Multi-informant evaluation of Cognitive Disengagement Syndrome (formerly Slow Cognitive Tempo). Children's self-reported measures in relation to parents / Evaluación multi-informante del Síndrome de Desconexión Cognitiva (anteriormente Tempo Cognitivo Lento). Medidas autoinformadas de los niños con relación a padres

El objetivo fue examinar, desde una aproximación multi-informante, las medidas del Síndrome de Desconexión Cognitiva (SDC) de padres/madres e hijos/as y su relación con síntomas internalizantes y externalizantes. 279 niños/as (9-13 años), y sus padres/madres completaron las evaluaciones sobre SDC, la inatención del trastorno por déficit de atención e hiperactividad (TDAH) y otras medidas internalizadas y externalizadas. Los ítems de las tres medidas de SDC convergieron razonablemente bien en el factor SDC. Se aportaron pruebas discriminantes de la validez de las relaciones entre las puntuaciones de las pruebas y las medidas de los tres constructos diferentes (SDC, soledad y preferencia por la soledad). La asociación más estrecha estuvo entre la evaluación parental de las medidas de SDC con ansiedad y depresión, y entre inatención con hiperactividad/impulsividad y trastorno negativista desafiante. Se observó capacidad predictiva de la medida de SDC sobre la soledad y preferencia por estar solo autoinformadas. Se encontró una posible asociación entre la medida del SDC evaluado por padres/madres y sexo y edad de los niños. En conclusión, los datos apoyan la inclusión de medidas autoinformadas en la evaluación del SDC. Las medidas del SDC en niños se vinculan con medidas internalizantes y, la inatención con las externalizantes.(AU)

Cognitive Disengagement Syndrome Symptoms from Early Childhood to Adolescence in a Nationally Representative Spanish Sample.

OBJECTIVE: The identification of a common set of symptoms for assessing cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) for early childhood (ages 5-8), middle childhood (ages 9-12), and adolescence (ages 13-16) is needed to advance research on the developmental psychopathology of CDS (i.e. a common symptom set with comparable internal and external validity for each age group). METHOD: Parents of a nationally representative sample of 5,525 Spanish children and adolescents (ages 5 to 16, 56.1% boys) completed measures of CDS, attention-deficit/hyperactivity disorder-inattention (ADHD-IN), and other measures. RESULTS: First, the 15 CDS symptoms showed convergent and discriminant validity relative to the ADHD-IN symptoms within each age group. Second, CDS showed stronger first-order and unique associations than ADHD-IN with anxiety, depression, somatization, daytime sleep-related impairment, and nighttime sleep disturbance, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-hyperactivity/impulsivity, oppositional defiant disorder, and academic impairment. Third, CDS showed stronger first-order and unique associations than ADHD-IN with a history of having an anxiety, depression, or bipolar disorder diagnosis, whereas ADHD-IN showed stronger first-order and unique associations with having an ADHD diagnosis. CONCLUSIONS: The identification of a common set of CDS symptoms spanning early childhood to adolescence allows for the advancement of research on CDS, with a particular need now for longitudinal studies and examination of CDS with other functional outcomes and across other cultural contexts.

Assessment of sustained attention in high-performance and attention deficit/hyperactivity disorder (ADHD) children with a vigilance task / Evaluación de la atención sostenida en niños de alto rendimiento y con trastorno por déficit de atención e hiperactividad (TDAH) en una tarea de vigilancia

El objetivo principal de este estudio fue comparar a niños se-leccionados en un contexto comunitario con TDAH, alto rendimiento, y desarrollo normotípico, en una tarea de atención sostenida. Se selecciona-ron tres grupos de niños: TDAH (n= 42), alto rendimiento (n= 20) y desarrollo normotípico (n= 28). Se aplicó una tarea breve de vigilancia computarizada (CSAT-R) para comparar la capacidad deatención y el tiempo de reacción. Para analizar la validez clínica, los participantes se divi-dieron en aquellos con "disfunción atencional" y aquellos con "atención normal”. Los niños con alto rendimiento se diferenciaron claramente de los otros dos grupos, con tamaños del efecto grandes. Las diferencias entre los grupos normotípico y TDAH solo fueron significativas en los errores y en un índice no paramétrico de capacidad de atención, pero con tamaños del efecto pequeños. La CSAT-R mostró una buena especificidad y un valor predictivo positivo aceptable, pero niveles bajos de sensibilidad y un pobre valor predictivo negativo. Por tanto, la atención sostenida podría ser un mecanismo destacado en niños con altas capacidades. La CSAT-R (y pro-bablemente la mayoría de las tareas de atención) sería moderadamente útil en entornos comunitarios para el diagnóstico del TDAH, pero no para des-cartarlo.(AU)

The main objective of this study was to compare children select-ed in a community setting with ADHD, high-performance, and normo-typical development on a sustained attention task. Three groups of chil-dren were selected: ADHD (n= 42), high-performance (n= 20), and nor-mo-typical development (n= 28). A brief computerized vigilance task (CSAT-R) was applied to compare attentional capacity and reaction time. The participants were divided into those with “attentional dysfunction” and those with “normal attention” to analyze clinical validity. Children with high-performance were clearly differentiated from the other two groups, with large effect sizes. The differences between normo-typical and ADHD groups were only significant in the errors and in a nonparametric index of attentional capacity, but with small effect sizes. The CSAT-R showed good specificity and an acceptable positive predictive value, but low levels of sensitivity, and a poor negative predictive value. Therefore, sustained attention could be a prominent mechanism in children with high capacities. The CSAT-R (and probably most of attentional tasks) would be moderately useful in community settings for ADHD diagnosis, but not to rule it out.(AU)

Cognitive Disengagement Syndrome and Child Sleep Problems in ADHD, Anxiety and Depression.

The main objective of this study was to analyse the relationship and differential contribution of Cognitive Disengagement Syndrome (CDS) and sleep problems in children in different psychopathological measures. A total of 1133 participants (612 fathers/mothers and 521 children aged 7-13 years in Years 3-6 of Primary Education) completed the scales on CDS, sleep problems, depression (DEP), anxiety (ANX) and attention deficit and hyperactivity disorder (ADHD). Similar and significant correlations were identified in the measures of CDS and sleep problems between fathers and mothers, obtaining a high coefficient between the two parents. However, weak correlations were found between fathers/mothers and children. The scores of CDS and the sleep disturbance scale for children (SDSC) significantly predicted the internalising measures and ADHD, especially between SDSC and DEP. It was confirmed that sleep problems had a greater presence in the group of children with the highest ADHD scores, and especially in CDS and ADHD jointly. To conclude, the data indicate the importance of sleep problems in understanding CDS and its relationship with other psychopathological measures, especially ADHD, although to a greater extent with internalising symptoms, especially DEP.

Oppositional Defiant Disorder in the DSM-5: Does the Limited Prosocial Emotions Specifier Portend a More Severe Clinical Presentation?

This study investigated whether oppositional defiant disorder (ODD) with the DSM-5 limited prosocial emotions (LPE) specifier marks a more severe clinical presentation than ODD alone. Mothers, fathers, and teachers of 2,142 Spanish children (49.49% girls; ages 8 to 13 years) completed measures of ODD, LPE, ADHD-hyperactivity/impulsivity (HI), ADHD-inattention (IN), cognitive disengagement syndrome (CDS), anxiety, depression, social impairment, academic impairment, and peer rejection (teacher only measure). Scores greater or less than 1.50 SDs above the ODD and LPE means were used to create ODD-only (5.89-7.22% of the sample, depending on informant), LPE-only (7.61-8.25%), ODD + LPE (1.69-2.20%), and comparison groups (82.96-84.68%) for each source. For all three sources, the LPE-only group scored higher than the comparison group on social impairment, peer rejection, and academic impairment but did not differ significantly on anxiety. Although the ODD-only and ODD + LPE groups scored higher than the LPE-only group on all symptom and most impairment dimensions, the ODD + LPE group did not show a consistent pattern of higher scores than the ODD-only group. There were no differences on mother ratings, and higher scores for the ODD + LPE group emerged on only three of seven father-report measures (depression, CDS, and ADHD-IN) and three of eight teacher-report measures (peer rejection, social impairment, and academic impairment). Limited differences between the ODD + LPE and ODD-only groups raise questions about the usefulness of LPE as a severity specifier for ODD among children. Future studies need to address this issue with adolescents and clinical samples.

Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome.

OBJECTIVE: The aim of this work was 2-fold: (1) to evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT); and (2) to arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients. METHOD: An international Work Group was convened that, in early 2021, compiled an online archive of all research studies on SCT and summarized the current state of knowledge, noted methodological issues, and highlighted future directions, and met virtually on 10 occasions in 2021 to discuss these topics and terminology. RESULTS: Major progress has been made over the last decade in advancing our understanding of SCT across the following domains of inquiry: construct measurement and stability; genetic, environmental, pathophysiologic, and neuropsychological correlates; comorbid conditions; functional impairments; and psychosocial and medication interventions. Findings across these domains are summarized, and potential avenues to pursue in the next generation of SCT-related research are proposed. Following repeated discussions on terminology, the Work Group selected "cognitive disengagement syndrome" (CDS) to replace "SCT" as the name for this construct. This term was deemed to best satisfy considerations that should apply when selecting terms for a condition or syndrome, as it does not overlap with established terms for other constructs, is not offensive, and reflects the current state of the science. CONCLUSION: It is evident that CDS (SCT) has reached the threshold of recognition as a distinct syndrome. Much work remains to further clarify its nature (eg, transdiagnostic factor, separate disorder, diagnostic specifier), etiologies, demographic factors, relations to other psychopathologies, and linkages to specific domains of functional impairment. Investigators are needed with interests and expertise spanning basic, clinical, and translational research to advance our understanding and to improve the lives of individuals with this unique syndrome.

El TDAH en la etapa preescolar: Una revisión narrativa / ADHD in Preschool: A Narrative Review

El Trastorno por Déficit de Atención (TDAH) es un trastorno del neurodesarrollo muy heterogéneo y altamente prevalente en población infanto-juvenil. La detección del TDAH en la etapa preescolar (entre los 3 y 5 años) permitiría intervenir de manera precoz, reducir sus síntomas y modificarel curso del trastorno. El presente estudio tiene como objetivo revisar de manera narrativa el concepto del TDAH en población preescolar, suscaracterísticas, los instrumentos que permiten su detección y los tratamientos disponibles. Los síntomas clínicos del TDAH en preescolares no sontan frecuentes como se ha pensado tradicionalmente y además presentan una gran validez predictiva, manteniéndose con frecuencia a lo largo delos años. La presentación del TDAH más frecuente en esta etapa es la hiperactiva/impulsiva y las presentaciones con predominancia de inatenciónaparecen con poca frecuencia. La evaluación del TDAH abarca la detección de psicopatología general que pueda ser comórbida al TDAH o bienque permita un correcto diagnóstico diferencial. Existen escalas de evaluación de síntomas de TDAH que son fiables para la detección clínica deltrastorno y deben combinarse con medidas que evalúen posibles dificultades asociadas. Las intervenciones familiares son las más frecuentementeutilizadas, no siendo recomendado el tratamiento farmacológico hasta los 6 años. Sin embargo, los resultados de efectividad de los tratamientosson poco robustos. Es necesaria una intervención preventiva precoz en la etapa preescolar con casos que presenten o estén en riesgo de presentarTDAH y no “sentarse y esperar” si bien se necesita encontrar intervenciones más efectivas. (AU)

Attention Deficit Disorder (ADHD) is a very heterogeneous and highly prevalent neurodevelopmentaldisorder in children and adolescents. The detection of ADHD in the preschool stage (between 3 and 5 years of age) would allow early intervention, reducing its symptoms and modifying the course of the disorder. The present study aims to review in a narrative way the concept of ADHD inpreschool population, its characteristics, the instruments that allow its detection and the available treatments. The clinical symptoms of ADHD inpreschoolers are not as frequent as traditionally thought and present a high predictive validity, being frequently maintained over the years. The mostcommon presentation of ADHD at this stage is hyperactive/impulsive and inattentive-dominant presentations occur infrequently. The evaluation ofADHD includes the detection of general psychopathology that may be comorbid to ADHD or that allows a correct differential diagnosis. SeveralADHD symptom assessment scales are reliable for the clinical detection of the disorder and should be combined with measures that assess possible associated difficulties. Family interventions are the most frequently used, and pharmacological treatment is not recommended until 6 years ofage. However, the results of treatment effectiveness are not very robust. Early preventive intervention is needed in the preschool stage with casesthat present or are at risk of presenting ADHD and not “sit and wait”, although more effective interventions need to be found. (AU)

The External Validity of Sluggish Cognitive Tempo Versus Inattention in Behavioral, Social Interaction, and Academic Performance Measures.

BACKGROUND: The main objective was to replicate data on the external validity of the Sluggish Cognitive Tempo (SCT) dimension, versus ADHD Inattention (IN), with the Spanish version of the Child and Adolescent Behavior Inventory (CABI) SCT subscale [ Cuestionario sobre el Comportamiento de Niños ] (Burns et al., 2015). METHOD: 273 mothers and 255 fathers evaluated their 9 to13 year old children on SCT, IN and other CABI internalizing externalizing, academic impairment and social interaction measures. RESULTS: As hypothesized, the relationship between SCT and externalizing measures, in contrast to IN, was practically nonexistent, whereas both measures were related to internalizing and social interaction measures. Thus, the unique predictive capacity of SCT and IN was significant and similar on internalizing measures, except in the case of shyness, where SCT was better, while IN was better on externalizing measures. CONCLUSIONS: The data largely replicated previous results: SCT, despite its relationship with IN, is capable of predicting a significant proportion of anxiety, depression, and excessive shyness problems and, unlike IN, functions as a protective measure for externalizing problems.

Consistency and source specificity of symptom ratings for Child and Adolescent Behavior Inventory Scales with mother, father, and teacher ratings of Spanish children.

The study determined consistency relative to a reference source (convergent validity for nonreference sources with a reference source) and specificity for nonreference sources in true score variance in Child and Adolescent Behavior Inventory (CABI) ADHD-inattentive (IN), ADHD-hyperactive/impulsive (HI), sluggish cognitive tempo (SCT), oppositional defiant disorder (ODD), limited prosocial emotions (LPE), depression, anxiety, academic impairment, and social impairment scale scores. A multiple indicator by single trait by correlated (methods-1) model with indicator-specific trait factors was used to evaluate CABI scale scores with mother, father, and teacher ratings of 2,142 Spanish children (49.49% girls; ages 8-13). Mother ratings served as the reference source with father and teacher ratings serving as nonreference sources. Father with mother ratings showed substantial convergent correlations for each CABI scale (.73 to .90). Teacher with mother ratings showed a substantial convergent correlation for academic impairment (.72), strong convergent correlations for ADHD-IN (.57), ADHD-HI (.46), SCT (.52), and depression (.46), and small-to-moderate convergent correlations for ODD (.33), LPE (.24), and anxiety (.22) scales. Source independent and context-specific measures with appropriate content validity for home and school settings are required to better understand the greater variability in consistency from teacher to mother ratings. These results provide new information for the use of the CABI with multiple sources. In addition, the study indicates how a multiple indicator by single trait by correlated (methods-1) model with indicator-specific trait factors can be used to better understand multiple source ratings of child and adolescent psychopathology and adjustment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multisource Network and Latent Variable Models of Sluggish Cognitive Tempo, ADHD-Inattentive, and Depressive Symptoms with Spanish Children: Equivalent Findings and Recommendations.

Multisource network and latent variable models were used to examine the construct validity of sluggish cognitive tempo (SCT) symptoms relative to attention-deficit/hyperactivity disorder-inattentive (ADHD-IN) and depressive symptoms. The five objectives were to determine the (1) distinctiveness of SCT, ADHD-IN, and depressive symptom communities, (2) similarity of the three symptom communities across mother, father, and teacher ratings, (3) individual symptoms with the strongest influence on other symptoms, (4) individual symptoms with the strongest relations to academic and social impairment, and (5) similarity between network and latent variable model results. Mothers, fathers, and teachers rated SCT, ADHD-IN, and depressive symptoms for 2,142 Spanish children (49.49% girls, ages 8-13 years, third to sixth grade). Walktrap community analysis resulted in SCT, ADHD-IN, and depressive symptom communities with three SCT symptom communities within the overall SCT symptom community (daydreams, mental confusion, and hypoactive communities). The symptom networks were also similar across mothers, fathers, and teachers, especially mothers and fathers. Finally, for all three sources, the same two SCT and two ADHD-IN symptoms showed unique relations with academic impairment and the same depressive symptom showed unique relations with social impairment. A latent variable model yielded equivalent results. Both models thus supported the validity of SCT symptoms relative to ADHD-IN and depressive symptoms. Complexities are noted in the selection of network and latent variable models to study child and adolescent psychopathology with recommendations for their selection.

Multisource Longitudinal Network and Latent Variable Model Analyses of ADHD Symptoms in Children.

Objective: Multisource longitudinal network analysis was used to determine if between-child and within-child variance of attention-deficit/hyperactivity disorder (ADHD) symptoms provided unique findings of ADHD relative to latent variable model (LVM) analyses.Method: Mothers and fathers of 802 Spanish first-grade children (54% boys) provided ratings of ADHD symptoms at two time points six weeks apart (assessment 1: 723 mothers and 603 fathers; assessment 2: 667 mothers and 584 fathers). Network and latent variable models were applied to the ratings.Results: Inattention, hyperactivity, and mixed hyperactive/impulsive symptom communities occurred for the within- and between-children's symptom networks with the results being consistent across mothers and fathers, especially for the between-children's symptom networks. LVM analyses identified three factors with the same symptoms on each factor as in the symptom communities. These models also showed invariance across mothers and fathers as well as assessments.Conclusions: Longitudinal networks provided several useful insights for ADHD, including centrality symptoms that differed across between- and within-child levels. However, many findings were also largely consistent with the LVM analyses. Future studies should use novel methods (e.g., intensive longitudinal measurement) and analytic tools to determine if more unique theoretical and clinical findings emerge when applying network analysis to longitudinally measured ADHD symptoms.

Tic disorders in children and adolescents: does the clinical presentation differ in males and females? A report by the EMTICS group.

Tic disorders have a strong male predominance, with a male-to-female ratio of 4:1 in Tourette syndrome (TS) and 2:1 in persistent tic disorders. In other neurodevelopmental conditions, such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), the disparity in sex distribution has been partially related to differences in symptom presentation between males and females. In tic disorders, however, little research has been conducted on this topic, probably due to the limited access to large samples with a significant proportion of females. The aim of this study was to describe sex differences in the clinical presentation of tic disorders in children and adolescents in one of the largest pediatric samples with TS/persistent tic disorders (n = 709, 23.3% females) recruited as part of the European Multicenter Tics in Children Study (EMTICS). Validated measures assessed the severity of tics and comorbid psychiatric symptoms. Using mixed-effect models, we found that sex had a significant influence on the severity of tics, ADHD symptoms, ASD symptoms, and emotional problems. Males had more severe symptoms than females, except for emotional problems. We also observed a statistically significant interaction between sex and age on the severity of tics and compulsions, with females showing higher symptom severity with increasing age than males. These findings indicate that the clinical presentation of TS/persistent tic disorders varies with sex. Males seem to exhibit a more noticeable pattern of clinical symptoms at a younger age that may contribute to their earlier detection in comparison to females.

The External Validity of Sluggish Cognitive Tempo Versus Inattention in Behavioral, Social Interaction, and Academic Performance Measures / La Validez Externa del Tempo Cognitivo Lento Frente a la Inatención en Medidas Comportamentales, de Interacción Social y de Rendimiento Académico

Background: The main objective was to replicate data on the external validity of the Sluggish Cognitive Tempo (SCT) dimension, versus ADHD Inattention (IN), with the Spanish version of the Child and Adolescent Behavior Inventory (CABI) SCT subscale [Cuestionario sobre el Comportamiento de Niños] (Burns et al., 2015). Method: 273 mothers and 255 fathers evaluated their 9 to13 year old children on SCT, IN and other CABI internalizing externalizing, academic impairment and social interaction measures. Results: As hypothesized, the relationship between SCT and externalizing measures, in contrast to IN, was practically nonexistent, whereas both measures were related to internalizing and social interaction measures. Thus, the unique predictive capacity of SCT and IN was significant and similar on internalizing measures, except in the case of shyness, where SCT was better, while IN was better on externalizing measures. Conclusions: The data largely replicated previous results: SCT, despite its relationship with IN, is capable of predicting a significant proportion of anxiety, depression, and excessive shyness problems and, unlike IN, functions as a protective measure for externalizing problems.(AU)

Antecedentes: El objetivo principal del presente trabajo ha sido replicar datos de la validez externa de la dimensión Tempo Cognitivo Lento (TCL), frente a inatención del TDAH (IN), con la versión española de la medida del TCL del Child and Adolescent Behavior Inventory (CABI) [Cuestionario sobre el Comportamiento de Niños] (Burns et al., 2015). Método: 273 madres y 255 padres evaluaron a sus hijos entre 9 y 13 años en TCL, IN y otras medidas internalizadas, externalizadas, de dificultades académicas e interacción social del CABI. Resultados: La relación de TCL con las medidas externalizadas, al contrario de IN, fue prácticamente nula, en cambio ambas medidas se relacionaron con las medidas internalizadas y de interacción social. La capacidad predictiva única de TCL e IN fue significativa y similar sobre las medidas internalizadas, excepto en el caso de timidez, donde TCL fue superior y, en cambio, en las medidas externalizadas fue superior IN. Conclusiones: Los datos replican en gran parte los resultados previos: el TCL, a pesar de su relación con IN, es capaz de predecir una parte significativa de problemas de ansiedad, depresión y timidez excesiva y, en cambio, al contrario de IN, resulta una medida protectora para los problemas externalizados.(AU)

Long-Term Profiles of Bullying Victims and Aggressors: A Retrospective Study.

Bullying is a widespread and worrying phenomenon, related to many different personal, behavioral, and social variables which can modulate it and its outcomes, also in the long term. These relationships are usually studied in children and adolescents, but less often in adults who have suffered or perpetrated bullying in the past. The present work explored the long-term characteristics of bullying victims and aggressors using a retrospective design. A sample of 138 adults of different ages completed an on-line protocol that included measures of bullying and victimization, substance use, sensitivity to reward and punishment, social skills, antisocial behavior, emotional regulation strategies, depression, anxiety, stress, self-esteem, and risk of suicide. The sample was divided into three groups (victims, aggressors, and controls) based on their responses to bullying-related questions. A set of Multiple Analyses of Variance with group as a fixed factor was carried out for each dependent variable. Victims and aggressors did not significantly differ in their self-reported substance consumption. Victims showed higher global depression, anxiety and stress in the past than aggressors (M = 34.66, SD = 11.74; aggressors: M = 19.70, SD = 16.53), higher emotional lack of control (M = 23.97, SD = 10.62; controls: M = 17.11, SD = 7.95) and rejection (M = 21.72, SD = 7.24; controls: M = 16.33, SD = 5.67), lower self-esteem (M = 27.72, SD = 6.70; controls: M = 31.60, SD = 6.60), and a larger frequency of suicidal thoughts (in the past) than controls. Aggressors showed higher sensitivity to reward (M = 12.03, SD = 3.66; controls: M = 8.42, SD = 3.92), larger communicational and relational skills (M = 22.10, SD = 7.20; controls: M = 17.96, SD = 7.16), and lower emotional sensitivity (M = 14.80, SD = 4.10; controls: M = 16.76, SD = 2.21). Accordingly, the logistic regression analysis identified sensitivity to reward and low psychological adjustment as the main predictors of the aggressor and victim profiles, respectively. The present results are discussed considering the extant literature on bullying and may help to improve prevention programs for this relevant social scourge.

Psychometric properties and normative information on the child and adolescent behavior inventory with ratings for Spanish children from parents and teachers / Información Psicométrica y Normativa del Child and Adolescent Behavior Inventory con Evaluaciones de Madres, Padres y Maestros de Niños Españoles

BACKGROUND: Psychometric properties and initial normative information are provided for the sluggish cognitive tempo, attention-deficit/hyperactivity disorder-inattention, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, oppositional defiant disorder, callous-unemotional behavior (limited prosocial emotions specifier), anxiety, depression, social impairment, and academic impairment scales of the Spanish Child and Adolescent Behavior Inventory. METHOD: Mothers, fathers, and teachers of 2,142 third to sixth grade Spanish children (49.49% girls; ages 8-13) from randomly selected schools on the Balearic Islands completed the Child and Adolescent Behavior Inventory. RESULTS: Scores from the scales demonstrated reliability (internal consistency and inter-rater), structural validity, and convergent/discriminant validity with attention-deficit/hyperactivity disorder and learning disorder diagnoses for boys and girls separately for each source. Normative information (T-scores) is provided for the nine scales separately for boys and girls, with test information functions supporting use of the symptom scales for screening purposes. CONCLUSIONS: Although more comprehensive Spanish norms are still needed, the initial normative information on the scales should be useful to inform the clinical care of individual Spanish children, with the positive psychometric properties of the scores also supporting the use of the scale for research. Copies of the Spanish Child and Adolescent Behavior Inventory and norms are available for free to clinicians and researchers

ANTECEDENTES: en este trabajo se presenta información psicométrica y normativa inicial de la versión española del Child and Adolescent Behavior Inventory para las escalas: tempo cognitivo lento, inatención e hiperactividad/impulsividad del trastorno por déficit de atención e hiperactividad, negativismo desafiante, dureza emocional, ansiedad, depresión, afectación social y deterioro académico. MÉTODO: una muestra de madres, padres y maestros de 2.142 niños españoles de tercer a sexto curso de escuelas seleccionadas al azar en las Islas Baleares completaron el Child and Adolescent Behavior Inventory. RESULTADOS: las puntuaciones de las escalas demostraron fiabilidad, validez estructural y validez de criterio con diagnósticos de TDAH y de trastornos del aprendizaje para niños y niñas. Se proporciona información normativa para las nueve escalas por separado para niños y niñas, mientras las funciones de información del test han respaldado el uso de las escalas de síntomas para fines de detección inicial. CONCLUSIONES: aunque todavía son necesarios datos normativos más completos en niños de muestras españolas, la información normativa inicial que proporcionamos de las escalas CABI debería ser útil para los informes en el ámbito clínico, además los datos psicométricos positivos de sus puntuaciones también apoyan su uso en investigación

Psychometric Properties and Normative Information on the Child and Adolescent Behavior Inventory with Ratings for Spanish Children from Parents and Teachers.

BACKGROUND: Psychometric properties and initial normative information are provided for the sluggish cognitive tempo, attention-deficit/hyperactivity disorder-inattention, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, oppositional defiant disorder, callous-unemotional behavior (limited prosocial emotions specifier), anxiety, depression, social impairment, and academic impairment scales of the Spanish Child and Adolescent Behavior Inventory. METHOD: Mothers, fathers, and teachers of 2,142 third to sixth grade Spanish children (49.49% girls; ages 8-13) from randomly selected schools on the Balearic Islands completed the Child and Adolescent Behavior Inventory. RESULTS: Scores from the scales demonstrated reliability (internal consistency and inter-rater), structural validity, and convergent/discriminant validity with attention-deficit/hyperactivity disorder and learning disorder diagnoses for boys and girls separately for each source. Normative information (T-scores) is provided for the nine scales separately for boys and girls, with test information functions supporting use of the symptom scales for screening purposes. CONCLUSIONS: Although more comprehensive Spanish norms are still needed, the initial normative information on the scales should be useful to inform the clinical care of individual Spanish children, with the positive psychometric properties of the scores also supporting the use of the scale for research. Copies of the Spanish Child and Adolescent Behavior Inventory and norms are available for free to clinicians and researchers.

Perinatal psychological interventions to promote breastfeeding: a narrative review.

BACKGROUND: Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However, literature on initiatives to improve breastfeeding rates has focused mainly on providing community-based peer support, or social policies. The aim of this review is to assess evidence on the effectiveness of a broad range of psychological interventions to facilitate breastfeeding for mothers facing difficulties around the time of delivery. METHODS: The review of the literature is derived from a search on Cochrane Library, PubMed, EBSCOhost, and PsycINFO for papers published since 1980. The approach was to explore quantitative and qualitative parameters. Quantitative parameters included breastfeeding initiation, duration, and composition. Qualitative parameters recorded the evaluation of maternal perceptions on breastfeeding success. The high heterogeneity of the studies led to a narrative review; 20 selected papers that report on breastfeeding outcomes and psychological programs met the inclusion criteria. RESULTS: The evidence on breastfeeding support through psychotherapy is heterogeneous and scant. Out of the included studies, 11 were randomized controlled trials, two were non-randomised trials, and two used a quasi-experimental design. None of the studies reported an increase in adverse breastfeeding outcomes. Three studies failed to report an association between psychological procedures and improved breastfeeding outcomes. A literature review showed that 17 (85%) analyses support stress-releasing techniques to facilitate breastfeeding. CONCLUSIONS: This review suggests that relaxation interventions carefully tailored to address perinatal emotional distress may lead to important health benefits, including improvement in breastfeeding outcomes. There is also some indication that psychotherapy support while breastfeeding may have more impact than routine counselling. Conversely, this review did not find an association between self-hypnosis and breastfeeding outcomes. Data from this study can be used in designing prevention programs and future research with appropriate theoretical underpinning.

Correction to: Promises and Pitfalls of Latent Variable Approaches to Understanding Psychopathology: Reply to Burke and Johnston, Eid, Junghänel and Colleagues, and Willoughby.

The original version of this article unfortunately contained a mistake. The supplementary material was not captured to our commentary article.

Promises and Pitfalls of Latent Variable Approaches to Understanding Psychopathology: Reply to Burke and Johnston, Eid, Junghänel and Colleagues, and Willoughby.

The commentaries by Burke and Johnston (this issue), Eid (this issue), Junghänel et al. (this issue), and Willoughby (this issue) on Burns et al. (this issue) provide useful context for comparing three latent variable modeling approaches to understanding psychopathology-the correlated first-order syndrome-specific factors model, the bifactor S - 1 model, and the symmetrical bifactor model. The correlated first-order syndrome-specific factors model has proven useful in constructing explanatory models of psychopathology. The bifactor S - 1 model is also useful for examining the latent structure of psychopathology, especially in contexts with clear theoretical predictions. Joint use of correlated first-order syndrome-specific model and bifactor S - 1 model provides leverage for explaining psychopathology, and both models can also guide individual clinical assessment. In this reply, we further clarify reasons why the symmetrical bifactor model should not be used to study the latent structure of psychopathology and also discuss a restricted bifactor S - 1 model that is equivalent to the first-order syndrome-specific factors model.

Feasibility of a virtual reality program to treat children with fear of darkness with nonexpert therapists / Viabilidad de un programa de realidad virtual para tratar niños con miedo a la oscuridad con terapeutas no expertos

Fear of darkness is highly prevalent and stable in children and often ends up becoming a specific situational phobia. The aim of this study is to analyze the feasibility of adapting and applying it through a Virtual Reality (VR) tool by nonexpert therapists. A pre-experimental study was carried out with six participants between the ages of 8 and 12 years old using pre- and posttreatment scales for assessing the fear of darkness. Statistically significant differences with large effects were found in all posttreatment measures: EMO (Roshenthal's r = 0.64), WCDAN (r = 0.52), and Global item of current fear of darkness (r = 0.59). Using the Reliable Change Index (RCI) as a measure of clinically significant change, four participants improved satisfactorily, one acceptably, and the other did not improve. The results support the feasibility of using an adapted VR program to treat fear of darkness without being an expert therapist. However, more detailed experimental studies need to be carried out in order to analyze its efficacy

El miedo a la oscuridad es muy frecuente y estable en los niños y, a menudo, termina convirtiéndose en una fobia situacional específica. El objetivo de este estudio es analizar la viabilidad de adaptarlo y aplicarlo a través de una herramienta de realidad virtual (RV) por terapeutas no expertos. Se ha llevado a cabo un estudio pre-experimental con seis participantes de 8 a 12 años de edad utilizando escalas de pre y postratamiento para evaluar el miedo a la oscuridad. Se han encontrado diferencias estadísticamente significativas con tamaños del efecto grandes en todas las medidas posteriores al tratamiento: EMO (Roshenthal's r = 0.64), WCDAN (r = 0.52), e ítem global del miedo actual a la oscuridad (r = 0.59). Al usar el Índice de Cambio Fiable (ICF) como una medida del cambio clínicamente significativo, cuatro participantes mejoraron satisfactoriamente, uno aceptablemente, y el otro no mejoró. Los resultados apoyan la viabilidad de utilizar un programa de RV adaptado para tratar el miedo a la oscuridad sin necesidad de un terapeuta experto. Sin embargo, se necesitan estudios experimentales más detallados para analizar su eficacia