The relationship between personality traits and individual factors with perinatal depressive symptoms: a cross-sectional study.

BACKGROUND: Pregnancy is a crucial transition moment exposing women to potential mental health problems, especially depressive disturbances. Sociodemographic, pregnancy-related, and psychological factors have been related to depressive symptoms in the perinatal period. This study aims at (1) exploring personality and individual factors related with perinatal depressive symptoms, and (2) testing the mediating role of personality in the relation between characteristics of the woman's family of origin and depressive symptoms. METHODS: Women in the perinatal period admitted to the gynecology unit for motherhood-related routine assessments (n = 241) were included in the study. A survey on individual sociodemographic, clinical, and pregnancy-related factors was administered, also including the Edinburgh Postnatal Depression Scale (EPDS) and the BIG-5 personality test. RESULTS: Couple conflict and neuroticism were independent and directly correlated with EPDS total score (respectively: B = 2.337; p = .017; B = 0.303; p < .001). Neuroticism was a significant mediator of the relation between the presence of a psychiatric disorder diagnosis in participant's parents and the EPDS total score (indirect b = 0.969; BCCI95%=0.366-1.607). CONCLUSIONS: Couple relation and neuroticism traits are individual factors related to depressive symptoms in the perinatal period. The family of origin also plays an indirect role on perinatal depressive symptoms. Screening of these factors could lead to early recognition and more tailored treatments, ultimately leading to better outcome for the entire family.

Children's and parent's psychological profiles in selective mutism and generalized anxiety disorder: a clinical study.

Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety disorder (GAD) children and their parents. The parents of 26 preschool children with SM and 32 with children with GAD filled out the child behavior check list for 1½-5 years (CBCL1½-5) and the symptom checklist-90-revised (SCL-90-R). Information about the children and their parents' histories was collected through clinical interviews. Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive-compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on the Global Severity Index than fathers of children with GAD. Parents of children with SM displayed a greater presence of stressful life events than parents of children with GAD. Data appeared to confirm that SM and GAD share a common anxious core, though some differences in the children's psychological profiles and the parents' history and personality emerged. Future research should focus on the role of external factors, such as parent-child relationship, in the development of SM.

Grasping the world through words: from action to linguistic production of verbs in early childhood.

We investigated whether the bodily-mediated production of verbs emerges earlier than verb recognition and oral production during early language acquisition. Children (aged 18-22, 23-27, 28-32, and 33-37 months) viewed animated pictures representing actions related to transitive and intransitive verbs and were asked to (i) orally indicate the verb presented, (ii) recognize the target verb among other verbs, and (iii) perform the actions corresponding to the target verb enunciated by the experimenter. Children 18-22 months showed a capacity to enact the verbs, while their recognition and oral production abilities were not comparably developed. Until 27 months of age, children produced more transitive than intransitive verbs across tasks. The gap between verb recognition and verb oral production was found in all ages tested. This is the first study to directly demonstrate that the ability to produce verbs, especially transitive verbs, via overt body actions emerges ontogenetically earlier than recognition and oral production.

Assessment of Psychotic Risk in a Sample of Children and Adolescents with Autism Spectrum Disorder Compared to a Group of "Clinical High Risk" Patients: A Preliminary Study.

1. BACKGROUND: Autism spectrum disorder and psychotic risk show several overlapping symptoms, so differential diagnosis is often difficult. In addition, there is a high rate of comorbidity between the two conditions, which further complicates the work of clinicians. We evaluated the presence of subthreshold psychotic symptoms and/or defined psychotic risk syndromes in autistic children and adolescents; we compared the prevalence, type, and severity of psychotic risk symptoms with those of a group of non-autistic patients at clinical high risk for psychosis (CHR-P). 2. METHODS: In total, 23 autistic patients and 14 CHR-P patients without autism (aged 8-17) were enrolled in the study. The main assessment was made through clinical interviews for autism (Autism Diagnostic Observation Schedule, Second Edition-ADOS-2, Autism Diagnostic Interview, Revised-ADI-R) and psychotic risk (Schizophrenia Proneness Instrument, Child and Youth version-SPI-CY, Structured Interview for Psychosis Risk Syndromes-SIPS). 3. RESULTS: No above-threshold psychotic risk symptoms were detected in our autistic patients, but subthreshold psychotic symptoms were identified in all areas. Specific items from all four dimensions of SIPS appear to be more specific for psychotic risk than autism without comorbidity. 4. CONCLUSIONS: An a priori screening of psychotic risk in neurodiverse populations is fundamental to prevent more severe conditions. Research should clarify the effective specificity of the available tools to modify them to improve their detection capability.

Perinatal mental health and Covid-19-related distress: the role of personality traits.

BACKGROUND: Perinatal mental health is a topic of growing interest, that could affect mothers in a period of high vulnerability, and the impact of coronavirus disease 2019 (Covid-19) pandemic is an important factor to consider in this field. The aim of our study is to study the correlations between five dimensions of personality and subjective Covid-19-related distress in a sample of women in the perinatal period. METHODS: The study included 114 Italian women in the perinatal period. Subjects were asked to complete the Big Five Inventory (BIG-5) and a version of the Impact of Event Scale - Revised (IES-R) anchored to Covid-19-related distress. RESULTS: When the BIG-5 personality traits and several confounding variables were included in a regression model with IES-R total score as criterion, neuroticism subscale of BIG-5 inventory was the only variable independently associated with higher IES-R total score (p<0.001). CONCLUSION: Our study highlights the importance of considering the personality vulnerability factors that can worsen psychopathological symptoms of women in the perinatal period, especially in periods of high psychological stress.

Behavioral gender differences across Pre-School Children with Autism Spectrum Disorders: a cross-sectional study.

There is increasing literature showing that the presentation of Autism Spectrum Disorder (ASD) could be different according to the sex of the patient. Through the analysis of the Autism Diagnostic Interview Revised interview results of a study group consisting of 56 preschool children diagnosed with ASD potential differences in the presentation of ASD were searched. Variables investigated were verbal abilities, the presence/absence of unusual sensory interests, as well as of echolalia. The results showed significant differences between gender in restricted and repetitive behavior (p < 0.01), in particular for those children who have no unusual sensory interest (p < 0.05) and with minimal verbal ability (p < 0.05). The findings contribute providing evidences on phenotypical differences in preschool children with a diagnosis of Autism Spectrum Disorder.

A Link between Parental Psychopathology and Preschool Depression: Take Care of Parents to Take Care of Children.

There is a lot of evidence in the literature showing that early-onset depression determines an emotional and cognitive vulnerability for psychiatric disorders in subsequent years. AIMS: The first aim of this outcome research was to analyze the impact of parental support treatment in a sample of depressed preschool children divided into two groups of comparison (under-reactive and over-reactive) through evolution in the Clinical Global Impression (CGI). The second aim was to analyze the correlation between the presence of parental psychopathology and the severity of children's disorders. METHODS: Our clinical sample consisted of 32 preschool-age children with a final diagnosis of MDD. The children's assessment included a psychiatric assessment to establish a diagnosis of MDD, confirmed by means of a semi-structured interview, which was administered again one month after the end of parental treatment. All the parents began a six-month parent training treatment conducted by experienced child psychiatrists, whereas children were not treated. During this period, the Clinical Global Impression Scale (CGI) was filled out monthly in order to observe the evolution of the children's disorders. RESULTS: Post-hoc tests showed a significant difference from before the treatment to after the treatment only in the over-reactive group (p = 0.00). Regarding parental psychiatric disorders, in the over-reactive group, only 3 children had no parents with psychopathology. In the under-reactive group, no child lacked a parent with psychopathology. CONCLUSION: Parent training treatment seems to be a valid intervention to improve preschool depression, especially in over-reactive groups, and to prevent dysfunctional parental styles connected to parental psychopathology.

Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition.

Objectives: The Ages & Stages Questionnaires Third Version (ASQ-3) identifies the risk of developmental delay in children aged 1 to 66 months. The aim of this study was to determine a reliable and valid instrument for the Italian population to enable the screening of children's development. Methods: Data from 2278 Italian children (age range: 1-66 months) were used to evaluate item discrimination power using the corrected item-total correlation. Internal consistency was analyzed by Cronbach's alpha scores and a Confirmative Factor Analysis was conducted to test the factor structure of the test. Data were also collected to examine the ASQ-3 test-retest reliability and concurrent validity, which was investigated using the Griffiths Scales of Child Development, Third Edition, the Peabody Developmental Motor Scale, Second Edition, and the Developmental Profile, Third Edition tools. In order to evaluate discriminant validity, differences between typical development children and several clinical groups have been performed. Finally, two different cut-off scores have been proposed. Results: The results showed that the questionnaires are composed of high-quality items; the original factor structure has been confirmed and strong Pearson product-moment correlation coefficients between the overall and the total for each domain (ranging from 0.73 to 0.88). The Italian version of the ASQ-3 had adequate internal consistency and a strong agreement between observations with two weeks' intervals. Moreover, the test showed a high discriminant validity due to the possibility of fully discriminating between typical development children and several clinical groups. Finally, two different cut-off scores have been identified using ROC curves in order to have a screening and a diagnostic cut-off value. Conclusion: This study evaluated the psychometric properties of the Italian adaptation of ASQ-3 questionnaires. We demonstrated the validity of the ASQ-3 and determined new cut-off scores for Italian children. Early identification and accurate assessment are important starting points to better understand and anticipate the needs of children and their link to services.

Brief Autism Mealtime Behavior Inventory (BAMBI): Italian Translation and Validation.

Food selectivity is among the most common problems for children with Autism Spectrum Disorder (ASD). The present study aims to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) in an Italian population of children with ASD. BAMBI was translated and cross-culturally adapted following international guidelines, then we investigated internal consistency as measured by Cronbach's alpha and test-retest reliability, as measured by the Intraclass Correlation Coefficient (ICC) in a sample of both children with ASD and with typical development (TD). A total of 131 children were recruited in a clinical and community sample. Internal consistency revealed significant data for both TD and ASD children, with a Cronbach's Alpha of 0.86 and 0.71, respectively. Test-retest reliability showed excellent values for each item of the BAMBI (range 0.83-1.00). Furthermore, we investigated differences in gender and body max index; however, no significant differences were found among groups. In conclusion, the Italian version of the BAMBI showed good internal consistency and test-retest reliability and it can be used for clinical and research purposes.

The teleNIDA: Early Screening of Autism Spectrum Disorder Through a Novel Telehealth Approach.

The COVID-19 pandemic has fast-tracked interest in telehealth methods to guarantee the continuity of care of children with Autism Spectrum Disorder (ASD). Store-and-forward telehealth approaches offer the opportunity to facilitate timely screening of ASD, allowing parents to record videos of their child's behaviors, subsequently shared with clinicians that provide an assessment remotely. This study aimed to examine the psychometric properties of a new telehealth screening tool, the teleNIDA, administered in home settings for remote observation of early signs of ASD in toddlers aged 18-30 months. Results showed good psychometric properties of the teleNIDA, as compared to the gold standard in-person assessment, and the predictive validity on the diagnosis of ASD at 36 months was demonstrated. This study supports the teleNIDA as a promising level 2 screening tool for ASD able to speed up diagnostic and intervention processes.

[Parental care and post partum depression: a case report]. / Cure parentali e depressione post partum: un caso clinico.

The post partum depression (PPD) is a severe risk factor for the emotional and cognitive development of offspring. The Authors describe the relationship between mother with PPD and her two-year old child. The mother repeats patterns of parental care experienced during her own childhood.

The efficacy of executive function interventions in children with autism spectrum disorder: a systematic review and meta-analysis.

INTRODUCTION: Children with Autism Spectrum Disorder (ASD) experience difficulties in Executive Functions (EFs) performance. However, the efficacy of EF intervention needs to be further investigated. OBJECTIVE: To evaluate the efficacy of different EF interventions in children and adolescents with ASD. METHODS: A systematic review and meta-analysis were carried out according to PRISMA guidelines. Relevant databases including PubMed, PsycINFO, Scopus, and Web of Science were searched up to November 2019. Papers included in the study have the following characteristics: randomized controlled trial or quasi-experimental design and published in English or Spanish. RESULTS: After the elimination of duplicates, 949 were screened. Among these, six were included in the systematic review. The main approaches for EF in ASD were computer-based interventions, cognitive-behavioral therapy, and assisted-animal therapy. Statistically significant results (p = 0.003) were found in using exergames. CONCLUSION: Different approaches can be used for improving EF intervention, with positive effects on working memory, behavior, and flexibility.

Evaluation of test-retest reliability and concurrent validity of the Italian version of the pediatric evaluation of disability inventory in children with down syndrome: A cross-sectional study.

PURPOSE: Down Syndrome (DS) is a common genetic disorder caused by trisomy 21. Due to cognitive challenges associated with DS, individuals often experience difficulty performing activities of daily living (ADLs), at levels that can range from mild to significant. This study aimed to measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in the DS population. METHODS: The PEDI-I was administered to children with DS. The internal consistency was examined using Cronbach's Alpha. Test-retest reliability was demonstrated by intraclass correlation coefficient (ICC) and Bland-Altman plots. The concurrent validity was evaluated with the Italian version of the Barthel Index. RESULTS: The PEDI-I was administered to 54 children with DS. Cronbach's Alpha showed statistically significant values (0.899 -0.986). The ICC confirmed the reproducibility of the scale with a range of (0.988 -1), while Bland-Altman plots showed a smallest detectable change of (0.18-1.63). The Pearson Correlation Coefficient with the Barthel Index showed statistically significant values for all PEDI-I subscales (range 0.75-0.95). CONCLUSION: The study provides evidence of good test-retest reliability and convergent validity when used in children with DS. Other psychometric proprieties need to be investigated in future studies.

A Narrative Review about Prosocial and Antisocial Behavior in Childhood: The Relationship with Shame and Moral Development.

We conducted a literature review aimed at identifying the origins of shame as well as its effects on moral development, especially in terms of behavioral outcomes, and we reflected on the practical implications of our findings. We explored the role of shame in moral development through cultural differences and parental influences, collecting evidence of psychopathological consequences of primary moral emotion dysregulation. These studies showed a dichotomous feature of shame, as a prosocial behavior enhancer in morally relevant situations and, simultaneously, a risk factor for aggressive and antisocial behaviors on other occasions. Dysregulated shame leads to maladaptive interpersonal behaviors, which could evolve towards psychopathological paths. Therefore, an integrated intervention is recommended in children with emotional/behavioral problems.

Diagnostic and Therapeutic Challenges of Comorbid ASD, ADHD and Psychosis: A Case Report.

Autism Spectrum Disorder (ASD) and attention deficit hyperactivity disorder (ADHD) comorbidity is common in clinical practice and it seems to be related to shared etiological mechanisms and genetic susceptibility. Moreover, occurrence of psychosis can further complicate these complex clinical pictures. Here, we discuss the case of a nine-years-old boy presenting with an episode of abnormal sustained posture of the upper limbs, resembling dystonia, at the age of 3. At this time, auditory and visual hallucinations, as well as obsessive thoughts and attentional lability were also present and a diagnosis of "Early onset psychosis" was initially made. Due to the worsening of clinical picture, several hospitalizations were necessary and pharmacological treatment with carbamazepine, risperidone and aripiprazole was carried out. Extensive clinic evaluation revealed a past medical and personal history of toe walking, weak social skills and stereotyped behavior observed and ADOS-2 Module 2 administration revealed severe Autism scores. Moreover, signs of attention and hyperactivity were consistent with ADHD diagnosis. This work highlights the importance of a complete diagnostic assessment in patients with complex presentation, suggesting the possible overlap diagnosis of ADHD and Autism even in presence of psychotic-like symptoms.

Feasibility of Screening Programs for Domestic Violence in Pediatric and Child and Adolescent Mental Health Services: A Literature Review.

Each year, 275 million children worldwide are exposed to domestic violence (DV) and suffer negative mental and physical health consequences; however, only a small proportion receive assistance. Pediatricians and child psychiatrists can play a central role in identifying threatened children. We reviewed experiences of DV screening in pediatric and child and adolescent mental health services (CAMHS) to understand its feasibility and provide clues for its implementation. We performed bibliographic research using the Sapienza Library System, PubMed, and the following databases: MEDLINE, American Psychological Association PsycArticles, American Psychological Association PsycInfo, ScienceDirect, and Scopus. We considered a 20-year interval when selecting the articles and we included studies published in English between January 2000 and March 2021. A total of 23 out of 2335 studies satisfied the inclusion criteria. We found that the prevalence of disclosed DV ranged from 4.2% to 48%, with most prevalence estimates between 10% and 20%. Disclosure increases with a detection plan, which is mostly welcomed by mothers (70-80% acceptance rates). Written tools were used in 55% of studies, oral interviews in 40%, and computer instruments in 20%. Mixed forms were used in three studies (15%). The most used and effective tool appeared to be the Conflict Tactics Scale (CTS) (30% of studies). For young children, parental reports are advisable and written instruments are the first preference; interviews can be conducted with older children. Our research pointed out that the current literature does not provide practical clinical clues on facilitating the disclosure in pediatric clinics and CAMHS. Further studies are needed on the inpatient population and in the field of children psychiatry.

Unraveling the Relationship between Sleep Problems, Emotional Behavior Disorders, and Stressful Life Events in Preschool Children.

Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior disorders in preschoolers. Methods: The parents of 213 preschool children with SM, GAD, ODD, and TD (typical development, age range 2-6 years) completed the Children's Sleep Habits Questionnaire (CSHQ), the Coddington Life Events Scale, preschool version (CLES-P), and the CBCL 1½-5. Results: Eighty-three subjects reported sleep problems before the age of 2 years. Seventy-five children (86.14%) with a clinical diagnosis and eight children with TD (8.4%) exceeded the threshold level on the CSHQ. For the bedtime resistance (p = 0.042) and sleep duration subscales (p = 0.038), the SM group had significantly higher scores in comparison to the ODD group. The same pattern was also true for the sleep onset (p = 0.024) and sleep anxiety subscales (p = 0.019). The linear regression analysis model showed that the impact of stressful life events and internalizing problems could predict sleep habits in children. Conclusions: Emotional behavior disorders and stress factors should be regularly investigated in children who are referred to clinics for sleep problems. Clinicians should consider how these symptoms may exacerbate sleep problems and/or interfere with treatment.

Effects of Mirror Neurons-Based Rehabilitation Techniques in Hand Injuries: A Systematic Review and Meta-Analysis.

Background: Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduce immobilization time, and various techniques and methods are adopted, depending on the structures involved. Objective: To measure the effects of mirror neurons-based rehabilitation techniques in hand injuries throughout a systematic review and meta-analysis. Methods: The protocol was accepted in PROSPERO database. A literature search was conducted in Cinahl, Scopus, Medline, PEDro, OTseeker. Two authors independently identified eligible studies, based on predefined inclusion criteria, and extracted the data. RCT quality was assessed using the JADAD scale. Results: Seventy-nine suitable studies were screened, and only eleven were included for qualitative synthesis, while four studies were selected for quantitative analysis. Four studies were case reports/series, and seven were RCTs. Nine investigate the effect of Mirror Therapy and two the effect of Motor Imagery. Quantitative analyses revealed Mirror Therapy as effective for hand function recovery (mean difference = −14.80 95% Confidence Interval (CI) = −17.22, −12.38) (p < 0.00001) in the short term, as well as in long follow-up groups (mean difference = −13.11 95% Confidence Interval (CI) = −17.53, −8.69) (p < 0.00001). Clinical, but not statistical, efficacy was found for manual dexterity (p = 0.15), while no benefit was reported for range of motion. Conclusions: Mirror neurons-based rehabilitation techniques, combined with conventional occupational and physical therapy, can be a useful approach in hand trauma. Mirror therapy seems to be effective for hand function recovery, but, for motor imagery and action observation, there is not sufficient evidence to recommend its use. Further research on the efficacy of the mirror neurons-based technique in hand injury is recommended.

Early Neuro-Psychomotor Therapy Intervention for Theory of Mind and Emotion Recognition in Neurodevelopmental Disorders: A Pilot Study.

The aim of the present study is to explore the effect of early neuro-psychomotor therapy to improve theory of mind skills and emotion recognition in children with neurodevelopmental disorders. A pilot study was set up, consisting of in-group training activities based on the neuro-psychomotor approach. Children were evaluated using Neuropsychological Assessment for Child (Nepsy-II), Test of Emotion Comprehension (TEC), and Social Communication Questionnaire (SCQ). For data analysis, one-sample Wilcoxon signed rank test was used with a significance of p < 0.05. Two children with a developmental language disorder and four children with autism spectrum disorders participated in a 3-month training program. Our findings revealed significant improvement in emotion recognition, as measured with Nepsy-II (p = 0.04), while no statistical improvement was found for theory of mind. Despite the limited sample, early neuro-psychomotor therapy improves emotion recognition skills in children with neurodevelopmental disorders. However, considering the explorative nature of the study, findings should be interpreted with caution.

Clinical, Cognitive and Neurodevelopmental Profile in Tetrasomies and Pentasomies: A Systematic Review.

Background: Sex chromosome aneuploidies (SCAs) are a group of disorders characterised by an abnormal number of sex chromosomes. Collective prevalence rate of SCAs is estimated to be around 1 in 400-500 live births; sex chromosome trisomies (e.g., XXX, XXY, XYY) are most frequent, while tetra- and pentasomies (e.g., XXXX, XXXXX, XXXY, XXXXY) are rarer, and the most common is 48, XXYY syndrome. The presence of additional X and/or Y chromosomes is believed to cause neurodevelopmental differences, with increased risk for developmental delays, language-based learning disabilities, cognitive impairments, executive dysfunction, and behavioural and psychological disorders. Aim of the Study: Our review has the purpose of analysing the neurocognitive, linguistical and behavioural profile of patients affected by sex chromosomes supernumerary aneuploidies (tetrasomy and pentasomy) to better understand the specific areas of weakness, in order to provide specific rehabilitation therapy. Methods: The literature search was performed by two authors independently. We used MEDLINE, PubMed, and PsycINFO search engines to identify sources of interest, without year or language restrictions. At the end of an accurate selection, 16 articles fulfilled the inclusion and exclusion criteria. Results and Conclusions: International literature has described single aspects of the neuropsychological profile of 48, XXYY and 49, XXXXY patients. In 48, XXYY patients, various degrees of psychosocial/executive functioning issues have been reported and there is an increased frequency of behavioural problems in childhood. Developmental delay and behavioural problems are the most common presenting problems, even if anxiety, depression and oppositional defiant disorder are also reported. They also show generalized difficulties with socialization and communication. Cognitive abilities are lower in measures of verbal IQ than in measures of performance IQ. Visuospatial skills are a relative strength compared to verbal skills. In patients with 49, XXXXY, both intellectual and adaptive functioning skills fall into the disability range, with better non-verbal cognitive performance. Speech and language testing reveals more deficits in expressive language than receptive language and comprehension. Anxiety, thought problems, internalizing and externalizing problems, and deficits in social cognition and communication are reported. Behavioural symptoms lessen from school age to adolescence, with the exception of thought problems and anxiety. Individuals affected by sex chromosome aneuploidies show testosterone deficiency, microorchidism, lack of pubertal progression and infertility. Hormone replacement therapy (HRT) is usually recommended for these patients: different studies have found that testosterone-based HRT benefit a wide range of areas initiated in these disorders, affecting not only neuromotor, cognitive and behavioural profile but also structural anomalies of the brain (i.e., increase of volume of grey temporal lobe matter). In conclusion, further studies are needed to better understand the neuropsychological profile with a complete evaluation, including neurocognitive and psychosocial aspects and to establish the real impact of HRT on improving the cognitive and behavioural profile of these patients.