Bidirectional Relationships between Maternal Parenting Behaviors and Conduct Disorder Symptoms in Preschool Children

Conduct disorder (CD) symptoms emerge in preschool children, and some evidence for bidirectional effects between maternal parenting behaviors and these symptoms has been found in school-age children and adolescents. However, the strength and pattern of these effects are unknown during the preschool years. The present study examined the bidirectional relationships between several key maternal parenting behaviors (negative affect, warmth, overreactivity, and laxness) and CD symptoms across the preschool years. Participants were 197 preschool children (M = 44.24 months, SD = 3.37; Girls = 92) exhibiting significant behavior problems and their mothers who participated in a 3-year longitudinal study. Maternal parenting behaviors were assessed annually through self-report and observational measures, while mothers reported CD symptoms via structured interviews. As expected, CD symptoms were found to be stable during the preschool years. Only maternal self-reported overreactivity was concurrently correlated with CD symptoms. With regards to bidirectional relationships, CD symptoms only predicted a decrease in maternal warmth, and there was no evidence of mother-to-child effects in our models. The stability of CD symptoms provide support for the validity of early CD and results raise questions about the direct role of maternal parenting in the development of this disorder during the preschool years

ADHD in children and young people: prevalence, care pathways & service provision

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common childhood behavioural disorder – systematic reviews indicate that the community prevalence of ADHD globally is between 2% to 7%, with an average of around 5%. In addition, a further 5% of children have significant difficulties with over-activity, inattention and impulsivity that are just sub-threshold to meet full diagnostic criteria for ADHD. Estimates of the administrative (clinically diagnosed and/or recorded) prevalence vary worldwide and although increasing over time, ADHD is still relatively under-recognised and under-diagnosed in most countries, particularly in girls and older children. ADHD often persists into adulthood and is a risk factor for other mental health disorders and negative outcomes including educational under-achievement, difficulties with employment and relationships, and criminality. The timely recognition and treatment of children with ADHD-type difficulties provides an opportunity to improve their long-term outcomes. This review includes a systematic review of the community and administrative prevalence of ADHD in children and adolescents; an overview of the barriers to accessing care for ADHD; a description of costs associated with ADHD; and a broad discussion of evidence-based pathways for the delivery of clinical care, including a focus on key issues for two specific age groups - pre-school children and adolescents requiring transition of care from child to adult services

The Psychometric Properties of the Diagnostic Interview Schedule for Children: Disruptive Behaviors in Preschool-Age Children

The present study examined the psychometric properties of the Diagnostic Interview Schedule for Children (DISC-IV), specifically the disruptive behavior module for preschool-age children. The participants were 128 children (M = 4.43 years, SD = .54; Girls = 63) of African American (n = 37), European American (n = 41), Latino American (n = 38), and Mixed Ethnic (n = 12) background from Western Massachusetts. The overall internal consistency, concurrent validity, and predictive validity of the ADHD and ODD subsections were examined. Gender and ethnicity were examined as potential moderators of those as well. The DISC-IV and a behavior rating scale for teachers were administered at the beginning of the school year and the administration of the rating scale occurred again at end of the school year. The DISC-IV ADHD and ODD subsections exhibited acceptable overall internal consistency. The concurrent validity of the ADHD subsection was also found, but not for the ODD subsection. Most importantly, both DISC-IV subsections exhibited overall predictive validity, above initial teacher ratings. Partially supporting our hypotheses, ethnicity moderated the concurrent validity of the DISC-IV ADHD subsection, with DISC-IV scores of African American children having a stronger association with teachers’ ratings; boys also exhibited a stronger association than girls although not reaching significance. Also approaching significance, the DISC ADHD subsection appeared to predict year-end teacher ratings better for African American children than for European American and Latino American children. Overall, the DISC-IV was found to be a psychometrically reliable and valid diagnostic instrument for preschool-age children

The UCLA PTSD Reaction Index for DSM-5 Brief Form: A Screening Tool for Trauma-Exposed Youth

ObjectiveChildren and adolescents who experience potentially traumatic events are at risk for developing posttraumatic stress disorder (PTSD). Although psychometrically sound measures are now available to assess these youths, brief tools are currently needed for screening purposes. Two studies were conducted to develop and validate the UCLA PTSD Reaction Index for DSM-5-Brief Form (RI-5-BF).MethodStudy 1 used item response theory models to derive the RI-5-BF from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 486 trauma-exposed youths (mean age = 13.32 years, SD = 2.90) recruited through a practice research network. Study 2 used receiver operating characteristic analyses and diagnostic efficiency statistics to assess the discriminant-groups validity and clinical utility of the RI-5-BF in identifying children at different levels of PTSD risk using a sample of 41 treatment-seeking youths (mean age = 12.44 years, SD = 2.99).ResultsIn study 1, item response theory models identified the 11 most informative items across their respective subscales. The RI-5-BF exhibited excellent internal consistency in both studies (α > .93). In study 2, receiver operating characteristic analyses indicated that an RI-5-BF score of 21 maximized sensitivity and specificity. Moreover, diagnostic likelihood ratios across multiple levels of scores provided support for the measure's clinical utility in identifying different levels of PTSD risk.ConclusionThese findings provide support for both the psychometric properties of the RI-5-BF as a brief screening measure for PTSD in children and adolescents and its utility for identifying youths meriting further assessment and consideration for treatment

The UCLA PTSD Reaction Index for DSM-5 Brief Form: A Screening Tool for Trauma-Exposed Youths

ObjectiveChildren and adolescents who experience potentially traumatic events are at risk for developing posttraumatic stress disorder (PTSD). Although psychometrically sound measures are now available to assess these youths, brief tools are currently needed for screening purposes. Two studies were conducted to develop and validate the UCLA PTSD Reaction Index for DSM-5-Brief Form (RI-5-BF).MethodStudy 1 used item response theory models to derive the RI-5-BF from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 486 trauma-exposed youths (mean age = 13.32 years, SD = 2.90) recruited through a practice research network. Study 2 used receiver operating characteristic analyses and diagnostic efficiency statistics to assess the discriminant-groups validity and clinical utility of the RI-5-BF in identifying children at different levels of PTSD risk using a sample of 41 treatment-seeking youths (mean age = 12.44 years, SD = 2.99).ResultsIn study 1, item response theory models identified the 11 most informative items across their respective subscales. The RI-5-BF exhibited excellent internal consistency in both studies (α > .93). In study 2, receiver operating characteristic analyses indicated that an RI-5-BF score of 21 maximized sensitivity and specificity. Moreover, diagnostic likelihood ratios across multiple levels of scores provided support for the measure's clinical utility in identifying different levels of PTSD risk.ConclusionThese findings provide support for both the psychometric properties of the RI-5-BF as a brief screening measure for PTSD in children and adolescents and its utility for identifying youths meriting further assessment and consideration for treatment

Validation of the UCLA PTSD Reaction Index for DSM-5: A Developmentally Informed Assessment Tool for Youth

ObjectiveTo describe the test construction procedure and evaluate the internal consistency, criterion-referenced validity, and diagnostic accuracy of the Child/Adolescent Self-Report Version of the UCLA PTSD Reaction Index for DSM-5 (RI-5) across 2 independent samples.MethodStudy 1 examined the clarity, developmental appropriateness, acceptability of individual RI-5 items, and internal consistency and criterion-referenced validity of the full test. The study 1 sample included 486 youth recruited from 2 major US cities who completed the RI-5 and a measure of depression. Study 2 evaluated the reliability and diagnostic accuracy of the RI-5 in 41 treatment-seeking youth who completed the RI-5 and a "gold standard" structured diagnostic interview, the Clinician-Administered PTSD Scale for DSM-5-Child/Adolescent Version.ResultsRI-5 total scale scores showed excellent internal consistency in the 2 samples. Study 1 provided evidence of criterion-referenced validity, in that total scale scores correlated positively with depressive symptoms. Study 2 provided evidence of diagnostic accuracy (including discriminant-groups validity). RI-5 total scores discriminated youth with from youth without PTSD as benchmarked against the structured diagnostic interview. Further, receiver operating characteristic analyses using a total score of 35 provided excellent diagnostic classification accuracy (area under the curve 0.94).ConclusionThe developmental appropriateness and diagnostic accuracy of the RI-5 support its utility for clinical assessment, case conceptualization, and treatment planning in different child-serving systems, including schools, juvenile justice, child welfare, and mental health