Executive functions in preschoolers with ADHD, ODD and comorbid ODD-ADHD : evidence from ecological and performance-based measures

Executive functioning in 3-year-old preschoolers with attention-deficit hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), comorbid ADHD+ODD, and children without any of these conditions (control group) was examined. A community sample including 622 children was diagnosed using a diagnostic interview following DSM-IV criteria, and assessed using the Behavior Rating Inventory of Executive Function Preschool version (BRIEF-P) and the Kiddie-Conners' Continuous Performance Test. The children diagnosed with ADHD showed the poorest executive function (EF) profile in comparison with controls, and were closely followed up in this respect by the comorbid ADHD+ODD children. The ADHD and comorbid groups presented similar executive difficulties. The ODD group obtained mean scores statistically equal to those of controls in EF. These findings suggest that, in preschoolers, executive functioning deficits assessed with a performance-based measure or with behavioural descriptions are specific to children with ADHD, in comparison with those with ODD. This study contributes knowledge about EFs in two prevalent and comorbid disorders in preschool children, ADHD and ODD, knowledge that can help our understanding of specific deficits and the design of specific early intervention initiative

Measurement invariance of oppositional defiant disorder dimensions in 3-year-old preschoolers

Measurement invariance (metric/scalar) of oppositional defiant disorder (ODD) dimensions (negative affect, oppositional behavior, and antagonistic behavior) across sex and informants is tested. Parents and teachers of 622 preschool children from the general population answered a dimensional measure of ODD. ODD dimensions function similarly in boys and girls. Some differences were found by informant, indicating that the equivalence of the ratings of parents and teachers is not complete and that given the same underlying level of the latent trait, some parents' item scores were higher than those of teachers. Metric invariance was complete but scalar invariance was not attained. The results contribute evidence on the conceptualization of ODD as a source-specific disorder. The simultaneous use of ODD dimensions reported by parents and teachers must be considered in the context of a lack of complete measurement invariance, which implies that comparisons of observed means from parents and teachers are not readily interpretabl

Socioeconomic status and oppositional defiant disorder in preschoolers : parenting practices and executive functioning as mediating variables

Objectives: To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the independent variable and the parenting style and the children's executive functioning (EF) as the mediating factors. Method: The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. Results: Structural Equation Modeling showed that the associations between SES, EF, parenting style and ODD levels differed by children's gender: (a) for girls, the association of low SES and high ODD scores was partially mediated by difficulties in EF inhibition, and parenting practices defined by corporal punishment and inconsistent discipline obtained a quasi-significant indirect effect into the association between SES and ODD; (b) for boys, SES and EF (inhibition and emotional control) had a direct effect on ODD with no mediation. Conclusion: SES seems a good indicator to identify children at high-risk for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition contro

The reciprocal influence of callous-unemotional traits, oppositional defiant disorder and parenting practices in preschoolers

The present study investigates reciprocal associations between positive parenting, parental monitoring, CU traits, and ODD in children assessed at age 3 and again at age 6. Data were collected from a sample of preschoolers (N = 419; 51.58 % female) through diagnostic interviews and questionnaires answered by parents and teachers. Structural equation modeling revealed a bidirectional relationship between poor monitoring and ODD, with poor monitoring at age 3 predicting ODD at age 6 (β = 0.11, p < 0.05), and ODD at age 3 predicting poor monitoring at age 6 (β = 0.10, p < 0.05). While poor monitoring at age 3 predicted CU traits at age 6 (β = 0.11, p < 0.05), CU traits at age 3 predicted positive parenting (β = 0.09, p < 0.05) and ODD (β = 0.13, p < 0.05) at age 6. Results have important implications for early targeted parenting interventions for CU traits and ODD. Keyword

Factores de riesgo para el sobrepeso en edades tempranas: diseño longitudinal con preescolares españoles

Previous studies have shown that there are several significant early-life risk factors associated with childhood overweight. However, research has mainly focused on school-aged children. The aim of this study is to identify risk factors in early life for overweight in a community sample of Spanish preschoolers. A sample of 622 three-year-olds was monitored until the age of 5, and their height and weight were registered annually. Overweight status was defined by World Health Organization standards. A large set of risk factors including sociodemographic variables, family structure, pregnancy, birth, postnatal period, school and neighborhood were measured through semi-structured interviews. Stepwise logistic regressions created predictive models with the best predictors of overweight for each age group. This is the first longitudinal study to examine a large set of risk factors among Spanish preschoolers. Several potential early risk factors in preschool children were associated with later overweight: high birth weight, ethnicity, excess screen time, low attention span, maternal smoking during pregnancy, inconsistent discipline, fewer rules, corporal punishment and parents psychopathology. Among them, the most powerful factor was high birth-weight (odds ratio = 1.89 at age 3, 1.87 at age 4, and 2.35 at age 5), underlining the importance of weight monitoring from postpartum and routine screening for overweight in children who have high birth weight. With the increasing prevalence of overweight in children at early ages, understanding the determinants for overweight risk becomes crucial for public health professionals and policy-makers in order to implement effective prevention and intervention programs ResumenDiferentes estudios han mostrado una asociación clara en­tre determinados factores de riesgo en edad temprana y so­brepeso en la infancia. Sin embargo, hasta ahora la inves­tigación solo se ha centrado en niños en edad escolar. El objetivo de este estudio es el de examinar en niños prees­colares los factores de riesgo para el sobrepeso en una muestra comunitaria de niños españoles. En el presente es­tudio se seleccionó una muestra de 622 niños de 3 años de edad a los que se siguió anualmente hasta los 5 años. El peso y la talla fueron registrados anualmente y el sobre­peso fue definido siguiendo los criterios definidos por la Organización Mundial de la Salud. A través de una entre­vista semi-estructurada, se analizaron diversos factores de riesgo tales como estructura familiar, embarazo, parto, pe­ríodo post-natal, escuela y vecindario. Las regresiones lo­gísticas múltiples permitieron crear modelos predictivos que seleccionaron los mejores predictores de sobrepeso para cada grupo de edad. El presente estudio es el primer estudio longitudinal en examinar diferentes factores de riesgo para el sobrepeso en niños españoles con edad preescolar. Diferentes factores de riesgo están asociados a un posterior sobrepeso: mayor peso al nacer, etnia, uso ex­cesivo de pantallas, capacidad de atención baja, madre fu­madora durante el embarazo, disciplina inconsistente, cas­tigo físico y psicopatología parental. De entre ellos, el fac­tor más importante fue: mayor peso al nacer (razón de pro­babilidades = 1.89 a los 3 años, 1.87 a los 4 años y 2.35 a los 5 años), subrayando la importancia de monitorizar el peso del niño desde el post-parto y realizar cribados ruti­narios de sobrepeso en aquellos niños que nacieron con un peso elevado. La prevalencia cada vez mayor de sobrepeso en niños cada vez más pequeños hace que la comprensión e identificación de los factores de riesgo relacionados con el sobrepeso sea crucial para que los profesionales públi­cos de salud y los responsables políticos implementen pro­gramas de prevención e intervención efectivos.AbstractPrevious studies have shown that there are several significant early-life risk factors associated with childhood overweight. However, research has mainly focused on school-aged children. The aim of this study is to identify risk factors in early life for overweight in a community sample of Spanish preschoolers. A sample of 622 three-year-olds was monitored until the age of 5, and their height and weight were registered annually. Overweight status was defined by World Health Organization standards. A large set of risk factors including sociodemographic variables, family structure, pregnancy, birth, postnatal period, school and neighborhood were measured through semi-structured interviews. Stepwise logistic regressions created predictive models with the best predictors of overweight for each age group. This is the first longitudinal study to examine a large set of risk factors among Spanish preschoolers. Several potential early risk factors in preschool children were associated with later overweight: high birth weight, ethnicity, excess screen time, low attention span, maternal smoking during pregnancy, inconsistent discipline, fewer rules, corporal punishment and parents psychopathology. Among them, the most powerful factor was high birth-weight (odds ratio = 1.89 at age 3, 1.87 at age 4, and 2.35 at age 5), underlining the importance of weight monitoring from postpartum and routine screening for overweight in children who have high birth weight. With the increasing prevalence of overweight in children at early ages, understanding the determinants for overweight risk becomes crucial for public health professionals and policy-makers in order to implement effective prevention and intervention programs

Sex differences in oppositional defiant disorder

The goal was to analyze the sex differences in symptoms, comorbidity and functional impairment in outpatient children with Oppositional Defiant Disorder (ODD). A sample of 343 children, aged 8 to 17 years and diagnosed with ODD, were assessed with a semi-structured diagnostic interview and dimensional measures of psychopathology and functional impairment. Boys with ODD more frequently displayed the symptoms «deliberately annoys» and «blames others», presented comorbid ADHD, and had greater functional impairment in school and community contexts; girls presented higher comorbidity with internalizing symptomatology (anxiety, depression and somatic complaints). Given that some clinical differences are apparent in ODD between boys and girls, it is necessary to consider the sex of the patient in order to identify and treat this disorder efficiently and effectively in boys and in girlsEl objetivo es analizar las diferencias de sexo en la prevalencia, sintomatología, comorbilidad y deterioro funcional en pacientes externos con Trastorno Negativista Desafiante (TND). Una muestra de 343 niños y adolescentes de entre 8 y 17 años diagnosticados de TND fueron evaluados con una entrevista diagnóstica semiestructurada y otras medidas dimensionales de psicopatología y deterioro funcional. Los niños con TND mostraron con mayor frecuencia los síntomas «molestar deliberadamente» y «acusar a otros», mayor comorbilidad con trastorno por déficit de atención con hiperactividad y mayor deterioro funcional en el colegio y en la comunidad; las niñas presentaron mayor comorbilidad con sintomatología interiorizada (ansiedad, depresión y quejas somáticas). Niños y niñas presentan un cuadro clínico de TND con algunas diferencias. Es necesario adoptar una perspectiva de sexo para identificar y tratar el TND de manera eficaz y eficiente en niños y en niña

Reciprocity between parental psychopathology and oppositional symptoms from preschool to middle childhood

Objective: Oppositional defiant disorder (ODD) is a common disorder in preschool children. Evidence indicates that maternal and paternal psychopathology, particularly aggressive behavior and anxious and depressed symptoms, contributes to the development of this disorder. The latest research also suggests that ODD symptoms may exacerbate the mental health problems of parents. Our aim was to establish the existence of a reciprocal association between paternal and maternal psychopathology (aggression, depression, and anxiety) and child ODD at ages 3 and 8, using a longitudinal design in a community sample of preschoolers. Method: The sample included 331 children evaluated at ages 3 and 8 through questionnaires and a semistructured diagnostic interview with parents. Parents also informed about their own psychopathology. Results: At 3 years of age, higher levels of ODD symptoms in girls were concurrently associated with maternal anxious and depressed symptoms and paternal aggressive behavior, and higher levels of ODD symptoms in boys were concurrently associated with maternal aggressive behavior. Longitudinally, for boys, higher levels of maternal anxious and depressed symptoms at child age 3 predicted increases in ODD symptoms from 3 to 8 years of age. In addition, higher levels of ODD symptoms in boys aged 3-8 years predicted increases in fathers' anxious and depressive symptoms. Conclusion: Children with ODD should be evaluated and treated promptly, but efforts should be extended to their parents. Mothers' and fathers' mental health must be explored because the psychopathologies of children and parents reciprocally affect each othe

Parental psychopathology levels as a moderator of temperament and Oppositional Defiant Disorder symptoms in preschoolers

Oppositional Defiant Disorder (ODD) is among the most prevalent disorders in preschoolers. It has been linked to temperament, since characteristics such as elevated surgency and negative affect, as well as low levels of effortful control, contribute to the development of this disorder. Evidence also indicates that parental psychopathology can accentuate temperamental traits. Our aim was to assess whether the levels of psychopathology of mothers and fathers acts as a moderator of the relationship between temperament and ODD symptoms in preschoolers, both cross-sectionally at ages 3, 4 and 5, and longitudinally between ages 3 and 5. The sample included 550 children evaluated at ages 3, 4 and 5 through questionnaires and a semi-structured diagnostic interview with parents. Parents also answered a questionnaire about their own psychopathology. The results indicated that negative affect and effortful control are associated with higher levels of ODD symptoms in preschoolers. At child age 5, higher levels of paternal depression and anxiety increased the effect of low effortful control on ODD. High levels of negative affect and low levels of effortful control at age 3 were statistical predictors of ODD levels at age 5, and this relationship was also moderated by paternal anxiety and depression. The results have important clinical implications for the proper orientation of interventions, suggesting that interventions should integrate the paternal caregiver in the treatmen

La importància de la disponibilitat emocional en el desenvolupament de l'infant

Quines són les necessitats emocionals en la primera infància? Quines són les conseqüències de la negligència emocional greu en infants de 0 a 4 anys? Què posa en risc la capacitat dels adults d'estar «emocionalment disponibles» i quines condicions l'afavoreixen

Usefulness of the Social and Communication Disorders Checklist (SCDC) for the assessment of social cognition in preschoolers

This study provides data on the usefulness of the Spanish version of the Social and Communication Disorders Checklist (SCDC; Skuse et al., 1997), in terms of the validity and reliability of derived scores. Data were obtained from parents' interviews and parents' and teachers' questionnaires that measured different psychological variables from a community sample of 579 (291 boys and 288 girls), 5-year-old children. These children were tested to assess their intellectual capacity. Confirmatory factor analyses yield a one-dimensional structure invariant across sex within each informant (parents or teachers), with negligible latent mean differences between boys and girls for both informants (parents-teachers). The internal consistency was satisfactory (alpha values ≥ .85 for teacher version and ≥ .75 for parent version). SCDC scores correlated with specific scales related to developmental problems, aggressive behavior, executive functioning, and uncaring behavior toward others. SCDC scores were unrelated to intelligence quotient, whereas SCDC scores were associated with the presence of disruptive disorders, measured with diagnostic interview. Results provide evidence on reliability and validity of SCDC scores, which is potentially a useful measure for the study of social cognition and its relationship with preschool adjustmen