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1.
Nat Rev Dis Primers ; 5(1): 43, 2019 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-31249310

RESUMO

Conduct disorder (CD) is a common and highly impairing psychiatric disorder that usually emerges in childhood or adolescence and is characterized by severe antisocial and aggressive behaviour. It frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD) and often leads to antisocial personality disorder in adulthood. CD affects ~3% of school-aged children and is twice as prevalent in males than in females. This disorder can be subtyped according to age at onset (childhood-onset versus adolescent-onset) and the presence or absence of callous-unemotional traits (deficits in empathy and guilt). The aetiology of CD is complex, with contributions of both genetic and environmental risk factors and different forms of interplay among the two (gene-environment interaction and correlation). In addition, CD is associated with neurocognitive impairments; smaller grey matter volume in limbic regions such as the amygdala, insula and orbitofrontal cortex, and functional abnormalities in overlapping brain circuits responsible for emotion processing, emotion regulation and reinforcement-based decision-making have been reported. Lower hypothalamic-pituitary-adrenal axis and autonomic reactivity to stress has also been reported. Management of CD primarily involves parent-based or family-based psychosocial interventions, although stimulants and atypical antipsychotics are sometimes used, especially in individuals with comorbid ADHD.


Assuntos
Transtorno da Conduta/diagnóstico , Transtorno da Conduta/terapia , Adolescente , Adulto , Criança , Comorbidade , Transtorno da Conduta/tratamento farmacológico , Feminino , Neuroimagem Funcional/métodos , Doenças Genéticas Inatas/epidemiologia , Humanos , Masculino , Programas de Rastreamento/métodos , Transtornos Mentais , Prevalência , Fatores de Risco
3.
Atten Defic Hyperact Disord ; 11(1): 47-58, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927230

RESUMO

Increased reaction time variability (RTV) is one of the most replicable behavioral correlates of attention-deficit/hyperactivity disorder (ADHD). However, this may not be specific to ADHD but a more general marker of psychopathology. Here we compare RT variability in individuals with ADHD and those with other childhood internalizing and externalizing conditions both in terms of standard (i.e., the standard deviation of reaction time) and alternative indices that capture low-frequency oscillatory patterns in RT variations over time thought to mark periodic lapses of attention in ADHD. A total of 667 participants (6-12 years old) were classified into non-overlapping diagnostic groups consisting of children with fear disorders (n = 91), distress disorders (n = 56), ADHD (n = 103), oppositional defiant or conduct disorder (ODD/CD; n = 40) and typically developing controls (TDC; n = 377). We used a simple two-choice reaction time task to measure reaction time. The strength of oscillations in RTs across the session was extracted using spectral analyses. Higher RTV was present in ADHD compared to all other disorder groups, effects that were equally strong across all frequency bands. Interestingly, we found that lower RTV to characterize ODD/CD relative to TDC, a finding that was more pronounced at lower frequencies. In general, our data support RTV as a specific marker of ADHD. RT variation across time in ADHD did not show periodicity in a specific frequency band, not supporting that ADHD RTV is the product of spontaneous periodic lapses of attention. Low-frequency oscillations may be particularly useful to differentiate ODD/CD from TDC.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtorno da Conduta/fisiopatologia , Modelos Neurológicos , Transtornos Fóbicos/fisiopatologia , Tempo de Reação/fisiologia , Estresse Psicológico/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Criança , Comportamento de Escolha/fisiologia , Transtorno da Conduta/diagnóstico , Endofenótipos , Feminino , Humanos , Masculino
4.
Psychiatry Res ; 271: 740-746, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30791350

RESUMO

Conduct disorder is characterized by both habitual aggression as well as non-aggressive rule-breaking behavior. While a large body of research has focused on aggressive behavior to date, the subtype of non-aggressive rule-breaking behavior is poorly understood. The current study represents a first attempt to directly assess decision biases toward rule-breaking behavior, their motivational salience, and the association with interpersonal factors in conduct disorder. Participants (n = 20 children with conduct disorder and n = 20 healthy controls) played a video game with the goal to deliver a hot pizza by bicycle to a marked location on a two-dimensional city map. In each trial, participants decided whether to use the regular route (streets) or opt for a potential shortcut that was either permitted (bicycle lane) or prohibited (park). The efficiency of the shortcut was parametrically varied to assess individual decision functions. Consistent with our hypotheses, group differences emerged only when taking a shortcut represented a rule violation (park condition), with the conduct disorder group committing significantly more rule violations than controls. Furthermore, conduct disorder children showed a substantial frequency of rule violations even in the absence of shortcut related gains, indicating a pronounced insensitivity towards sanctions. Importantly, this tendency was associated with self-reported impulsivity and rule violations in real life.


Assuntos
Comportamento Infantil/fisiologia , Comportamento Infantil/psicologia , Transtorno da Conduta/psicologia , Motivação/fisiologia , Jogos de Vídeo/psicologia , Adolescente , Criança , Transtorno da Conduta/diagnóstico , Feminino , Humanos , Masculino , Desempenho Psicomotor/fisiologia , Fatores de Risco
5.
Behav Ther ; 50(1): 1-14, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30661550

RESUMO

The purpose of this study was to examine whether callous-unemotional (CU) traits moderated the effects of intensive behavior therapy in elementary school-age children with varying levels of conduct problems (CP). Both treatment response (magnitude of change between pre- and posttreatment) and treatment outcomes (likelihood of normalization from treatment) were examined. Participants were 67 children (n = 49 boys, Mage = 9.6 years) with varying levels of CP and CU who participated in an intensive 8-week summer treatment program (STP) in which behavior therapy was delivered to children in recreational and classroom settings and to parents via weekly parent training sessions. Effects of treatment were measured using parent and teacher ratings of oppositional defiant disorder (ODD), conduct disorder (CD), callous behavior, and impairment. Results showed that CU moderated treatment effects for CD and callous behavior but not ODD or impairment. The moderating effects showed some evidence that participants with high CP and high CU before treatment had better treatment responses (larger change between pre- and posttreatment) but worse treatment outcomes (lower likelihood of normalization after treatment). These results suggest that intensive treatment, such as the STP, may be necessary but not sufficient for children with CP and CU traits.


Assuntos
Sintomas Afetivos/psicologia , Sintomas Afetivos/terapia , Terapia Comportamental/métodos , Transtorno da Conduta/psicologia , Transtorno da Conduta/terapia , Comportamento Problema/psicologia , Sintomas Afetivos/diagnóstico , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Personalidade Antissocial/terapia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Criança , Transtorno da Conduta/diagnóstico , Emoções/fisiologia , Feminino , Humanos , Intenção , Masculino , Pais/psicologia , Resultado do Tratamento
6.
Infant Ment Health J ; 40(1): 67-83, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30576588

RESUMO

Research on early childhood predictors of violent behaviors in early adulthood is limited. The current study investigated whether individual, family, and community risk factors from 18 to 42 months of age were predictive of violent criminal arrests during late adolescence and early adulthood using a sample of 310 low-income male participants living in an urban community. In addition, differences in trajectories of overt conduct problems (CP), hyperactivity/attention problems (HAP), and co-occurring patterns of CP and HAP from age 1½ to 10 years were investigated in regard to their relationship to violent and nonviolent behaviors, depression, and anxiety at age 20. Results of multivariate analyses indicated that early childhood family income, home environment, emotion regulation, oppositional behavior, and minority status were all significant in distinguishing violent offending boys from those with no criminal records. In addition, trajectories of early childhood CP, but not attention deficit hyperactivity disorder, were significantly related to self-reports of violent behavior, depressive symptoms, and anxiety symptoms. Implications for the prevention of early childhood risk factors associated with adolescent and adult violent behavior for males are discussed.


Assuntos
Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Conduta/diagnóstico , Pobreza/psicologia , Violência/psicologia , Transtorno da Personalidade Antissocial/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Pré-Escolar , Transtorno da Conduta/psicologia , Depressão/diagnóstico , Depressão/psicologia , Emoções , Humanos , Masculino , Comportamento Problema/psicologia , Fatores de Risco , Adulto Jovem
7.
Compr Psychiatry ; 88: 57-64, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30504071

RESUMO

OBJECTIVE: We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD). METHODS: Participants were 658 children with ASD (age 3-17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. All children were referred for hyperactivity or irritability. Study designs varied, but all used the Child and Adolescent Symptom Inventory or Early Childhood Inventory to assess Attention Deficit Hyperactivity Disorder (ADHD), Oppositional-Defiant Disorder (ODD), Conduct Disorder (CD), Anxiety Disorders, and Mood Disorders. In addition, several measures in common were used to assess demographic and clinical characteristics. RESULTS: Of the 658 children, 73% were Caucasian and 59% had an IQ >70. The rates of concomitant disorders across studies were: ADHD 81%, ODD 46%, CD 12%, any anxiety disorder 42%, and any mood disorder 8%. Two or more psychiatric disorders were identified in 66% of the sample. Of those who met criteria for ADHD, 50% also met criteria for ODD and 46% for any anxiety disorder. Associations between types of concomitant disorders and a number of demographic and clinical characteristics are presented. CONCLUSION: In this well-characterized sample of treatment-seeking children with ASD, rates of concomitant psychiatric disorders were high and the presence of two or more co-occurring disorders was common. Findings highlight the importance of improving diagnostic practice in ASD and understanding possible mechanisms of comorbidity.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Adolescente , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno do Espectro Autista/epidemiologia , Criança , Pré-Escolar , Comorbidade , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Feminino , Humanos , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia
8.
J Pediatr ; 206: 256-267.e3, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30322701

RESUMO

OBJECTIVES: To use the latest data to estimate the prevalence and correlates of currently diagnosed depression, anxiety problems, and behavioral or conduct problems among children, and the receipt of related mental health treatment. STUDY DESIGN: We analyzed data from the 2016 National Survey of Children's Health (NSCH) to report nationally representative prevalence estimates of each condition among children aged 3-17 years and receipt of treatment by a mental health professional. Parents/caregivers reported whether their children had ever been diagnosed with each of the 3 conditions and whether they currently have the condition. Bivariate analyses were used to examine the prevalence of conditions and treatment according to sociodemographic and health-related characteristics. The independent associations of these characteristics with both the current disorder and utilization of treatment were assessed using multivariable logistic regression. RESULTS: Among children aged 3-17 years, 7.1% had current anxiety problems, 7.4% had a current behavioral/conduct problem, and 3.2% had current depression. The prevalence of each disorder was higher with older age and poorer child health or parent/caregiver mental/emotional health; condition-specific variations were observed in the association between other characteristics and the likelihood of disorder. Nearly 80% of those with depression received treatment in the previous year, compared with 59.3% of those with anxiety problems and 53.5% of those with behavioral/conduct problems. Model-adjusted effects indicated that condition severity and presence of a comorbid mental disorder were associated with treatment receipt. CONCLUSIONS: The latest nationally representative data from the NSCH show that depression, anxiety, and behavioral/conduct problems are prevalent among US children and adolescents. Treatment gaps remain, particularly for anxiety and behavioral/conduct problems.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/terapia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Adolescente , Transtornos de Ansiedade/diagnóstico , Criança , Pré-Escolar , Transtorno da Conduta/diagnóstico , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Masculino , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia
9.
Z Kinder Jugendpsychiatr Psychother ; 47(1): 35-47, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30022702

RESUMO

OBJECTIVE: The study reports the prevalence of disruptive behaviors in a help-seeking sample of young children across a diverse range of clinical diagnoses (based on ICD-10). METHOD: The Eyberg Child Behavior Inventory (ECBI), a parent rating scale of disruptive behaviors, was completed on 310 children (2-11 years) at three child and adolescent psychiatry clinics in three German states (Bavaria, Hesse, Lower Saxony); the majority of children were outpatients. RESULTS: Mean intensity scores of disruptive behaviors differed significantly by diagnostic group, with the lowest ratings within a community sample, and increasingly higher scores in children with a diagnosis from the internalizing spectrum, those with pervasive developmental disorders, and finally, those with externalizing disorders (e. g. hyperkinetic disorder, conduct disorders). Seventy percent of the clinical sample, compared to only 17 % of the community sample, exceeded the normative cut-off score of 111, indicating that disruptive behaviors are common in young German children seeking help for different mental health problems. CONCLUSIONS: These findings support the Research Domain Criteria approach by showing that disruptive behaviors cross our current diagnostic labels and may need to be assessed and conceptualized in treatment planning, even in children without a primary diagnosis from the externalizing spectrum.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Comportamento Infantil/psicologia , Comportamento Problema/psicologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pacientes Ambulatoriais , Pais/psicologia , Prevalência
10.
Adicciones ; 31(2): 117-135, 2019 Apr 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29353299

RESUMO

Parenting is linked to conduct disorders (CD) and substance related disorders (SRD) in adolescents, but with differences according to cultural context. A questionnaire with two versions (parenting questionnaire TXP-A for adolescents and TXP-C  for primary caregivers) was designed using the Delphi method to evaluate parenting practices related to CD and SRD in a Spanish population. It was validated in a community sample of 631 adolescents aged between 14 and 16 and their caregivers. Results suggest a 29-item TXP-A questionnaire with bifactorial structure: affection-communication and control-structure, with high internal (Cronbach’s alpha=0.89) and test-retest (intraclass correlation coefficient=0.94) reliabilities. Both factors are related to SRD (r=0.273, p<0.001) and with most of the psychopathological dimensions studied. The total score and affection-communication are related to dissocial disorder (t=3.259, p=0.001) and its severity (r=-0,119; p=0.003). Inter-observer reliability between adolescents and caregivers is low, in part because the 16-item TXP-C has a different bifactorial structure: affection-communication and prosocial values. TXP-C’s internal (Cronbach’s alpha=0.87) and test-retest (intraclass correlation coefficient=0.94) reliabilities are high. The total score and affection-communication were related to dissocial disorder (t=2.586; p=0.010) but TXP-C did not discriminate according to SRD. In conclusion, the TXP-A questionnaire for adolescents seems to be a reliable, valid and unbiased instrument that evaluates the perception of parenting practices, relating higher affection-communication and control-structure to less psychopathology and alcohol and drug use. TXP-C also seems to be reliable and unbiased, but shows less evidence of validity regarding substance use and psychopathology. .


Assuntos
Comportamento do Adolescente/psicologia , Poder Familiar/psicologia , Psicometria/instrumentação , Inquéritos e Questionários , Adolescente , Adulto , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Técnica Delfos , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Espanha , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia
11.
Psychol Assess ; 31(1): 15-26, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30080064

RESUMO

The development of the Inventory of Callous-Unemotional Traits (ICU) has contributed importantly to research on the role of callous-unemotional traits in youth offending. However, findings from recent studies have raised questions about the measure's psychometric properties by yielding discrepant findings about how best to optimize the ICU for capturing meaningful variability in callous-unemotional traits across genders, reporters, and samples. The present study drew data from a sample of justice-involved adolescents and examined the psychometric properties of the ICU across caregiver- and youth self-report versions as well as across genders. Findings suggested that the ICU functioned differently across caregiver- and youth self-report versions and, thus, that different scale variations may better optimize the use of the ICU for caregiver versus youth self-reports. Specifically, findings from the current study supported the use of a youth self-reported ICU scale excluding reverse-coded items and the caregiver-reported full scale. Minimal gender differences emerged. Continued efforts to optimize the psychometric qualities and functional significance of the ICU, particularly the youth self-report form, may enhance efforts both to identify and intervene with the subgroup of youth at particular risk for recidivism. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Conduta/diagnóstico , Delinquência Juvenil/psicologia , Escalas de Graduação Psiquiátrica/normas , Autorrelato/normas , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Inventário de Personalidade/normas , Reprodutibilidade dos Testes , Adulto Jovem
12.
Child Psychiatry Hum Dev ; 50(2): 245-256, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30062495

RESUMO

The primary aim of the present study was to examine the psychometric properties and measurement invariance of the Inventory of Callous-Unemotional Traits (ICU) self-report and its short version (ICU-12) among a mixed-sex normative sample of 782 Portuguese youth (M = 15.87 years; SD = 1.72). Confirmatory factor analysis revealed that the three-factor structure of the ICU obtained the best fit after the removal of two items, and the two-factor structure of the ICU-12 obtained the best fit after the removal of one item. Cross-sex measurement invariance was demonstrated for both versions of the inventory. The 22-item version of the ICU and its 11-item short form (ICU-SF) demonstrated generally adequate psychometric properties of internal consistency, convergent validity, discriminant validity, and criterion-related validity (e.g., with conduct disorder symptoms). In terms of known-groups validity, males scored significantly higher than females. Results suggest that the use of the ICU and ICU-SF among Portuguese-speaking youth is psychometrically justified.


Assuntos
Transtorno da Conduta , Inventário de Personalidade/normas , Psicometria , Adolescente , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Feminino , Humanos , Masculino , Portugal , Psicometria/métodos , Psicometria/normas , Reprodutibilidade dos Testes , Comportamento Social , Traduções , Adulto Jovem
13.
Adicciones (Palma de Mallorca) ; 31(2): 117-135, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185206

RESUMO

El estilo parental de socialización se relaciona con trastornos de conducta (TC) y trastornos relacionados con sustancias (TRS) en adolescentes, con diferencias según el contexto cultural. Se diseñó mediante método Delphi un cuestionario con dos versiones (Cuestionario de socialización parental TXP-A para adolescentes y TXP-C para cuidador principal) para evaluar en población española las prácticas de socialización parental relacionadas con TC y TRS. Se validó en una muestra comunitaria de 631 adolescentes entre 14 y 16 años y sus cuidadores. Los resultados recomiendan un cuestionario TXP-A de 29 ítems y estructura bifactorial: afecto-comunicación y controlestructura, mostrando alta fiabilidad interna (alfa de Cronbach = 0,89) y test-retest (coeficiente de correlación intraclase = 0,94). Ambos factores correlacionan con TRS (r = 0,273; p < 0,001) y con la mayoría de las dimensiones psicopatológicas estudiadas. La puntuación total y afectocomunicación se relacionan con el trastorno disocial (t = 3,259; p = 0,001) y su gravedad (r = -0,119; p = 0,003). La fiabilidad interjueces entre adolescentes y cuidadores es baja, en parte porque el TXP-C, de 16 ítems, presenta una estructura bifactorial diferente: afecto-comunicación y valores prosociales. La fiabilidad interna (alfa de Cronbach = 0,87) y test-retest (coeficiente de correlación intraclase = 0,94) del TXP-C son altas. La puntuación total y afecto-comunicación se relacionan con el trastorno disocial (t = 2,586; p = 0,010) pero no discrimina según el TRS. En conclusión, el cuestionario TXP-A para adolescentes parece un instrumento fiable, válido y sin sesgos que evalúa la percepción de las prácticas de socialización parental, relacionando mayores puntuaciones en afecto-comunicación y control-estructura con menor psicopatología y consumo de alcohol y drogas. El TXP-C también parece fiable y sin sesgos, pero muestra menos evidencias de validez respecto al consumo de sustancias y la psicopatología


Parenting is linked to conduct disorders (CD) and substance related disorders (SRD) in adolescents, but with differences according to cultural context. A questionnaire with two versions (parenting questionnaire TXP-A for adolescents and TXP-C for primary caregivers) was designed using the Delphi method to evaluate parenting practices related to CD and SRD in a Spanish population. It was validated in a community sample of 631 adolescents aged between 14 and 16 and their caregivers. Results suggest a 29-item TXP-A questionnaire with bifactorial structure: affection-communication and control-structure, with high internal (Cronbach's alpha = 0.89) and test-retest (intraclass correlation coefficient = 0.94) reliabilities. Both factors are related to SRD (r = 0.273, p < 0.001) and with most of the psychopathological dimensions studied. The total score and affection-communication are related to dissocial disorder (t = 3.259, p = 0.001) and its severity (r = -0,119; p = 0.003). Inter-observer reliability between adolescents and caregivers is low, in part because the 16-item TXP-C has a different bifactorial structure: affection-communication and prosocial values. TXP-C's internal (Cronbach’s alpha=0.87) and test-retest (intraclass correlation coefficient=0.94) reliabilities are high. The total score and affection-communication were related to dissocial disorder (t = 2.586; p = 0.010) but TXP-C did not discriminate according to SRD. In conclusion, the TXP-A questionnaire for adolescents seems to be a reliable, valid and unbiased instrument that evaluates the perception of parenting practices, relating higher affection-communication and control-structure to less psychopathology and alcohol and drug use. TXP-C also seems to be reliable and unbiased, but shows less evidence of validity regarding substance use and psychopathology


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Comportamento do Adolescente/psicologia , Poder Familiar/psicologia , Psicometria/instrumentação , Inquéritos e Questionários , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Técnica Delfos , Análise Fatorial , Reprodutibilidade dos Testes , Espanha , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia
14.
PLoS One ; 13(11): e0206442, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30383806

RESUMO

Externalizing problems (EP), including rule-breaking, aggression, and criminal involvement, are highly prevalent during adolescence, but the adult outcomes of adolescents exhibiting EP are characterized by heterogeneity. Although many youths' EP subside after adolescence, others' persists into adulthood. Characterizing the development of severe EP is essential to prevention and intervention efforts. Multiple predictors of adult antisocial personality disorder (ASPD) and legal outcomes of a large sample (N = 1205) of clinically- or legally-ascertained adolescents (ages 12-19 years) with severe EP were examined. Many psychosocial predictors hypothesized to predict persistence of EP demonstrated zero-order associations with adult outcomes, but accounted for little unique variation after accounting for baseline conduct disorder symptoms (CD) and demographic factors. Baseline measures of intelligence, which explained independent variation in legal outcomes, provided the only consistent exception to this pattern, though future work is needed to parse these effects from those of socioeconomic factors. CD severity during adolescence is a parsimonious index of liability for persistence of EP into adulthood that explains outcome variance above and beyond all other demographic and psychosocial predictors in this sample.


Assuntos
Comportamento do Adolescente/fisiologia , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Conduta/diagnóstico , Comportamento Criminoso , Emoções Manifestas , Delinquência Juvenil , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Idade de Início , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Comportamento Criminoso/fisiologia , Comportamento Perigoso , Progressão da Doença , Feminino , Humanos , Delinquência Juvenil/legislação & jurisprudência , Delinquência Juvenil/psicologia , Delinquência Juvenil/estatística & dados numéricos , Estudos Longitudinais , Masculino , Prognóstico , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
15.
Am Fam Physician ; 98(10): 584-592, 2018 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-30365289

RESUMO

Conduct disorder is a psychiatric syndrome that most commonly occurs in childhood and adolescence. It is characterized by symptoms of aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules. Risk factors include male sex, maternal smoking during pregnancy, poverty in childhood, exposure to physical or sexual abuse or domestic violence, and parental substance use disorders or criminal behavior. At least three symptoms should have been present in the past 12 months, with at least one present in the past six months to diagnose conduct disorder. Interventions consist of treating comorbid conditions such as attention-deficit/hyperactivity disorder; supporting clear, direct, and positive communication within the family; and encouraging the family and youth to connect with community resources. There are several evidence-based psychosocial interventions that a psychologist or therapist may implement as part of long-term treatment. Currently, no medications have been approved by the U.S. Food and Drug Administration to treat conduct disorder. Treatment with psychostimulants is highly recommended for patients who have both attention-deficit/hyperactivity disorder and conduct problems. There is some evidence to support the treatment of conduct disorder and aggression with risperidone, but health care professionals should weigh the medication's potential benefits against its adverse metabolic effects.


Assuntos
Transtorno da Conduta/diagnóstico , Transtorno da Conduta/terapia , Atenção Primária à Saúde/métodos , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pais/psicologia , Fatores de Risco
16.
Rev. psiquiatr. salud ment. (Barc., Ed. impr.) ; 11(3): 141-150, jul.-sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-176743

RESUMO

Introducción: La escala Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) fue creada para evaluar de forma breve el funcionamiento de las personas con trastorno de desarrollo intelectual y problemas de salud mental/trastornos de conducta. El objetivo del presente trabajo fue estudiar las evidencias sobre la validez de las puntuaciones obtenidas con la escala HoNOS-LD traducida al castellano. Material y método: La muestra estaba formada por 111 participantes que fueron evaluados con la HoNOS-LD traducida al castellano y otros cuestionarios relacionados. Para estudiar la fiabilidad entre examinadores y la fiabilidad test-retest, 33 participantes fueron evaluados por 2 examinadores y reevaluados al cabo de 7 días. Resultados: De acuerdo con criterios clínicos y conceptuales, y con el resultado del análisis paralelo, se seleccionó una solución factorial con único factor. La consistencia interna fue buena (coeficiente omega de 0,87). Las fiabilidades entre examinadores y test-retest fueron excelentes (coeficientes de correlación intraclase de 0,95 y 0,98, respectivamente). Las correlaciones entre secciones de la HoNOS-LD y los instrumentos relacionados fueron en el sentido esperado y altamente significativas (p<0,001), y la puntuación HoNOS-LD aumentaba con el nivel de apoyos necesario de los participantes, resultados que aportaron evidencia sobre la validez de asociación con otras variables externas. Conclusiones: La versión en castellano de la HoNOS-LD representa un instrumento breve, válido y fiable, que permitirá la evaluación rutinaria del funcionamiento con distintas finalidades, incluyendo el diagnóstico y la intervención


Introduction: The Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) is a brief instrument that assesses functioning in people with intellectual development disorder and mental health problems/behaviour disorders. The aim of the present study was to examine the evidence on the validity of the scores based on the Spanish version of the HoNOS-LD. Material and methods: The study included 111 participants that were assessed by the Spanish version of the HoNOS-LD and other questionnaires that measured different variables related to the scale. Thirty-three participants were assessed by 2 examiners, and retested 7 days later, in order to study inter-examiner reliability and test-retest reliabilities. Results: Based on clinical and conceptual criteria, and on the results of the parallel analysis, a factorial solution with one factor was selected. Internal consistency was good (Omega coefficient of 0.87). Inter-examiner and test-retest reliabilities were excellent (intraclass correlation coefficients of 0.95 and 0.98, respectively). Correlations between sections of the HoNOS-LD and the related instruments showed the expected direction, and were highly significant (P<.001), and the HoNOS-LD score increased with the intensity of the support required by the participants. These results showed evidence of the validity of association with other external variables. Conclusions: The Spanish version of the HoNOS-LD is a brief, valid and reliable instrument, which will enable a routine assessment of functioning for different uses, including diagnosis and intervention


Assuntos
Humanos , Masculino , Feminino , Adulto , Psicometria/instrumentação , Testes Psicológicos/normas , Transtornos de Aprendizagem/diagnóstico , Deficiência Intelectual/diagnóstico , Transtorno da Conduta/diagnóstico , Transtornos Mentais/diagnóstico , Traduções , Reprodutibilidade dos Testes , Reprodutibilidade dos Testes , Diagnóstico Diferencial , Testes Genéticos
17.
Psychiatry Res ; 267: 333-339, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29957550

RESUMO

Recent studies suggest a higher threshold number of self-injuries during the past year than the one proposed in the DSM-5 criteria for non-suicidal self-injury disorder (NSSID). Therefore, we aimed to test a validity of the frequency criterion in girls with conduct disorder (CD) based on psychopathology and the level of functioning. Mixture modelling analysis revealed that the frequency of at least 8 self-harm behaviours in the previous year differentiated adolescents with CD. Thus, we divided adolescents into three subgroups: group 1: at least 8 self-harm acts; group 2: 1-7 self-harm behaviours and group 3: those who did not injure themselves during the last 12 months. Individuals from group 1 were significantly younger and had earlier age of self-harm onset. There were significant differences between groups 1 and 3 in terms of anxiety and depressive symptoms, self-esteem, aggression and the global functioning level. The group 1 scored significantly higher on depressive symptoms compared to the group 2. The group 2 scored significantly higher than the group 3 on the level of hostility. Our results provide further evidence supporting the need for modification of the NSSID frequency criterion.


Assuntos
Comportamento do Adolescente/psicologia , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Adolescente , Agressão/psicologia , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtorno da Conduta/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Autoimagem , Comportamento Autodestrutivo/epidemiologia , Fatores de Tempo , Adulto Jovem
20.
Z Kinder Jugendpsychiatr Psychother ; 46(6): 523-533, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29846123

RESUMO

OBJECTIVE: This study served to establish German norms for the Strengths and Difficulties Questionnaire self-report (SDQ-S) by using data from a representative epidemiological sample from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS study). Although the German version of the SDQ has been widely used and normative data for the parent version (SDQ-P) exist, no German norms for the self-report version have been reported, so that practitioners had to rely on the available British norms. In addition, we investigated whether sex- and age-specific norms are necessary. METHODS: At the baseline of the KiGGS study, SDQ-S ratings were collected from n = 6,726 children and adolescents between 11 and 17 years (n = 3,440 boys und n = 3,286 girls). We assessed the internal consistency and age/sex effects of the SDQ-S. Confirmatory factor analysis was conducted to assess the factor structure of the SDQ-S. Banding scores were developed to differentiate children and adolescents with levels of difficulties and categorized them as "normal," "borderline," and "abnormal." General as well as age- and sex-specific bandings were created for both total score and subscales of SDQ-S. In addition, the German norms of the SDQ-S were compared with those of the UK, Norway, and Thailand. RESULTS: The five-factor solution of the SDQ-S (including Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer problems, and Prosocial behavior) provided a satisfactory fit to the data. Moderate internal consistencies (Cronbach's α) were observed for the scales Emotional symptoms, Hyperactivity/Inattention, and Total difficulties score, whereas insufficient internal consistency was found for the scales Peer problems and Conduct problems. However, using McDonald's ω as a more appropriate measure of homogeneity, internal consistencies were found to be satisfactory for all subscales and for Total difficulties. Normative banding scores were established conservatively to avoid producing too many false positives in the category "abnormal." In line with previous research, girls showed more emotional problems but fewer Peer problems than boys. German normative bandings of SDQ-S were similar to the original British bandings and those of other countries. CONCLUSIONS: This study of the German SDQ-S in a large representative epidemiological sample presents evidence of partly moderate to good psychometric properties. It also supports the usefulness of SDQ-S as an effective and efficient instrument for child and adolescent mental health problems in Germany. German normative banding scores of SDQ-S established in this study were comparable with the original British norms as well as with those of other countries, so that SDQ-S can be recommended as a psychopathological broadband-screening tool.


Assuntos
Sintomas Afetivos/diagnóstico , Sintomas Afetivos/epidemiologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Determinação da Personalidade/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Sintomas Afetivos/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Transtornos do Comportamento Infantil/psicologia , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Estudos Transversais , Feminino , Alemanha , Humanos , Masculino , Valores de Referência , Autorrelato
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