Screening for Significant Behavior Problems in Diverse Young Children Living in Poverty

The development and use of first line screening instruments is an essential first step in assessing behavior disorders in very young children. The Early Childhood Behavior Screen (ECBS) is a parent-report measure for behavior disorders and is normed on young children (1–5 years old) living in poverty. The current study presents psychometric support for the discriminative validity of the ECBS’s 10-item Challenging Behavior Scale (CBS) as a first-line screener for externalizing behavior problems for preschool aged-children in poverty. The study’s sample included 673 participants (M age years = 2.81; 63.2 % male; 65.8 % African American) that all met the federal definitional standard for living in poverty. A confirmatory factor analysis was run to provide support for the ECBS factor structure. Receiver operating characteristics (ROC) curve analyses were used to test the CBS’s ability to distinguish between 428 clinic-referred children and 245 non-clinic-referred children. Results showed an acceptable fit model for the ECBS, providing further evidence of its construct validity. Optimal cut-scores by child age derived from the ROC curve analyses were provided with corresponding levels of sensitivity, specificity, and positive and negative predictive values. Sensitivity rates for cut scores ranged from 0.76 to 0.83 and specificity rates ranged from 0.88 to 0.95. Acceptable test–retest reliability and good internal consistency also was observed. The CBS quickly identifies young children from low-income, urban, diverse populations that may be at-risk for developing significant behavior disorders and should be considered by health care professionals who work with very young children

Family-Expressed Emotion, Childhood-Onset Depression, and Childhood-Onset Schizophrenia Spectrum Disorders: Is Expressed Emotion a Nonspecific Correlate of Child Psychopathology or a Specific Risk Factor for Depression?

Expressed emotion (EE) was examined, using the brief Five Minute Speech Sample measure, in families of (1) children with depressive disorders, (2) children with schizophrenia spectrum disorders, and (3) normal controls screened for the absence of psychiatric disorder. Consistent with the hypothesis of some specificity in the association between EE and the form of child disorder, rates of EE were significantly higher among families of depressed children compared to families of normal controls and families of children with schizophrenia spectrum disorders. Within the depressed group, the presence of a comorbid disruptive behavior disorder was associated with high levels of critical EE, underscoring the need to attend to comorbid patterns and subtypes of EE in future research

Review about comorbidities of behavioural disorders in children and adolescents: The focus on attention-deficit/hyperactivity disorder

Disruptive behavior disorders (DBD) present high comorbidity rate mainly for opposite-defiant disorders that are frequent among children, adolescents and adults affected by with attention deficit and hyperactivity disorder (ADHD), probably as result of common temperamental risk factors such as attention, distraction, impulsivity. ADHD tend to manifest in about 50% of individuals diagnosed as disruptive behavioral disorders

Complete recovery from anxiety disorders following Cognitive Behavioural Therapy in children and adolescents: a meta analysis

Cognitive Behavior Therapy (CBT) is a well-established treatment for childhood anxiety disorders. Meta-analyses have concluded that approximately 60% of children recover following treatment, however these include studies using a broad range of diagnostic indices to assess outcomes including whether children are free of the one anxiety disorder that causes most interference (i.e. the primary anxiety disorder) or whether children are free of all anxiety disorders. We conducted a meta-analysis to establish the efficacy of CBT in terms of absence of all anxiety disorders. Where available we compared this rate to outcomes based on absence of primary disorder. Of 56 published randomized controlled trials, 19 provided data on recovery from all anxiety disorders (n = 635 CBT, n = 450 control participants). There was significant heterogeneity across those studies with available data and full recovery rates varied from 47.6 to 66.4% among children without autistic spectrum conditions (ASC) and 12.2 to 36.7% for children with ASC following treatment, compared to up to 20.6% and 21.3% recovery in waitlist and active treatment comparisons. The lack of consistency in diagnostic outcomes highlights the urgent need for consensus on reporting in future RCTs of childhood anxiety disorders for the meaningful synthesis of data going forwards

Percieved confidence when working with children affected by disruptive behavior disorders

Abstract only availablePrevious studies have found that up to ten percent of children have some form of a disruptive behavior disorder. Disruptive behavior disorders are a group of psychiatric problems characterized by antisocial behaviors, aggressiveness, and oppositionality. Two childhood psychiatric diagnoses fall within this category: Oppositional Defiant Disorder and Conduct Disorder. Many children with a disruptive behavior disorder also have co-occurring problems including Attention-Deficit/Hyperactivity Disorder (ADHD), learning disorders, mood disorders, anxiety disorders, and substance abuse. Disruptive behavior disorders are the most common reason for child referral to mental health services, accounting for one third to one half of all referrals. Given the prevalence and interference associated with these disorders, extensive research has been done to identify effective treatments. To date, the most effective treatments are behavioral parent training (e.g., coaching parents on behavioral management strategies) and child cognitive-behavioral skills training (e.g., training in social skills, challenging cognitive biases to attribute hostile intent to others). Using a large national survey of child mental health providers, we examined providers confidence in their ability to successfully treat children with disruptive behavior disorders. We compared confidence levels for disruptive behavior disorders versus depressive and anxiety disorders, and compared confidence in treating children with a single diagnosis of disruptive behavior disorder versus children who also had one or more co-morbid diagnoses. We also examined differences across psychiatrists, psychologists, social workers, marriage and family therapists, and professional counselors in perceived success in treating children with disruptive behavior disorders. Depending on our findings, future research may focus on developing clinician training programs to address potential gaps in training for one or more mental health disciplines.Missouri Academy at Northwest Missouri State Universit

Longitudinal Study of Diagnoses in Children of Women With Unipolar and Bipolar Affective Disorder

School-age children of unipolar depressed, bipolar, chronically medically ill, or normal women were diagnosed every 6 months for up to 3 years. Offspring of unipolar women had the highest rates of disorder at all evaluations, but children of bipolar and medically ill mothers also experienced significant rates of disorder. Observing diagnoses from both past lifetime and prospective follow-up assessments, it appeared that most children who had diagnoses had onsets in preadolescence and continued a chronic or intermittent course of disorder. Thus, risk to offspring of ill mothers is not transitory and indicates a pernicious course that commonly includes affective disorders alone or in combination with behavior and anxiety disorders

Sex Differences in Internalizing and Externalizing Behaviors in Children with Autism Spectrum Disorder

This study used a retrospective practice-based research method to compare levels of internalizing and externalizing behaviors of a clinically-ascertained sample of young children with autism spectrum disorder (ASD; n=90). As measured by the Child Behavior Checklist (CBCL), internalizing and externalizing behaviors were compared to normative behavior, and between boys and girls with ASD. Findings suggest that in a clinical sample, children with ASD are more likely than typically developing children to have internalizing and/or externalizing problems. No significant sex differences were found for Internalizing Problems, Externalizing Problems, or Total Problems scores on either the parent or teacher versions of the CBCL. These findings may help clinicians better understand how children with ASD are affected by co-morbid psychiatric disorders, and could help to inform diagnosis and intervention

The relations of metabolic syndrome to anxiety and depression symptoms in children and adults

Metabolic syndrome is a cluster of five factors (elevated systolic blood pressure, elevated blood glucose, elevated triglycerides, large waist circumference, and decreased HDL) that are related to a greater chance of heart disease, stroke, and diabetes. There is evidence that metabolic syndrome is correlated with depression, but the directionality and mechanism is unclear. There is also dispute in the literature as to whether there is a correlation with anxiety and metabolic syndrome. In this study, levels of depression and anxiety determined from questionnaires and interviews (Adult Self Report, Child Behavior Checklist, Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime, and the Composite International Diagnostic Interview) were compared with the five factors of metabolic syndrome in 100 three-person families. In children and adolescents, elevated triglycerides were predictive of elevated depressive behavior above the age of 12.68 (pppp \u3c .05 respectively). Additionally, a lower SES, older age, greater anxious behavior, and being male were all predictive of greater overall metabolic risk. Results implicate an age-moderated difference in how metabolic factors affect depression in children, possibly having a mechanism coinciding or affected by puberty. In adults, the directionality seems to reverse, with the anxious behavior having an effect on the metabolic syndrome factor, possibly related to stress and inflammation. Further research is needed to study these mechanisms and elucidate the connections between the disorders