Changes in self-reported emotional and behavioral problems of Polish adolescents in 2000 and 2013. / Zmiany w samoopisie problemów emocjonalnych i behawioralnych polskich nastolatków w 2000 i 2013 roku.

OBJECTIVES: This study assesses 13-year changes in self-reported emotional and behavioral problems of Polish adolescents. Even though we already assessed time-related changes in emotional problems of Polish 16-year-olds, a comparison covering more age groups has been lacking. METHODS: Youth Self Report (YSR) questionnaire was used to assess emotional and behavioral problems. We compared median scores and ran regression models to see whether age and gender influenced the observed changes. We ran a logistic regression analysis for deviant scores. RESULTS: We found that median scores on most scales were higher after 13 years albeit the differences were quite small. We found that gender moderated the effect of age on scale scores. Score on the deviant range in attention problems and thought problems were 1.5 more frequent in the 2013 group. CONCLUSIONS: We did not detect significant differences in self-reported emotional and behavioral problems of Polish adolescents between 2000 and 2013. We detected different coping strategies for boys and girls: boys reported more problems with delinquency and more externalizing behaviors whereas girls reported more problems on each scale.

Cognitive impairments in Polish children and adolescents with perinatal HIV infection. / Zaburzenia poznawcze u dzieci i mlodziezy z wrodzonym zakazeniem HIV w Polsce.

OBJECTIVES: The aim of the study was to assess the presence of cognitive impairments in children and adolescents with vertically transmitted HIV infection and to determine possible relationships with clinical and socio-demographic variables. METHODS: Fifty children with perinatal HIV infection aged 6-18 years were included in the experimental group (PHIV+). Two sex- and age-matched groups were recruited as reference groups: (1) a PHEU group that included 24 healthy children perinatally HIV-exposed but uninfected, and (2) an HIV-nA group that included 43 healthy children of uninfected parents. CANTAB Research Suite was used to assess cognitive functioning. RESULTS: In comparison with the HIV-nA group, the PHIV+ group scored worse in movement execution, shifting and flexibility of attention, reversal learning and working memory. In comparison with the PHEU group, the PHIV+ group had significantly longer planning time in the memory task. The analysis of results for the 12-18 year-old age group revealed deterioration of cognitive functions in all tests of the PHIV+ children in comparison with the HIV-nA group. A higher logarithm of viral load at the start of the ARV treatment was associated with worse results in the use of feedback, shifting of attention, cognitive flexibility and worse information processing. CONCLUSIONS: Results of the research indicate deterioration of executive functioning in the PHIV+ group associated with longer duration of HIV neuroinfection and severity of infection before treatment.

Morphometric evaluations based on Voxel Based Morphometry on adolescents with autism spectrum disorders. / Badania morfometryczne oparte o pomiar voksela (Voxel Based Morphometry) u nastolatków z zaburzeniami ze spektrum autyzmu.

OBJECTIVES: Goal: to evaluate changes in the grey matter volume using the VBM method in a group of adolescents with ASD, who met the criteria for Asperger's Syndrome. METHODS: Material and methods: Morphometric evaluations based on Voxel Based Morphometry (VBM) were performed on 37 male adolescents aged 12 to 19 (M = 14.3 ± 2.0), with autism spectrum disorders, who met the DSM-IV-TR criteria for Asperger's Syndrome and 15 neurotypical adolescents matched by age. Significance was set at p<0.007 without FWE correction and p<0.05 with FWE correction. RESULTS: Results: the decrease in the volume of the grey matter was observed in ASD group including the pre- and postcentral gyrus, the superior and middle frontal gyrus, the inferior and superior parietal lobule, the praecuneus, the anterior and posterior cingulate cortex, the fusiform gyrus, the parahippocampal gyrus, the lingual gyrus, the middle occipital region, the cuneus and the angular gyrus, the regions of calcarine sulcus and the cerebellum. The majority of changes was localized bilaterally. CONCLUSIONS: Conclusions: the decrease in the volume of grey matter observed in ASD group can be related functionally with the characteristics of deficits observed in autism spectrum disorders which highlights the role of abnormal organization of numerous CNS structures in the genesis of symptoms observed in cognitive and behavioural domains.

Semantic decisions in adolescents with autism spectrum disorders - functional magnetic resonance imaging study. / Decyzje semantyczne u nastolatków z zaburzeniami ze spektrum autyzmu - badanie czynnosciowym rezonansem magnetycznym.

OBJECTIVES: Goal: to assess fMRI activation during semantic tasks in adolescents with ASD. METHODS: Material: 44 right-handed male adolescents aged 12-19 (mean 14.3 ± 2.0) - 31 with autism spectrum disorders who met DSM-IV-TR criteria for Asperger's syndrome and 13 neurotypical adolescents matched according to age and handiness. Method: Functional testing (fMRI) was performed during semantic decisions tasks and phonological decisions in three categories of tasks: concrete nouns, verbs with plural meanings, words describing states of mind, as a control condition. Statistical analyzes were performed at the level of p <0.05 with FWE (family-wise error) correction and p <0.001. RESULTS: Results: lower BOLD signal was demonstrated in many brain areas including precuneus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, regardless of task category and processing method in the ASD group. The smallest differences in semantic processing were found for concrete nouns and the greatest ones for words describing states of mind. CONCLUSIONS: Conclusions: the presence of different activation patterns in the ASD group suggests that far more than just the areas traditionally attributed to language processing, are involved in semantic deficits in ASD.

Weak central coherence - construct conception, development, research methods. / Slaba centralna koherencja ­ rozwój i koncepcja konstruktu, metody badania.

Central coherence allows for integration of different stimuli into a coherent whole. It also enables context-dependent information processing. This term was coined in an effort to arrange multiple observations of cognitive functioning of people with autism spectrum disorder (ASD). Weak central coherence, which is characteristic of ASD, is understood as adivergent cognitive style with a tendency to process incoming information locally. This allows us to describe central coherence as a continuous trait. Despite manifold research programs, a conclusive conceptualization of the construct is still lacking. The open question is whether weak central coherence constitutes alimited ability to integrate stimuli or rather an increased ability to focus on details. An important postulate concerns the establishment of a standard for measuring central coherence and its individual dimensions. Studies of central coherence outside of ASD context are scarce and deal predominantly with eating disorders. The following work is an overview of the current state of knowledge about central coherence construct and methods of research.

Psychiatric, behavioral and emotional disorders in Polish children and adolescents with perinatal HIV infection. / Zaburzenia psychiczne, behawioralne i emocjonalne u dzieci i mlodziezy z wrodzonym zakazeniem HIV w Polsce.

OBJECTIVES: The aims of the study were to evaluate the prevalence of psychiatric, behavioral and emotional disorders in children and adolescents with perinatal HIV infection and to establish their possible relationships with clinical and sociodemographic variables. METHODS: 56 children with perinatal HIV infection (PHIV+ group), 24 healthy children perinatally HIV-exposed but uninfected (PHEU) and 43 healthy children of uninfected parents (HIV-nA), aged 6-18 years, were assessed. The Child Behavior Checklist (CBCL/4-18), completed by parents, and the Youth Self-Report (YSR) were used to assess behavioral and emotional disorders, while the semi-structured diagnostic interview K-SADS-PL was used to assess the symptoms of psychiatric disorders. RESULTS: Higher prevalence of psychiatric disorders was found in the PHIV+ group and the PHEU group compared to the HIV-nAgroup. Anxiety disorders and affective disorders were diagnosed most often. Prevalence of symptoms of emotional and behavioral disorders in the PHIV+ group and in the PHEU group was associated with similar sociodemographic variables (male, not living with the biological caregiver, the experience of stressful life events). Psychiatric disorders were noted more often among PHIV+ subjects whose ARV treatment was started after 12 months of age. Positive correlations were observed between the results of some YSR and CBCL/4-18 problem scales and CD4 counts at the time of the study, higher logarithm of viral load at the start of ARV treatment and at the time of HIV diagnosis. CONCLUSIONS: The prevalence of psychiatric disorders in PHIV+ group and the PHEU group is higher in comparison with HIV-nAgroup. Amore serious course of HIV infection and its severity before treatment are associated with the severity of internalizing problems.

The change in the intensity of symptoms in children and adolescents with attention deficit hyperactivity disorder after "Workshops for Parents of Hyperactive Children". / Zmiana nasilenia objawów zespolu nadpobudliwosci psychoruchowej po zastosowaniu programu "Warsztatów dla rodziców dzieci nadpobudliwych".

OBJECTIVES: To evaluate changes in the intensity of ADHD symptoms and size effects after the completion of the twelve-week "Workshops for Parents of Hyperactive Children". METHODS: Intervention group included parents (N = 199) of children and adolescents diagnosed with ADHD, who completed the twelve-week parental training. The reference group included parents (N = 24) of children and adolescents diagnosed with ADHD, who received 1-2 standard psychiatric visits within twelve weeks (treatment-as-usual). The following questionnaires were completed by the participants at the beginning and at the end of the training: CBCLand Conners-IOWA-10 (parent's assessment of the child), TRF and Conners-RCTRS-28 (assessment of the child by the teacher/educator), and YSR (in children of 11 years and over). The same diagnostic regime was used in the reference group - the patients were assessed during the first visit and after twelve weeks. RESULTS: The majority of attendees were parents of boys diagnosed with: ADHD mixed type with or without ODD and ADHD predominantly inattentive type. The intervention resulted in significant reduction of inattentive-impulsive-hyperactive and oppositional-defiant symptoms in Conners-IOWA-10 and significant reduction of symptoms in the following CBCL scales: "Social problems", "Attention problems", "Aggressive behavior", "Externalizing behavior", as well as the overall score, as rated by mothers. The improvement was age, diagnosis and pharmacotherapy independent. CONCLUSIONS: The therapeutic program used in our study resulted in small to moderate reduction of symptoms in children and adolescents with attention deficit hyperactivity disorder irrespective of subtype, comorbid disorders or pharmacotherapy (if implemented).

Health-related quality of life in Polish children and adolescents with perinatal HIV infection - short report.

The aims of the study were to assess health-related quality of life (HRQoL) in children and adolescents with perinatal HIV infection and to establish possible relationships with clinical and socio-demographic variables. About 56 children with perinatal HIV infection, aged 6-18 years (PHIV+ group), 24 healthy perinatally HIV-exposed but uninfected (PHEU) children, and 43 children HIV-unexposed uninfected (HUU) were assessed using the PedsQL 4.0. Generic Core. The perceptions of school functioning according to children and social functioning, according to parents, were worse in the PHIV+ group compared to those in the PHEU group. In comparison to the HUU group, PHIV+ children received lower total HRQoL scores in the caregivers' perception. Most of the life-quality indices increased systematically with age in PHIV+ group, whereas opposite trends were present in both control groups. Caregivers of children with a final CDC category C and caregivers of children diagnosed with encephalopathy perceived most domains of their children functioning as more problematic. A more serious course and more severe HIV infection before treatment were associated with worse multidimensional functioning and a worse total HRQoL score. Results highlight the importance of early diagnosis and treatment initiation as having significant implications for the quality of life.

General health, sense of coherence and coping styles in parents participating in Workshops for Parents of Hyperactive Children. / Ogólny stan zdrowia, poczucie koherencji oraz style radzenia sobie ze stresem rodziców uczestniczacych w "Warsztatach dla rodziców dzieci nadpobudliwych".

OBJECTIVES: The assessment of changes in the general health, sense of coherence and stress coping styles in parents of children and adolescents with ADHD, participating in 12-week Workshops for Parents of Hyperactive Children. METHODS: The experimental group included 186 mothers and 139 fathers (parents of 199 children); the reference group included 23 mothers and 19 fathers (parents of 24 children), attending 1-2 standard medical visits within a 12-week period (treatment as usual). Parents from both groups were assessed twice using (1) the General Health Questionnaire (GHQ), (2) the Life Orientation Questionnaire (SOC-29), and (3) the Coping Inventory for Stressful Situations (CISS). RESULTS: (1) The experimental group showed a significant improvement in the severity of somatic symptoms and anxiety/insomnia in mothers and the general well-being of mothers and fathers. We observed the influence of workshops on manageability and reduction of the emotion-oriented coping in mothers; (2) the participation in the workshops was associated with a statistically significant effect (mostly moderate) in relation to general health of mothers, while TAU was mostly associated with a low or insignificant effect. CONCLUSIONS: The assessed form of interventions improves the functioning of parents of children with ADHD.

The prevalence of mental disorders among children and youth staying in residential institutions, children's homes - a review of epidemiological studies. / Rozpowszechnienie zaburzen psychicznych wsród dzieci i mlodziezy przebywajacych w placówkach opiekunczo-wychowawczych, domach dziecka ­ przeglad badan epidemiologicznych.

Emergence of mental health problems in childhood can seriously affect further development of a man and thus hamper his adaptation to adult life. Children in residential institutions may be particularly vulnerable at risk of abnormal mental development, this includes so-called 'children's homes'. In the article we present an overview of the few studies carried out so far in the European residential institutions, including children's homes, over the years 1940-2011 in the UK, Germany, Romania, and Poland. Firstly, we briefly describe a classic research carried out in the world in the 1940s among children from children's homes. Secondly, we present a study conducted in the UK among children and youth from different age groups staying in residential institutions, including children's homes. Then we focus on studies carried out among children and adolescents form German residential institutions and on a group of preschool children from Romanian children's homes. At the end of the article we describe the first epidemiological study carried out in Poland on the population of children and young people staying in children's homes in Warsaw. The review of researches shows that children from day-care facilities are a population with a high prevalence of psychiatric disorder. Children and youth staying in residential institutions probably require specialized psychiatric, psychological and psychotherapeutic care.

The application of computer assisted technologies (CAT) in the rehabilitation of cognitive functions in psychiatric disorders of childhood and adolescence. / Zastosowanie komputerowych technologii wspomagajacych (CAT) w rehabilitacji funkcji poznawczych w zaburzeniach psychicznych wieku rozwojowego.

First applications of computer-assisted technologies (CAT) in the rehabilitation of cognitive deficits, including child and adolescent psychiatric disorders date back to the 80's last century. Recent developments in computer technologies, wide access to the Internet and vast expansion of electronic devices resulted in dynamic increase in therapeutic software as well as supporting devices. The aim of computer assisted technologies is the improvement in the comfort and quality of life as well as the rehabilitation of impaired functions. The goal of the article is the presentation of most common computer-assisted technologies used in the therapy of children and adolescents with cognitive deficits as well as the literature review of their effectiveness including the challenges and limitations in regard to the implementation of such interventions.

Mechanisms shaping the development of personality and personality disorders in children and adolescents. / Mechanizmy ksztaltujace rozwój osobowosci i jej zaburzen u dzieci i mlodziezy.

Until the end of the nineties last century personality disorders could not be diagnosed before the age of eighteen. Nevertheless, the results of studies published in the last decade have revealed that personality disorders can be observed in children and adolescents and that personality disorders diagnosed in adult patients had been present as early as in childhood. The knowledge of possible mechanisms shaping personality disorders in childhood is unsatisfactory and needs to be expanded. Developmental psychology explains the development of abnormal personality through inappropriate attachment patterns and abnormal transitions between developmental phases. Genetic and temperamental factors are also important in the aetiology of personality disorders as well as early maladaptive schemas resulting from personal experiences and interactions with others. The aim of this article is to review the current knowledge on the mechanisms shaping the development of personality and personality disorders in childhood and adolescence.

Obsessive-compulsive symptoms and physical activity in patients with anorexia nervosa - possible relationships.

OBJECTIVES: The aim of the study was to find relationship between obsessive-compulsive symptoms and level and characteristic of physical activity among patients with anorexia nervosa (AN). METHODS: Material and methods. 76 female patients, aged 14.8 +/ - 1.8 years with AN completed the Polish version of the Leyton Obsessional Inventory-Child Version (LOI-CV). In order to assess the level and type of physical activity, Physical Activity Questionnaire was developed. RESULTS: 35 (46%) subjects were qualified to HR group (Obsessive-Compulsive Disorder "High-risk group") (25 or more points on the Interference Score of LOI-CV) and 41 (54%) to nHR group (no "High-risk group"). nHR patients spent less studying in a standing position, significantly more often used elevators rather than stairs and, according to their parents, devote less time for physical activity. Positive correlation between the caregiver's perception of patient's weekly activity and the number of "YES" answers in LOI-CV, positive trend between Patient's Activity Index or summarised Activity Index and the number of "YES" answers in LOI-CV were found. We also found negative correlation between the time spent studying at school and the number of "YES" answers in LOI-CV. CONCLUSIONS: The results show that there is a connection between obsessive-compulsive symptoms and the hyperactivity in AN patients.

Personality disorders in adolescence.

Adult personality disorders are well recognized and described in the literature. The discussion about the possibility of the presence of personality disorders in adolescents started about 20 years ago. Some authors claim the before the age of 18 it is only possible to identify precursors of future personality disorders and such a standpoint is reflected in diagnostic criteria. This is based on the assumption that personality in adolescence is still not well established. Consequently, the criterion on the persistence of symptoms for the period of time cannot be met (the persistence of symptoms of personality disorders for the period of at least two years). Other approach postulates that problems presented in adolescence should not be exclusively limited to Axis I according to DSM. The proponents of this approach claim that current diagnostic tools are not adjusted to adolescents, thus it is very difficult to measure stability and persistence of symptoms in this age group. This paper presents literature review on personality disorders in adolescence.

[State and trait anxiety level and increase of depression among mothers of children with attention deficit hyperactivity disorder and conduct disorder. pilot study]. / Poziom leku jako stanu i jako cechy oraz nasilenie depresji u matek dzieci z zespolem nadpobudliwosci psychoruchowej i zaburzeniami zachowania - doniesienie wstepne.

OBJECTIVES: To evaluate anxiety level (as a trait and as a state) and the intensity of depressive symptoms in mothers of children with hyperkinetic disorder (HD) and with and without comorbid conduct disorder (CD); to determine the relationship between the intensity of anxiety and depression and intensity of symptoms of HD. MATERIALS AND METHODS: Beck Depression Inventory (BDI) and STAI questionnaire to measure state-trait anxiety were filled by 24 mothers of children with HD and 26 mothers of children without HD. Mothers of children with HD were also asked to complete the Conners Questionnaire for Parents and Teachers (IOWA). Teachers were asked to complete the Conners Questionnaire for Teachers (RCTS). RESULTS: 75% of HD subjects had a comorbid CD, in comparison with 19.2 % in the control group. No significant differences were found between the mothers of children with HD and the control group in the results of BDI scale and STAI questionnaire in anxiety state and anxiety trait subscales. The difference was found between mothers of children with CD and without CD in anxiety-state subscale in STAI questionnaire. No correlations were found between the number of depressive symptoms, anxiety as a state and as a trait and the results of Conners IOWA and RCTS. CONCLUSIONS: The presence of HD in children does not correlate with the level of depression and anxiety in their mothers. There is a relationship between the presence of CD in children and elevated levels of state anxiety in their mothers.

[The influence of obsessive compulsive symptoms on the course of anorexia nervosa]. / Wplyw objawów obsesyjno-kompulsyjnych na przebieg jadlowstretu psychicznego.

OBJECTIVE: to assess the prevalence of obsessive-compulsive disorder (OCD) or OC symptoms in patients with anorexia nervosa (AN) and to find a possible relationship between the presence of OC symptoms and the course of AN. METHOD: 137 adolescent female patients with AN, aged 14.8 +/- 1.8 years, completed the Polish version of the LOI-CV. Two groups, High-risk (HR) and no High-risk (nHR), were defined according to the cut-off score of LOI-CV. The diagnosis of OCD was confirmed with the Polish version of K-SADS-PL. The relationship between the number and intensity of OC symptoms and the following data were analyzed: age of onset and on admittance to a psychiatric facility, weight loss, BMI on admittance and its changes, age of first menstruation, time of amenorrhea and of restitution of menses, length of treatment and number of relapses. RESULTS: OCD was not diagnosed in any subject, but 25% of the examined patients had OC symptoms which qualified them to High-risk group. Differences in HR and nHR groups were found between duration of AN before hospitalization, age and body mass after release from hospital. Negative correlation was found between "Yes" Score and Interference Score in LOI-CV and the age of patient at the time of release from hospital. CONCLUSIONS: the results of our study do not support the observations about a high co-occurrence of AN and OCD, but indicate the frequent co-occurrence of OK symptoms.

Adolescent outcome of child ADHD in primary care setting: stability of diagnosis.

OBJECTIVE: The aim of the study was to assess the functioning of patients with ADHD 6 to 7 years after the diagnosis. One objective was to determine the stability of diagnosis, symptoms decline, subtype change, remission, and change of diagnosis. METHOD: In all, 101 participants were chosen for testing. All were interviewed for the presence of ADHD and social, academic, and peer functioning, and completed Youth Self-Report. The caregivers completed a Wender Utah Rating Scale and Child Behavior Checklist, and were asked to assess the social, academic, and peer functioning of their offspring. RESULTS: A total of 56% (n = 57) still met the criteria for ADHD and 24.7% (n = 25) still met the criteria for hyperkinetic disorder (HKD). Subtype migration was observed. In all, 7.7% (n = 14) were rediagnosed with Asperger's syndrome, 2.2% (n = 4) received a diagnosis of bipolar disorder, 2.2% (n = 4) were diagnosed with mental retardation, 1 with schizophrenia, and 1 with genetic disorder. CONCLUSION: The reliability of diagnosis was high. The rates of all subtypes of ADHD decreased. More measures need to be taken in terms of differential diagnosis of ADHD and Asperger's Syndrome.