Commentary: The potential of sleep research to contribute to our understanding on antisocial behaviour - a reflection on Brown, Beardslee, Frick, Steinberg and Cauffman (2022).

A growing body of work indicates that sleep problems are associated with antisocial behaviour in young people. This opens up the opportunity for interventions that improve sleep to reduce antisocial behaviour. Brown et al. (2022) provide important new leads that can help to target interventions, highlighting that the relationship may be most relevant to aggressive offending and that it is consistent across adolescence and young adulthood. The within-individual design adopted in this study has a number of methodological strengths. This commentary evaluates the effectiveness of the approach in terms of accounting for confounding effects and addressing temporal ordering. Directions for future research to build on the target paper are considered.

External validation of a bifactor model of oppositional defiant disorder.

Dimensions of irritability and defiant behavior, though correlated within the structure of ODD, convey separable developmental risks through adolescence and adulthood. Irritability predicts depression and anxiety, whereas defiant behavior is a precursor to antisocial outcomes. Previously we demonstrated that a bifactor model comprising irritability and defiant behavior dimensions, in addition to a general factor, provided the best-fitting structure of ODD symptoms in five large datasets. Herein we extend our previous work by externally validating the bifactor model of ODD using multiple regression and multivariate behavior genetic analyses. We used parent ratings of DSM IV ODD symptoms, and symptom dimensions for ADHD (i.e., inattention and hyperactivity-impulsivity), conduct disorder (CD), depression/dysthymia, and generalized anxiety disorder (GAD) from 846 6-18-year-old twin pairs. We found that the ODD irritability factor was associated only with depression/dysthymia and GAD and the ODD defiant behavior factor was associated only with inattention, hyperactivity-impulsivity, and CD, whereas the ODD general factor was associated with all five symptom dimensions. Multivariate behavior genetic analyses found all five symptom dimensions shared genetic influences in common with the ODD general, irritability, and defiant behavior factors. In contrast, the defiant behavior factor shared genetic influences uniquely with inattention and hyperactivity-impulsivity, whereas the irritability factor shared genetic influences uniquely with depression/dysthymia and GAD, but not vice versa. This suggests that genes that influence irritability in early childhood also predispose to depression and anxiety in adolescence and adulthood. These multivariate genetic findings also support the external validity of the three ODD dimensions at the etiological level. Our study provides additional support for subtyping ODD based on these symptom dimensions, as in the revisions in the ICD-11, and suggests potential mechanisms underlying the development from ODD to behavioral or affective disorders.

Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings.

BACKGROUND: Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. METHODS: In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. RESULTS: Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. CONCLUSIONS: Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

Psychoeducation for Children with Chronic Conditions: A Systematic Review and Meta-analysis.

OBJECTIVE: This systematic review and meta-analysis evaluated the effectiveness of psychoeducational interventions in improving quality of life (QoL) for children with chronic conditions. METHODS: We identified 25 randomized controlled trials of psychoeducational interventions for children with chronic conditions that reported a QoL outcome and were published 1980-2018. Due to small numbers of interventions in other chronic conditions, comparisons between chronic conditions were limited to 17 studies addressing interventions for asthma and diabetes. RESULTS: Psychoeducational interventions were associated with a small, statistically significant improvement in QoL (standardized mean difference = 0.14; 95% confidence interval: 0.06-0.23). The effect was significantly larger for asthma interventions compared to diabetes interventions, and in interventions delivered to younger (under 12 years) rather than older children (12 years and over). CONCLUSIONS: These results suggest that currently evaluated psychoeducational interventions improve QoL for children with asthma but not for children with diabetes. Children with diabetes may require tailored interventions with additional components alongside psychoeducation. Further intervention studies are needed to generalize to other conditions and to draw conclusions about which settings and modes of delivery are most effective in improving QoL.

Comparing the characteristics and outcomes of parent- and teacher-reported oppositional defiant disorder: findings from a national sample.

BACKGROUND: Parents and teachers often disagree on the presence of Oppositional Defiant Disorder (ODD) in children. It has been argued that ODD should be treated as an informant-specific disorder. This study compared the characteristics of children identified with ODD by parent- and teacher report. METHODS: We used the 1999 British Child and Adolescent Mental Health Survey, including more than 10,000 observations aged 5-15 years, to investigate symptom profiles, risk factors, comorbidities and three-year outcomes of parent- and teacher-reported ODD. RESULTS: Parents and teachers poorly agreed on ODD diagnosis. Parent-reported ODD was more strongly associated with a concurrent anxiety disorder at time1 and a successive diagnosis of ODD at time2 . Beyond these differences, parent- and teacher- reported ODD showed similar symptom profiles, risk factors, comorbidities, and outcomes. CONCLUSIONS: Children identified by parent report and teacher report share more similarities than differences in the characteristics of their disorder. This does not support the formation of informant-specific ODD disorders.

A Methylome-Wide Association Study of Trajectories of Oppositional Defiant Behaviors and Biological Overlap With Attention Deficit Hyperactivity Disorder.

In 671 mother-child (49% male) pairs from an epidemiological birth cohort, we investigated (a) prospective associations between DNA methylation (at birth) and trajectories (ages 7-13) of oppositional defiant disorder (ODD), and the ODD subdimensions of irritable and headstrong; (b) common biological pathways, indexed by DNA methylation, between ODD trajectories and attention deficit hyperactivity disorder (ADHD); (c) genetic influence on DNA methylation; and (d) prenatal risk exposure associations. Methylome-wide significant associations were identified for the ODD and headstrong, but not for irritable. Overlap analysis indicated biological correlates between ODD, headstrong, and ADHD. DNA methylation in ODD and headstrong was (to a degree) genetically influenced. DNA methylation associated with prenatal risk exposures of maternal anxiety (headstrong) and cigarette smoking (ODD and headstrong).

The role of cortical sensorimotor oscillations in action anticipation.

The human mirror neuron system is believed to play an important role in facilitating the ability of athletes to anticipate the actions of an opponent. This system is often assessed with EEG by measuring event-related changes in mu (8-13Hz) sensorimotor oscillations. However, traditional channel-based analyses of this measure are flawed in that due to volume conduction effects mu and non-mu alpha activity can become mixed. This flaw means it is unclear the extent to which mu activity indexes the mirror system, as opposed to other processes such as attentional demand. As a solution to this problem, we use independent component analysis to separate out the underlying brain processes during a tennis-related action observation and anticipation task. We investigated expertise-related differences in independent component activity. Experienced tennis players (N=18) were significantly more accurate than unexperienced novices (N=21) on the anticipation task. EEG results found significant group differences in both the mu and beta (15-25Hz) frequency bands in sensorimotor components, with earlier and greater desynchronisation in the experienced tennis players. In particular, only experienced players showed desynchronisation in the high mu (11-13Hz) band. No group differences were found in posterior alpha components. These results show for the first time that expertise differences during action observation and anticipation are unique to sensorimotor sources, and that no expertise-related differences exist in attention modulated, posterior alpha sources. As such, this paper provides a much cleaner measure of the human mirror system during action observation, and its modulation by motor expertise, than has been possible in previous work.

An exploratory randomised trial of a simple, brief psychological intervention to reduce subsequent suicidal ideation and behaviour in patients admitted to hospital for self-harm.

BACKGROUND: Implementation intentions link triggers for self-harm with coping skills and appear to create an automatic tendency to invoke coping responses when faced with a triggering situation. AIMS: To test the effectiveness of implementation intentions in reducing suicidal ideation and behaviour in a high-risk group. METHOD: Two hundred and twenty-six patients who had self-harmed were randomised to: (a) forming implementation intentions with a 'volitional help sheet'; (b) self-generating implementation intentions without help; or (c) thinking about triggers and coping, but not forming implementation intentions. We measured self-reported suicidal ideation and behaviour, threats of suicide and likelihood of future suicide attempt at baseline and then again at the 3-month follow-up. RESULTS: All suicide-related outcome measures were significantly lower at follow-up among patients forming implementation intentions compared with those in the control condition (ds>0.35). The volitional help sheet resulted in fewer suicide threats (d = 0.59) and lowered the likelihood of future suicide attempts (d = 0.29) compared with patients who self-generated implementation intentions. CONCLUSIONS: Implementation intention-based interventions, particularly when supported by a volitional help sheet, show promise in reducing future suicidal ideation and behaviour.

The relationship between smoking and quality of life in advanced lung cancer patients: a prospective longitudinal study.

PURPOSE: Smoking is a major cause of lung cancer, and continued smoking may compromise treatment efficacy and quality of life (health-related quality of life (HRQoL)) in patients with advanced lung cancer. Our aims were to determine (i) preference for treatments which promote quality over length of life depending on smoking status, (ii) the relationship between HRQoL and smoking status at diagnosis (T1), after controlling for demographic and clinical variables, and (iii) changes in HRQoL 6 months after diagnosis (T2) depending on smoking status. METHODS: Two hundred ninety-six patients with advanced lung cancer were given questionnaires to assess HRQoL (EORTC QLQ-C30), time-trade-off for life quality versus quantity (QQQ) and smoking history (current, former or never smoker) at diagnosis (T1) and 6 months later (T2). Medical data were extracted from case records. RESULTS: Questionnaires were returned by 202 (68.2 %) patients at T1 and 114 (53.3 %) at T2. Patients favoured treatments that would enhance quality of life over increased longevity. Those who continued smoking after diagnosis reported worse HRQoL than former smokers or those who never smoked. Smoking status was a significant independent predictor of coughing in T1 (worse in smokers) and cognitive functioning in T2 (better in never smokers). CONCLUSIONS: Smoking by patients with advanced lung cancer is associated with worse symptoms on diagnosis and poorer HRQoL for those who continue smoking. The results have implications to help staff explain the consequences of smoking to patients.

The Utilisation of Music by Casino Managers: An Interview Study.

Music is ubiquitous in retail and commercial environments, with some managers believing that music can enhance the customer experience, increase footfall and sales and improve consumer satisfaction. Casino gambling is popular in the United Kingdom and anecdotal evidence suggests that music is often present. However, little is known about the rationale for music use from the perspective of casino managers. In this study semi-structured interviews were conducted with five casino managers to establish their motivations for utilising music, the factors informing their choice of music and the extent to which music is used with the intention of influencing gambling behaviour. Results showed that casino managers utilised two types of music-recorded background music, often sourced via external music supply companies and live music. Live music was often situated away from the gaming floor and used primarily to accompany participation in non-gambling activities. Recorded background music was not used with the direct aim of influencing customers' gambling behaviour, but to create the right atmosphere for gambling and to promote certain moods within the casinos. To achieve these aims casino managers manipulated the tempo, volume and genre of the recorded background music. Casino managers also reported that some gamblers listen to music via portable music players, possibly with the intention of customising their gambling experience. This study is unique as it has provided a first-hand account of casino managers' implicit theories with regards to why they utilise music and the roles which music is considered to fulfil in casinos.

Income gradients within child and adolescent antisocial behaviours.

BACKGROUND: Low income is a widely studied risk factor for child and adolescent behavioural difficulties. Previous research on this relationship has produced mixed findings. AIMS: To investigate the level, shape and homogeneity of income gradients in different types of antisocial behaviour. METHOD: A representative sample of 7977 British children and adolescents, aged 5-16 years, was analysed. Hypotheses concerning the shapes and homogeneity of the relationships between family socioeconomic status and multiple antisocial behaviour outcomes, including clinical diagnoses of oppositional-defiant disorder, conduct disorder and symptom subscales, such as irritability and hurtfulness, were tested by structural equation models. RESULTS: Consistent income gradients were demonstrated across all antisocial behaviours studied. Disorder prevalence and mean symptom counts decreased across income quintiles in a non-linear fashion. CONCLUSIONS: Our findings emphasise that income gradients are similar across different forms of antisocial behaviour and indicate that income may lead to greater behavioural differences in the mid-income range and less variation at low- and high-income extremes.

A twin and molecular genetics study of sleep paralysis and associated factors.

Sleep paralysis is a relatively common but under-researched phenomenon. In this paper we examine prevalence in a UK sample and associations with candidate risk factors. This is the first study to investigate the heritability of sleep paralysis in a twin sample and to explore genetic associations between sleep paralysis and a number of circadian expressed single nucleotide polymorphisms. Analyses are based on data from the Genesis1219 twin/sibling study, a community sample of twins/siblings from England and Wales. In total, data from 862 participants aged 22-32 years (34% male) were used in the study. This sample consisted of monozygotic and dizygotic twins and siblings. It was found that self-reports of general sleep quality, anxiety symptoms and exposure to threatening events were all associated independently with sleep paralysis. There was moderate genetic influence on sleep paralysis (53%). Polymorphisms in the PER2 gene were associated with sleep paralysis in additive and dominant models of inheritance-although significance was not reached once a Bonferroni correction was applied. It is concluded that factors associated with disrupted sleep cycles appear to be associated with sleep paralysis. In this sample of young adults, sleep paralysis was moderately heritable. Future work should examine specific polymorphisms associated with differences in circadian rhythms and sleep homeostasis further in association with sleep paralysis.

Commentary: Integrating callous and unemotional traits into the definition of antisocial behaviour--a commentary on Frick et al. (2014).

Heterogeneity in the presentation, antecedents, prognosis and treatment response of antisocial behaviour has long provided a challenge to developmental psychopathology researchers. As illustrated in the incisive Frick and colleagues' Annual Research Review, there is growing evidence that the presence of high callous-unemotional (CU) traits identifies a subgroup of antisocial young people with a particularly aggressive and pervasive form of disorder. Frick and colleagues extend their developmental psychopathology approach to CU traits by linking in theories of conscience development and considering evidence on the stability of CU traits. This commentary addresses these themes and the area more generally, considering (1) comparison of a CU specifier to alternative approaches to antisocial heterogeneity (2) high CU traits in the absence of antisocial behaviour and (3) aspects of the measurement of CU traits.

Functional outcomes of child and adolescent oppositional defiant disorder symptoms in young adult men.

BACKGROUND: Oppositional defiant disorder(ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within families, poor peer relationships, peer rejection, and academic difficulties. Little examination of functional outcomes in adulthood associated with ODD has been undertaken. METHOD: Data for the present analyses come from a clinic referred sample of 177 boys aged 7-12 followed up annually to age 18 and again at age 24. Annual parental report of psychopathology through adolescence was used to predict self-reported functional outcomes at 24. RESULTS: Controlling for parent reported symptoms of attention deficit hyperactivity disorder (ADHD), Conduct disorder (CD), depression and anxiety, ODD symptoms from childhood through adolescence predicted poorer age 24 functioning with peers, poorer romantic relationships, a poorer paternal relationship, and having nobody who would provide a recommendation for a job. CD symptoms predicted workplace problems, poor maternal relationship, lower academic attainment, and violent injuries. Only parent reported ODD symptoms and child reported CD symptoms predicted a composite of poor adult outcomes. CONCLUSION: Oppositional defiant disorder is a disorder that significantly interferes with functioning, particularly in social or interpersonal relationships. The persistence of impairment associated with ODD into young adulthood calls for a reconsideration of ODD as a disorder limited to childhood.

Factors associated with parent-teacher hyperactivity/inattention screening discrepancy: Findings from a UK national sample.

BACKGROUND: To fulfil the diagnostic criteria of Attention Deficit Hyperactivity Disorder in the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms should be observed in two or more settings. This implies that diagnostic procedures require observations reported from informants in different settings, such as teachers in school and caregivers at home. This study examined parent-teacher agreement in reporting hyperactivity/inattention and its relationship with child's, parent's, and family's characteristics. METHOD: We used data from the 2004 United Kingdom Mental Health of Children and Young People survey, including 7977 children aged 4-17, to investigate cross-informant agreement between parents and teachers on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. The characteristics of different patterns of informant agreement were assessed using multinomial logistic regression. RESULTS: Cross-informant agreement of parent and teacher was low (weighted kappa = .34, 95% C.I.: .31, .37). Some characteristics, such as male child and parental emotional distress, were associated with higher likelihood of parent-teacher discrepancy. CONCLUSION: We found low informant agreement in the hyperactive/inattention subscale, as hypothesised and consistent with previous studies. The current study has found several factors that predict discrepancy, which were partly consistent with previous research. Possible explanation, implications, and further research on parent-teacher informant discrepancy in reporting hyperactivity/inattention were discussed.

Anaesthesia and airway management in mucopolysaccharidosis.

This paper provides a detailed overview and discussion of anaesthesia in patients with mucopolysaccharidosis (MPS), the evaluation of risk factors in these patients and their anaesthetic management, including emergency airway issues. MPS represents a group of rare lysosomal storage disorders associated with an array of clinical manifestations. The high prevalence of airway obstruction and restrictive pulmonary disease in combination with cardiovascular manifestations poses a high anaesthetic risk to these patients. Typical anaesthetic problems include airway obstruction after induction or extubation, intubation difficulties or failure [can't intubate, can't ventilate (CICV)], possible emergency tracheostomy and cardiovascular and cervical spine issues. Because of the high anaesthetic risk, the benefits of a procedure in patients with MPS should always be balanced against the associated risks. Therefore, careful evaluation of anaesthetic risk factors should be made before the procedure, involving evaluation of airways and cardiorespiratory and cervical spine problems. In addition, information on the specific type of MPS, prior history of anaesthesia, presence of cervical instability and range of motion of the temporomandibular joint are important and may be pivotal to prevent complications during anaesthesia. Knowledge of these risk factors allows the anaesthetist to anticipate potential problems that may arise during or after the procedure. Anaesthesia in MPS patients should be preferably done by an experienced (paediatric) anaesthetist, supported by a multidisciplinary team (ear, nose, throat surgeon and intensive care team), with access to all necessary equipment and support.

The Genesis 12-19 (G1219) Study: a twin and sibling study of gene-environment interplay and adolescent development in the UK.

The Genesis 12-19 (G1219) Study is an ongoing longitudinal study of a sample of UK twin pairs, non-twin sibling pairs, and their parents. G1219 was initially designed to examine the role of gene-environment interplay in adolescent depression. However, since then data have continued to be collected from both parents and their offspring into young adulthood. This has allowed for longitudinal analyses of depression and has enabled researchers to investigate multiple phenotypes and to ask questions about intermediate mechanisms. The study has primarily focused on emotional development, particularly depression and anxiety, which have been assessed at multiple levels of analysis (symptoms, cognitions, and relevant environmental experiences). G1219 has also included assessment of a broader range of psychological phenotypes ranging from antisocial behaviors and substance use to sleep difficulties, in addition to multiple aspects of the environment. DNA has also been collected. The first wave of data collection began in the year 1999 and the fifth wave of data collection will be complete before the end of 2012. In this article, we describe the sample, data collection, and measures used. We also summarize some of the key findings to date.

The development of risky attitudes from pre-driving to fully-qualified driving.

BACKGROUND: Young drivers are at increased crash risk as a result of adopting risky driving styles. The present work examines the development of risky attitudes from pre-driving to fully-qualified driving, focussing on speed related attitudes. METHODS: Data were drawn from a UK longitudinal study of adolescent behaviour development in the general population (the G1219 study). At baseline (modal age 17 years) there were 1596 participants, only 18% of whom were fully-qualified drivers. At follow-up (modal age 20 years) 64% were fully-qualified drivers. Attitudes to driving violations, particularly speeding, were measured in all participants at both assessments. Self-reported driving violations, also related to speeding, were measured in fully-qualified drivers at follow-up. RESULTS: Attitudes became riskier with driver training/experience. Baseline attitudes measured in pre-drivers did not independently predict violations in those that had become fully-qualified drivers at follow-up. The attitudes of learner and fully-qualified drivers at baseline independently predicted violations at follow-up. CONCLUSIONS: These results indicate that the driver training period offers a promising opportunity for interventions to develop safer driving attitudes.

Self-Affirmation and Image/Performance Enhancing Drug Use in Recreational Exercise.

Objectives: The use of image and performance enhancement drugs (IPEDs) in recreational sport represents an emerging public health and societal problem. The present study investigated whether self-affirmation changed exercisers' intentions to use IPEDs, via the effects of mental construal and message acceptance. Method: Sixty-eight exercisers who self-reported IPEDs use participated in the study and were randomly assigned to either a self-affirmation or a control group. All participants read a health-related message about the 10 consequences of IPEDs and subsequently completed a survey measuring message acceptance, mental construal, doping intentions and IPEDs-related social cognitive variables. Results: There were no significant differences between the self-affirmed and the control groups. Hierarchical linear regression analysis further showed that message acceptance, subjective norms, and situational temptation were significantly associated with intentions to use IPEDs. Conclusion: Our findings raise the possibility that for recreational exercisers IPED's use is seen mostly as a health-related matter than a socio-moral transgression.

Impulsivity and self-regulation: A dual-process model of risky driving in young drivers in Iran.

The dual-process model of risky driving (Lazuras, Rowe, Poulter, Powell, & Ypsilanti, 2019) suggested that regulatory processes mediate the effect of impulsivity on risky driving. The current study aimed to examine the cross-cultural generalisability of this model to Iranian drivers, who are from a country with a markedly higher rate of traffic collisions. We sampled 458 Iranian drivers aged 18 to 25 using an online survey measuring impulsive processes including impulsivity, normlessness and sensation-seeking, and regulatory processes comprising emotion-regulation, trait self-regulation, driving self-regulation, executive functions, reflective functioning and attitudes toward driving. In addition, we used the Driver Behaviour Questionnaire to measure driving violations and errors. Executive functions and driving self-regulation mediated the effect of attention impulsivity on driving errors. Executive functions, reflective functioning, and driving self-regulation mediated the relationship between motor impulsivity and driving errors. Finally, attitudes toward driving safety significantly mediated the relationship of both normlessness and sensation-seeking with driving violations. These results support the mediatory role of cognitive and self-regulatory capacities in the connection between impulsive processes and driving errors and violations. Overall, the present study confirmed the validity of the dual-process model of risky driving in a sample of young drivers in Iran. Implications for educating drivers and implementing policies and interventions based on this model are discussed.