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A variety of antenatal risk factors have been established as being detrimental to a child's developing language ability. Our aim was to examine the relationship between exposure to cumulative risk (CR), including antenatal maternal, perinatal, and maternal health characteristics, and children's preschool language ability. Analyses were comprised of interviews and observational data from 5,721 children and their mothers enrolled in the longitudinal "Growing up in New Zealand" cohort study. Language ability status was measured using the PPVT-III and DIBELS letter naming task (LNF) task at age 4.5 years. Results showed that CR was significantly associated with language status on both measures after controlling for multiple covariates. Improving maternal awareness and support during the perinatal period may reduce the number of risks a fetus is exposed to, which may aid early childhood language development.

Background: The Aggressive Student Culture Scale (ASCS) is a survey designed to measure the extent to which New Zealand (NZ) students experience aggressive behaviours within the school environment. The aim of this study is to assess the psychometric properties of the ASCS in the multidisciplinary Growing Up in NZ longitudinal study. Methods: We used data from 4938 children from the Growing Up in NZ study to examine the psychometric properties of ASCS for 8-year-old children. Confirmatory factor analysis was conducted, and measurement invariance was tested across sex, ethnicity, and deprivation levels. Results: The ASCS tool comprises a single latent factor: aggressive student behaviour. The ASCS provides an adequate and satisfactory measure for student aggression experiences. Full measurement invariance was supported for child's sex, but only configural invariance was confirmed across ethnicity and area-level deprivation. Males reported higher levels of aggressive experiences than females. Conclusions: The one-factor model structure offers an excellent fit to our data with good internal consistency. Comparisons across sex are valid; however, direct comparisons across ethnicity and deprivation levels should be approached with caution. We recommend replication studies and encourage further research involving participants from different age groups to better understand the factor structure across diverse demographic variables. [ABSTRACT FROM AUTHOR]

Diagnosing Autism Spectrum Disorders (ASD) is important throughout the lifespan. The objective was to investigate the transcultural diagnostic validity of the Social Communication Questionnaire (SCQ) in a clinical sample of 451 adults with Intellectual Developmental Disorder (IDD) with and without ASD in Germany, the U.S.A. and Great Britain. Variables associated with higher SCQ sum-scores were higher levels of IDD, male gender, a diagnosis of ASD and the study site (Germany > U.S.A > G.B.). An ROC analysis revealed a cut-score of 13, which resulted in a sensitivity of 0.87 and a specificity of 0.58. It is recommended to adjust the cut-score according to level of IDD and gender. Further research is needed to align diagnostic assignment of ASD across different sites and countries.

Objectives Antenatal and postnatal depression can lead to poor outcomes for women and their children. The aim of this study was to explore whether risk factors differ for depression symptoms that are present during pregnancy and/or after childbirth. Methods An ethnically and socioeconomically diverse sample of 5301 women completed interviews during the third trimester of pregnancy and 9 months after childbirth. Depression symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Depression symptoms (defined as EPDS >12) among participants and associations with pre-pregnancy and pregnancy maternal characteristics were explored using logistic regression. Results The rate of antenatal depression symptoms (ADS) only was 8.5, 5% of women had depression symptoms at 9 months postpartum (PDS) only and 3% experienced depression symptoms at both time points. Perceived stress and Pacific or Asian ethnicity were risk factors for ADS and PDS. Anxiety during and before pregnancy was a risk factor for ADS only while having a pre-pregnancy diagnosis of depression was a risk factor for PDS only. Having ADS increased the odds ratio of PDS by 1.5 (95% CI 1.01-2.30). Conclusions The results supported evidence from previous longitudinal studies that depression symptoms appear to be higher during pregnancy than in the first year following childbirth. The study found that PDS may often be a continuation or recurrence of ADS., Author(s): Lisa Underwood [sup.1] , Karen E. Waldie [sup.2] , Stephanie D'Souza [sup.1] [sup.2] , Elizabeth R. Peterson [sup.2] , Susan M. B. Morton [sup.1] [sup.3] Author Affiliations: (1) grid.9654.eCentre [...]

There is little information on the mental health needs of adults with intellectual disability (ID) and autism spectrum disorders (ASDs). Such evidence is much needed for the development of more effective mental health services for this group. The aim of this study is to compare adults with ID and ASD receiving specialist mental health services with participants without ASD. Data were collected from the anonymized case records of a clinic-based population in South East London. Health and social functioning were measured using the Health of the Nation Outcome Scale for people with Learning Disability (HoNOS-LD). A review of case records identified 371 service users in receipt of specialist mental health care who were eligible for the study. There were 117 people (32% of the sample) with a clinical diagnosis of ID and ASD. Participants with ASD were younger, more likely to be male, less likely to live independently and had more severe ID than those without ASD. Furthermore, those with ID and ASD were less likely to be diagnosed with a psychiatric disorder but had significantly higher scores on the HoNOS-LD (indicating lower health and social functioning) than those without ASD. A significant proportion of adults with ID who are in receipt of specialist mental health services also have a clinical diagnosis of ASD. This group has different mental health needs compared with those without ASD. The authors note the need for a more personalized approach to service delivery with a focus on improving social functioning and behavioral impairments.

The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N = 90) on ratings of psychopathology and autism-related symptoms. All participants were referrals to specialist mental heath services for people with ID. Clinical diagnoses of psychopathology and ASD were based on ICD-10 criteria. Key informants also completed the Psychopathology Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) checklist. The analysis showed that there were statistically significant differences in rates of co-morbid psychopathology and clinical management between males and females with ASD, although there were no significant differences in level of ID and age. More specifically, personality disorder and schizophrenia were more common among males, where as dementia was more common among females. Regarding clinical management, males were more likely to be prescribed a combination of medication and females were more likely to receive sedation. Overall, the results suggest that male and female patients with ASD have, at least to some extent, different mental health needs. (Contains 4 tables and 2 figures.)

The present study employed the Disability Assessment Schedule (DAS) to assess problem behaviors in a large sample of adults with ID (N = 568) and evaluate the psychometric properties of this instrument. Although the DAS problem behaviors were found to be internally consistent (Cronbach's [alpha] = 0.87), item analysis revealed one weak item ("Objectional habits") with item-total biserial correlation of only 0.20. An exploratory factor analysis revealed two main factors. The first factor consisted of items relating to "disruptive/distractive" problems. The second factor consisted of items relating to "antisocial/delinquent" problems. "Disruptive/distractive" problems were specifically associated with low ID level. "Antisocial/delinquent" behaviors were specifically associated with male gender, schizophrenia, hospital admission and troubles with police. For patients who had both "disruptive/distractive" problems and "antisocial/delinquent" behaviors, personality disorders and autism were more frequent, where as anxiety and depression were less frequent. On the basis of the obtained results, two new DAS subscales for assessing challenging behavior were proposed. Both subscales had good levels of internal consistency, as well as face and criterion validity. Overall, the new DAS subscales were shown to have acceptable psychometric properties and have therefore potential for use in both research and clinical practice. (Contains 1 figure and 4 tables.)

Although epilepsy is particularly common among people with intellectual disability (ID) it remains unclear whether it is associated with an increased likelihood of co-morbid psychopathology. We therefore investigated rates of mental health problems and other clinical characteristics in patients with ID and epilepsy (N=156) as compared to patients with ID but no epilepsy (N=596). All participants were consecutive referrals to specialist mental heath services. Specialist clinicians agreed on the mental health diagnoses by applying ICD-10 clinical criteria using information gained from interviews with key informants and the patients. Bivariate and multivariate analyses showed that patients with epilepsy were more likely to live in residential housing and have severe ID in line with previous evidence. However, the presence of epilepsy was not associated with an increased likelihood of co-morbid psychopathology. On the contrary, rates of mental health problems, including schizophrenia spectrum, personality and anxiety disorders, were significantly lower among patients with epilepsy. The results are discussed in the context of mood-stabilizing and other psychotropic effects of anti-epileptic drugs in adults with ID and epilepsy, as well as possible diagnostic overshadowing. (Contains 4 tables.)

Aim: To examine the association between perinatal adversities and neurodevelopmental outcome in tuberous sclerosis complex (TSC). Method: The Tuberous Sclerosis 2000 study is a prospective, longitudinal UK study of TSC. In phase 1, mutation type, TSC family history, tuber characteristics, presence of cardiac rhabdomyomas, seizure characteristics, and intellectual ability were assessed in 125 children affected with TSC (64 females, 61 males; median age 39mo, range 4–254). In phase 2, 88 participants (49 females, 39 males; median age 148mo, range 93–323) were assessed for neurodevelopmental outcomes including intellectual ability, autism spectrum disorder, and attention‐deficit/hyperactivity disorder. Perinatal histories of 88 participants with TSC and 80 unaffected siblings were collected retrospectively using the Obstetric Enquiry Schedule and coded with a modified Gillberg Optimality Scale to measure levels of perinatal adversity. Data were analysed using Mann–Whitney U tests, Spearman's rank correlation, and linear regression with robust standard errors. Results: Children with familial TSC experienced significantly greater perinatal adversity than unaffected siblings. Perinatal adversity was higher in children with TSC‐affected mothers than those with unaffected mothers. There was no significant association between perinatal adversities and neurodevelopmental outcomes after controlling for confounders. Interpretation: Maternal TSC is a significant marker of elevated perinatal risk in addition to risks incurred by fetal genotype. Pregnancies complicated by maternal or fetal TSC require higher vigilance, and mechanisms underlying increased perinatal adversity require further research. What this paper adds: Higher perinatal adversity is associated with familial tuberous sclerosis complex (TSC).Maternal TSC was associated with higher frequencies of several perinatal risk markers.Paternal TSC was not associated with higher levels of perinatal adversity.Perinatal adversity levels in TSC1 and TSC2 subgroups did not differ significantly.Perinatal adversities were not associated with neurodevelopmental outcomes. What this paper adds: Higher perinatal adversity is associated with familial tuberous sclerosis complex (TSC).Maternal TSC was associated with higher frequencies of several perinatal risk markers.Paternal TSC was not associated with higher levels of perinatal adversity.Perinatal adversity levels in TSC1 and TSC2 subgroups did not differ significantly.Perinatal adversities were not associated with neurodevelopmental outcomes. This original article is commented on by Franz on pages 1184–1185 of this issue. [ABSTRACT FROM AUTHOR]

Our editorial introduction to this volume on drag queens highlights what we believe are some of the most prominent and important themes of female impersonation in the past and today. Building on contributors' articles, a substantial body of literature on female impersonators/drag queens and the social construction of gender, and our own extensive ethnographic experiences in a multitude of drag settings, we first suggest that such individuals can be seen as symbolic representatives of the cultural ideals associated with the feminine and women and how they have changed over time. We next argue that the notion of the effeminate drag queen is more a myth than a reality with the contextual benefits many performers receive--status and power-being indicative of the hegemony of masculinity in male-dominated societies. We next explore how additional social identities, such as race, class, nation, and religion, often impact drag performances and how others interpret them. We end our introduction by offering a model that delineates what are some of the present transgressive limits and subversive possibilities of female impersonation. KEYWORDS. Drag queen, female impersonator, transgressive, subversive, transgendered, third gender, female impersonation in a historical framework, cross-dressing, effeminate, masculinity, race, class, nation, religion