RESUMO
Pediatric attention deficit/hyperactivity disorder (ADHD) is a heterogeneous condition. In particular, children with ADHD display varying profiles of dispositional traits, as assessed through temperament and personality questionnaires. Previous data-driven community detection analyses based on temperament dimensions identified an irritable profile of patients with ADHD, uniquely characterized by elevated emotional dysregulation symptoms. Belonging to this profile increased the risk of developing comorbid disorders. Here, we investigated whether we could replicate this profile in a sample of 178 children with ADHD, using community detection based on personality dimensions. Stability of the identified profiles, of individual classifications, and clinical prediction were longitudinally assessed over a 1-year interval. Three personality profiles were detected: The first two profiles had high levels of neuroticism, with the first displaying higher ADHD severity and lower openness to experience (profile 1; N = 38), and the second lower agreeableness (profile 2; N = 73). The third profile displayed scores closer to the normative range on all five factors (profile 3; N = 67). The identified profiles did only partially replicate the temperament-based profiles previously reported, as higher levels of neuroticism were found in two of the three detected profiles. Nonetheless, despite changes in individual classifications, the profiles themselves were highly stable over time and of clinical predictive value. Whereas children belonging to profiles 1 and 2 benefited from starting medication, children in profile 3 did not. Hence, belonging to an emotionally dysregulated profile at baseline predicted the effect of medication at follow-up over and above initial ADHD symptom severity. This finding suggests that personality profiles could play a role in predicting treatment response in ADHD.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Inventário de Personalidade/normas , Valor Preditivo dos Testes , Adolescente , Criança , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Impairing irritability is highly prevalent in children with attention deficit/hyperactivity disorder (ADHD), although manifestations of irritability are not necessarily present in all settings (home, school, with peers). At the moment, little is known about the relative prevalence, stability, and etiologies of contextual versus cross-situational manifestations of irritability in ADHD. In this study, levels of dysfunctional parenting practices and sleep problems were compared in irritable versus nonirritable children with ADHD, in cases of family-restricted versus cross-situational irritability, and examined as predictors of irritability levels over a one-year interval. Stability of irritability manifestations over time was investigated, and prevalence of cross-situational disruptive mood dysregulation disorder (DMDD) versus 'family-restricted' DMDD was compared. METHOD: One hundred and seventy children with ADHD (age 6-11) were examined. Parents completed a semi-structured interview and questionnaire to assess irritability, and parent-report questionnaires were used to evaluate parenting practices and sleep problems. Questionnaires were completed for a second time after a one-year interval. RESULTS: Parenting practices were more dysfunctional in the irritable group compared to the nonirritable group, while sleep problems did not differ between these two groups. Levels of parenting practices and sleep problems did not predict later irritability after correction for multiple comparison nor did they differ between the family-restricted and cross-situational irritable groups. Finally, family-restricted irritability was as prevalent and as stable over time as cross-situational irritability and family-restricted DMDD as prevalent as cross-situational DMDD. CONCLUSIONS: Factors associated with contextual versus cross-situational manifestations of irritability in ADHD remain elusive. More subtle measures of parenting practices should be considered, including psychological control or accommodation, and other constructs such as social inhibition. Despite not being captured by current nosography, severe forms of family-restricted irritability may be as prevalent as severe forms of cross-situational irritability.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Criança , Humanos , Humor Irritável , PrevalênciaRESUMO
Mental health issues in children and young people are frequent and can have enduring negative consequences. Preventive early interventions delivered at school may foster psychological well-being, and preliminary evidence suggests that mindfulness-based social and emotional learning (SEL) interventions have positive effects on children's mental health. The aim of this study was to evaluate a mindfulness-based SEL curriculum including a French adaptation of the Kindness Curriculum (KC), delivered by pre-kindergarten teachers, in a cluster randomized control trial. Sixty-four classes (761 children, aged 38-58 months) from a socio-economically disadvantaged area in France were randomly assigned to either intervention or waiting-list control conditions. Indicators of children's mental health, self-management, positive relationships with teachers and peers, emotional processing and executive functioning were collected through teacher-rated questionnaires, standardized observations, and behavioral tasks. Results in the whole sample indicated a positive effect of the intervention on children's mental health, including a reduction in emotional, conduct and peer relationship problems, and a reduction in teacher-child conflicts. No significant effects were found on the other indicators. Heterogeneity analyses revealed stronger effects of the intervention on several indicators for children who had a teacher with lower level of teaching experience, for children with lower baseline mental health and for older children. This program therefore appears as a promising early school-based intervention promoting mental health and positive relationships, especially in a subgroup of at-risk preschool-aged children.
Assuntos
Emoções , Atenção Plena , Humanos , Atenção Plena/métodos , Masculino , Feminino , Pré-Escolar , Saúde Mental , França , Aprendizado Social , Currículo , Bem-Estar PsicológicoRESUMO
Categorization - whether of objects, ideas, or events - is a cognitive process that is essential for human thinking, reasoning, and making sense of everyday experiences. Categorization abilities are typically measured by the Wechsler Adult Intelligence Scale (WAIS) similarity subtest, which consists of naming the shared category of two items (e.g., 'How are beer and coffee alike'). Previous studies show that categorization, as measured by similarity tasks, requires executive control functions. However, other theories and studies indicate that semantic memory is organized into taxonomic and thematic categories that can be activated implicitly in semantic priming tasks. To explore whether categories can be primed during a similarity task, we developed a double semantic priming paradigm. We measured the priming effect of two primes on a target word that was taxonomically or thematically related to both primes (double priming) or only one of them (single priming). Our results show a larger and additive priming effect in the double priming condition compared to the single priming condition, as measured by both response times and, more consistently, event-related potentials. Our results support the view that taxonomic and thematic categorization can occur during a double priming task and contribute to improving our knowledge on the organization of semantic memory into categories. These findings show how abstract categories can be activated, which likely shapes the way we think and interact with our environment. Our study also provides a new cognitive tool that could be useful to understand the categorization difficulties of neurological patients.
Assuntos
Café , Semântica , Adulto , Cerveja , Potenciais Evocados/fisiologia , Humanos , Tempo de Reação/fisiologiaRESUMO
Among youths with conduct disorder, those with callous-unemotional traits are at increased risk for persistent antisocial behaviour. Although callous-unemotional traits have been found to be associated with white-matter brain abnormalities, previous diffusion imaging studies were conducted in small samples, preventing examination of potential sex by callous-unemotional traits interaction effects on white matter. Here, we used tract-based spatial statistics at a whole-brain level and within regions of interest to compare the white matter correlates of callous-unemotional traits in female vs. male youths with conduct disorder, in a sample (n = 124) recruited through a multi-site protocol. A sex-specific association between callous-unemotional traits and white matter was found in the left uncinate fasciculus, where callous-unemotional traits were positively associated with axial diffusivity in males, while an opposite pattern was found in females. These findings are in line with previous studies suggesting that the uncinate fasciculus is a key tract implicated in the development of psychopathy, but also add to recent evidence showing that sexual dimorphism needs to be taken into account when examining the structural correlates of mental disorders in general, and callous-unemotional traits in conduct disorder in particular.