The use of the international classification of functioning, disability and health in primary care: Findings of exploratory implementation throughout life

__Purpose:__ The International Classification of Functioning (ICF) has found widespread acceptance since it was launched in 2001. Yet, little is known about its use in Primary Care. This paper aims to contribute to the dialogue about the practical use of the ICF by exploring how this framework constitutes a supplementary source to inform disability-related decision making in integrated Primary Care. __Method:__ The implementation process of the ICF in a Latin American Primary Care and Community-Based Rehabilitation setting is described and the ICF diagram is applied to a life story as an example of its current use. Participant observation, in-depth study of reports of team meetings and the review of clinical files are the main data collection methods. Data analysis is enabled by the combination of single-case study with theory testing, which facilitates the generation of hypotheses in this exploratory study. __Results:__ A valuable time component of the ICF may support continuity in Primary Care and the universal application of the ICF framework can promote comprehensiveness by integrating individual rehabilitation and collective disability prevention. A way to mitigate the perceived dominance of biomedical disease and deficiency thinking is proposed in order to encourage the biopsychosocial focus of Primary Care. Finally, the implementation of the International Classification of Diseases (ICD-10) in the health condition domain of the ICF highlights the importance of social responsibility towards disability. __Conclusion:__ This study suggests that a creative implementation of the ICF during life course to everyone who uses universally accessible healthcare may strengthen the integrative functions of Primary Care, and may be at the heart of the information system of this essential part of the healthcare system. Further research on the complementary use of ICF and ICD-10 is suggested in order to support community-based multisectoral intervention which may be coordinated by Primary Care

Psychometric Properties of the Grief Cognitions Questionnaire for Children (GCQ-C)

Negative thinking is seen as an important mediating factor in the development of prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief. No measure of specific grief related cognitions is available yet. Based on an adult measure of negative thinking in adults we developed a questionnaire for children, the Grief Cognitions Questionnaire for Children (GCQ-C). This study investigated several psychometric properties of the GCQ-C. Both reliability and validity were investigated in this study, in which hundred fifty-one children and adolescents (aged 8–18 years) participated. Findings showed that items of the GCQ-C represented one underlying dimension. Furthermore, the internal consistency and temporal stability were found to be adequate. Third, the findings supported the concurrent validity (e.g., significant positive correlations with self-report indices of PGD, depression and posttraumatic stress disorder), convergent and divergent validity of the GCQ-C. This study provides further evidence for the importance of negative thinking in PGD in children and adolescents

Testing the Direction of Longitudinal Paths between Victimization, Peer Rejection, and Different Types of Internalizing Problems in Adolescence

The transition to secondary school is accompanied by the fragmentation of peer groups, while adolescents are also confronted with heightened incidents of bullying and increased levels of internalizing problems. Victimization, peer rejection, and internalizing problems are known to be interrelated, but how they influence each other over time remains unclear. We tested the direction of these associations by applying a cross-lagged path model among a large sample of Finnish adolescents (N = 5645; 49.1 % boys; M age at T1 = 14.0 years) after they transitioned to secondary school (grades 7–9). Self-reported depression, anxiety, and victimization and peer-reported rejection were measured 3 times over the course of 1 year. Results showed that depression was predictive of subsequent victimization for both boys and girls, in line with a symptoms-driven model; for girls, anxiety was reciprocally related to victimization, in line with a transactional model; for boys, victimization was related to subsequent anxiety, in line with an interpersonal risk model. Peer rejection was not directly related to depression or anxiety, but among girls peer rejection was bi-directionally related to victimization. Overall, our results suggest that associations between internalizing problems and peer relations differ between depression and anxiety and between genders. Implications for practice and directions for future research are discussed

Conduct Problem Trajectories Between Age 4 and 17 and Their Association with Behavioral Adjustment in Emerging Adulthood

Individual heterogeneity exists in the onset and development of conduct problems, but theoretical claims about predictors and prognosis are often not consistent with the empirical findings. This study examined shape and outcomes of conduct problem trajectories in a Belgian population-based sample (N = 682; 49.5 % boys). Mothers reported on children’s conduct problems across six waves (age 4–17) and emerging adults reported on their behavioral adjustment (age 17–20). Applying mixture modeling, we found four gender-invariant trajectories (labeled life-course-persistent, adolescence-onset, childhood-limited, and low). The life-course-persistent group was least favorably adjusted, but the adolescence-onset group was similarly maladjusted in externalizing problems and may be less normative (15 % of the sample) than previously believed. The childhood-limited group was at heightened risk for specifically internalizing problems, being more worrisome than its label suggests. Interventions should not only be aimed at early detection of conduct problems, but also at adolescents to avoid future maladjustment

The role of the assessment policy in the relation between learning and performance

__Context:__ Optimising student learning and academic performance is a continuous challenge for medical schools. The assessment policy may influence both learning and performance. Previously, the joint contribution of self-regulated learning (SRL) and participation in scheduled learning activities towards academic performance has been reported. However, little is known about the relationships between SRL, participation and academic performance under different assessment policies. __Objectives:__ The goal of this study was to investigate differences in average scores of SRL, participation and academic performance of students under two assessment policies: (i) a conjunctive lower stakes, lower performance standard (old) assessment policy and (ii) a compensatory higher stakes, higher performance standard (new) assessment policy. In addition, this research investigated whether the relationships between academic performance, SRL and participation are similar across both assessment policies. __Methods:__ Year-1 medical students (i) under the old assessment policy (n = 648) and (ii) under the new assessment policy (n = 529) completed the Motivated Strategies for Learning Questionnaire on SRL, and additional items on participation. Year-1 performance was operationalised as students’ average Year-1 course examination grades. manova and structural equation modelling were used for analyses. __Results:__ Generally, students under the new assessment policy showed significantly higher Year-1 performance, SRL and participation, compared with students under the old assessment policy. The relationships between Year-1 performance, SRL and participation were similar across assessment policies. __Conclusions:__ This study indicates that the higher academic performance under a compensatory higher stakes, higher performance standard assessment policy, results from higher SRL and participation, but not from altered relationships between SRL, participation and performance. In sum, assessment policies have the potential to optimise student learning and performance

The Dysregulation Profile in middle childhood and adolescence across reporters: factor structure, measurement invariance, and links with self-harm and suicidal ideation

Recently, a phenotype of severe dysregulation, the Dysregulation Profile (DP), has been identified. DP consists of elevated scores on the Anxious/Depressed (AD), Aggressive Behavior (AGG) and Attention Problems (AP) scales of the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), or Youth Self Report (YSR). A drawback in current research is that DP has been conceptualized and operationalized in different manners and research on the factor structure of DP is lacking. Therefore, we examined the factor structure of DP across

No differential susceptibility or diathesis stress to parenting in early adolescence: Personality facets predicting behaviour problems

This multi-sample study investigated the main and interactive effects of parenting (responsiveness, overreactivity) and young adolescents' personality traits (negative-affectivity: irritability and anxiety; and orienting-sensitivity) on behaviour problems during adolescence. Data from two samples (N1 = 222; girls 45.5%; Mean age = 11.54 years; N2 = 252; girls 50.4%; Mean age = 10.85 years) were analysed using a multivariate approach. Parenting and y

Long-Term Developmental Changes in Children's Lower-Order Big Five Personality Facets

__Objective:__ This study examined long-term developmental changes in mother-rated lower-order facets of children's Big Five dimensions. __Method:__ Two independent community samples covering early childhood (2-4.5 years; N=365, 39% girls) and middle childhood to the end of middle adolescence (6-17 years; N=579, 50% girls) were used. All children had the Belgian nationality. Developmental changes were examined using cohort-sequential latent growth modeling on the 18 facets of the Hierarchical Personality Inventory for Children. __Results:__ In early childhood, changes were mostly similar across child gender. Between 2 and 4.5 years, several facets showed mean-level stability; others changed in the direction of less Extraversion and Emotional Stability, and more Benevolence and Imagination. The lower-order facets of Conscientiousness showed opposite changes. Gender differences became more apparent from middle childhood onward for facets of all dimensions except Imagination, for which no gender differences were found. Between 6 and 17 years, same-dimension facets showed different shapes of growth. Facets that changed linearly changed mostly in the direction of less Extraversion, Benevolence, Conscientiousness, Emotional Stability, and Imagination. Changes in facets for which nonlinear growth was found generally moved in direction or magnitude during d

Moderation of associations between interparental stress and (mal)adaptation by adolescents' personality: Contrasting differential susceptibility and diathesis–stress models

Objective: This study aimed to contrast differential susceptibility and diathesis–stress models in examining adolescents' Big Five personality dimensions as moderators of longitudinal associations between interparental stress and (mal)adaptation in emerging adulthood (i.e., self-efficacy, externalizing and internalizing behavior). Method: Data from the large longitudinal Flemish Study on Parenting, Personality and Development were used (475 families, adolescents' Mage = 15.82, SDage = 1.15), with both parents reporting on their interparental stress and mothers reporting on the adolescent's personality and in 2009, and emerging adults reporting on their own (mal)adaptive functioning in 2009 and 2015 and their personality in 2015. Results: Multivariate models showed that extraversion, benevolence, emotional stability and imagination were uniquely related to (mal)adaptation across the 6-year interval. In general, our results exhibited no consistent moderating role for adolescents' personality. Only for girls, high levels of extraversion functioned as a “susceptibility maker” in associations between father's interparental stress and self-efficacy, and, low levels of emotional stability functioned as a “vulnerability marker” in associations between parents' interparental stress and self-efficacy. Conclusions: The interaction effects as well as their (restricted) generalizability across gender should be replicated before drawing firm conclusions. Adolescents' personality characteristics were important predictors of (mal)adaptation during the transition into emerging adulthood

Socialization of prosocial behavior: Gender differences in the mediating role of child brain volume

Evidence has been accumulating for the impact of normal variation in caregiving quality on brain morphology in children, but the question remains whether differences in brain volume related to early caregiving translate to behavioral implications. In this longitudinal population-based study (N = 162), moderated mediation was tested for the relation between parental sensitivity and child prosocial behavior via brain volume, in boys and girls. Both maternal and paternal sensitivity were repeatedly observed between 1 and 4 years of age. Brain volume was assessed using magnetic resonance imaging measurements at age 8, and self-reported prosocial behavior of children was assessed at 9 years of age. Parental sensitivity was positively related to child brain volume, and to child prosocial behavior at trend level. Child brain volume was negatively related to child prosocial behavior. A significant gender-by-brain interaction was found, illustrating that daughters of sensitive parents were more prosocial and that less prosocial behavior was reported for girls with a larger total brain volume. Child gender significantly moderated the indirect effect of parental sensitivity on prosocial behavior via total brain volume. A significant indirect pathway was found only in girls. The results warrant replication but indicate the importance of considering gender when studying the behavioral implications of differences in brain volume related to early caregiving experiences