Differentiating the behavioural profile in autism and mental retardation and testing of a screener

Abstract. : In order to differentiate the behavioural profiles in autism and mental retardation and to cross-validate a behavioural autism screen, 84 subjects with autism (64 males and 20 females) with a mean age of 10 years selected from a Swiss national survey were compared to a control group of 84 subjects matched by age and gender with mental retardation, but without autistic features. The behavioural profile was assessed using the Developmental Behaviour Checklist (DBC). The behavioural profile in autism, in contrast to mental retardation, was marked by higher scores in the domains of disruptive, self-absorbed, communication disturbed, anxious and autistic behaviour, and a higher total DBC score. Furthermore, a higher vulnerability for behavioural abnormalities became evident for females with autism. A recently proposed DBC-Autism Screen was cross-validated, and a slight extension of the screen led to even higher correct classification rates. It was concluded that the DBC is a suitable instrument for the assessment of the behavioural profile and for screening in autis

Psychosocial Factors in Adolescent and Young Adult Self-Reported Depressive Symptoms: Causal or Correlational Associations?

Using a large longitudinal representative community sample, this study identified three groups of subjects who were depressed either in pre-adolescence, late adolescence or early adulthood, and matched by age and gender to controls without depression. The 90th percentile on one or two self-reported symptom scales [i. e. the Center for Epidemilogical Studies Depression Scale (CES-D) or the subscale Anxious / Depressed subscale on either the Youth Self Report (YSR) or the Young Adult Self Report (YASR)] served as the cut-off for the depression groups. Psychosocial variables under study included life events and life events impact, coping, self-related cognitions, perceived parental rearing style, family relations, perceived school environment, and the internalizing (except anxious/depressed) and externalizing problem scale of the YSR/YASR. The study found a large number of time-related correlations between psychosocial factors and depression. Evidence for causal effect (either antecedent or consequent) was obtained only for self-esteem, perceived maternal rejection, and internalizing problem

Continuity, psychosocial correlates, and outcome of problematic substance use from adolescence to young adulthood in a community sample

ABSTRACT: BACKGROUND: The study of the continuity, psychosocial correlates, and prediction of problematic substance use (PSU) across time from adolescence to young adulthood. METHODS: Substance use was studied in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS). Based on the frequency of tobacco, alcohol, and cannabis consumption, groups with PSU were defined at each of the three measurement points in time and compared to the rest of the sample. Comparisons included questionnaire data regarding emotional and behavioural problems, life events, coping style, self-related cognitions, perceived parenting style, perceived school environment, and size and efficiency of the social network. RESULTS: The size of the groups with PSU increased continuously across time. The cross-sectional correlates of PSU were characterized by a similar pattern that included higher scores for externalizing behaviour, and both number and negative impact of life events across all three times. At time 1 and 2 subjects with PSU also experienced less favourable parenting styles and school environments. Longitudinally, PSU in young adulthood was predicted most strongly and persistently by previous risk status, externalizing problems and male gender. CONCLUSION: Problematic substance use is a major problem in youth. Its contributing pattern of associated and predictive psychosocial variables can be identified in the community

Frequency, stability and differentiation of self-reported school fear and truancy in a community sample

BACKGROUND: Surprisingly little is known about the frequency, stability, and correlates of school fear and truancy based on self-reported data of adolescents. METHODS: Self-reported school fear and truancy were studied in a total of N = 834 subjects of the community-based Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) at two times with an average age of thirteen and sixteen years. Group definitions were based on two behavioural items of the Youth Self-Report (YSR). Comparisons included a control group without indicators of school fear or truancy. The three groups were compared across questionnaires measuring emotional and behavioural problems, life-events, self-related cognitions, perceived parental behaviour, and perceived school environment. RESULTS: The frequency of self-reported school fear decreased over time (6.9 vs. 3.6%) whereas there was an increase in truancy (5.0 vs. 18.4%). Subjects with school fear displayed a pattern of associated internalizing problems and truants were characterized by associated delinquent behaviour. Among other associated psychosocial features, the distress coming from the perceived school environment in students with school fear is most noteworthy. CONCLUSION: These findings from a community study show that school fear and truancy are frequent and display different developmental trajectories. Furthermore, previous results are corroborated which are based on smaller and selected clinical samples indicating that the two groups display distinct types of school-related behaviour

Risk factors for the development of emotional and behavioural problems in children born to drug-dependent mothers

Background: The study of biological and psychosocial risk factors for the development of emotional and behavioural problems in children of drug-dependent mothers. Methods: In a sample of 52 children and drug-dependent mothers participating in a residential intervention programme emotional and behavioural problems were studied in the children by use of the Child Behaviour Checklist (CBCL). The Symptom-Checklist Revised (SCL-90-R) served to assess mental problems in the mother. Drug exposure during pregnancy, various psychosocial risk factors due to the drug-career, and educational status of the mother were assessed by maternal interview. A brief assessment of intelligence of the mother was included. Results: Among the various biological and psychosocial risk factors, maternal mental health problems, maternal educational status, and a small number of close social relationships correlated significantly with child outcome variables. Multiple regression analyses identified maternal mental health factors as the main predictors of child behaviour. Conclusions: Assisting drug-dependent mothers in overcoming the psychosocial sequelae of drug abuse implies also assistance to the children in terms of prevention of emotional and behavioural problem

Psychosocial adaptation of adolescent migrants in a Swiss community survey

Objective: The aim of this study was to compare psychosocial adaptation in adolescent (first generation) migrants, double-citizens (mainly second generation with one migrant parent), and native Swiss, and to compare migrants from various European regions. Method: Data from a community survey were based on 1,239 participants (mean age 13.8, SD=1.6years) with 996 natives, 55 double-citizens, and 188 migrants. The adolescents completed the youth self-report measuring emotional and behavioural problems, and various questionnaires addressing life events, personality variables, perceived parental behaviour (PPB), family functioning, school environment, and social network. Results: Adolescent migrants had significantly higher scores for internalizing and externalizing problems. There was a pattern of various unfavourable psychosocial features including life events, coping, self-related cognitions, and PPB that was more common among adolescent migrants than natives. Double-citizens were similar to natives in all domains. Young adolescents from South and South-East Europe differed from natives in terms of more unfavourable psychosocial features. Migrant status was best predicted by adverse psychosocial features rather than emotional and behavioural problems. Conclusion: There is some indication that certain migrant adolescents are at risk of psychosocial mal-adaptation. Obviously, ethnic origin is an important moderato

The use of the development and well-being assessment (DAWBA) in clinical practice: a randomized trial

The development and well-being assessment (DAWBA) has been used in various epidemiological studies, whereas the clinical value of the instrument needs support from further studies. In particular, it is important to document how the use of the DAWBA influences clinical decision-making. The present study employed the DAWBA in a consecutive series of 270 new referrals to a large public child and adolescent psychiatric service in Zurich, Switzerland. ICD-10 based diagnoses were obtained from clinicians for all patients and reliability of DAWBA expert raters was calculated. The DAWBA diagnoses were randomly disclosed (n=144) or not disclosed (n=126) before clinical decision-making. The reliability of DAWBA expert diagnoses was very satisfactory and the agreement under the disclosed versus the non-disclosed condition amounted to 77 versus 68% for internalizing disorders and to 63 versus 71% for externalizing disorders. The increment in agreement due to disclosure of the DAWBA diagnosis was significant for internalizing disorders. Access to DAWBA information was more likely to prompt clinicians to add an extra diagnosis. Professional background and degree of clinical experience did not affect diagnostic agreement. Overall, diagnostic agreements between DAWBA expert diagnoses and clinical diagnoses were in the fair to moderate range and comparable to previous studies with other structured diagnostic interviews. The inclusion of the DAWBA into the clinical assessment process had an impact on diagnostic decision-making regarding internalizing disorders but not regarding externalizing disorder

Problem coping skills, psychosocial adversities and mental health problems in children and adolescents as predictors of criminal outcomes in young adulthood

Abstract : The purpose of this study was to test child and adolescent psychosocial and psychopathological risk factors as predictors of adult criminal outcomes in a Swiss community sample. In particular, the role of active and avoidant problem coping in youths was analysed. Prevalence rates of young adult crime convictions based on register data were calculated. Univariate and multivariate logistic regressions were used to analyse the prediction of adult criminal convictions 15years after assessment in a large Swiss community sample of children and adolescents (n=1,086). Risk factors assessed in childhood and adolescence included socio-economic status (SES), migration background, perceived parental behaviour, familial and other social stressors, coping styles, externalizing and internalizing problems and drug abuse including problematic alcohol consumption. The rate of any young adult conviction was 10.1%. Besides externalizing problems and problematic alcohol consumption, the presence of any criminal conviction in young adulthood was predicted by low SES and avoidant coping even after controlling for the effects of externalizing problems and problematic alcohol use. The other predictors were significant only when externalizing behaviours and problematic alcohol use were not controlled. In addition to child and adolescent externalizing behaviour problems and substance use, low SES and inadequate problem-solving skills, in terms of avoidant coping, are major risk factors of young adult criminal outcomes and need to be considered in forensic research and criminal prevention programs