Attention-Deficit/Hyperactivity Disorder Symptoms and Externalizing Progression in the LAMS Study: A Test of Trait Impulsivity Theory.

OBJECTIVE: To test differential prospective prediction of growth in externalizing behavior, including oppositional defiant disorder, conduct disorder, and substance use disorders, by earlier hyperactive-impulsive (HI) vs inattentive (IN) symptoms of attention-deficit/hyperactivity disorder (ADHD). METHOD: Participants in the Longitudinal Assessment of Manic Symptoms (LAMS) Study (N = 685 at study entry), including 458 boys and 227 girls ages 6-12, completed full parent report and self-report assessments every year for 8 years on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Three sets of analyses were conducted. First, hierarchal regression (block entry) was used to test independent associations between HI symptoms and later externalizing outcomes, controlling for IN symptoms, and IN symptoms and later externalizing outcomes, controlling for HI symptoms. Second, logistic regression was used to test progression of DSM externalizing disorders. Third, tests of mediation were used to assess potentiation of externalizing progression through environmental risk mediators (eg, family environment, neighborhood violence). RESULTS: Consistent with hypotheses derived from trait impulsivity theories of externalizing behavior, HI symptoms of ADHD were associated independently with long-term externalizing outcomes, whereas IN symptoms were not. Between months 48 and 96, ADHD-HI/combined symptom subtype diagnoses predicted later oppositional defiant disorder diagnoses, oppositional defiant disorder diagnoses predicted later conduct disorder diagnoses, and conduct disorder diagnoses predicted later substance use disorder diagnoses. Evidence for environmental risk mediation (eg, parental monitoring, neighborhood violence) was also found. CONCLUSION: Findings support trait impulsivity models of externalizing progression, whereby ADHD-HI/combined symptoms subtypes predispose to increasingly severe externalizing behaviors, which are magnified in contexts of environmental risk.

Silent word-reading fluency is strongly associated with orthotactic sensitivity among elementary school children.

Some written languages (the so-called "deep orthographies" such as English) have often unpredictable links to word sounds, making some written words difficult to associate with their spoken forms (i.e., to decode), thereby impeding comprehension. To read these languages efficiently for comprehension, readers require visual cues such as predictable spelling patterns (orthotactic conventions). Sensitivity to English orthotactic conventions (e.g., which letters are sometimes doubled, where configurations such as wh can typically be found in a word) was assessed in a cross-sectional sample of children (N = 271, ages 5-11 years) in kindergarten through Grade 5 using a word-likeness task. Orthotactic sensitivity was strongly correlated with silent word-reading fluency, an important reading skill used frequently in daily life to obtain information, and was modestly correlated with lexical spelling recognition. Among fluent decoders of predictable letter-sound relations, orthotactic sensitivity began to emerge prior to formal reading instruction and developed rapidly from kindergarten to Grade 2. About two thirds of dysfluent decoders (a proxy for dyslexia) demonstrated above-chance orthotactic sensitivity; however, their performance lagged behind that of fluent decoders through Grade 5. Orthotactic acquisition, possible reasons for impairment, and classroom implications are discussed.

Using automated computer vision and machine learning to code facial expressions of affect and arousal: Implications for emotion dysregulation research.

As early as infancy, caregivers' facial expressions shape children's behaviors, help them regulate their emotions, and encourage or dissuade their interpersonal agency. In childhood and adolescence, proficiencies in producing and decoding facial expressions promote social competence, whereas deficiencies characterize several forms of psychopathology. To date, however, studying facial expressions has been hampered by the labor-intensive, time-consuming nature of human coding. We describe a partial solution: automated facial expression coding (AFEC), which combines computer vision and machine learning to code facial expressions in real time. Although AFEC cannot capture the full complexity of human emotion, it codes positive affect, negative affect, and arousal-core Research Domain Criteria constructs-as accurately as humans, and it characterizes emotion dysregulation with greater specificity than other objective measures such as autonomic responding. We provide an example in which we use AFEC to evaluate emotion dynamics in mother-daughter dyads engaged in conflict. Among other findings, AFEC (a) shows convergent validity with a validated human coding scheme, (b) distinguishes among risk groups, and (c) detects developmental increases in positive dyadic affect correspondence as teen daughters age. Although more research is needed to realize the full potential of AFEC, findings demonstrate its current utility in research on emotion dysregulation.

Respiratory sinus arrhythmia reactivity across empirically based structural dimensions of psychopathology: A meta-analysis.

Low resting respiratory sinus arrhythmia (RSA) is observed in many mental health conditions, including anxiety disorders, mood disorders, schizophrenia spectrum disorders, disruptive behavior disorders, and nonsuicidal self-injury, among others. Findings for RSA reactivity are more mixed. We evaluate associations between RSA reactivity and empirically derived structural categories of psychopathology-including internalizing, externalizing, and thought problems-among physically healthy adults. We searched multiple electronic databases for studies of RSA among participants who were assessed either dimensionally using well-validated measures or diagnostically using structured interviews. Strict inclusion criteria were used to screen 3,605 published reports, which yielded 37 studies including 2,347 participants and 76 effect sizes. We performed a meta-analysis, with meta-analytic regressions of potential moderators, including psychopathology subtypes. The sample-wide meta-analytic association between RSA reactivity and psychopathology was quite small, but heterogeneity was considerable. Moderation analyses revealed significant RSA reactivity (withdrawal) specifically in externalizing samples. Additional moderators included (a) stimulus conditions used to elicit RSA reactivity (only negative emotion inductions were effective), (b) sex (women showed greater RSA reactivity than men), and (c) adherence to established methodological guidelines (e.g., higher electrocardiographic sampling rates yielded greater RSA reactivity). These findings indicate that associations between RSA reactivity and psychopathology are complex and suggest that future studies should include more standardized RSA assessments to increase external validity and decrease measurement error.

Improvements in Negative Parenting Mediate Changes in Children's Autonomic Responding Following a Preschool Intervention for ADHD.

Abnormal patterns of sympathetic- and parasympathetic- linked cardiac activity and reactivity are observed among externalizing children, and mark deficiencies in central nervous system regulation of behavior and emotion. Although changes in these biomarkers have been observed following treatment, mechanisms remain unexplored. We used MEMORE-a new approach to analyzing intervening variable effects-to evaluate improvements in parenting as mediators of changes in SNS- and PNS-linked cardiac activity and reactivity among 99 preschoolers with attention-deficit hyperactivity disorder who were treated using an empirically supported intervention. Decreases in negative parenting (criticism, negative commands, physical intrusions) were associated with increases in resting RSA and PEP reactivity to incentives from pre- to post-intervention. Increases in positive parenting were not associated with changes in autonomic function. These findings suggest socially-induced plasticity in peripheral biomarkers of behavior and emotion regulation, and underscore the importance of reducing aversive interactions between parents and children when treating externalizing behavior.

Quantifying respiratory sinus arrhythmia: Effects of misspecifying breathing frequencies across development.

Low resting respiratory sinus arrhythmia (RSA), and to a lesser extent excessive RSA reactivity to emotion evocation, are observed in many psychiatric disorders characterized by emotion dysregulation, including syndromes spanning the internalizing and externalizing spectra, and other conditions such as nonsuicidal self-injury. Nevertheless, some inconsistencies exist. For example, null outcomes in studies of RSA-emotion dysregulation relations are sometimes observed among younger participants. Such findings may derive from use of age inappropriate frequency bands in calculating RSA. We combine data from five published samples (N = 559) spanning ages 4 to 17 years, and reanalyze RSA data using age-appropriate respiratory frequencies. Misspecifying respiratory frequencies results in overestimates of resting RSA and underestimates of RSA reactivity, particularly among young children. Underestimates of developmental shifts in RSA and RSA reactivity from preschool to adolescence were also observed. Although correlational analyses revealed weak negative associations between resting RSA and aggression, those with clinical levels of externalizing exhibited lower resting RSA than their peers. No associations between RSA reactivity and externalizing were observed. Results confirm that age-corrected frequency bands should be used when estimating RSA, and that literature-wide overestimates of resting RSA, underestimates of RSA reactivity, and underestimates of developmental shifts in RSA and RSA reactivity may exist.

Validation of a Brief Structured Interview: The Children's Interview for Psychiatric Syndromes (ChIPS).

Evidence-based assessment is important in the treatment of childhood psychopathology. While researchers and clinicians frequently use structured diagnostic interviews to ensure reliability, the most commonly used instrument, the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS) is too long for most clinical applications. The Children's Interview for Psychiatric Syndromes (ChIPS/P-ChIPS) is a highly-structured brief diagnostic interview. The present study compared K-SADS and ChIPS/P-ChIPS diagnoses in an outpatient clinical sample of 50 parent-child pairs aged 7-14. Agreement between most diagnoses was moderate to high between the instruments and with consensus clinical diagnoses. ChIPS was significantly briefer to administer than the K-SADS. Interviewer experience level and participant demographics did not appear to affect agreement. Results provide further evidence for the validity of the ChIPS and support its use in clinical and research settings.