results supported the effectiveness and cost-efficiency of LiCBT for depression and anxiety at a Hong Kong community mental health centre. The effect sizes and the recovery and reliable improvement rates achieved were comparable to those reported from countries such as the UK and Australia.

There has been increasing interest in transdiagnostic cognitive-behavioral therapy (CBT), which is more cost efficient yet yields similar effect sizes when compared to disorder-specific CBT. The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders was adapted for Hong Kong Chinese adults with common mental disorders, such as depression and anxiety. It was piloted in community settings and delivered in a group format. Thirty-one Chinese adults (female = 93.5%, mean age = 44 years) with heterogeneous anxiety and depressive disorders were recruited from a number of public-funded community mental health centers in Hong Kong to participate in a pilot trial of a locally adapted variant of UP. Treatment consisted of 14 group sessions plus one individual session. Each group included six to nine participants. The diagnostic and outcome measures included Anxiety Disorders Interview Schedule for DSM-IV, The Chinese versions of Beck Depression Inventory-Revised (C-BDI-II), Beck Anxiety Inventory (C-BAI), Positive Affect subscale of Positive and Negative Affect Scale, and Work and Social Adjustment Scale. Results indicate significant improvement across a number of outcome measures, with moderate-to-large effect sizes for measures of depression (d = 1.11), anxiety (d = 0.67), positive affect (d = 0.54), and work and social functioning (d = 0.49). Furthermore, 45.2% and 29.0% of the participants scored within the normal range of C-BDI-II and C-BAI at posttreatment, respectively, compared to 3.2% and 6.5% at pretreatment. This pilot, uncontrolled trial demonstrated potential effectiveness of a locally adapted variant of group UP for Chinese adults with common mental disorders. It achieved comparable effect sizes to those observed in western populations.

PROBLEM: The debate on whether psychiatric symptoms are universal and to what extent they are affected by culture is generally divided between the universalist and relativist approaches. METHODS: This study compared Achenbach/Rescorla's model and Weisz's model of youth self-report in 2521 Chinese adolescents (mean age = 12 years). Indigenous exploratory factor analyses were conducted to explore the factor structure of youth self-report (YSR), and the derived models were tested with confirmatory factor analysis. FINDINGS: These analyses indicated good support of the Chinese YSR models for males and females. Further analyses revealed three syndromes, namely anxious/depressed, somatic complaints, and aggressive behaviors, which represented broad internalizing and externalizing factors. These syndromes consistently demonstrated high correlations across the different models, indicating their universal nature. Conversely, some unique factors emerged in the Chinese YSR model, such as weight concern and rule-breaking behavior, which may reflect underlying culture-bound factors. CONCLUSIONS: Our findings support a combined perspective to the universalist and relativist approaches, which argues that some syndromes including Anxious/Depressed, Somatic Complaints, Aggressive Behavior and Attention Problems are more likely to be universal in male adolescents, while a new emerging syndrome like Weight Concern may reflect the socioeconomic, culture, and lifestyle changes that are currently emerging in China.

The Autism-Spectrum Quotient-Adult (AQ-Adult) is a screening tool for adults with autism spectrum disorder (ASD). The present study examined the psychometric properties of the Chinese self- and parent-report versions of the AQ-Adult in Hong Kong (AQ-Adult-HK). Participants included adults with ASD (n = 27) and community controls (n = 345). Parents of a subset of adults with ASD (n = 21) and controls (n = 87) also participated as informants. The parent-report version showed significantly stronger psychometric properties, including a larger area under receiver operating characteristic curve (AUC) and higher sensitivity/specificity, than those of the self-report version. The stronger psychometric properties of the former were related to its significantly higher ratings of ASD symptoms in the ASD adults.

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.

Purpose of the research Cortico-striatal functional connectivity has been implicated in the neuropathology of schizophrenia. However, the longitudinal relationship between the cortico-striatal connectivity and schizotypy remains unknown. We examined the resting-state fMRI connectivity in 27 individuals with a high level of schizotypy and 20 individuals with a low level of schizotypy at baseline and 18 months later. Correlations between changes in cortico-striatal connectivity and changes in schizotypy scores over time were examined. Principal results We found both increased and decreased cortico-striatal connectivity in individuals with a high level of schizotypy at baseline. Over time, these individuals showed improvement in both the negative and positive schizotypal domains. Changes in striatal-insula connectivity were positively correlated with changes in positive schizotypy from baseline to follow-up. Major conclusions Our results suggested impaired cortico-striatal connectivity in individuals with a high level of schizotypy. The dysconnectivity mainly involves the dorsal striatum. The connectivity between the dorsal striatum and the insula may be a putative marker for temporal changes in positive schizotypy.

Objectives It is common, among clinical and non-clinical populations alike, for paranoia and anxiety to co-occur. It has been suggested that anxiety and its related appraisal styles may contribute to development of paranoia. We aimed to evaluate different aspects of risk perception in relation to paranoia and anxiety and to identify specific aspects that may differentiate paranoia from anxiety. This paper consists of two inter-related studies. Methods Study 1 compared 30 patients with persecutory delusions, 21 patients with generalized anxiety disorder and 52 healthy controls. Study 2 compared 30 non-clinical individuals with high levels of paranoia and anxiety, 28 individuals with high anxiety only and 36 healthy controls. Within each study, the two symptomatic groups were matched on level of anxiety. Four dimensions of risk perception (i.e. likelihood, harm, controllability, and intentionality) were compared across groups, as measured by the locally validated Risk Perception Questionnaire. Results In both studies, the paranoia and the anxiety groups reported an elevated perceived likelihood of negative events than controls respectively. Only the paranoia groups reported an elevated perceived harm of neutral events than controls. In Study 2, the two at-risk groups attributed more harm and intentionality to negative events than controls. Conclusion Although perception of negative events was characteristic in anxiety (with or without paranoia), a biased perception of neutral events as risky was unique to the addition of paranoia. Implications to the transdiagnostic and continual view of psychopathology, and mechanism-based interventions were discussed.

There is growing evidence supporting the individual associations of maternal occupation and maternal education with children’s behavioral outcomes. However, few studies have linked these factors together in a mediation model. The current study is the first to examine the mediating effect of maternal occupational skillfulness on the relationship between the length of maternal education and preschool children’s behavioral outcomes in the Chinese context. To assess children’s behavior, parents and teachers of 286 preschoolers from the China Jintan Cohort Study completed the Child Behavior Checklist (CBCL) and Caregiver-Teacher Report Form (C-TRF), respectively. Sociodemographic information, such as maternal occupational skillfulness and education level, was also collected. Using PROCESS and kappa statistics, maternal occupational skillfulness was found to mediate the effect of length of maternal education on both internalizing and externalizing behaviors of preschoolers, as rated by parents but not on behaviors as rated by teachers. Such findings can provide insight for counseling psychologists or family therapists in providing mothers, particularly those in low-skill jobs, appropriate advice and strategies for handling job-related stress. Mother-child relationships would consequently improve, which could then minimize the development of children’s internalizing and externalizing behaviors. Furthermore, teachers could identify at-risk children and provide early intervention. Our findings also offer insight for policy makers to consider legislation providing financial assistance from the government to low-income mothers. Future replication studies should be conducted in other countries so as to determine whether similar results can be obtained.

Schizotypy is a set of personality traits that convey liability to develop schizophrenia. Studying schizotypy in healthy individuals may facilitate the understanding of the psychopathological processes underlying schizophrenia. The present study aimed to examine the developmental trajectories of schizotypy over time using a longitudinal study design. The Chapman Scales for Psychosis Proneness were administered to 1541 college students at baseline, and subsequently at six-monthly intervals up to 18 months. Latent class growth analysis was conducted to track the different trajectories. In addition, self-reported scales were used to measure idea of reference, emotional experiences and expression, stress and coping, as well as social functioning. We identified four latent classes with distinct trajectories: “nonschizotypy” group (LC1), “stable high schizotypy” group (LC3), “high reactive schizotypy” group (LC2) and “low reactive schizotypy” group (LC4). These findings suggest that there may be distinct developmental trajectories for schizotypy. Two groups may be of particular interest: the “stable high schizotypy” group that displayed the worst clinical and functioning outcomes on almost all measures and the “high reactive schizotypy” group characterized by a relatively rapid decline in functioning.

Partners in an intercultural couple can be similar because of selection effects (they were attracted to each other because of their similarity), accommodation (relationship length diminishes differences), or acculturation (the migrant partner adjusts to the dominant culture). The current study explored these sources of similarity, as well as the association of relationship standards with relationship satisfaction, by comparing intercultural couples (68 Chinese-Western couples) with two groups of monocultural couples (63 Western couples and 66 Chinese couples) across 2 countries of residence (China and Australia). Regardless of country of residence, Chinese couples rated Family Responsibility standards (e.g., relations with the extended family and maintaining relational harmony) as more important than Western couples. Western couples rated Couple Bond standards (e.g., the demonstration of love and caring) as more important than Chinese. Intercultural couples endorsed standards to an intermediate extent between the Chinese and Western couples. There was considerable similarity of partners' standards within couples in all 3 groups of couples. Endorsement of Couple Bond standards and partner similarity on Family Responsibility standards were associated with relationship satisfaction across all 3 groups and both countries of residence. We conclude that cultural differences in endorsement of relationship standards show little acculturative change, at least in first-generation migrants. The substantial similarity in partners' standards in intercultural couples seems to be due primarily to selection effects. The association of standards with satisfaction is remarkably similar across countries of residence and cultural groups.

Mandy H Chan,1 Patrick WL Leung,2 Ting-pong Ho,3 Se-fong Hung,4 Chi-chiu Lee,5 Chun-pan Tang,5 Ka-chai Cheung,2 Fung-yee Ching,2 Fefe HK Chan,6 Lu-hua Chen,2 Merce Garcia-Barcelo,7 Pak-chung Sham3 1Department of Clinical Psychology, Kowloon Hospital, Hospital Authority, 2Department of Psychology, The Chinese University of Hong Kong, 3Department of Psychiatry, University of Hong Kong, 4Department of Psychiatry, The Chinese University of Hong Kong, 5Department of Psychiatry, Kwai Chung Hospital, Hospital Authority, 6Department of Clinical Psychology, Alice Ho Mui Ling Nethersole Hospital, Hospital Authority, 7Department of Surgery, University of Hong Kong, Hong Kong, People’s Republic of China Background: Methylphenidate (MPH) has been found to be an effective medication for attention-deficit/hyperactivity disorder (ADHD). However, there are neither consistent nor sufficient findings on whether psychiatric comorbidities and associated cognitive functions of ADHD are related to treatment response to MPH in ADHD children.Objectives: This study investigated whether psychiatric comorbidities, IQ, and neurocognitive deficits are related to treatment response to MPH in ADHD children. In some ways, it is preferable to have a drug that the effectiveness of which to a disorder is not affected by its associated cognitive functions and psychiatric comorbidities. On the other hand, it is likely that the baseline symptom severity of ADHD is associated with the effectiveness of MPH treatment on the symptoms post treatment.Methods: A total of 149 Chinese boys (aged 6–12years) with ADHD, combined type, and normal IQ participated in this study. Assessment of ADHD symptom severity was conducted pre and post MPH treatment, while assessment of psychiatric comorbidities, IQ, and neurocognitive deficits was performed in a non-medicated condition. Treatment response was defined as the ADHD symptom severity post MPH treatment.Results: Results indicated that MPH treatment was effective, significantly improving the ADHD condition. Yet, comorbid disorders, IQ, and neurocognitive deficits were not related to MPH treatment response on ADHD symptoms. These findings indicated that the effectiveness of MPH was not affected by psychiatric comorbidities and associated cognitive functions of ADHD. Instead, as expected, it was the baseline symptom severity that was mainly related to the treatment response, ie, the milder the baseline condition, the better the treatment response.Conclusion: The current findings positively endorse the widespread clinical use of MPH for treating ADHD. It improves the behavioral symptoms of ADHD regardless of varying psychiatric comorbidities, IQ, and neurocognitive deficits. Keywords: ADHD, psychiatric comorbidities, cognitive functions, treatment response, methylphenidate

Recent studies have shown that worry and related negative metacognitions are characteristic in generalized anxiety and paranoia respectively. However, most of these studies did not take into account common co-occurrence of anxiety and paranoia, and longitudinal modelling of the role of worry and metacognitions on the development of anxiety and paranoia is rare. The current study aimed at examining the bidirectional longitudinal relationship between anxiety and paranoia, as well as the importance of worry and metacognitions in the development of these symptoms. Our validated sample consisted of 2291 participants recruited from universities, among whom 1746 participants (76.21%) completed online questionnaires at baseline and at one year, reporting levels of anxiety, paranoia, worry, and negative metacognitions. Structural equation modeling analyses, followed by path comparisons, revealed that anxiety and paranoia mutually reinforced each other over time. Negative metacognitions, rather than worry itself, were contributive to the development of both symptoms over time. Negative metacognitions showed bi-directional relationships with anxiety over the time period assessed and showed uni-directional relationships with paranoia. Clinical implications of our findings are discussed.

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.

The relationship between sub-dimensions of posttraumatic growth (PTG) and distress was investigated for survivors of motor vehicle crashes (MVC). PTG and symptoms of posttraumatic stress disorder (PTSD) for 1045 MVC survivors who attended the Accident and Emergency Services were examined with the Chinese versions of the Posttraumatic Growth Inventory (PTGI) and the Impact of Event Scale-Revised 1 week after the experience of a MVC. A factor structure, which was different from both the original English version of the PTGI and the Chinese version of PTGI for cancer survivors, was identified. Factors extracted were: (1) Life and Self Appreciation; (2) New Commitments; (3) Enlightenment; and (4) Relating to Others. However, correlation analyses indicated a functional similarity between factors from this study and those from previous studies. Relations between PTG sub-dimensions and PTSD symptoms were identified. Results from hierarchical multiple regression analysis and structural equation modeling show that there were different predictors for different PTG sub-dimensions. Findings suggest that different modes of relationship between PTSD symptoms and PTG sub-dimensions may co-exist.

This study tested for similarities and differences across societies in self-ratings ofproblems, personal strengths, and aspects of adaptive functioning on the Adult Self-Report (ASR) for nonclinical samples of adults ages 18 to 59 in 17 societies (N 10,197). Results indicated considerable consistency across societies regarding meanratings on the ASR problem items. Most effect sizes (ESs) for societal differences inproblem scales were small (2?5%). Hierarchical linear modeling (HLM) analysesindicated that culture clusters and society accounted for small percentages of variancein Internalizing, Externalizing, and Total Problems scores, with most of the variationaccounted for by individual differences within societies. In contrast to the small effectsof society on problem scores, for the ASR Personal Strengths scale the societal ES was 34%and culture cluster accounted for 12% of the variance. Worse reported relations withspouse/partner were associated with higher problem scores. Overall, findings indicatedconsiderable similarity but also some important differences in self-reported problems andadaptive functioning across 17 societies. Fil: Rescorla, Leslie A.. Bryn Mawr College; Estados Unidos Fil: Achenbach, Thomas M.. University Of Vermont.; Estados Unidos Fil: Ivanova, Masha Y.. University Of Vermont.; Estados Unidos Fil: Turner, Lori V.. University Of Vermont.; Estados Unidos Fil: Althoff, Robert R.. University Of Vermont.; Estados Unidos Fil: Árnadóttir, Hervör Alma. University of Iceland; Islandia Fil: Au, Alma. Hong Kong Polytechnic University; China Fil: Bellina, Monica. Eugenio Medea Scientific Institute; Italia Fil: Caldas, J. C.. Instituto Superior de Ciencias da Saude-Norte; Brasil Fil: Chen, Yi-Chuen. National Chung Cheng University; China Fil: Csemy, Ladislav. National Institute of Mental Health; Estados Unidos Fil: da Rocha, Marina M.. Mackenzie Presbyterian University; Brasil Fil: Decoster, Jeroen. University of Ghent; Bélgica Fil: Fontaine, Johnny R. J.. University of Ghent; Bélgica Fil: Funabiki, Yasuko. Kyoto University Hospital; Japón Fil: Guðmundsson, Halldór S.. University of Iceland; Islandia Fil: Harder, Valerie S.. University Of Vermont.; Estados Unidos Fil: Kim, Young Ah. No especifíca; Fil: Leung, Patrick. The Chinese University of Hong Kong; China Fil: Ndetei, David M.. Africa Mental Health Foundation; Kenia Fil: Srdanovic Maraš, Jelena. Clinical Center of Vojvodina; Serbia Fil: Markovic, Jasminka. Clinical Center of Vojvodina; Serbia Fil: Oh, Kyung Ja. Yonsei University; Corea del Sur Fil: Samaniego, Virginia Corina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires"; Argentina Fil: Sebre, Sandra. University of Latvia; Letonia Fil: Silvares, Edwiges. Universidade de Sao Paulo; Brasil Fil: Simulioniene, Roma. Klaipeda University; Lituania Fil: Sokoli, Elvisa. University of Tirana; Albania Fil: Vázquez, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires"; Argentina Fil: Zasepa, Ewa. The Maria Grzegorzewska Academy of Special Education; Polonia

This study examined the epidemiology of trauma exposure (TE) and posttraumatic stress disorder (PTSD) among community-dwelling Chinese adults in Hong Kong. Multistage stratification sampling design was used, and 5,377 participants were included. In Phase 1, TE, probable PTSD (p-PTSD), and psychiatric comorbid conditions were examined. In Phase 2, the Structured Clinical Interview for the DSM-IV (SCID-I) was used to determine the weighted diagnostic prevalence of lifetime full PTSD. Disability level and health service utilization were studied. The findings showed that the weighted prevalence of TE was 64.8%, and increased to 88.7% when indirect TE types were included, with transportation accidents (50.8%) reported as the most common TE. The prevalence of current p-PTSD among participants with TE was 2.9%. Results of logistic regression suggested that nine specific trauma types were significantly associated with p-PTSD; among this group, severe human suffering, sexual assault, unwanted or uncomfortable sexual experience, captivity, and sudden and violent death carried the greatest risks for developing PTSD, odds ratio (OR) = 2.32-2.69. The occurrence of p-PTSD was associated with more mental health burdens, including (a) sixfold higher rates for any past-week common mental disorder, OR = 28.4, (b) more mental health service utilization, p.001, (c) poorer mental health indexes in level of symptomatology, suicide ideation and functioning, p.001, and (d) more disability, ps.001-p = .014. The associations found among TE, PTSD, and health service utilization suggest that both TE and PTSD should be considered public health concerns.Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) La Encuesta Hong Kong sobre la Epidemiología de las Experiencias Traumáticas y el Trastorno de Estrés Postraumático ENCUESTA HONG KONG SOBRE EXPERIENCIA TRAUMÁTICA Y TEPT Este estudio examinó la epidemiología de la experiencia traumática (ET) y el trastorno por estrés postraumático (TEPT) entre adultos chinos que viven en comunidades en Hong Kong. Se utilizó un diseño de muestreo de estratificación multietapa y se incluyeron 5,377 participantes. En la Fase 1, ET, probable TEPT (p-TEPT) y enfermedades psiquiátricas comórbidas fueron examinadas. En la Fase 2, se utilizó la Entrevista Clínica Estructurada para el DSM-IV (SCID-I) para determinar la prevalencia de diagnóstico ponderado de TEPT completo a lo largo de la vida. Se estudiaron el nivel de discapacidad y la utilización de los servicios de salud. Los resultados mostraron que la prevalencia ponderada de ET fue del 64.8% y aumentó al 88.7% cuando se incluyeron tipos indirectos de ET, tales como accidentes de transporte (50.8%), los que fueron reportados como el ET más común. La prevalencia actual de p-TEPT entre los participantes con ET fue del 2.9%. Los resultados de la regresión logística sugirieron que nueve tipos específicos de trauma fueron significativamente asociados con p-PTSD; entre este grupo encontramos: sufrimiento humano severo, agresión sexual, experiencia sexual no deseada o incómoda, cautiverio y la muerte inesperada y violenta acarrearon el mayor riesgo para desarrollar TEPT, odds ratio (OR) = 2.32-2.69. La aparición de p-PTSD fue asociado con más riesgo de problemas de salud mental, que incluyen (a) tasas 6 veces más altas para cualquier trastorno mental común experimentado la última semana, OR = 28.4 (b) más utilización de servicios de salud mental, p.001, (c) índices de salud mental más pobres a nivel de sintomatología, ideación y funcionamiento suicida, p.001, y (d) más discapacidad, p.001 - p = .014. Las asociaciones encontradas entre ET, TEPT, y la utilización de los servicios de salud sugieren que tanto el ET como el TEPT deben considerarse una preocupación de salud pública.Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 The Hong Kong Survey on the Epidemiology of Traumatic Experience and Posttraumatic Stress Disorder Traditional Chinese 標題: 香港的創傷經歷及創傷後壓力症流行病學調查 撮要: 本研究檢視在香港居於社區內的中國裔成人, 當中的創傷經歷(TE)及創傷後壓力症(PTSD)的流行病學。我們採用多段分層抽樣法, 檢視5,377名樣本。第一階段檢視TE、很有可能患PTSD的個案(p-PTSD), 及共病精神狀況。第二階段採用DSM-IV結構性臨床會談量表(SCID-I), 來找出終生患完整PTSD的加權診斷普遍率。我們亦檢視殘疾水平及治療服務使用率。結果反映, TE的加權普遍率為64.8%。當我們把間接的TE類別也包含在內時, TE的加權普遍率提升至88.7%, 當中交通意外(50.8%)屬最普遍的TE。有TE的樣本中, 當前有p-PTSD的普遍率為2.9%。邏輯迴歸分析顯示, 有9種特殊的創傷類別跟p-PTSD顯著地有關。當中, 嚴重的痛苦、性侵犯、非自願或令人不安的性經驗、被囚禁, 及突然而且暴力的死亡, 有最大的風險導致PTSD產生(勝算比(OR) = 2.32-2.69)。p-PTSD跟精神健康負擔較大有關, 包括(a) 過去一星期有任何普遍精神疾病的比率高出六倍(OR = 28.4)、(b) 更常使用心理治療服務(p.001)、(c) 症狀學、自殺意念、功能運作方面的健康指數較差(p.001)、(d) 較大程度的殘疾(ps.001-p = .014)。TE、PTSD與治療服務使用的關連反映, TE 與PTSD應視為公眾健康問題。 Simplified Chinese 标题: 香港的创伤经历及创伤后压力症流行病学调查 撮要: 本研究检视在香港居于小区内的中国裔成人, 当中的创伤经历(TE)及创伤后压力症(PTSD)的流行病学。我们采用多段分层抽样法, 检视5,377名样本。第一阶段检视TE、很有可能患PTSD的个案(p-PTSD), 及共病精神状况。第二阶段采用DSM-IV结构性临床会谈量表(SCID-I), 来找出终生患完整PTSD的加权诊断普遍率。我们亦检视残疾水平及治疗服务使用率。结果反映, TE的加权普遍率为64.8%。当我们把间接的TE类别也包含在内时, TE的加权普遍率提升至88.7%, 当中交通意外(50.8%)属最普遍的TE。有TE的样本中, 当前有p-PTSD的普遍率为2.9%。逻辑回归分析显示, 有9种特殊的创伤类别跟p-PTSD显著地有关。当中, 严重的痛苦、性侵犯、非自愿或令人不安的性经验、被囚禁, 及突然而且暴力的死亡, 有最大的风险导致PTSD产生(胜算比(OR) = 2.32-2.69)。p-PTSD跟精神健康负担较大有关, 包括(a) 过去一星期有任何普遍精神疾病的比率高出六倍(OR = 28.4)、(b) 更常使用心理治疗服务(p.001)、(c) 症状学、自杀意念、功能运作方面的健康指数较差(p.001)、(d) 较大程度的残疾(ps.001-p = .014)。TE、PTSD与治疗服务使用的关连反映, TE 与PTSD应视为公众健康问题。.

Background Attention Deficit/Hyperactivity Disorder (ADHD) is characterized with inattention, hyperactivity and impulsivity, while Autism Spectrum Disorder (ASD) is characterized with impaired social communication and interaction, restricted and repetitive patterns of behavior and activities. Phenotypically, both appear to be quite different. However, clinically it has been found that 20–50% ADHD children meet diagnostic criteria for ASD, while 30–80% ASD children meet diagnostic criteria for ADHD. These rates of comorbidity between the two disorders imply that they may share underlying etiologies. Although recent evidence has suggested a genetic overlap between ADHD and ASD, little progress has been made so far to identify the specific genes involved. The shank synaptic scaffold proteins, which are encoded by SHANK genes and located at the post-synaptic density of glutamatergic synapses, have been reported to be associated with a number of psychiatric disorders, including ADHD and ASD, separately. The aim of the current study is to investigate whether there is a genetic overlap between ADHD and ASD in SHANK genes. Methods In the present study, only male children with Chinese ethnicity, aged between 6 to 12 years, were included. 298 ADHD family trios (including ADHD children without ASD and their biological fathers and mothers), 134 ASD children without ADHD, and 109 children with both ASD and ADHD were recruited from public hospitals in Hong Kong. 232 normal control children were recruited from local primary schools. A number of single-nucleotide polymorphisms (SNPs) from SHANK2 and SHANK3 were selected for genotyping. After quality control, 14 SNPs from SHANK2 and 7 SNPs from SHANK3 were included for data analyses. For ADHD family trios’ data, we constructed ADHD cases and matched pseudo-control, which were based on transmitted and un-transmitted parental alleles using the Haplotype-Relative-Risk (HRR) principle. The pseudo-control supplemented the normal control to increase the statistical power. Likewise, ASD children with or without ADHD were also paired with samples of normal control and pseudo-control for association analysis. PLINK and KGG were used for statistical association analyses at SNP-level and gene-level, respectively. Results When association analysis was done between ADHD children without ASD and samples of normal control and pseudo-control, the T allele of rs7106631 of SHANK2 significantly decreased the ADHD risk (p=0.001, OR=0.70). When allele frequencies’ comparisons were conducted between ASD children with or without ADHD and samples of normal control and pseudo-control, the same protective effect of rs7106631 T allele was identified with OR=0.74 (p=0.011). Further association analysis conducted between all clinical children (i.e., ADHD children without ASD & ASD children with or without ADHD) and samples of normal control and pseudo-control yielded more significant results for rs7106631 (p=0.0003, OR=0.72). Additionally, significant associations were found for other SHANK2 SNPs, namely, rs7113016 (p=0.027), rs1073294 (p=0.008), rs11236616 (p=0.003), rs10899158 (p=0.048), and rs9888288 (p=0.004). However, no significant result was detected for SNPs of SHANK3. Subsequent gene-level analysis based on whole dataset suggested the significant role of SHANK2 in both ADHD and ASD (gene-level p=0.003). Discussion Consistent with previous findings in Western populations, this current study provides additional evidence for the significant association of SHANK2 with ASD from a Chinese population. A new finding rarely reported in previous studies is the association of SHANK2 with ADHD. This implies a shared genetic susceptibility between ADHD and ASD. Both disorders do share a number of characteristics, including male preponderance, increased level of oxidative stress, and abnormal neuronal connectivity, reflecting potentially common underlying neurodevelopmental abnormality. Speculatively, the identification of SHANK2 from this current candidate gene study as associating to both ADHD and ASD may provide the common genetic etiology to explain their shared characteristics and higher-than-chance comorbidity. Further studies examining the functional abnormalities of the identified gene, SHANK2, are warranted in the future.

Background Worry processes are implicated in paranoia and anxiety. However, clinical studies focused on patients with co-occurring paranoia and anxiety. As both paranoia and anxiety are distributed across clinical and non-clinical groups, an investigation on worry processes among non-clinical individuals will allow us to delineate the specific worry mechanisms in paranoia and anxiety respectively. Aims To identify clusters of non-clinical individuals who report varied levels of paranoia and anxiety, and to compare worry processes across clusters. Method An online survey, consisting of self-report questionnaires on generalized anxiety, paranoia, and worry processes, was completed by 2796 undergraduate students. A multiple-step validity check procedure resulted in a subsample of 2291 students, upon which cluster analyses and multivariate analyses of variance were conducted. Results Four clusters of individuals were identified: (1) high paranoia/moderate anxiety, (2) average paranoia/high anxiety, (3) average paranoia/average anxiety, and (4) low paranoia/low anxiety. A unique cluster of individuals with high paranoia but low/average level of anxiety was not found. Cluster 1 reported a significantly higher intensity of day-to-day worries, a higher level of meta-worry, and more extreme meta-cognitive beliefs about worry than other clusters. Conclusions Individuals with high paranoia tended to report anxiety as well, but not vice versa. Our findings supported a hierarchical structure of anxiety and paranoia. All worry processes were exacerbated in individuals with paranoia and anxiety than those with anxiety alone.

The 48-basepair (48-bp) variable number tandem repeat (VNTR) polymorphism in exon 3 of the dopamine receptor D4 gene (DRD4) is implicated in the etiology of attention-deficit/ hyperactivity disorder (ADHD). In particular, ADHD in European-ancestry population is associated with an increased prevalence of the 7-repeat (7R) allele of the exon 3 VNTR. However, it is intriguing to note that the 7R allele has been found to be of very low prevalence in the Chinese general population. In a previous case-control study, our research team had found that the 7R allele was similarly absent in Chinese ADHD children in Hong Kong. Instead, there was an increased prevalence of the 2R allele in Chinese ADHD children. Interestingly, in Asian samples, the 2R allele had been found to be an evolutionary derivative of the 7R allele with equivalent biochemical functionality. So, the finding of an association between ADHD and 2R allele in Chinese population does not exactly contradict the original 7R allele finding in European-ancestry population. However, given the potential pitfall of population stratification in the previous case-control design, this current study tested the 2R allele and ADHD association using a methodologically more rigorous family-based approach on 33 Chinese ADHD probands who had favorable clinical responses to stimulant medication (methylphenidate). Haplotype Relative Risk (HRR) analysis and Transmission Disequilibrium Test (TDT) both showed a significant preferential transmission of the 2R allele from the biological parents to ADHD probands (pone-tailed = 0.038, OR = 2.04; pone-tailed = 0.048, OR = 2.29, respectively). A second hypothesis speculates that it is the deviation, including 7R and 2R alleles, from the conserved ancestral 4R allele which confers risk to ADHD. Thus, a preferential transmission of non-4R alleles, against the 4R allele, from biological parents to their ADHD probands is predicted. Both HRR analysis and TDT confirmed such prediction (pone-tailed = 0.029, OR = 2.07; pone-tailed = 0.032, OR = 2.43, respectively). This study re-confirmed the original finding of a previous study that in Chinese population, the 2R allele of the DRD4 exon 3 VNTR was related to ADHD. This endorses the general thesis that DRD4 exon 3 VNTR polymorphism is related to ADHD, despite that the exact length or number of repeats of the associated alleles varies across ethnicity. This in turn supports the dopamine dysregulation theory of ADHD.

This chapter begins with the significance of intercultural couple relationships and provides a framework for understanding cultural differences in couple relationships. It discusses the implications of this framework for couple relationship education and therapy and illustrates the application of the framework using the case of the Wongs. Intercultural couple relationships have historically been unusual and formed against the wishes of the partners' families and societies. Intercultural couples are at higher risk of divorce than intra-cultural couples, and this risk increases with the extent of difference between the partners' cultures. The dimensions of individualism and collectivism provide a simple framework via which cultural differences in couple relationships can be understood. In individualistic cultures, people are perceived as separate beings whose behaviour is primarily determined by internal attributes. Relationship standards regarding psychological intimacy and emotional support also differ along the dimension of individualism– collectivism. In individualistic cultures, individual thoughts and feelings are regarded as important matters worthy of exploration.

To conduct international comparisons of parent-adolescent cross-informant agreement in clinical samples, we analyzed ratings on the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) for 6,762 clinically referred adolescents ages 11-18 from 7 societies (M = 14.5 years, SD = 2.0 years; 51% boys). Using CBCL and YSR data, we asked the following questions: (a) Do parents report more problems for their adolescent children than the adolescents report about themselves? (b) How do cross-informant correlations (rs) for scale scores differ by problem type and by society? (c) How well do parents and adolescents, on average, agree regarding which problems they rate as low, medium, or high? (d) How does within-dyad item agreement vary within and between societies? (e) How do societies vary in dichotomous cross-informant agreement with respect to the deviance status of the adolescents? CBCL and YSR scores were quite similar, with small and inconsistent informant effects across societies. Cross-informant rs averaged .47 across scales and societies. On average, parents and adolescents agreed well regarding which problem items received low, medium, or high ratings (M r = .87). Mean within-dyad item agreement was moderate across all societies, but dyadic agreement varied widely within every society. In most societies, adolescent noncorroboration of parent-reported deviance was more common than parental noncorroboration of adolescent-reported deviance. Overall, somewhat better parent-adolescent agreement and more consistency in agreement patterns across diverse societies were found in these seven clinical samples than in population samples studied using the same methods.

Autism spectrum disorder (ASD) is a disorder with high levels of co-morbidities. The Developmental, Dimensional and Diagnostic Interview (3 Di) is a relatively new instrument designed to provide dimensional as well as categorical assessment of autistic behaviours among children with normal intelligence. Its sound psychometric properties and relatively short administration time make it a versatile instrument. The 3 Di was translated into Chinese (Cantonese) and its applicability among 194 clinic children was examined. Results found excellent reliability and validity, and achieved a sensitivity of 95% and specificity of 77%. It was able to capture the diagnosis of ASD among children presenting with attention deficit hyperactivity disorder. However, although the disorder of ASD is considered universal, the use of a western instrument in a Chinese context should also take note of cultural influences that may impact on the manifestation of its symptoms.

The extended Strengths and Difficulties Questionnaire (SDQ) provides information on problem behaviours and impairment measures. Western studies found impairment measures to be as good as symptom scores in predicting clinical caseness. The high levels of comorbidities among child psychiatric disorders also meant that disorders not specifically captured by the questionnaire could be identified. This study examines its applicability among Chinese school children in Hong Kong. Results found that impairment measures were more predictive of clinical status than were symptom scores. Children with low symptom but high impairment ratings had profiles that were intermediate between the low symptom low impairment and high symptom low impairment groups. The extended SDQ is useful in identifying children who might otherwise be missed if symptom scores alone were used in screening. The acceptance of child psychiatric care in Hong Kong is a multi-step process that depends on how symptoms are perceived.

Objectives: The concept of mental defeat (MD) has been applied to describe the deeper impact of pain on the persons sense of self. It describes an intense psychological reaction to pain, whereby people feel that pain has taken away their autonomy and identity. Although MD has been found to characterize Western individuals who are most distressed and disabled by CP, it is debatable whether the concept can be generalized to the experience of CP patients in other cultures. The present study examined whether MD contributed to the prediction of distress and disability among Hong Kong (HK) Chinese reporting CP. Methods: Using questionnaires, the present study assessed MD, pain, distress, and disability in a sample of HK Chinese, comprising CP patients seeking specialist treatment and community volunteers with chronic or acute pain but not seeking specialist treatment. Results: MD was found to be elevated in CP patients seeking specialist treatment but not in nontreatment-seeking volunteers with pain of comparable duration and severity. Hierarchical regression indicated that MD was a significant predictor of functioning and distress, over and above the effects of pain severity and other potential demographic confounds. Discussion: These findings provide further evidence that MD is a factor that differentiates treatment-seeking from nontreatment-seeking individuals with CP. They also highlight the potential value of applying this psychological concept to the understanding and treatment of CP in HK Chinese.

While the impact of active maternal smoking during pregnancy on child health has been well investigated, the association between maternal passive smoking, or environmental tobacco smoke (ETS), or second-hand smoke, and behavioral development of offspring is less clear. This study examines the association between maternal ETS exposure during pregnancy and child behavior problems.Cross-sectional data of 646 mother-child pairs from the Jintan China Cohort Study were used in the analyses. Mother's exposure to tobacco smoking at home, the workplace, and other places during pregnancy (for the determination of maternal ETS exposure) and children's behaviors (via Child Behavior Checklist) were assessed when the children were 5-6 years old. Logistic regression models were constructed to examine associations between maternal exposure to ETS during pregnancy and internalizing and externalizing behavior problems, adjusting for potential cofounders including child sex and parental characteristics.37% of mothers reported ETS during pregnancy. Children of mothers exposed to ETS during pregnancy had higher scores for externalizing and total behavior problems, with 25% of children whose mothers were exposed to ETS compared to 16% of children of unexposed mothers. After adjusting for potential confounders, ETS exposure was associated with a higher risk of externalizing behavior problems in offspring of exposed mothers (OR=2.08, 95% confidence interval [CI] 1.27-3.43). Analysis after multiple imputations and sensitivity analysis further verified the association, but no dose-response relationship was found. ETS exposure, however, was not associated with internalizing or total behavior problems.This study suggests that maternal ETS exposure during pregnancy may impact child behavioral development, particularly externalizing behaviors.

To advance international mental health assessment, instruments that have been internationally validated are needed. To this end, we analyzed ratings from 14 societies on the Adult Behavior Checklist (ABCL), a collateral-report form parallel to the Adult Self-Report (ASR; Achenbach and Rescorla 2003) for ages 18 to 59. Both the ABCL and the ASR assess problems, personal strengths, and adaptive functioning. For a sample of 8322 see note below collaterals, we found strong consistency across societies regarding which ABCL problem items tended to obtain relatively low, medium, or high ratings. Most societal effect sizes (ESs) for problem scale scores were small to medium (< 13.9 %), but the ES for the ABCL Personal Strengths scale was 25 %. For most of the same participants (N = 8,302), we analyzed cross-informant agreement between self-reports on the ASR and collateral reports on the ABCL. Cross-informant correlations for problem scale scores averaged.47, with considerable societal variation. Problem score means were higher on the ASR than the ABCL in every society, but the size of the difference varied across societies. Mean item ratings on the ABCL and ASR were highly correlated within every society (mean r = .92), but within-dyad item rating agreement varied widely in every society (mean r = .39). In all societies, non-corroboration of self-reported deviance and of collateral-reported deviance was common. Overall findings indicated considerable similarity but also some important differences in collateral-reported problems and adaptive functioning across 14 societies. Fil: Rescorla, L.A. Bryn Mawr College; Estados Unidos Fil: Achenbach, T.M.. University of Vermont; Estados Unidos Fil: Ivanova, M.Y. University of Vermont; Estados Unidos Fil: Turner, L.V. University of Vermont; Estados Unidos Fil: Árnadóttir, Hervör. University of Iceland; Islandia Fil: Au, Alma. Hong Kong Polytechnic University; China Fil: Caldas,J. C.. Instituto Superior de Ciencias da Saude-Norte; Portugal Fil: Chen, Y.. National Chung-Cheng University; China Fil: Decoster, J.. University of Ghent; Bélgica Fil: Fontaine,J.R.J.. University of Ghent; Bélgica Fil: Funabiki,Y.. Kyoto University; Japón Fil: Gudmundsson,H.. University of Iceland; Islandia Fil: Leung, P.. The Chinese University of Hong Kong; China Fil: Liu, J.. University of Pennsylvania; Estados Unidos Fil: Maras, J,S.. No especifíca; Fil: Markovic, J.. No especifíca; Fil: Oh, Kyung Ja. Yonsei University; Corea del Sur Fil: da Rocha,M.. Mackenzie Presbyterian University; Brasil Fil: Samaniego, Virginia Corina. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Facultad de Psicología y Psicopedagogía. Centro de Investigaciones en Psicología y Psicopedagogía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Silvares, E.. Universidade de Sao Paulo; Brasil Fil: Simulioniene, R.. Klaipeda University; Lituania Fil: Vázquez, Natalia. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Facultad de Psicología y Psicopedagogía. Centro de Investigaciones en Psicología y Psicopedagogía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Zasepa, Ewa. The Maria Grzegorzewska Academy of Special Education; Polonia

Objective: Unlike rating scales that focus on the severity of ADHD symptoms, the Strengths and Weaknesses of ADHD-Symptoms and Normal-Behaviors (SWAN) rating scale is phrased in neutral or positive terms for carers to compare the index child’s behaviors with that of their peers. This study explores its psychometric properties when applied to Chinese children in Hong Kong. Method: Ratings from the Chinese SWAN scale collected from parents and teachers of a community sample of 3,722 6- to 12-year-old students recruited by stratified random sampling were compared with 247 clinic children with a diagnosis of ADHD. Reliability, validity, factor structure, and cutoff scores were calculated. Results: Favorable psychometrics and a two-factor structure identical to the original were reproduced. Cutoff scores were supported by satisfactory sensitivities and specificities. Conclusion: The SWAN scale is a reliable and valid instrument for the assessment of ADHD symptoms in Chinese children in Hong Kong.

Objective: To test the fit of a seven-syndrome model to ratings of preschoolers' problems by parents in very diverse societies. Method: Parents of 19,106 children 18 to 71 months of age from 23 societies in Asia, Australasia, Europe, the Middle East, and South America completed the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Confirmatory factor analyses were used to test the seven-syndrome model separately for each society. Results: The primary model fit index, the root mean square error of approximation (RMSEA), indicated acceptable to good fit for each society. Although a six-syndrome model combining the Emotionally Reactive and Anxious/Depressed syndromes also fit the data for nine societies, it fit less well than the seven-syndrome model for seven of the nine societies. Other fit indices yielded less consistent results than the RMSEA. Conclusions: The seven-syndrome model provides one way to capture patterns of children's problems that are manifested in ratings by parents from many societies. Clinicians working with preschoolers from these societies can thus assess and describe parents' ratings of behavioral, emotional, and social problems in terms of the seven syndromes. The results illustrate possibilities for culture general taxonomic constructs of preschool psychopathology. Problems not captured by the CBCL/1.5-5 may form additional syndromes, and other syndrome models may also fit the data., Dr. Ivanovo receives research and salary support from the Research Center for Children, Youth, and Families, which publishes the Child Behavior Checklist [CBCL]. Dr. Achenbach is President of the Research Center for Children, Youth, and Families, and receives remuneration. Dr. Rescorla receives remuneration from the Research Center for Children, Youth, and Families. Dr. Harder previously held a University of Vermont Postdoctoral Fellowship funding by the Research Center for Children, Youth, and Families. Drs. Bjarnadottir, Gudmundsson, Leung, Verhulst, and Mr. Gudmundsson, receive research support from the sole of the CBCL. Dr. Bilenberg has received honoraria from Eli Lilly and Co., Novartis, Neuroscience, and Janseen Cilag. He has received research support from the Danish Research Foundation, the Lundbeck Foundation, Hermansens Mindelegat, and Mods Clausen Fond. Dr. Rapes has received research support from the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences. Dr. Jusiene has received research support from the Lithuanian Science and Studies Foundation. Drs. Ang, Capron, Dias, Dobrean, Doepfner, Duyme, Erol, Esmaeili, Ezpeleta, Frigerio, Goncalves, Jung, Kim, Liu, Oh, Plueck, Pomo limo, Shahini, Silva, Simsek, Souronder, Valverde, Van Leeuwen, and Zubrick, Ms. De Paw, Ms. Kristensen, Mr. Lecannelier, Ms. Montirosso, Ms. Jetishi, Ms. Woo, and Ms. Wu report no biomedical financial interests or potential conflicts of interest., info:eu-repo/semantics/publishedVersion

This study aimed at proposing and testing a conceptual model of youth suicide attempt. We proposed a model that began with family factors such as a history of physical abuse and parental divorce/separation. Family relationship, presence of psychopathology, life stressors, and suicide ideation were postulated as mediators, leading to youth suicide attempt. The stepwise entry of the risk factors to a logistic regression model defined their proximity as related to suicide attempt. Path analysis further refined our proposed model of youth suicide attempt. Our originally proposed model was largely confirmed. The main revision was dropping parental divorce/separation as a risk factor in the model due to lack of significant contribution when examined alongside with other risk factors. This model was cross-validated by gender. This study moved research on youth suicide from identification of individual risk factors to model building, integrating separate findings of the past studies.

including negative behavioural outcomes.The Jintan Cohort Project was established in thesummer of 2004 to help address these concerns onlead exposure and other environmental and health-related issues. This population-based pre-schoolcohort study was initiated in 2004 and reflectscollaboration between American scientists from theUniversity of Pennsylvania and members of ShanghaiJiaotong University, Southeastern University, JintanHospital and Jintan Maternal Health Center. Thestudy will follow children into adolescence to investi-gate the influence of lead exposure and micronutrientdeficiency on their behaviour. Other biological and psy-chosocial risk factors such as sleep patterns, familyconflict and parenting affecting children’s cognitiveand behavioural outcomes are also examined.Theinitialfocus of thiscohort study was on theimpactof lead exposure and micronutrient deficiency on chil-dren’s cognitive and behaviour outcomes. Child devel-opment is complex and likely reflects the individual andcombined effects of neuro-toxicants, micronutrientsand the social environments.

BackgroundChildren with attention-deficit hyperactivity disorder (ADHD) have difficulties with executive function and impulse control which may improve with age.AimsTo map the brain correlates of executive function in ADHD and determine age-related changes in reaction times and brain volumes.MethodAttention-deficit hyperactivity disorder and control groups were compared on the change task measures of response inhibition (stop signal reaction time, SSRT) and shifting (change response reaction time, CRRT). Voxel-wise magnetic resonance imaging (MRI) correlations of reaction times and grey matter volume were determined, along with bivariate correlations of reaction times, brain volumes and age.ResultsIndividuals in the ADHD group had longer SSRTs and CRRTs. Anterior cingulate, striatal and medial temporal volumes highly correlated with SSRT. Striatal and cerebellar volumes strongly correlated with CRRT. Older children had faster reaction times and larger regional brain volumes. In controls, orbitofrontal, medial temporal and cerebellar volumes correlated with CRRT but not SSRT. Neither reaction times nor regional brain volumes were strongly age-dependent.ConclusionsOur evidence supports delayed brain maturation in ADHD and implies that some features of ADHD improve with age.

Background The effectiveness of a combined methylphenidate/behavioural treatment (BT) versus methylphenidate-only for Chinese children with Attention-Deficit/Hyperactivity Disorder (ADHD) was tested in routine clinical practice in Hong Kong. Methods A randomized group comparison design was adopted with two treatment conditions (methylphenidate-only; methylphenidate/BT), which lasted for 6 months. There were four assessment time points (pre-treatment, post-treatment, and 6-month and 12-month follow-ups), using the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviours (SWAN) Rating Scale. Parental attitude toward different treatment options of ADHD was also assessed at pre-treatment and post-treatment. Participants included 90 Chinese ADHD children (mean age = 8 years, SD = .95). Results The combination of BT and a low-dose methylphenidate was significantly more effective than methylphenidate-only in reducing ADHD and ODD symptoms at post-treatment. At follow-ups, the benefits of the combined treatment were maintained, while the methylphenidate-only group caught up in improvement in ADHD symptoms. Parents in both treatment conditions showed improved attitude toward medication after the 6-month treatment phase, while their attitude toward BT was positive all along. Conclusions This study supported the added benefits of BT, on top of medication, for Chinese ADHD children in routine practice with treatments conducted by regular medical and paramedical staffs.

Diagnosis of HIV-associated neurobehavioral disorders often heavily relies upon patient complaints of cognitive difficulties. Yet, research in North America suggests that such complaints may be heavily influenced by affective factors. However, no work in this area has been done in China. The present study examined the relationships among depressed mood, anxiety, memory performance and subjective memory complaints among HIV/AIDS patients in Hong Kong. A total of 90 individuals with HIV were administered the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Patient's Assessment of Own Functioning Inventory (PAOF), and Hong Kong List Learning Test. Forward regression analysis indicated that the BDI Cognitive-Affective score was the most significant predictor of subjective memory complaints on the PAOF. Furthermore, present results also supported previous findings that some individuals with HIV infection are more "accurate" than others in the self-appraisal of their memory ability. Given inaccuracies that exist in subjective memory complaints, these findings highlight the importance of comprehensive cognitive assessment when evaluating the neuropsychological status of individuals of HIV.

Udgivelsesdato: 2007-Oct As a basis for theories of psychopathology, clinical psychology and related disciplines need sound taxonomies that are generalizable across diverse populations. To test the generalizability of a statistically derived 8-syndrome taxonomic model for youth psychopathology, confirmatory factor analyses (CFAs) were performed on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) completed by 30,243 youths 11-18 years old from 23 societies. The 8-syndrome taxonomic model met criteria for good fit to the data from each society. This was consistent with findings for the parent-completed Child Behavior Checklist (Achenbach & Rescorla, 2001) and the teacher-completed Teacher's Report Form (Achenbach & Rescorla, 2001) from many societies. Separate CFAs by gender and age group supported the 8-syndrome model for boys and girls and for younger and older youths within individual societies. The findings provide initial support for the taxonomic generalizability of the 8-syndrome model across very diverse societies, both genders, and 2 age groups.

The China Jintan Child Cohort study began in 2004 with 1656 pre-school participants and a research focus on studying the impact of environmental exposures, such as lead, on children’s neurobehavioural outcomes. This population cohort now includes around 1000 of the original participants, who have been assessed three times over a period of 10 years. Since the original IJE cohort profile publication in 2010, participants have experienced a critical developmental transition from pre-school to school age and then adolescence. The study has also witnessed an increase in breadth and depth of data collection from the original aim of risk assessment. This cohort has added new directions to investigate the mechanisms and protective factors for the relationship between early health factors and child physical and mental health outcomes, with an emphasis on neurobehavioural consequences. The study now encompasses 11 domains, composed of repeated measures of the original variables and new domains of biomarkers, sleep, psychophysiology, neurocognition, personality, peer relationship, mindfulness and family dynamics. Depth of evaluation has increased from parent/teacher report to self/peer report and intergenerational family report. Consequently, the cohort has additional directions to include: (i) classmates of the original cohort participants for peer relationship assessment; and (ii) parental and grandparental measures to assess personality and dynamics within families. We welcome interest in our study and ask investigators to contact the corresponding author for additional information on data acquisition.

Fil: Ivanova, Masha Y. University of Vermont; Estados Unidos Fil: Achenbach, Thomas M. University of Vermont; Estados Unidos Fil: Rescorla, Leslie A. Bryn Mawr College. Department of Psychology; Estados Unidos Fil: Tumer, Lori V. University of Vermont; Estados Unidos Fil: Ahmeti-Pronaj, Adelina. University Clinical Center of Kosova. Department of Child and Adolescent Psychiatry; Kosovo Fil: Au, Alma. Hong Kong Polytechnic University. Department of Applied Social Sciences; China Fil: Maese, Carmen Ávila. El Colegio de Chihuahua; México Fil: Bellina, Mónica. Eugenio Medea Scientific Institute. Department of Child Psychiatry; Italia Fil: Caldas, J. Carlos. Instituto Superior de Ciências da Saúde. Departamento de Ciências Sociais e do Comportamento; Brasil Fil: Chen, Yi Chuen. National Chung Cheng University. Department of Psychology; Taiwan Fil: Csemy, Ladislav. Laboratory of Social Psychiatry. Prague Psychiatric Centre; República Checa Fil: da Rocha, Marina M. University Paulista. Institute of Human Sciences; Brasil Fil: Decoster, Jeroen. Ghent University. Department of Personnel Management, Work, and Organizational Psychology; Bélgica Fil: Dobrean, Anca. Babes-Bolyai University; Department of Clinical Psychology and Psychotherapy; Rumania Fil: Ezpeleta, Lourdes. Universitat Autonoma de Barcelona. Departament de Psicologia Clinica i de la Salut; España Fil: Fontaine, Johnny R. J. Ghent University. Department of Personnel Management, Work, and Organizational Psychology; Bélgica Fil: Funabiki, Yasuko. Kyoto University Hospital. Department of Psychiatry; Japón Fil: Gudmundsson, Halldór S. University of Iceland. Faculty of Social Work; Islandia Fil: Harder, Valerie S. University of Vermont; Estados Unidos Fil: de la Cabada, Marie Leiner. Texas Tech University Health Sciences. Department of Pediatrics; Estados Unidos Fil: Leung, Patrick. The Chinese University of Hong Kong. Department of Psychology; China Fil: Liu, Jianghong. University of Pennsylvania. School of Nursing and Medicine; Estados Unidos Fil: Mahr, Safia. Université Paris Ouest Nanterre la Défense. Laboratoire EVACLIPSY. Departement de Psychologie; Francia Fil: Malykh, Sergey. Psychological Institute of Russian Academy of Education; Rusia Fil: Maras, Jelena Srdanovic. Clinical Center of Vojvodina; Serbia Fil: Marković, Jasminka. University of Novi Sad. Medical Faculty Novi Sad, Clinical Center of Vojvodina; Serbia Fil: Ndetei, David M. Africa Mental Health Foundation; Kenia Fil: Oh, Kyung Ja. Yonsei University. Department of Psychology; Corea del Sur Fil: Petot, Jean-Michel. Université de Paris Ouest. Laboratoire EVACLIPSY. Departement de Psychologie; Francia Fil: Riad, Geylan. Helwan University; Egipto Fil: Sakarya, Direnc. Ankara University. Faculty of Medicine. Department of Psychiatry; Turquía Fil: Samaniego, Virginia Corina. Pontificia Universidad Católica Argentina. Facultad de Psicología y Psicopedagogía; Argentina Fil: Sebre, Sandra. University of Latvia. Department of Psychology; Letonia Fil: Shahini, Mimoza. University Clinical Center of Kosova. Department of Child and Adolescent Psychiatry; Kosovo Fil: Silvares, Edwiges Ferreira de Mattos. University of São Paulo. Instituto de Psicologia; Brasil Fil: Šimulionienė, Roma. Klaipeda University. Department of Psychology; Lituania Fil: Sokoli, Elvisa. University of Tirana. Department of Psychology; Albania Fil: Aston University. School of Life and Health Sciences. Aston Brain Centre; Inglaterra Fil: Vázquez, Natalia. Pontificia Universidad Católica Argentina. Facultad de Psicología y Psicopedagogía; Argentina Fil: Zasępa, Ewa. The Maria Grzegorzewska Academy of Special Education; Polonia Abstract: This study tested the multi-society generalizability of an eight-syndrome assessment model derived from factor analyses of American adults' self-ratings of 120 behavioral, emotional, and social problems. The Adult Self-Report (ASR; Achenbach and Rescorla 2003) was completed by 17,152 18-59-year-olds in 29 societies. Confirmatory factor analyses tested the fit of self-ratings in each sample to the eight-syndrome model. The primary model fit index (Root Mean Square Error of Approximation) showed good model fit for all samples, while secondary indices showed acceptable to good fit. Only 5 (0.06%) of the 8,598 estimated parameters were outside the admissible parameter space. Confidence intervals indicated that sampling fluctuations could account for the deviant parameters. Results thus supported the tested model in societies differing widely in social, political, and economic systems, languages, ethnicities, religions, and geographical regions. Although other items, societies, and analytic methods might yield different results, the findings indicate that adults in very diverse societies were willing and able to rate themselves on the same standardized set of 120 problem items. Moreover, their self-ratings fit an eight-syndrome model previously derived from self-ratings by American adults. The support for the statistically derived syndrome model is consistent with previous findings for parent, teacher, and self-ratings of 1½-18-year-olds in many societies. The ASR and its parallel collateral-report instrument, the Adult Behavior Checklist (ABCL), may offer mental health professionals practical tools for the multi-informant assessment of clinical constructs of adult psychopathology that appear to be meaningful across diverse societies.

Aggression (e.g., assaulting others, bullying, oppositionality; AGG) and non-aggressive rule-breaking (e.g., lying, stealing, vandalism; RB) appear to constitute meaningfully distinct dimensions of antisocial behavior. Despite these differences, it is equally clear that AGG and RB are moderately-to-strongly intercorrelated with one another. To date, however, we have little insight into the sampling and methodologic characteristics that might moderate the association between AGG and RB. The current study sought to evaluate several such moderators (i.e., age, sex, informant, and society) in a sample of 27,861 parent-adolescent dyads from 25 societies. AGG and RB were assessed with the well-known Child Behavior Checklist and Youth Self-Report (Achenbach & Rescorla, 2001). Results revealed small effects of informant and adolescent sex, such that the association between AGG and RB was stronger for parents' reports than for adolescents' self-reports, and for boys than for girls. The association also varied by society. Unexpectedly, the specific operationalization of 'aggression' emerged as a particularly strong moderator, such that the association was stronger for a general measure of AGG than for a more focused measure of physical aggression per se. Such findings inform our understanding of similarities and differences between aggressive and non-aggressive antisocial problems. (C) 2015 Elsevier Ltd. All rights reserved

Background: Psychometric properties of the Chinese version of CBCL, TRF, and YSR were understudied. This study aimed at examining their test–retest reliability and criterion validity. Methods: Three Chinese community and clinic samples were recruited in Hong Kong. The parents, teachers, and youths respectively completed the CBCL, TRF, and YSR. Results: The Chinese CBCL, TRF, and YSR were test–retest reliable and valid. However, there was score/case attenuation at retest. CBCL and TRF appeared to screen externalizing and ADHD problems better, while YSR screened internalizing problems better. Conclusions: Clinicians should be cautious about score/case attenuation at retest while using CBCL, TRF, and YSR to chart patients’ progress. They should also recognize their different strengths in screening various disorders.

Socio-cultural perspectives explain inconsistency in Chinese child-rearing research when imported methods and concepts are applied. We sought to elucidate child-rearing belief constructs relevant to Chinese contexts. Exploratory factor analysis identified items representing child-rearing concepts both imported and indigenous to Chinese culture and forming four dimensions: Training, Shame, Authoritative, and Autonomy. Data from parents of preschool-aged children in Hong Kong (N = 228) and Taiwan (N = 213) were subject to confirmatory factor and scale internal consistency analyses. Results support the conceptual and psychometric coherence of each subscale. Discussion of findings focuses on the benefits of culturally responsive methodology and the potential utility of the scales in child-rearing research with Chinese and other Confucian cultural populations.

Most past research findings suggest that phonological deficit is unique to developmental dyslexia insofar as alphabetic languages are concerned. The present study investigated the existence of any similar unique reading-related cognitive deficits associated with developmental dyslexia in a nonalphabetic script, Chinese. The pattern of comorbidity among various developmental disorders was also examined. One hundred six Chinese children with different types of developmental disorders or learning difficulties, including developmental dyslexia (DYS), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and borderline intelligence (BI), were tested on literacy, rapid-naming, phonological, orthographic, and visual processing skills. It was found that (a) the comorbidity rates among these developmental disorders were high; (b) the DYS-only group was most impaired in rapid naming and orthographic processing and performed significantly worse than other “pure” groups; (c) the ADHD-only and DCD-only groups performed very closely to the average normal range in literacy and cognitive domains; and (d) the cognitive profile of the DYS+ADHD group resembled that of the DYS-only group, while that of the DYS+DCD group resembled some characteristics of both the “pure” groups. The authors conclude that rapid-naming deficit and orthographic deficit are unique marker deficits of developmental dyslexia in Chinese, while children with ADHD or DCD are less impaired in literacy and reading-related cognitive areas. Implications for educational and clinical practices are also discussed. Los resultados RESULTADOS de la mayor parte de las investigaciones sugieren que el deficit fonologico es especifico de la dislexia evolutiva en el caso de las lenguas de escritura alfabetica. El presente estudio investigo la existencia de deficits cognitivos especificos que incidan en la lectura y se asocien a la dislexia evolutiva en una lengua no alfabetica: el chino. Tambien se examino el patron de comorbilidad entre varios desordenes evolutivos. Participaron del estudio 106 ninos chinos con diversos tipos de desordenes evolutivos o dificultades de aprendizaje que incluian dislexia evolutiva (DYS), desorden de deficit atencional/hiperactividad (ADHD), desorden de coordinacion evolutiva (DCD) e inteligencia borderline (BI). Se aplicaron pruebas de lectoescritura, denominacion rapida, habilidades de procesamiento fonologicas, ortograficas y visuales. Se encontro que: a) las tasas de comorbilidad entre estos desordenes evolutivos eran altas, b) el grupo DYS tuvo mas dificultades en denominacion rapida y procesamiento ortografico y se desempeno significativamente peor que los otros grupos “puros”, c) los grupos ADHD y DCD se desempenaron en forma similar al rango promedio normal en lectoescritura y habilidades cognitivas y d) el perfil cognitivo del grupo DYS + ADHD se asemejo al del grupo DYS, en tanto que el perfil del grupo DYS + DCD presento ciertas caracteristicas de ambos grupos “puros”. Los autores concluyen que los deficits ortografico y de denominacion rapida son marcadores especificos de la dislexia evolutiva en chino. Por otra parte los ninos con ADHD o DCD tienen menos dificultades en lectoescritura y las areas cognitivas relacionadas con la lectura. Se discuten implicancias para las practicas educativa y clinica. Die meisten zuruckliegenden Forschungserkenntnisse vermuten, dass ein phonologisches Defizit einzigartig der Entwicklungsdyslexia anhaftet, insofern alphabethische Sprachen betroffen sind. Die vorliegende Studie untersuchte die Existenz von moglichen, ahnlichen lesebezogenen kognitiven Defiziten, assoziiert mit Entwicklungsdyslexia bei einer nichtalphabethischen Schrift, Chinesisch. Die Muster uber Koerkrankung unter verschiedenen Entwicklungsstorungen wurden ebenfalls untersucht. 106 chinesische Kinder mit unterschiedlichen Arten von Entwicklungsstorungen, einschlieslich Entwicklungsdyslexia (DYS), Aufmerksamkeitsdefizit/Hyperaktivitatsstorung (ADHD), Entwicklungskoordinierungsstorung (DCD), und begrenzter Intelligenz (BI) wurden auf ihren Bildungsgrad im Lesen und Schreiben, dem schnellen Benennen, phonologischer, orthographischer und visueller Verarbeitungsfahigkeiten gepruft. Es wurde festgestellt, das (a) die Koerkrankungsanteile unter diesen Entwicklungsstorungen hoch waren; (b) die reine DYS-Gruppe am meisten im schnellen Benennen und bei der orthographischen Verarbeitung benachteiligt war und diese leistete wesentlich Schlechteres als andere “reine” Gruppen; (c) die ausschlieslich ADHD und ausschlieslich DCD Gruppen sehr Nahe dem durchschnittlich-normalen Bereich im Lesen und Schreiben und auf kognitiven Gebieten kamen; und (d) das kognitive Profil der DYS+ADHD Gruppen dem der reinen DYS Gruppe glich, wahrend das der DYS+DCD Gruppen einigen Charakteristiken von den beiden “reinen” Gruppen glich. Die Autoren schliesen daraus, dass ein rapides Benennungsdefizit und orthographisches Defizit eindeutig einzigartige Defizitsmarkierungen der Entwicklungsdyslexia im Chinesischen sind, wahrend Kinder mit ADHD oder DCD weniger benachteiligt in schriftlicher Bildung und auf lesebezogenen, kognitiven Gebieten sind. Auswirkungen fur auszubildende und klinische Anwendungen werden ebenfalls diskutiert. La plupart des recherches effectuees jusqu'ici laissent penser que le deficit phonologique est propre a la dyslexie de developpement, dans la mesure ou l'on a affaire a des langues alphabetiques. La recherche presentee ici concerne l'existence de deficits cognitifs specifiques similaires lies a la lecture et associes a la dyslexie developpementale dans une ecriture non alphabetique, le chinois. On s'est aussi interesse a la structure de comorbidite relative a differents troubles du developpement. On a teste en litteratie, denomination rapide, competences phonologiques, orthographiques, traitement visuel, 106 enfants chinois presentant differents types de troubles du developpement ou des difficultes d'apprentissage, a savoir la dyslexie developpementale (DYS), les troubles par deficit de l'attention/hyperactivite (ADHD), les troubles de la coordination developpementale (DCD), et une intelligence limite (BI). Il est apparu que a) les taux de comorbidite de ces differents troubles du developpement sont eleves; b) le groupe uniquement DYS avait de gros problemes en denomination rapide et traitement orthographique et reussissait significativement moins bien que les autres groupes «purs»; c) les groupes uniquement ADHD et uniquement DCD avaient des resultats tres proches de la moyenne dans le domaine cognitif et en litteratie; d) le profil cognitif du groupe DYS+ADHD etait semblable a celui du groupe uniquement DYS, tandis que celui du groupe DYS+DCD presentait quelques caracteristiques des deux groupes «purs» Les auteurs concluent que le deficit en denomination rapide et le deficit orthographique sont les seuls marqueurs de deficit de dyslexie developpementale en chinois, et que les enfants avec ADHD ou DCD ont moins de difficultes en litteratie et troubles cognitifs associes. On discute egalement des implications sur les plans educatif et clinique.