Showing papers in "Journal of Child Psychology and Psychiatry in 1993"

An Epidemiological Study of Disorders in Late Childhood and Adolescence—I. Age‐ and Gender‐Specific Prevalence

Abstract: Developmental aspects of psychiatric disorders may be inferred from patterns of age differences in prevalence. Age-specific prevalences are provided for nine disorders in a general population sample of ages 10-20. Age and gender patterns for several disorders suggest developmental stage-associated risks. These include oppositional disorder in both genders and conduct disorder and major depression in girls. Major depression shows a pattern suggestive of a role for the onset of puberty. The prevalence of one or more disorders did not differ by age or gender. However, the pattern of specific diagnoses varied greatly by both age and gender.

Why do autistic individuals show superior performance on the block design task

Abstract: Systematic variations of the block design task were given to 20 autistic, 33 normal and 12 mildly retarded subjects. Designs were contrasted which were either "whole" or segmented, rotated or unrotated, and which did or did not contain obliques. Only segmentation, but neither of the spatial orientation factors, revealed a significant group difference. Autistic subjects, regardless of age and ability, performed better than controls when presented with unsegmented designs. This result suggests that they need less of the normally required effort to segment a gestalt, and thus supports the hypothesis of weak central coherence as a characteristic of information processing in autism.

The epidemiology of Asperger syndrome. A total population study

Abstract: This paper describes a total population study of Asperger syndrome using a two-stage procedure. All school children in an outer Goteborg borough were screened. Final case selection based on clinical work-up showed a minimum prevalence of 3.6 per 1.000 children (7-16 years of age) using Gillberg and Gillberg's criteria and a male to female ratio of 4:1. Including suspected and possible Asperger syndrome cases, the prevalence rose to 7.1 per 1.000 children and the male:female ratio dropped to 2.3:1. These findings are discussed as they relate to previously published results in the field and to findings obtained using Szatmari et al.'s and ICD-10 draft criteria for the disorder.

Emotional/Behavioral Problems in Clinic and Nonclinic Children: Correspondence Among Child, Parent and Teacher Reports

Abstract: This study examined the correspondence among child, parent and teacher reports, in rating emotional and behavioral problems of 98 community nonpatients and 64 clinically referred children (ages 6-13). The mean ratings differed significantly for the three sources and for the two samples, and there were a few significant interactions. Correlations of the scores between sources, especially parents and teachers, were in the moderate range and were not significantly different from one another. Informant correspondence was higher for externalizing than internalizing problems in both patient and nonpatient samples, and was higher for nonpatients than patients. In general, informant agreement was higher for cases characterized by lower family stress and higher child acceptance, among other clinical variables.

Annotation: methodological and conceptual issues in research on childhood resilience.

Abstract: Recent advances in research on childhood resilience have yielded valuable insights on protective processes in adjustment. At the same time, however, as with any growing discipline, the rapid accrual of data has led to the identification of additional important questions, many of which are currently inadequately resolved. The focus of this paper is on salient methodological and conceptual issues that merit further scrutiny in research on resilience. The discussion focuses in turn on definitions of competence, measurement of risk, terminology used to describe protective mechanisms, main effect and interaction effect models of resilience, and processes underlying “buffering” or “moderating” effects.

Developmental Normative Data on The Test of Variables of Attention (T.O.V.A.

Abstract: Developmental normative data for 775 children aged 6-16 are presented for the Test of Variables of Attention (T.O.V.A.), a 23-minute fixed-interval visual Continuous Performance Test with minimal language demands and no left-right discrimination. The target is presented on 22.5% and 77.5% of the trials during the first and second halves, respectively, T.O.V.A. indices include omission and commission errors, response time means and standard deviations, and anticipatory responses. Attention and impulse control developed in a non-linear manner, changing rapidly in early childhood and leveling off during later childhood and adolescence.

Executive function and social communication deficits in young autistic children.

Abstract: Preschool-aged, autistic children were compared with both developmentally delayed children of similar non-verbal mental age and normally developing children of similar verbal skill on measures of executive function and social communication skills. Autistic children exhibited significantly more perseverative responses on a test of executive function when compared to both comparison groups. Autistic children also exhibited significantly fewer joint attention and social interaction behaviors. Moreover, a significant relationship was found between executive function skill and the two social communication skills, which was independent of group membership or verbal ability. Competing hypotheses to account for the relationship between executive function deficits and social communication deficits in autism are discussed.

Is the Continuous Performance Task a Valuable Research Tool for use with Children with Attention‐Deficit‐Hyperactivity Disorder?

Abstract: The Continuous Performance Task (CPT) has become a popular research tool used to distinguish children with Attention-Deficit-Hyperactivity Disorder (ADHD) from their normal peers. Whether hyperactive children have a vigilance decrement remains an ongoing controversy. The theoretical basis of the CPT and variables known to influence performance are examined in order to interpret the inconsistencies evident in the research. Studies which employed the CPT in order to examine the possibility of sustained attention deficits in children with ADHD will be reviewed. The results are examined in light of group selection criteria, task variables and situational and external variables. It is concluded that there is no compelling evidence for a sustained deficit in ADHD children. An alternative theoretical model for understanding the results of CPT performance in ADHD children is provided.

Depressed Mothers' Speech to Their Infants and its Relation to Infant Gender and Cognitive Development

Abstract: — The speech of depressed and well mothers during play with their infants at two months was compared on dimensions of structure and semantics. No differences between maternal groups were found on measures of complexity and syntax. However, the speech of depressed women expressed more negative affect, was less focused on infant experience, and tended to show less acknowledgement of infant agency. Speech style of depressed women also varied according to infant gender. Regression analyses indicated that the quality of maternal communication with the infant, and particularly the focus of speech, mediated the association between depression and infant cognitive development in the first 18 months.

Evaluation of the revised Ontario Child Health Study scales.

Abstract: This article describes the development and evaluation of the revised Ontario Child Health Study (OCHS) scales to measure conduct disorder, oppositional disorder, attention-deficit hyperactivity disorder, overanxious disorder, separation anxiety- and depression based on DSM-III-R symptom criteria Problem checklist assessments were obtained from parents and teachers of children aged 6–16 and youths aged 12–16 drawn from: (1) a general population sample (N= 1751); and (2) a mental health clinic sample (N= 1027) in the tame industrialized, urban setting Evaluation of the revised OCHS scales indicates that they possess adequate psychometric properties and provide an efficient means to obtain measurements of childhood psychiatric disorder, in general population studies, that correspond to DSM-III-R classification of disorder

Convergence of the Child Behavior Checklist with structured interview-based psychiatric diagnoses of ADHD children with and without comorbidity.

Abstract: — We evaluated the convergence of CBCL scales with the diagnosis of ADHD and comorbid disorders in 133 ADHD and 118 normal control boys, aged 6–17 years old. We evaluated the strength of association between each CBCL scale and structured-interview derived diagnoses with Total Predictive Value (TPV) and the odds-ratio (OR). Excellent convergence was found between the GBGL Attention Problems scale with the diagnosis of ADHD, between the Delinquent Behaviour scale and the diagnosis of CD, and between die Anxiety/Depression scale and the diagnoses of Anxiety Disorders. These findings indicate that the CBCL could serve as a rapid and useful screening instrument to identity comoribid and non-comorbid cases of ADHD.

One-Year Outcomes of Depressive Disorders in Child Psychiatric In-patients: Evaluation of the Prognostic Power of a Brief Measure of Expressed Emotion

Abstract: The association between 1-year post-hospitalization outcome and the brief Five Minute Speech Sample (FMSS) measure of expressed emotion (EE) was examined among children with depressive disorders. Results indicated a strong association between 1-year outcome and the FMSS-EE measure. Whereas children returning to high EE homes were likely to show persistent mood disorder, recovery was more common among children returning to low EE homes. This predictive relationship was independent of possible mediating variables such as treatment regimen and clinical characteristics. Results provide the first reported demonstration that (1) the brief FMSS-EE measure predicts clinical outcome, and (2) EE measures predict 1-year outcome for children with depressive disorders.

An Epidemiological Study of Disorders in Late Childhood and Adolescence—II. Persistence of Disorders

Abstract: The persistence and new onset of psychiatric disorder were studied in a sample of 734 children from the general population. Diagnoses for six of the more prevalent disorders were generated from maternal and child interviews when the children were ages 9-18 and again 2 1/2 years later. Analyses demonstrated substantial levels of diagnostic persistence over the 2 1/2 year period for all diagnoses except major depression. With few exceptions persistence was roughly equivalent for age and gender subgroups. It is concluded that disorders assessed by structured interview of non-clinical samples of children cannot be dismissed as transitory.

Risk and Resistance Factors in the Adaptation of Parents of Children with Severe Physical Disability

Abstract: Associations between descriptor variables of child characteristics, life events, parental resources and coping strategies and outcome measures of psychological distress, satisfaction with life and adaptation to the child were investigated for both mothers and fathers in a sample of families of children with severe physical disability. Results indicated high levels of psychological distress, particularly for mothers. Personality factors, coping strategies, life events and socio-economic disadvantage were related to outcome for both parents. For mothers, greater physical disability and communication problems in the child were risk factors; for fathers, child gender and feeding problems showed significant associations with outcome.

Sociometric Status and Social Behaviour of Children with and without Learning Difficulties

Abstract: The sociometric status and behaviour of 179 children aged 80-120 years, including 36 children with learning disabilities, were examined Compared to non-LD children, more LD children were rejected and fewer were popular LD children were nominated as shy, seeking help and as victims of bullying significantly more than non-LD children; fewer were nominated as cooperative or as a leader Aggressive behaviours did not distinguish the two groups Teacher scores of LD children's behaviour were not related to peer nominations, although those of non-LD children were Findings are discussed in relation to the role of social cognitive deficits in LD children's relationships with peers

The Evaluation and Treatment of Sleep Disturbances in Young Children

Abstract: This study examines the accuracy of parents' reports about their children's sleep behavior and their response to a behavioral treatment. Twenty-eight sleep-disordered and thirty control children aged 12-36 months were filmed during three nights using an infrared camera and their sleep behavior compared with parental reports. There were significant differences among the groups with parents of good sleepers being less accurate in reporting on their children's sleep behavior. Poor sleepers also had more behavior problems, a more difficult temperament and more adverse early medical histories. The good sleepers woke up as frequently as the poor sleepers. However, they managed to soothe themselves back to sleep without disturbing anyone. Virtually all poor sleepers showed significant improvement following treatment.

The natural history of change in intellectual performance : who changes ? How much ? Is it meaningful ?

Abstract: A prerequisite step for studying the magnitude and meaning of IQ change is to distinguish between true IQ change that is a researchable phenomenon and IQ “change” that can be accounted for by measurement error. We studied she reliability, magnitude and meaning of IQ change using scores on she WISC-R obtained from a representative sample of 794 children at ages 7, 9,11 and 13. The findings suggest that, in the majority of children, IQ change is either negligible in amount, unreliably measured or both. In a nontrivial minority of children, naturalistic IQ change is marked and real, but this change is variable in its timing, idiosyncratic in its source and transient in its course. We discuss the implications of these findings for interventions that aspire to improve IQ scores.

Diagnostic specificity of a brief measure of expressed emotion: a community study of children.

Abstract: The association between expressed emotion (EE) and psychiatric disorders was investigated in a community survey of 108 preadolescent children Results indicated that the two components of EE, critical comments and emotional overinvolvement, identified non-overlapping subsets of families and displayed diagnostic specificity Significantly higher rates of disruptive behavior diagnoses were observed in children of parents who expressed high levels of criticism, while children of parents who expressed high levels of emotional overinvolvement were significantly more likely to have an anxiety disorder when compared in the remaining sample Findings support the utility of this brief measure of EE in epidemiologic samples

Structured Interviews for Assessing Children

Abstract: Structured interviews provide a valuable means of obtaining and quantifying information about the mental status of children. This review indicates that children can reliably self-report and that the information they provide can concur with the opinion of adults knowledgeable about them. However, considerably more research is warranted before it may be assumed that these interviews are adequately reliable and valid. In general, it appears that the task of documenting the psychometric soundness of these interviews has not been taken seriously, as if content validity were sufficient. For example, except for the CAS and the DISC, there has been little effort to study contrast group validity (i.e. whether the interview even differentiates "known groups"). More specifically, review of the reliability and validity data relevant to DSM-III-R diagnoses provides support for the CAS, DICA, ISC and K-SADS, with the validity data for the DICA being weaker than for the others. One limitation of these data for the DICA, ISC and K-SADS is that the diagnoses were clinician-generated, rather than algorithm-generated. Unfortunately the processes for generating clinical diagnoses were not specified, except for criterion reference to DSM-III-R. The findings for the DISC and the DISC-R are notably weak. There is no evidence for DISC reliability, except for adolescents, and the validity studies have demonstrated only weak relationships. There has been limited study of the psychometric properties of symptom scales. In fact, for two interviews (i.e. DICA and ISC), there are no data available. Reliability for the DISC scales is adequate only for adolescents. Psychometric data have been generated for the CAS and the K-SADS, with considerably more studies conducted with the CAS. The relative paucity of interest in scale scores is striking given that they provide a continuous variable which can indicate extent of symptoms. Other measures of mental status, besides presence/absence of diagnosis, will become increasingly important as research in child psychopathology progresses toward more sophisticated studies (i.e. treatment effects, risk factors). These interviews are labor intensive and costly to the researcher as well as time-consuming and tedious for the children and parents. Given this commitment, researchers should invest in developing other ways of exploiting the richness of the data generated. An example is the CAS "content" scales, which generate scores reflecting on the child's functioning in various areas (e.g. school, friends, family). As the evolution of these interviews continues, it will be important to remain attentive to the developmental limitations of children.(ABSTRACT TRUNCATED AT 400 WORDS)

Hyperactivity and Spelling Disability: Testing for Shared Genetic Aetiology

Abstract: — The influence of genetic Factors in the comorbidity of spelling disability arid hyperactivity was investigated in two samples of 190 and 260 Sadie sex twin pairs. The method of bivariate group heritability was used to estimate the genetic correlation for spelling disability and hyperactivity A similar though not statistically significant value for the genetic correlation was obtained for the two samples (0.29 and 0.42). It was estimated that approximately 75% of the co-occurrence of these two conditions was due to shared generic influences.

The effects of conduct disorder and attention deficit in middle childhood on offending and scholastic ability at age 13.

Abstract: The relationship between conduct disorder and attention deficit behaviours in middle childhood (6, 8 and 10 years) and juvenile offending and academic achievement were examined in a birth cohort of New Zealand children. The application of structural equation modelling methods suggested that early behavioural tendencies are related to later developmental outcomes by two highly correlated but distinct developmental progressions. In the first such progression, early conduct disorder behaviours acted as a precursor of future offending patterns but these behaviours were unrelated to later school performance when the correlation between conduct disorder and attention deficit was taken into account. In the second developmental progression early attentional/cognitive behaviours were related to future school performance but were unrelated to the development of antisocial behaviours when the correlations between conduct disorder and cognitive/attentional variables were taken into account. The implications of these findings for validating the distinction between conduct disorder and attention deficit behaviours is discussed and the problems of analysing and explaining the high comorbidity between conduct disorder and attention deficit behaviours are considered.

Maternal Emotional Responsiveness and Toddlers' Social-Emotional Competence

Abstract: —This study investigated, via extended naturalistic observation: (a) how mothersand children responded emotionally to each other's emotional displays; eUid (b) whetherratings of the child's social-emotional competence (made when the mother was absent)could be predicted by specific matemal responses to the child's emotions. Subjects were28 mother-toddler pairs. Sequential analyses suggested that emotional dialogue does existbetween mothers and children: certain emotional responses of mothers and children occurredmore often than expected by their base rate during interaction. Matemal responsivenessto child sadness, anger, fear and neutrjdity predicted dimensions of children's social-emotional competence. Implications regarding the mother-child affective environment,socialization of emotion and socisd competency, and developmental methodology arediscussed.Keywords: Social competence, mother-child interaction, maternal responsiveness,emotion IntroductionThe two central goals of this investigation were: (1) to illustrate and specify thenature of maternal/toddler emotional responsivity to each other's emotions; and (2)to demonstrate the importance of maternal emotional responsiveness to toddlers' social-emotioned development. Both attachment and socialization of emotion theories supportthese goals, each offering a unique perspective on matern2d emotional responsiveness(Ainsworth, Blehar, Waters & Wall, 1978; Halberstadt, 1991; Malatesta, 1981;Malatesta, Culver, Tesman & Shepard, 1989).According to the attachment perspective, infzint social-emotional development ismaximized when the caregiver is sensitive (i.e. aware ofthe infant's emotional signals,interpreting them accurately, and responding contingently; see Main, Tomasini T Malatesta & Haviland, 1982).

Abnormal Shyness in Children

Abstract: Recent nonclinical studies of children who do not often interact with their peers have identified at least three different kinds of solitude: temperamental shyness, social-evaluative shyness, and unsociability. These kinds of solitude can be clearly distinguished from social nonacceptance. The evidence for the different faces of children's solitude and their situational, age, and cultural specificity is reviewed, and potential implications for clinical child psychology are discussed. Clinical practitioners can profit from a recognition of the multifaceted nature of solitude in childhood.

Prevalence of the fragile X anomaly amongst autistic twins and singletons.

Abstract: Early screening studies of autistic individuals suggested that up to one-quarter of cases were associated with the Fragile X anomaly. Recent studies find that the usual behavioural phenotype of the Fragile X anomaly is distinct from autism as usually defined, and that a variety of methodological factors contribute to the variability of the prevalence estimates. We report the prevalence of the Fragile X anomaly, using strict cytogenetic criteria, in a large sample of autistic individuals whose diagnosis was confirmed using a standardised diagnostic instrument. The anomaly was detected in 1.6% of tested autistic individuals from a combined sample of: autistic twins; clinic attenders; and, individuals from families multiplex for autism or related cognitive phenotypes. The anomaly was not detected in greater than 2.5% of any of the constituent samples and accounted for only a small proportion of the genetic influences amongst concordant twins and multiplex families. The anomaly was detected in 5% of the 40 tested autistic females, confirming reports that the prevalence of the anomaly is similar amongst autistic individuals of both sexes.

Annotation: Autism, Executive Functions and Theory of Mind: A Neuropsychological Perspective

Abstract: It is widely accepted nowadays that some kind of neurological abnormality must beresponsible for the symptoms of autism. However, we are still a very long way fromunderstanding how brain damage or dysfunction can cause such a distinctive patternof symptoms, with impairments in language and social interaction and limitationsof the behavioural repertoire. Although some evidence of neurological impairmentcan be demonstrated in the majority of autistic children if a detailed investigatIonis undertaken (Steffenburg, 1991) there is considerable variation in etiological factors,which may involve genetic constitution, biochemical disorders and many differenttypes of neurological disease.Because the majority of autistic children are mentally retarded, it is not surprisingto find widespread neuropathology associated with autism. However, although CTand MRI scanning have revealed brain abnormalities in several series of autisticchildren, there is little agreement from one case to another in the extent and typesof impairment found (see reviews by Coleman & Gillberg, 1985; Reichler & Lee,1987). The unresolved question is why brain dysfunction leads to general mentalretardation in some children, and to autistic disorder in others.This brief paper will not attempt to review the neurobiological or psychologicalliterature on autism, but will rather focus on selected recent ~tudies to show how aneuropsychological approach to autistic symptoms can provide new ways of analysingcognitive deficits in this syndrome, which may guide the search for neurologicalcorrelates of the disorder using more direct techniques.A Neurological Model of Autism: Damasio and MaurerDamasio and Maurer (1978) drew attention to an area of cortex in the mesial aspectof the frontal and temporal lobes, the mesolimbic cortex, that is both phylogenetically

"Comorbidity" in an epidemiological sample: a longitudinal perspective.

Abstract: Parents' CBCL ratings of problem behaviors in 1117 4- to 11-year-olds from the general population were obtained across a 6-year interval. Data were analyzed categorically as well as quantitatively. Positive association, or overlap, was found between the majority of CBCL problem scales. Most CBCL scales were able to predict non-corresponding scales across the 6-year interval. Children who were scored in the deviant range on one particular syndrome but low on another syndrome had a better prognosis than children who were scored high on both syndromes. Studies concerning the etiology or treatment of certain conditions should control for co-occurring conditions because they may influence the results in unknown ways.

The structure, stability and correlations of the trait components of conduct disorder, attention deficit and anxiety/withdrawal reports

Abstract: A general model for describing the structure of multiple trait measures reported by multiple sources and observed at multiple times is developed. This model is applied to data on conduct disorder/oppositional behaviour, attention deficit and anxiety/withdrawal reported by three sources (child, mother, teacher) at three ages (8, 10 and 12 years) for a birth cohort of 1265 New Zealand children. This model was shown to fit the observed data adequately. The major conclusions of the analysis were: (a) reports of child behaviour derived from a specific source at a given time were of limited validity as measures of the child's behavioural tendencies; (b) reports of child behaviour derived from the same source were subject to correlated errors of measurement; (c) there was evidence of strong correlations (r = .80-.85) between conduct disorder/oppositional behaviour and attention deficit and weaker correlations (r = .30) between externalising traits and anxiety/withdrawal; and (d) when due allowance was made for errors of measurement in the report data, conduct disorder/oppositional behaviour, attention deficit and anxiety/withdrawal emerged as having very high stability across measurement periods. The implications of the results for a range of issues relating to the validity of report data, the interpretation of inter-informant correlations, the correlation/comorbidity of child behaviour problems and the stability of behaviour are discussed.

Creating satisfaction: a psychological perspective on stress and coping in families of handicapped children.

Abstract: —This paper briefly reviews the literature on stress and coping in families ofdevelopmentally handicapped children and proposes an alternative way for conceptualizingsome of the psychologicjJ processes involved. The approach specifies how threats to certainhuman needs lead to predictable patterns of appraisal and coping. The usefulness of thisalternative is demonstrated for families of autistic children and the theoretical and clinicalimplications are discussedKeywords Stress, coping, autism, parenting In recent years researchers from a variety of disciplines have devoted considerableeffort to the study of stress and coping in families of developmentally handicappedchildren. The purpose of this paper is to briefly review the literature in this area andto propose an alternative method for conceptualizing stress and coping in these families.The usefulness of this alternative will be demonstrated by applying it to the literatureon families of autistic children.Theories of Stress and CopingSince the term stress has become a subject of research in psychology, there hasbeen considerable controversy over its definition (Elliot & Eisdorfer, 1982; Hansen& Hill, 1964; Lazarus, 1966). Initial attempts at studying stress involved trying toidentify the types of stimuli cuid/or responses that indicate that stimulus has occured.This led to in-depth investigations of'' stressful'' stimuli such a.s aerial combat (Grinkel& Spiegel, 1945) or surgical threat (Janis, 1958) and studies of "stress-indicating"responses such as frustration (Buss, 1961) and neural hormonal reactions (Selye, 1956).Because research often showed considerable V2u-iability in response to the same"stressful" situation, more recent views define stress as a tremsactional process betweenthe environment, the availability of resources, and individual patterns of appraisal

Annotation: Children's Reactions to Traumatic Events

Abstract: An overview over post-traumatic stress reactions in children is provided. Subjects: range of PTSD reactions in children, studies of PTSD in children after disasters (natural disasters, terrorism, war, criminality), risk factors for the development of PTSD symptoms, approaches to treatment.

Causal attributions and posttraumatic stress in adolescents

Abstract: The aim of the present study was to explore the relationship between causal attributions made by adolescent survivors of the jupiter cruise ship sinking, and post-traumatic symptomatology in the year following disaster. Evidence is presented that more internal causal attributions for negative and uncontrollable events during the incident are associated with greater post-traumatic stress one year later. The findings are discussed with reference to an attributional model of shame.