Attention-deficit/hyperactivity disorder in preschool children: an investigation of validation based on visual attention performance

OBJECTIVES: The present study compared the performance of preschoolers who met Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) criteria for attention-deficit/hyperactivity disorder (ADHD) to those who did not meet these criteria on a test of visual attention. The aim was to investigate whether attentional impairments in preschoolers with DSM-IV ADHD could be detected, informing the nosology of preschool ADHD. METHODS: A demographically diverse sample of n = 304 preschoolers, aged 3.0–5.11 years, was separated into two diagnostic groups: Those who met DSM-IV ADHD criteria and those who did not. Subtypes of ADHD were also examined. Parametric and nonparametric analyses were used to examine performance scores on accuracy, including errors of omission and commission. The sample was stratified into 3, 4-, and 5-year-old age groups. RESULTS: Overall ADHD but not subtype-specific ADHD was associated with poor performance accuracy in the 4-year-old age group after controlling for gender and age. CONCLUSIONS: Attentional impairments detected only in the 4-year-old age group suggest that DSM-IV ADHD criteria are useful and valid at this age. Study findings suggest modification to the DSM criteria may be needed for children younger than 4 and that further investigation of this issue using performance-based measures is now warranted

Neural activation associated with the cognitive emotion regulation of sadness in healthy children

AbstractWhen used effectively, cognitive reappraisal of distressing events is a highly adaptive cognitive emotion regulation (CER) strategy, with impairments in cognitive reappraisal associated with greater risk for psychopathology. Despite extensive literature examining the neural correlates of cognitive reappraisal in healthy and psychiatrically ill adults, there is a dearth of data to inform the neural bases of CER in children, a key gap in the literature necessary to map the developmental trajectory of cognitive reappraisal. In this fMRI study, psychiatrically healthy schoolchildren were instructed to use cognitive reappraisal to modulate their emotional reactions and responses of negative affect after viewing sad photos. Consistent with the adult literature, when actively engaged in reappraisal compared to passively viewing sad photos, children showed increased activation in the vlPFC, dlPFC, and dmPFC as well as in parietal and temporal lobe regions. When children used cognitive reappraisal to minimize their experience of negative affect after viewing sad stimuli they exhibited dampened amygdala responses. Results are discussed in relation to the importance of identifying and characterizing neural processes underlying adaptive CER strategies in typically developing children in order to understand how these systems go awry and relate to the risk and occurrence of affective disorders

Parenting practices in pregnancy smokers compared to non smokers

BACKGROUND: The present investigation compared parenting practices in a sample of preschoolers whose mothers reported smoking during pregnancy versus those who did not. METHODS: A sample of n = 216, 3.0- to 5.11-year-old children, participants in an ongoing longitudinal study, was separated into those reportedly exposed to smoking in utero and those who were not. Parenting practices were compared between the two groups, using T-tests and exact logistic regressions. Multiple linear regressions and multivariate logistic regressions were used to examine the association between smoking status and parenting, controlling for variables also known to be associated with parenting practices. RESULTS: Current study findings suggest that smoking during pregnancy is associated with harsh parenting practices. CONCLUSIONS: Study results highlight the possible role of parenting in disruptive outcomes well-known in toddlers exposed to nicotine in utero and have implications for targeting early interventions in these populations

Functional connectivity of the amygdala and subgenual cingulate during cognitive reappraisal of emotions in children with MDD history is associated with rumination

AbstractMajor Depressive Disorder (MDD) is characterized by poor emotion regulation. Rumination, a maladaptive strategy for dealing with negative emotions, is common in MDD, and is associated with impaired inhibition and cognitive inflexibility that may contribute to impaired emotion regulation abilities. However, it is unclear whether rumination is differently associated with emotion regulation in individuals with MDD history (MDD-ever) and healthy individuals. In this study, children (8–15 years old) performed a cognitive reappraisal task in which they attempted to decrease their emotional response to sad images during fMRI scanning. Functional connectivity (FC) between both the amygdala and subgenual anterior cingulate (sACC) increased with cortical control regions during reappraisal as rumination increased in MDD-ever, while connectivity between those regions decreased during reappraisal as rumination increased in healthy controls. As the role of cortical control regions is to down-regulate activity of emotion processing regions during reappraisal, this suggests that rumination in MDD-ever, but not controls, is associated with inefficient regulation. This finding suggests that rumination may be particularly associated with poor emotion regulation in MDD-ever, and may also indicate qualitative group differences in whether rumination is maladaptive. These differences in rumination may provide important insight into depressive risk and potential avenues for treatment

Preschoolers' depression severity and behavior during dyadic interactions: The mediating role of parental support

ABSTRACT Objective: To investigate the relationship between preschool depression severity, observed behavior, and parental emotional support in a population of 3.0-to 5.6-year-olds and their mothers. Method: One hundred fifty preschoolers who underwent a comprehensive mental health assessment during which DSM-1V diagnoses were derived were included in this analysis. Child and parent behaviors during challenging structured dyadic tasks were systematically coded. Dyads with preschoolers in three diagnostic groups of interest were explored: depression, disruptive, and healthy. Depression severity sum scores were derived for children in all of the groups. Results: Depression severity accounted for a significant (p < .05) portion of the variance in preschoolers' persistence, compliance, and enthusiasm during dyadic tasks after controlling for the effects of age and gender. Depression severity was also significantly associated with parental emotional support, which was itself associated with all three preschool behaviors. When the effect of parental support was controlled for statistically, however, preschoolers' depression severity was no longer significantly assodiated with observed persistence or compliance, whereas the relationship between depression severity and enthusiasm remained significant