RESUMO
What Would we Like to (Diagnose) and what do we have to Diagnose. A Systemic Overview and Perspective Behavioral problems in children and young people are currently quickly suspected of being a sign of a psychological problem or a psychiatric disorder. In many cases, the caregivers agree on this, but in others there are clearly different perspectives from obvious to possible diagnoses. Whether a diagnosis makes sense and whether appropriate diagnostics are effective depends on various factors. From a systemic perspective, the common process, the symptomatic patients and their environment benefit from a solution- and resource-oriented view, which should have a greater impact on the future design of classifications of health and illness.
Assuntos
Transtornos Mentais , Humanos , Criança , Adolescente , Transtornos Mentais/diagnóstico , Transtornos Mentais/classificação , Transtornos Mentais/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/classificação , Pré-Escolar , Diagnóstico DiferencialRESUMO
Previous research has shown the harmful effects that out of home care can have on children. Specifically, institutionalized children experience high rates of developmental and psychological problems, and therefore special attention is needed so that a fast intervention can be achieved and further complications can be prevented. This paper focuses on building the psychological and behavioural profile of children living in four residential care units in western Greece, in respect to gender, age and nationality. 153 children (88 children in residential care and 65 children rearing in their families) participated in the study. The children age ranged from 6 to 18 years. Children's behavioural profile was assessed through Child Βehaviour Checklist 6-18 (CBCL 6-18) and was afterwards analyzed with respect to variables such as age, gender and nationality. Children in residential care had higher rates of clinical/borderline range symptoms in Internalizing, Externalizing and Total Problems scale than their counterparts rearing at home. Specifically, they were more withdrawn/ depressed and tended to indicate more rule-breaking behaviour. Both genders showed vulnerability in Internalizing behaviour scale, but girls presented higher rates than boys in the clinical range in Externalizing behaviour scale (22% vs 12%) and Total Problems scale (24% vs 5%). Finally, adolescents in residential care exhibit more internalizing symptoms in clinical range than younger children (22% vs 0%), whereas children of Greek nationality were more vulnerable than children of other nationalities, especially in externalizing behavioural symptoms (28% vs 6%). Our study suggests that children in residential care are at high risk for developing mental health issues. The finding that children are more withdrawn and depressed underlines the possible difficulties in establishing confident relations with peers and adults and can destruct their orientation towards social reality, exhibit mistrust to other people and cause insecurity for their future. There is a lack of longitudinal studies investigating children who have lived in institutions in Greece. Such studies would possibly reveal protective or aggravating parameters that have a positive or negative impact on the development of those children and the transition to adult life.
Assuntos
Adolescente Institucionalizado/psicologia , Sintomas Comportamentais/diagnóstico , Lista de Checagem/métodos , Transtornos do Comportamento Infantil , Criança Institucionalizada/psicologia , Comportamento Problema/psicologia , Adolescente , Técnicas de Observação do Comportamento/métodos , Escala de Avaliação Comportamental , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/prevenção & controle , Transtornos do Comportamento Infantil/psicologia , Feminino , Grécia , Humanos , Masculino , Prognóstico , Psicopatologia , Instituições Residenciais/estatística & dados numéricosRESUMO
We inquire how early in childhood children most at risk for problematic patterns of internalizing and externalizing behaviors can be accurately classified. Yearly measures of anxiety/depressive symptoms and aggressive behaviors (ages 6-13; n = 334), respectively, are used to identify behavioral trajectories. We then assess the degree to which limited spans of yearly information allow for the correct classification into the elevated, persistent pattern of the problem behavior, identified theoretically and empirically as high-risk and most in need of intervention. The true positive rate (sensitivity) is below 70% for anxiety/depressive symptoms and aggressive behaviors using behavioral information through ages 6 and 7. Conversely, by age 9, over 90% of the high-risk individuals are correctly classified (i.e., sensitivity) for anxiety/depressive symptoms, but this threshold is not met until age 12 for aggressive behaviors. Notably, the false positive rate of classification for both high-risk problem behaviors is consistently low using each limited age span of data (< 5%). These results suggest that correct classification into highest risk groups of childhood problem behavior is limited using behavioral information observed at early ages. Prevention programming targeting those who will display persistent, elevated levels of problem behavior should be cognizant of the degree of misclassification and how this varies with the accumulation of behavioral information. Continuous assessment of problem behaviors is needed throughout childhood in order to continually identify high-risk individuals most in need of intervention as behavior patterns are sufficiently realized.
Assuntos
Idade de Início , Transtornos do Comportamento Infantil , Adolescente , Fatores Etários , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/prevenção & controle , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Medição de RiscoRESUMO
The position of selective mutism disorder - SM - has been modified in the last edition of the classification of mental disorders DSM-5. It was removed from "Disorders of childhood and adolescence" and placed in "Anxiety disorders". This caused two important changes in the interpretation of the symptoms of selective mutism. It highlighted anxious etiology of the disorder and also open the possibility to diagnose selective mutism in adults as a special category of anxiety disorders. The aim of this study was to present three different cases concerning the diagnostic difficulties of selective mutism (the child, the teenager and the persons who became adult during our observation) regarding current views on SM. In this study we presented the current view on the etiology, course and available therapies for selective mutism. Owing to updating the clinical knowledge about SM and describing three cases, we highlighted the controversies around the diagnosis and treatment of this disorder. Selective mutism might be a preliminary diagnosis, often leading to the diagnosis of other disorders of diverse etiology and course. Among the psychiatric aspects of the disorder, the 'anxiety component' of SM is crucial. In individuals with selective mutism, developmental disorders, social cognition and neurocognition deficits or dysfunctions of auditory processing often coexist. The severity and the type of comorbidities may determine the future course of the illness and the final effects of the therapy.
Assuntos
Mutismo/classificação , Mutismo/diagnóstico , Índice de Gravidade de Doença , Adolescente , Adulto , Transtornos de Ansiedade/classificação , Transtornos de Ansiedade/diagnóstico , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Feminino , Humanos , Masculino , Mutismo/complicações , Transtornos Fóbicos/classificação , Transtornos Fóbicos/diagnóstico , Medição de RiscoRESUMO
Objective: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. Methods: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. Results: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. Conclusion: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtornos do Comportamento Infantil/psicologia , Comportamento Problema/psicologia , Perda Auditiva/psicologia , Relações Pais-Filho , Adaptação Psicológica , Estudos de Casos e Controles , Transtornos do Comportamento Infantil/classificação , Educação Infantil/psicologia , Fatores de Risco , Perda Auditiva/complicaçõesRESUMO
Objective: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. Methods: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. Results: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). Conclusion: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.
Assuntos
Humanos , Masculino , Feminino , Gravidez , Pré-Escolar , Criança , Adulto , Adulto Jovem , Cesárea/efeitos adversos , Transtornos do Comportamento Infantil/epidemiologia , Comportamento Problema , Transtornos do Comportamento Infantil/classificação , China/epidemiologia , Prevalência , Inquéritos e Questionários , Fatores de Risco , EscolaridadeRESUMO
Objective: To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents. Methods: Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaboraí, state of Rio de Janeiro (n=480), and Embu, state of São Paulo (n=217). The Itaboraí study involved a representative sample of 6-to-16-year-olds (n=1,248; response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813; response rate = 82.4%). The outcome variable was mother's opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ); child's age and gender; maternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]). Results: Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships. Conclusion: Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Transtornos Mentais/diagnóstico , Relações Mãe-Filho , Brasil/epidemiologia , Comorbidade , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Saúde Mental , Estudos Transversais , Inquéritos e Questionários , Transtornos Mentais/classificação , Transtornos Mentais/epidemiologiaRESUMO
OBJECTIVE: To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents. METHODS: Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaboraí, state of Rio de Janeiro (n=480), and Embu, state of São Paulo (n=217). The Itaboraí study involved a representative sample of 6-to-16-year-olds (n=1,248; response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813; response rate = 82.4%). The outcome variable was mother's opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ); child's age and gender; maternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]). RESULTS: Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships. CONCLUSION: Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children.
Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Transtornos Mentais/diagnóstico , Relações Mãe-Filho , Adolescente , Adulto , Brasil/epidemiologia , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/classificação , Transtornos Mentais/epidemiologia , Saúde Mental , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. METHODS: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. RESULTS: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). CONCLUSION: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.
Assuntos
Cesárea/efeitos adversos , Transtornos do Comportamento Infantil/epidemiologia , Comportamento Problema , Adulto , Criança , Transtornos do Comportamento Infantil/classificação , Pré-Escolar , China/epidemiologia , Escolaridade , Feminino , Humanos , Masculino , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
This article reviews and critically evaluates available research on latent classes of maltreatment. Three major databases (PsycINFO, Web of Knowledge, and Academic Search Complete) were used to identify studies on latent classes of maltreatment published before June 1, 2016. Of 365 potentially relevant studies, 14 met inclusion criteria for review. Our analysis was guided by the following questions: (a) What observed indicators are being used to model classes of maltreatment? (b) What are the most commonly identified classes of maltreatment? and (c) What are the predictors and outcomes of classes of maltreatment? Across the studies, findings demonstrated how person-centered methods (i.e., latent class/profile analysis) may facilitate the study of maltreatment by concurrently addressing several methodological limitations common to the study of maltreatment, while also addressing heterogeneity in experiences of maltreatment. After providing an account of existing trends within the literature employing person-centered methodology in the study of maltreatment, we offer a critique of extant research, note recent methodological developments, and make numerous recommendations for future research using person-centered approaches to understanding maltreatment.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/classificação , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/classificação , Maus-Tratos Infantis/psicologia , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/psicologia , HumanosRESUMO
OBJECTIVE: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. METHODS: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. RESULTS: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. CONCLUSION: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.
Assuntos
Transtornos do Comportamento Infantil/psicologia , Perda Auditiva/psicologia , Comportamento Problema/psicologia , Adaptação Psicológica , Adolescente , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/classificação , Educação Infantil/psicologia , Feminino , Perda Auditiva/complicações , Humanos , Masculino , Relações Pais-Filho , Fatores de RiscoRESUMO
OBJECTIVE: Irritable and oppositional behaviors are increasingly considered as distinct dimensions of oppositional defiant disorder. However, few studies have explored this multidimensionality across the broader spectrum of disruptive behavior problems (DBPs). This study examined the presence of dimensions and distinct subgroups of childhood DBPs, and the cross-sectional and longitudinal associations between these dimensions. METHOD: Using factor mixture models (FMMs), the presence of dimensions and subgroups of DBPs was assessed in the Generation R Study at ages 6 (n = 6,209) and 10 (n = 4,724) years. Replications were performed in two population-based cohorts (Netherlands Twin Registry, n = 4,402, and Swedish Twin Study of Child and Adolescent Development, n = 1,089) and a clinical sample (n = 1,933). We used cross-lagged modeling in the Generation R Study to assess cross-sectional and longitudinal associations between dimensions. DBPs were assessed using mother-reported responses to the Child Behavior Checklist. RESULTS: Empirically obtained dimensions of DBPs were oppositional behavior (age 6 years), disobedient behavior, rule-breaking behavior (age 10 years), physical aggression, and irritability (both ages). FMMs suggested that one-class solutions had the best model fit for all dimensions in all three population-based cohorts. Similar results were obtained in the clinical sample. All three dimensions, including irritability, predicted subsequent physical aggression (range, 0.08-0.16). CONCLUSION: This study showed that childhood DBPs should be regarded as a multidimensional phenotype rather than comprising distinct subgroups. Incorporating multidimensionality will improve diagnostic accuracy and refine treatment. Future studies need to address the biological validity of the DBP dimensions observed in this study; herein lies an important opportunity for neuroimaging and genetic measures.
Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos do Comportamento Infantil/fisiopatologia , Sistema de Registros , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Criança , Transtornos do Comportamento Infantil/classificação , Feminino , Humanos , Humor Irritável/fisiologia , Masculino , Países Baixos , Fenótipo , SuéciaRESUMO
BACKGROUND: Originating in the 1960s, the Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of instruments for assessing problems and strengths for ages 1½-90+ years. PURPOSE: To provide an overview of the ASEBA, related research, and future directions for empirically based assessment and taxonomy. CONTENT: Standardized, multi-informant ratings of transdiagnostic dimensions of behavioral, emotional, social, and thought problems are hierarchically scored on narrow-spectrum syndrome scales, broad-spectrum internalizing and externalizing scales, and a total problems (general psychopathology) scale. DSM-oriented and strengths scales are also scored. The instruments and scales have been iteratively developed from assessments of clinical and population samples of hundreds of thousands of individuals. Items, instruments, scales, and norms are tailored to different kinds of informants for ages 1½-5, 6-18, 18-59, and 60-90+ years. To take account of differences between informants' ratings, parallel instruments are completed by parents, teachers, youths, adult probands, and adult collaterals. Syndromes and Internalizing/Externalizing scales derived from factor analyses of each instrument capture variations in patterns of problems that reflect different informants' perspectives. Confirmatory factor analyses have supported the syndrome structures in dozens of societies. Software displays scale scores in relation to user-selected multicultural norms for the age and gender of the person being assessed, according to ratings by each type of informant. Multicultural norms are derived from population samples in 57 societies on every inhabited continent. Ongoing and future research includes multicultural assessment of elders; advancing transdiagnostic progress and outcomes assessment; and testing higher order structures of psychopathology.
Assuntos
Diversidade Cultural , Pesquisa Empírica , Transtornos Mentais/classificação , Transtornos Mentais/etnologia , Escalas de Graduação Psiquiátrica/normas , Adolescente , Adulto , Fatores Etários , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/etnologia , Emoções , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pais , PsicopatologiaRESUMO
In preparation for the World Health Organization's development of the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11) chapter on Mental and Behavioral Disorders, this article reviews the literature pertaining to severe irritability in child and adolescent psychopathology. First, research on severe mood dysregulation suggests that youth with irritability and temper outbursts, among other features of hyperactivity and arousal, demonstrate cross-sectional correlates and developmental outcomes that distinguish them from youth with bipolar disorder. Second, other evidence points to an irritable dimension of Oppositional Defiant Disorder symptomatology, which is uniquely associated with concurrent and subsequent internalizing problems. In contrast to the Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Disruptive Mood Dysregulation Disorder, our review of the literature supports a different solution: a subtype, Oppositional Defiant Disorder with chronic irritability/anger (proposal included in Appendix). This solution is more consistent with the available evidence and is a better fit with global public health considerations such as harm/benefit potential, clinical utility, and cross-cultural applicability. Implications for assessment, treatment, and research are discussed.
Assuntos
Sintomas Afetivos/classificação , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Transtorno Bipolar/classificação , Transtornos do Comportamento Infantil/classificação , Classificação Internacional de Doenças , Humor Irritável/classificação , Adolescente , Criança , HumanosRESUMO
OBJECTIVE: Disruptive mood dysregulation disorder is a newly proposed childhood disorder included in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to describe children ⩽18 years of age with chronic irritability/temper outbursts. This study aimed to examine the prevalence of disruptive mood dysregulation disorder, severe mood dysregulation and chronic irritability in an Australian study of young people at increased familial risk of developing bipolar disorder ('HR' group) and controls ('CON' group). METHODS: A total of 242 12- to 30-year-old HR or CON subjects were administered the severe mood dysregulation module. Of these, 42 were aged ⩽18 years at the time of assessment, with 29 subjects in the HR group and 13 in the CON group. RESULTS: No subjects ⩽18 years - in either group - fulfilled current or lifetime criteria for disruptive mood dysregulation disorder or severe mood dysregulation, the precursor to disruptive mood dysregulation disorder. Similarly, no subjects in either group endorsed the severe mood dysregulation/disruptive mood dysregulation disorder criteria for irritable mood or marked excessive reactivity. One HR participant endorsed three severe mood dysregulation criteria (distractibility, physical restlessness and intrusiveness), while none of the comparison subjects endorsed any criteria. Exploratory studies of the broader 12- to 30-year-old sample similarly found no subjects with severe mood dysregulation/disruptive mood dysregulation disorder in either the HR or CON group and no increased rates of chronic irritability, although significantly more HR subjects reported at least one severe mood dysregulation/disruptive mood dysregulation disorder criterion (likelihood ratio = 6.17; p = 0.013); most of the reported criteria were severe mood dysregulation 'chronic hyper-arousal' symptoms. CONCLUSION: This study comprises one of the few non-US reports on the prevalence of disruptive mood dysregulation disorder and severe mood dysregulation and is the first non-US study of the prevalence of these conditions in a high-risk bipolar disorder sample. The failure to replicate the finding of higher rates of disruptive mood dysregulation disorder and chronic irritability in high-risk offspring suggests that these are not robust precursors of bipolar disorder.
Assuntos
Transtorno Bipolar/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humor Irritável , Transtornos do Humor/epidemiologia , Adolescente , Adulto , Austrália/epidemiologia , Criança , Transtornos do Comportamento Infantil/classificação , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Transtornos do Humor/classificação , Risco , Adulto JovemRESUMO
BACKGROUND: Individuals with sensory regulation disorders present with many difficulties in terms of managing emotions, behavior, and motor control. Children with such difficulties are often referred to psychiatric clinics for assessment of their behavioral and emotional problems. Few studies have investigated the role of environmental factors on sensory dysfunctions, and none have specifically studied its association with child attachment in a clinical sample. OBJECTIVE: In this cross-sectional study, we examined the association between sensory regulation and child attachment among preschoolers referred to a psychiatric clinic. METHOD: A sample of 60 preschoolers and their mothers were recruited through a child psychiatric clinic. Child attachment was assessed with the gold standard separation-reunion procedure for preschoolers. Parents completed the sensory profile, which assesses the presence of child hypersensitivity (sensitivity and avoidant scale) and hyposensitivity (sensory seeking and registration scale). RESULTS: Data showed that 57% of the children were presented with clinical symptoms of sensory regulation. In addition, 53% of the children were classified insecure behaviorally disorganized or insecure disorganized controlling. In particular, results revealed that children classified as insecure disorganized controlling were significantly more likely to show hypersensitivity avoidance and sensory-seeking behaviors. CONCLUSION: This study underscores the importance of the parent-child relationship for children with sensory regulation difficulties.
Assuntos
Transtornos do Comportamento Infantil/fisiopatologia , Relações Mãe-Filho , Apego ao Objeto , Autocontrole , Transtornos do Comportamento Infantil/classificação , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Relações Mãe-Filho/psicologia , Autocontrole/psicologiaRESUMO
OBJECTIVE: We used latent class analysis (LCA) to examine the prevalence and characteristics of the Dysregulation Profile (DP) based on data from the Youth Self-Report (YSR). The DP comprises elevated scores on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndromes and thus reflects significant problems in self-regulation of affect, attention, and behavior. METHOD: We examined YSR data for 38,070 adolescents (48.1% male) in 34 societies. Participants ranged in age from 11 to 16 years. Researchers in 31 societies used translations of the YSR (not in Jamaica, Australia, or the United States). RESULTS: The various statistical indices for good LCA model fit (entropy, bootstrapped parametric likelihood ratio test, adjusted Bayesian Information Criterion, and probability of correct assignment) were not always consistent but generally supported a DP class in every society. However, prevalence of the DP ranged from 1% to 26% and the T score syndrome profile for the DP class in many societies featured elevations on all scales. In every society, the DP class had significantly higher scores than the pooled non-DP classes on all 3 DP syndromes, with large d values. CONCLUSION: Because model fit, the number of classes, and the prevalence of the DP class varied across societies, and because the DP "3-peak" profile was relatively uncommon, results for the DP based on adolescents' ratings in 34 societies must be considered as mixed.
Assuntos
Transtornos do Comportamento Infantil , Saúde Global/estatística & dados numéricos , Modelos Estatísticos , Adolescente , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/fisiopatologia , Feminino , Humanos , Masculino , AutorrelatoRESUMO
The new approach to classification of the epilepsies emphasizes the role of dysfunction in networks in defining types of epilepsies. This paper reviews the structural and neuropsychological deficits in two types of childhood epilepsy: frontal lobe and temporal lobe epilepsy. The evidence for and against a pattern of specificity of deficits in executive function and memory associated with these two types of epilepsies is presented. The evidence varies with the methodologies used in the studies, but direct comparison of the two types of epilepsies does not suggest a clear-cut mapping of function onto structure. These findings are discussed in light of the concept of network dysfunction. The evidence supports the conceptualization of epilepsy as a network disease. Implications for future work in the neuropsychology of pediatric epilepsy are suggested. This article is part of a Special Issue entitled "The new approach to classification: Rethinking cognition and behavior in epilepsy".
Assuntos
Transtornos do Comportamento Infantil/classificação , Transtornos Cognitivos/classificação , Epilepsia do Lobo Frontal/classificação , Epilepsia do Lobo Temporal/classificação , Pensamento , Criança , Transtornos do Comportamento Infantil/diagnóstico por imagem , Transtornos do Comportamento Infantil/epidemiologia , Cognição , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Epilepsia do Lobo Frontal/diagnóstico , Epilepsia do Lobo Frontal/epidemiologia , Epilepsia do Lobo Temporal/diagnóstico , Epilepsia do Lobo Temporal/epidemiologia , Função Executiva , Humanos , Memória , Neuroimagem/classificação , Neuroimagem/métodos , Testes NeuropsicológicosRESUMO
Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was .84 and specificity was .54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.
Assuntos
Transtorno do Espectro Autista/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Sintomas Afetivos/classificação , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Transtorno do Espectro Autista/classificação , Transtorno do Espectro Autista/psicologia , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos Globais do Desenvolvimento Infantil/classificação , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Transtornos Globais do Desenvolvimento Infantil/psicologia , Pré-Escolar , Comorbidade , Feminino , Humanos , Lactente , Masculino , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To analyse the administrative prevalence and regional differences in hyperkinetic disorder (HK) diagnoses in Germany. METHODS: The administrative prevalence of HK (ICD-10 F90) was analysed for 3,6 million children, up to 18 years old and in the whole year 2009 insured by the AOK, using health insurance data. Additionally, administrative prevalence changes between 2006 and 2008 were investigated. The prevalence analyses were differenciated according to postal code areas and regions of the associations of statutory health insurance physicians (SHIP-regions). RESULTS: The analyses revealed a continous increase of the administrative HK-prevalence between 2006 (2,8â%) and 2009 (3,8â%). The administrative prevalence was notably lower in the city states Bremen, Hamburg and Berlin, but rather high in four of five SHIP-regions in the New Laender. 14â% of children with HK were diagnosed with HK and ICD-10 F98.8. In 47â% these different diagnoses had been coded by different physicians. CONCLUSIONS: Regional differences in administrative prevalence rates and discrepancies in diagnosis coding by different physicians may indicate uncertainties regarding HK-diagnosis in routine health care. Future studies should analyse these associations more detailed.