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1.
Fortschr Neurol Psychiatr ; 87(11): 634-637, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756742

RESUMO

Aggressive behaviour is a typical phenomenon in childhood and adolescence. Aggression is one of the frequent reasons for parents to seek child and adolescent psychiatric and psychotherapeutic treatment. Disorders with increased aggressive behaviour, such as conduct or oppositional defiant disorder, carry an increased risk for long-lasting negative impact on well-being, especially when comorbid with substance abuse or affective symptoms. Barriers for treatment are frequently a lack of insight into consequences and non-compliance with intervention shown by adolescents. In addition, interdisciplinary intervention needs to combine psychiatric and psychotherapeutic interventions as well as complex interventions supported by the youth welfare system, and in particular including families. Further research is needed for the implementation of evidence-based treatments in routine care as well in special populations, such as girls with conduct disorders or youth with substance abuse.


Assuntos
Transtorno da Personalidade Antissocial/terapia , Transtorno da Conduta/terapia , Adolescente , Agressão , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/complicações , Transtorno da Conduta/psicologia , Feminino , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
2.
Psychiatr Hung ; 34(3): 280-286, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31570659

RESUMO

BACKGROUND: Quality of life is the individuals' subjective evaluation of their general well-being, including physical and mental health, social relationships and everyday functionality. The aim of our study was to examine conduct disorder in terms of gender differences in prevalence, and relationship to quality of life domains in the presence or absence of comorbid oppositional defiant disorder. METHODS: Altogether 392 adolescents, aged 13-18 years (M=14.5; SD= 1.37), participated in this study. The members of the clinical group were selected from Vadaskert Child and Adolescent Psychiatry Hospital, Budapest, Hungary with externalizing symptoms in their case history. The control group was selected from public schools in Budapest, Hungary. Mini International Neuropsychiatric Interview Kid was used to diagnose conduct disorder and oppositional defiant disorder, and parent and adolescent version of the Inventory of Quality of Life in Children and Adolescents (Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen) was used to measure the children's quality of life. RESULTS: In this sample 8.5% of adolescents were diagnosed with conduct disorder, of which 52.9% had a comorbid oppositional defiant diagnosis. Conduct disorder diagnosis was only present in the clinical group, 9 of participants with such diagnosis were male and 24 were female. Girls with conduct disorder evaluated their family life domain (p<0.01) and their global quality of life (p<0.05) lower than the boys. Compared to adolescents without comorbid oppositional defiant disorder diagnosis, adolescents with conduct disorder and comorbid oppositional defiant disorder had significantly worse quality of life in the domain of time spent alone (p<0.05). CONCLUSIONS: Conduct disorder is associated with decreased quality of life. The presence of comorbid oppositional defiant disorder correlates with lower quality of life in several domains. These findings are considerable for the clinical management of these externalizing disorders.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Qualidade de Vida , Caracteres Sexuais , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Comorbidade , Transtorno da Conduta/complicações , Feminino , Humanos , Hungria/epidemiologia , Masculino
4.
Z Kinder Jugendpsychiatr Psychother ; 47(6): 547-553, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31448668

RESUMO

Rejection of closed placement in youth welfare: Two case reports and a discussion of needs and effectiveness Abstract. Locked-door residential care in the custody of adolescents with severe behavioral problems has been a controversial subject in Germany for many decades. Sometimes the debate is held on an ideological level, sometimes it concerns the legal and ethical legitimacy of such actions, but it always is about providing the best care possible for severely disturbed adolescents with attachment disorder, severe conduct disorder, and psychosocial disintegration. Because of differing viewpoints on this issue, some German federal states have set up locked-door youth welfare institutions, whereas as others do not. Here, we present two stereotypical case constellations from the state of Saxony, where the absence of such locked-door residential institutions has served to shift the problem to clinics for child and adolescent psychiatry. Based on these case constellations, we discuss the present knowledge concerning the necessity and efficacy of these institutions. The discussion is followed by a critical reflection on constraint and autonomy in youth welfare.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Bem-Estar da Criança , Determinação de Necessidades de Cuidados de Saúde , Transtornos do Neurodesenvolvimento/psicologia , Transtornos do Neurodesenvolvimento/terapia , Adolescente , Criança , Transtorno da Conduta/psicologia , Transtorno da Conduta/terapia , Alemanha , Humanos , Apego ao Objeto
5.
J Consult Clin Psychol ; 87(8): 706-719, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31204839

RESUMO

OBJECTIVE: We examined the relative efficacy of an online versus face-to-face (FTF) parenting intervention for reducing the severity of child conduct problems and related parent and child outcomes in 2 randomized controlled trials. METHOD: In Study 1, rural families (n = 133) with a child 3-9 years of age with a full or subclinical primary diagnosis of oppositional defiant or conduct disorder traveled to Sydney, Australia for a comprehensive assessment and randomization to receive either AccessEI, a 6-10 week online therapist-assisted parenting program, or FTF treatment, whereby they received the same program presented FTF during a 1-week treatment. To control for unavoidable treatment dosage differences in the first study, Study 2 was conducted in which urban families (n = 73) with a child aged 3 to 14 years meeting similar criteria as Study 1 were randomized to receive AccessEI versus FTF treatment. RESULTS: In both studies, improvements in severity of child diagnoses and maternal measures of child behavior showed very large effect sizes for both treatments at posttreatment and 3-month follow-up and did not differ across treatment conditions. There were moderate effect sizes for improvements in parent mental health and no differences across treatment conditions. CONCLUSIONS: It is concluded that the effects of the therapist-assisted online parenting interventions for the treatment of child conduct problems were similar to a FTF intervention, providing evidence for the effectiveness of an accessible treatment for rural and remote families. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtorno da Conduta/terapia , Consulta Remota/métodos , Adolescente , Austrália , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Transtorno da Conduta/psicologia , Feminino , Humanos , Masculino , Poder Familiar/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , População Rural , Resultado do Tratamento , População Urbana
6.
Eur. j. psychol. appl. legal context (Internet) ; 11(1): 23-32, ene.-jun. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183539

RESUMO

The current work aimed to analyse the prospective effects of parenting practices on adolescent problematic behaviour taking into account the mediation effects of deviant affiliations in normative Spanish adolescents. For this purpose, a sample of 663 adolescents aged 12 to 15 (M = 12.49, SD = 0.68) and gender-balanced (54.3% male) were recruited from 13 state secondary schools in Galicia (NW Spain). Two structural equation models were tested separately on violent behaviour, nonviolent antisocial behaviour, and substance use: the parenting model analysed parental knowledge and parental support through deviant peers, and the sources model analysed adolescent disclosure, parental control, and parental solicitation through deviant peer affiliations. The results of the parenting model indicated that the effects of parental knowledge on all the types of problematic behaviour were significantly mediated by deviant peer affiliations. In addition, the direct effect of parental knowledge was significant on substance use for males. Regarding the sources model, the results indicated that the effects of adolescent disclosure were significantly mediated by deviant peer affiliations on all the types of problematic behaviour only for females. No significant effects of parental support, parental control, and parental solicitation were found. Methodological and practical implications of these findings are discussed


El presente trabajo tuvo como objetivo analizar los posibles efectos de las prácticas parentales sobre el comportamiento problemático en adolescentes españoles normativos, teniendo en cuenta los efectos de mediación de la afiliación con iguales desviados. Para ello, se utilizó una muestra de 663 adolescentes de 12 a 15 años (M = 12.49, DT = 0.68) equilibrada por género (54.3% varones) de 13 centros públicos de secundaria de Galicia (NO de España). Se analizaron dos modelos de ecuaciones estructurales por separado para conducta violenta, comportamiento antisocial no violento y consumo de sustancias: el modelo de crianza que analiza el conocimiento parental y el apoyo parental a través de los iguales desviados y el modelo de fuentes que analiza la autorrevelación adolescente, control parental y solicitud parental a través de la afiliación con iguales desviados. Los resultados del modelo de crianza indicaron que los efectos del conocimiento parental sobre todos los tipos de comportamiento problemático estuvieron significativamente mediados por la afiliación con iguales desviados. Además, el efecto directo del conocimiento parental fue significativo sobre el consumo de sustancias para los varones. Con respecto al modelo de fuentes, los resultados indicaron que solo para las mujeres los efectos de la autorrevelación adolescente estuvieron significativamente mediados por la afiliación con iguales desviados sobre todos los tipos de comportamiento problemático. No se encontraron efectos significativos del apoyo, el control y la solicitud parentales. Se discuten las implicaciones metodológicas y prácticas de estos hallazgos


Assuntos
Humanos , Adolescente , Comportamento do Adolescente/psicologia , Educação Infantil/psicologia , Poder Familiar/psicologia , Violência/psicologia , Comportamento Problema/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtorno da Conduta/psicologia , Características da Família , Distribuição por Sexo , Socialização , Comportamento Social , Autorrelato/estatística & dados numéricos
7.
Neural Plast ; 2019: 9638973, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31097957

RESUMO

Previous studies indicated that a lack of empathy could be considered the core feature of callous-unemotional (CU) traits in children and adolescents. The present study is aimed at exploring relationships among CU traits, cognitive and emotional dimensions of empathy, emotion recognition (basic, social, and complex emotions), and history of maltreatment in a sample of youths with conduct disorder diagnosis. The sample consisted of 60 Italian male patients (age range 11-17 years, mean age 13.27 ± 1.90 years) referred to the Department of Child and Adolescent Psychiatry (Pisa, Italy). In the whole sample, the levels of CU traits were significantly negatively associated with both cognitive and emotional dimensions of empathy; in addition, the CD patients with high levels of CU traits show significantly lower levels of empathic concern compared to those with low levels of CU traits. Clinical implications of the findings are discussed.


Assuntos
Transtorno da Conduta/psicologia , Emoções , Empatia , Adolescente , Criança , Maus-Tratos Infantis/psicologia , Cognição , Humanos , Masculino , Teoria da Mente
8.
BMC Psychiatry ; 19(1): 105, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30943981

RESUMO

BACKGROUND: Disruptive Behavioral Disorders (DBDs) and Attention Deficit/Hyperactivity Disorder (ADHD) are chronic, impairing, and costly child and adolescent mental health challenges which, when untreated, can result in disruptions in school performance, friendships and family relations. Yet, there is dearth of prevalence data on child and adolescent behavioral challenges within sub-Saharan Africa, including Uganda. This study aims to estimate the prevalence rate of behavioral challenges and ADHD among young school going children and early adolescents (ages 8-13 at study enrollment), utilizing a school-based sample in southwest Uganda. METHODS: We present screening results from a 5-year scale-up study titled SMART Africa-Uganda (2016-2021), set across 30 public primary schools located in the greater Masaka region in Uganda, a region heavily impacted by poverty and HIV/AIDS. Specifically, we draw on screening data from caregivers of 2434 children that used well-established standardized measures that had been pre-tested in the region. These were: 1) oppositional defiant disorder (ODD) and conduct disorder (CD) subscales of the Disruptive Behavior Disorders (DBD) scale; and 2) the Iowa Connors and Impairment scales. Slightly over half of the children in the sample were female (52%), with a mean age of 10.27 years. RESULTS: Of the 2434 participants screened for disruptive behaviors: 1) 6% (n = 136) scored positive on ODD and 2% (n = 42) scored positive on CD subscales of the DBD scale; 2) 9.61% (n = 234), and 2.67% (n = 65) were reported to have elevated symptoms of ODD and ADHD on the Iowa Connors caregiver report scale respectively. Twenty-five percent (n = 586) of children were described by their caregivers as having experienced some form of impairment in at least four domains of the Impairment scale. CONCLUSION: The results indicate the presence of behavioral challenges and ADHD among school going children, aged 8-13 years, in Uganda. Given the negative outcomes associated with behavioral challenges as children transition to adolescence and adulthood, detecting these emerging behavioral challenges early is critical in developing appropriate interventions. School settings could be considered as one of the contextually-relevant, culturally-appropriate, and non-stigmatizing venues to implement screening procedures and to detect emerging behavioral challenges and to make necessary referrals.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Pré-Escolar , Transtorno da Conduta/psicologia , Relações Familiares , Feminino , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Prevalência , Comportamento Problema/psicologia , Índice de Gravidade de Doença , Uganda/epidemiologia
9.
Eur Child Adolesc Psychiatry ; 28(11): 1537-1546, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31004293

RESUMO

Conduct disorder (CD) is a heterogeneous pattern of rule-breaking and aggressive symptoms. Until now it has been unclear whether valid, clinically useful symptom profiles can be defined for populations in youth at high-risk of CD. Interview-based psychiatric disorders, CD symptoms and officially recorded offences were assessed in boys from a detention facility and a forensic psychiatric hospital (N = 281; age 11.2-21.3 years). We used latent class analyses (LCA) to examine CD subtypes and their relationships with comorbid psychiatric disorders, suicidality, and criminal recidivism. LCA revealed five CD subtypes: no CD, mild aggressive CD, mild covert CD, moderate CD, and severe CD. The severe and, to a lesser degree, the moderate CD subtype were related to comorbid attention deficit hyperactivity disorder, substance use disorder, affective disorder, and suicidality. Time to violent criminal re-offending was predicted by severe CD (OR 5.98, CI 2.5-13.80) and moderate CD (OR 4.18, CI 1.89-9.21), but not by any other CD subtype in multivariate Cox regressions (controlling for age, low socioeconomic status and foreign nationality). These results confirm the existence of different CD symptom profiles in a high-risk group. Additional variable-oriented analyses with CD symptom count and aggressive/rule-breaking CD-dimensions further supported a dimensional view and a dose-response relationship of CD and criminal recidivism. Classifying high-risk young people according to the number of aggressive and rule-breaking CD symptoms is of major clinical importance and may provide information about risk of violent recidivism.


Assuntos
Transtorno da Conduta/psicologia , Adolescente , Comorbidade , Humanos , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
10.
Psychopharmacology (Berl) ; 236(9): 2593-2611, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30955107

RESUMO

RATIONALE: Deficits in empathy constitute a distinctive feature of several psychopathologies, including conduct disorder (CD). The co-occurrence of callous-unemotional (CU) traits, excess rates of aggression and violation of societal norms confers specific risk for adult psychopathy. To date, the off-label use of methylphenidate (MPH) constitutes the drug treatment of choice. OBJECTIVES: Herein, we tested the therapeutic potential of MPH in a recently devised mouse model recapitulating the core phenotypic abnormalities of CD. METHODS: Two subgroups of BALB/cJ male mice exhibiting opposite profiles of emotional contagion (i.e. socially transmitted adoption of another's emotional states) were investigated for reactive aggression, sociability, attention control, anxiety-related behaviours and locomotor activity, in response to MPH administration (0.0, 3.0 or 6.0 mg/kg). RESULTS: Our data indicate that mice selected for excess callousness exhibit phenotypic abnormalities isomorphic to the symptoms of CD: stability of the low emotional contagion trait, increased aggression and reduced sociability. In accordance with our predictions, MPH reduced aggression and increased sociability in callous mice; yet, it failed to restore the low responsiveness to the emotions of a conspecific in pain, isomorphic to CU traits. CONCLUSIONS: Although our data support the notion that MPH may contribute to the management of excess aggression in CD patients, additional studies shall identify specific treatments to target the callousness domain. The latter, unaffected by MPH in our experimental model, demands focused consideration whereby it constitutes a specifier associated with a worse prognosis.


Assuntos
Agressão/efeitos dos fármacos , Agressão/psicologia , Modelos Animais de Doenças , Inibidores da Captação de Dopamina/administração & dosagem , Metilfenidato/administração & dosagem , Animais , Atenção/efeitos dos fármacos , Atenção/fisiologia , Transtorno da Conduta/tratamento farmacológico , Transtorno da Conduta/psicologia , Emoções/efeitos dos fármacos , Emoções/fisiologia , Empatia/efeitos dos fármacos , Empatia/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C
11.
Neurosci Biobehav Rev ; 100: 85-97, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30817934

RESUMO

BACKGROUND: Callous-unemotional (CU) traits represent the affective features of psychopathy used to delineate youth at high risk for externalizing pathology. The genetic etiology CU traits is not currently well-understood. METHODS: The current review surveyed the literature for studies on the genetic underpinnings of CU traits and integrated information from 39 genetic studies. RESULTS: The results from 24 studies with quantitative data suggest that the heritability for CU traits is likely between 36-67%. A majority of the 16 molecular genetic studies focused on candidate genes in the serotonin and oxytocin systems with results that have not been well replicated. Although two genome-wide association studies have been conducted, no genome-wide significant loci have been discovered. DISCUSSION: There is some evidence to suggest that the serotonin and oxytocin systems may play a role in CU traits; however, there is currently not enough evidence to implicate specific genetic mechanisms. The authors encourage researchers to continue to apply the most up-to-date and relevant methodology, specifically collaborations and consortiums using genome-wide and polygenic methods.


Assuntos
Transtorno da Conduta/genética , Transtorno da Conduta/psicologia , Emoções/fisiologia , Epigênese Genética , Predisposição Genética para Doença , Humanos , Personalidade/genética , Fatores de Risco , Estudos em Gêmeos como Assunto
12.
Soc Psychiatry Psychiatr Epidemiol ; 54(8): 997-1006, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30790027

RESUMO

PURPOSE: To estimate the prevalence of enduring mental health (EMH) and examine important correlates of EMH 23 years later in the Baltimore Epidemiologic Catchment Area Follow-Up study. METHODS: We estimated the prevalence of EMH among 964 adults with diagnostic data at all four study waves (1981-2004). Those with EMH were compared to those with any mental or behavioral disorder by demographic, psychosocial, and health characteristics. We used forward selection models to identify the most important predictors of EMH. RESULTS: Twenty-six percent of participants met criteria for enduring mental health across the four waves. Neuroticism, GHQ-20 score, childhood conduct problems, female sex, maternal depression, and poor self-rated health were negatively associated with EMH. CONCLUSIONS: We identified several malleable factors associated with a decreased likelihood of enduring mental health. Interventions that target high neuroticism, childhood conduct problems, or maternal depression may increase the likelihood that children achieve EMH later in life. Identifying and treating other factors such as poor self-reported health and greater psychological distress may also keep sub-clinical symptoms from developing into a full mental or behavioral disorder.


Assuntos
Transtornos Mentais/epidemiologia , Saúde Mental/tendências , Adolescente , Adulto , Baltimore/epidemiologia , Criança , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Depressão/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Neuroticismo , Prevalência , Autorrelato , Adulto Jovem
13.
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
14.
Eur Child Adolesc Psychiatry ; 28(7): 1011-1022, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30680520

RESUMO

Oppositional defiant disorder, conduct disorder (ODD/CD), and autism spectrum disorder (ASD) share poor empathic functioning and have been associated with impaired emotional processing. However, no previous studies directly compared similarities and differences in these processes for the two disorders. A two-choice emotional valence detection task requiring differentiation between positive, negative, and neutral IAPS pictures was administered to 52 adolescents (12-19 years) with ODD/CD, 52 with ASD and 24 typically developing individuals (TDI). Callous-unemotional (CU) traits were assessed by self- and parent reports using the Inventory of callous-unemotional traits. Main findings were that adolescents with ODD/CD or ASD both performed poorer than TDI in terms of accuracy, yet only the TDI-not both clinical groups-had relatively most difficulty in discriminating between positive versus neutral pictures compared to neutral-negative or positive-negative contrasts. Poorer performance was related to a higher level of CU traits. The results of the current study suggest youth with ODD/CD or ASD have a diminished ability to detect emotional valence which is not limited to facial expressions and is related to a higher level of CU traits. More specifically, youth with ODD/CD or ASD seem to have a reduced processing of positive stimuli and/or lack a 'positive perception bias' present in TDI that could either contribute to the symptoms and/or be a result of having the disorder and may contribute to the comorbidity of both disorders.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno do Espectro Autista/psicologia , Transtorno da Conduta/psicologia , Emoções/fisiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem
15.
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
16.
Qual Life Res ; 28(5): 1271-1279, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30656535

RESUMO

PURPOSE: To assess the quality of life (QoL) of children and adolescents in Kenya as rated by parents and youth themselves, and examine how QoL is related to emotional and behavioral problems (EBP). METHOD: QoL and EBP reports were obtained from 1022 Kenyan parents and 533 adolescents living in the country's Central Province. Parents with children between 6 and 18 years completed the Pediatric Quality of Life Inventory (PedsQL) and the Child Behavior Checklist, while the adolescents (12-18) completed the PedsQL and the Youth Self-Report. RESULTS: Parent-reported QoL in Kenyan youth was somewhat above that of US standardization samples, while levels of adolescent self-reports were well within the range of those from most high- and middle-income countries. Average adolescent girls' self-reports were lower on all QoL scales than boys. QoL in children/adolescents with clinical to borderline levels of EBP (cf. multicultural norms, Achenbach and Rescorla, 2007) was lower than QoL in agemates with normal levels of EBP. Regression analyses indicated unique associations of QoL with parent-reported withdrawn/depressed, somatic complaints, attention problems, and aggressive behavior, and with adolescent self-reported somatic complaints, attention problems, and rule-breaking behavior. CONCLUSION: QoL levels were well within ranges of other countries. Moreover, associations of QoL with EBP indicated that those with borderline/clinical levels of EBP had a much lower QoL most notable for those with somatic complaints and attention problems. Mental health providers might focus on interventions that reduce EBP in Kenyan children and adolescents and simultaneously reduce the risk of lowered QoL.


Assuntos
Transtorno da Conduta/psicologia , Pais/psicologia , Comportamento Problema/psicologia , Qualidade de Vida/psicologia , Adolescente , Criança , Emoções , Feminino , Humanos , Quênia , Masculino , Saúde Mental , Autorrelato , Inquéritos e Questionários
17.
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
18.
Res Dev Disabil ; 85: 217-228, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30580152

RESUMO

Most research does not address the overlap between neurodevelopmental disorders when investigating concomitant mental health problems. The purpose of the present study was to examine the association of intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) with the presence of behavioural and emotional problems after controlling for other well-known correlates and risk factors. The sample included 4- to 18-year-old children who attended neuropaediatric clinics (N = 331). After controlling for adversity, age, gender, other developmental/neurological disorders, parental emotional problems, and parenting strategies, the presence of ADHD but not ASD or ID was uniquely associated with behaviour problems. Neither ADHD nor ASD nor ID was significantly associated with emotional problems after controlling for other risk factors. However, ADHD, ASD and behavioural/emotional disorders but not ID were significantly associated with functional impairment in everyday activities after controlling for other risk factors. Because children with neurodevelopmental disorders have complex needs, a holistic approach to diagnosis and interventions is highly warranted, including the assessment and treatment of behavioural and emotional disorders.


Assuntos
Atividades Cotidianas , Transtornos de Ansiedade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Espectro Autista/fisiopatologia , Transtorno da Conduta/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Deficiência Intelectual/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Adolescente , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Transtorno da Conduta/psicologia , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Deficiência Intelectual/psicologia , Masculino , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Transtornos do Neurodesenvolvimento/psicologia , Razão de Chances , Poder Familiar , Pais/psicologia , Classe Social , Transtornos de Estresse Pós-Traumáticos/psicologia
19.
Eur Child Adolesc Psychiatry ; 28(2): 165-175, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29594368

RESUMO

Patient-focused cognitive-behavioral therapy in children with aggressive behavior, which uses group-based social skills training, has resulted in significant reductions in behavioral problems, with effect sizes in the small-to-medium range. However, effects of individually delivered treatments and effects on aggressive behavior and comorbid conditions rated from different perspectives, child functional impairment, child quality of life, parent-child relationship, and parental psychopathology have rarely been assessed. In a randomized controlled trial, 91 boys aged 6-12 years with a diagnosis of oppositional defiant disorder/conduct disorder and peer-related aggression were randomized to receive individually delivered social competence training (Treatment Program for Children with Aggressive Behavior, THAV) or to an active control involving group play that included techniques to activate resources and the opportunity to train prosocial interactions in groups (PLAY). Outcome measures were rated by parents, teachers, or clinicians. Mostly moderate treatment effects for THAV compared to PLAY were found in parent ratings and/or clinician ratings on aggressive behavior, comorbid symptoms, psychosocial impairment, quality of life, parental stress, and negative expressed emotions. In teacher ratings, significant effects were found for ADHD symptoms and prosocial behavior only. THAV is a specifically effective intervention for boys aged 6-12 years with oppositional defiant disorder/conduct disorder and peer-related aggressive behavior as rated by parents and clinicians.


Assuntos
Agressão , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Terapia Cognitivo-Comportamental/métodos , Transtorno da Conduta/terapia , Habilidades Sociais , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Criança , Comorbidade , Transtorno da Conduta/psicologia , Grupos Controle , Humanos , Relações Interpessoais , Masculino , Relações Pais-Filho , Pais/educação , Qualidade de Vida
20.
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
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