Il processamento dei volti nei bambini con diagnosi di disturbo della condotta

I disturbi del comportamento in età evolutiva sono un fenomeno molto frequente. Tali disturbi vanno a delineare un gruppo di bambini estremamente eterogeneo. Negli ultimi anni, gli studiosi hanno individuato un particolare sottotipo di minori con disturbo della condotta, i quali presentano tratti di personalità callous-unemotional (CU). Questi bambini mostrano caratteristiche peculiari, quali, ad esempio, mancanza di rimorso o senso di colpa, insensibilità e mancanza di empatia, indifferenza per i risultati; inoltre, manifestano specifici deficit nel riconoscimento e processamento delle emozioni, nonché una generale alterazione dei processi attenzionali e dei meccanismi di contatto visivo. Lo scopo del presente elaborato è quello di andare ad indagare la modalità con cui i bambini con disturbo della condotta esplorano visivamente gli stimoli emozionali; questo permetterà di ampliare le conoscenze relative al processamento emozionale in questa categoria. La direzione dello sguardo è stata rilevata mediante il sistema di eye tracking SMI RED 500

The Contribution of Bullying Involvement and Alexithymia to Somatic Complaints in Preadolescents

Somatic complaints during preadolescence are connected to individual and contextual factors, and extant research highlights the relevance of alexithymia and bullying involvement. In this cross-sectional study, we explored the joint and unique influence of bullying involvement-as perpetrators, victims, or outsiders-and alexithymia on somatic complaints in a sample of 179 Italian middle-school students (aged 11-15). Findings revealed an indirect association between bullying perpetration and victimization complaints through alexithymia. We also found a significant direct association between victimization and somatic complaints. No significant association between outsider behavior and somatization was found. Our results revealed that bullying perpetration and victimization could increase youths' risk for somatic complaints and clarify one of the processes underlying this association. The current findings further emphasize the relevance of emotional awareness for youths' well-being and propose that implementing social-emotional skills might prevent some of the adverse consequences of being involved in bullying episodes

Parent Training Interventions for Children and Adolescents with Aggressive Behavioral Problems

Children who display early disruptive and aggressive behavior are also at greater risk for delinquency, mood and anxiety disorders, and substance use in the long term. As is the case for many forms of childhood psychopathology, a number of factors are associated with the emergence of aggressive and disruptive behavior, including family factors. Indeed, conduct problems during childhood are usually associated with peculiar parenting practices, such as increasingly coercive cycles of harsh parenting and noncompliance exhibited by child; insensitive and nonresponsive parenting; inconsistent, severe discipline and vague commands and directions; lack of parental warmth and involvement; and absence of parental monitoring and supervision. That is why behavioral parent trainings (BPTs) represent one of the gold standard interventions for conduct problems. The main goal of BPT is to decrease coercive interchanges and, consequently, children aggressive problems by teaching parents strategies in order to apply a more effective discipline. Therefore, the putative mechanism for change in youth behavior in BPT is change in parent behavior. Some of the most employed parent training interventions for aggressive behavior problems are presented

Acute Tolerability of Methylphenidate in Treatment-Naïve Children with ADHD: An Analysis of Naturalistically Collected Data from Clinical Practice

OBJECTIVES: The acute tolerability of methylphenidate (MPH) in children with attention-deficit/hyperactivity disorder (ADHD) has been studied mainly in research samples. Taking advantage of the mandatory test-dose procedure required for starting MPH in Italy, this study aimed to assess the incidence of intolerable adverse events after initial exposure to MPH in routine clinical practice. METHODS: The medical records of 480 consecutively treated, previously drug-naïve children and adolescents with ADHD (90% male, mean age 10.6 ± 3.0 years) were retrospectively analyzed. All children received an initial single dose of MPH immediate release (5 or 10 mg) followed by a 4-hour direct medical observation. Heart rate and blood pressure were measured at dosing and 1, 2, and 3 hours afterwards. If the first dose was well tolerated, the child continued treatment with MPH 5–20 mg daily, and was reassessed a week later. RESULTS: Eleven patients (2.3%, 95% CI 1.1–4.1) interrupted treatment within a week of initiation because of the following adverse events: irritability (n = 3), tics worsening (n = 3), reduced appetite (n = 1), enuresis (n = 1), hallucinations (n = 1), hyperfocus (n = 1), and ‘rebound’ behavioral worsening (n = 1). The most common adverse events were reduced appetite (20%), irritability (14.2%), headache (10.6%), sleep problems (9.4%), stomachache (9.4%), and tics (5%). Intellectual disability increased the risk of any adverse event in general and of irritability in particular. No cardiovascular symptom was clinically reported. However, routine assessments of vital signs during the first 3 hours after the first dose of MPH showed that 9% of the children had a 20% increase in heart rate, 8.8% had a 20% increase in diastolic blood pressure and 4.5% had a 20% increase in systolic blood pressure. Of these, 25.2% still had an elevated heart rate 1 week later. CONCLUSIONS: Among stimulant-naïve children in clinical practice, the incidence of acute MPH intolerance can be estimated to be between 1.2 and 4.1%. An asymptomatic elevation in cardiovascular parameters can be observed in about 1 out of 10 children and warrants monitoring during ongoing treatment

Narcissistic traits as predictors of emotional problems in children with oppositional defiant disorder: A longitudinal study

Background: Children's self-views encompass two independent dimensions: self-esteem and narcissism, which recently have received growing attention from researchers and clinicians. The current study sought to test whether these dimensions might predict the developmental course of children with Oppositional Defiant Disorder diagnosis. Method: The sample (N = 64, M age = 10.1 years, 57 boys) included children with Oppositional Defiant Disorder diagnosis. We examined longitudinal relationships between self-views (both self-esteem and narcissism) and parent-reported internalizing and externalizing behavioral problems. Results: The study spanned two time-points, spaced 12 months apart. None of the predictors were longitudinally associated with the levels of externalizing behavioral problems in children. However, narcissism predicted the levels of children's internalizing problems at the follow-up, whereas self-esteem did not. Limitations: The relatively small sample and the lack of assessing causality limit the generalizability of the findings. Results need to be replicated in larger samples. Conclusions: These findings illustrate the value of taking into account children's narcissistic traits in clinical assessment. By broadening knowledge of narcissistic traits in clinical samples of children, we hope to inform assessment procedures in standard clinical practice, as well as the development of tailored interventions to curb the emergence of later negative outcomes related to childhood narcissism, such as internalizing problems

Six-year outcome for children with ODD or CD treated with the coping power program

: Children with severe aggressive behavioral problems are one of the groups most frequently referred to mental health clinics, and they engage in behaviors that put them at risk for substance use problems and a host of other negative outcomes. The present study aimed to assess the long-term outcome (six-year follow up) of the Coping Power Program delivered in a mental health hospital for children with behavioral disorders. We recruited one hundred and twenty children (mean age = 9.9, SD = 0.85), twenty-three patients were lost during the follow-ups. The sample of the current study included sixty-seven youths with Oppositional Defiant Disorder, and thirty with Conduct Disorder. We used Child Behavior Check List, Inventory of Callous Unemotional traits and a youth survey to evaluate substance use. After the baseline evaluation they were allocated to Coping Power or to a generic multi-component treatment. Coping Power produced significant reduction in Callous Unemotional traits, relative to the control condition; Coping Power seems to be effective also in reducing the rate of substance use. However, no differences have been found in externalizing behavior reduction in the two groups. This study contributes to the successful dissemination of best-practice treatments in public mental health services for children

Paternal psychopathological risk and psychological functioning in children with eating disorders and Disruptive Behavior Disorder

Several studies demonstrated that maternal psychopathological risk is related to child's maladjustment, but until recently research has relatively neglected fathers. Disruptive Behavior Disorder (DBD) and Eating disorders (ED) have a large prevalence during childhood but a few studies have focused on their association with paternal psychopathological risk. One-hundred and thirty-nine children and their fathers were recruited from pediatric hospitals and outpatient clinics and paired with a healthy control group (CG). Fathers were administered the SCL-90/R and the CBCL 6-18 to assess: 1) psychopathological risk of fathers of children with DBD, ED and CG; 2) significant differences between ED and DBD fathers' psychopathological profiles; and 3) associations between specific fathers' psychopathological symptoms and children's emotional-behavioral problems. Fathers of children with ED showed a higher psychopathological risk than fathers of DBD offspring. Children with DBD showed higher externalizing symptoms. Paternal hostility was associated with internalizing problems in children with DBD. Paternal hostility showed a non-significant but clinically interesting association with internalizing problems in DBD children; interpersonal sensitivity was associated with internalizing problems in ED children. This study can constitute a contribution to a better understanding of the clinical characteristics of fathers of children with DBD and ED

Psychopathic traits and emotion processing in a clinical sample of children with disruptive behavior disorder

Previous research identified emotion processing (i.e., emotion recognition and gaze pattern towards emotional stimuli) deficits in youths with callous-unemotional (CU) traits, though mixed results have emerged. CU traits frequently co-occur with high levels of the other psychopathy dimensions, namely narcissism and impulsivity, and overall, psychopathic traits in youths might be better understood from a multidimensional perspective. However, little is known about the contribution of narcissism and impulsivity. Participants included a clinical sample of 116 boys (aged 7–12) with Oppositional Defiant Disorder and Conduct Disorder based on the DSM-IV criteria. Psychopathic traits were assessed with the Antisocial Process Screening Device. Gaze pattern was recorded with an eye-tracker while participants completed a computerized emotion recognition task. Partial correlations showed negative associations between CU traits and sadness recognition and between narcissism and disgust recognition. Also, CU traits were associated with reduced attention to the mouth of angry faces and the eyes of sad and disgusted faces. Impulsivity was associated with greater attention to the eyes of angry and fearful faces. Narcissism was negatively associated with disgust recognition and the number of fixation to the eyes of angry faces, and positively associated with fixation count and duration to the mouth of angry faces. Findings support the association between CU traits and emotion processing deficits even after controlling for the effects of the other psychopathy dimensions. Our results also preliminary suggested emotional processing impairments associated with narcissism and impulsivity. A better understanding of emotional processing impairments associated with youths’ psychopathy dimensions would provide a new key to interpret extant literature and, more importantly, constitute a first step towards developing early tailored interventions