Recognising autism: a latent transition analysis of parental reports of child autistic spectrum disorder 'red flag' traits before and after age 3.

PURPOSE: It has been proposed that parents should be educated about child autistic spectrum disorder (ASD) 'red flag' traits to help professionals identify and address concerning behaviours as early as possible. This study aimed to empirically demonstrate that established/recognised 'red flag' traits in the first 3 years of life would reliably predict ASD risk severity in later childhood, associated with established ASD risk correlates and mirroring functioning diagnostic categories. METHODS: Using retrospective parental report data from the Mental Health of Children and Young People in Great Britain survey (N = 7977), latent class analysis (LCA) and a quasi -latent transition analysis were used to (1) identify profiles of variation in parent reports of child 'red flag' traits before and after age 3 and (2) model transitions in risk from 3 years and below to ≥ 3 years, respectively, per the 'optimal outcome' model. RESULTS: Three distinct classes, each characterised by variation in parent 'red flag' trait reporting were identified for the '≤ 3 years of age' and the '≥ 3 years of age' data. Both LCA class profiles comprised groups of children characterised by low, medium and high ASD risk. Dose-response effects for a number of recognised ASD correlates across the low, moderate and high risk '≥ 3 years of age' classes seemed to validate older classes in terms of ASD relevance. Over 54% of children characterised by the highest levels of ASD 'red flag' trait probability at 3 years and below (2% of sample), also populated the high-risk class evidenced in the '≥ 3 years of age' LCA. CONCLUSIONS: Retrospective parental reports of child ASD 'red flag' traits ≤ 3 years of age were reliable indicators of ASD risk in later childhood.

Preliminary Findings of a New Primary and Community Care Psychological Service in Northern Ireland: Low-Intensity Cognitive Behavioural Therapy for Common Mental Health Difficulties.

BACKGROUND: The prevalence of mental health difficulties in Northern Ireland (NI) is significantly higher than in England. In recent years, there have been extensive consultations, and subsequent recommendations made in NI in an effort to address this. AIMS: The current study aims to evaluate the effectiveness of an 'Improving Access to Psychological Therapies' (IAPT) stepped care service model using low-intensity cognitive behavioural therapy (LI-CBT) in primary and community care settings. METHOD: A pilot intervention trial design utilized two standardized outcome measures (PHQ-9 and GAD-7) before treatment (at baseline), during treatment (in every session) and at discharge (at final session). RESULTS: Preliminary reliable change outcomes for the pilot cohorts showed a recovery rate of 47.9%, improvement rate of 76.7% and deterioration rate of 6%. CONCLUSIONS: These findings suggest that the IAPT service model is clinically effective in the NI population. Data collection for the larger study was completed in December 2017. Future analyses will include follow-up data collected at 4 months post-treatment, and will also aim to identify individual and service level factors that potentially impact treatment effectiveness.

Predictors of PTSD and CPTSD in UK firefighters.

Background: Globally, professional firefighters are often exposed to traumatic events and are at high risk of developing posttraumatic stress disorder (PTSD) symptoms. Objective: With the publication of the 11th edition of the International Classification of Diseases (ICD-11) there arose a need for research based on the new diagnostic criteria, and the associated disorder, Complex PTSD (CPTSD). Method: Participants were 1300 former or present firefighters from the UK. Prevalence rates of PTSD and CPTSD were estimated using International Trauma Questionnaire in accordance with ICD-11 criteria, and service related and personal trauma exposure were also assessed using an anonymous online questionnaire. Multinomial logistic regression was performed to assess how service and personal trauma exposure predicted PTSD and CPTSD. Results: CPTSD criteria were met by 18.23% (95% CI 16.13-20.33%) and PTSD criteria were met by 5.62% (95% CI 4.37-6.87%) of the sample. Experiencing higher levels of service-related trauma significantly increased the risk for both PTSD and CPTSD, and nonwork related trauma uniquely predicted CPTSD but not PTSD. Conclusions: This study provided the first examination of the new ICD-11 criteria for PTSD and CPTSD in a large sample of firefighters, and CPTSD was more common than PTSD. Exposure to multiple different types of trauma increased the odds of PTSD and CPTSD.

Antecedentes: A nivel mundial, los bomberos profesionales están con frecuencia expuestos a eventos traumáticos y están en alto riesgo de desarrollar síntomas del trastorno de estrés postraumático (TEPT).Objetivo: Con la publicación de la 11° edición de la Clasificación Internacional de Enfermedades (CIE-11) surgió la necesidad de realizar una investigación basada en los nuevos criterios diagnósticos y el trastorno asociado, el TEPT complejo (TEPT-C).Método: Los participantes fueron 1 300 bomberos, tanto en retiro como en servicio, del Reino Unido. Se estimaron las tasas de prevalencia del TEPT y del TEPT-C usando el Cuestionario Internacional de Trauma de acuerdo con los criterios de la CIE-11. También fueron evaluados la exposición a trauma personal y al relacionado con el servicio mediante un cuestionario anónimo en línea. Se realizó una regresión logística multinomial para evaluar cómo la exposición al trauma personal y del servicio predijeron el TEPT y el TEPT-C.Resultados: Los criterios del TEPT-C fueron cumplidos por el 18,23% (95% IC 16,13% - 20,33%) y los criterios del TEPT fueron cumplidos por el 5,62% (95% IC 4,37% −6,87%) de la muestra. Experimentar niveles más altos de trauma relacionado con el servicio aumentó significativamente tanto el riesgo del TEPT como del TEPT-C. El trauma no relacionado con el trabajo predijo de manera única el TEPT-C pero no el TEPT.Conclusiones: Este estudio proporcionó la primera evaluación de los nuevos criterios de la CIE-11 para el TEPT y el TEPT-C en una muestra grande de bomberos. Asimismo, el TEPT-C fue más común que el TEPT. La exposición a múltiples traumas de distintos tipos aumentó la probabilidad de desarrollar el TEPT y el TEPT-C.