Sample records for problems oppositional defiant

  1. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Journal of the American Academy of Child and Adolescent Psychiatry, 2007

    2007-01-01

    Oppositional defiant disorder (ODD) is a common clinical problem in children and adolescents. Oppositionality and associated types of aggressive behavior are among the most common referral problems in child psychiatry. Grouped among the disruptive behavior disorders, ODD is frequently comorbid with other psychiatric conditions and often precedes…

  2. The Role of Family Experiences and ADHD in the Early Development of Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Harvey, Elizabeth A.; Metcalfe, Lindsay A.; Herbert, Sharonne D.; Fanton, John H.

    2011-01-01

    Objective: The present study examined the role of family experiences in the early development and maintenance of oppositional defiant disorder (ODD) symptoms in preschool-age children with behavior problems. Method: Participants were 199 3-year-old children with behavior problems who took part in 4 annual child and family assessments. Results:…

  3. Examining Subtypes of Behavior Problems among 3-Year-Old Children, Part I: Investigating Validity of Subtypes and Biological Risk-Factors

    ERIC Educational Resources Information Center

    Harvey, Elizabeth A.; Friedman-Weieneth, Julie L.; Goldstein, Lauren H.; Sherman, Alison H.

    2007-01-01

    This study examined 3-year-old children who were classified as hyperactive (HYP), oppositional-defiant (OD), hyperactive and oppositional defiant (HYP/OD), and non-problem based on mothers' reports of behavior. Using fathers', teachers', and observers' ratings of children's behavior, concurrent validity was excellent for the HYP/OD group, moderate…

  4. What's in a Disruptive Disorder? Temperamental Antecedents of Oppositional Defiant Disorder: Findings from the Avon Longitudinal Study

    ERIC Educational Resources Information Center

    Stringaris, Argyris; Maughan, Barbara; Goodman, Robert

    2010-01-01

    Objective: Oppositional defiant disorder (ODD) is classified as a disruptive disorder, but shows a wide range of associations with other psychopathology, including internalizing problems. The reasons for these associations are unclear. Here we test the hypothesis that two distinct early temperamental precursors--emotionality and activity--underlie…

  5. Examining subtypes of behavior problems among 3-year-old children, Part I: investigating validity of subtypes and biological risk-factors.

    PubMed

    Harvey, Elizabeth A; Friedman-Weieneth, Julie L; Goldstein, Lauren H; Sherman, Alison H

    2007-02-01

    This study examined 3-year-old children who were classified as hyperactive (HYP), oppositional-defiant (OD), hyperactive and oppositional defiant (HYP/OD), and non-problem based on mothers' reports of behavior. Using fathers,' teachers,' and observers' ratings of children's behavior, concurrent validity was excellent for the HYP/OD group, moderate for the HYP group, and poor for the OD group. As predicted, both the HYP/OD and HYP groups reported more prenatal/perinatal birth complications and a greater family history of hyperactivity than did non-problem children. Furthermore, the HYP/OD group showed a greater family history of conduct disorder and oppositional defiant disorder (ODD) symptoms than did non-problem children; however, the HYP group also showed a greater family history of ODD than did non-problem children. Results suggest that as early as age 3, these behavior subtypes appear to be linked to biologically-based risk-factors in ways that are consistent with theories of the development of ADHD.

  6. Predicting Depression and Anxiety from Oppositional Defiant Disorder Symptoms in Elementary School-Age Girls and Boys with Conduct Problems.

    PubMed

    Déry, Michèle; Lapalme, Mélanie; Jagiellowicz, Jadzia; Poirier, Martine; Temcheff, Caroline; Toupin, Jean

    2017-02-01

    This study investigated the relationship between the three DSM-5 categories of oppositional defiant disorder (ODD) symptoms (irritable mood, defiant behavior, vindictive behavior) and anxiety/depression in girls and boys with conduct problems (CP) while controlling for comorbid child psychopathology at baseline. Data were drawn from an ongoing longitudinal study of 6- to 9-year-old French-Canadian children (N = 276; 40.8 % girls) receiving special educational services for CP at school and followed for 2 years. Using linear regression analysis, the results showed that irritable mood symptoms predicted a higher level of depression and anxiety in girls and boys 2 years later, whereas the behavioral symptoms of ODD (e.g., defiant, vindictive symptoms) were linked to lower depression scores. The contribution of ODD symptoms to these predictions, while statistically significant, remained modest. The usefulness of ODD irritable symptoms as a marker for identifying girls and boys with CP who are more vulnerable to developing internalizing problems is discussed.

  7. Are We Doing Enough? Assessing the Needs of Teachers in Isolated Schools with Students with Oppositional Defiant Disorder in Mainstream Classrooms

    ERIC Educational Resources Information Center

    McLean, Fiona; Dixon, Roselyn

    2010-01-01

    The Vinson report (2001) into public education highlighted the growing incidence of behavioural problems within the NSW public school system. One disorder that is currently causing particular concern is Oppositional Defiant Disorder (ODD) as the outcomes for students with ODD who do not receive intervention are dire. Barcalow (2006) claims that…

  8. Impact of Oppositional Defiant Disorder Dimensions on the Temporal Ordering of Conduct Problems and Depression across Childhood and Adolescence in Girls

    ERIC Educational Resources Information Center

    Hipwell, Alison E.; Stepp, Stephanie; Feng, Xin; Burke, Jeff; Battista, Deena R.; Loeber, Rolf; Keenan, Kate

    2011-01-01

    Background: Little is known about the role of oppositional defiant disorder (ODD) dimensions on the temporal unfolding of conduct disorder (CD) and depression in girls between childhood and adolescence. Method: The year-to-year associations between CD and depressive symptomatology were examined using nine waves of annually collected data (ages 8…

  9. Discriminant of validity the Wender Utah rating scale in Iranian adults.

    PubMed

    Farokhzadi, Farideh; Mohammadi, Mohammad Reza; Salmanian, Maryam

    2014-01-01

    The aim of this study is the normalization of the Wender Utah rating scale which is used to detect adults with Attention-Deficit and Hyperactivity Disorder (ADHD). Available sampling method was used to choose 400 parents of children (200 parents of children with ADHD as compared to 200 parents of normal children). Wender Utah rating scale, which has been designed to diagnose ADHD in adults, is filled out by each of the parents to most accurately diagnose of ADHD in parents. Wender Utah rating scale was divided into 6 sub scales which consist of dysthymia, oppositional defiant disorder; school work problems, conduct disorder, anxiety, and ADHD were analyzed with exploratory factor analysis method. The value of (Kaiser-Meyer-Olkin) KMO was 86.5% for dysthymia, 86.9% for oppositional defiant disorder, 77.5% for school related problems, 90.9% for conduct disorder, 79.6% for anxiety and 93.5% for Attention deficit/hyperactivity disorder, also the chi square value based on Bartlett's Test was 2242.947 for dysthymia, 2239.112 for oppositional defiant disorder, 1221.917 for school work problems, 5031.511 for conduct, 1421.1 for anxiety, and 7644.122 for ADHD. Since mentioned values were larger than the chi square critical values (P<0.05), it found that the factor correlation matrix is appropriate for factor analysis. Based on the findings, we can conclude that Wender Utah rating scale can be appropriately used for predicting dysthymia, oppositional defiant disorder, school work problems, conduct disorder, anxiety, in adults with ADHD.

  10. Is prenatal smoking associated with a developmental pattern of conduct problems in young boys?

    PubMed

    Wakschlag, Lauren S; Pickett, Kate E; Kasza, Kristen E; Loeber, Rolf

    2006-04-01

    Prenatal smoking is robustly associated with increased risk of conduct problems in offspring. Observational studies that provide detailed phenotypic description are critical for generating testable hypotheses about underlying processes through which the effects of prenatal smoking may operate. To this end, we use a developmental framework to examine the association of exposure with (1) oppositional defiant disorder and attention-deficit/hyperactivity disorder in young boys and (2) the pattern of delinquent behavior at adolescence. Using diagnostic measures and repeated measures of delinquency, we compare exposed and nonexposed boys from the youngest cohort of the Pittsburgh Youth Study (N = 448). Exposed boys were significantly more likely to (1) develop oppositional defiant disorder and comorbid oppositional defiant disorder-attention-deficit/hyperactivity disorder but not attention-deficit/hyperactivity disorder alone and (2) to have an earlier onset of significant delinquent behavior. The early emergence and developmental coherence of exposure-related conduct problems is striking and is consistent with a behavioral teratological model. Phenotypically, exposure-related conduct problems appear to be characterized by socially resistant and impulsively aggressive behavior. Whether prenatal smoking plays an etiological role in or is a risk marker for the development of conduct problems, exposed offspring are at increased risk of an early-starter pathway to conduct problems.

  11. ADHD subtypes and comorbid anxiety, depression, and oppositional-defiant disorder: differences in sleep problems.

    PubMed

    Mayes, Susan Dickerson; Calhoun, Susan L; Bixler, Edward O; Vgontzas, Alexandros N; Mahr, Fauzia; Hillwig-Garcia, Jolene; Elamir, Belal; Edhere-Ekezie, Linda; Parvin, Matthew

    2009-04-01

    Sleep problems were analyzed in children with ADHD (Attention-deficit hyperactivity disorder). Scales were completed by parents of 135 control children and 681 children with ADHD combined type (ADHD-C) or inattentive type (ADHD-I) with or without comorbid oppositional defiant disorder (ODD), anxiety, or depression. Children with ADHD-I alone had the fewest sleep problems and did not differ from controls. Children with ADHD-C had more sleep problems than controls and children with ADHD-I. Comorbid anxiety/depression increased sleep problems, whereas ODD did not. Daytime sleepiness was greatest in ADHD-I and was associated with sleeping more (not less) than normal. Medicated children had greater difficulty falling asleep than unmedicated children. Differences in sleep problems were found as a function of ADHD subtype, comorbidity, and medication.

  12. Are Oppositional-Defiant and Hyperactive-Inattentive Symptoms Developmental Precursors to Conduct Problems in Late Childhood?: Genetic and Environmental Links

    ERIC Educational Resources Information Center

    Lahey, Benjamin B.; Van Hulle, Carol A.; Rathouz, Paul J.; Rodgers, Joseph Lee; D'Onofrio, Brian M.; Waldman, Irwin D.

    2009-01-01

    Inattentive-hyperactive and oppositional behavior have been hypothesized to be developmental precursors to conduct problems. We tested these hypotheses using a longitudinal sample of 6,466 offspring of women selected from nationally representative US households. Conduct problems across 8-13 years were robustly predicted by conduct problems at 4-7…

  13. Symptoms of conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, and callous-unemotional traits as unique predictors of psychosocial maladjustment in boys: advancing an evidence base for DSM-V.

    PubMed

    Pardini, Dustin A; Fite, Paula J

    2010-11-01

    The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys. Several outcomes were assessed semiannually across a 2-year follow-up, including antisocial behavior, internalizing problems, peer conflict, and academic difficulties. Official criminal charges were also examined across adolescence. CD symptoms emerged as the most robust predictor of future antisocial outcomes. However, ODD symptoms predicted later criminal charges and conduct problems, and CU traits were robustly associated with serious and persistent criminal behavior in boys. Attention-deficit/hyperactivity disorder symptoms predicted increases in oppositional defiant behavior and conduct problems over time and were uniquely related to future academic difficulties. Both ADHD and ODD symptoms predicted social and internalizing problems in boys, whereas CU traits were associated with decreased internalizing problems over time. The current findings have implications for revisions being considered as part of the DSM-V. Specifically, incorporating CU traits into the diagnostic criteria for Disruptive Behavior Disorders (DBD) may help to further delineate boys at risk for severe and persistent delinquency. Although currently prohibited, allowing a diagnosis of ODD when CD is present may provide unique prognostic information about boys who are at risk for future criminal behavior, social problems, and internalizing problems. Copyright © 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. What Is a Developmental-Behavioral Pediatrician?

    MedlinePlus

    ... dyslexia, writing diffi culties, math disorders, and other school-related learning problems Attention and behavioral disorders including attention-deficit/hyperactivity disorder and associated conditions including oppositional-defiant behavior, conduct ...

  15. Anxiety and oppositional behavior profiles among youth with selective mutism.

    PubMed

    Diliberto, Rachele A; Kearney, Christopher A

    2016-01-01

    Selective mutism (SM) is a debilitating condition in which a child does not speak in social situations where speech is expected. The clinical conceptualization of SM has been debated historically, with evidence pointing partly to anxious and oppositional behavior profiles. Behavioral characteristics were examined in a clinical sample of 57 youth formally diagnosed with selective mutism. Parents rated children across internalizing and externalizing behaviors on the Child Behavior Checklist. Eighteen highly rated items were subjected to exploratory and then confirmatory factor analysis. Anxiety and oppositional behavior factors were derived. The anxious behavior profile was associated with social anxiety disorder symptoms, social problems, and aggressive behaviors but not oppositional defiant disorder symptoms. The oppositional behavior profile was associated with aggressive behaviors, oppositional defiant disorder symptoms, social problems, and inversely to social anxiety disorder symptoms. Results are consistent with emerging research regarding subgroups of children with SM. Behavior profiles are discussed as well with respect to assessment and treatment implications. Readers will learn about the nature of children with selective mutism as well as behaviors that differentiate anxious and oppositional behavior profiles. Items that comprise anxious and oppositional behavior profiles are presented. These item profiles may have ramifications for assessment and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Testing Developmental Pathways to Antisocial Personality Problems

    ERIC Educational Resources Information Center

    Diamantopoulou, Sofia; Verhulst, Frank C.; van der Ende, Jan

    2010-01-01

    This study examined the development of antisocial personality problems (APP) in young adulthood from disruptive behaviors and internalizing problems in childhood and adolescence. Parent ratings of 507 children's (aged 6-8 years) symptoms of attention deficit hyperactivity disorder, oppositional defiant disorder, and anxiety, were linked to…

  17. The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 1: Psychostimulants, Alpha-2 Agonists, and Atomoxetine

    PubMed Central

    Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

    2015-01-01

    Objective: Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. Method: We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Conclusions: Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit. PMID:25886655

  18. The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine.

    PubMed

    Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

    2015-02-01

    Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit.

  19. Separating the Domains of Oppositional Behavior: Comparing Latent Models of the Conners' Oppositional Subscale

    ERIC Educational Resources Information Center

    Kuny, Ana V.; Althoff, Robert R.; Copeland, William; Bartels, Meike; Van Beijsterveldt, C. E. M.; Baer, Julie; Hudziak, James J.

    2013-01-01

    Objective: Although oppositional defiant disorder (ODD) is usually considered the mildest of the disruptive behavior disorders, it is a key factor in predicting young adult anxiety and depression and is distinguishable from normal childhood behavior. In an effort to understand possible subsets of oppositional defiant behavior (ODB) that may…

  20. Comorbid Problems in ADHD: Degree of Association, Shared Endophenotypes, and Formation of Distinct Subtypes. Implications for a Future "DSM"

    ERIC Educational Resources Information Center

    Rommelse, Nanda N. J.; Altink, Marieke E.; Fliers, Ellen A.; Martin, Neilson C.; Buschgens, Cathelijne J. M.; Hartman, Catharina A.; Buitelaar, Jan K.; Faraone, Stephen V.; Sergeant, Joseph A.; Oosterlaan, Jaap

    2009-01-01

    We aimed to assess which comorbid problems (oppositional defiant behaviors, anxiety, autistic traits, motor coordination problems, and reading problems) were most associated with Attention-Deficit/Hyperactivity Disorder (ADHD); to determine whether these comorbid problems shared executive and motor problems on an endophenotype level with ADHD; and…

  1. Maltreatment and Emotional and Behavioral Problems in Chinese Children With and Without Oppositional Defiant Disorder: The Mediating Role of the Parent-Child Relationship.

    PubMed

    Li, Longfeng; Lin, Xiuyun; Chi, Peilian; Heath, Melissa Allen; Fang, Xiaoyi; Du, Hongfei; Wang, Zhonghui

    2016-11-01

    Maltreatment has negative effects on the parent-child relationship and the emotional and behavioral development of children. The current study aimed to examine the associations among maltreatment, parent-child relationship, and emotional and behavioral problems in Chinese children with or without oppositional defiant disorder (ODD). Participants in the study included 259 children with ODD and their 269 non-ODD counterparts from northern, eastern, and southwestern China. We also collected data from their teachers and fathers or mothers. The results showed that ODD children suffered more maltreatment and had more emotional and behavioral problems than their non-ODD peers. For all children (both ODD and non-ODD children), emotional abuse predicted emotional problems but not behavioral problems. Physical abuse predicted behavioral problems but not emotional problems. Parent-child relationship mediated the effects of emotional abuse and physical abuse on emotional problems among ODD children but not among non-ODD children. Implications for prevention of emotional and physical abuse and ODD in the Chinese cultural context are discussed. © The Author(s) 2016.

  2. Encopresis

    MedlinePlus

    ... Starting toilet training when the child was too young Emotional problems, such as oppositional defiant disorder or conduct disorder Whatever the cause, the child may feel shame, guilt, or low self-esteem, and may hide signs of encopresis. Factors that ...

  3. Transdiagnostic, Cognitive and Behavioral Intervention for in School-aged Children With Emotional and Behavioral Disturbances

    ClinicalTrials.gov

    2018-05-25

    Anxiety; Anxiety Disorders; Depressive Symptoms; Depressive Disorders; Problem Behavior; Oppositional Defiant Disorder; Conduct Disorder; Other Behavioral and Emotional Disorders With Onset Usually Occurring in Childhood and Adolescence

  4. Parent- and Self-Reported Dimensions of Oppositionality in Youth: Construct Validity, Concurrent Validity, and the Prediction of Criminal Outcomes in Adulthood

    ERIC Educational Resources Information Center

    Aebi, Marcel; Plattner, Belinda; Metzke, Christa Winkler; Bessler, Cornelia; Steinhausen, Hans-Christoph

    2013-01-01

    Background: Different dimensions of oppositional defiant disorder (ODD) have been found as valid predictors of further mental health problems and antisocial behaviors in youth. The present study aimed at testing the construct, concurrent, and predictive validity of ODD dimensions derived from parent- and self-report measures. Method: Confirmatory…

  5. Teachers' ratings of disruptive behaviors: the influence of halo effects.

    PubMed

    Abikoff, H; Courtney, M; Pelham, W E; Koplewicz, H S

    1993-10-01

    This study evaluated the accuracy of teachers' ratings and examined whether these ratings are influenced by halo effects. One hundred thirty-nine elementary school teachers viewed videotapes of what they believed were children in regular fourth-grade classrooms. In fact, the children were actors who followed prepared scripts that depicted a child engaging in behaviors characteristic of an attention-deficit hyperactivity disorder (ADHD), an oppositional defiant disorder or a normal youngster. The findings provide support for a bias that was unidirectional in nature. Specifically, teachers rated hyperactive behaviors accurately when the child behaved like an ADHD youngster. However, ratings of hyperactivity and of ADHD symptomatic behaviors were spuriously inflated when behaviors associated with oppositional defiant disorder occurred. In contrast, teachers rated oppositional and conduct problem behaviors accurately, regardless of the presence of hyperactive behaviors. The implications of these findings regarding diagnostic practices and rating scale formats are discussed.

  6. Childhood behavior problems and academic outcomes in adolescence: longitudinal population-based study.

    PubMed

    Sayal, Kapil; Washbrook, Elizabeth; Propper, Carol

    2015-05-01

    To investigate the impact of increasing levels of inattention, hyperactivity/impulsivity, and oppositional/defiant behaviors at age 7 years on academic achievement at age 16 years. In a population-based sample of 7-year-old children in England, information was obtained about inattention, hyperactivity/impulsivity, and oppositional/defiant behaviors (using parent and teacher ratings) and the presence of attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (DBDs). After adjusting for confounder variables, their associations with academic achievement in national General Certificate of Secondary Education (GCSE) examinations (using scores and minimum expected school-leaving qualification level [5 "good" GCSEs]) at age 16 years were investigated (N = 11,640). In adjusted analyses, there was a linear association between each 1-point increase in inattention symptoms and worse outcomes (2- to 3-point reduction in GCSE scores and 6% to 7% (10%-12% with teacher ratings) increased likelihood of not achieving 5 good GCSEs). ADHD was associated with a 27- to 32-point reduction in GCSE scores and, in boys, a more than 2-fold increased likelihood of not achieving 5 good GCSEs. In boys, oppositional/defiant behaviors were also independently associated with worse outcomes, and DBDs were associated with a 19-point reduction in GCSE scores and a 1.83-increased likelihood of not achieving 5 good GCSEs. Across the full range of scores at a population level, each 1-point increase in inattention at age 7 years is associated with worse academic outcomes at age 16. The findings highlight long-term academic risk associated with ADHD, particularly inattentive symptoms. After adjusting for inattention and ADHD respectively, oppositional/defiant behaviors and DBDs are also independently associated with worse academic outcomes. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Comorbidity of Anxiety and Conduct Problems in Children: Implications for Clinical Research and Practice

    ERIC Educational Resources Information Center

    Cunningham, Natoshia Raishevich; Ollendick, Thomas H.

    2010-01-01

    Given the relative lack of research on the comorbidity of anxiety disorders (ADs) and conduct problems (oppositional defiant disorder, conduct disorder) in youth, we examine this comorbidity from both basic and applied perspectives. First, we review the concept of comorbidity and provide a framework for understanding issues pertaining to…

  8. Oppositional Defiant Disorder: Information for School Nurses

    ERIC Educational Resources Information Center

    Barcalow, Kelly

    2006-01-01

    Oppositional defiant disorder, one of the disruptive behavior disorders, has far-reaching consequences for the individual, family, school, community, and society. Early recognition allows interventions geared toward promotion of prosocial behaviors, possibly halting progression to the more deviant conduct disorder. Awareness of this disorder and…

  9. Oppositional Defiant Disorder in Children with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Christensen, Lisa; Baker, Bruce L.; Blacher, Jan

    2013-01-01

    The study examines the epidemiology of oppositional defiant disorder (ODD) for children with intellectual disabilities (ID; n = 49), children with borderline intellectual functioning (BIF; n = 20), and typically developing children (TD; n = 115). The Diagnostic Interview Schedule for Children was administered to mothers at child ages 5, 6, 7, 8,…

  10. Perspectives on Oppositional Defiant Disorder, Conduct Disorder, and Psychopathic Features

    ERIC Educational Resources Information Center

    Loeber, Rolf; Burke, Jeffrey; Pardini, Dustin A.

    2009-01-01

    This paper presents a few perspectives on oppositional defiant disorder (ODD), conduct disorder (CD), and early forms of psychopathy. The developmental changes and stability of each, and the interrelationship between the three conditions are reviewed, and correlates and predictors are highlighted. The paper also examines effective interventions…

  11. Students' Evidence-Based Practice Intervention for Children with Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Ronen, Tammie

    2005-01-01

    Objective: This project integrates clinical intervention as an integral part of social work studies for third-year students. Students applied a new manual-based intervention aiming to develop self-control skills among children exhibiting oppositional defiant disorder. Throughout, students were involved in assessment, intervention, and evaluation.…

  12. Oppositional Defiant Disorder in Adults with ADHD

    ERIC Educational Resources Information Center

    Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.

    2013-01-01

    Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…

  13. The "REST" Program: A New Treatment System for the Oppositional Defiant Adolescent.

    ERIC Educational Resources Information Center

    Stein, David B.; Smith, Edward D.

    1990-01-01

    Compared REST (Real Economy System for Teens) program, which combines behavioral treatment and cognitive restructuring, with traditional talk therapy, which uses primarily cognitive restructuring, in treatment of oppositional defiant adolescents. Results showed significantly greater improvement on all target behaviors (room care, personal hygiene,…

  14. Source-Specific Oppositional Defiant Disorder among Inner-City Children: Prospective Prediction and Moderation

    ERIC Educational Resources Information Center

    Drabick, Deborah A. G.; Bubier, Jennifer; Chen, Diane; Price, Julia; Lanza, H. Isabella

    2011-01-01

    We examined prospective prediction from parent- and teacher-reported oppositional defiant disorder (ODD) symptoms to parent-reported ODD, conduct disorder (CD), major depressive disorder (MDD), and generalized anxiety disorder symptoms and whether child executive functioning abilities moderated these relations among an urban, low-income sample of…

  15. Effect of play therapy on behavioral problems of maladjusted preschool children.

    PubMed

    Jafari, Niloufar; Mohammadi, Mohammad Reza; Khanbani, Mehdi; Farid, Saeedeh; Chiti, Parisa

    2011-01-01

    The present research was conducted to study the effect of play therapy on reducing behavioral problems of children with oppositional defiant disorder. Using multistage cluster sampling, regions 6, 7, and 8 in Tehran were selected. Among kindergartens of these areas, 3 kindergartens which were supported by the welfare organization were randomly selected. Of all the pre-school children of these 3 kindergartens, 40 children who could have behavioral disorder, according to their teachers and parents, were carefully tested. Of them, 16 children who showed severe symptoms of oppositional defiant disorder, were selected via the results obtained from the child symptom inventory questionnaire (CSI-4), teacher's form, and a researcher-made self-control checklist, Then, the subjects were randomly divided into one control and one experimental group. This research is quasi-experimental, and is conducted using pre-test, post-test, and control group. Values of the calculated F for oppositional defiant disorder in control group and experimental group was meaningful after fixing the effect of pre-test (P<0/001). Therefore, a meaningful difference existed between the means of post-test scores of disobedience disorder in the experimental and control groups through the fixed effect of the pre-test effect. Comparison of adjusted means of the 2 groups showed that the mean of attention-deficit hyperactivity disorder (ADHD) in experimental group was lower than control group. Therefore, applying play therapy reduced severity of ADHD in those children in experimental group compared to those in control group who did not receive such instructions. Results of this research demonstrates that children's disobedience can be reduced by play therapy.

  16. Parental Emotion Coaching and Child Emotion Regulation as Protective Factors for Children with Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Dunsmore, Julie C.; Booker, Jordan A.; Ollendick, Thomas H.

    2013-01-01

    We assessed linkages of mothers' emotion coaching and children's emotion regulation and emotion lability/negativity with children's adjustment in 72 mother-child dyads seeking treatment for oppositional defiant disorder (ODD). Dyads completed the questionnaires and discussed emotion-related family events. Maternal emotion coaching was associated…

  17. Respiratory Sinus Arrhythmia and Heart Period in Infancy as Correlates of Later Oppositional Defiant and Callous-Unemotional Behaviors

    ERIC Educational Resources Information Center

    Wagner, Nicholas; Mills-Koonce, Roger; Willoughby, Michael; Propper, Cathi; Rehder, Peter; Gueron-Sela, Noa

    2017-01-01

    Extant literature suggests that oppositional defiant disorder (ODD) and callous-unemotional (CU) behaviors in childhood and adolescence are associated with distinct patterns of psychophysiological functioning, and that individual differences in these patterns have implications for developmental pathways to disorder. Very little is known about the…

  18. Efficacy and Safety of Atomoxetine in Childhood Attention-Deficit/Hyperactivity Disorder with Comorbid Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Kaplan, S.; Heiligenstein, J.; West, S.; Busner, J.; Harder, D.; Dittmann, R.; Casat, C.; Wernicke, J. F.

    2004-01-01

    Objective: To compare the safety and efficacy of atomoxetine, a selective inhibitor of the norepinephrine transporter, versus placebo in Attention-Deficit/Hyperactivity Disorder (ADHD) patients with comorbid Oppositional Defiant Disorder (ODD). Methods: A subset analysis of 98 children from two identical, multi-site, double-blind, randomized,…

  19. Oppositional Defiant Disorder: An Overview and Strategies for Educators

    ERIC Educational Resources Information Center

    Jones, Sara H.

    2018-01-01

    Oppositional defiant disorder (ODD) is a behavioral disorder that affects approximately 3.3% of the population across cultures. In this article, the author discusses symptoms, methods of diagnosis, and treatments for the disorder. Although most empirically supported treatments of ODD are based on parent--child training and therapy, there are some…

  20. Motor Correlates of ADHD: Contribution of Reading Disability and Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Kooistra, Libbe; Crawford, Susan; Dewey, Deborah; Cantell, Marja; Kaplan, Bonnie J.

    2005-01-01

    This study investigated whether the likelihood of motor impairment in children with attention-deficit/hyperactivity disorder (ADHD) increases with the presence of other disorders, and whether the cooccurring diagnoses of reading disability (RD) and oppositional defiant disorder (ODD) account for the motor deficits seen in ADHD. A total of 291…

  1. A Comprehensive Investigation of Memory Impairment in Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Rhodes, Sinead M.; Park, Joanne; Seth, Sarah; Coghill, David R.

    2012-01-01

    Background: We conducted a comprehensive and systematic assessment of memory functioning in drug-naive boys with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Methods: Boys performed verbal and spatial working memory (WM) component (storage and central executive) and verbal and spatial storage load tasks,…

  2. Diagnostic Efficiency of Symptoms for Oppositional Defiant Disorder and Attention-Deficit Hyperactivity Disorder.

    ERIC Educational Resources Information Center

    Waldman, Irwin D.; Lilienfeld, Scott O.

    1991-01-01

    Examined diagnostic efficiency of symptoms for experimentally diagnosed oppositional defiant disorder (OD) and attention-deficit hyperactivity disorder (ADHD) in 102 elementary-age boys. Findings from teacher ratings revealed that, on average, ADHD symptoms were as useful as OD symptoms as exclusion criteria for OD, whereas OD symptoms were nearly…

  3. ADHD with Comorbid Oppositional Defiant Disorder or Conduct Disorder: Discrete or Nondistinct Disruptive Behavior Disorders?

    ERIC Educational Resources Information Center

    Connor, Daniel F.; Doerfler, Leonard A.

    2008-01-01

    Objective: In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD. Method: Consecutively referred and systematically assessed male…

  4. Deconstructing Oppositional Defiant Disorder: Clinic-Based Evidence for an Anger/Irritability Phenotype

    ERIC Educational Resources Information Center

    Drabick, Deborah A. G.; Gadow, Kenneth D.

    2012-01-01

    Objective: To examine risk factors and co-occurring symptoms associated with mother-reported versus teacher-reported anger/irritability symptoms (AIS) of oppositional defiant disorder (ODD) in a clinic-based sample of 1,160 youth aged 6 through 18 years. Method: Participants completed a background history questionnaire (mothers), school…

  5. Oppositional Defiant Disorder: A Guide for Families

    ERIC Educational Resources Information Center

    American Academy of Child & Adolescent Psychiatry (NJ1), 2009

    2009-01-01

    Oppositional defiant disorder (ODD) is one of a group of behavioral disorders called disruptive behavior disorders (DBD). These disorders are called this because children who have these disorders tend to disrupt those around them. ODD is one of the more common mental health disorders found in children and adolescents. This paper discusses the…

  6. The Use of Empirically Supported Strategies for Building a Therapeutic Relationship with an Adolescent with Oppositional-Defiant Disorder

    ERIC Educational Resources Information Center

    Karver, Marc S.; Caporino, Nicole

    2010-01-01

    Manualized evidence-based treatments, particularly behavioral and cognitive-behavioral interventions, have been found efficacious for the treatment of adolescents with oppositional-defiant disorder (ODD). However, despite research that underscores the importance of the therapeutic relationship for the success of treatment, manuals do not…

  7. Functional Outcomes of Child and Adolescent Oppositional Defiant Disorder Symptoms in Young Adult Men

    ERIC Educational Resources Information Center

    Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista

    2014-01-01

    Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…

  8. Mode Deactivation Therapy (MDT) Comprehensive Meta-Analysis

    ERIC Educational Resources Information Center

    Apsche, Jack A.; Bass, Christopher K.; DiMeo, Lucia

    2011-01-01

    MDT provides an empirically based treatment for adolescents with behavioral problems such as anger, oppositional defiant and sexual and physical aggression (Apsche & DiMeo, 2010). It offers therapists a more efficient and timely intervention that positively effects recidivism rates (Apsche, Bass & Murphy, 2004). Based on Cognitive Behavioral…

  9. Oppositional defiant- and conduct disorder-like problems: neurodevelopmental predictors and genetic background in boys and girls, in a nationwide twin study.

    PubMed

    Kerekes, Nóra; Lundström, Sebastian; Chang, Zheng; Tajnia, Armin; Jern, Patrick; Lichtenstein, Paul; Nilsson, Thomas; Anckarsäter, Henrik

    2014-01-01

    Background. Previous research has supported gender-specific aetiological factors in oppositional defiant disorder (ODD) and conduct disorder (CD). The aims of this study were to identify gender-specific associations between the behavioural problems-ODD/CD-like problems-and the neurodevelopmental disorders-attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD)-and to investigate underlying genetic effects. Methods. 17,220 twins aged 9 or 12 were screened using the Autism-Tics, AD/HD and other Comorbidities inventory. The main covariates of ODD- and CD-like problems were investigated, and the relative importance of unique versus shared hereditary and environmental effects was estimated using twin model fitting. Results. Social interaction problems (one of the ASD subdomains) was the strongest neurodevelopmental covariate of the behavioural problems in both genders, while ADHD-related hyperactivity/impulsiveness in boys and inattention in girls stood out as important covariates of CD-like problems. Genetic effects accounted for 50%-62% of the variance in behavioural problems, except in CD-like problems in girls (26%). Genetic and environmental effects linked to ADHD and ASD also influenced ODD-like problems in both genders and, to a lesser extent, CD-like problems in boys, but not in girls. Conclusions. The gender-specific patterns should be considered in the assessment and treatment, especially of CD.

  10. Examining Subtypes of Behavior Problems among 3-Year-Old Children, Part II: Investigating Differences in Parent Psychopathology, Couple Conflict, and Other Family Stressors

    ERIC Educational Resources Information Center

    Goldstein, Lauren H.; Harvey, Elizabeth A.; Friedman-Weieneth, Julie L.; Pierce, Courtney; Tellert, Alexis; Sippel, Jenna C.

    2007-01-01

    This study examined family stressors among 3-year-old children who were classified as hyperactive (HYP), hyperactive and oppositional defiant (HYP/OD), and non-problem based on mothers' reports of behavior. Children with HYP/OD were found to experience higher levels of family stressors than non-problem children on almost every family stressor…

  11. Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

    ERIC Educational Resources Information Center

    Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

    2012-01-01

    Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD…

  12. Dimensions of Oppositional Defiant Disorder in 3-Year-Old Preschoolers

    ERIC Educational Resources Information Center

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Nuria; Penelo, Eva; Domenech, Josep M.

    2012-01-01

    Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622…

  13. Impaired Neurocognitive Functions Affect Social Learning Processes in Oppositional Defiant Disorder and Conduct Disorder: Implications for Interventions

    ERIC Educational Resources Information Center

    Matthys, Walter; Vanderschuren, Louk J. M. J.; Schutter, Dennis J. L. G.; Lochman, John E.

    2012-01-01

    In this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations between behaviors and negative and positive…

  14. Symptoms of Autism and Schizophrenia Spectrum Disorders in Clinically Referred Youth with Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Drabick, Deborah A. G.

    2012-01-01

    Examined autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) symptoms in a clinically referred, non-ASD sample (N = 1160; ages 6-18) with and without oppositional defiant disorder (ODD). Mothers and teachers completed "DSM-IV"-referenced symptom checklists. Youth with ODD were subdivided into angry/irritable symptom (AIS) or…

  15. Atomoxetine Treatment in Children and Adolescents with Attention-Deficit/hyperactivity Disorder and Comorbid Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Newcorn, Jeffrey H.; Spencer, Thomas J.; Biederman, Joseph; Milton, Denai R.; Michelson, David

    2005-01-01

    Objective: To examine (1) moderating effects of oppositional defiant disorder (ODD) on attention-deficit/hyperactivity disorder (ADHD) treatment response and (2) responses of ODD symptoms to atomoxetine. Method: Children and adolescents (ages 8-18) with ADHD were treated for approximately 8 weeks with placebo or atomoxetine (fixed dosing: 0.5,…

  16. A Genetic Study of Attention Deficit Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder and Reading Disability: Aetiological Overlaps and Implications

    ERIC Educational Resources Information Center

    Martin, Neilson C.; Levy, Florence; Pieka, Jan; Hay, David A.

    2006-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) commonly co-occurs with Oppositional Defiant Disorder, Conduct Disorder and Reading Disability. Twin studies are an important approach to understanding and modelling potential causes of such comorbidity. Univariate and bivariate genetic models were fitted to maternal report data from 2040 families of…

  17. An Affective Dimension within Oppositional Defiant Disorder Symptoms among Boys: Personality and Psychopathology Outcomes into Early Adulthood

    ERIC Educational Resources Information Center

    Burke, Jeffrey D.

    2012-01-01

    Background: A dimension of negatively oriented affect within oppositional defiant disorder (ODD) symptoms, which has been described as irritability, has been shown to predict depression and anxiety. Related constructs have been linked to temperament and personality constructs. However, only a few studies have examined the prediction from…

  18. Lifetime Prevalence, Correlates, and Persistence of Oppositional Defiant Disorder: Results from the National Comorbidity Survey Replication

    ERIC Educational Resources Information Center

    Nock, Matthew K.; Kazdin, Alan E.; Hiripi, Eva; Kessler, Ronald C.

    2007-01-01

    Background: Oppositional defiant disorder (ODD) is a leading cause of referral for youth mental health services; yet, many uncertainties exist about ODD given it is rarely examined as a distinct psychiatric disorder. We examined the lifetime prevalence, onset, persistence, and correlates of ODD. Methods: Lifetime prevalence of ODD and 18 other…

  19. Efficacy of individualized social competence training for children with oppositional defiant disorders/conduct disorders: a randomized controlled trial with an active control group.

    PubMed

    Goertz-Dorten, Anja; Benesch, Christina; Berk-Pawlitzek, Emel; Faber, Martin; Hautmann, Christopher; Hellmich, Martin; Lindenschmidt, Timo; Schuh, Lioba; Stadermann, Rahel; Doepfner, Manfred

    2018-03-28

    Patient-focused cognitive-behavioral therapy in children with aggressive behavior, which uses group-based social skills training, has resulted in significant reductions in behavioral problems, with effect sizes in the small-to-medium range. However, effects of individually delivered treatments and effects on aggressive behavior and comorbid conditions rated from different perspectives, child functional impairment, child quality of life, parent-child relationship, and parental psychopathology have rarely been assessed. In a randomized controlled trial, 91 boys aged 6-12 years with a diagnosis of oppositional defiant disorder/conduct disorder and peer-related aggression were randomized to receive individually delivered social competence training (Treatment Program for Children with Aggressive Behavior, THAV) or to an active control involving group play that included techniques to activate resources and the opportunity to train prosocial interactions in groups (PLAY). Outcome measures were rated by parents, teachers, or clinicians. Mostly moderate treatment effects for THAV compared to PLAY were found in parent ratings and/or clinician ratings on aggressive behavior, comorbid symptoms, psychosocial impairment, quality of life, parental stress, and negative expressed emotions. In teacher ratings, significant effects were found for ADHD symptoms and prosocial behavior only. THAV is a specifically effective intervention for boys aged 6-12 years with oppositional defiant disorder/conduct disorder and peer-related aggressive behavior as rated by parents and clinicians.

  20. Parental Emotion Coaching and Child Emotion Regulation as Protective Factors for Children with Oppositional Defiant Disorder

    PubMed Central

    Dunsmore, Julie C.; Booker, Jordan A.; Ollendick, Thomas H.

    2012-01-01

    We assessed linkages of mothers’ emotion coaching and children’s emotion regulation and emotion lability/negativity with children’s adjustment in 72 mother-child dyads seeking treatment for Oppositional Defiant Disorder (ODD). Dyads completed questionnaires and discussed emotion-related family events. Maternal emotion coaching was associated with children’s emotion regulation, which in turn was related to higher mother-reported adaptive skills, higher child-reported internalizing symptoms, and lower child-reported adjustment. When children were high in emotion lability/negativity, mothers’ emotion coaching was associated with lower mother and child reports of externalizing behavior. Results suggest the role of emotion regulation and emotion lability in child awareness of socio-emotional problems and support the potential of maternal emotion coaching as a protective factor for children with ODD, especially for those high in emotion lability. PMID:24187441

  1. Social Information Processing of Positive and Negative Hypothetical Events in Children with ADHD and Conduct Problems and Controls

    ERIC Educational Resources Information Center

    Andrade, Brendan F.; Waschbusch, Daniel A.; Doucet, Amelie; King, Sara; MacKinnon, Maura; McGrath, Patrick J.; Stewart, Sherry H.; Corkum, Penny

    2012-01-01

    Objective: This study examined social information processing (SIP) of events with varied outcomes in children with ADHD and conduct problems (CPs; defined as oppositional defiant disorder [ODD] or conduct disorder [CD]) and controls. Method: Participants were 64 children (46 boys, 18 girls) aged 6 to 12, including 39 with ADHD and 25 controls.…

  2. Examining Subtypes of Behavior Problems among 3-Year-Old Children, Part III: Investigating Differences in Parenting Practices and Parenting Stress

    ERIC Educational Resources Information Center

    Goldstein, Lauren H.; Harvey, Elizabeth A.; Friedman-Weieneth, Julie L.

    2007-01-01

    This study examined parenting of mothers and fathers of 3-year-old children who were classified as hyperactive (HYP), hyperactive and oppositional defiant (HYP/OD), and non-problem based on mothers' reports of behavior. Parents of children with HYP/OD were less warm, showed more negative affect, and more laxness than parents of non-problem…

  3. Developmental transitions in presentations of externalizing problems among boys and girls at risk for child maltreatment.

    PubMed

    Villodas, Miguel T; Litrownik, Alan J; Thompson, Richard; Jones, Deborah; Roesch, Scott C; Hussey, Jon M; Block, Stephanie; English, Diana J; Dubowitz, Howard

    2015-02-01

    The present study examined the impact of children's maltreatment experiences on the emergence of externalizing problem presentations among children during different developmental periods. The sample included 788 youth and their caregivers who participated in a multisite, prospective study of youth at-risk for maltreatment. Externalizing problems were assessed at ages 4, 8, and 12, and symptoms and diagnoses of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed at age 14, during interviews with youth and caregivers. Information about maltreatment allegations was coded from official records. Latent transition analysis identified three groups of youth with similar presentations of externalizing problems ("well adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking") and transitions between groups from ages 4, 8, and 12. A "defiant/deceitful" group also emerged at age 12. Girls were generally more likely to present as well adjusted than boys. Children with recent physical abuse allegations had an increased risk for aggressive/rule-breaking presentations during the preschool and preadolescent years, while children with sexual abuse or neglect allegations had lower probabilities of having well-adjusted presentations during middle childhood. These findings indicate that persistently severe aggressive conduct problems, which are related to the most concerning outcomes, can be identified early, particularly among neglected and physically and sexually abused children.

  4. Therapeutic Assessment for Preadolescent Boys with Oppositional Defiant Disorder: A Replicated Single-Case Time-Series Design

    ERIC Educational Resources Information Center

    Smith, Justin D.; Handler, Leonard; Nash, Michael R.

    2010-01-01

    The Therapeutic Assessment (TA) model is a relatively new treatment approach that fuses assessment and psychotherapy. The study examines the efficacy of this model with preadolescent boys with oppositional defiant disorder and their families. A replicated single-case time-series design with daily measures is used to assess the effects of TA and to…

  5. Getting the Balance Right: The Challenge of Balancing Praise and Correction for Early School Years Children Who Exhibit Oppositional and Defiant Behaviour

    ERIC Educational Resources Information Center

    Fields, Barry

    2012-01-01

    Increasingly, early childhood practitioners are faced with children who present with significant levels of oppositional and defiant behaviour. The management of this behaviour is often difficult and stressful. Efforts to minimise disruptive behaviour and to encourage more prosocial behaviour have very much revolved around the teaching of…

  6. Risk Factors for Conduct Disorder and Oppositional/Defiant Disorder: Evidence from a New Zealand Birth Cohort

    ERIC Educational Resources Information Center

    Boden, Joseph M.; Fergusson, David M.; Horwood, L. John

    2010-01-01

    Objective: To examine the social, family background, and individual antecedents of conduct disorder (CD) and oppositional defiant disorder (ODD), the extent to which CD and ODD symptoms were predicted by common environmental risk factors, and the extent to which the antecedents of CD and ODD accounted for the comorbidity between the two disorders.…

  7. Should Sex-Specific Norms be Used to Assess Attention-Deficit/Hyperactivity Disorder or Oppositional Defiant Disorder?

    ERIC Educational Resources Information Center

    Waschbusch, Daniel A.; King, Sara

    2006-01-01

    The authors investigated whether sex-specific norms should be used to assess symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in girls. It was hypothesized that (a) there would be a group of girls who exhibit ADHD or ODD symptoms using sex-specific norms but not using Diagnostic and Statistical…

  8. Impairment in Children with and without ADHD: Contributions from Oppositional Defiant Disorder and Callous-Unemotional Traits

    ERIC Educational Resources Information Center

    Brammer, Whitney A.; Lee, Steve S.

    2012-01-01

    Objective: To ascertain the association of childhood ADHD and oppositional defiant disorder (ODD) on functional impairment and to test the moderating influence of callous-unemotional (CU) traits. Method: Ethnically diverse 6- to 9-year-old children with (n = 59) and without (n = 47) ADHD were ascertained using multiple methods (i.e., rating scales…

  9. CBCL Clinical Scales Discriminate ADHD Youth with Structured-Interview Derived Diagnosis of Oppositional Defiant Disorder (ODD)

    ERIC Educational Resources Information Center

    Biederman, Joseph; Ball, Sarah W.; Monuteaux, Michael C.; Kaiser, Roselinde; Faraone, Stephen V.

    2008-01-01

    Objective: To evaluate the association between the clinical scales of the child behavior checklist (CBCL) and the comorbid diagnosis of oppositional defiant disorder (ODD) in a large sample of youth with attention deficit hyperactivity disorder (ADHD). Method: The sample consisted of 101 girls and 106 boys ages 6 to 17 with ADHD. Conditional…

  10. Effect of Play Therapy on Behavioral Problems of Maladjusted Preschool Children

    PubMed Central

    Mohammadi, Mohammad Reza; Khanbani, Mehdi; Farid, Saeedeh; Chiti, Parisa

    2011-01-01

    Objective The present research was conducted to study the effect of play therapy on reducing behavioral problems of children with oppositional defiant disorder. Method Using multistage cluster sampling, regions 6, 7, and 8 in Tehran were selected. Among kindergartens of these areas, 3 kindergartens which were supported by the welfare organization were randomly selected. Of all the pre-school children of these 3 kindergartens, 40 children who could have behavioral disorder, according to their teachers and parents, were carefully tested. Of them, 16 children who showed severe symptoms of oppositional defiant disorder, were selected via the results obtained from the child symptom inventory questionnaire (CSI-4), teacher's form, and a researcher-made self-control checklist, Then, the subjects were randomly divided into one control and one experimental group. This research is quasi-experimental, and is conducted using pre-test, post-test, and control group. Results Values of the calculated F for oppositional defiant disorder in control group and experimental group was meaningful after fixing the effect of pre-test (P<0/001). Therefore, a meaningful difference existed between the means of post-test scores of disobedience disorder in the experimental and control groups through the fixed effect of the pre-test effect. Comparison of adjusted means of the 2 groups showed that the mean of attention-deficit hyperactivity disorder (ADHD) in experimental group was lower than control group. Therefore, applying play therapy reduced severity of ADHD in those children in experimental group compared to those in control group who did not receive such instructions. Conclusion Results of this research demonstrates that children's disobedience can be reduced by play therapy. PMID:22952519

  11. Oppositional Defiant Disorder dimensions: genetic influences and risk for later psychopathology

    PubMed Central

    Mikolajewski, Amy J.; Taylor, Jeanette; Iacono, William G.

    2016-01-01

    Background This study was undertaken to determine how well two Oppositional Defiant Disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree to which these outcomes can be attributed to genetic influences shared with ODD dimensions. Methods Psychopathology was assessed via diagnostic interviews of 1225 twin pairs at ages 11 and 17. Results Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior, and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Conclusions Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions. PMID:28059443

  12. Oppositional defiant disorder dimensions: genetic influences and risk for later psychopathology.

    PubMed

    Mikolajewski, Amy J; Taylor, Jeanette; Iacono, William G

    2017-06-01

    This study was undertaken to determine how well two oppositional defiant disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree to which these outcomes can be attributed to genetic influences shared with ODD dimensions. Psychopathology was assessed via diagnostic interviews of 1,225 twin pairs at ages 11 and 17. Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed that the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions. © 2017 Association for Child and Adolescent Mental Health.

  13. Case Study: Camptocormia, a Rare Conversion Disorder.

    ERIC Educational Resources Information Center

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

    Camptocormia is a condition characterized by severe frontal flexion of the spinal cord and knees, with passive drooping of both arms. It occurs as a form of conversion disorder. Some cases are associated with behavioral problems. A case of camptocormia of 2-year duration in a south Indian adolescent girl with oppositional defiant disorder and…

  14. ADHD Subtypes and Co-Occurring Anxiety, Depression, and Oppositional-Defiant Disorder: Differences in Gordon Diagnostic System and Wechsler Working Memory and Processing Speed Index Scores

    ERIC Educational Resources Information Center

    Mayes, Susan Dickerson; Calhoun, Susan L.; Chase, Gary A.; Mink, Danielle M.; Stagg, Ryan E.

    2009-01-01

    Objective: Wechsler Intelligence Scale for Children Freedom-from-Distractibility/Working Memory Index (FDI/WMI), Processing Speed Index (PSI), and Gordon Diagnostic System (GDS) scores in ADHD children were examined as a function of subtype and coexisting anxiety, depression, and oppositional-defiant disorder. Method: Participants were 587…

  15. Inattention, Hyperactivity, and Oppositional-Defiant Symptoms in Brazilian Adolescents: Gender Prevalence and Agreement between Teachers and Parents in a Non-English Speaking Population

    ERIC Educational Resources Information Center

    Serra-Pinheiro, Maria Antonia; Mattos, Paulo; Regalla, Maria Angelica

    2008-01-01

    Objective: To assess hyperactivity (H/I), inattention (IN), and oppositional-defiant (OP) symptoms in a nonclinical Brazilian sample of adolescents, and to investigate the association between scoring profiles of teachers and parents, symptom levels, and gender. Method: Symptoms were assessed through the Swanson, Nolan, and Pelhman (SNAP-IV)…

  16. Oppositional Defiant Disorder toward Adults and Oppositional Defiant Disorder toward Peers: Initial Evidence for Two Separate Constructs

    ERIC Educational Resources Information Center

    Taylor, Ted K.; Burns, G. Leonard; Rusby, Julie C.; Foster, E. Michael

    2006-01-01

    Confirmatory factor analysis of 25 items on the Child and Adolescent Disruptive Behavior Inventory (CADBI, Version 2.3; G. L. Burns, T. K. Taylor, & J. C. Rusby, 2001) was conducted on teacher ratings of 824 kindergarten children and replicated on 534 children. Model fit was improved when correcting for 2 method effects: (a) adjacent items and…

  17. Time course of the development of depressive mood and oppositional defiant behavior among boys with attention deficit hyperactivity disorder: differences between subtypes.

    PubMed

    Ushijima, Hirokage; Usami, Masahide; Saito, Kazuhiko; Kodaira, Masaki; Ikeda, Manabu

    2012-06-01

    The aim of this research was to clarify the development of depression among boys with attention deficit hyperactivity disorder (ADHD) by examining the correlation between depressive mood, oppositional defiant behavior, and age for each ADHD subtype. The Birleson Depression Self-Rating Scale (DSRS) was used to evaluate depressive mood while the Oppositional Defiant Behavior Inventory (ODBI) was used to evaluate oppositional defiant behavior. The 90 subjects were divided into three groups: 22 boys (mean age, 12.4 ± 1.9 years) were placed in the ADHD predominantly inattentive type (ADHD-I) group; 45 boys (mean age, 10.4 ± 2.0 years) were placed in the ADHD combined type (ADHD-C) group; and 23 boys (mean age, 12.7 ± 2.4 years) were placed in the depressive disorder (DD) group. The DD group was included to highlight characteristics of depressive mood among boys with ADHD. The DSRS score was significantly higher in the DD group compared to the ADHD-I and ADHD-C groups. The ODBI score was significantly higher in the ADHD-C group compared to the ADHD-I (P = 0.043) and DD (P = 0.013) groups. In the DD group, ODBI was seen to decrease with increasing age. A certain degree of oppositional defiant behavior was seen in each ADHD subtype. The DSRS score correlated with the ODBI score in the ADHD-C group, while the DSRS score correlated with age in the ADHD-I group. The characteristics of developing depressive mood in childhood ADHD appeared to differ between subtypes and also differed from depression without ADHD. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  18. Symptoms of Conduct Disorder, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, and Callous-Unemotional Traits as Unique Predictors of Psychosocial Maladjustment in Boys: Advancing an Evidence Base for DSM-V

    ERIC Educational Resources Information Center

    Pardini, Dustin A.; Fite, Paula J.

    2010-01-01

    Objective: The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys. Method: Several outcomes were assessed…

  19. Invariance and Convergent and Discriminant Validity between Mothers' and Fathers' Ratings of Oppositional Defiant Disorder toward Adults, ADHD-HI, ADHD-IN, and Academic Competence Factors within Brazilian, Thai, and American Children

    ERIC Educational Resources Information Center

    Burns, G. Leonard; de Moura, Marcela Alves; Walsh, James A.; Desmul, Chris; Silpakit, Chatchawan; Sommers-Flanagan, John

    2008-01-01

    Confirmatory factor analysis was used to test the invariance of an oppositional defiant disorder toward adults, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, attention-deficit/hyperactivity disorder-inattention, and an Academic Competence factor model between mothers' and fathers' ratings within Brazilian (n = 894), Thai (n =…

  20. Mothers' Attributions for Behavior in Nonproblem Boys, Boys with Attention Deficit Hyperactivity Disorder, and Boys with Attention Deficit Hyperactivity Disorder and Oppositional Defiant Behavior

    ERIC Educational Resources Information Center

    Johnston, Charlotte; Chen, Mandy; Ohan, Jeneva

    2006-01-01

    This study compared attributions for child behavior among mothers of 38 nonproblem boys, 26 boys with attention deficit hyperactivity disorder (ADHD), and 25 boys with ADHD and oppositional defiant (OD) behavior. Boys ranged from 7 to 10 years of age. To capture different aspects of mothers' attributions, 2 assessment methods were employed: (a)…

  1. Onset and Progression of Disruptive Behavior Problems among Community Boys and Girls: A Prospective Longitudinal Analysis

    ERIC Educational Resources Information Center

    Farris, Jaelyn R.; Nicholson, Jody S.; Borkowski, John G.; Whitman, Thomas L.

    2011-01-01

    Attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder are the most common forms of psychopathology seen among community youth. This study investigated prospective symptomatology of these disruptive behavior disorders from ages 5 though 14 in an at-risk community-based sample of 170 boys and girls born to…

  2. Cognitive Functioning and Family Risk Factors in Relation to Symptom Behaviors of ADHD and ODD in Adolescents

    ERIC Educational Resources Information Center

    Forssman, Linda; Eninger, Lilianne; Tillman, Carin M.; Rodriguez, Alina; Bohlin, Gunilla

    2012-01-01

    Objective: In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and…

  3. Multi-domain predictors of Oppositional Defiant Disorder symptoms in preschool children: Cross-informant differences

    PubMed Central

    Lavigne, John V.; Dahl, Katharine P.; Gouze, Karen R.; LeBailly, Susan A.; Hopkins, Joyce

    2014-01-01

    Existing research suggests that parent and teacher reports of children's behavior problems are often discrepant. The current study examined whether contextual (stress and family conflict), parent (depression), parenting (hostility, support, and scaffolding), and child factors (receptive vocabulary; negative affect, NA; effortful control, EC; inhibitory control, IC; attachment; and sensory regulation, SR) are related to parent-teacher reporting discrepancies. Participants included a community sample of 344 4-year-old children. A multi-informant approach was used to assess contextual, parent, parenting, and child factors. Parents and teachers completed the Oppositional Defiant Disorder (ODD) scale of the Child Symptom Inventory. Consistent with previous data, there was poor agreement between parents and teachers (r =.17). After correcting for multiple comparisons, child effortful control, parent hostility, and family conflict were significant predictors of parent-rated symptoms of ODD symptoms but not teacher-rated ODD symptoms. Only family conflict was a significant predictor of discrepancies in parent and teacher ratings. PMID:24997089

  4. Treating Children With Early-Onset Conduct Problems: Intervention Outcomes for Parent, Child, and Teacher Training

    ERIC Educational Resources Information Center

    Webster-Stratton, Carolyn; Reid, M. Jamila; Hammond, Mary

    2004-01-01

    Families of 159, 4- to 8-year-old children with oppositional defiant disorder (ODD) were randomly assigned to parent training (PT); parent plus teacher training (PT + TT); child training (CT); child plus teacher training (CT + TT); parent, child, plus teacher training (PT + CT + TT); or a waiting list control. Reports and independent observations…

  5. Significance of Childhood Conduct Problems to Later Development of Conduct Disorder among Children with ADHD: A Prospective Follow-Up Study

    ERIC Educational Resources Information Center

    Mannuzza, Salvatore; Klein, Rachel G.; Abikoff, Howard; Moulton, John L., III

    2004-01-01

    This study investigates whether low to moderate levels of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) behaviors contribute to the development of clinically diagnosed CD in adolescence, in children with attention deficit hyperactivity disorder (ADHD). Participants were 207 White boys (ages 6-12) with ADHD free of conduct…

  6. Should there be separate parent and teacher-based categories of ODD? Evidence from a general population.

    PubMed

    Munkvold, Linda; Lundervold, Astri; Lie, Stein Atle; Manger, Terje

    2009-10-01

    To examine the occurrence of oppositional defiant disorder (ODD) symptoms in a general population of boys and girls, as reported by parents and teachers, and to investigate differences in prevalence estimates, depending on how parents' and teachers' ratings were combined. Data were collected from 7007 children (aged 7-9) who participated in The Bergen Child Study (BCS), an ongoing population-based study of children's development and mental health. ODD symptoms were measured by the SNAP-IV (Swanson, Nolan, & Pelham-IV) Oppositional Defiant Disorder sub-scale (SNAP-IV ODD) that was distributed to parents and teachers. Co-occurring symptoms of mental health problems were measured by the Strengths and Difficulties Questionnaire (SDQ). Prevalence-estimates of ODD varied considerably depending on how ratings from parents and teachers were combined. Specific ODD symptoms occurred at very different rates depending on the rater and on the gender of the child being rated. Parents and teachers co-identified very few children with ODD. ODD identified by only one informant was associated with high levels of comorbid mental health problems and impairment according to both informants. The results support an informant-specific conceptualization of childhood ODD.

  7. Variability in emotional/behavioral problems in boys with oppositional defiant disorder or conduct disorder: the role of arousal.

    PubMed

    Schoorl, Jantiene; Van Rijn, Sophie; De Wied, Minet; Van Goozen, Stephanie H M; Swaab, Hanna

    2016-08-01

    It is often reported that children with oppositional defiant disorder (ODD) or conduct disorder (CD) are under-aroused. However, the evidence is mixed, with some children with ODD/CD displaying high arousal. This has led to the hypothesis that different profiles of arousal dysfunction may exist within children with ODD/CD. This knowledge could explain variability within children with ODD/CD, both in terms of specific types of aggression as well as comorbid symptoms (e.g., other emotional/behavioral problems). We measured heart rate variability (HRV), heart rate (HR) and skin conductance level (SCL) during rest and stress, and obtained parent and teacher reports of aggression, anxiety, attention problems and autism traits in a sample of 66 ODD/CD and 36 non-clinical boys (aged 8-12 years). The ODD/CD group scored significantly higher on aggression, anxiety, attention problems and autism traits than the controls; boys with ODD/CD also had higher resting HRs than controls, but HR stress, HRV and SCL did not differ. Hierarchical regressions showed different physiological profiles in subgroups of boys with ODD/CD based on their type of aggression; a pattern of high baseline HR and SCL, but low stress HRV was related to reactive aggression, whereas the opposite physiological pattern (low HR, low stress SCL, high stress HRV) was related to proactive aggression. Furthermore, high stress SCL was related to anxiety symptoms, whereas low stress SCL was related to attention problems. These findings are important because they indicate heterogeneity within boys with ODD/CD and highlight the importance of using physiology to differentiate boys with different ODD/CD subtypes.

  8. Functional outcomes of child and adolescent oppositional defiant disorder symptoms in young adult men.

    PubMed

    Burke, Jeffrey D; Rowe, Richard; Boylan, Khrista

    2014-03-01

    Oppositional defiant disorder(ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within families, poor peer relationships, peer rejection, and academic difficulties. Little examination of functional outcomes in adulthood associated with ODD has been undertaken. Data for the present analyses come from a clinic referred sample of 177 boys aged 7-12 followed up annually to age 18 and again at age 24. Annual parental report of psychopathology through adolescence was used to predict self-reported functional outcomes at 24. Controlling for parent reported symptoms of attention deficit hyperactivity disorder (ADHD), Conduct disorder (CD), depression and anxiety, ODD symptoms from childhood through adolescence predicted poorer age 24 functioning with peers, poorer romantic relationships, a poorer paternal relationship, and having nobody who would provide a recommendation for a job. CD symptoms predicted workplace problems, poor maternal relationship, lower academic attainment, and violent injuries. Only parent reported ODD symptoms and child reported CD symptoms predicted a composite of poor adult outcomes. Oppositional defiant disorder is a disorder that significantly interferes with functioning, particularly in social or interpersonal relationships. The persistence of impairment associated with ODD into young adulthood calls for a reconsideration of ODD as a disorder limited to childhood. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  9. Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis.

    PubMed

    Murray, Joseph; Anselmi, Luciana; Gallo, Erika Alejandra Giraldo; Fleitlich-Bilyk, Bacy; Bordin, Isabel A

    2013-10-01

    This study aimed to review evidence on the prevalence of and risk factors for conduct problems in Brazil. We searched electronic databases and contacted Brazilian researchers up to 05/2012. Studies were included in the review if they reported the prevalence of or risk factors for conduct problems, conduct disorder, or oppositional defiant disorder for 100 + Brazilian children aged ≤18 years, systematically sampled in schools or the community. Prevalence rates and sex differences were meta-analysed. Risk factor studies were reviewed one by one. The average prevalence of conduct problems in screening questionnaires was 20.8%, and the average prevalence of conduct disorder/oppositional defiant disorder was 4.1%. There was systematic variation in the results of screening studies according to methodology: recruitment location, informants, instruments, impairment criterion for case definition, and response rates. Risk factors previously identified in high-income countries were mainly replicated in Brazil, including comorbid mental health problems, educational failure, low religiosity, harsh physical punishment and abuse, parental mental health problems, single parent family, and low socioeconomic status. However, boys did not always have higher risk for conduct problems than girls. Studies using screening questionnaires suggest that Brazilian children have higher rates of conduct problems than children in other countries, but diagnostic studies do not show this difference. Risk factors in Brazil were similar to those in high-income countries, apart from child sex. Future research should investigate developmental patterns of antisocial behaviour, employ a variety of research designs to identify causal risk mechanisms, and examine a broader range of risk factors.

  10. Therapeutic assessment for preadolescent boys with oppositional defiant disorder: a replicated single-case time-series design.

    PubMed

    Smith, Justin D; Handler, Leonard; Nash, Michael R

    2010-09-01

    The Therapeutic Assessment (TA) model is a relatively new treatment approach that fuses assessment and psychotherapy. The study examines the efficacy of this model with preadolescent boys with oppositional defiant disorder and their families. A replicated single-case time-series design with daily measures is used to assess the effects of TA and to track the process of change as it unfolds. All 3 families benefitted from participation in TA across multiple domains of functioning, but the way in which change unfolded was unique for each family. These findings are substantiated by the Behavior Assessment System for Children (Reynolds & Kamphaus, 2004). The TA model is shown to be an effective treatment for preadolescent boys with oppositional defiant disorder and their families. Further, the time-series design of this study illustrated how this empirically grounded case-based methodology reveals when and how change unfolds during treatment in a way that is usually not possible with other research designs.

  11. The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 2: Antipsychotics and Traditional Mood Stabilizers

    PubMed Central

    Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

    2015-01-01

    Objective: Attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are among the most common psychiatric diagnoses in childhood. Aggression and conduct problems are a major source of disability and a risk factor for poor long-term outcomes. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) of antipsychotics, lithium, and anticonvulsants for aggression and conduct problems in youth with ADHD, ODD, and CD. Each medication was given an overall quality of evidence rating based on the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Eleven RCTs of antipsychotics and 7 RCTs of lithium and anticonvulsants were included. There is moderate-quality evidence that risperidone has a moderate-to-large effect on conduct problems and aggression in youth with subaverage IQ and ODD, CD, or disruptive behaviour disorder not otherwise specified, with and without ADHD, and high-quality evidence that risperidone has a moderate effect on disruptive and aggressive behaviour in youth with average IQ and ODD or CD, with and without ADHD. Evidence supporting the use of haloperidol, thioridazine, quetiapine, and lithium in aggressive youth with CD is of low or very-low quality, and evidence supporting the use of divalproex in aggressive youth with ODD or CD is of low quality. There is very-low-quality evidence that carbamazepine is no different from placebo for the management of aggression in youth with CD. Conclusion: With the exception of risperidone, the evidence to support the use of antipsychotics and mood stabilizers is of low quality. PMID:25886656

  12. Perceived Parent-Child Relations, Conduct Problems, and Clinical Improvement Following the Treatment of Oppositional Defiant Disorder.

    PubMed

    Booker, Jordan A; Ollendick, Thomas H; Dunsmore, Julie C; Greene, Ross W

    2016-05-01

    Our objective in this study was to examine the moderating influence of parent-child relationship quality (as viewed by the child) on associations between conduct problems and treatment responses for children with oppositional defiant disorder (ODD). To date, few studies have considered children's perceptions of relationship quality with parents in clinical contexts even though extant studies show the importance of this factor in children's behavioral adjustment in non-clinical settings. In this study, 123 children (ages 7 - 14 years, 61.8% male, 83.7% white) who fulfilled DSM-IV criteria for ODD received one of two psychosocial treatments: Parent Management Training or Collaborative & Proactive Solutions. In an earlier study, both treatments were found to be effective and equivalent in treatment outcomes (Ollendick et al., in press). In the current study, pre-treatment maternal reports of conduct problems and pre-treatment child reports of relations with parents were used to predict outcomes in ODD symptoms and their severity following treatment. Elevated reports of children's conduct problems were associated with attenuated reductions in both ODD symptoms and their severity. Perceived relationship quality with parents moderated the ties between conduct problems and outcomes in ODD severity but not the number of symptoms. Mother reports of elevated conduct problems predicted attenuated treatment response only when children viewed relationship quality with their parents as poorer. When children viewed the relationship as higher quality, they did not show an attenuated treatment response, regardless of reported conduct problems. The current findings underscore the importance of children's perspectives in treatment response and reductions in externalizing child behaviors.

  13. The influence of comorbid oppositional defiant disorder on white matter microstructure in attention-deficit/hyperactivity disorder.

    PubMed

    van Ewijk, Hanneke; Noordermeer, Siri D S; Heslenfeld, Dirk J; Luman, Marjolein; Hartman, Catharina A; Hoekstra, Pieter J; Faraone, Stephen V; Franke, Barbara; Buitelaar, Jan K; Oosterlaan, J

    2016-07-01

    Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are highly comorbid disorders. ADHD has been associated with altered white matter (WM) microstructure, though the literature is inconsistent, which may be due to differences in the in- or exclusion of participants with comorbid ODD. WM abnormalities in ODD are still poorly understood, and it is unclear whether comorbid ODD in ADHD may have confounded the current ADHD literature. Diffusion Tensor Imaging (DTI) was used to compare fractional anisotropy (FA) and mean diffusivity (MD) between ADHD patients with (n = 42) and without (n = 117) comorbid ODD. All participants were between 8-25 years and groups did not differ in mean age or gender. Follow-up analyses were conducted to examine the role of antisocial behaviour (conduct problems) on FA and MD values in both groups. Comorbid ODD in ADHD was associated with lower FA in left frontotemporal WM, which appeared independent of ADHD symptoms. FA was negatively associated with antisocial behaviour in ADHD + ODD, but not in ADHD-only. Comorbid ODD is associated with WM abnormalities in individuals with ADHD, which appears to be independent of ADHD symptoms. Altered WM microstructure in comorbid ODD may play a role in inconsistencies in the current DTI literature in ADHD. Altered development of these tracts may contribute to social-emotional and cognitive problems in children with oppositional and antisocial behaviour.

  14. Does oppositional defiant disorder have temperament and psychopathological profiles independent of attention deficit/hyperactivity disorder?

    PubMed

    Kim, Hyo-Won; Cho, Soo-Churl; Kim, Boong-Nyun; Kim, Jae-Won; Shin, Min-Sup; Yeo, Jin-Young

    2010-01-01

    Most studies on temperamental and behavioral/emotional characteristics of oppositional defiant disorder (ODD) did not rule out the effect of comorbid attention-deficit/hyperactivity disorder (ADHD). The main objective of this study was to identify the temperamental and psychopathological patterns of ODD independent of comorbid ADHD. We also aimed to compare the patterns of temperament and psychopathology between ODD with and without ADHD. Parents of 2673 students, randomly selected from 19 representative schools in Seoul, Korea, completed the Diagnostic Interview Schedule for Children Version IV. Among 118 children and adolescents with ODD diagnosed by the Diagnostic Interview Schedule for Children Version IV, the parents of 94 subjects (mean age, 10.4 +/- 3.0 years) and the parents of a random sample of 94 age- and gender-matched non-ODD/non-ADHD children and adolescents completed the parent's version of the Child Behavior Checklist (CBCL) and the Junior Temperament and Character Inventory. Subjects with ODD showed temperament and character profiles of high Novelty Seeking, low Self-directedness, and low Cooperativeness, a distinct pattern on the CBCL, and were at increased risk for anxiety and mood disorders compared to the controls after controlling for the effect of comorbid ADHD. The children and adolescents with both ODD and ADHD showed decreased levels of Persistence and Self-directedness and higher scores on 4 subscales of the CBCL (Anxious/Depressed, Attention Problems, Delinquent Behaviors, and Aggressive Behaviors) compared to those with ODD only. Oppositional defiant disorder is associated with specific temperamental and behavioral/emotional characteristics, independent of ADHD. Moreover, the results of this study support that co-occurring ADHD and ODD have differentially higher levels of behavioral and emotional difficulties. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Malaysian parent and teacher ratings of the oppositional defiant disorder symptoms: measurement invariance and parent-teacher agreement.

    PubMed

    Gomez, Rapson

    2014-10-01

    This study evaluated the measurement invariance and agreement across parent and teacher ratings of the DSM-IV-TR oppositional defiant disorder (ODD) symptoms. Malaysian parents and teachers of 934 children (between 6 and 11 years of age) completed rating scales comprising the ODD symptoms. Findings showed support for full measurement invariance (configural, metric and thresholds). Additional results indicated low parent-teacher agreement for all symptoms. The theoretical and clinical and implications of these findings are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Dimensions of Oppositionality in a Brazilian Community Sample: Testing the "DSM-5" Proposal and Etiological Links

    ERIC Educational Resources Information Center

    Krieger, Fernanda Valle.; Polanczyk, Guilherme Vanoni; Goodman, Robert; Rohde, Luis Augusto; Graeff-Martins, Ana Soledade; Salum, Giovanni; Gadelha, Ary; Pan, Pedro; Stahl, Daniel; Stringaris, Argyris

    2013-01-01

    Objective: Investigating dimensions of oppositional symptoms may help to explain heterogeneity of etiology and outcomes for mental disorders across development and provide further empirical justification for the "DSM-5"-proposed modifications of oppositional defiant disorder (ODD). However, dimensions of oppositionality have not…

  17. Is emotional dysregulation a risk indicator for auto-aggression behaviors in adolescents with oppositional defiant disorder?

    PubMed

    Muratori, Pietro; Pisano, Simone; Milone, Annarita; Masi, Gabriele

    2017-01-15

    The Child Behavior Checklist Dysregulation Profile (CBCL-DP), (high scores in Anxious/Depressed, Attention Problems, and Aggressive Behavior subscales), has been related to poor emotional and behavioral self-regulation in children and adolescents. Our aim is to evaluate if it may be associated with auto-aggression in youth with oppositional defiant disorder (ODD). Method In 72 consecutively referred youths with ODD, emotional dysregulation was assessed with the CBCL-DP, auto-aggression and physical aggression against other persons with the Modified Overt Aggression Scale. Regression analysis showed that greater higher CBCL-DP scores were associated to higher levels of auto-aggression, even when controlling for the levels of physical aggression against others and CBCL Total score. The small sample size, the cross-sectional design, and the lack of a control group limit the generalization of our findings. Referred ODD youths with higher scores of CBCL-DP are more likely to present auto-aggression, besides aggression against others. The CBCL could improve the screening and detection of these high-risk patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Multiple Levels of Family Factors and Oppositional Defiant Disorder Symptoms Among Chinese Children.

    PubMed

    Lin, Xiuyun; Li, Longfeng; Heath, Melissa A; Chi, Peilian; Xu, Shousen; Fang, Xiaoyi

    2018-03-01

    Family factors are closely associated with child developmental outcomes. This study examined the relationship of oppositional defiant disorder (ODD) symptoms and factors at whole family, dyadic, and individual levels in Chinese children. Participants, who were recruited from 14 primary schools in north, east, and south-west China, included 80 father-child dyads and 169 mother-child dyads. Children in the participating dyads were previously diagnosed with ODD. Results revealed that family cohesion/adaptability was indirectly associated with ODD symptoms via parent-child relationship and child emotion regulation. Parent-child relationship affected ODD symptoms directly and indirectly through child emotion regulation. In addition, the effects of family cohesion/adaptability on parent emotion regulation and child emotion regulation were mediated by the parent-child relationship. The tested model provides a comprehensive framework of how family factors at multiple levels are related to child ODD symptoms and highlights the importance of understanding child emotional and behavioral problems within the family context, more specifically within the multiple levels of family relationships. © 2016 Family Process Institute.

  19. Understanding the Defiant Child. [Videotape and Program Manual].

    ERIC Educational Resources Information Center

    Barkley, Russell A.

    This videotape recording and accompanying program manual are intended to provide a review of current knowledge about defiance in children, a behavior pattern that research suggests may be increasing in prevalence and that is a known precursor to serious disorders such as oppositional defiant disorder (ODD) and conduct disorder. The manual provides…

  20. Oppositional Defiant Disorder (ODD)

    MedlinePlus

    ... child with ODD. Doctors, mental health professionals and child development experts can help. Behavioral treatment of ODD involves ... exhibit oppositional behavior at certain stages of a child's development. Signs of ODD generally begin during preschool years. ...

  1. Irritable and Defiant Sub-Dimensions of ODD: Their Stability and Prediction of Internalizing Symptoms and Conduct Problems from Adolescence to Young Adulthood

    PubMed Central

    Homel, Jacqueline

    2016-01-01

    Emerging research has identified sub-dimensions of oppositional defiant disorder – irritability and defiance -that differentially predict internalizing and externalizing symptoms in preschoolers, children, and adolescents. Using a theoretical approach and confirmatory factor analyses to distinguish between irritability and defiance, we investigate the associations among these dimensions and internalizing (anxiety and depression) and externalizing problems (conduct problems) within and across time in a community-based sample of 662 youth (342 females) spanning ages 12 to 18 years old at baseline. On average, irritability was stable across assessment points and defiance declined. Within time, associations of irritability with internalizing were consistently stronger than associations of irritability with conduct problems. Defiance was similarly associated within time with both internalizing and conduct problems in mid-adolescence, but was more highly related to internalizing than to conduct problems by early adulthood (ages 18 to 25). Over time, increasing irritability was related to changes in both internalizing and conduct problems; whereas increases in defiance predicted increases in conduct problems more strongly than internalizing symptoms. Increases in both internalizing and conduct problems were also associated with subsequent increases in both irritability and defiance. Sex differences in these associations were not significant. PMID:25028284

  2. Irritable and defiant sub-dimensions of ODD: their stability and prediction of internalizing symptoms and conduct problems from adolescence to young adulthood.

    PubMed

    Leadbeater, Bonnie J; Homel, Jacqueline

    2015-04-01

    Emerging research has identified sub-dimensions of oppositional defiant disorder - irritability and defiance - that differentially predict internalizing and externalizing symptoms in preschoolers, children, and adolescents. Using a theoretical approach and confirmatory factor analyses to distinguish between irritability and defiance, we investigate the associations among these dimensions and internalizing (anxiety and depression) and externalizing problems (conduct problems) within and across time in a community-based sample of 662 youth (342 females) spanning ages 12 to 18 years old at baseline. On average, irritability was stable across assessment points and defiance declined. Within time, associations of irritability with internalizing were consistently stronger than associations of irritability with conduct problems. Defiance was similarly associated within time with both internalizing and conduct problems in mid-adolescence, but was more highly related to internalizing than to conduct problems by early adulthood (ages 18 to 25). Over time, increasing irritability was related to changes in both internalizing and conduct problems; whereas increases in defiance predicted increases in conduct problems more strongly than internalizing symptoms. Increases in both internalizing and conduct problems were also associated with subsequent increases in both irritability and defiance. Sex differences in these associations were not significant.

  3. Managing the Defiant Child: A Guide to Parent Training. [Videotape and Program Manual].

    ERIC Educational Resources Information Center

    Barkley, Russell A.

    This videotape and accompanying manual are intended to provide a review of current knowledge about the management of defiance in children, a common behavior pattern which may be increasing in prevalence and is a known precursor to such serious disorders as oppositional defiant disorder (ODD) and conduct disorder. The first section of the manual…

  4. The Longitudinal Association between Oppositional and Depressive Symptoms across Childhood

    ERIC Educational Resources Information Center

    Boylan, Khrista; Georgiades, Katholiki; Szatmari, Peter

    2010-01-01

    Objective: Symptoms of oppositional defiant disorder (ODD) and depression show high rates of co-occurrence, both cross-sectionally and longitudinally. This study examines the extent to which variation in oppositional symptoms predict, variation in depressive symptoms over time, accounting for co-occurring depressive symptoms and measurement error.…

  5. [Family violence and aggressive and oppositional behavior in childhood: a literature review].

    PubMed

    Pesce, Renata

    2009-01-01

    This article presents a review of the world literature about two important subjects: family violence and problems of aggressive behavior and oppositional defiant disorder in childhood. We opted for publications that had used the CBCL- Child Behavior Checklist for investigating behavior problems in children. This instrument is internationally recognized for its reliability and validity, considered an efficient tool for identifying behavior problems in children. Our findings showed that marital violence predominated in the studies as kind of familiar violence able to cause problems of aggressiveness and transgression in children. Another point discussed was the lack of consensus on the terms used in the articles to refer to such behavior problems. The review showed the need for in-depth studies into this subject, mainly in the sense of thinking about prevention and health promotion in childhood and adolescence. Aggressive behavior in children tends to remain and increase over time, a fact that points to the need for strategies for preventing these problems in the school, familiar and health environments.

  6. Defiant Children: A Clinician's Manual for Assessment and Parent Training. Second Edition.

    ERIC Educational Resources Information Center

    Barkley, Russell A.

    Ways in which adults can work with noncompliant, defiant, or oppositional children are presented in this manual. The program presented here was designed to help children having at least a two-year level of language or general cognitive developmental level and who fall between the ages of 2 and 12 years. The methods are meant for use by experienced…

  7. Oppositional Defiant Disorder: prevalence based on parent and teacher ratings of Malaysian primary school children.

    PubMed

    Gomez, Rapson; Hafetz, Nina; Gomez, Rashika Miranjani

    2013-08-01

    This study examined the prevalence rate of Oppositional Defiant Disorder (ODD) in Malaysian primary school children. In all 934 Malaysian parents and teachers completed ratings of their children using a scale comprising DSM-IV-TR ODD symptoms. Results showed rates of 3.10%, 3.85%, 7.49% and 0.64% for parent, teacher, parent or teacher ("or-rule"), and parent and teacher ("and-rule") ratings, respectively. When the functional impairment criterion was not considered, the rate reported by parents was higher at 13.28%. The theoretical, diagnostic and cultural implications of the findings are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Longitudinal synergies between cortisol reactivity and diurnal testosterone and antisocial behavior in young adolescents.

    PubMed

    Susman, Elizabeth J; Peckins, Melissa K; Bowes, Jacey L; Dorn, Lorah D

    2017-10-01

    The aims were to identify the correspondence between simultaneous, longitudinal changes in cortisol reactivity and diurnal testosterone and to test the hypothesis that cortisol reactivity and diurnal testosterone interact so as to influence antisocial behavior. Participants were 135 children and young adolescents assessed at 6-month intervals over 1 year. Upon enrollment girls were age 8, 10, or 12 years (N = 69, M = 10.06 years) and boys were age 9, 11, or 13 years (N = 66, M = 10.94 years). Assessments included Tanner staging by a nurse, cortisol reactivity (Trier Social Stress Test for Children), diurnal testosterone, and interviews and questionnaires. Growth models showed that cortisol reactivity and diurnal testosterone basal levels (intercept) and rate of change (slopes) were not related, suggesting different mechanisms of growth. Longitudinal regression analyses assessed cortisol reactivity and diurnal testosterone longitudinally. The interactions of cortisol reactivity and diurnal testosterone showed that when diurnal testosterone was low, boys with low cortisol reactivity were reported to have more behavior problems (i.e., oppositional defiant disorder symptoms and attention problems) than when testosterone was high. In addition, when diurnal testosterone was high, boys with high or moderate cortisol reactivity were significantly higher on total antisocial behavior, attention behavior problems, and oppositional defiant disorder symptoms than when testosterone was low or moderate. The results were similar but less frequent for girls. These findings advance the science of young adolescence by showing the interaction between preexisting sensitivity to stressors and the normative testosterone changes of puberty and antisocial behavior.

  9. Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India.

    PubMed

    Jacob, P; Srinath, S; Girimaji, S; Seshadri, S; Sagar, J V

    2016-12-01

    To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

  10. Mother-Son Interactions in Families of Boys with Attention-Deficit/hyperactivity Disorder with and without Oppositional Behavior.

    ERIC Educational Resources Information Center

    Seipp, Carla M.; Johnston, Charlotte

    2005-01-01

    Parenting responsiveness and over-reactivity were assessed among 25 mothers of 7-9-year-old sons with Attention-Deficit/Hyperactivity Disorder (ADHD) and oppositional behavior (Oppositional Defiant, OD), 24 mothers of sons with ADHD only, and 38 mothers of nonproblem sons. Responsiveness was observed during mother-son play and clean-up…

  11. Classroom-based functional and adjunctive assessments: proactive approaches to intervention selection for adolescents with attention deficit hyperactivity disorder.

    PubMed Central

    Ervin, R A; DuPaul, G J; Kern, L; Friman, P C

    1998-01-01

    The present investigation evaluated the utility of classroom-based functional and adjunctive assessments of problem behaviors for 2 adolescents who met diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD). For children with ADHD-ODD, environmental classroom variables, when systematically manipulated by teachers, were related to the occurrence and nonoccurrence of problem behaviors. Classroom interventions derived from information that was obtained during functional and adjunctive assessments and from subsequent analyses resulted in substantial reductions in problem behaviors. Teacher and student consumer satisfaction ratings indicated that the interventions were effective and feasible in the classroom setting. PMID:9532751

  12. Oppositional Defiance, Moral Reasoning and Moral Value Evaluation as Predictors of Self-Reported Juvenile Delinquency

    ERIC Educational Resources Information Center

    Beerthuizen, Marinus G. C. J.; Brugman, Daniel; Basinger, Karen S.

    2013-01-01

    This study investigated the relationships among oppositional defiant attitudes, moral reasoning, moral value evaluation and self-reported delinquent behaviour in adolescents ("N" = 351, "M"[subscript AGE] = 13.8 years, "SD"[subscript AGE] = 1.1). Of particular interest were the moderating effects of age, educational…

  13. Methylphenidate Transdermal System in Adult ADHD and Impact on Emotional and Oppositional Symptoms

    ERIC Educational Resources Information Center

    Marchant, Barrie K.; Reimherr, Frederick W.; Robison, Reid J.; Olsen, John L.; Kondo, Douglas G.

    2011-01-01

    Objective: This trial evaluated the effect of methylphenidate transdermal system (MTS) on the full spectrum of adult symptoms (attention-disorganization, hyperactivity-impulsivity, emotional dysregulation [ED], and oppositional-defiant disorder [ODD]) found in this disorder. Method: This placebo-controlled, double-blind, flexible-dose, crossover…

  14. Family Correlates of Oppositional and Conduct Disorders in Children with Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Pfiffner, Linda J.; McBurnett, Keith; Rathouz, Paul J.; Judice, Samuel

    2005-01-01

    Comorbidities among children with ADHD are key determinants of treatment response, course, and outcome. This study sought to separate family factors (parental psychopathology and parenting practices) associated with comorbid Oppositional Defiant Disorder (ODD) from those associated with Conduct Disorder (CD) among children with Attention…

  15. Emotional Regulation and Executive Function Deficits in Unmedicated Chinese Children with Oppositional Defiant Disorder.

    PubMed

    Jiang, Wenqing; Li, Yan; Du, Yasong; Fan, Juan

    2016-05-01

    This study aims to explore the feature of emotional regulation and executive functions in oppositional defiant disorder (ODD) children. The emotional regulation and executive functions of adolescents with ODD, as well as the relationship between the two factors were analyzed using tools including Adolescent Daily Emotional Regulation Questionnaire (ADERQ), Wisconsin Card Sorting Test (WCST) and Cambridge Neuropsychological Test Automated Battery (CANTAB), in comparison with attention deficit hyperactivity disorder (ADHD) children without behavioral problem and healthy children; the ADERQ assessed emotional regulation ability and others were used to assess executive function. Compared to normal children, the ODD group displayed significant differences in the scores of cognitive reappraisal, rumination, expressive suppression, and revealing of negative emotions, as well as in the score of cognitive reappraisal of positive emotions. WCST perseverative errors were well correlated with rumination of negative emotions (r=0.47). Logistic regression revealed that the minimum number of moves in the Stocking of Cambridge (SOC) test (one test in CANTAB) and negative emotion revealing, were strongly associated with ODD diagnosis. Children with ODD showed emotion dysregulation, with negative emotion dysregulation as the main feature. Emotion dysregulation and the lack of ability to plan lead to executive function deficits. The executive function deficits may guide us to understand the deep mechanism under ODD.

  16. Negative parenting behavior and childhood oppositional defiant disorder: differential moderation by positive and negative peer regard.

    PubMed

    Tung, Irene; Lee, Steve S

    2014-01-01

    Although negative parenting behavior and peer status are independently associated with childhood conduct problems (e.g., oppositional defiant disorder (ODD)), relatively little is known about their interplay, particularly in relation to differentiated measures of positive and negative peer regard. To improve the specificity of the association of negative parenting behavior and peer factors with ODD, we explored the potential interaction of parenting and peer status in a sample of 169 five-to ten-year-old ethnically diverse children with and without attention-deficit/hyperactivity disorder (ADHD) assessed using multiple measures (i.e., rating scales, interview) and informants (i.e., parents, teachers). Controlling for children's age, sex, number of ADHD symptoms, and parents' race-ethnicity, peer acceptance inversely predicted and inconsistent discipline, harsh punishment, and peer rejection were each positively associated with ODD symptom severity. Interactive influences were also evident such that inconsistent discipline and harsh punishment each predicted elevated ODD but only among children experiencing low peer acceptance or high peer rejection. These findings suggest that supportive environments, including peer acceptance, may protect children from negative outcomes associated with inconsistent discipline and harsh punishment. Findings are integrated with theories of social support, and we additionally consider implications for intervention and prevention. © 2013 Wiley Periodicals, Inc.

  17. Gene-set and multivariate genome-wide association analysis of oppositional defiant behavior subtypes in attention-deficit/hyperactivity disorder.

    PubMed

    Aebi, Marcel; van Donkelaar, Marjolein M J; Poelmans, Geert; Buitelaar, Jan K; Sonuga-Barke, Edmund J S; Stringaris, Argyris; Consortium, Image; Faraone, Stephen V; Franke, Barbara; Steinhausen, Hans-Christoph; van Hulzen, Kimm J E

    2016-07-01

    Oppositional defiant disorder (ODD) is a frequent psychiatric disorder seen in children and adolescents with attention-deficit-hyperactivity disorder (ADHD). ODD is also a common antecedent to both affective disorders and aggressive behaviors. Although the heritability of ODD has been estimated to be around 0.60, there has been little research into the molecular genetics of ODD. The present study examined the association of irritable and defiant/vindictive dimensions and categorical subtypes of ODD (based on latent class analyses) with previously described specific polymorphisms (DRD4 exon3 VNTR, 5-HTTLPR, and seven OXTR SNPs) as well as with dopamine, serotonin, and oxytocin genes and pathways in a clinical sample of children and adolescents with ADHD. In addition, we performed a multivariate genome-wide association study (GWAS) of the aforementioned ODD dimensions and subtypes. Apart from adjusting the analyses for age and sex, we controlled for "parental ability to cope with disruptive behavior." None of the hypothesis-driven analyses revealed a significant association with ODD dimensions and subtypes. Inadequate parenting behavior was significantly associated with all ODD dimensions and subtypes, most strongly with defiant/vindictive behaviors. In addition, the GWAS did not result in genome-wide significant findings but bioinformatics and literature analyses revealed that the proteins encoded by 28 of the 53 top-ranked genes functionally interact in a molecular landscape centered around Beta-catenin signaling and involved in the regulation of neurite outgrowth. Our findings provide new insights into the molecular basis of ODD and inform future genetic studies of oppositional behavior. © 2015 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc. © 2015 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.

  18. Gene‐set and multivariate genome‐wide association analysis of oppositional defiant behavior subtypes in attention‐deficit/hyperactivity disorder

    PubMed Central

    van Donkelaar, Marjolein M. J.; Poelmans, Geert; Buitelaar, Jan K.; Sonuga‐Barke, Edmund J. S.; Stringaris, Argyris; consortium, IMAGE; Faraone, Stephen V.; Franke, Barbara; Steinhausen, Hans‐Christoph; van Hulzen, Kimm J. E.

    2015-01-01

    Oppositional defiant disorder (ODD) is a frequent psychiatric disorder seen in children and adolescents with attention‐deficit‐hyperactivity disorder (ADHD). ODD is also a common antecedent to both affective disorders and aggressive behaviors. Although the heritability of ODD has been estimated to be around 0.60, there has been little research into the molecular genetics of ODD. The present study examined the association of irritable and defiant/vindictive dimensions and categorical subtypes of ODD (based on latent class analyses) with previously described specific polymorphisms (DRD4 exon3 VNTR, 5‐HTTLPR, and seven OXTR SNPs) as well as with dopamine, serotonin, and oxytocin genes and pathways in a clinical sample of children and adolescents with ADHD. In addition, we performed a multivariate genome‐wide association study (GWAS) of the aforementioned ODD dimensions and subtypes. Apart from adjusting the analyses for age and sex, we controlled for “parental ability to cope with disruptive behavior.” None of the hypothesis‐driven analyses revealed a significant association with ODD dimensions and subtypes. Inadequate parenting behavior was significantly associated with all ODD dimensions and subtypes, most strongly with defiant/vindictive behaviors. In addition, the GWAS did not result in genome‐wide significant findings but bioinformatics and literature analyses revealed that the proteins encoded by 28 of the 53 top‐ranked genes functionally interact in a molecular landscape centered around Beta‐catenin signaling and involved in the regulation of neurite outgrowth. Our findings provide new insights into the molecular basis of ODD and inform future genetic studies of oppositional behavior. © 2015 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc. PMID:26184070

  19. The protective effect of character maturity in child aggressive antisocial behavior.

    PubMed

    Kerekes, Nóra; Falk, Örjan; Brändström, Sven; Anckarsäter, Henrik; Råstam, Maria; Hofvander, Björn

    2017-07-01

    Childhood aggressive antisocial behavior (CD) is one of the strongest predictors of mental health problems and criminal behavior in adulthood. The aims of this study were to describe personality profiles in children with CD, and to determine the strength of association between defined neurodevelopmental symptoms, dimensions of character maturity and CD. A sample of 1886 children with a close to equal distribution of age (9 or 12) and gender, enriched for neurodevelopmental and psychiatric problems were selected from the nationwide Child and Adolescent Twin Study in Sweden. Their parents rated them according to the Junior Temperament and Character Inventory following a telephone interview during which information about the children's development and mental health was assessed with the Autism-Tics, AD/HD and other Comorbidities inventory. Scores on the CD module significantly and positively correlated with scores on the Novelty Seeking temperament dimension and negatively with scores on character maturity (Self-Directedness and Cooperativeness). In the group of children with either neurodevelopmental or behavioral problems, the prevalence of low or very low character maturity was 50%, while when these two problems coexisted the prevalence of low or very low character maturity increased to 70%. Neurodevelopmental problems (such as: oppositional defiant disorder, symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder) and low scores on character maturity emerged as independently significant predictors of CD; in a multivariable model, only oppositional defiant symptoms and impulsivity significantly increased the risk for coexisting CD while a mature self-agency in a child (Self-Directedness) remained a significant protective factor. These results suggest that children's willpower, the capacity to achieve personally chosen goals may be an important protective factor - even in the presence of neurodevelopmental and psychiatric problems - against progressing into persistent negative outcomes, such as aggressive antisocial behaviors. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Emotion Regulation Difficulties in Boys with Oppositional Defiant Disorder/Conduct Disorder and the Relation with Comorbid Autism Traits and Attention Deficit Traits.

    PubMed

    Schoorl, Jantiene; van Rijn, Sophie; de Wied, Minet; van Goozen, Stephanie; Swaab, Hanna

    2016-01-01

    Previous research has pointed towards a link between emotion dysregulation and aggressive behavior in children. Emotion regulation difficulties are not specific for children with persistent aggression problems, i.e. oppositional defiant disorder or conduct disorder (ODD/CD), children with other psychiatric conditions, such as autism spectrum disorders or attention-deficit/hyperactivity disorder, have emotion regulation difficulties too. On a behavioral level some overlap exists between these disorders and comorbidity is high. The aim of this study was therefore twofold: 1) to examine emotion regulation difficulties in 65 boys with ODD/CD in comparison to a non-clinical control group (NC) of 38 boys (8-12 years) using a performance measure (Ultimatum Game), parent report and self-report, and 2) to establish to what extent emotion regulation in the ODD/CD group was correlated with severity of autism and/or attention deficit traits. Results on the Ultimatum Game showed that the ODD/CD group rejected more ambiguous offers than the NC group, which is seen as an indication of poor emotion regulation. Parents also reported that the ODD/CD group experienced more emotion regulation problems in daily life than the NC group. In contrast to these cognitive and behavioral measures, self-reports did not reveal any difference, indicating that boys with ODD/CD do not perceive themselves as having impairments in regulating their emotions. Emotional decision making within the ODD/CD group was not related to variation in autism or attention deficit traits. These results support the idea that emotion dysregulation is an important problem within ODD/CD, yet boys with ODD/CD have reduced awareness of this.

  1. Emotion Regulation Difficulties in Boys with Oppositional Defiant Disorder/Conduct Disorder and the Relation with Comorbid Autism Traits and Attention Deficit Traits

    PubMed Central

    Schoorl, Jantiene; van Rijn, Sophie; de Wied, Minet; van Goozen, Stephanie; Swaab, Hanna

    2016-01-01

    Previous research has pointed towards a link between emotion dysregulation and aggressive behavior in children. Emotion regulation difficulties are not specific for children with persistent aggression problems, i.e. oppositional defiant disorder or conduct disorder (ODD/CD), children with other psychiatric conditions, such as autism spectrum disorders or attention-deficit/hyperactivity disorder, have emotion regulation difficulties too. On a behavioral level some overlap exists between these disorders and comorbidity is high. The aim of this study was therefore twofold: 1) to examine emotion regulation difficulties in 65 boys with ODD/CD in comparison to a non-clinical control group (NC) of 38 boys (8–12 years) using a performance measure (Ultimatum Game), parent report and self-report, and 2) to establish to what extent emotion regulation in the ODD/CD group was correlated with severity of autism and/or attention deficit traits. Results on the Ultimatum Game showed that the ODD/CD group rejected more ambiguous offers than the NC group, which is seen as an indication of poor emotion regulation. Parents also reported that the ODD/CD group experienced more emotion regulation problems in daily life than the NC group. In contrast to these cognitive and behavioral measures, self-reports did not reveal any difference, indicating that boys with ODD/CD do not perceive themselves as having impairments in regulating their emotions. Emotional decision making within the ODD/CD group was not related to variation in autism or attention deficit traits. These results support the idea that emotion dysregulation is an important problem within ODD/CD, yet boys with ODD/CD have reduced awareness of this. PMID:27420110

  2. Mis-Diagnosis and Dual Diagnosis of Gifted Children: Gifted and LD, ADHD, OCD, Oppositional Defiant Disorder.

    ERIC Educational Resources Information Center

    Webb, James T.

    Many gifted and talented children are often misdiagnosed by psychologists and other health professionals as having Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Disorder (OD), Obsessive Compulsive Disorder (OCD), or another of the mood disorders. The misdiagnosis can stem from mistaken assumptions being made about the social and…

  3. How Oppositionality, Inattention, and Hyperactivity Affect Response to Atomoxetine versus Methylphenidate: A Pooled Meta-Analysis

    ERIC Educational Resources Information Center

    van Wyk, Gregory W.; Hazell, Philip L.; Kohn, Michael R.; Granger, Renee E.; Walton, Richard J.

    2012-01-01

    Objective: To assess how threshold oppositional defiant disorder (ODD), inattention, and hyperactivity-impulsivity affect the response to atomoxetine versus methylphenidate. Method: Systematic review of randomized controlled trials (RCTs; greater than or equal to 6 weeks follow-up). The primary measure was core symptom response--greater than or…

  4. Familial Risk Factors to Oppositional Defiant Disorder and Conduct Disorder: Parental Psychopathology and Maternal Parenting.

    ERIC Educational Resources Information Center

    Frick, Paul J.; And Others

    1992-01-01

    In sample of 177 clinic-referred children aged 7-13, association was found between diagnosis of conduct disorder and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parent adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant…

  5. Do Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Influence Preschool Unintentional Injury Risk?

    PubMed Central

    Garzon, Dawn Lee; Huang, Hongyan; Todd, Richard D.

    2008-01-01

    Purpose This study explores the relationship between preschool attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), injury risk-taking behavior, and unintentional injury. Method Emergency department case control study of parent reported child behavior. Findings Children with ODD and ADHD had significantly more injury risk-taking behaviors (OR=7.68, 95% CI 2.25–26.25, OR 4.87, 95% CI 1.17–20.28 respectively) and injured children had a 17-fold increase in high risk-taking behaviors (OR 17.2, 95% CI 2.14–138.0). No significant association existed between ODD or ADHD and ED-treated unintentional injury. Implications Disruptive behavior disorders are not major contributors to ED-treated unintentional injury in preschool children. PMID:18809121

  6. Prevention of Serious Conduct Problems in Youth with Attention Deficit/Hyperactivity Disorder

    PubMed Central

    Villodas, Miguel T.; Pfiffner, Linda J.; McBurnett, Keith

    2013-01-01

    The purpose of this review is to discuss issues in the prevention of serious conduct problems among children and adolescents with Attention Deficit/Hyperactivity Disorder (ADHD). We begin by reviewing research on the common genetic and environmental etiological factors, developmental trajectories, characteristics, and impairments associated with ADHD and comorbid Oppositional Defiant and Conduct Disorders. Next, we present empirically-based models for intervention with children and adolescents with ADHD that are at risk of developing serious conduct problems and detail the evidence supporting these models. Researchers have demonstrated the utility of medication and psychosocial intervention approaches to treat youth with these problems, but current evidence appears to support the superiority of multi-modal treatments that include both approaches. Future directions for researchers are discussed. PMID:23082741

  7. Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder.

    PubMed

    Fonseka, Trehani M; Swampillai, Brenda; Timmins, Vanessa; Scavone, Antonette; Mitchell, Rachel; Collinger, Katelyn A; Goldstein, Benjamin I

    2015-01-01

    Little is known regarding correlates of borderline personality-spectrum symptoms (BPSS) among adolescents with bipolar disorder (BP). Participants were 90 adolescents, 13-19 years of age, who fulfilled DSM-IV-TR criteria for BP using semi-structured diagnostic interviews. BPSS status was ascertained using the Life Problems Inventory which assessed identity confusion, interpersonal problems, impulsivity, and emotional lability. Analyses compared adolescents with "high" versus "low" BPSS based on a median split. Participants with high, relative to low, BPSS were younger, and had greater current and past depressive episode severity, greater current hypo/manic episode severity, younger age of depression onset, and reduced global functioning. High BPSS participants were more likely to have BP-II, and had higher rates of social phobia, generalized anxiety disorder, conduct disorder, oppositional defiant disorder, homicidal ideation, assault of others, non-suicidal self-injury, suicidal ideation, and physical abuse. Despite greater illness burden, high BPSS participants reported lower rates of lithium use. The most robust independent predictors of high BPSS, identified in multivariate analyses, included lifetime social phobia, non-suicidal self-injury, reduced global functioning, and conduct and/or oppositional defiant disorder. The study design is cross-sectional and cannot determine causality. High BPSS were associated with greater mood symptom burden and functional impairment. Presence of high BPSS among BP adolescents may suggest the need to modify clinical monitoring and treatment practices. Future prospective studies are needed to examine the direction of observed associations, the effect of treatment on BPSS, and the effect of BPSS as a moderator or predictor of treatment response. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Types of Noncompliance in Boys with Attention-Deficit/Hyperactivity Disorder with and without Oppositional Behavior

    ERIC Educational Resources Information Center

    Johnston, Charlotte; Murray, Candice

    2007-01-01

    This study examined both the frequency and type of noncompliant behavior in 14 boys with co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) and oppositional defiant (OD) behavior, 24 boys with only ADHD, and 33 nonproblem boys. Mothers rated boys' noncompliant behavior on the Response Style Questionnaire (RSQ) and observers coded…

  9. Gender Differences in the Effects of Oppositional Behavior on Teacher Ratings of ADHD Symptoms.

    ERIC Educational Resources Information Center

    Jackson, David A.; King, Alan R.

    2004-01-01

    H. Abikoff, M. Courtney, W. E. Pelham, and H. S. Koplewicz (1993) presented elementary school teachers with a videotape of a 4th-grade male child exhibiting behavior associated with either Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD). Comparisons with ratings generated from a control tape (same child…

  10. Study to Determine Whether There Are Any Cognitive or Motor Effects From Taking the Medicine Risperidone.

    ClinicalTrials.gov

    2016-06-21

    Oppositional Defiant Disorder; Conduct Disorder; Attention Deficit/Hyperactivity Disorder (ADHD); Intermittent Explosive Disorder; Impulse-Control Disorders; Adjustment Disorder; Bipolar Disorder; Pervasive Developmental Disorder

  11. Reliability and Validity of the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)

    ClinicalTrials.gov

    2009-02-13

    Major Depression; Mania; Anxiety Disorders; Psychotic Disorder; Alcohol Dependence; Drug Dependence; Eating Disorders; Suicidality; Dysthymia; ADHD; Tourettes Disorder; Conduct Disorder; Oppositional Defiant Disorder; Pervasive Developmental Disorder

  12. [Oppositional defiant disorder: aspects related to sex differences and informant].

    PubMed

    Cardo, E; Meisel, V; García-Banda, G; Palmer, C; Riutort, L; Bernad, M; Servera, M

    2009-02-27

    Oppositional defiant disorder (ODD) is one of the most common externalizing disorders in childhood. ODD prevalence global rates vary from 2% to 16%. Along with conduct disorder and attention deficit disorder, ODD is one of the leading reasons for referral to neuropediatric and psychiatric services. Even though ODD has recognized clinical importance, key aspects of its conceptualization and prevalence in childhood and adolescence remain uncertain. We examine previous research findings of ODD prevalence and analyze sex differences and differences according to informants. ODD prevalence rates present high variability. A number of studies suggest that ODD is more common in boys than in girls. Nevertheless, some authors point that this sex differences may be due to methodological bias. We recommend the validation of an ODD scale that has into consideration the following aspects: level of the subject's development (age), gender and environment.

  13. Social Anxiety Predicts Aggression in Children with ASD: Clinical Comparisons with Socially Anxious and Oppositional Youth

    ERIC Educational Resources Information Center

    Pugliese, Cara E.; White, Bradley A.; White, Susan W.; Ollendick, Thomas H.

    2013-01-01

    The present study examined the degree to which social anxiety predicts aggression in children with high functioning autism spectrum disorders (HFASD, n = 20) compared to children with Social Anxiety Disorder (SAD, n = 20) or with Oppositional Defiant Disorder or Conduct Disorder (ODD/CD, n = 20). As predicted, children with HFASD reported levels…

  14. Co-Occurring Trajectories of Symptoms of Anxiety, Depression, and Oppositional Defiance from Adolescence to Young Adulthood

    ERIC Educational Resources Information Center

    Leadbeater, Bonnie; Thompson, Kara; Gruppuso, Vincenza

    2012-01-01

    This study uses a cohort-sequential longitudinal design to examine the patterns of change and codevelopment of anxiety, depression, and oppositional defiant symptoms (ODS) from late adolescence to young adulthood. Four waves of data were collected biennially by individual interview with a random, community-based sample of 662 youth ages 12 to 18…

  15. The Prospective Links Between Hyperactive/Impulsive, Inattentive, and Oppositional-Defiant Behaviors in Childhood and Antisocial Behavior in Adolescence: The Moderating Influence of Gender and the Parent-Child Relationship Quality.

    PubMed

    Giannotta, Fabrizia; Rydell, Ann-Margret

    2016-12-01

    We prospectively investigated the effect of child hyperactive/impulsive, inattentive, and oppositional/defiant behaviors on the development of youth antisocial behaviors, and the moderating influence of gender and the parent-child relationship quality in a normative sample. Participants (N = 673, 50 % girls) were assessed at 10 years of age (parent reports) and at age 15 (parent and adolescent reports). Using latent change models, we found that initial levels of, as well as increases in, hyperactivity/impulsivity and oppositional behaviors and initial levels of inattention behaviors predicted youth antisocial behaviors. The increase in oppositional behaviors was predictive of youth antisocial behaviors in girls only. Child hyperactive/impulsive behaviors predicted youth antisocial behaviors only in children for whom the quality of the parent-child relationship deteriorated from childhood to adolescence. Thus, both initial levels of and increases in disruptive behaviors as well as gender are important for understanding the development of antisocial behaviors in adolescence. We received partial support for the hypothesized, moderating role of a high-quality parent-child relationship.

  16. Interpretive understanding, sympathy, and moral emotion attribution in oppositional defiant disorder symptomatology.

    PubMed

    Dinolfo, Caterina; Malti, Tina

    2013-10-01

    This study examined the relations between interpretive understanding, sympathy, and moral emotion attribution (MEA) in the prediction of oppositional defiant disorder (ODD) symptomatology in an ethnically diverse sample of 128 4- and 8-year-old children (49 % girls). Caregivers rated the children's ODD symptoms. Interpretive understanding was assessed using an advanced theory-of-mind task. Sympathy was measured via caregiver- and child-report. Strength of MEA was assessed utilizing the children's responses to six hypothetical moral transgressions. Results revealed that interpretive understanding, sympathy, and strength of MEA in the exclusion domain predicted ODD symptoms negatively. Caregiver-reported sympathy partially mediated and moderated the relation between interpretive understanding and ODD symptoms. Strength of MEA in the rule violation domain moderated the relation between interpretive understanding and ODD symptoms. The findings shed light on the importance of social-cognitive and affective-moral antecedents of ODD symptoms.

  17. Dimensions of Oppositional Defiant Disorder in Young Children: Heterotypic Continuity with Anxiety and Depression

    PubMed Central

    Lavigne, John V.; Gouze, Karen R.; Bryant, Fred B.; Hopkins, Joyce

    2014-01-01

    There are distinct dimensions of Oppositional Defiant Disorder (ODD) that have been associated with symptoms of other disorders (heterotypic continuity). The present study compared the heterotypic continuity of a two-factor (Pitt-2) model and the three-factor model incorporated into DSM-5 with symptoms of anxiety and depression. Participants were a diverse community sample of 796 children (38.8% minority, 49.1% boys) assessed at ages 4, 5 and 6 years. Symptoms were assessed with the dimensional scales of the Diagnostic Interview Schedule for Children-Young Child version and the Child Symptom Inventory. Dimensions of both the two- and three-factor DSM-5 models were associated with later symptoms of anxiety and depression. The association, however, was weak when accounting for initial levels of internalizing symptoms: thus there was little evidence for the unique contributions of ODD dimensions to symptoms of subsequent internalizing disorders for either model. PMID:24497230

  18. The impact of parenting on the associations between child aggression subtypes and oppositional defiant disorder symptoms.

    PubMed

    Pederson, Casey A; Fite, Paula J

    2014-12-01

    The current study evaluated parenting behaviors (i.e., parental monitoring, inconsistent discipline, parental involvement, positive parenting, and corporal punishment) as moderators of the link between proactive and reactive aggression and oppositional defiant disorder (ODD) symptoms in a community sample of 89 children ranging from 9 to 12 years of age (M = 10.44, SD = 1.14; 56 % male). Reactive, but not proactive, aggression was uniquely positively associated with ODD symptoms. Additionally, inconsistent discipline moderated the association between proactive, but not reactive, aggression and ODD symptoms, such that proactive aggression was associated with ODD symptoms only when levels of inconsistent discipline were high. Findings appear to suggest that associations between these aggression subtypes and ODD symptoms are influenced by different factors, with inconsistent discipline indicated in the association between proactively aggressive behavior and ODD symptoms. Implications for intervention are discussed.

  19. Impaired decision making in oppositional defiant disorder related to altered psychophysiological responses to reinforcement.

    PubMed

    Luman, Marjolein; Sergeant, Joseph A; Knol, Dirk L; Oosterlaan, Jaap

    2010-08-15

    When making decisions, children with oppositional defiant disorder (ODD) are thought to focus on reward and ignore penalty. This is suggested to be associated with a state of low psychophysiological arousal. This study investigates decision making in 18 children with oppositional defiant disorder and 24 typically developing control subjects. Children were required to choose between three alternatives that carried either frequent small rewards and occasional small penalties (advantageous), frequent large rewards and increasing penalties (seductive), or frequent small rewards and increasing penalties (disadvantageous). Penalties in the seductive and disadvantageous alternatives increased either in frequency or magnitude in two conditions. Heart rate (HR) and skin conductance responses to reinforcement were obtained. In the magnitude condition, children with ODD showed an increased preference for the seductive alternative (carrying large rewards); this was not observed in the frequency condition. Children with ODD, compared with typically developing children, displayed greater HR reactivity to reward (more HR deceleration) and smaller HR reactivity to penalty. Correlation analyses showed that decreased HR responses to penalty were related to an increased preference for large rewards. No group differences were observed in skin conductance responses to reward or penalty. The findings suggest that an increased preference for large rewards in children with ODD is related to a reduced cardiac reactivity to aversive stimuli. This confirms notions of impaired decision making and altered reinforcement sensitivity in children with ODD and adds to the literature linking altered autonomic control to antisocial behavior. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Disrupted reinforcement signaling in the orbitofrontal cortex and caudate in youths with conduct disorder or oppositional defiant disorder and a high level of psychopathic traits.

    PubMed

    Finger, Elizabeth C; Marsh, Abigail A; Blair, Karina S; Reid, Marguerite E; Sims, Courtney; Ng, Pamela; Pine, Daniel S; Blair, R James R

    2011-02-01

    Dysfunction in the amygdala and orbitofrontal cortex has been reported in youths and adults with psychopathic traits. The specific nature of the functional irregularities within these structures remains poorly understood. The authors used a passive avoidance task to examine the responsiveness of these systems to early stimulus-reinforcement exposure, when prediction errors are greatest and learning maximized, and to reward in youths with psychopathic traits and comparison youths. While performing the passive avoidance learning task, 15 youths with conduct disorder or oppositional defiant disorder plus a high level of psychopathic traits and 15 healthy subjects completed a 3.0-T fMRI scan. Relative to the comparison youths, the youths with a disruptive behavior disorder plus psychopathic traits showed less orbitofrontal responsiveness both to early stimulus-reinforcement exposure and to rewards, as well as less caudate response to early stimulus-reinforcement exposure. There were no group differences in amygdala responsiveness to these two task measures, but amygdala responsiveness throughout the task was lower in the youths with psychopathic traits. Compromised sensitivity to early reinforcement information in the orbitofrontal cortex and caudate and to reward outcome information in the orbitofrontal cortex of youths with conduct disorder or oppositional defiant disorder plus psychopathic traits suggests that the integrated functioning of the amygdala, caudate, and orbitofrontal cortex may be disrupted. This provides a functional neural basis for why such youths are more likely to repeat disadvantageous decisions. New treatment possibilities are raised, as pharmacologic modulations of serotonin and dopamine can affect this form of learning.

  1. Conduct Disorder and Comorbidity.

    ERIC Educational Resources Information Center

    Stahl, Nicole D.; Clarizio, Harvey F.

    1999-01-01

    Provides critical examination of research published during past ten years addressing Conduct Disorder (CD), Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder (ODD), and internalizing disorders. Concludes comorbidity varies with age, gender, informant, diagnostic criteria, and nature of the sample. Implications of comorbidity…

  2. Oppositional defiant disorder

    MedlinePlus

    ... more common in boys than in girls. Some studies have shown that it affects 20% of school-age children. However, most experts believe this figure is high due to changing definitions of normal childhood behavior. It may also possibly have racial, cultural, and ...

  3. Impact of oppositional defiant disorder dimensions on the temporal ordering of conduct problems and depression across childhood and adolescence in girls.

    PubMed

    Hipwell, Alison E; Stepp, Stephanie; Feng, Xin; Burke, Jeff; Battista, Deena R; Loeber, Rolf; Keenan, Kate

    2011-10-01

    Little is known about the role of oppositional defiant disorder (ODD) dimensions on the temporal unfolding of conduct disorder (CD) and depression in girls between childhood and adolescence. The year-to-year associations between CD and depressive symptomatology were examined using nine waves of annually collected data (ages 8 through 16 years) from 1215 participants of the Pittsburgh Girls Study. A series of autoregressive path models were tested that included ODD-Emotion Dysregulation (ODD-ED) and ODD-Defiance, as time-varying covariates on CD predicting depression severity in the following year, and vice versa. Conduct problems, depression, and ODD dimensions were relatively stable throughout childhood and adolescence, and a moderate degree of covariance was observed between these variables. Path analyses showed that CD often preceded depression across this developmental period, although the effect sizes were small. There was less consistent prediction from depression to CD. The overlap between ODD-ED and CD partially explained the prospective relations from CD to depression, whereas these paths were fully explained by the overlap between ODD-ED and depression. The overlap between ODD-Defiance and CD did not account for the prospective relations from CD to depression. In contrast, the overlap between ODD-Defiance and depression accounted for virtually all paths from CD to depression. Accounting for the overlap between ODD dimensions and both CD and depression eliminated all significant predictive paths. Symptoms of CD tend to precede depression in girls during childhood and adolescence. However, covariance between depression and both ODD-ED and ODD-Defiance accounts for these prospective relations. ODD dimensions should be assessed when evaluating risk for comorbid depression in girls with conduct problems, and emotion dysregulation and defiance aspects of ODD should be identified as targets for treatment in order to prevent depression in the future. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

  4. Combining Parent and Child Training for Young Children with ADHD

    PubMed Central

    Webster-Stratton, Carolyn

    2011-01-01

    The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder (ODD) but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder (ADHD). We conducted a randomized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD (ages 4–6). Mother reported significant treatment effects for appropriate and harsh discipline, use of physical punishment, and monitoring, whereas fathers reported no significant parenting changes. Independent observations revealed treatment effects for mothers' praise and coaching, mothers' critical statements, and child total deviant behaviors. Both mothers and fathers reported treatment effects for children's externalizing, hyperactivity, inattentive and oppositional behaviors, and emotion regulation and social competence. There were also significant treatment effects for children's emotion vocabulary and problem-solving ability. At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children's social competence. PMID:21391017

  5. Predicting later problematic cannabis use from psychopathological symptoms during childhood and adolescence: Results of a 25-year longitudinal study.

    PubMed

    Zohsel, Katrin; Baldus, Christiane; Schmidt, Martin H; Esser, Günter; Banaschewski, Tobias; Thomasius, Rainer; Laucht, Manfred

    2016-06-01

    Cannabis is the most commonly used illegal substance among adolescents and young adults. Problematic cannabis use is often associated with comorbid psychopathological problems. The purpose of the current study was to elucidate the underlying developmental processes connecting externalizing and internalizing psychopathology in childhood and adolescence with problematic cannabis use in young adulthood. Data were drawn from the Mannheim Study of Children at Risk, an ongoing epidemiological cohort study from birth to adulthood. For n=307 participants, symptom scores of conduct/oppositional defiant disorder, attention problems, hyperactivity/impulsivity, and internalizing disorders were available for the periods of childhood (4.5-11 years) and adolescence (15 years). At age 25 years, problematic cannabis use was assessed via clinical interview and a self-rating questionnaire. At age 25 years, problematic cannabis use was identified in n=28 participants (9.1%). Childhood conduct/oppositional behavior problems were predictive of problematic cannabis use during young adulthood when comorbid symptoms were controlled for. No such effect was found for childhood attention, hyperactivity/impulsivity or internalizing problems. With respect to psychopathological symptoms during adolescence, only attention problems were significantly related to later problematic cannabis use when controlling for comorbidity. The current study highlights the role of conduct/oppositional behavior problems during childhood and attention problems during adolescence in later problematic cannabis use. It sheds more light on the developmental sequence of childhood and adolescence psychopathology and young adult cannabis use, which is a prerequisite for effective prevention approaches. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Psychiatric Disorders and Treatments: A Primer for Teachers.

    ERIC Educational Resources Information Center

    Forness, Steven R.; Walker, Hill M.; Kavale, Kenneth A.

    2003-01-01

    This article for teachers provides basic information on psychiatric disorders and treatments. It covers oppositional defiant and conduct disorders, attention deficit/hyperactivity disorder, depression or other mood disorders, anxiety disorders, schizophrenia or other psychotic disorders, and autistic spectrum disorders. Insets provide additional…

  7. Co-occurring Trajectories of Symptoms of Anxiety, Depression, and Oppositional Defiance From Adolescence to Young Adulthood

    PubMed Central

    Leadbeater, Bonnie; Thompson, Kara; Gruppuso, Vincenza

    2016-01-01

    This study uses a cohort-sequential longitudinal design to examine the patterns of change and codevelopment of anxiety, depression, and oppositional defiant symptoms (ODS) from late adolescence to young adulthood. Four waves of data were collected biennially by individual interview with a random, community-based sample of 662 youth ages 12 to 18 years at Time 1 (18–26 years at Time 4). Using latent growth curve modeling, we examined co-occurring changes in the levels, rates of change, and variability in symptoms of anxiety, depression, and oppositional defiance. Sex differences were also assessed. Levels of anxiety, depression, and ODS were correlated at each time point. Moreover, adolescents with high initial levels in one domain tended to have high initial levels in the other domains. In addition, increases in depressive symptoms were significantly correlated with increases in anxiety and in ODS, but adolescent levels of symptoms did not predict increases over time. Symptoms of anxiety (for female and male individuals) and depression (for male individuals) continue to increase in young adulthood, whereas ODS stabilize or decline. Adolescent levels of these problems have a significant impact on later levels, suggesting that preventive interventions may be needed in adolescence to defer negative consequences of mental health problems in young adults. PMID:22742519

  8. Which Childhood and Adolescent Psychiatric Disorders predict which Young Adult Disorders?

    PubMed Central

    Copeland, William E.; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian

    2009-01-01

    Context Most adults with a psychiatric disorder first met diagnostic criteria during childhood and/or adolescence, yet specific homotypic and heterotypic patterns of prediction have not been firmly established. Objective To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disaggregating similar disorders, and examining childhood and adolescent predictors separately. Design/Setting/Patients Eleven waves of data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used, covering children in the community ages 9−16, 19, and 21 years old. Outcome Common psychiatric disorders were assessed in childhood (ages 9 to 12) and adolescence (ages 13 to 16) with the Child and Adolescent Psychiatric Assessment, and in young adulthood (ages 19 and 21) with the Young Adult Psychiatric Assessment. Results Adolescent depression significantly predicted young adult depression in the bivariate analysis, but this effect was entirely accounted for by comorbidity of adolescent depression with adolescent oppositional defiant disorder, anxiety and substance disorders in adjusted analyses. Generalized anxiety and depression cross-predicted each other, and oppositional defiant disorder (but not conduct disorder) predicted later anxiety disorders and depression. Evidence of homotypic prediction was supported for substance use disorders, antisocial personality disorder (from conduct disorder) and anxiety disorders, although this effect was primary accounted for by DSM-III-R overanxious disorder. Conclusions Stringent tests of homotypic and heterotypic prediction patterns suggest a more developmentally and diagnostically nuanced picture in comparison with the previous literature. The putative link between adolescent and young adult depression was not supported. Oppositional defiant disorder was singular in being part of the developmental history of a wide range of young adult disorders. PMID:19581568

  9. Prosocial skills may be necessary for better peer functioning in children with symptoms of disruptive behavior disorders

    PubMed Central

    Browne, Dillon T.; Tannock, Rosemary

    2014-01-01

    Children with disruptive behavior disorders experience substantial social challenges; however, the factors that account for (i.e., mediate), or influence (i.e., moderate), peer problems are not well understood. This study tested whether symptoms of Oppositional Defiant Disorder and Conduct Disorder were associated with peer impairment and whether prosocial skills mediated or moderated these associations. Teacher ratings were gathered for 149 children (Mage = 9.09, SD = 1.71, 26% female) referred for behavioral concerns to an urban child psychiatry clinic. Path-analytic linear regressions testing mediation and moderation effects showed that prosocial skills significantly moderated the negative effects of symptoms of Conduct Disorder on peer impairment. Children showed less peer impairment only when they had relatively few conduct symptoms and high prosocial skills. Measurement of prosocial skills, in addition to conduct problems, may best capture factors which contribute to peer problems of children with disruptive behaviors. PMID:25083349

  10. Prosocial skills may be necessary for better peer functioning in children with symptoms of disruptive behavior disorders.

    PubMed

    Andrade, Brendan F; Browne, Dillon T; Tannock, Rosemary

    2014-01-01

    Children with disruptive behavior disorders experience substantial social challenges; however, the factors that account for (i.e., mediate), or influence (i.e., moderate), peer problems are not well understood. This study tested whether symptoms of Oppositional Defiant Disorder and Conduct Disorder were associated with peer impairment and whether prosocial skills mediated or moderated these associations. Teacher ratings were gathered for 149 children (Mage = 9.09, SD = 1.71, 26% female) referred for behavioral concerns to an urban child psychiatry clinic. Path-analytic linear regressions testing mediation and moderation effects showed that prosocial skills significantly moderated the negative effects of symptoms of Conduct Disorder on peer impairment. Children showed less peer impairment only when they had relatively few conduct symptoms and high prosocial skills. Measurement of prosocial skills, in addition to conduct problems, may best capture factors which contribute to peer problems of children with disruptive behaviors.

  11. Making Sense of Every Child

    ERIC Educational Resources Information Center

    Viola, Stephen; Noddings, Alicia

    2006-01-01

    This article presents an example of two boys who have received a list of diagnoses including Attention Deficit Hyperactivity Disorder (ADHD), autism, Asperger's syndrome, Oppositional Defiant Disorder (ODD), and clinical depression. Both boys received a variety of interventions ranging from behavior modification plans to counseling and medication,…

  12. Best Practices in Working with Students with Emotion Dysregulation

    ERIC Educational Resources Information Center

    Cunningham, Jennifer; Mendez, Linda M. Raffaele; Sundman-Wheat, Ashley N.

    2011-01-01

    Students with emotion dysregulation have significant difficulty modulating emotional reactions, particularly in response to frustration or challenge. These children can present with a variety of DSM diagnoses in schools, including attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), major depressive disorder (MDD),…

  13. Observed parenting behaviors interact with a polymorphism of the brain-derived neurotrophic factor gene to predict the emergence of oppositional defiant and callous-unemotional behaviors at age 3 years.

    PubMed

    Willoughby, Michael T; Mills-Koonce, Roger; Propper, Cathi B; Waschbusch, Daniel A

    2013-11-01

    Using the Durham Child Health and Development Study, this study (N = 171) tested whether observed parenting behaviors in infancy (6 and 12 months) and toddlerhood/preschool (24 and 36 months) interacted with a child polymorphism of the brain-derived neurotrophic factor gene to predict oppositional defiant disorder (ODD) and callous-unemotional (CU) behaviors at age 3 years. Child genotype interacted with observed harsh and intrusive (but not sensitive) parenting to predict ODD and CU behaviors. Harsh-intrusive parenting was more strongly associated with ODD and CU for children with a methionine allele of the brain-derived neurotrophic factor gene. CU behaviors were uniquely predicted by harsh-intrusive parenting in infancy, whereas ODD behaviors were predicted by harsh-intrusive parenting in both infancy and toddlerhood/preschool. The results are discussed from the perspective of the contributions of caregiving behaviors as contributing to distinct aspects of early onset disruptive behavior.

  14. Neurocognitive Deficits in Attention-Deficit/Hyperactivity Disorder With and Without Comorbid Oppositional Defiant Disorder

    PubMed Central

    Noordermeer, Siri D. S.; Luman, Marjolein; Buitelaar, Jan K.; Hartman, Catharina A.; Hoekstra, Pieter J.; Franke, Barbara; Faraone, Stephen V.; Heslenfeld, Dirk J.; Oosterlaan, Jaap

    2016-01-01

    Objective Oppositional Defiant Disorder (ODD) is highly prevalent in Attention-Deficit/Hyperactivity Disorder (ADHD) and may account for inconsistencies in findings on neurocognitive functioning in ADHD. Our aim was to assess cool and hot executive functioning (EF) and temporal processing in ADHD with and without comorbid ODD to elucidate the effects of comorbid ODD. Method ADHD-only (n = 82), ADHD + ODD (n = 82), and controls (n = 82), with mean age 16 years (SD = 3.1), matched for age, gender, IQ, and ADHD type (clinical groups) were assessed on cool EF (inhibition, working memory), hot EF (reinforcement processing, emotion recognition), and temporal processing (time production and reproduction). Results Individuals with ADHD + ODD showed abnormalities in inhibition, working memory, facial emotion recognition, and temporal processing, whereas individuals with ADHD-only were solely impaired in working memory and time production. Conclusion Findings suggest that ODD carries a substantial part of the EF deficits observed in ADHD and contrast with current theories of neurocognitive impairments in ADHD. PMID:26486602

  15. Problem behaviour and psychosocial functioning in young children with Williams syndrome: parent and teacher perspectives.

    PubMed

    Klein-Tasman, B P; Lee, K

    2017-09-01

    There is sparse literature about problem behaviour in young children with Williams syndrome (WS) and little consideration of the perspectives of multiple respondents. Problem behaviour of 35 children with WS ages 2 to 6 was examined based on both parent and teacher report using the Achenbach preschool forms. The most prominent areas of difficulty based on both parent and teacher report were attention problems, pervasive developmental problems and emotion reactivity difficulties. Some rater differences were observed; most notably, teachers reported more externalising behaviour problems including more aggressive behaviour, Attention Deficit/Hyperactivity problems and Oppositional Defiant problems than did parents. Few relations to intellectual functioning, age or gender were observed. Some aspects of problem behaviour evident in older children (e.g. attention problems, social problems) are also apparent for young children with WS, while other areas are less prominent (e.g. anxiety). The implications of the findings for understanding the behavioural phenotype associated with WS are discussed. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  16. Functional Impairments in Attention Deficit Hyperactivity Disorder: The Mediating Role of Neuropsychological Functioning

    PubMed Central

    Sjöwall, Douglas; Thorell, Lisa B.

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is associated with multiple neuropsychological deficits and the present study aimed to investigate to what extent these deficits are related to the functional impairments associated with the disorder. The results showed that all executive functioning deficits and reaction time variability acted as mediators in the relation between ADHD and academic achievement. However, only the effect of working memory for language skills, and the effects of reaction time variability and working memory for mathematics, remained significant when studying independent effects. Regulation of anger was a significant mediator for peer problems. Gender or symptoms of oppositional defiant disorder (ODD) or conduct disorder (CD) did not moderate these findings. PMID:24742310

  17. Maltreatment and Affective and Behavioral Problems in Emerging Adults With and Without Oppositional Defiant Disorder Symptoms: Mediation by Parent-Child Relationship Quality.

    PubMed

    McKinney, Cliff; Stearns, Melanie; Szkody, Erica

    2018-03-01

    The current study examined the indirect effect of maternal and paternal emotional and physical maltreatment on affective and behavioral symptoms of oppositional defiant disorder (ODD) through parent-child relationship quality; gender and overall ODD symptoms were examined as moderators. Participants included 2,362 emerging adults who completed questionnaires about parental emotional and physical maltreatment, parent-child relationship quality, and affective and behavioral ODD symptoms. These characteristics were compared across parent and child gender (i.e., maternal and paternal effects as well as male and female differences) as well as participants reporting high and low ODD symptoms. In the low ODD group, indirect effects of emotional maltreatment occurred in all parent-child dyads except the mother-son dyad, whereas in the high ODD group, indirect effects occurred only in the father-son dyad. Indirect effects of physical maltreatment occurred only in the father-son dyad in the low ODD group, and only in the mother-daughter dyad on behavioral ODD symptoms in the high ODD group. The results suggest that specific parent-child gender dyads respond differently, warranting further investigation of gender effects. Moreover, emerging adults in the low ODD symptoms group demonstrated a positive association between parental maltreatment and ODD symptoms and a negative association between parent-child relationship quality and ODD symptoms, whereas those high in the high ODD symptoms group did not demonstrate these associations. That is, emerging adults reporting high ODD symptoms demonstrated no relationship between their ODD symptoms and harsh parenting, suggesting an ineffective coercive process.

  18. Obsessive Compulsive Disorder: What an Educator Needs to Know

    ERIC Educational Resources Information Center

    Chaturvedi, Amrita; Murdick, Nikki L.; Gartin, Barbara C.

    2014-01-01

    The presence of obsessive compulsive disorder (OCD) impairs social, emotional and academic functioning. Individuals with OCD may have co-morbid disorders including attention deficit hyperactivity disorder, depression, oppositional defiant disorder, or Tourette syndrome. Challenges occur when students with OCD become a part of the general education…

  19. Comorbid Psychiatric Diagnoses in Preschoolers with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Hayashida, Kristen; Anderson, Bryan; Paparella, Tanya; Freeman, Stephanny F. N.; Forness, Steven R.

    2010-01-01

    Although comorbid or co-occurring psychiatric diagnoses such as attention deficit hyperactivity disorder, anxiety disorders, depression, and oppositional defiant or conduct disorders have been well studied in children or adolescents with autism spectrum disorders (ASDs), very little research is available on preschool samples. The current study…

  20. Intellectual Disability Modifies Gender Effects on Disruptive Behaviors

    ERIC Educational Resources Information Center

    Einfeld, Stewart L.; Gray, Kylie M.; Ellis, Louise A.; Taffe, John; Emerson, Eric; Tonge, Bruce J.; Horstead, Sian K.

    2010-01-01

    In typically developing children, boys are more commonly diagnosed than girls with disruptive behavior disorders, namely, attention-deficit/hyperactivity disorder, conduct disorder, and oppositional defiant disorder. For children with intellectual disability (ID), the evidence for this gender effect is less clear. In this report we examine gender…

  1. Pharmacological Management of Treatment-Induced Insomnia in ADHD

    ERIC Educational Resources Information Center

    Kratochvil, Christopher J.; Lake, Marybeth; Pliszka, Steven R.; Walkup, John T.

    2005-01-01

    A 7-year-old girl with attention-deficit/hyperactivity disorder (ADHD), combined subtype, and oppositional defiant disorder presents with a complaint of marked insomnia. Her parents describe 60 to 90 minutes of nightly initial insomnia that began with the initiation of 36 mg OROS methylphenidate (Concerta) 2 months ago. Behavioral interventions…

  2. A Closer Examination of Bipolar Disorder in School-Age Children

    ERIC Educational Resources Information Center

    Bardick, Angela D.; Bernes, Kerry B.

    2005-01-01

    Children who present with severe behavioral concerns may be diagnosed as having other commonly diagnosed childhood disorders, such as attention deficit hyperactivity disorder, oppositional defiant disorder, and/or conduct disorder, among others, when they may be suffering from early-onset bipolar disorder. Awareness of the symptoms of early-onset…

  3. Augmented Self-Modeling as an Intervention for Selective Mutism

    ERIC Educational Resources Information Center

    Kehle, Thomas J.; Bray, Melissa A.; Byer-Alcorace, Gabriel F.; Theodore, Lea A.; Kovac, Lisa M.

    2012-01-01

    Selective mutism is a rare disorder that is difficult to treat. It is often associated with oppositional defiant behavior, particularly in the home setting, social phobia, and, at times, autism spectrum disorder characteristics. The augmented self-modeling treatment has been relatively successful in promoting rapid diminishment of selective mutism…

  4. School Counselors Serving Students with Disruptive Behavior Disorders

    ERIC Educational Resources Information Center

    Grothaus, Tim

    2013-01-01

    School counselors are in a prime position to collaborate with school and community stakeholders to both prevent and respond to the challenges experienced and exhibited by students with one or more disruptive behavior disorders (DBD). In this article, the DBDs discussed include conduct disorder, oppositional defiant disorder, intermittent explosive…

  5. Perspectives on the Aetiology of ODD and CD: A Grounded Theory Approach

    ERIC Educational Resources Information Center

    McFarland, Patrick; Sanders, James; Hagen, Bradley

    2016-01-01

    Antisocial disorders, such as oppositional defiant disorder (ODD) and conduct disorder (CD), are common reasons for youth to be seen for clinical intervention. The intent of this constructivist grounded theory study was to evaluate clinicians' perspectives on the aetiology of antisocial disorders. Six professionals from various professional…

  6. A Comparison of Pure and Comorbid CD/ODD and Depression

    ERIC Educational Resources Information Center

    Ezpeleta, Lourdes; Domenech, Josep M.; Angold, Adrian

    2006-01-01

    Background: We studied the symptomatology of conduct/oppositional defiant disorder and major depression/dysthymic disorder in "pure" and comorbid presentations. Method: The sample comprised 382 children of 8 to 17 years of age attending for psychiatric outpatient consultation. Ninety-two had depressive disorders without conduct disorders, 165…

  7. Investigation of Cool and Hot Executive Function in ODD/CD Independently of ADHD

    ERIC Educational Resources Information Center

    Hobson, Christopher W.; Scott, Stephen; Rubia, Katya

    2011-01-01

    Background: Children with oppositional defiant disorder/conduct disorder (ODD/CD) have shown deficits in "cool" abstract-cognitive, and "hot" reward-related executive function (EF) tasks. However, it is currently unclear to what extent ODD/CD is associated with neuropsychological deficits, independently of attention deficit hyperactivity disorder…

  8. Combining Parent and Child Training for Young Children with ADHD

    ERIC Educational Resources Information Center

    Webster-Stratton, Carolyn H.; Reid, M. Jamila; Beauchaine, Ted

    2011-01-01

    The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder (ADHD). We conducted a randomized control trial evaluating the combined parent and child program…

  9. Zero Tolerance: Moving the Conversation Forward

    ERIC Educational Resources Information Center

    Evans, Katherine R.; Lester, Jessica Nina

    2012-01-01

    Special educators frequently teach students with a variety of diagnostic labels, including autism and oppositional defiant disorder. Some of these diagnoses point to the presence of challenging behaviors that might be viewed as threatening and disruptive. Teachers working with these students must make daily choices in how they approach such…

  10. The ESSENCE in Child Psychiatry: Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations

    ERIC Educational Resources Information Center

    Gillberg, Christopher

    2010-01-01

    Co-existence of disorders--including attention-deficit/hyperactivity disorder, oppositional defiant disorder, tic disorder, developmental coordination disorder, and autism spectrum disorder--and sharing of symptoms across disorders (sometimes referred to as comorbidity) is the rule rather than the exception in child psychiatry and developmental…

  11. The Mental Effort-Reward Imbalances Model and Its Implications for Behaviour Management

    ERIC Educational Resources Information Center

    Poulton, Alison; Whale, Samina; Robinson, Joanne

    2016-01-01

    Attention deficit hyperactivity disorder (ADHD) is frequently associated with oppositional defiant disorder (ODD). The Mental Effort Reward Imbalances Model (MERIM) explains this observational association as follows: in ADHD a disproportionate level of mental effort is required for sustaining concentration for achievement; in ODD the subjective…

  12. Understanding Desisting and Persisting Forms of Delinquency: The Unique Contributions of Disruptive Behavior Disorders and Interpersonal Callousness

    ERIC Educational Resources Information Center

    Byrd, Amy L.; Loeber, Rolf; Pardini, Dustin A.

    2012-01-01

    Background: While associations between conduct disorder (CD), oppositional defiant disorder (ODD), attention deficit hyperactivity disorder (ADHD), and interpersonal callousness (IC) symptoms and delinquency onset are well established, less is known about whether these characteristics differentiate desisting and persisting delinquency. The current…

  13. Anger and Irritability Symptoms among Youth with ODD: Cross-Informant versus Source-Exclusive Syndromes

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Drabick, Deborah A. G.

    2012-01-01

    We examined differences in co-occurring psychological symptoms and background characteristics among clinically referred youth with oppositional defiant disorder (ODD) with and without anger/irritability symptoms (AIS) according to either parent or teacher (source-exclusive) and both informants (cross-informant), youth with noncompliant symptoms…

  14. Prevalence of oppositional defiant disorder in Spain.

    PubMed

    López-Villalobos, José Antonio; Andrés-De Llano, Jesús María; Rodríguez-Molinero, Luis; Garrido-Redondo, Mercedes; Sacristán-Martín, Ana María; Martínez-Rivera, María Teresa; Alberola-López, Susana; Sánchez-Azón, María Isabel

    2014-01-01

    Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. ODD is one of the most frequent reasons for clinical consultation on mental health during childhood and adolescence. ODD has a high morbidity and dysfunction, and has important implications for the future if not treated early. To determine the prevalence of ODD in schoolchildren aged 6-16 years in Castile and Leon (Spain). Population study with a stratified multistage sample, and a proportional cluster design. Sample analyzed: 1,049. Cases were defined according to DSM-IV criteria. An overall prevalence rate of 5.6% was found (95% CI: 4.2%-7%). Male gender prevalence=6.8%; female=4.3%. Prevalence in secondary education=6.2%; primary education=5.3%. No significant differences by gender, age, grade, type of school, or demographic area were found. ODD prevalence without considering functional impairment, such as is performed in some research, would increase the prevalence to 7.4%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, maths and writing), and worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks, and disruption of the class). Castile and Leon has a prevalence rate of ODD slightly higher to that observed in international publications. Depending on the distribution by age, morbidity and clinical dysfunctional impact, an early diagnosis and a preventive intervention are required for health planning. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  15. Does Anxiety Modify the Risk for, or Severity of, Conduct Problems Among Children With Co-Occurring ADHD: Categorical and Dimensional and Analyses.

    PubMed

    Danforth, Jeffrey S; Doerfler, Leonard A; Connor, Daniel F

    2017-08-01

    The goal was to examine whether anxiety modifies the risk for, or severity of, conduct problems in children with ADHD. Assessment included both categorical and dimensional measures of ADHD, anxiety, and conduct problems. Analyses compared conduct problems between children with ADHD features alone versus children with co-occurring ADHD and anxiety features. When assessed by dimensional rating scales, results showed that compared with children with ADHD alone, those children with ADHD co-occurring with anxiety are at risk for more intense conduct problems. When assessment included a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnosis via the Schedule for Affective Disorders and Schizophrenia for School Age Children-Epidemiologic Version (K-SADS), results showed that compared with children with ADHD alone, those children with ADHD co-occurring with anxiety neither had more intense conduct problems nor were they more likely to be diagnosed with oppositional defiant disorder or conduct disorder. Different methodological measures of ADHD, anxiety, and conduct problem features influenced the outcome of the analyses.

  16. Implementation and evaluation of treatments for children and adolescents with conduct problems: Findings, challenges, and future directions.

    PubMed

    Kazdin, Alan E

    2018-01-01

    The intervention work of our clinical-research team has focused on the treatment of children and young adolescents referred for Conduct Disorder or Oppositional Defiant Disorder. We have evaluated two interventions: parent management training (PMT) and cognitive problem-solving skills training in several randomized controlled clinical trials. Our findings have indicated the treatments, alone or in combination, produce reliable and significant reductions in oppositional, aggressive, and antisocial behaviour and increases in prosocial behaviour among children. Parent dysfunction (depression, multiple symptom domains) and stress decline and family relations improve as well. Apart from outcome studies, we have studied the therapeutic alliance, factors that influence dropping out and retaining cases, and variations of treatment delivery (e.g., computer based, reduced therapist contact). The article considers challenges in conducting controlled trials in clinic settings (e.g., recruiting cases, maintaining treatment integrity, securing funding) and activities related to implementation that are not easily covered within the confines of research articles. The article ends with a discussion of one of the treatments (PMT) and the broad role it can play in treatment, prevention, and help with many parenting challenges of everyday life.

  17. Conduct Disorder and Oppositional Defiant Disorder in a National Sample: Developmental Epidemiology

    ERIC Educational Resources Information Center

    Maughan, Barbara; Rowe, Richard; Messer, Julie; Goodman, Robert; Meltzer, Howard

    2004-01-01

    Background: Despite an expanding epidemiological evidence base, uncertainties remain over key aspects of the epidemiology of the "antisocial" disorders in childhood and adolescence. Methods: We used cross-sectional data on a nationally representative sample of 10,438 5-15-year-olds drawn from the 1999 British Child Mental Health Survey…

  18. Estimated Risk of Developing Selected DSM-IV Disorders among 5-Year-Old Children with Prenatal Cocaine Exposure

    ERIC Educational Resources Information Center

    Morrow, Connie E.; Accornero, Veronica H.; Xue, Lihua; Manjunath, Sudha; Culbertson, Jan L.; Anthony, James C.; Bandstra, Emmalee S.

    2009-01-01

    We estimated childhood risk of developing selected DSM-IV Disorders, including Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Separation Anxiety Disorder (SAD), in children with prenatal cocaine exposure (PCE). Children were enrolled prospectively at birth (n = 476) with prenatal drug exposures documented…

  19. CBCL Pediatric Bipolar Disorder Profile and ADHD: Comorbidity and Quantitative Trait Loci Analysis

    ERIC Educational Resources Information Center

    McGough, James J.; Loo, Sandra K.; McCracken, James T.; Dang, Jeffery; Clark, Shaunna; Nelson, Stanley F.; Smalley, Susan L.

    2008-01-01

    The pediatric bipolar disorder profile of the Child Behavior checklist is used to differentiate patterns of comorbidity and to search for quantitative trait loci in multiple affected ADHD sibling pairs. The CBCL-PBD profiling identified 8 percent of individuals with severe psychopathology and increased rates of oppositional defiant, conduct and…

  20. ODD and ADHD Symptoms in Ukrainian Children: External Validators and Comorbidity

    ERIC Educational Resources Information Center

    Drabick, Deborah A. G.; Gadow, Kenneth D.; Carlson, Gabrielle A.; Bromet, Evelyn J.

    2004-01-01

    Objective: To examine potential external validators for oppositional defiant disorder (ODD) and attention-deficient/hyperactive disorder (ADHD) symptoms in a Ukrainian community-based sample of 600 children age 10 to 12 years old and evaluate the nature of co-occurring ODD and ADHD symptoms using mother- and teacher-defined groups. Method: In…

  1. Evidence-Based Treatment of Attention Deficit/Hyperactivity Disorder in a Preschool-Age Child: A Case Study

    ERIC Educational Resources Information Center

    Verduin, Timothy L.; Abikoff, Howard; Kurtz, Steven M. S.

    2008-01-01

    This case study illustrates a behavioral treatment of "Peter," a 4-year-old male with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder. Multiple evidence-based treatment procedures were implemented, affording the opportunity to explore issues common to the clinical application of empirically supported…

  2. A Systematic Evaluation of ADHD and Comorbid Psychopathology in a Population-Based Twin Sample

    ERIC Educational Resources Information Center

    Volk, Heather E.; Neuman, Rosalind J.; Todd, Richard D.

    2005-01-01

    Objective: Clinical and population samples demonstrate that attention-deficit/hyperactivity disorder (ADHD) occurs with other disorders. Comorbid disorder clustering within ADHD subtypes is not well studied. Method: Latent class analysis (LCA) examined the co-occurrence of DSM-IV ADHD, oppositional defiant disorder (ODD), conduct disorder (CD),…

  3. Subclinical ADHD, Stress, and Coping in Romantic Relationships of University Students

    ERIC Educational Resources Information Center

    Overbey, Gail A.; Snell, William E., Jr.; Callis, Kenneth E.

    2011-01-01

    Objective: To examine how the subclinical symptoms of adult ADHD and those of oppositional-defiant disorder (ODD) affect relationship satisfaction and stress and to determine whether different patterns of coping strategies emerge when undergraduates have symptoms of one or both disorders. Method: Participants (N = 497) complete self-report surveys…

  4. Child and Adolescent Behaviorally Based Disorders: A Critical Review of Reliability and Validity

    ERIC Educational Resources Information Center

    Mallett, Christopher A.

    2014-01-01

    Objectives: The purpose of this study was to investigate the historical construction and empirical support of two child and adolescent behaviorally based mental health disorders: oppositional defiant and conduct disorders. Method: The study utilized a historiography methodology to review, from 1880 to 2012, these disorders' inclusion in…

  5. The Appalachian Perspective: An Adaptation to a Parent Training Program for Disruptive Behavior Disorders

    ERIC Educational Resources Information Center

    Newland, Jessica Marie

    2010-01-01

    Disruptive behavior disorders in children are distressing to others due to the abnormal nature of the child's behavior (Christophersen & Mortweet, 2003). These disorders include attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Prevalent rates for these disorders range from 2% to…

  6. Clinical Reasoning in the Assessment and Planning for Intervention for Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Wilcox, Gabrielle; Heudes, Alethea

    2017-01-01

    Clinical reasoning requires thoughtful consideration of a variety of factors that contribute to the conceptualization of a case such as the reason for referral, school information, home environment, assessment outcomes, and behavioural observations made during assessments. The purpose of this article is to provide the reader with insight into the…

  7. Affective Decision-Making and Externalizing Behaviors: The Role of Autonomic Activity

    ERIC Educational Resources Information Center

    Bubier, Jennifer L.; Drabick, Deborah A. G.

    2008-01-01

    We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N…

  8. Motor Profile of Children with Attention Deficit Hyperactivity Disorder, Combined Type

    ERIC Educational Resources Information Center

    Goulardins, Juliana B.; Marques, Juliana C. Bilhar; Casella, Erasmo B.; Nascimento, Roseane O.; Oliveira, Jorge A.

    2013-01-01

    Objectives: The aim of this study was to assess the motor profile of children with attention deficit hyperactivity disorder (ADHD), combined type. Method: The case group consisted of 34 treatment-naive, male patients, aged 7-11 years, who had been diagnosed with ADHD, combined type, without comorbidities (except oppositional defiant disorder). The…

  9. Bringing It to the Teachers: Building a Professional Network among Teachers in Isolated Schools

    ERIC Educational Resources Information Center

    McLean, Fiona M.; Dixon, Roselyn M.; Verenikina, Irina

    2014-01-01

    Teachers in isolated schools are often under-resourced and overwhelmed with additional pressures. Teaching in an isolated community can sometimes challenge teachers' skills and knowledge, particularly when additional pressures such as behavioural issues associated with students with Oppositional Defiant Disorder (ODD) like behaviours are present.…

  10. Evidence-Based School Behavior Assessment of Externalizing Behavior in Young Children

    ERIC Educational Resources Information Center

    Bagner, Daniel M.; Boggs, Stephen R.; Eyberg, Sheila M.

    2010-01-01

    This study examined the psychometric properties of the Revised Edition of the School Observation Coding System (REDSOCS). Participants were 68 children ages 3 to 6 who completed parent-child interaction therapy for Oppositional Defiant Disorder as part of a larger efficacy trial. Interobserver reliability on REDSOCS categories was moderate to…

  11. Co-Occurring ODD and GAD Symptom Groups: Source-Specific Syndromes and Cross-Informant Comorbidity

    ERIC Educational Resources Information Center

    Drabick, Deborah A. G.; Gadow, Kenneth D.; Loney, Jan

    2008-01-01

    Despite important clinical and nosological implications, the comorbidity of oppositional defiant disorder (ODD) and generalized anxiety disorder (GAD) has received little attention. A clinic-based sample of 243 boys (ages 6-10 years), their parents, and teachers participated in an evaluation that involved assessments of behavioral, academic, and…

  12. Further evaluation of associations between attention-deficit/hyperactivity and oppositional defiant disorder symptoms and bullying-victimization in adolescence.

    PubMed

    Fite, Paula J; Evans, Spencer C; Cooley, John L; Rubens, Sonia L

    2014-02-01

    Relations between symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and bullying-victimization in adolescence are not yet clear. Accordingly, the current study evaluated these associations, with attention to gender differences, in a sample of predominantly Latino 9th-12th grade students (52.6 % male; mean grade level = 10.35, SD = 1.11). Further, the role of peer delinquency in these associations was evaluated. Findings indicated that ODD symptoms were more strongly associated with both bullying and victimization than ADHD symptoms, and the effects of ODD symptoms on physical forms of both bullying and victimization were stronger for males than females. The association between ODD symptoms and physical bullying was stronger at high levels of peer delinquency when compared to low levels of peer delinquency for both males and females. The role of peer delinquency in the link between ADHD symptoms and bullying and victimization appears to be gender specific and in need of further evaluation. Implications for the need to focus primarily on ODD symptoms for both bullying and victimization prevention and intervention are discussed.

  13. Multi-Level Family Factors and Affective and Behavioral Symptoms of Oppositional Defiant Disorder in Chinese Children

    PubMed Central

    Tang, Yixin; Lin, Xiuyun; Chi, Peilian; Zhou, Qing; Hou, Xiangning

    2017-01-01

    Given the important role of family environment in children's psychological development, the objective of this study was to examine the linkages between family factors at the whole, dyadic, and individual levels and two dimensions (affective and behavioral) of Oppositional Defiant Disorder (ODD) symptoms in Chinese children. Participants comprised of 80 father-child dyads and 169 mother-child dyads from families with ODD children. The results indicated that multilevel family factors were differently associated with children's affective and behavioral ODD symptoms. All the family factors at the dyadic and individual levels were significantly associated with child affective ODD symptoms. However, only the most proximal factors (parent-child relationship and child emotion regulation, which were directly related to child) were significantly related to child behavioral ODD symptoms. The present study extends the current knowledge regarding the relationships between family factors and two dimensions of child ODD symptoms by testing the comprehensive multilevel family factors model. This study also recommends that future interventions for ODD children should consider the multi-level family factors to enhance intervention efficacy. PMID:28713321

  14. Love, eye contact and the developmental origins of empathy v. psychopathy.

    PubMed

    Dadds, Mark R; Allen, Jennifer L; Oliver, Bonamy R; Faulkner, Nathan; Legge, Katherine; Moul, Caroline; Woolgar, Matthew; Scott, Stephen

    2012-03-01

    A propensity to attend to other people's emotions is a necessary condition for human empathy. To test our hypothesis that psychopathic disorder begins as a failure to attend to the eyes of attachment figures, using a `love' scenario in young children. Children with oppositional defiant disorder, assessed for callous-unemotional traits, and a control group were observed in a love interaction with mothers. Eye contact and affection were measured for each dyad. There was no group difference in affection and eye contact expressed by the mothers. Compared with controls, children with oppositional defiant disorder expressed lower levels of affection back towards their mothers; those with high levels of callous-unemotional traits showed significantly lower levels of affection than the children lacking these traits. As predicted, the former group showed low levels of eye contact toward their mothers. Low eye contact was not correlated with maternal coercive parenting or feelings toward the child, but was correlated with psychopathic fearlessness in their fathers. Impairments in eye contact are characteristic of children with callous-unemotional traits, and these impairments are independent of maternal behaviour.

  15. Current Issues in the Diagnosis of Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder

    PubMed Central

    Frick, Paul J.; Nigg, Joel T.

    2015-01-01

    This review evaluates the diagnostic criteria for three of the most common disorders for which children and adolescents are referred for mental health treatment: attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Although research supports the validity and clinical utility of these disorders, several issues are highlighted that could enhance the current diagnostic criteria. For ADHD, defining the core features of the disorder and its fit with other disorders, enhancing the validity of the criteria through the lifespan, considering alternative ways to form subtypes of the disorder, and modifying the age-of-onset criterion are discussed relative to the current diagnostic criteria. For ODD, eliminating the exclusionary criteria of CD, recognizing important symptom domains within the disorder, and using the cross-situational pervasiveness of the disorder as an index of severity are highlighted as important issues for improving classification. Finally, for CD, enhancing the current subtypes related to age of onset and integrating callous-unemotional traits into the diagnostic criteria are identified as key issues for improving classification. PMID:22035245

  16. Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder.

    PubMed

    Lin, Xiuyun; Li, Longfeng; Chi, Peilian; Wang, Zhonghui; Heath, Melissa Allen; Du, Hongfei; Fang, Xiaoyi

    2016-01-01

    Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent-child relationship, teacher-student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent-child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

    Granero, Roser; Louwaars, Leonie; Ezpeleta, Lourdes

    2015-01-01

    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. The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. 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. 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 control.

  18. School-based mental health programming for children with inattentive and disruptive behavior problems: first-year treatment outcome.

    PubMed

    Owens, Julie Sarno; Richerson, Lauren; Beilstein, Elizabeth A; Crane, Anna; Murphy, Caroline E; Vancouver, Jeffrey B

    2005-08-01

    This article examines the effectiveness of an evidence-based behavioral treatment package for children with inattentive and disruptive behavior problems when delivered in the context of a school-based mental health program. Child symptomatology and functioning are assessed in a treatment group (n = 30) and a waitlist control group (n = 12) across multiple time points (fall, winter, and spring). Treatment includes a daily report card procedure, year-long teacher consultation, and parenting sessions. According to the parent report, treated children show marked reductions in hyperactive and impulsive, oppositional or defiant and aggressive behavior, and marked improvement in peer relationships. Teachers observe treatment-related group differences in inattention, academic functioning, and the student-teacher relationship. Feasibility and acceptability data have implications for transporting evidence-based treatments to community settings and for integrating mental health services into the culture of the school community.

  19. A Systematic Review and Meta-analysis of Neuroimaging in Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) Taking Attention-Deficit Hyperactivity Disorder (ADHD) Into Account.

    PubMed

    Noordermeer, Siri D S; Luman, Marjolein; Oosterlaan, Jaap

    2016-03-01

    Oppositional defiant disorder (ODD) and conduct disorder (CD) are common behavioural disorders in childhood and adolescence and are associated with brain abnormalities. This systematic review and meta-analysis investigates structural (sMRI) and functional MRI (fMRI) findings in individuals with ODD/CD with and without attention-deficit hyperactivity disorder (ADHD). Online databases were searched for controlled studies, resulting in 12 sMRI and 17 fMRI studies. In line with current models on ODD/CD, studies were classified in hot and cool executive functioning (EF). Both the meta-analytic and narrative reviews showed evidence of smaller brain structures and lower brain activity in individuals with ODD/CD in mainly hot EF-related areas: bilateral amygdala, bilateral insula, right striatum, left medial/superior frontal gyrus, and left precuneus. Evidence was present in both structural and functional studies, and irrespective of the presence of ADHD comorbidity. There is strong evidence that abnormalities in the amygdala are specific for ODD/CD as compared to ADHD, and correlational studies further support the association between abnormalities in the amygdala and ODD/CD symptoms. Besides the left precuneus, there was no evidence for abnormalities in typical cool EF related structures, such as the cerebellum and dorsolateral prefrontal cortex. Resulting areas are associated with emotion-processing, error-monitoring, problem-solving and self-control; areas associated with neurocognitive and behavioural deficits implicated in ODD/CD. Our findings confirm the involvement of hot, and to a smaller extent cool, EF associated brain areas in ODD/CD, and support an integrated model for ODD/CD (e.g. Blair, Development and Psychopathology, 17(3), 865-891, 2005).

  20. Intellectual Disability in Children with Attention Deficit Hyperactivity Disorder

    PubMed Central

    Ahuja, Alka; Martin, Joanna; Langley, Kate; Thapar, Anita

    2013-01-01

    Objective To determine whether children with attention deficit hyperactivity disorder (ADHD) and mild intellectual disability (ID) are a clinically distinct ADHD subgroup. Study design This was a cross-sectional study comparing clinical characteristics (ADHD subtypes, total number of symptoms, and rates of common comorbidities) between children with ADHD and mild ID and those with ADHD and IQ test scores >70, and also between children with ADHD and ID and a general population sample of children with ID alone. The sample comprised a clinical sample of children with ADHD with ID (n = 97) and without ID (n = 874) and a general population sample of children with ID and without ADHD (n = 58). Results After correcting for multiple statistical tests, no differences were found between the 2 ADHD groups on any measure except the presence of conduct disorder (CD) symptoms and diagnoses. Children with ADHD and ID had higher rates of both (OR, 2.38; 95% CI, 1.71-3.32 and OR, 2.69; 95% CI, 1.69-4.28, respectively). Furthermore, children with ADHD and ID had significantly higher rates of oppositional defiant disorder (OR, 5.54; 95% CI, 2.86-10.75) and CD (OR, 13.66; 95% CI, 3.25-57.42) symptoms and a higher incidence of oppositional defiant disorder diagnoses (OR, 30.99; 95% CI, 6.38-150.39) compared with children with ID without ADHD. Conclusion Children with ADHD and mild ID appear to be clinically typical of children with ADHD except for more conduct problems. This finding has implications for clinicians treating these children in terms of acknowledging the presence and impact of ADHD symptoms above and beyond ID and dealing with a comorbid CD. PMID:23608559

  1. Intellectual disability in children with attention deficit hyperactivity disorder.

    PubMed

    Ahuja, Alka; Martin, Joanna; Langley, Kate; Thapar, Anita

    2013-09-01

    To determine whether children with attention deficit hyperactivity disorder (ADHD) and mild intellectual disability (ID) are a clinically distinct ADHD subgroup. This was a cross-sectional study comparing clinical characteristics (ADHD subtypes, total number of symptoms, and rates of common comorbidities) between children with ADHD and mild ID and those with ADHD and IQ test scores >70, and also between children with ADHD and ID and a general population sample of children with ID alone. The sample comprised a clinical sample of children with ADHD with ID (n = 97) and without ID (n = 874) and a general population sample of children with ID and without ADHD (n = 58). After correcting for multiple statistical tests, no differences were found between the 2 ADHD groups on any measure except the presence of conduct disorder (CD) symptoms and diagnoses. Children with ADHD and ID had higher rates of both (OR, 2.38; 95% CI, 1.71-3.32 and OR, 2.69; 95% CI, 1.69-4.28, respectively). Furthermore, children with ADHD and ID had significantly higher rates of oppositional defiant disorder (OR, 5.54; 95% CI, 2.86-10.75) and CD (OR, 13.66; 95% CI, 3.25-57.42) symptoms and a higher incidence of oppositional defiant disorder diagnoses (OR, 30.99; 95% CI, 6.38-150.39) compared with children with ID without ADHD. Children with ADHD and mild ID appear to be clinically typical of children with ADHD except for more conduct problems. This finding has implications for clinicians treating these children in terms of acknowledging the presence and impact of ADHD symptoms above and beyond ID and dealing with a comorbid CD. Copyright © 2013 Mosby, Inc. All rights reserved.

  2. Impaired neurocognitive functions affect social learning processes in oppositional defiant disorder and conduct disorder: implications for interventions.

    PubMed

    Matthys, Walter; Vanderschuren, Louk J M J; Schutter, Dennis J L G; Lochman, John E

    2012-09-01

    In this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations between behaviors and negative and positive consequences is compromised in children and adolescents with these disorders due to reduced sensitivity to punishment and to reward. As a result, both learning of appropriate behavior and learning to refrain from inappropriate behavior may be affected. Likewise, problem solving is impaired due to deficiencies in inhibition, attention, cognitive flexibility, and decision making. Consequently, children and adolescents with ODD and CD may have difficulty learning to optimize their behavior in changeable environments. This conceptualization of ODD and CD is relevant for the improvement of the effect of psychological treatments. Behavioral and cognitive-behavioral interventions that have been shown to be modestly effective in ODD and CD are based on social learning. Limited effectiveness of these interventions may be caused by difficulties in social learning in children and adolescents with ODD and CD. However, although these impairments have been observed at a group level, the deficits in reward processing, punishment processing, and cognitive control mentioned above may not be present to the same extent in each individual with ODD and CD. Therefore, the neurocognitive characteristics in children and adolescents with ODD and CD should be assessed individually. Thus, instead of delivering interventions in a standardized way, these programs may benefit from an individualized approach that depends on the weaknesses and strengths of the neurocognitive characteristics of the child and the adolescent.

  3. Description and immediate impacts of a preventive intervention for conduct problems.

    PubMed

    Reid, J B; Eddy, J M; Fetrow, R A; Stoolmiller, M

    1999-08-01

    A population-based randomized intervention trial for the prevention of conduct problems (i.e., oppositional defiant disorder and conduct disorder) is described. The LIFT (Linking the Interests of Families and Teachers) intervention was designed for all first- and fifth-grade elementary school boys and girls and their families living in at-risk neighborhoods characterized by high rates of juvenile delinquency. The 10-week intervention strategy was carefully targeted at proximal and malleable antecedents in three social domains that were identified by a developmental model of conduct problems. From 12 elementary schools, 671 first and fifth graders and their families participated either in the theory-based universal preventive intervention or in a control condition. The intervention consisted of parent training, a classroom-based social skills program, a playground behavioral program, and systematic communication between teachers and parents. A multiple measure assessment strategy was used to evaluate participant satisfaction and participation, fidelity of implementation, and the immediate impacts of the program on targeted antecedents.

  4. The Comorbidity of ADHD in the General Population of Saudi Arabian School-Age Children

    ERIC Educational Resources Information Center

    Alqahtani, Mohammed M.

    2010-01-01

    Objective: To investigate comorbidity of oppositional-defiant disorder (ODD), conduct disorder (CD), anxiety, and depression and to investigate the impaired social and academic developments among children with ADHD in primary school settings in Saudi Arabia. Method: Data for the purpose of this study are obtained from parent and teachers of 652…

  5. Common Genetic and Nonshared Environmental Factors Contribute to the Association between Socioemotional Dispositions and the Externalizing Factor in Children

    ERIC Educational Resources Information Center

    Taylor, Jeanette; Allan, Nicholas; Mikolajewski, Amy J.; Hart, Sara A.

    2013-01-01

    Background: Childhood behavioral disorders including conduct disorder (CD), oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD) often co-occur. Prior twin research shows that common sets of genetic and environmental factors are associated with these various disorders and they form a latent factor called…

  6. The Interplay among Preschool Child and Family Factors and the Development of ODD Symptoms

    ERIC Educational Resources Information Center

    Harvey, Elizabeth A.; Metcalfe, Lindsay A.

    2012-01-01

    The present study examined (a) the interactions between early behavior, early parenting, and early family adversity in predicting later oppositional defiant disorder (ODD) symptoms, and (b) the reciprocal relations between parent functioning and ODD symptoms across the preschool years. Participants were 258 three-year-old children (138 boys, 120…

  7. Disregard for Rules: The Early Development and Predictors of a Specific Dimension of Disruptive Behavior Disorders

    ERIC Educational Resources Information Center

    Petitclerc, Amelie; Boivin, Michel; Dionne, Ginette; Zoccolillo, Mark; Tremblay, Richard E.

    2009-01-01

    Background: Disregard for rules, an important dimension of oppositional defiant and conduct disorders, is frequent during early childhood, but the development of its chronic form has not been studied during this key socialization period. This study aimed to describe the developmental trajectories of disregard for rules during early childhood and…

  8. Psychological Symptoms in Youth and Later Socioeconomic Functioning: Do Associations Vary by Informant?

    ERIC Educational Resources Information Center

    Dirks, Melanie A.; Boyle, Michael H.; Georgiades, Katholiki

    2011-01-01

    We examined whether associations between symptoms of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), depression, and anxiety assessed in a sample of 2,026 youth aged 6 to 16 years and socioeconomic functioning measured 18 years later varied as a function of whether parents or teachers had rated symptomatology.…

  9. The Brief Child and Family Phone Interview (BCFPI): 2. Usefulness in Screening for Child and Adolescent Psychopathology

    ERIC Educational Resources Information Center

    Boyle, Michael H.; Cunningham, Charles E.; Georgiades, Katholiki; Cullen, John; Racine, Yvonne; Pettingill, Peter

    2009-01-01

    Background: This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD),…

  10. ADHD Preschoolers with and without ODD: Do They Act Differently Depending on Degree of Task Engagement/Reward?

    ERIC Educational Resources Information Center

    Gopin, Chaya B.; Berwid, Olga; Marks, David J.; Mlodnicka, Agnieska; Halperin, Jeffrey M.

    2013-01-01

    Objective: To examine the impact of reinforcement on reaction time (RT) and RT variability (RT standard deviation [RTSD]) in preschoolers with ADHD with and without oppositional defiant disorder (ODD), and a typically developing (TD) comparison group. Method: Participants were administered a computerized task consisting of two conditions: simple…

  11. A Common Genetic Factor Explains the Covariation among ADHD ODD and CD Symptoms in 9-10 Year Old Boys and Girls

    ERIC Educational Resources Information Center

    Tuvblad, Catherine; Zheng, Mo; Raine, Adrian; Baker, Laura A.

    2009-01-01

    Previous studies examining the covariation among Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) have yielded inconsistent results. Some studies have concluded that the covariation among these symptoms is due to common genetic influences, whereas others have found a common…

  12. Treatment of Moderately Intellectually Disabled Delinquent Youth in a Dutch Juvenile Justice Facility with Closed and Open Units

    ERIC Educational Resources Information Center

    Lodewijks, Henny P. B.

    2011-01-01

    This article will focus on a juvenile justice facility in the Netherlands, targeted at moderately intellectually disabled juveniles, who are sentenced because of serious crimes. All of the juveniles have a disruptive disorder (conduct disorder or oppositional defiant disorder) and 70% have comorbid psychiatric classifications. Treatment amounts to…

  13. The Relationship between Social Defiance, Vindictiveness, Anger, and Brain Morphology in Eight-Year-Old Boys and Girls

    ERIC Educational Resources Information Center

    Fahim, Cherine; Fiori, Marina; Evans, Alan C.; Perusse, Daniel

    2012-01-01

    The goal of this study is twofold: (1) to assess brain anatomical differences between children meeting diagnostic criteria for oppositional defiant disorder (ODD) and healthy controls, and (2) to investigate whether morphological brain characteristics associated with ODD differ in boys and girls. Eight-year-old participants (N = 38) were scanned…

  14. Sex Differences in Autonomic Correlates of Conduct Problems and Aggression

    PubMed Central

    BEAUCHAINE, THEODORE P.; HONG, JAMES; MARSH, PENNY

    2009-01-01

    Objective To examine sex differences in autonomic nervous system functioning in children and adolescents with conduct problems and to evaluate the role of aggression in predicting autonomic nervous system functioning, over and above the effects of disruptive behavior. Although deficiencies in autonomic responding among boys with oppositional defiant disorder and/or conduct disorder are well documented, it remains unclear whether such findings extend to girls or apply only to children with aggressive forms of conduct problems. Method Electrodermal responding, cardiac pre-ejection period, and respiratory sinus arrhythmia were recorded while boys (n = 110; 53 with conduct problems, 57 controls) and girls (n = 65; 33 with conduct problems, 32 controls) between the ages of 8 and 12 sat for an extended baseline, then played a game with conditions of reward and frustrative nonreward. Results Both sex effects and aggression effects were found. Aggressive boys with conduct problems demonstrated reduced autonomic functioning, consistent with previous research. In contrast, aggressive girls with conduct problems exhibited greater electrodermal responding than controls, with no differences in cardiovascular reactivity to incentives. Conclusions Observed sex differences in the autonomic correlates of conduct problems and aggression may suggest different etiological mechanisms of externalizing psychopathology for girls compared with boys. PMID:18520959

  15. One-Year Follow-Up of Combined Parent and Child Intervention for Young Children with ADHD

    ERIC Educational Resources Information Center

    Webster-Stratton, Carolyn; Reid, M. Jamila; Beauchaine, Theodore P.

    2013-01-01

    Efficacies of the Incredible Years (IY) interventions are well-established in children with oppositional defiant disorder (ODD) but not among those with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate 1-year follow-up outcomes among young children with ADHD who were treated with the IY interventions.…

  16. Association of Anxiety and ODD/CD in Children with and without ADHD

    ERIC Educational Resources Information Center

    Humphreys, Kathryn L.; Aguirre, Vincent P.; Lee, Steve S.

    2012-01-01

    The goal of this study is to examine levels of oppositional defiant disorder (ODD) and conduct disorder (CD) in four groups of children: attention-deficit/hyperactivity disorder (ADHD) only, anxiety only, ADHD and anxiety, and controls (i.e., non-ADHD youth). Although children with ADHD exhibit more ODD and CD than non-ADHD youth, it is unknown if…

  17. Should There Be Separate Parent and Teacher-Based Categories of ODD? Evidence from a General Population

    ERIC Educational Resources Information Center

    Munkvold, Linda; Lundervold, Astri; Lie, Stein Atle; Manger, Terje

    2009-01-01

    Objective: To examine the occurrence of oppositional defiant disorder (ODD) symptoms in a general population of boys and girls, as reported by parents and teachers, and to investigate differences in prevalence estimates, depending on how parents' and teachers' ratings were combined. Method: Data were collected from 7007 children (aged 7-9) who…

  18. Trajectories of Symptom Reduction and Engagement during Treatment for Childhood Behavior Disorders: Differences across Settings

    ERIC Educational Resources Information Center

    Lindhiem, Oliver; Kolko, David J.

    2010-01-01

    In this study, we examined trajectories of symptom reduction and family engagement during the modular treatment phase of a clinical trial for early-onset disruptive behavior disorders that was applied either in community settings or a clinic. Participants (N = 139) were 6-11 year-old children with diagnoses of Oppositional Defiant Disorder (ODD)…

  19. Predictors and Correlates of Completing Behavioral Parent Training for the Treatment of Oppositional Defiant Disorder in Pediatric Primary Care

    ERIC Educational Resources Information Center

    Lavigne, John V.; LeBailly, Susan A.; Gouze, Karen R.; Binns, Helen J.; Keller, Jennifer; Pate, Lindsay

    2010-01-01

    This study examined the role of pretreatment demographic and clinical predictors of attendance as well as barriers to treatment and consumer satisfaction on attendance at therapist-led parent training with 86 families of children ages 3 to 6 years conducted in pediatric primary care settings. Only socioeconomic status (SES) and minority group…

  20. The Possible Effect of Methylphenidate Treatment on Empathy in Children Diagnosed with Attention-Deficit/Hyperactivity Disorder, Both With and Without Comorbid Oppositional Defiant Disorder.

    PubMed

    Golubchik, Pavel; Weizman, Abraham

    2017-06-01

    To assess the Empathizing Quotient (EQ) of patients diagnosed with attention-deficit/hyperactivity disorder (ADHD) only or comorbid with oppositional defiant disorder (ODD) and compare the two groups' responses to methylphenidate (MPH) treatment. Fifty-two children (8-18 years) diagnosed with ADHD, 26 of whom were also diagnosed with comorbid ODD (ADHD/ODD), were treated with MPH for 12 weeks. The level of EQ was assessed with the Children's version of the Empathizing Quotient (EQ-C) and the severity of ADHD symptoms with the ADHD Rating Scale (ADHD-RS). Assessments were done at baseline and at end point. A significant increase in EQ scores was obtained in both groups following MPH treatment (p = 0.003 for ADHD/ODD; p = 0.002 for ADHD). Significant correlation was found in the ADHD group between the changes in ADHD-RS and those in EQ, following MPH treatment (p = 0.015), but not in the ADHD/ODD group (p = 0.48). A correlation exists between MPH-related improvement in ADHD symptoms and between more empathy in children with ADHD not comorbid with ODD.

  1. Memory consolidation of socially relevant stimuli during sleep in healthy children and children with attention-deficit/hyperactivity disorder and oppositional defiant disorder: What you can see in their eyes.

    PubMed

    Prehn-Kristensen, Alexander; Molzow, Ina; Förster, Alexandra; Siebenhühner, Nadine; Gesch, Maxime; Wiesner, Christian D; Baving, Lioba

    2017-02-01

    Children with attention-deficit/hyperactivity disorder (ADHD) display deficits in sleep-dependent memory consolidation, and being comorbid with oppositional defiant disorder (ODD), results in deficits in face processing. The aim of the present study was to investigate the role of sleep in recognizing faces in children with ADHD+ODD. Sixteen healthy children and 16 children diagnosed with ADHD+ODD participated in a sleep and a wake condition. During encoding (sleep condition at 8p.m.; wake condition at 8a.m.) pictures of faces were rated according to their emotional content; the retrieval session (12h after encoding session) contained a recognition task including pupillometry. Pupillometry and behavioral data revealed that healthy children benefited from sleep compared to wake with respect to face picture recognition; in contrast recognition performance in patients with ADHD+ODD was not improved after sleep compared to wake. It is discussed whether in patients with ADHD+ODD social stimuli are preferentially consolidated during daytime. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Dysthymic disorder contributes to oppositional defiant behaviour in children with Attention Deficit Hyperactivity Disorder, combined type (ADHD-CT).

    PubMed

    Vance, Alasdair; Sanders, Michelle; Arduca, Yolanda

    2005-06-01

    The specific relationships between oppositional defiant disorder (ODD), ADHD-CT, dysthymic disorder (DD) and anxiety disorders symptoms have not been studied in children with ADHD-CT. The relationship to DD is important because DD is common, has an earlier age of onset, is associated with significant morbidity and with increased rates of treatment non-responsiveness when comorbid with major depressive disorder and/or ADHD-CT. 200 clinically referred children with ADHD-CT, without comorbid major depressive disorder, were identified. "ODD", "ADHD-CT", "DD" and "anxiety disorders" symptoms were defined by composite measures of (1) semi-structured clinical interview and (2) parent and/or child standardized questionnaires. Standard multiple regression was used to examine how well "ADHD-CT", "DD" and "anxiety disorders" symptoms predict "ODD" symptoms. Only "ADHD-CT" (15% of the variance) and "DD" (8% of the variance) symptoms made independent significant contributions to the prediction of "ODD" symptoms. The study's sample size did not allow "ODD" and "conduct disorder" symptoms to be analysed separately. The association of DD with ODD may reflect a unique contribution of DD to ODD in children, whether ADHD-CT is present or not, or only when ADHD-CT is present.

  3. Parenting practices as mediating variables between parents' psychopathology and oppositional defiant disorder in preschoolers.

    PubMed

    Trepat, Esther; Granero, Roser; Ezpeleta, Lourdes

    2014-01-01

    Oppositional defiant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents' psychopathology and ODD in preschoolers. A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on children's psychopathology through a diagnostic interview, and on their own psychological state and parenting style through questionnaires. At ages 3 and 5, corporal punishment mediated the relationships between mothers' anxiety-depression and ODD (in girls), between mothers' aggressive behavior and ODD (in boys), and between parents' rule-breaking and ODD both in boys and girls. For both sexes, there was a direct association between mothers' aggressive behavior score and ODD. The association between fathers' psychopathology and ODD was not mediated by the fathers' parenting practices. Fathers' anxiety-depression and aggressive behavior scores were directly associated with ODD. Parents' psychopathology must be explored and, in families where such psychopathology is a relevant variable, parenting practices must be addressed with a view to the prevention and treatment of children's ODD in the preschool years.

  4. Response perseveration and sensitivity to reward and punishment in boys with oppositional defiant disorder.

    PubMed

    Matthys, Walter; van Goozen, Stephanie H M; Snoek, Heddeke; van Engeland, Herman

    2004-12-01

    Response perseveration is the tendency to continue a response set for reward despite punishment. In the present study, response perseveration and sensitivity to reward and punishment were assessed in boys with oppositional defiant disorder (ODD). The study also examined the relation between punishment sensitivity and autonomic arousal. Nineteen ODD boys (mean age 9.8 years) and 20 normal control boys (NC) (mean age 9.7 years) were administered the door-opening task. In this task, the subject chooses either to open the next door or to stop playing; the opening of doors is initially rewarded and then increasingly punished. ODD boys opened more doors than NC boys. Following punishment, ODD boys took less time than NC boys before opening the next door, but did not differ from NC boys in time after reward. Mean skin conductance level was lower in ODD boys than in NC boys. The correlation coefficient between time after punishment and skin conductance level was moderately positive in the total sample. These results suggest that response perseveration in ODD boys is related to low punishment sensitivity and that skin conductance level is a marker of punishment sensitivity.

  5. The health consequences of child mental health problems and parenting styles: unintentional injuries among European schoolchildren.

    PubMed

    Keyes, Katherine M; Susser, Ezra; Pilowsky, Daniel J; Hamilton, Ava; Bitfoi, Adina; Goelitz, Dietmar; Kuijpers, Rowella C W M; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Kovess, Viviane

    2014-10-01

    Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past-year injuries serious enough to seek medical attention were reported by mothers. Child mental health problems were assessed using validated measures and reported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. Children with attention-deficit/hyperactivity symptoms and oppositional defiant symptoms had a higher risk of injury compared to other children whether based on parent report (OR=1.47, 95% C.I. 1.2-1.9), teacher report (OR=1.36, 95% C.I. 1.1-1.7), or parent and teacher report combined (OR=1.53, 95% C.I. 1.1-2.1). Children who self-reported oppositional symptoms also had higher risk of injury (OR=1.6, 95% C.I. 1.1-2.4). Low-caring behavior of parents increased the risk of injury (OR=1.4, 95% C.I. 1.1-1.9). Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent-child relationships and prevention as well as focused treatment for externalizing problems may reduce the burden of injury. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The Effects of a Direct Instruction Flashcard System on Multiplication Fact Mastery by Two High School Students with ADHD and ODD

    ERIC Educational Resources Information Center

    Brasch, Tera L.; Williams, Randy Lee; McLaughlin, T. F.

    2008-01-01

    The purpose of the present research is to compare the effects of a Direct Instruction flashcard procedure on the mastery of multiplication facts by two high school students with attention deficit hyper-activity disorder (ADHD) and oppositional defiant disorder (ODD). Both students were enrolled in a separate high school for students with behavior…

  7. Autism Symptoms in Attention-Deficit/Hyperactivity Disorder: A Familial Trait which Correlates with Conduct, Oppositional Defiant, Language and Motor Disorders

    ERIC Educational Resources Information Center

    Mulligan, Aisling; Anney, Richard J. L; O'Regan, Myra; Chen, Wai; Butler, Louise; Fitzgerald, Michael; Buitelaar, Jan; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Minderaa, Ruud; Nijmeijer, Judith; Hoekstra, Pieter J.; Oades, Robert D.; Roeyers, Herbert; Buschgens, Cathelijne; Christiansen, Hanna; Franke, Barbara; Gabriels, Isabel; Hartman, Catharina; Kuntsi, Jonna; Marco, Rafaela; Meidad, Sheera; Mueller, Ueli; Psychogiou, Lamprini; Rommelse, Nanda; Thompson, Margaret; Uebel, Henrik; Banaschewski, Tobias; Ebstein, Richard; Eisenberg, Jacques; Manor, Iris; Miranda, Ana; Mulas, Fernando; Sergeant, Joseph; Sonuga-Barke, Edmund; Asherson, Phil; Faraone, Stephen V.; Gill, Michael

    2009-01-01

    It is hypothesised that autism symptoms are present in Attention-Deficit/Hyperactivity Disorder (ADHD), are familial and index subtypes of ADHD. Autism symptoms were compared in 821 ADHD probands, 1050 siblings and 149 controls. Shared familiality of autism symptoms and ADHD was calculated using DeFries-Fulker analysis. Autism symptoms were higher…

  8. Influence of Disruptive Behavior Disorders on Academic Performance and School Functions of Youths with Attention-Deficit/Hyperactivity Disorder.

    PubMed

    Liu, Chao-Yu; Huang, Wei-Lieh; Kao, Wei-Chih; Gau, Susan Shur-Fen

    2017-12-01

    Childhood attention-deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder/conduct disorder (ODD/CD) are associated with negative school outcomes. The study aimed to examine the impact of ADHD and ODD/CD on various school functions. 395 youths with ADHD (244 with ADHD + ODD/CD and 151 with ADHD only) and 156 controls received semi-structured psychiatric interviews. School functions were assessed and compared between each group with a multiple-level model. The results showed that youths with ADHD had poorer performance across different domains of school functioning. Youths with ADHD + ODD/CD had more behavioral problems but similar academic performance than those with ADHD only. The multiple linear regression models revealed that ADHD impaired academic performance while ODD/CD aggravated behavioral problems. Our findings imply that comorbid ODD/CD may specifically contribute to social difficulties in youths with ADHD. Measures of early detection and intervention for ODD/CD should be conducted to prevent adverse outcomes.

  9. Pathophysiology of ADHD and associated problems—starting points for NF interventions?

    PubMed Central

    Albrecht, Björn; Uebel-von Sandersleben, Henrik; Gevensleben, Holger; Rothenberger, Aribert

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) is characterized by severe and age-inappropriate levels of hyperactivity, impulsivity and inattention. ADHD is a heterogeneous disorder, and the majority of patients show comorbid or associated problems from other psychiatric disorders. Also, ADHD is associated with cognitive and motivational problems as well as resting-state abnormalities, associated with impaired brain activity in distinct neuronal networks. This needs to be considered in a multimodal treatment, of which neurofeedback (NF) may be a promising component. During NF, specific brain activity is fed-back using visual or auditory signals, allowing the participants to gain control over these otherwise unaware neuronal processes. NF may be used to directly improve underlying neuronal deficits, and/or to establish more general self-regulatory skills that may be used to compensate behavioral difficulties. The current manuscript describes pathophysiological characteristics of ADHD, heterogeneity of ADHD subtypes and gender differences, as well as frequently associated behavioral problems such as oppositional defiant/conduct or tic disorder. It is discussed how NF may be helpful as a treatment approach within these contexts. PMID:26157377

  10. A Randomized Placebo-Controlled Trial of D-Cycloserine for the Enhancement of Social Skills Training in Pervasive Development Disorders

    DTIC Science & Technology

    2015-03-01

    Harvard Medical School Boston, Massachusetts Keywords: D-cycloserine, Autism Spectrum Disorders , social skills training, social deficits ...427 to ensure that they did not have a history of psychiatric symptoms that were currently affecting social skills (e.g., attention - deficit ... hyperactivity disorder , oppositional defiant disorder , schizophrenia, ASD, social anxiety disorder , and major depression). The child’s appropriateness for

  11. Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

    ERIC Educational Resources Information Center

    Kolko, David J.; Dorn, Lorah D.; Bukstein, Oscar G.; Pardini, Dustin; Holden, Elizabeth A.; Hart, Jonathan

    2009-01-01

    This study examines the treatment outcomes of 139, 6-11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC).…

  12. A Multitrait (ADHD-IN, ADHD-HI, ODD toward Adults, Academic and Social Competence) by Multisource (Mothers and Fathers) Evaluation of the Invariance and Convergent/Discriminant Validity of the Child and Adolescent Disruptive Behavior Inventory with Thai Adolescents

    ERIC Educational Resources Information Center

    Burns, G. Leonard; Desmul, Chris; Walsh, James A.; Silpakit, Chatchawan; Ussahawanitchakit, Phapruke

    2009-01-01

    Confirmatory factor analysis was used with a multitrait (attention-deficit/hyperactivity disorder-inattention, attention-deficit/hyperactivity disorder-hyperactivity/impulsivity, oppositional defiant disorder toward adults, academic competence, and social competence) by multisource (mothers and fathers) matrix to test the invariance and…

  13. Parental involvement as an etiological moderator of middle childhood oppositional defiant disorder

    PubMed Central

    Li, I.; Clark, D.A.; Klump, K. L.; Burt, S. A.

    2018-01-01

    The goal of this study was to investigate parental involvement as an etiologic moderator of oppositional defiant disorder (ODD) during middle childhood. Previous studies examining the influence of genetic and environmental factors on ODD have not considered whether and how these factors might vary by parental involvement. We thus conducted a series of “latent G by measured E” interaction analyses, in which measured parental involvement was allowed to moderate genetic, shared, and non-shared environmental influences on child ODD. Participants include 1027 twin pairs (age ranged from 6 to 11 years old) from the Michigan State University Twin Registry (MSUTR). Results did indeed suggest that the etiology of ODD varies with maternal involvement, such that genetic influence on ODD became more prominent as maternal involvement decreased. However, these results were specific to children’s perceptions of maternal involvement and did not extend to maternal perceptions of her involvement. There was no evidence that paternal involvement moderated the etiology of ODD, regardless of informant. The different results found in twins’ and parents’ data is consistent with previous research that children may have different perceptions from parents about their family relationships and this discrepancy needs to be taken into account in future research. PMID:28263622

  14. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Comings, D.E.; Wu, S.; Chiu, C.

    Polymorphisms of three different dopaminergic genes, dopamine D{sub 2} receptor (DRD2), dopamine {beta}-hydroxylase (D{beta}H), and dopamine transporter (DAT1), were examined in Tourette syndrome (TS) probands, their relatives, and controls. Each gene individually showed a significant correlation with various behavioral variables in these subjects. The additive and subtractive effects of the three genes were examined by genotyping all three genes in the same set of subjects. For 9 of 20 TS associated comorbid behaviors there was a significant linear association between the degree of loading for markers of three genes and the mean behavior scores. The behavior variables showing the significantmore » associations were, in order, attention deficit hyperactivity disorder (ADHD), stuttering, oppositional defiant, tics, conduct, obsessive-compulsive, mania, alcohol abuse, and general anxiety - behaviors that constitute the most overt clinical aspects of TS. For 16 of the 20 behavior scores there was a linear progressive decrease in the mean score with progressively lesser loading for the three gene markers. These results suggest that TS, ADHD, stuttering, oppositional defiant and conduct disorder, and other behaviors associated with TS, are polygenic, due in part to these three dopaminergic genes, and that the genetics of other polygenic psychiatric disorders may be deciphered using this technique. 144 refs., 2 figs., 13 tabs.« less

  15. Parental involvement as an etiological moderator of middle childhood oppositional defiant disorder.

    PubMed

    Li, Ishien; Clark, D Angus; Klump, Kelly L; Burt, S Alexandra

    2017-09-01

    The goal of this study was to investigate parental involvement as an etiologic moderator of oppositional defiant disorder (ODD) during middle childhood. Previous studies examining the influence of genetic and environmental factors on ODD have not considered whether and how these factors might vary by parental involvement. We thus conducted a series of "latent genetic by measured environmental" interaction analyses, in which measured parental involvement was allowed to moderate genetic, shared, and nonshared environmental influences on child ODD. Participants include 1,027 twin pairs (age ranged from 6 to 11 years old) from the Michigan State University Twin Registry. Results did indeed suggest that the etiology of ODD varies with maternal involvement, such that genetic influence on ODD became more prominent as maternal involvement decreased. However, these results were specific to children's perceptions of maternal involvement and did not extend to maternal perceptions of her involvement. There was no evidence that paternal involvement moderated the etiology of ODD, regardless of informant. The different results found in twins' and parents' data are consistent with those in previous research showing that children may have different perceptions from parents' about their family relationships and that this discrepancy needs to be taken into account in future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Impaired functional but preserved structural connectivity in limbic white matter tracts in youth with conduct disorder or oppositional defiant disorder plus psychopathic traits.

    PubMed

    Finger, Elizabeth Carrie; Marsh, Abigail; Blair, Karina Simone; Majestic, Catherine; Evangelou, Iordanis; Gupta, Karan; Schneider, Marguerite Reid; Sims, Courtney; Pope, Kayla; Fowler, Katherine; Sinclair, Stephen; Tovar-Moll, Fernanda; Pine, Daniel; Blair, Robert James

    2012-06-30

    Youths with conduct disorder or oppositional defiant disorder and psychopathic traits (CD/ODD+PT) are at high risk of adult antisocial behavior and psychopathy. Neuroimaging studies demonstrate functional abnormalities in orbitofrontal cortex and the amygdala in both youths and adults with psychopathic traits. Diffusion tensor imaging in psychopathic adults demonstrates disrupted structural connectivity between these regions (uncinate fasiculus). The current study examined whether functional neural abnormalities present in youths with CD/ODD+PT are associated with similar white matter abnormalities. Youths with CD/ODD+PT and comparison participants completed 3.0 T diffusion tensor scans and functional magnetic resonance imaging scans. Diffusion tensor imaging did not reveal disruption in structural connections within the uncinate fasiculus or other white matter tracts in youths with CD/ODD+PT, despite the demonstration of disrupted amygdala-prefrontal functional connectivity in these youths. These results suggest that disrupted amygdala-frontal white matter connectivity as measured by fractional anisotropy is less sensitive than imaging measurements of functional perturbations in youths with psychopathic traits. If white matter tracts are intact in youths with this disorder, childhood may provide a critical window for intervention and treatment, before significant structural brain abnormalities solidify. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Co-occurring problems of early onset persistent, childhood limited, and adolescent onset conduct problem youth.

    PubMed

    Barker, Edward D; Oliver, Bonamy R; Maughan, Barbara

    2010-11-01

    It is increasingly recognized that youth who follow early onset persistent (EOP), childhood limited (CL) and adolescent onset (AO) trajectories of conduct problems show somewhat varying patterns of risk (in childhood) and adjustment problems (in adolescence and adulthood). Little, however, is known about how other adjustment problems differentially co-develop with the EOP, CL and AO trajectories across the childhood and adolescent years. Using data from the Avon Longitudinal Study of Parents and Children, an epidemiological, longitudinal cohort of boys and girls, we estimated growth curves for parent-reported hyperactivity, emotional difficulties, peer relational problems, and prosocial behaviors conditional on trajectories of conduct problems (i.e., EOP, CL and AO) from ages 4 to 13 years. At ages 7-8 years, DSM-IV-based diagnoses of conduct disorder, oppositional-defiant disorder, attention deficit/hyperactivity disorder (ADHD), anxiety, depression were examined by conduct problems trajectory. Overall, the development of hyperactivity, emotional difficulties, peer relational problems, and prosocial behaviors mirrored the development of conduct problems, showing similar trajectories. Results indicated that the problems of EOP youth were persistent across domains, CL youth showed decreased behavior problems while increasing in prosocial behaviors, and AO youth increased in adjustment problems after 10 years of age. © 2010 The Authors. Journal of Child Psychology and Psychiatry © 2010 Association for Child and Adolescent Mental Health.

  18. One-Year Follow-Up of Combined Parent and Child Intervention for Young Children with ADHD

    PubMed Central

    Webster-Stratton, Carolyn; Reid, M. Jamila; Beauchaine, Theodore P.

    2012-01-01

    Objective Efficacies of the Incredible Years (IY) interventions are well established in children with oppositional defiant disorder (ODD), but not among those with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate one-year follow-up outcomes among young children with ADHD who were treated with the IY interventions. Method Four- to six-year-olds with ADHD (n=49, 73% males) participated in six months of treatment using the IY parent and child interventions. Results Immediate post-treatment results indicated improvements in parenting, children’s externalizing and attention problems, and social contact at school. At one-year follow up, 22 of 27 variables that showed significant post-treatment effects demonstrated maintenance to one-year follow up. Children with higher ODD symptoms at baseline showed more improvement in oppositionality and total behavior problems, and their mothers showed more improvement on harsh discipline scores. Approximately 70–75% of children were reported by their parents and teachers to fall below clinical cut-offs on measures of externalizing symptoms at the one-year follow up (compared to 50% at baseline) and more than 50% fell below clinical cut-offs on measures of hyperactivity and inattentiveness (all were in the clinical range at baseline). Conclusions Children with ADHD who were treated with the IY parent and child treatment programs showed maintenance of treatment effects one year after treatment. PMID:23020199

  19. Sleep problems predict comorbid externalizing behaviors and depression in young adolescents with attention-deficit/hyperactivity disorder.

    PubMed

    Becker, Stephen P; Langberg, Joshua M; Evans, Steven W

    2015-08-01

    Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) experience high rates of sleep problems and are also at increased risk for experiencing comorbid mental health problems. This study provides an initial examination of the 1-year prospective association between sleep problems and comorbid symptoms in youth diagnosed with ADHD. Participants were 81 young adolescents (75 % male) carefully diagnosed with ADHD and their parents. Parents completed measures of their child's sleep problems and ADHD symptoms, oppositional defiant disorder (ODD) symptoms, and general externalizing behavior problems at baseline (M age = 12.2) and externalizing behaviors were assessed again 1 year later. Adolescents completed measures of anxiety and depression at both time-points. Medication use was not associated with sleep problems or comorbid psychopathology symptoms. Regression analyses indicated that, above and beyond demographic characteristics, ADHD symptom severity, and initial levels of comorbidity, sleep problems significantly predicted greater ODD symptoms, general externalizing behavior problems, and depressive symptoms 1 year later. Sleep problems were not concurrently or prospectively associated with anxiety. Although this study precludes making causal inferences, it does nonetheless provide initial evidence of sleep problems predicting later comorbid externalizing behaviors and depression symptoms in youth with ADHD. Additional research is needed with larger samples and multiple time-points to further examine the interrelations of sleep problems and comorbidity.

  20. Reduction in children's symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder during individual tutoring as compared with classroom instruction.

    PubMed

    Strayhorn, Joseph M; Bickel, Donna D

    2002-08-01

    Children who display symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in classrooms are reputed to display fewer symptoms in one-on-one interaction. We tested this hypothesis with children who received tutoring for reading and behavior problems. We selected 30 children whose teacher-rated ADHD symptoms fit a pattern consistent with DSM criteria for the diagnosis. Teachers rated the frequency of symptoms in classrooms before and after tutoring. Tutors rated the frequency of the same behaviors during individual tutoring sessions. Children's ADHD symptoms, as well as oppositional symptoms, were significantly lower in the tutoring sessions than in the classrooms. The effect sizes for the difference between behavior in classrooms and in individual tutoring ranged from 0.7 to 2.5 standard deviations. These effect sizes appear as large as those reported for the effect of stimulant medication on ADHD symptoms. All 30 children at preintervention fit the pattern for ADHD using teachers' ratings of classroom behavior; 87% of them did not meet those DSM criteria using tutors' ratings of behavior in individual sessions. The confound of different raters for the two different settings must be resolved by another study with a new design.

  1. Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents.

    PubMed

    Forssman, Linda; Eninger, Lilianne; Tillman, Carin M; Rodriguez, Alina; Bohlin, Gunilla

    2012-05-01

    In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

  2. [School-based prevention of antisocial behavior: efficacy of the "Verhaltenstraining für Schulanfänger"].

    PubMed

    Natzke, Heike; Petermann, Franz

    2009-01-01

    In order to test its short- and middle-term impact as well as differential gender effects the universal school-based "Verhaltenstraining für Schulanfänger", a German prevention program on antisocial behavior for elementary school students, was conducted and evaluated in Luxembourg. In a quasi-experimental setting, nine first grade classes (n=88) were assigned to intervention and control groups. Three waves of data (pretest, posttest and 12-months-follow up) including teacher and student assessments were analysed. As a result intervention effects in terms of significant reductions in oppositional defiant and aggressive behavior as well as an increase in social and emotional competencies according to teachers' assessments at 12-months-follow-up could be observed. Student interviews showed positive short-term effects in terms of increased emotional knowledge and social problem solving competencies at posttest, with girls showing a stronger improvement of their emotional knowledge than boys.

  3. Oppositional Defiant and Conduct Disorder Behaviors in Boys with Autism Spectrum Disorder with and without Attention-Deficit Hyperactivity Disorder versus Several Comparison Samples

    ERIC Educational Resources Information Center

    Guttmann-Steinmetz, Sarit; Gadow, Kenneth D.; DeVincent, Carla J.

    2009-01-01

    We compared disruptive behaviors in boys with either autism spectrum disorder (ASD) plus ADHD (n = 74), chronic multiple tic disorder plus ADHD (n = 47), ADHD Only (n = 59), or ASD Only (n = 107). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 including parent- (n = 168) and teacher-rated (n = 173)…

  4. Longitudinal Risk and Resilience Factors Predicting Psychiatric Disruption, Mental Health Service Utilization & Military Retention in OIF National Guard Troops

    DTIC Science & Technology

    2008-04-01

    learning disabilities and/or emotional difficulties • Wrote integrated assessment reports • Attended Individual Education Plan ( IEP ) meetings where...worked with wide range of disabilities from autism and cerebral palsy to oppositional defiant disorder and bipolar disorder; developed leadership...therapy program for a nine year old boy with autism to foster the development of social skills; utilized sign language to increase communication

  5. Anxiety disorders moderate the association between externalizing problems and substance use disorders: data from the National Comorbidity Survey-Revised.

    PubMed

    Hofmann, Stefan G; Richey, J Anthony; Kashdan, Todd B; McKnight, Patrick E

    2009-05-01

    Anxiety disorders and externalizing problems are both associated with substance use disorders. However, the nature of this relationship remains unclear. To examine whether presence of an anxiety disorder changes the association between externalizing problems (conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder) and substance use disorders, we analyzed data from the National Comorbidity Survey-Replication, which is based on a nationally representative sample of 9282 English-speaking adults. Presence of externalizing problems was associated with an increased odds for alcohol abuse (OR: 6.7, CI: 5.6-8.1), alcohol dependence (OR: 7.6, CI: 5.9-9.6), substance abuse (OR: 9.9, CI: 8.1-12.2), and substance dependence (OR: 13.1, CI: 9.6-17.8). Similarly, anxiety disorders were associated with increased odds for substance use disorders. The highest association was found between post-traumatic stress disorder and substance use disorder (OR: 9.2, CI: 5.4-15.5). Individuals who met diagnostic criteria for an anxiety disorder and externalizing problems showed consistently and significantly lower odds for substance use problems than subjects with externalizing problems without a comorbid anxiety disorder. The results suggest that presence of any anxiety disorder reduces the association between externalizing problems and substance use disorders, possibly because the fear of bodily symptoms prevents individuals with externalizing problems from engaging in drug-seeking behaviors.

  6. Disentangling Heterogeneity of Childhood Disruptive Behavior Problems Into Dimensions and Subgroups.

    PubMed

    Bolhuis, Koen; Lubke, Gitta H; van der Ende, Jan; Bartels, Meike; van Beijsterveldt, Catharina E M; Lichtenstein, Paul; Larsson, Henrik; Jaddoe, Vincent W V; Kushner, Steven A; Verhulst, Frank C; Boomsma, Dorret I; Tiemeier, Henning

    2017-08-01

    Irritable and oppositional behaviors are increasingly considered as distinct dimensions of oppositional defiant disorder. However, few studies have explored this multidimensionality across the broader spectrum of disruptive behavior problems (DBPs). This study examined the presence of dimensions and distinct subgroups of childhood DBPs, and the cross-sectional and longitudinal associations between these dimensions. Using factor mixture models (FMMs), the presence of dimensions and subgroups of DBPs was assessed in the Generation R Study at ages 6 (n = 6,209) and 10 (n = 4,724) years. Replications were performed in two population-based cohorts (Netherlands Twin Registry, n = 4,402, and Swedish Twin Study of Child and Adolescent Development, n = 1,089) and a clinical sample (n = 1,933). We used cross-lagged modeling in the Generation R Study to assess cross-sectional and longitudinal associations between dimensions. DBPs were assessed using mother-reported responses to the Child Behavior Checklist. Empirically obtained dimensions of DBPs were oppositional behavior (age 6 years), disobedient behavior, rule-breaking behavior (age 10 years), physical aggression, and irritability (both ages). FMMs suggested that one-class solutions had the best model fit for all dimensions in all three population-based cohorts. Similar results were obtained in the clinical sample. All three dimensions, including irritability, predicted subsequent physical aggression (range, 0.08-0.16). This study showed that childhood DBPs should be regarded as a multidimensional phenotype rather than comprising distinct subgroups. Incorporating multidimensionality will improve diagnostic accuracy and refine treatment. Future studies need to address the biological validity of the DBP dimensions observed in this study; herein lies an important opportunity for neuroimaging and genetic measures. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Attention Deficit Hyperactivity Disorder comorbid oppositional defiant disorder and its predominately inattentive type: evidence for an association with COMT but not MAOA in a Chinese sample.

    PubMed

    Qian, Qiu-Jin; Liu, Jin; Wang, Yu-Feng; Yang, Li; Guan, Li-Li; Faraone, Stephen V

    2009-02-19

    There are three childhood disruptive behavior disorders (DBDs), attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). The most common comorbid disorder in ADHD is ODD. DSM-IV describes three ADHD subtypes: predominantly inattentive type (ADHD-IA), predominantly hyperactive-impulsive type (ADHD-HI), and combined type (ADHD-C). Prior work suggests that specific candidate genes are associated with specific subtypes of ADHD in China. Our previous association studies between ADHD and functional polymorphisms of COMT and MAOA, consistently showed the low transcriptional activity alleles were preferentially transmitted to ADHD-IA boys. Thus, the goal of the present study is to test the hypothesis that COMT Val158Met and MAOA-uVNTR jointly contribute to the ODD phenotype among Chinese ADHD boys. 171 Chinese boys between 6 and 17.5 years old (mean = 10.3, SD = 2.6) with complete COMT val158met and MAOA-uVNTR genotyping information were studied. We used logistic regression with genotypes as independent variables and the binary phenotype as the dependent variable. We used p < 0.05 as the level of nominal statistical significance. Bonferroni correction procedures were used to adjust for multiple comparisons. Our results highlight the potential etiologic role of COMT in the ADHD with comorbid ODD and its predominately inattentive type in male Chinese subjects. ADHD with comorbid ODD was associated with homozygosity of the high-activity Val allele, while the predominantly inattentive ADHD subtype was associated with the low-activity Met allele. We found no evidence of association between the MAOA-uVNTR variant and ADHD with comorbid ODD or the ADHD-IA subtype. Our study of attention deficit hyperactivity disorder comorbid oppositional defiant disorder and its predominately inattentive type highlights the potential etiologic role of COMT for ADHD children in China. But we failed to observe an interaction between COMT and MAOA, which suggests that epistasis between COMT and MAOA genes does not influence the phenotype of ADHD-IA with comorbid ODD in a clinical sample of Chinese male subjects. To confirm our findings further studies with a larger number of subjects and healthy controls are needed.

  8. The Mutual Effect of Marital Quality and Parenting Stress on Child and Parent Depressive Symptoms in Families of Children with Oppositional Defiant Disorder

    PubMed Central

    Lin, Xiuyun; Zhang, Yulin; Chi, Peilian; Ding, Wan; Heath, Melissa A.; Fang, Xiaoyi; Xu, Shousen

    2017-01-01

    The purpose of the current study was to examine the mutual relationships between dyadic level (i.e., marital quality and parenting stress) and individual level factors (i.e., children and parental depressive symptoms) in families of children with Oppositional Defiant Disorder (ODD). Specifically, we explored whether marital interaction (marital quality) was associated with symptoms of child depression through parent-child interaction (parenting stress) and parent depressive symptoms. We also explored whether parent-child interaction was associated with symptoms of parent depression through marital interaction and child depressive symptoms. This study was conducted with 256 parent-child dyads, consisting of children with ODD and one of each child's parents. Participants were recruited from 14 primary schools located in northern, eastern, and southwestern China. Results revealed that marital quality predicted symptoms of child depression through the parenting stress, but not parent depressive symptoms; and parenting stress predicted symptoms of parent depression through marital quality, but not through child depressive symptoms. Also, parenting stress significantly and directly predicted parent depressive symptoms. We concluded in families of children with ODD, the association of marital interaction and parent-child interaction on both symptoms of parent and child depression highlighted the mutual effects of the couple subsystem and the parent-child subsystem. Furthermore, in regard to parental and child depressive symptoms, implications for intervention are provided. PMID:29104548

  9. Hot and Cool Executive Functions in Children with Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder.

    PubMed

    Antonini, Tanya N; Becker, Stephen P; Tamm, Leanne; Epstein, Jeffery N

    2015-09-01

    While neuropsychological deficits in both "hot" and "cool" executive functions (EFs) have been documented among individuals with attention-deficit/hyperactivity disorder (ADHD), these EF deficits are not universal across all individuals with this diagnosis. One potential moderator of executive dysfunction may be the presence of comorbid oppositional defiant disorder (ODD). This study examined the association between "hot" and "cool" EFs and comorbid ODD in children with ADHD. Thirty-three children with ADHD and comorbid ODD (ADHD+ODD), 67 with ADHD without ODD (ADHD-ODD), and 30 typically developing controls participated. Children were 7-12 years of age. "Cool" EFs were assessed with a spatial span task and a card sorting test. "Hot" EFs were assessed using a delay discounting task and a gambling task. ADHD-ODD and ADHD+ODD groups performed more poorly on "cool" EF tasks than controls, but did not differ from each other. Furthermore, the number of ADHD symptoms, but not ODD symptoms, was associated with "cool" EF scores. The three groups did not differ on "hot" EF tasks and the number of ADHD or ODD symptoms was unrelated to "hot" EF scores. In sum, children with ADHD presented with "cool" EF deficits which appear to be unrelated to ODD comorbidity. However, "hot" EF deficits were not present among children with ADHD, irrespective of comorbid ODD status.

  10. Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services.

    PubMed

    Brookman-Frazee, Lauren; Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Ganger, William

    2017-09-01

    Publicly funded mental health programs play a significant role in serving children with autism spectrum disorder. Understanding patterns of psychiatric comorbidity for this population within mental health settings is important to implement appropriately tailored interventions. This study (1) describes patterns of psychiatric comorbidity in children with autism spectrum disorder who present to mental health services with challenging behaviors and (2) identifies child characteristics associated with comorbid conditions. Data are drawn from baseline assessments from 201 children with autism spectrum disorder who participated in a community effectiveness trial across 29 publicly funded mental health programs. Non-autism spectrum disorder diagnoses were assessed using an adapted Mini-International Neuropsychiatric Interview, parent version. Approximately 92% of children met criteria for at least one non-autism spectrum disorder diagnosis (78% attention deficit hyperactivity disorder, 58% oppositional defiant disorder, 56% anxiety, 30% mood). Logistic regression indicated that child gender and clinical characteristics were differentially associated with meeting criteria for attention deficit hyperactivity disorder, oppositional defiant disorder, an anxiety, or a mood disorder. Exploratory analyses supported a link between challenging behaviors and mood disorder symptoms and revealed high prevalence of these symptoms in this autism spectrum disorder population. Findings provide direction for tailoring intervention to address a broad range of clinical issues for youth with autism spectrum disorder served in mental health settings.

  11. The Mutual Effect of Marital Quality and Parenting Stress on Child and Parent Depressive Symptoms in Families of Children with Oppositional Defiant Disorder.

    PubMed

    Lin, Xiuyun; Zhang, Yulin; Chi, Peilian; Ding, Wan; Heath, Melissa A; Fang, Xiaoyi; Xu, Shousen

    2017-01-01

    The purpose of the current study was to examine the mutual relationships between dyadic level (i.e., marital quality and parenting stress) and individual level factors (i.e., children and parental depressive symptoms) in families of children with Oppositional Defiant Disorder (ODD). Specifically, we explored whether marital interaction (marital quality) was associated with symptoms of child depression through parent-child interaction (parenting stress) and parent depressive symptoms. We also explored whether parent-child interaction was associated with symptoms of parent depression through marital interaction and child depressive symptoms. This study was conducted with 256 parent-child dyads, consisting of children with ODD and one of each child's parents. Participants were recruited from 14 primary schools located in northern, eastern, and southwestern China. Results revealed that marital quality predicted symptoms of child depression through the parenting stress, but not parent depressive symptoms; and parenting stress predicted symptoms of parent depression through marital quality, but not through child depressive symptoms. Also, parenting stress significantly and directly predicted parent depressive symptoms. We concluded in families of children with ODD, the association of marital interaction and parent-child interaction on both symptoms of parent and child depression highlighted the mutual effects of the couple subsystem and the parent-child subsystem. Furthermore, in regard to parental and child depressive symptoms, implications for intervention are provided.

  12. Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder.

    PubMed

    Gunes, Hatice; Tanidir, Canan; Adaletli, Hilal; Kilicoglu, Ali Guven; Mutlu, Caner; Bahali, Mustafa Kayhan; Topal, Melike; Bolat, Nurullah; Uneri, Ozden Sukran

    2018-06-05

    Objectives The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA.

  13. Early-onset Conduct Problems: Predictions from daring temperament and risk taking behavior.

    PubMed

    Bai, Sunhye; Lee, Steve S

    2017-12-01

    Given its considerable public health significance, identifying predictors of early expressions of conduct problems is a priority. We examined the predictive validity of daring, a key dimension of temperament, and the Balloon Analog Risk Task (BART), a laboratory-based measure of risk taking behavior, with respect to two-year change in parent, teacher-, and youth self-reported oppositional defiant disorder (ODD), conduct disorder (CD), and antisocial behavior. At baseline, 150 ethnically diverse 6- to 10-year old (M=7.8, SD=1.1; 69.3% male) youth with ( n =82) and without ( n =68) DSM-IV ADHD completed the BART whereas parents rated youth temperament (i.e., daring); parents and teachers also independently rated youth ODD and CD symptoms. Approximately 2 years later, multi-informant ratings of youth ODD, CD, and antisocial behavior were gathered from rating scales and interviews. Whereas risk taking on the BART was unrelated to conduct problems, individual differences in daring prospectively predicted multi-informant rated conduct problems, independent of baseline risk taking, conduct problems, and ADHD diagnostic status. Early differences in the propensity to show positive socio-emotional responses to risky or novel experiences uniquely predicted escalating conduct problems in childhood, even with control of other potent clinical correlates. We consider the role of temperament in the origins and development of significant conduct problems from childhood to adolescence, including possible explanatory mechanisms underlying these predictions.

  14. Factor structure of parent and teacher ratings of the ODD symptoms for Malaysian primary school children.

    PubMed

    Gomez, Rapson

    2017-02-01

    This present study used confirmatory factor analysis (CFA) to examine the applicability of one-, two- three- and second order Oppositional Defiant Disorder (ODD) factor models, proposed in previous studies, in a group of Malaysian primary school children. These models were primarily based on parent reports. In the current study, parent and teacher ratings of the ODD symptoms were obtained for 934 children. For both groups of respondents, the findings showing some support for all models examined, with most support for a second order model with Burke et al. (2010) three factors (oppositional, antagonistic, and negative affect) as the primary factors. The diagnostic implications of the findings are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. The association of ADHD and depression: Mediation by peer problems and parent-child difficulties in two complementary samples

    PubMed Central

    Humphreys, Kathryn L.; Katz, Shaina J.; Lee, Steve S.; Hammen, Constance L.; Brennan, Patricia A.; Najman, Jake M.

    2013-01-01

    Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for the development of depression, with evidence that peer and academic difficulties mediate predictions of later depression from ADHD. The present study hypothesized that parent-child relationship difficulties may be an additional potential mediator of this association. Academic, peer, and parent-child functioning were tested as mediators of the association of attention problems and depression in two distinctly different, yet complementary samples. Study 1 was a cross-sectional sample of 230 5–10 year-old children with and without ADHD. Study 2 was a prospective longitudinal sample of 472 youth followed prospectively from birth to age 20 at risk for depression. Despite differences in age, measures, and designs, both studies implicated peer and parent-child problems as unique mediators of depressive symptoms, although academic difficulties did not uniquely mediate the ADHD-depression association. Further, inattention symptoms, but not hyperactivity, predicted depressive symptoms via the disruption of interpersonal functioning. The inclusion of oppositional defiant disorder into models impacted results, and supported its independent role in parent-child problems. Implications include support for interventions that target interpersonal competence, which may effectively reduce the risk of depression among children with ADHD. PMID:24016021

  16. Reactive Attachment Disorder

    MedlinePlus

    ... and/or defiant behavior inhibition or hesitancy in social interactions being too close with strangers Most children with attachment disorders have had severe problems or difficulties in their early ... and social problems associated with attachment disorders may persist as ...

  17. Information Technology Administrator’s Instruction Manual for the Personal Academic Strategies for Success (PASS) Tool, With Subcomponent Academic Class Composite Tool (AC2T)

    DTIC Science & Technology

    2013-12-01

    Attention Deficit / Hyperactivity Disorder Symptom Score 20. Parental Marital Status – Parents Divorced 21. Home Until Enlisted 22. High School...FL, 2012; pp 86–96. Rice, V. J. B.; Butler, J.; Marra, D. Neuro-Cognitive Assessment, Symptoms of Attention Deficit and Hyperactivity Disorder , and...V. J.; Butler, J.; Marra, D. The Relationship Between Symptoms of Attention Deficit and Hyperactivity Disorder and Oppositional Defiant Disorder

  18. Conduct problems in youth and the RDoC approach: A developmental, evolutionary-based view.

    PubMed

    Fonagy, Peter; Luyten, Patrick

    2017-09-08

    Problems related to aggression in young people are traditionally subsumed under the header of conduct problems, which include conduct disorder and oppositional defiant disorder. Such problems in children and adolescents are an important societal and mental health problem. In this paper we present an evolutionarily informed developmental psychopathology view of conduct problems inspired by the NIMH Research Domain Criteria (RDoC) initiative. We assume that while there are many pathways to conduct problems, chronic or temporary impairments in the domain of social cognition or mentalizing are a common denominator. Specifically, we conceptualize conduct problems as reflecting temporary or chronic difficulties with mentalizing, that is, the capacity to understand the self and others in terms of intentional mental states, leading to a failure to inhibit interpersonal violence through a process of perspective-taking and empathy. These difficulties, in turn, stem from impairments in making use of a normally evolutionarily protected social learning system that functions to facilitate intergenerational knowledge transmission and protect social collaborative processes from impulsive and aggressive action. Temperamental, biological, and social risk factors in different combinations may all contribute to this outcome. This adaptation then interacts with impairments in other domains of functioning, such as in negative and positive valence systems and cognitive systems. This view highlights the importance of a complex interplay among biological, psychological, and environmental factors in understanding the origins of conduct problems. We outline the implications of these views for future research and intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Trait and State Variance in Oppositional Defiant Disorder Symptoms: A Multi-Source Investigation with Spanish Children

    PubMed Central

    Preszler, Jonathan; Burns, G. Leonard; Litson, Kaylee; Geiser, Christian; Servera, Mateu

    2016-01-01

    The objective was to determine and compare the trait and state components of oppositional defiant disorder (ODD) symptom reports across multiple informants. Mothers, fathers, primary teachers, and secondary teachers rated the occurrence of the ODD symptoms in 810 Spanish children (55% boys) on two occasions (end first and second grades). Single source latent state-trait (LST) analyses revealed that ODD symptom ratings from all four sources showed more trait (M = 63%) than state residual (M = 37%) variance. A multiple source LST analysis revealed substantial convergent validity of mothers’ and fathers’ trait variance components (M = 68%) and modest convergent validity of state residual variance components (M = 35%). In contrast, primary and secondary teachers showed low convergent validity relative to mothers for trait variance (Ms = 31%, 32%, respectively) and essentially zero convergent validity relative to mothers for state residual variance (Ms = 1%, 3%, respectively). Although ODD symptom ratings reflected slightly more trait- than state-like constructs within each of the four sources separately across occasions, strong convergent validity for the trait variance only occurred within settings (i.e., mothers with fathers; primary with secondary teachers) with the convergent validity of the trait and state residual variance components being low to non-existent across settings. These results suggest that ODD symptom reports are trait-like across time for individual sources with this trait variance, however, only having convergent validity within settings. Implications for assessment of ODD are discussed. PMID:27148784

  20. Predictive validity of childhood oppositional defiant disorder and conduct disorder: implications for the DSM-V.

    PubMed

    Burke, Jeffrey D; Waldman, Irwin; Lahey, Benjamin B

    2010-11-01

    Data are presented from 3 studies of children and adolescents to evaluate the predictive validity of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) and the International Classification of Diseases, Version 10 (ICD-10; World Health Organization, 1992). The present analyses strongly support the predictive validity of these diagnoses by showing that they predict both future psychopathology and enduring functional impairment. Furthermore, the present findings generally support the hierarchical developmental hypothesis in DSM-IV that some children with ODD progress to childhood-onset CD, and some youth with CD progress to antisocial personality disorder (APD). Nonetheless, they reveal that CD does not always co-occur with ODD, particularly during adolescence. Importantly, the present findings suggest that ICD-10 diagnostic criteria for ODD, which treat CD symptoms as ODD symptoms when diagnostic criteria for CD are not met, identify more functionally impaired children than the more restrictive DSM-IV definition of ODD. Filling this "hole" in the DSM-IV criteria for ODD should be a priority for the DSM-V. In addition, the present findings suggest that although the psychopathic trait of interpersonal callousness in childhood independently predicts future APD, these findings do not confirm the hypothesis that callousness distinguishes a subset of children with CD with an elevated risk for APD. PsycINFO Database Record (c) 2010 APA, all rights reserved

  1. Cognitive and affective empathy in children with conduct problems: additive and interactive effects of callous-unemotional traits and autism spectrum disorders symptoms.

    PubMed

    Pasalich, Dave S; Dadds, Mark R; Hawes, David J

    2014-11-30

    Callous-unemotional (CU) traits and autism spectrum disorders (ASD) symptoms are characterized by problems in empathy; however, these behavioral features are rarely examined together in children with conduct problems. This study investigated additive and interactive effects of CU traits and ASD symptoms in relation to cognitive and affective empathy in a non-ASD clinic-referred sample. Participants were 134 children aged 3 to 9 years (M=5.60; 79% boys) with oppositional defiant/conduct disorder, and their parents. Clinicians, teachers, and parents reported on dimensions of child behavior, and parental reports of family dysfunction and direct observations of parental warmth/responsiveness assessed quality of family relationships. Results from multiple regression analysis showed that, over and above the effects of child conduct problem severity and quality of family relationships, both ASD symptoms and CU traits were uniquely associated with deficits in cognitive empathy. Moreover, CU traits demonstrated an independent association with affective empathy, and this relationship was moderated by ASD symptoms. That is, there was a stronger negative association between CU traits and affective empathy at higher versus lower levels of ASD symptoms. These findings suggest including both CU traits and ASD-related social impairments in models delineating the atypical development of empathy in children with conduct problems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Prenatal Exposure to Maternal and Paternal Smoking on Attention Deficit Hyperactivity Disorders Symptoms and Diagnosis in Offspring

    PubMed Central

    Nomura, Yoko; Marks, David J.; Halperin, Jeffrey M.

    2011-01-01

    The study examined the effect of maternal and paternal smoking during pregnancy on the child’s inattention and hyperactivity/impulsivity symptoms, and the risk for attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Generalized estimating equations, incorporating data from multiple informants (parents and teachers), was used to evaluate levels of ADHD as a function of parental smoking. The risk for ADHD, ODD, and comorbid ADHD and ODD was evaluated using polytomous logistic regression. We found that maternal, but not paternal, smoking was significantly associated with elevated inattention, hyperactivity/impulsivity, and total ADHD symptoms in children. Children of smoking, relative to nonsmoking, mothers had a significant increased risk for comorbid ADHD and ODD and ADHD, but not ODD. Although father’s smoking was not associated with an increased risk, as it strongly influenced mothers’ smoking, intervention for both parents may be most effective in preventing the pathway to ADHD-related problems in the children. PMID:20823730

  3. Tailoring Parent-Child Interaction Therapy (PCIT) for Older Children: A Case Study.

    PubMed

    Briegel, Wolfgang

    2017-08-15

    Parent-Child Interaction Therapy (PCIT) is an evidence-based intervention designed for families of 2- to 6-year-old children with disruptive behavior disorders. This article illustrates the application of PCIT in a 10-year-old boy with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Both parents and the patient attended PCIT sessions. The course of therapy included minor changes to the PCIT protocol. After 13 PCIT sessions, the patient displayed disruptive behaviors within normal limits, and 12 months later he no longer met diagnostic criteria for ODD. Results remained stable at a 17-month follow-up assessment. This case study suggests that the use of PCIT in families of children with ODD markedly older than the recommended age range might be a promising approach for improving family functioning and reducing behavior problems. Further research with larger samples of older children with ODD is needed to replicate and elaborate the findings of this case study.

  4. Adolescent Substance Use & Psychopathology: Interactive Effects of Cortisol Reactivity and Emotion Regulation

    PubMed Central

    Turpyn, Caitlin C.; Hansen, Amysue; Jacangelo, Juliana; Chaplin, Tara M.

    2015-01-01

    How are emotional processes associated with the increased rates of substance use and psychological disorders commonly observed during adolescence? An index of emotion-related physiological arousal—cortisol reactivity—and subjective emotion regulation have both been independently linked to substance use and psychological difficulties among youth. The current study (N = 134 adolescents) sought to elucidate the interactive effects of cortisol reactivity following a stressful parent–child interaction task and self-reported emotion regulation ability on adolescents’ substance use and externalizing and internalizing behavior problems. Results revealed that adolescents with low levels of cortisol reactivity and high emotion regulation difficulties were more likely to use substances, and also had the highest parent-reported symptoms of oppositional defiant disorder. With respect to internalizing symptoms, high emotion-related physiological reactivity coupled with high emotion regulation difficulties were associated with higher self-reported major depression symptoms among youth. Findings reveal that different profiles of HPA axis arousal and emotion regulation are associated with substance use and symptoms of psychopathology among adolescents. PMID:27330232

  5. Attention-deficit hyperactive disorder presenting with school truancy in an adolescent: a case report

    PubMed Central

    2011-01-01

    Attention-deficit hyperactive disorder (ADHD) is a psychiatric illness commonly diagnosed during the early years of childhood. In many adolescents with undiagnosed ADHD, presentation may not be entirely similar to that in younger children. These adolescents pose significant challenges to parents and teachers coping with their disability. Often adolescents with behavioural problems are brought to medical attention as a last resort. This case describes an adolescent who presented to a primary care clinic with school truancy. He was initially treated for depression with oppositional defiant disorder and sibling rivalry. Only following a careful detailed history and further investigations was the diagnosis of ADHD made. He showed a positive improvement with the use of methylphenidate for his ADHD and escitalopram for his depression. The success of his management was further supported by the use of behavioural therapy and parenting interventions. There is a need to increase public awareness of ADHD, especially among parents and teachers so that early intervention can be instituted in these children. PMID:23205066

  6. Rate and predictors of divorce among parents of youth with ADHD

    PubMed Central

    Wymbs, Brian T.; Pelham, William E.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Wilson, Tracey K.; Greenhouse, Joel B.

    2008-01-01

    Despite numerous studies asserting the prevalence of marital conflict among families of children with attention-deficit hyperactivity disorder (ADHD), evidence is surprisingly less convincing regarding whether parents of youth with ADHD are more at-risk for divorce than parents of children without ADHD. Using survival analyses, this study compared the rate of marital dissolution between parents of adolescents and young adults with and without ADHD. Results indicated that parents of youth diagnosed with ADHD in childhood (n=282) were more likely to divorce and had a shorter latency to divorce than parents of children without ADHD (n=206). Among a subset of those families of youth with ADHD, prospective analyses indicated that maternal and paternal education level, paternal antisocial behavior, and child age, race/ethnicity, and oppositional-defiant/conduct problems each uniquely predicted the timing of divorce between parents of youth with ADHD. These data underscore how parent and child variables likely interact to exacerbate marital discord and, ultimately, dissolution among families of children diagnosed with ADHD in childhood. PMID:18837591

  7. Disruptive behaviour disorders and DSM-5.

    PubMed

    Hawes, David J

    2014-10-01

    This article provides an overview of the revisions to the diagnoses of oppositional defiant disorder (ODD) and conduct disorder (CD) in DSM-5, and examines the key issues they raise. Particular attention is given to these changes in light of current treatment outcome evidence, including that published since the development of DSM-5. For both ODD and CD, DSM-5 retains the core features that previously defined the phenotypes for these diagnoses. DSM-5 nonetheless introduces a number of revisions pertaining to the guidelines for the application of these criteria, and markers for key individual differences in presentations of these disorders. These revisions reflect small but significant steps towards the perspective that children with disruptive behaviour problems are a highly heterogeneous population, and best characterised on the basis of both behavioural and emotional features. Importantly, there is growing evidence that the newly introduced changes to these diagnoses in DSM-5 may be better able to inform predictions regarding treatment response than previous diagnostic criteria. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Evaluation of the Interplay Between Homework Motivation and Sluggish Cognitive Tempo in Youth With ADHD: Associations With Homework Performance.

    PubMed

    Smith, Zoe R; Breaux, Rosanna P; Green, Cathrin D; Langberg, Joshua M

    2018-03-01

    This study evaluated which Sluggish Cognitive Tempo (SCT) factors (i.e., Slow, Sleepy, Daydreamer) are most strongly associated with homework motivation, and whether homework motivation mediates the path between SCT and academic impairment. Participants were 285 middle school students (boys 209) in Grades 6 to 8 (ages 10-15 years) who were comprehensively diagnosed with ADHD. Parent- and self-report of SCT Slow behaviors predicted homework motivation above and beyond symptoms of ADHD, oppositional defiant disorder (ODD), anxiety, depression, and intelligence. The mediation models tested were multi-informant and cross-rater (parent-report of SCT to self-report of motivation to teacher-report of homework problems), and suggest that low motivation may help explain the associations between SCT and functional impairment. SCT and motivation are significantly associated constructs. Clinically, youth with ADHD and comorbid SCT may be more likely to present with low motivation, placing them at risk for academic failure. The manuscript discusses potential clinical implications of these findings.

  9. Attention-deficit hyperactive disorder presenting with school truancy in an adolescent: a case report.

    PubMed

    Muhammad, Noor Azimah; Wan Ismail, Wan Salwina; Tan, Chai Eng; Jaffar, Aida; Sharip, Shalisah; Omar, Khairani

    2011-12-01

    Attention-deficit hyperactive disorder (ADHD) is a psychiatric illness commonly diagnosed during the early years of childhood. In many adolescents with undiagnosed ADHD, presentation may not be entirely similar to that in younger children. These adolescents pose significant challenges to parents and teachers coping with their disability. Often adolescents with behavioural problems are brought to medical attention as a last resort. This case describes an adolescent who presented to a primary care clinic with school truancy. He was initially treated for depression with oppositional defiant disorder and sibling rivalry. Only following a careful detailed history and further investigations was the diagnosis of ADHD made. He showed a positive improvement with the use of methylphenidate for his ADHD and escitalopram for his depression. The success of his management was further supported by the use of behavioural therapy and parenting interventions. There is a need to increase public awareness of ADHD, especially among parents and teachers so that early intervention can be instituted in these children.

  10. Psychopathology in 7-year-old children: Differences in maternal and paternal ratings and the genetic epidemiology.

    PubMed

    Wesseldijk, Laura W; Fedko, Iryna O; Bartels, Meike; Nivard, Michel G; van Beijsterveldt, Catharina E M; Boomsma, Dorret I; Middeldorp, Christel M

    2017-04-01

    The assessment of children's psychopathology is often based on parental report. Earlier studies have suggested that rater bias can affect the estimates of genetic, shared environmental and unique environmental influences on differences between children. The availability of a large dataset of maternal as well as paternal ratings of psychopathology in 7-year old children enabled (i) the analysis of informant effects on these assessments, and (ii) to obtain more reliable estimates of the genetic and non-genetic effects. DSM-oriented measures of affective, anxiety, somatic, attention-deficit/hyperactivity, oppositional-defiant, conduct, and obsessive-compulsive problems were rated for 12,310 twin pairs from the Netherlands Twin Register by mothers (N = 12,085) and fathers (N = 8,516). The effects of genetic and non-genetic effects were estimated on the common and rater-specific variance. For all scales, mean scores on maternal ratings exceeded paternal ratings. Parents largely agreed on the ranking of their child's problems (r 0.60-0.75). The heritability was estimated over 55% for maternal and paternal ratings for all scales, except for conduct problems (44-46%). Unbiased shared environmental influences, i.e., on the common variance, were significant for affective (13%), oppositional (13%), and conduct problems (37%). In clinical settings, different cutoffs for (sub)clinical scores could be applied to paternal and maternal ratings of their child's psychopathology. Only for conduct problems, shared environmental and genetic influences explain an equal amount in differences between children. For the other scales, genetic factors explain the majority of the variance, especially for the common part that is free of rater bias. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.

  11. Perceived Racial/Ethnic Discrimination Among Fifth-Grade Students and Its Association With Mental Health

    PubMed Central

    Elliott, Marc N.; Kanouse, David E.; Grunbaum, Jo Anne; Schwebel, David C.; Gilliland, M. Janice; Tortolero, Susan R.; Peskin, Melissa F.; Schuster, Mark A.

    2009-01-01

    Objectives. We sought to describe the prevalence, characteristics, and mental health problems of children who experience perceived racial/ethnic discrimination. Methods. We analyzed cross-sectional data from a study of 5147 fifth-grade students and their parents from public schools in 3 US metropolitan areas. We used multivariate logistic regression (overall and stratified by race/ethnicity) to examine the associations of sociodemographic factors and mental health problems with perceived racial/ethnic discrimination. Results. Fifteen percent of children reported perceived racial/ethnic discrimination, with 80% reporting that discrimination occurred at school. A greater percentage of Black (20%), Hispanic (15%), and other (16%) children reported perceived racial/ethnic discrimination compared with White (7%) children. Children who reported perceived racial/ethnic discrimination were more likely to have symptoms of each of the 4 mental health conditions included in the analysis: depression, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. An association between perceived racial/ethnic discrimination and depressive symptoms was found for Black, Hispanic, and other children but not for White children. Conclusions. Perceived racial/ethnic discrimination is not an uncommon experience among fifth-grade students and may be associated with a variety of mental health disorders. PMID:19299673

  12. Lack of guilt, guilt, and shame: a multi-informant study on the relations between self-conscious emotions and psychopathology in clinically referred children and adolescents.

    PubMed

    Muris, Peter; Meesters, Cor; Heijmans, Jolina; van Hulten, Sandra; Kaanen, Linsy; Oerlemans, Birgit; Stikkelbroeck, Tessa; Tielemans, Tim

    2016-04-01

    The present study examined the relationships between dysregulations in self-conscious emotions and psychopathology in clinically referred children and adolescents. For this purpose, parent-, teacher-, and self-report Achenbach System of Empirically Based Assessment data of 1000 youth aged 4-18 years was analyzed as this instrument not only provides information on the intensity levels of lack of guilt, guilt, and shame, but also on the severity of various types of psychopathology. The results first of all indicated that dysregulations of self-conscious emotions were more common in this clinical sample than in the general population. Further, a consistent pattern was found with regard to the relationships between self-conscious emotions and childhood psychopathology. That is, lack of guilt was predominantly associated with oppositional defiant and conduct (i.e., externalizing) problems, while guilt and shame were primarily linked with affective and anxiety (i.e., internalizing) problems. By and large, these findings confirm what has been found in non-clinical youth, and suggest that self-conscious emotions play a small but significant role in the psychopathology of children and adolescents.

  13. Experiences of physical and relational victimization in children with ADHD: The role of social problems and aggression.

    PubMed

    McQuade, Julia D; Breslend, Nicole L; Groff, Destin

    2018-04-16

    The social risk factors for physical and relational peer victimization were examined within a mixed-gender sample of children with and without attention-deficit/hyperactivity disorder (ADHD). Participants were 124 children (ages 8-12 years; 48% boys), with 47% exhibiting sub-clinical or clinical elevations in ADHD symptoms. ADHD and oppositional defiant disorder (ODD) symptom counts were assessed based on parent- and teacher-reports; parents rated children's social problems and teachers rated children's use of physical and relational aggression and experiences of physical and relational victimization. A multiple mediator model was used to test whether there were indirect effects of ADHD or ODD symptoms on physical and relational victimization through social problems, physical aggression, or relational aggression. At the bivariate level, ADHD and ODD symptoms were both significantly associated with higher rates of physical and relational victimization. In the mediational model, there were significant indirect effects of ADHD symptoms on relational victimization via social problems, of ODD on relational victimization via relational aggression, and of ODD symptoms on physical victimization via physical aggression. Results suggest that there are distinct risk factors implicated in the physical and relational victimization of youth with ADHD and that the co-occurrence of ODD symptoms is important to assess. Clinical implications for addressing victimization in children with ADHD are discussed. © 2018 Wiley Periodicals, Inc.

  14. Children with ADHD and symptoms of oppositional defiant disorder improved in behavior when treated with methylphenidate and adjuvant risperidone, though weight gain was also observed - Results from a randomized, double-blind, placebo-controlled clinical trial.

    PubMed

    Jahangard, Leila; Akbarian, Shahrokh; Haghighi, Mohammad; Ahmadpanah, Mohammad; Keshavarzi, Amir; Bajoghli, Hafez; Sadeghi Bahmani, Dena; Holsboer-Trachsler, Edith; Brand, Serge

    2017-05-01

    Children with ADHD often show symptoms of oppositional defiant disorders (ODD). We investigated the impact of adjuvant risperidone (RISP) to a standard treatment with methylphenidate (MPH) in children with ADHD and symptoms of ODD. Eighty-four children with ADHD and ODD (age: M=8.55; range: 7.28-9.95 years; 73.8% males) took part in a double-blind, randomized, placebo-controlled, clinical trial lasting eight weeks. Participants were randomly assigned either to the MPH+RISP (1mg/kg/d+0.5mg/d) or to the MPH+PLCO (1mg/kg/d+placebo) condition. Symptoms of ADHD, weight, height, and blood pressure were assessed at baseline, and at weeks 2, 4, 6 and 8. Symptoms of ADHD decreased over time, but more so in the MPH+RISP than in the MPH only condition. In the MPH+RISP condition weight, waist circumference and prolactine levels increased over time. Data suggest that adjuvant RISP improved symptoms in children with ADHD and ODD, but weight gain and higher prolactine levels were also observed, which are two alarming side effects. This may become an issue, once children become adolescents, a period of life in which body shape and body self-image are closely linked to self-confidence and peer acceptance. Health care professionals should carefully balance the short-term and long-term costs and benefits of administration of RISP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Symptoms of autism and schizophrenia spectrum disorders in clinically referred youth with oppositional defiant disorder.

    PubMed

    Gadow, Kenneth D; Drabick, Deborah A G

    2012-01-01

    Examined autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) symptoms in a clinically referred, non-ASD sample (N=1160; ages 6-18) with and without oppositional defiant disorder (ODD). Mothers and teachers completed DSM-IV-referenced symptom checklists. Youth with ODD were subdivided into angry/irritable symptom (AIS) or noncompliant symptom (NS) subtypes. Two different classification strategies were used: within-informant (source-specific) and between-informant (source-exclusive). For the source-specific strategy, youth were classified AIS, NS, or Control (C) according to mothers' and teachers' ratings separately. A second set of analyses focused on youth classified AIS according to mother or teacher report but not both (source-exclusive) versus both mother and teacher (cross-informant) AIS. Results indicated the mother-defined source-specific AIS groups generally evidenced the most severe ASD and SSD symptoms (AIS>NS>C), but this was more pronounced among younger youth. Teacher-defined source-specific ODD groups exhibited comparable levels of symptom severity (AIS, NS>C) with the exception of SSD (AIS>NS>C; younger youth). Source-exclusive AIS groups were clearly differentiated from each other, but there was little evidence of differential symptom severity in cross-informant versus source-exclusive AIS. These findings were largely dependent on the informant used to define the source-exclusive groups. AIS and NS groups differed in their associations with ASD and SSD symptoms. Informant discrepancy provides valuable information that can inform nosological and clinical concerns and has important implications for studies that use different strategies to configure clinical phenotypes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

    PubMed Central

    Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

    2011-01-01

    Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8–10 and 10–13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder (CD) and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10–13 and the rate of growth in ODD scores from 8–10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls. PMID:21671009

  17. Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: The first analytic study.

    PubMed

    Tashakori, Ashraf; Safavi, Atefeh; Neamatpour, Sorour

    2017-04-01

    The main source of information about children's masturbation is more on the basis of case reports. Due to the lack of consistent and accurate information. This study aimed to determine prevalence and underlying factors of masturbation and its comorbidity with psychiatric disorders in children. In this descriptive-analytical study, among the children referred to the Pediatrics Clinic of Psychiatric Ward, Golestan Hospital, Ahvaz, Southwest Iran, 98 children were selected by convenience sampling in 2014. Disorders were diagnosed by clinical interview based on the fourth edition of the Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-IV) and the Child Symptom Inventory-4 (CSI-4). We also used a questionnaire, containing demographic information about the patient and their family and also other data. Data was analyzed using descriptive statistics and chi-square test with SPSS software version 16. Of the children who participated in this study (most of whom were boys), 31.6% suffered from masturbation. The phobias (p=0.002), separation anxiety disorder (p=0.044), generalized anxiety disorder (p=0.037), motor tics (p=0.033), stress disorder (p=0.005), oppositional defiant disorder (p=0.044), thumb sucking (p=0.000) and conduct disorder (p=0.001) were associated with masturbation. Masturbation was common in children referred to psychiatric clinic, and may be more associated with oppositional defiant disorder, or conduct disorder, some anxiety disorders, motor tics and other stereotypical behavior. Authors recommended more probing for psychiatric disorders in children with unusual sexual behavior.

  18. Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: The first analytic study

    PubMed Central

    Tashakori, Ashraf; Safavi, Atefeh; Neamatpour, Sorour

    2017-01-01

    Background The main source of information about children’s masturbation is more on the basis of case reports. Due to the lack of consistent and accurate information. Objective This study aimed to determine prevalence and underlying factors of masturbation and its comorbidity with psychiatric disorders in children. Methods In this descriptive-analytical study, among the children referred to the Pediatrics Clinic of Psychiatric Ward, Golestan Hospital, Ahvaz, Southwest Iran, 98 children were selected by convenience sampling in 2014. Disorders were diagnosed by clinical interview based on the fourth edition of the Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-IV) and the Child Symptom Inventory-4 (CSI-4). We also used a questionnaire, containing demographic information about the patient and their family and also other data. Data was analyzed using descriptive statistics and chi-square test with SPSS software version 16. Results Of the children who participated in this study (most of whom were boys), 31.6% suffered from masturbation. The phobias (p=0.002), separation anxiety disorder (p=0.044), generalized anxiety disorder (p=0.037), motor tics (p=0.033), stress disorder (p=0.005), oppositional defiant disorder (p=0.044), thumb sucking (p=0.000) and conduct disorder (p=0.001) were associated with masturbation. Conclusion Masturbation was common in children referred to psychiatric clinic, and may be more associated with oppositional defiant disorder, or conduct disorder, some anxiety disorders, motor tics and other stereotypical behavior. Authors recommended more probing for psychiatric disorders in children with unusual sexual behavior. PMID:28607641

  19. Metallic Burden of Deciduous Teeth and Childhood Behavioral Deficits

    PubMed Central

    Chan, Tony J.H.; Gutierrez, Carolina; Ogunseitan, Oladele A.

    2015-01-01

    Attention Deficit/Hyperactivity Disorder (ADHD) affects 5%–8% of children in the U.S. (10% of males and 4% of females). The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of this study was to test the hypothesis that the body burden of Mn is positively correlated with ADHD symptoms. We also investigated the putative roles of Ca, Fe, Pb, and Hg. We collected shed molars from 266 children (138 boys and 128 girls) who lost a tooth between 11 and 13 years of age. The molars were analyzed for metals using ICP-OES. The third grade teacher of each child completed the Teacher’s Disruptive Behavior Disorders Rating Scale (DBD) to produce a score for “Total Disruptive Behavior” and subscale scores for “Attention Deficit Hyperactivity Disorder”, Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant. The mean Mn, Fe, Pb and Ca concentrations found in teeth was 3.1 ± 2.9 µg/g, 11.4 ± 12.1 µg/g, 0.5 ± 0.7 µg/g, and 3.0 × 105 ± 0.8 × 105 µg/g, respectively. Hg was not detected. No significant association was found between Mn and behavioral deficits. Ca was significantly negatively associated, and Pb showed a significant positive association with Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant Disorders. These findings call into question the putative independent association of manganese exposure and behavioral deficits in children, when the balance of other metallic burden, particularly Ca and Pb burdens play significant roles. PMID:26084001

  20. P3 event-related potential amplitude and the risk for disinhibitory disorders in adolescent boys.

    PubMed

    Iacono, William G; Carlson, Scott R; Malone, Stephen M; McGue, Matthew

    2002-08-01

    The children of parents who abuse alcohol typically show reduced amplitude of the P3 event-related potential wave. We determined if this effect was present in a population-based sample of older adolescent boys, whether it was associated with paternal antisocial personality and drug use, and whether it appeared in youth with childhood externalizing and substance use disorders. A statewide sample of 502 male youth, identified from Minnesota birth records as members of twin pairs, had their P3 amplitude measured, using a visual oddball paradigm when they were approximately 17 years old. Structured clinical interviews covering attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, antisocial personality disorder, and substance use disorders were administered in person to the youth and his parents at the time of the P3 assessment and again to the youth 3 years later. Reduced P3 was associated with disorders and paternal risk for disorders, reflecting a behavioral disinhibition spectrum that included attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, antisocial personality disorder, alcoholism, nicotine dependence, and illicit drug abuse and dependence. Reduced P3 at age 17 predicted the development of substance use disorders at age 20. Most effect sizes associated with these group differences exceeded 0.70, indicating medium to moderately large group differences. Maternal alcoholism and substance use during pregnancy were unrelated to P3 amplitude in offspring. Small amplitude P3 may indicate genetic risk for a dimension of disinhibiting psychiatric disorders, including childhood externalizing, adult antisocial personality disorder, and substance use disorders.

  1. The Impact of Group Drumming on Social-Emotional Behavior in Low-Income Children

    PubMed Central

    Ho, Ping; Tsao, Jennie C. I.; Bloch, Lian; Zeltzer, Lonnie K.

    2011-01-01

    Low-income youth experience social-emotional problems linked to chronic stress that are exacerbated by lack of access to care. Drumming is a non-verbal, universal activity that builds upon a collectivistic aspect of diverse cultures and does not bear the stigma of therapy. A pretest-post-test non-equivalent control group design was used to assess the effects of 12 weeks of school counselor-led drumming on social-emotional behavior in two fifth-grade intervention classrooms versus two standard education control classrooms. The weekly intervention integrated rhythmic and group counseling activities to build skills, such as emotion management, focus and listening. The Teacher's Report Form was used to assess each of 101 participants (n = 54 experimental, n = 47 control, 90% Latino, 53.5% female, mean age 10.5 years, range 10–12 years). There was 100% retention. ANOVA testing showed that intervention classrooms improved significantly compared to the control group in broad-band scales (total problems (P < .01), internalizing problems (P < .02)), narrow-band syndrome scales (withdrawn/depression (P < .02), attention problems (P < .01), inattention subscale (P < .001)), Diagnostic and Statistical Manual of Mental Disorders-oriented scales (anxiety problems (P < .01), attention deficit/hyperactivity problems (P < .01), inattention subscale (P < .001), oppositional defiant problems (P < .03)), and other scales (post-traumatic stress problems (P < .01), sluggish cognitive tempo (P < .001)). Participation in group drumming led to significant improvements in multiple domains of social-emotional behavior. This sustainable intervention can foster positive youth development and increase student-counselor interaction. These findings underscore the potential value of the arts as a therapeutic tool. PMID:21660091

  2. A general population twin study of conduct problems and the auditory P300 waveform.

    PubMed

    Bertoletti, Eleonora; Michelini, Giorgia; Moruzzi, Sara; Ferrer, Giuseppina; Ferini-Strambi, Luigi; Stazi, Maria Antonietta; Ogliari, Anna; Battaglia, Marco

    2014-01-01

    Reduced amplitude of the P300 event-related potential has been consistently associated with a variety of externalising problems, including conduct disorder. The few available genetically-informative studies of these relationships, however, were conducted among adolescents/adults (i.e., at an age when conduct disorder has typically already become manifest). Among 200 general population twins with a mean age of 9 years (range 6-14 years), we studied the relationship between the P300 waveform elicited by an auditory oddball task and the DSM-oriented conduct problems scale of the Child Behavior Checklist 6-18. Conduct problems scores were negatively and significantly correlated (r = -0.19, p = 0.01) with P300 amplitude; correlations between P300 amplitude and the other DSM-oriented Child Behavior Checklist scales were non-significant, except for oppositional defiant problems (p = 0.01). We found moderate heritability estimates for both P300 amplitude (0.58, CI:0.37;0.73) and conduct problems (0.52, CI:0.25;0.70). Bivariate twin analyses indicated that the covariation between these two phenotypes can be explained by additive genetic factors only, with a genetic correlation of -0.33. An association between reduced P300 amplitude and conduct problems can be substantiated already in childhood, at an age that precedes the most typical onset of conduct disorder. This relationship appears to be genetic in nature. Reduced P300 amplitude can represent a valuable marker for conduct problems, and can contribute to the early identification of children at high-risk for conduct disorder.

  3. ADHD and risky sexual behavior in adolescents: Conduct problems and substance use as mediators of risk

    PubMed Central

    Sarver, Dustin E.; McCart, Michael R.; Sheidow, Ashli J.; Letourneau, Elizabeth J.

    2015-01-01

    Background Recent studies have linked attention-deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. Methods ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross-sectional sample of adolescents (N=115; mean age=14.9 years) involved in the juvenile justice system. Results Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow-up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive but not inattentive symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. Conclusions The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD. PMID:24813803

  4. Selective mutism: more than social anxiety?

    PubMed

    Yeganeh, Robin; Beidel, Deborah C; Turner, Samuel M

    2006-01-01

    This study investigated the relationship between selective mutism (SM), social phobia (SP), oppositionality, and parenting styles. Twenty-one children with SP, 21 children with SM and SP, and 21 normal children ages 7-15, and the mother of each child, participated in an assessment of psychopathological factors potentially related to SM. Children with SM did not endorse higher levels of social anxiety than did children with SP, although clinicians gave higher severity ratings to those who had both disorders. In addition, although a dimensional measure of oppositionality (Eyberg Child Behavior Inventory) did not reveal group differences, there were significantly more diagnoses of oppositional defiant disorder among children with SM (29%) in comparison to children with SP alone (5%). With respect to parenting styles, there were no significant differences among parents of children with SM and the other groups, except that children with SP reported significantly less warmth/acceptance from parents than normal children. These data replicate previous findings that children with SM do not report greater social anxiety than other children with a SP diagnosis. Furthermore, they suggest that oppositional behaviors may be part of the clinical presentation of a subset of children with SM.

  5. The effect of adding Coping Power Program-Sweden to Parent Management Training-effects and moderators in a randomized controlled trial.

    PubMed

    Helander, Maria; Lochman, John; Högström, Jens; Ljótsson, Brjánn; Hellner, Clara; Enebrink, Pia

    2018-04-01

    For children with oppositional defiant disorder (ODD), Parent Management Training (PMT) is a recommended treatment in addition to child Cognitive Behavioral Therapy (child-CBT). There is however a lack of studies investigating the additive effect of group-based child-CBT to PMT for children between 8 and 12 years. The current study investigated the incremental effect of group-based child-CBT, based on the Coping Power Program, when added to the Swedish group-based PMT program KOMET. Outcomes were child behavior problems, child prosocial behavior, parenting skills and the moderating effect of child characteristics. One hundred and twenty children 8-12 years with ODD or Disruptive Behavioral Disorder NOS and their parents were randomized either to combined child-CBT and PMT (n = 63) or to PMT only (n = 57) in Swedish Child- and Adolescent Psychiatric settings. Participants were assessed pre- and post-treatment using semi-structured interviews and child- and parent ratings. After treatment, behavior problems were reduced in both groups. Prosocial behavior were significantly more improved in the combined treatment. Parenting skills were improved in both groups. In moderator analyses, behavior problems and prosocial behavior improved significantly more in the combined treatment compared to PMT only in the group of children with high levels of ODD symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Selective Mutism: The Fraternal Twin of Childhood Social Phobia.

    PubMed

    Gensthaler, Angelika; Maichrowitz, Verena; Kaess, Michael; Ligges, Marc; Freitag, Christine M; Schwenck, Christina

    Selective mutism (SM) is an anxiety disorder with a close link to childhood social phobia (SP). Our studies compare behavioral problem profiles in children and adolescents with SM and SP and control groups and assess the comorbidity patterns of SM and SP. Participants aged 3-18 years with SM (n = 95), SP (n = 74) and internalizing disorders (INT, n = 46) and a typically developing control group (CG, n = 119) were assessed with the Child Behavior Checklist (CBCL); adolescents were additionally assessed with the Youth Self-Report (YSR). Comorbidity was assessed in SM and SP participants with a diagnostic interview. SP was detected in 94% of children with SM. SM participants showed different behavioral and psychiatric symptoms than SP: they were more frequently affected by lifetime separation anxiety disorder (SM: 45%, SP: 26%) and oppositional defiant disorder (SM: 22%, SP: 5%), and less by generalized anxiety disorder (SM: 6%, SP: 20%) and major depression (SM: 12%, SP: 26%). Adolescents with SM showed high rates of agoraphobia (SM 27%; SP 10%) and more social problems (YSR), and were more withdrawn (CBCL, YSR) than those with SP alone. Specific behavioral problems of SM and SP compared to INT and CG were observed. SM and SP represent separate but closely related disorders, distinct from other INT and CG, with specific patterns of lifetime comorbidities. © 2016 S. Karger AG, Basel.

  7. Are Elevations in ADHD Symptoms Associated with Physiological Reactivity and Emotion Dysregulation in Children?

    PubMed

    McQuade, Julia D; Breaux, Rosanna P

    2017-08-01

    The present study examined whether children with elevated attention-deficit/hyperactivity disorder (ADHD) symptoms display a unique pattern of emotion dysregulation as indexed by both parent report and physiological reactivity during experiences of failure. A sample of 61 children (9 to 13 years; M = 11.62, SD = 1.29; 48 % male) with and without clinical elevations in ADHD symptoms participated. Parent and teacher report of ADHD and oppositional defiant disorder (ODD) symptoms and parent report of internalizing problems were collected. Parents also provided ratings of children's emotional negativity/lability and emotion regulation. Children's physiological reactivity, based on changes in respiratory sinus arrhythmia (RSA) and skin conductance level (SCL), were assessed while they completed a manipulated social rejection task and impossible puzzle task. Regression analyses indicated that ADHD symptoms were associated with higher parent-rated emotional negativity/lability and with blunted RSA withdrawal in response to social rejection; these effects were not accounted for by co-occurring ODD symptoms or internalizing problems. ODD symptoms also were uniquely associated with parent ratings of poor emotion regulation. Internalizing problems were uniquely associated with emotional negativity/lability, poor emotion regulation, and increased SCL activity in response to social rejection. Results suggest that there may be a pattern of emotion dysregulation that is specific to ADHD symptomatology. The importance of contextual factors when examining physiological reactivity to stress in youth with ADHD is discussed.

  8. Defiant: (DMRs: easy, fast, identification and ANnoTation) identifies differentially Methylated regions from iron-deficient rat hippocampus.

    PubMed

    Condon, David E; Tran, Phu V; Lien, Yu-Chin; Schug, Jonathan; Georgieff, Michael K; Simmons, Rebecca A; Won, Kyoung-Jae

    2018-02-05

    Identification of differentially methylated regions (DMRs) is the initial step towards the study of DNA methylation-mediated gene regulation. Previous approaches to call DMRs suffer from false prediction, use extreme resources, and/or require library installation and input conversion. We developed a new approach called Defiant to identify DMRs. Employing Weighted Welch Expansion (WWE), Defiant showed superior performance to other predictors in the series of benchmarking tests on artificial and real data. Defiant was subsequently used to investigate DNA methylation changes in iron-deficient rat hippocampus. Defiant identified DMRs close to genes associated with neuronal development and plasticity, which were not identified by its competitor. Importantly, Defiant runs between 5 to 479 times faster than currently available software packages. Also, Defiant accepts 10 different input formats widely used for DNA methylation data. Defiant effectively identifies DMRs for whole-genome bisulfite sequencing (WGBS), reduced-representation bisulfite sequencing (RRBS), Tet-assisted bisulfite sequencing (TAB-seq), and HpaII tiny fragment enrichment by ligation-mediated PCR-tag (HELP) assays.

  9. Attention deficit disorders--drugs or nutrition?

    PubMed

    Matsudaira, Toshiko

    2007-01-01

    3-9% of schoolchildren in the U.K. suffer Attention Deficit and Hyperactivity Disorder (ADHD). Since the 1950s stimulants have been used. particularly methylphenidate and dextroamphetamine, with some 75% response rate. The first non-stimulant medication--atmoxetine hydrochloride, has also been used. However, side effects have included: growth retardation; appetite loss: headache: stomachache: heart problem: insomnia: seizure; change of character: addiction or even suicidal thoughts. Alternative treatments have been used including omega-3s, yet the way they benefit in ADHD is uncertain. They may be important in remodelling dendrites and synapses, and/or sustaining: blood brain barrier, neuronal membrane. neurotransmitter channel, receptors and ion channel. Stevens in 2003 found long-chain polyunsaturated fatty acids (LCPUFAs) effective for oppositional defiant disorder, whereas Eicosapentaenoic acid (EPA) specifically was helpful with disruptive behaviour. Docosahexaenoic acid (DHA) is important during gestation and early infancy, particularly for neurodevelopment. The Durham Trial by Richardson published in 2005, tested omega-3s with omega-6s on schoolchildren with developmental coordination disorder (many of them had ADHD symptoms), improving scores in co-ordination and short term memory.

  10. Rate and predictors of divorce among parents of youths with ADHD.

    PubMed

    Wymbs, Brian T; Pelham, William E; Molina, Brooke S G; Gnagy, Elizabeth M; Wilson, Tracey K; Greenhouse, Joel B

    2008-10-01

    Numerous studies have asserted the prevalence of marital conflict among families of children with attention-deficit/hyperactivity disorder (ADHD), but evidence is surprisingly less convincing regarding whether parents of youths with ADHD are more at risk for divorce than are parents of children without ADHD. Using survival analyses, the authors compared the rate of marital dissolution between parents of adolescents and young adults with and without ADHD. Results indicated that parents of youths diagnosed with ADHD in childhood (n = 282) were more likely to divorce and had a shorter latency to divorce compared with parents of children without ADHD (n = 206). Among a subset of those families of youths with ADHD, prospective analyses indicated that maternal and paternal education level; paternal antisocial behavior; and child age, race/ethnicity, and oppositional-defiant/conduct problems each uniquely predicted the timing of divorce between parents of youths with ADHD. These data underscore how parent and child variables likely interact to exacerbate marital discord and, ultimately, dissolution among families of children diagnosed with ADHD. (c) 2008 APA, all rights reserved

  11. Behavioural and emotional disorders in childhood: A brief overview for paediatricians

    PubMed Central

    Ogundele, Michael O

    2018-01-01

    Mental health problems in children and adolescents include several types of emotional and behavioural disorders, including disruptive, depression, anxiety and pervasive developmental (autism) disorders, characterized as either internalizing or externalizing problems. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional, defiant or conduct disorders are the commonest behavioural problems in preschool and school age children. The routine Paediatric clinic or Family Medicine/General Practitioner surgery presents with several desirable characteristics that make them ideal for providing effective mental health services to children and adolescents. DSM-5 and ICD-10 are the universally accepted standard criteria for the classification of mental and behaviour disorders in childhood and adults. The age and gender prevalence estimation of various childhood behavioural disorders are variable and difficult to compare worldwide. A review of relevant published literature was conducted, including published meta-analyses and national guidelines. We searched for articles indexed by Ovid, PubMed, PubMed Medical Central, CINAHL, EMBASE, Database of Abstracts and Reviews, and the Cochrane Database of Systematic reviews and other online sources. The searches were conducted using a combination of search expressions including “childhood”, “behaviour”, “disorders” or “problems”. Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents. PMID:29456928

  12. Group Parent-Child Interaction Therapy: A Randomized Control Trial for the Treatment of Conduct Problems in Young Children

    PubMed Central

    Niec, Larissa N.; Barnett, Miya L.; Prewett, Matthew S.; Shanley, Jenelle

    2016-01-01

    Objective Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. Methods Eighty-one families with three- to six-year-old children (71.6% male; 85.2% Caucasian) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, group PCIT. Parents completed standardized measures of children’s conduct problems, parenting stress, and social support at intake, posttreatment, and six-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. Results Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children’s conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in group PCIT did not experience greater social support or treatment adherence. Conclusions Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of group PCIT in community settings. PMID:27018531

  13. Child sex moderates the association between negative parenting and childhood conduct problems.

    PubMed

    Tung, Irene; Li, James J; Lee, Steve S

    2012-01-01

    Although multiple dimensions of negative parenting behavior are associated with childhood conduct problems (CP), there is relatively little research on whether the association is equally robust in boys and girls. To improve the specificity of current models of negative parenting and offspring CP, we explored the potential moderating role of child sex in a sample of 179 5- to 10-year-old ethnically diverse boys and girls with and without attention-deficit/hyperactivity disorder (ADHD) who were assessed using multiple methods (i.e., rating scales, semistructured interviews) and informants (i.e., parents, teachers). Controlling for children's age, race-ethnicity, and ADHD diagnostic status (i.e., ADHD vs. non-ADHD), inconsistent discipline was positively associated with offspring aggression and rule-breaking behavior, whereas harsh punishment was positively associated with aggression, rule-breaking behavior, and oppositional defiant disorder symptoms. Furthermore, child sex significantly moderated the association of inconsistent discipline and aggression and rule-breaking behavior, such that inconsistent discipline was positively associated with CP for boys, but not for girls. Given the centrality of negative parenting to theories of and efficacious interventions for aggression and CP, we discuss these findings within a developmental psychopathology framework and consider their implications for intervention. © 2012 Wiley Periodicals, Inc.

  14. Sex differences in the associations between vagal reactivity and oppositional defiant disorder symptoms.

    PubMed

    Vidal-Ribas, Pablo; Pickles, Andrew; Tibu, Florin; Sharp, Helen; Hill, Jonathan

    2017-09-01

    Vagal reactivity to stress in children has been associated with future psychiatric outcomes. However, results have been mixed possibly because these effects are in opposite direction in boys and girls. These sex differences are relevant in the context of development of psychopathology, whereby the rates of psychiatric disorders differ by sex. In this study, we aimed to examine the association between vagal reactivity, assessed as a reduction in respiratory sinus arrhythmia (RSA) in response to a challenge, and the development of future oppositional defiant disorder (ODD) symptoms in boys and girls. In addition, we examine the specific associations with ODD symptom dimensions, named irritability and headstrong. We hypothesized that increased vagal reactivity was associated with increased ODD symptoms in girls and a reduction in ODD symptoms in boys. Participants were members of the Wirral Child Health and Development Study, a prospective epidemiological longitudinal study of 1,233 first-time mothers recruited at 20 weeks' gestation. RSA during four nonstressful and one stressful (still-face) procedures was assessed when children were aged 29 weeks in a sample stratified by adversity (n = 270). Maternal reports of ODD symptoms were collected when children were 2.5 years old (n = 253), 3.5 years old (n = 826), and 5 years old (n = 770). Structural equation modeling (SEM) was employed to test our hypotheses. There was a significant sex difference in the prediction of ODD symptoms due to the opposite directionality in which increasing vagal reactivity was associated with an increase in ODD symptoms in girls and a reduction of ODD symptoms in boys. This Sex by Vagal reactivity interaction was common for both ODD dimensions, with no sex by dimension-specific associations. Physiological reactivity to a stressful situation predicts differently ODD symptoms in boys and girls very early in life, with no difference across irritability and headstrong components. Findings are discussed in the context of the several mechanisms involved on the later development of distinct psychiatric disorders in boys and girls. © 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

  15. Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

    PubMed

    Topal, E; Catal, F; Soylu, N; Ozcan, O O; Celiksoy, M H; Babayiğit, A; Erge, D; Karakoç, H T E; Sancak, R

    2016-01-01

    Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cow's milk allergy. The parents of the pre-school children with cow's milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. The cow's milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cow's milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cow's milk allergy group. Psychiatric disorders are frequent and severe in pre-school children with cow's milk allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  16. Relationship between anxiety, anxiety sensitivity and conduct disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

    PubMed

    Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba

    2013-09-01

    Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.

  17. Effect of Methylphenidate on Emotional Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder + Oppositional Defiant Disorder/Conduct Disorder.

    PubMed

    Kutlu, Ayse; Akyol Ardic, Ulku; Ercan, Eyup Sabri

    2017-04-01

    Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (ADHD). It can be observed as a dysregulation profile or a deficient emotional self-regulation (DESR) profile. Oppositional defiant disorder/conduct disorder (ODD/CD) comorbidity is prevalent in ADHD and known to be related with ED. The first-line treatment of ADHD includes psychostimulants, but their effects on ED are not well studied. This study aimed to evaluate the outcomes of methylphenidate (MPH) treatment on ED in ADHD + ODD/CD cases. A total of 118 ADHD + ODD/CD patients with a mean age of 9.0 ± 1.9 years were treated with MPH for 1 year. Also, parents of cases were recruited for a parent-training program, which initiated after first month of MPH treatment. Symptom severity was assessed at baseline and 12th month by Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parent Form, Children Depression Inventory, Child Behavior Checklist 4-18 years, and Parental Acceptance and Rejection Questionnaire-Mother Form. Emotional dysregulation (DESR + DP) was present in 85.6% of cases. Conduct disorder was significantly higher in patients with DP, whereas ODD was significantly higher in the DESR and non-ED groups (P < 0.0001). Symptoms of ADHD and ED were significantly improved with 1-year of MPH treatment (P < 0.05). The improvement in ED was independent of improvement in ADHD symptoms and parent training (P < 0.05). Emotional dysregulation is highly prevalent in disruptive behavioral disorders as ODD and CD, which are comorbid with ADHD. The MPH treatment is effective on ED independently from other clinical determinants.

  18. The role of anxiety in cortisol stress response and cortisol recovery in boys with oppositional defiant disorder/conduct disorder.

    PubMed

    Schoorl, Jantiene; Rijn, Sophie van; Wied, Minet de; van Goozen, Stephanie; Swaab, Hanna

    2016-11-01

    Children with antisocial and aggressive behaviors have been found to show abnormal neurobiological responses to stress, specifically impaired cortisol stress reactivity. The role of individual characteristics, such as comorbid anxiety, in the stress response is far less studied. Furthermore, this study extended previous studies in that not only baseline and reactivity to a psychosocial stressor were examined, but also recovery from a stressor. These three phases of cortisol could be impacted differentially in boys with oppositional defiant disorder/conduct disorder (ODD/CD) with (+ANX) and without anxiety (-ANX). The results revealed that cortisol patterns in response to psychosocial stress were different for boys with ODD/CD+ANX (n=32), ODD/CD-ANX (n=22) and non-clinical controls (NC) (n=34), with age range of 7.8-12.9 years. The ODD/CD-ANX group showed lower overall cortisol levels than the NC group. When considering the three phases of cortisol separately, the ODD/CD-ANX group had lower baseline cortisol levels relative to the other groups, whereas the ODD/CD+ANX showed an impaired cortisol recovery response. Within those with ODD/CD, callous-unemotional traits were predictive of high baseline cortisol levels. Also, anxiety predicted high baseline and recovery cortisol levels, whereas a high number of CD symptoms predicted reduced cortisol stress reactivity. These results clearly indicate that comorbid anxiety is an important factor in explaining differences in stress response profiles in boys with ODD/CD; although boys with CD/ODD are generally characterized by an impaired cortisol stress response, we found that those with comorbid anxiety showed impaired cortisol recovery, whereas those without anxiety showed reduced baseline cortisol levels. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample

    PubMed Central

    Bussing, Regina; Mason, Dana M.; Bell, Lindsay; Porter, Phillip; Garvan, Cynthia

    2010-01-01

    Objective To describe adolescent outcomes of childhood attention deficit-/ hyperactivity disorder (ADHD) in a diverse community sample. Method ADHD screening of a school district sample of 1,615 students ages 5 to 11 years was followed by a case-control study 8 years later. High risk youths meeting full (n=94) and subthreshold (n=75) DSM-IV ADHD criteria were matched with demographically similar low risk peers (n=163). Outcomes domains included symptoms; functional impairment; quality of life; substance use; educational outcomes; and juvenile justice involvement. Results 44% of youths with childhood ADHD had not experienced remission. Compared to unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (OR=12.9; 95% CI 5.6-30.0), anxiety/depression (OR=10.3; 95% CI 2.7-39.3), significant functional impairment (OR=3.4; 95% CI 1.7-6.9), reduced quality of life (OR=2.5, 95% CI 1.3-4.7), and to have been involved with juvenile justice (OR=3.1; 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. Conclusions ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies. PMID:20494269

  20. Bifactor latent structure of attention-deficit/hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD) symptoms and first-order latent structure of sluggish cognitive tempo symptoms.

    PubMed

    Lee, SoYean; Burns, G Leonard; Beauchaine, Theodore P; Becker, Stephen P

    2016-08-01

    The objective was to determine if the latent structure of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms is best explained by a general disruptive behavior factor along with specific inattention (IN), hyperactivity/impulsivity (HI), and ODD factors (a bifactor model) whereas the latent structure of sluggish cognitive tempo (SCT) symptoms is best explained by a first-order factor independent of the bifactor model of ADHD/ODD. Parents' (n = 703) and teachers' (n = 366) ratings of SCT, ADHD-IN, ADHD-HI, and ODD symptoms on the Child and Adolescent Disruptive Behavior Inventory (CADBI) in a community sample of children (ages 5-13; 55% girls) were used to evaluate 4 models of symptom organization. Results indicated that a bifactor model of ADHD/ODD symptoms, in conjunction with a separate first-order SCT factor, was the best model for both parent and teacher ratings. The first-order SCT factor showed discriminant validity with the general disruptive behavior and specific IN factors in the bifactor model. In addition, higher scores on the SCT factor predicted greater academic and social impairment, even after controlling for the general disruptive behavior and 3 specific factors. Consistent with predictions from the trait-impulsivity etiological model of externalizing liability, a single, general disruptive behavior factor accounted for nearly all common variance in ADHD/ODD symptoms, whereas SCT symptoms represented a factor different from the general disruptive behavior and specific IN factor. These results provide additional support for distinguishing between SCT and ADHD-IN. The study also demonstrates how etiological models can be used to predict specific latent structures of symptom organization. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Junior temperament character inventory together with quantitative EEG discriminate children with attention deficit hyperactivity disorder combined subtype from children with attention deficit hyperactivity disorder combined subtype plus oppositional defiant disorder.

    PubMed

    Chiarenza, Giuseppe A; Villa, Stefania; Galan, Lidice; Valdes-Sosa, Pedro; Bosch-Bayard, Jorge

    2018-05-19

    Oppositional defiant disorder (ODD) is frequently associated with Attention Deficit Hyperactivity Disorder (ADHD) but no clear neurophysiological evidence exists that distinguishes the two groups. Our aim was to identify biomarkers that distinguish children with Attention Deficit Hyperactivity Disorder combined subtype (ADHD_C) from children with ADHD_C + ODD, by combining the results of quantitative EEG (qEEG) and the Junior Temperament Character Inventory (JTCI). 28 ADHD_C and 22 ADHD_C + ODD children who met the DSMV criteria participated in the study. JTCI and EEG were analyzed. Stability based Biomarkers identification methodology was applied to the JTCI and the qEEG separately and combined. The qEEG was tested at the scalp and the sources levels. The classification power of the selected biomarkers was tested with a robust ROC technique. The best discriminant power was obtained when TCI and qEEG were analyzed together. Novelty seeking, self-directedness and cooperativeness were selected as biomarkers together with F4 and Cz in Delta; Fz and F4 in Theta and F7 and F8 in Beta, with a robust AUC of 0.95 for the ROC. At sources level: the regions were the right lateral and medial orbito-frontal cortex, cingular region, angular gyrus, right inferior occipital gyrus, occipital pole and the left insula in Theta, Alpha and Beta. The robust estimate of the total AUC was 0.91. These structures are part of extensive networks of novelty seeking, self-directedness and cooperativeness systems that seem dysregulated in these children. These methods represent an original approach to associate differences of personality and behavior to specific neuronal systems and subsystems. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Structural Brain Abnormalities of Attention-Deficit/Hyperactivity Disorder With Oppositional Defiant Disorder.

    PubMed

    Noordermeer, Siri D S; Luman, Marjolein; Greven, Corina U; Veroude, Kim; Faraone, Stephen V; Hartman, Catharina A; Hoekstra, Pieter J; Franke, Barbara; Buitelaar, Jan K; Heslenfeld, Dirk J; Oosterlaan, Jaap

    2017-11-01

    Attention-deficit/hyperactivity disorder (ADHD) is associated with structural abnormalities in total gray matter, basal ganglia, and cerebellum. Findings of structural abnormalities in frontal and temporal lobes, amygdala, and insula are less consistent. Remarkably, the impact of comorbid oppositional defiant disorder (ODD) (comorbidity rates up to 60%) on these neuroanatomical differences is scarcely studied, while ODD (in combination with conduct disorder) has been associated with structural abnormalities of the frontal lobe, amygdala, and insula. The aim of this study was to investigate the effect of comorbid ODD on cerebral volume and cortical thickness in ADHD. Three groups, 16 ± 3.5 years of age (mean ± SD; range 7-29 years), were studied on volumetric and cortical thickness characteristics using structural magnetic resonance imaging (surface-based morphometry): ADHD+ODD (n = 67), ADHD-only (n = 243), and control subjects (n = 233). Analyses included the moderators age, gender, IQ, and scan site. ADHD+ODD and ADHD-only showed volumetric reductions in total gray matter and (mainly) frontal brain areas. Stepwise volumetric reductions (ADHD+ODD < ADHD-only < control subjects) were found for mainly frontal regions, and ADHD+ODD was uniquely associated with reductions in several structures (e.g., the precuneus). In general, findings remained significant after accounting for ADHD symptom severity. There were no group differences in cortical thickness. Exploratory voxelwise analyses showed no group differences. ADHD+ODD and ADHD-only were associated with volumetric reductions in brain areas crucial for attention, (working) memory, and decision-making. Volumetric reductions of frontal lobes were largest in the ADHD+ODD group, possibly underlying observed larger impairments in neurocognitive functions. Previously reported striatal abnormalities in ADHD may be caused by comorbid conduct disorder rather than ODD. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Canadian Guidelines on Pharmacotherapy for Disruptive and Aggressive Behaviour in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, or Conduct Disorder

    PubMed Central

    Gorman, Daniel A; Gardner, David M; Murphy, Andrea L; Feldman, Mark; Bélanger, Stacey A; Steele, Margaret M; Boylan, Khrista; Cochrane-Brink, Kate; Goldade, Roxanne; Soper, Paul R; Ustina, Judy; Pringsheim, Tamara

    2015-01-01

    Objective: To develop evidence-based guidelines on pharmacotherapy for severe disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), or conduct disorder (CD). The guidelines assume that psychosocial interventions have been pursued but did not achieve sufficient improvement. Method: A multidisciplinary consensus group used the Grading of Recommendations Assessment, Development and Evaluation approach for rating evidence quality and for grading recommendations. We conducted a systematic review of medications studied in placebo-controlled trials for treating disruptive and aggressive behaviour in children and adolescents with ADHD, ODD, or CD. We followed consensus procedures to make 1 of 4 recommendations for each medication: strong, in favour (↑↑); conditional, in favour (↑?); conditional, against (↓?); and strong, against (↓↓). Results: For children and adolescents with disruptive or aggressive behaviour associated with ADHD, psychostimulants received a strong recommendation in favour of use, while atomoxetine and alpha-2 agonists received a conditional recommendation in favour of use. If these patients do poorly with ADHD medications, the medication with the most evidence is risperidone. Risperidone also has the most evidence for treating disruptive or aggressive behaviour in the absence of ADHD. However, given risperidone’s major adverse effects, it received only a conditional recommendation in favour of use. We recommended against using quetiapine, haloperidol, lithium, or carbamazepine because of the poor quality of evidence and their major adverse effects. Conclusion: When severe disruptive or aggressive behaviour occurs with ADHD, medications for ADHD should be used first. Other medications have major adverse effects and, with the exception of risperidone, very limited evidence to support their use. PMID:25886657

  4. Risperidone Added to Parent Training and Stimulant Medication: Effects on Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Peer Aggression

    PubMed Central

    Gadow, Kenneth D.; Arnold, L. Eugene; Molina, Brooke S.G.; Findling, Robert L.; Bukstein, Oscar G.; Brown, Nicole V.; McNamara, Nora K.; Rundberg-Rivera, E. Victoria; Li, Xiaobai; Kipp, Heidi; Schneider, Jayne; Farmer, Cristan A.; Baker, Jennifer; Sprafkin, Joyce; Rice, Robert R.; Bangalore, Srihari S.; Butter, Eric M.; Buchan-Page, Kristin A.; Hurt, Elizabeth A.; Austin, Adrienne B.; Grondhuis, Sabrina N.; Aman, Michael G.

    2014-01-01

    Objective In this study, we aimed to expand on our prior research into the relative efficacy of combining parent training, stimulant medication and placebo (Basic) versus parent training, stimulant, and risperidone (Augmented) therapy by examining treatment effects for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and peer aggression, symptom-induced—impairment, and informant discrepancy. Method Children (6-12 years; N=168) with severe physical aggression, ADHD, and co-occurring ODD/CD received an open trial of parent training and stimulant medication for 3 weeks. Participants failing to show optimal clinical response were randomly assigned to Basic or Augmented therapy for an additional 6 weeks. Results Compared with Basic therapy, children receiving Augmented therapy experienced greater reduction in parent-rated ODD severity (p=.02, Cohen's d=0.27) and peer aggression (p=.02, Cohen's d=0.32), but not ADHD or CD symptoms. Fewer children receiving Augmented (16%) than Basic (40%) therapy were rated by their parents as impaired by ODD symptoms at Week 9/endpoint (p=.008). Teacher ratings indicated greater reduction in ADHD severity (p=.02, Cohen's d =0.61) with Augmented therapy, but not for ODD or CD symptoms or peer aggression. Although both interventions were associated with marked symptom reduction, a relatively large percentage of children were rated impaired for at least one targeted disorder at Week 9/endpoint by parents (Basic 47%; Augmented 27%) and teachers (Basic 48%; Augmented 38%). Conclusion Augmented was superior to Basic therapy in reducing severity of ADHD and ODD symptoms, peer aggression, and symptom-induced impairment, but clinical improvement was generally context-specific, and effect sizes ranged from small to moderate. PMID:25151418

  5. Stimulant-Responsive and Stimulant-Refractory Aggressive Behavior Among Children with ADHD

    PubMed Central

    Blader, Joseph C.; Pliszka, Steven R.; Jensen, Peter S.; Schooler, Nina R.; Kafantaris, Vivian

    2010-01-01

    OBJECTIVES The objective of this study was to examine factors that are associated with aggression that is responsive versus refractory to individualized optimization of stimulant monotherapy among children with attention-deficit/hyperactivity disorder (ADHD). METHODS Children who were aged 6 to 13 years and had ADHD, either oppositional defiant disorder or conduct disorder, significant aggressive behavior, and a history of insufficient response to stimulants completed an open stimulant monotherapy optimization protocol. Stimulant titration with weekly assessments of behavior and tolerability identified an optimal regimen for each child. Families also received behavioral therapy. Parents completed the Retrospective-Modified Overt Aggression Scale (R-MOAS) at each visit. Children were classified as having stimulant-refractory aggression on the basis of R-MOAS ratings and clinician judgment. Differences that pertained to treatment, demographic, and psychopathology between groups with stimulant monotherapy–responsive and –refractory aggression were evaluated. RESULTS Aggression among 32 (49.3%) of 65 children was reduced sufficiently after stimulant dosage adjustment and behavioral therapy to preclude adjunctive medication. Those who responded to stimulant monotherapy were more likely to benefit from the protocol’s methylphenidate preparation (once-daily, triphasic release), showed a trend for lower average dosages, and received fewer behavioral therapy sessions than did children with stimulant-refractory aggression. Boys, especially those with higher ratings of baseline aggression and of depressive and manic symptoms, more often exhibited stimulant-refractory aggression. CONCLUSIONS Among children whose aggressive behavior develops in the context of ADHD and of oppositional defiant disorder or conduct disorder, and who had insufficient response to previous stimulant treatment in routine clinical care, systematic, well-monitored titration of stimulant monotherapy often culminates in reduced aggression that averts the need for additional agents. PMID:20837589

  6. Unhealthy sleep practices, conduct problems, and daytime functioning during adolescence.

    PubMed

    Lin, Wen-Hsu; Yi, Chin-Chun

    2015-02-01

    Although sleep has been linked to activities in various domains of life, one under-studied link is the relationship between unhealthy sleep practices and conduct problems among adolescents. The present study investigates the influence of adolescents' unhealthy sleep practices-short sleep (e.g., less than 6 h a day), inconsistent sleep schedule (e.g., social jetlag), and sleep problems-on conduct problems (e.g., substance use, fighting, and skipping class). In addition, this study examines unhealthy sleep practices in relationship to adolescent emotional well-being, defiant attitudes, and academic performance, as well as these three domains as possible mediators of the longitudinal association between sleep practices and conduct problems. Three waves of the Taiwan Youth Project (n = 2,472) were used in this study. At the first time-point examined in this study, youth (51% male) were aged 13-17 (M = 13.3). The results indicated that all three measures of unhealthy sleep practices were related to conduct problems, such that short sleep, greater social jetlag, and more serious sleep problems were concurrently associated with greater conduct problems. In addition, short sleep and sleep problems predicted conduct problems one year later. Furthermore, these three unhealthy sleep practices were differently related to poor academic performance, low levels of emotional well-being, and defiant attitudes, and some significant indirect effects on later conduct problems through these three attributes were found. Cultural differences and suggestions for prevention are discussed.

  7. Psychosocial interventions for disruptive behavioural problems in children living in low- and middle-income countries: study protocol of a systematic review.

    PubMed

    Burkey, Matthew D; Hosein, Megan; Purgato, Marianna; Adi, Ahmad; Morton, Isabella; Kohrt, Brandon A; Tol, Wietse A

    2015-05-20

    Disruptive behaviour disorders (DBDs) are among the most common forms of child psychopathology and have serious long-term academic, social, and mental health consequences worldwide. Psychosocial treatments are the first line of evidence-based treatments for DBDs, yet their effectiveness often varies according to patient sociodemographic characteristics, practice setting, and implementation procedures. While a large majority of the world's children live in low- and middle-income countries (LMIC), most studies have evaluated psychosocial treatments for DBDs in high-income Anglo countries. The primary objective of this systematic review is to assess the effects of psychosocial treatments for DBDs in children and adolescents (under age 18) diagnosed with oppositional defiant disorder, conduct disorder, or other disruptive behavioural problems living in LMIC. The secondary objectives are to: (1) describe the range and types of psychosocial treatments used to address DBDs in LMIC and (2) identify key dissemination and implementation factors (adaptation processes, training/supervision processes, and financial costs). All controlled trials comparing psychosocial treatments versus waiting list, no treatment, or treatment as usual in children living in LMIC will be included. Studies will be identified using the methods outlined in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines without restrictions on language, publication type, status, or date of publication. The primary outcome measures will be disruptive behavioural problems (eg, oppositionality, defiance, aggression or deceit). Secondary outcomes will be positive mental health outcomes (eg, prosocial behaviour), function impairment, institutionalisation (or hospitalisation), academic outcomes and caregiver outcomes. This study uses data from published studies; therefore ethical review is not required. Findings will be presented in a published manuscript. PROSPERO CRD42014015334. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Bidirectional Associations Between Externalizing Behavior Problems and Maladaptive Parenting Within Parent-Son Dyads Across Childhood

    PubMed Central

    Loeber, Rolf; Hinshaw, Stephen P.; Pardini, Dustin A.

    2018-01-01

    Coercive parent–child interaction models posit that an escalating cycle of negative, bidirectional interchanges influences the development of boys’ externalizing problems and caregivers’ maladaptive parenting over time. However, longitudinal studies examining this hypothesis have been unable to rule out the possibility that between-individual factors account for bidirectional associations between child externalizing problems and maladaptive parenting. Using a longitudinal sample of boys (N = 503) repeatedly assessed eight times across 6-month intervals in childhood (in a range between 6 and 13 years), the current study is the first to use novel within-individual change (fixed effects) models to examine whether parents tend to increase their use of maladaptive parenting strategies following an increase in their son’s externalizing problems, or vice versa. These bidirectional associations were examined using multiple facets of externalizing problems (i.e., interpersonal callousness, conduct and oppositional defiant problems, hyperactivity/impulsivity) and parenting behaviors (i.e., physical punishment, involvement, parent–child communication). Analyses failed to support the notion that when boys increase their typical level of problem behaviors, their parents show an increase in their typical level of maladaptive parenting across the subsequent 6 month period, and vice versa. Instead, across 6-month intervals, within parent-son dyads, changes in maladaptive parenting and child externalizing problems waxed and waned in concert. Fixed effects models to address the topic of bidirectional relations between parent and child behavior are severely underrepresented. We recommend that other researchers who have found significant bidirectional parent–child associations using rank-order change models reexamine their data to determine whether these findings hold when examining changes within parent–child dyads. PMID:26780209

  9. Bidirectional Associations Between Externalizing Behavior Problems and Maladaptive Parenting Within Parent-Son Dyads Across Childhood.

    PubMed

    Besemer, Sytske; Loeber, Rolf; Hinshaw, Stephen P; Pardini, Dustin A

    2016-10-01

    Coercive parent-child interaction models posit that an escalating cycle of negative, bidirectional interchanges influences the development of boys' externalizing problems and caregivers' maladaptive parenting over time. However, longitudinal studies examining this hypothesis have been unable to rule out the possibility that between-individual factors account for bidirectional associations between child externalizing problems and maladaptive parenting. Using a longitudinal sample of boys (N = 503) repeatedly assessed eight times across 6-month intervals in childhood (in a range between 6 and 13 years), the current study is the first to use novel within-individual change (fixed effects) models to examine whether parents tend to increase their use of maladaptive parenting strategies following an increase in their son's externalizing problems, or vice versa. These bidirectional associations were examined using multiple facets of externalizing problems (i.e., interpersonal callousness, conduct and oppositional defiant problems, hyperactivity/impulsivity) and parenting behaviors (i.e., physical punishment, involvement, parent-child communication). Analyses failed to support the notion that when boys increase their typical level of problem behaviors, their parents show an increase in their typical level of maladaptive parenting across the subsequent 6 month period, and vice versa. Instead, across 6-month intervals, within parent-son dyads, changes in maladaptive parenting and child externalizing problems waxed and waned in concert. Fixed effects models to address the topic of bidirectional relations between parent and child behavior are severely underrepresented. We recommend that other researchers who have found significant bidirectional parent-child associations using rank-order change models reexamine their data to determine whether these findings hold when examining changes within parent-child dyads.

  10. ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk.

    PubMed

    Sarver, Dustin E; McCart, Michael R; Sheidow, Ashli J; Letourneau, Elizabeth J

    2014-12-01

    Recent studies have linked attention-deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross-sectional sample of adolescents (N = 115; mean age = 14.9 years) involved in the juvenile justice system. Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow-up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive, but not inattentive, symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

  11. Emotional and behavioral problems in adolescents and young adults with food allergy.

    PubMed

    Ferro, M A; Van Lieshout, R J; Ohayon, J; Scott, J G

    2016-04-01

    Adolescents with food allergy have poorer psychosocial outcomes compared with their nonallergic counterparts; however, few studies have prospectively examined the mental health of adolescents and young adults in this vulnerable population. Our objectives were to estimate the prevalence of emotional and behavioral problems in an epidemiological sample of adolescents and young adults with food allergy; determine whether food allergy is associated with adolescent and maternal reports of such problems; and examine the patterns of change in emotional and behavioral problems from adolescence to young adulthood among individuals with and without food allergy. Data came from 1303 participants at 14 and 21 years of age in the Mater University Study of Pregnancy. Emotional and behavioral problems were measured using self- and maternal-reported symptoms of depression, anxiety, attention/deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder. Maternal, but not self-reports suggested that emotional and behavioral problems were higher among adolescents with food allergy. Food allergy was associated with increased odds of elevated levels of maternal-reported symptoms of depression [OR = 4.50 (1.83, 11.07)], anxiety [OR = 2.68 (1.12, 6.44)], and ADHD [OR = 3.14 (1.07, 9.19)] in adolescence. Food allergy was also associated with depressive symptoms that persisted from adolescence to young adulthood [OR = 2.05 (1.04, 4.03)]. Emotional and behavioral problems, particularly symptoms of depression, anxiety, and ADHD, are common among adolescents with food allergy in the general population and, in the case of elevated levels of depressive symptoms, persist into young adulthood. Healthcare professionals should seek adolescent and parental perspectives when assessing emotional and behavioral problems and monitor mental health during the transition to adulthood. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Prevalence of attention deficit hyperactivity disorder and comorbid psychiatric and behavioral problems among primary school students in western Saudi Arabia

    PubMed Central

    AlZaben, Faten N.; Sehlo, Mohammad G.; Alghamdi, Waleed A.; Tayeb, Haythum O.; Khalifa, Doaa A.; Mira, Abdulrahman T.; Alshuaibi, Abdulaziz M.; Alguthmi, Mosab A.; Derham, Ahmad A.; Koenig, Harold G.

    2018-01-01

    Objectives: To determine the prevalence of attention deficit hyperactivity disorder (ADHD), subtypes of ADHD, and psychiatric, academic, and behavioral comorbidity in public primary school students in Jeddah, Saudi Arabia. Methods: This is a cross-sectional study. A simple random sample of 6 primary government schools in Jeddah, Saudi Arabia, was identified (3 male, 3 female), and a random sample of classes in each of grades 1-6 were selected. Between July and November 2016, teachers in these classes were asked to complete the Vanderbilt ADHD scale on all students in their classes. Results: A total of 929 students were screened. The overall prevalence of ADHD was 5% (5.3% in girls, 4.7% in boys). The most prevalent subtype of ADHD was combined type (2.7%), followed by hyperactive type (1.2%), and inattentive type (1.1%). The highest prevalence of ADHD overall was in grade 3 (7.1%) and the lowest prevalence in grade 6 (3.4%). Among students with ADHD, prevalence of comorbid psychiatric, academic, and behavioral problems was widespread (56.5% oppositional defiant disorder/conduct disorder, 54.4% impaired academic performance, 44.4% classroom behavioral problems, 41.3% depression/anxiety). Comorbid problems were especially prevalent in combined ADHD subtype and in boys. Conclusions: Attention deficit hyperactivity disorder is common in primary school children in Jeddah, and is associated with widespread psychiatric, academic, and behavioral problems, especially in boys. These findings have implications for the diagnosis and treatment of this serious neurobehavioral disorder. PMID:29332109

  13. The effectiveness of the Stop Now and Plan (SNAP) program for boys at risk for violence and delinquency.

    PubMed

    Burke, Jeffrey D; Loeber, Rolf

    2015-02-01

    Among the available treatments for disruptive behavior problems, a need remains for additional service options to reduce antisocial behavior and prevent further development along delinquent and violent pathways. The Stop Now and Plan (SNAP) Program is an intervention for antisocial behavior among boys between 6 and 11. This paper describes a randomized controlled treatment effectiveness study of SNAP versus standard behavioral health services. The treatment program was delivered to youth with aggressive, rule-breaking, or antisocial behavior in excess of clinical criterion levels. Outcomes were measured at 3, 9, and 15 months from baseline. Youth in the SNAP condition showed significantly greater reduction in aggression, conduct problems, and overall externalizing behavior, as well as counts of oppositional defiant disorder and attention deficit hyperactivity disorder symptoms. Additional benefits for SNAP were observed on measures of depression and anxiety. Further analyses indicated that the SNAP program was more effective among those with a higher severity of initial behavioral problems. At 1 year follow-up, treatment benefits for SNAP were maintained on some outcome measures (aggression, ADHD and ODD, depression and anxiety) but not others. Although overall juvenile justice system contact was not significantly different, youth in SNAP had significantly fewer charges against them relative to those standard services. The SNAP Program, when contrasted with standard services alone, was associated with greater, clinically meaningful, reductions in targeted behaviors. It may be particularly effective for youth with more severe behavioral problems and may result in improvements in internalizing problems as well.

  14. Dimensions of Oppositionality in a Brazilian Community Sample: Testing the DSM-5 Proposal and Etiological Links

    PubMed Central

    Krieger, Fernanda Valle; Polanczyk, Guilherme Vanoni; Goodman, Robert; Rohde, Luis Augusto; Graeff-Martins, Ana Soledade; Salum, Giovanni; Gadelha, Ary; Pan, Pedro; Stahl, Daniel; Stringaris, Argyris

    2013-01-01

    Objective Investigating dimensions of oppositional symptoms may help to explain heterogeneity of etiology and outcomes for mental disorders across development and provide further empirical justification for the DSM-5–proposed modifications of oppositional defiant disorder (ODD). However, dimensions of oppositionality have not previously been tested in samples outside Europe or the United States. In this study, we used a large Brazilian community sample to compare the fit of different models for dimensions of oppositional symptoms; to examine the association of psychiatric diagnoses and symptoms with dimensions of oppositionality; and to examine the associations between dimensions of oppositionality and parental history of mental disorders. Method A Brazilian community sample of 2,512 children 6 through 12 years old were investigated in this study. Confirmatory factorial analyses were performed to compare the fit of alternative models, followed by linear and logistic regression analyses of associations with psychiatric diagnosis and parental history of psychopathology. Results A three-factor model with irritable, headstrong, and hurtful dimensions fitted best. The irritable dimension showed a strong association with emotional disorders in the child (p<.001) and history of depression (p<.01) and suicidality (p<.05) in the mother. The headstrong dimension was uniquely associated with attention-deficit/hyperactivity disorder (ADHD) in the child (p<.001) and with maternal history of ADHD symptoms (p<.05). The hurtful dimension was specifically associated with conduct disorder (p< .05). Conclusions Our findings from a large community sample of Brazilian children support a distinction between dimensions of oppositionality consistent with current DSM-5 recommendations and provide further evidence for etiological distinctions between these dimensions. PMID:23582870

  15. Attention Deficit Hyperactivity Disorder in Preschool-Age Children.

    PubMed

    Tandon, Mini; Pergjika, Alba

    2017-07-01

    Attention deficit hyperactivity disorder is a neurodevelopmental disorder marked by age-inappropriate deficits in attention or hyperactivity/impulsivity that interfere with functioning or development. It is highly correlated with other disorders, such as oppositional defiant disorder, conduct disorder, and mood symptoms. The etiology is multifactorial, and neuroimaging findings are nonspecific. Although assessment tools exist, there is variability among them, and historically, parent-teacher agreement has not been consistent. Treatment algorithm for attention deficit hyperactivity disorder in preschoolers includes behavioral interventions first followed by psychopharmacologic treatment when behavioral therapies fail. Other nonpharmacologic and nonbehavioral interventions are discussed including the role of exercise and nutrition. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. ADHD bifactor model based on parent and teacher ratings of Malaysian children.

    PubMed

    Gomez, Rapson

    2014-04-01

    The study used confirmatory factor analysis to ascertain support for the bifactor model of the Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, based on parent and teacher ratings for a group of Malaysian children. Malaysian parents and teachers completed ratings of ADHD and Opposition Defiant Disorder (ODD) symptoms for 934 children. For both sets of ratings, the findings indicating good fit for the bifactor model, and the factors in this model showed differential associations with ODD, thereby supporting the internal and external validity of this model. The theoretical and clinical implications of the findings are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Disruptive Behavior Disorders in Children 0 to 6 Years Old.

    PubMed

    Tandon, Mini; Giedinghagen, Andrea

    2017-07-01

    Disruptive behavior disorders (DBDs), specifically oppositional defiant disorder and conduct disorder, are common, serious, and treatable conditions among preschoolers. DBDs are marked by frequent aggression, deceitfulness, and defiance, and often persist through the lifespan. Exposure to harsh or inconsistent parenting, as frequently seen with parental depression and stress, increases DBD risk. Candidate genes that may increase DBD risk in the presence of childhood adversity have also been identified, but more research is needed. Neurophysiologic and structural correlates with DBD also exist. Parent management training programs, focusing on increasing parenting competence and confidence, are the gold standard treatment of preschool DBDs. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Group parent-child interaction therapy: A randomized control trial for the treatment of conduct problems in young children.

    PubMed

    Niec, Larissa N; Barnett, Miya L; Prewett, Matthew S; Shanley Chatham, Jenelle R

    2016-08-01

    Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. Eighty-one families with 3- to 6-year-old children (71.6% boys, 85.2% White) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, Group PCIT. Parents completed standardized measures of children's conduct problems, parenting stress, and social support at intake, posttreatment, and 6-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children's conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in Group PCIT did not experience greater social support or treatment adherence. Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of Group PCIT in community settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Developmental trajectories of aggression, prosocial behavior, and social-cognitive problem solving in emerging adolescents with clinically elevated attention-deficit/hyperactivity disorder symptoms.

    PubMed

    Kofler, Michael J; Larsen, Ross; Sarver, Dustin E; Tolan, Patrick H

    2015-11-01

    Middle school is a critical yet understudied period of social behavioral risks and opportunities that may be particularly difficult for emerging adolescents with attention-deficit/hyperactivity disorder (ADHD) given their childhood social difficulties. Relatively few ADHD studies have examined social behavior and social-cognitive problem solving beyond the elementary years, or examined aspects of positive (prosocial) behavior. The current study examined how middle school students with clinically elevated ADHD symptoms differ from their non-ADHD peers on baseline (6th grade) and age-related changes in prosocial and aggressive behavior, and the extent to which social-cognitive problem solving strategies mediate these relations. Emerging adolescents with (n = 178) and without (n = 3,806) clinically elevated, teacher-reported ADHD-combined symptoms were compared longitudinally across 6th through 8th grades using parallel process latent growth curve modeling, accounting for student demographic characteristics, oppositional-defiant disorder (ODD) symptoms, deviant peer association, school climate, and parental monitoring. Sixth graders with elevated ADHD symptoms engaged in somewhat fewer prosocial behaviors (d = -0.44) and more aggressive behavior (d = 0.20) relative to their peers. These small social behavioral deficits decreased but were not normalized across the middle school years. Contrary to hypotheses, social-cognitive problem solving was not impaired in the ADHD group after accounting for co-occurring ODD symptoms and did not mediate the association between ADHD and social behavior during the middle school years. ADHD and social-cognitive problem solving contributed independently to social behavior, both in 6th grade and across the middle school years; the influence of social-cognitive problem solving on social behavior was highly similar for the ADHD and non-ADHD groups. (c) 2015 APA, all rights reserved).

  20. The impact of comorbid mental health symptoms and sex on sleep functioning in children with ADHD.

    PubMed

    Becker, Stephen P; Cusick, Caroline N; Sidol, Craig A; Epstein, Jeffery N; Tamm, Leanne

    2018-03-01

    Children with attention-deficit/hyperactivity disorder (ADHD) display more sleep problems than their peers, but it remains unclear whether comorbid mental health symptoms [i.e., anxiety, depression, oppositional-defiant disorder (ODD)] are uniquely related to sleep functioning. It is also largely unknown whether boys and girls with ADHD differ in their sleep functioning. This study (1) examined whether boys or girls with ADHD differ in their sleep functioning, (2) evaluated comorbid symptoms as uniquely related to sleep functioning domains, and (3) explored whether sex moderated associations between comorbid symptoms and sleep. Participants were 181 children (ages 7-13; 69% male; 82% White) diagnosed with ADHD. Parents completed measures assessing their child's ADHD symptoms, comorbid symptoms, and sleep functioning. Girls had poorer sleep functioning than boys across most sleep functioning domains. Sixty percent of children met cutoff criteria for having sleep problems, though rates differed significantly between girls (75%) and boys (53%). No differences in rates of sleep problems were found between ADHD subtypes/presentations or between younger and older children. In path models including ADHD and comorbid symptom dimensions, anxiety symptoms were uniquely associated with increased bedtime resistance and sleep anxiety, ADHD hyperactive-impulsive symptoms were associated with more night wakings and more parasomnia behaviors, and ODD and depressive symptoms were associated with shorter sleep duration. Depression was also uniquely associated with increased daytime sleepiness and overall sleep problems. Sex did not moderate associations between comorbid symptoms and sleep problems. This study provides important preliminary evidence that girls with ADHD experience more sleep problems than boys with ADHD. Findings also demonstrate that the associations between comorbid symptoms and sleep functioning in children with ADHD vary based on both the specific symptoms and sleep domains examined.

  1. Behavior therapy and callous-unemotional traits: Effects of a pilot study examining modified behavioral contingencies on child behavior

    PubMed Central

    Miller, Natalie V.; Haas, Sarah M.; Waschbusch, Daniel A.; Willoughby, Michael T.; Helseth, Sarah A.; Crum, Kathleen I.; Coles, Erika K.; Pelham, William E.

    2014-01-01

    The conduct problems of children with callous-unemotional traits (i.e., lack of empathy, guilt/lack of caring behaviors) (CU) are particularly resistant to current behavioral interventions, and it is possible that differential sensitivities to punishment and reward may underlie this resistance. Children with conduct problems and CU (CPCU) are less responsive to behavioral punishment techniques (e.g., time-out), however reward techniques (e.g., earning points for prizes or activities) are effective for reducing conduct problems. This study examined the efficacy of modified behavioral interventions, which de-emphasized punishment (condition B) and emphasized reward techniques (condition C), compared to a standard behavioral intervention (condition A). Interventions were delivered through a Summer Treatment Program over seven weeks with an A-B-A-C-A-BC-A design to a group of eleven children (7–11 years; 91% male). All children were diagnosed with either oppositional defiant disorder or conduct disorder, in addition to attention-deficit/hyperactivity disorder. Results revealed the best treatment response occurred during the low punishment condition, with rates of negative behavior (e.g., aggression, teasing, stealing) increasing over the seven weeks. However, there was substantial individual variability in treatment response, and several children demonstrated improvement during the modified intervention conditions. Future research is necessary to disentangle treatment effects from order effects, and implications of group treatment of CPCU children (i.e., deviancy training) are discussed. PMID:25022772

  2. Relationships between behavioral symptoms of non-medicated Chinese children with attention deficit hyperactivity disorder and parenting stress: Comparison of different subtypes and comorbidities.

    PubMed

    Li, Yan; Jiang, Wen-Qing; Du, Ya-Song; Coghill, David

    2016-06-01

    To identify the characteristics of behavior problems among children with attention deficit hyperactivity disorder (ADHD) and their relation with parenting stress. The Conners Parent Symptom Questionnaire (PSQ) and Parenting Stress Index (PSI) were used to assess the symptoms and parenting stress of 132 non-medicated children with ADHD as compared with 88 healthy controls. Every PSQ factor of ADHD children was higher than in the control group; children with the combined subtype of ADHD had the highest scores in conduct and learning problems, impulsivity/hyperactivity, and overall hyperactivity index; the PSI total stress, child domain, and parent domain scores were all higher in the ADHD group than in the control group; children with the combined subtype of ADHD had the highest score in the competence subscale of the parent domain, whereas the PSI total stress score of parents of children with ADHD and comorbid oppositional defiant disorder (ODD) was higher than that of parents of children with only ADHD. The PSI total stress score was positively correlated with all PSQ factor scores. The PSQ factors of conduct problems and learning problems were found to be significant predictors in a regression analysis. The children with ADHD exhibited abnormal parenting stress compared with healthy controls, which was much more pronounced when the children had comorbid ODD. Furthermore, parenting stress was related with the severity of ADHD symptoms, suggesting that children with the combined subtype of ADHD require particular attention in the future. © 2015 Wiley Publishing Asia Pty Ltd.

  3. Mental health outcomes of cocaine-exposed children at 6 years of age.

    PubMed

    Linares, Teresa J; Singer, Lynn T; Kirchner, H Lester; Short, Elizabeth J; Min, Meeyoung O; Hussey, Patrick; Minnes, Sonia

    2006-01-01

    To assess 6-year-old cocaine- and noncocaine-exposed children's mental health outcomes controlling for potential confounders. The sample consisted of 322 children [169 cocaine exposed (CE) and 153 noncocaine exposed (NCE)] enrolled in a longitudinal study since birth. At age 6, children were assessed for mental health symptoms using the Dominic Interactive (DI), a child self-report measure, and the Child Behavior Checklist (CBCL), a caregiver report of behavioral problems. CE children were more likely to self-report symptoms in the probable clinical range for oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). In contrast, prenatal cocaine exposure was not related to child behavior based on the CBCL. After control for exposure, CE children in adoptive or foster care were rated as having more problems with aggression, externalizing behaviors, and total behavioral problems than NCE children and CE children in maternal or relative care. Also, CE children in adoptive or foster care self-reported more externalizing symptoms than CE children in maternal or relative care and NCE children. Findings could not be attributed to caregiver intelligence or depressive symptoms, or to the quality of the home environment. CE children report more symptoms of ODD and ADHD than nonexposed children. Adoptive or foster caregivers rated their CE children as having more behavioral problems than did maternal or relative caregivers of CE children or parents of NCE children. Although further studies are needed to understand the basis for the more negative ratings by adoptive or foster caregivers of their CE children, the self-report of CE children indicates a need for psychological interventions.

  4. [Familial impact of children with the combined subtype of attention deficit hyperactivity disorder: the effects of associated behavioural disorders].

    PubMed

    Presentación-Herrero, M J; García-Castellar, R; Miranda-Casas, A; Siegenthaler-Hierro, R; Jara-Jiménez, P

    To determine the impact that children with ADHD-C (attention deficit hyperactivity disorder, combined subtype) have on their family by analysing their parents' perceptions, and to examine whether the presence of associated behavioural disorders affect that impact. Participants in the study included one group made up of the parents of 27 children with ADHD-C and another group consisting of the parents of 27 children without ADHD. The parents in the ADHD-C group were divided into two subgroups according to whether or not their children had an oppositional defiant disorder and/or a co-morbid conduct disorder (10 and 17 families, respectively). The results of the analyses performed showed significant differences between the perceptions of the parents of the control children and those of the parents of children with ADHD-C in the following categories: feelings and attitudes, social life, matrimonial relationship, day-to-day relationships with peers and siblings, stress and difficulty in living with their child. Comparisons between the two subgroups of children with ADHD-C did not reveal any significant differences in any of the categories that were analysed, and showed ADHD-C to be the fundamental factor underlying the problems in the family context. Some items, however, suggested that the problem is more serious in the subtype with associated behavioural disorders.

  5. Narcissism and Callous-Unemotional Traits Prospectively Predict Child Conduct Problems.

    PubMed

    Jezior, Kristen L; McKenzie, Meghan E; Lee, Steve S

    2016-01-01

    Although narcissism and callous-unemotional (CU) traits are separable facets of psychopathy, their independent prediction of conduct problems (CP) among young children is not well known. In addition, above-average IQ was central to the original conceptualization of psychopathy, yet IQ is typically inversely associated with youth CP. We examined narcissism and CU traits as independent and prospective predictors of oppositional defiant disorder (ODD), conduct disorder (CD), and youth self-reported antisocial behavior, as well as their moderation by IQ. At baseline, parents and teachers separately rated narcissism and CU traits in 188 6-to-10-year-old children (47.9% non-White; 69.1% male; M = 7.34 years, SD = 1.09) with (n = 99) and without (n = 89) attention-deficit/hyperactivity disorder (ADHD). Approximately 2 years later, parents and teachers separately rated youth ODD and CD symptoms, and youth self-reported antisocial behavior. With control of baseline ADHD and ODD/CD symptoms, narcissism and CU traits independently and positively predicted ODD and CD symptoms at follow-up. IQ did not moderate any CP predictions from baseline narcissism or CU traits. These preliminary findings suggest that individual differences in narcissism and CU traits, even relatively early in development, are uniquely associated with emergent CP. Findings are considered within a developmental framework and the multiple pathways underlying the heterogeneity of CP are discussed.

  6. Atomoxetine hydrochloride in the treatment of children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder: A placebo-controlled Italian study.

    PubMed

    Dell'Agnello, Grazia; Maschietto, Dino; Bravaccio, Carmela; Calamoneri, Filippo; Masi, Gabriele; Curatolo, Paolo; Besana, Dante; Mancini, Francesca; Rossi, Andrea; Poole, Lynne; Escobar, Rodrigo; Zuddas, Alessandro

    2009-11-01

    The primary aim of this study was to assess the efficacy of atomoxetine in improving ADHD and ODD symptoms in paediatric patients with ADHD and comorbid oppositional defiant disorder (ODD), non-responders to previous psychological intervention with parent support. This was a multicentre, randomised, placebo-controlled trial conducted in patients aged 6-15 years, with ADHD and ODD diagnosed according to the DSM-IV criteria by a structured clinical interview (K-SADS-PL). Only subjects who are non-responders to a 6-week standardized parent training were randomised to atomoxetine (up to 1.2 mg/kg/day) or placebo (in a 3:1 ratio) for the following 8-week double blind phase. Only 2 of the 156 patients enrolled for the parent support phase (92.9% of males; mean age: 9.9 years), improved after the parent training program; 139 patients were randomised for entering in the study and 137 were eligible for efficacy analysis. At the end of the randomised double blind phase, the mean changes in the Swanson, Nolan and Pelham Rating Scale-Revised (SNAP-IV) ADHD subscale were -8.1+/-9.2 and -2.0+/-4.7, respectively in the atomoxetine and in the placebo group (p<0.001 between groups); changes in the ODD subscale were -2.7+/-4.1 and -0.3+/-2.6, respectively in the two groups (p=0.001 between groups). The CGI-ADHD-S score decreased in the atomoxetine group (median change at endpoint: -1.0) compared to no changes in the placebo group (p<0.001 between groups). Statistically significant differences between groups, in favour of atomoxetine, were found in the CHIP-CE scores for risk avoidance domain, emotional comfort and individual risk avoidance subdomains. An improvement in all the subscales of Conners Parents (CPRS-R:S) and Teacher (CTRS-R:S) subscales was observed with atomoxetine, except in the cognitive problems subscale in the CTRS-R:S. Only 3 patients treated with atomoxetine discontinued the study due to adverse events. No clinically significant changes of body weight, height and vital signs were observed in both groups. Treatment with atomoxetine of children and adolescents with ADHD and ODD, who did not initially respond to parental support, was associated with improvements in symptoms of ADHD and ODD, and general health status. Atomoxetine was well tolerated.

  7. Effects of alcohol intoxication on parenting behavior in interactions with child confederates exhibiting normal or deviant behaviors.

    PubMed

    Lang, A R; Pelham, W E; Atkeson, B M; Murphy, D A

    1999-06-01

    Experimental analogue methods were used to study how acute alcohol intoxication in parents influences their perceptions of and reactions to child behaviors, as well as their strategies for management of those behaviors. All participating parents had a grade school-aged son, but in half the cases this target child had a diagnosed externalizing disorder, whereas for the remaining half neither the target son nor any other offspring of the parents evidenced any psychopathology. Equal numbers of married fathers, married mothers, and single mothers from each of these groups received either alcoholic or nonalcoholic beverages prior to videotaped interactions with male child confederates who, depending on condition, enacted behaviors characteristic of either normal boys or boys with attention deficit hyperactivity/conduct/oppositional defiant disorders (ADHD/CD/ODD). Results indicated that intoxicated parents rated their ADHD/CD/ODD child partners as less deviant than did sober parents. Alcohol intoxication caused all participant groups to exhibit less attention and productive work and more commands, indulgences, and off-task talk in the interactions. Implications for better understanding of the role of psychosocial factors in the correlation between adult drinking problems and childhood behavior disorders are discussed.

  8. The Limited Effects of Obstetrical and Neonatal Complications on Conduct and ADHD Symptoms in Middle Childhood

    PubMed Central

    Wagner, Anna I.; Schmidt, Nicole L.; Lemery-Chalfant, Kathryn; Leavitt, Lewis A.; Goldsmith, H. Hill

    2016-01-01

    Objective The purpose of this study was to examine the effects of a wide range of obstetrical and neonatal complications as well as socioeconomic variables on the behaviors characterized by attention deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD). Method Data were collected on 7–8 year old twins, using multiple instruments assessing many areas of individual and family functioning. The influence of several aspects of prenatal care, labor and delivery, and early life were considered as well as indicators of socioeconomic status such as family income and maternal education. Results The observed associations were stronger for ADHD than CD symptoms and stronger for females than males. Family income and gender significantly predicted both behavioral outcomes, while birthweight predicted ADHD symptoms only. However, the presence of ADHD and conduct symptom behaviors were not associated with an occurrence of more obstetrical or neonatal complications as indicated by hierarchical linear modeling (HLM) analyses. Conclusions By school age, behavioral problems related to inattention, impulsivity, hyperactivity, defiance, and conduct are relatively unaffected by general adversity in the neonatal and perinatal periods. PMID:19433988

  9. Analysis of the effectiveness of a training program for parents of children with ADHD in a hospital environment.

    PubMed

    Garreta, Esther; Jimeno, Teresa; Servera, Mateu

    2018-01-01

    Regarding the Attention Deficit Hyperactivity Disorder (ADHD), treatments combined with pharmacological, psychoeducational and parents training programs interventions are recommended. Parenting programs have been proven efficacy in the experimental area, but there is few data about their effectiveness and feasibility in the professional area. The objective of the study is to analyze the effectiveness of a parenting program implemented in a hospital setting to improve internalized and externalized behaviors as well as parenting styles in a sample of ADHD children. A training program for behavior management was applied to parents of 21 children with ADHD in a quasi-experimental pretest-posttest design, using measures from Child Behavior Checklist (CBCL) and Parenting Scale. Post-treatment data showed significant improvements specially on emotional, anxiety and oppositional defiant disorder measures. A significant but moderate improvement was found on ADHD, and non-significant on conduct problem measure. Additionally, there were moderate but significant improvements in parenting styles. Data support the effectiveness and feasibility of parent training programs for children with ADHD applied in hospital settings as they improve a large part of associated symptoms and parenting styles.

  10. Neurobiology and neurodevelopmental impact of childhood traumatic stress and prenatal alcohol exposure.

    PubMed

    Henry, Jim; Sloane, Mark; Black-Pond, Connie

    2007-04-01

    Research reveals that prenatal alcohol exposure and child trauma (i.e., abuse, neglect, sexual abuse) can have deleterious effects on child development across multiple domains. This study analyzed the impact on childhood neurodevelopment of prenatal alcohol exposure and postnatal traumatic experience compared to postnatal traumatic experience alone. Although the harmful effects of both have been well documented individually, there is no research documenting the concurrent effects of prenatal alcohol exposure and postnatal trauma on a child's developmental process. Transdisciplinary assessment of the children included the core disciplines of medicine, speech-language pathology, occupational therapy, social work, and psychology. Medical examination, standardized developmental and intelligence testing, projective tools, parent questionnaires, and psychosocial interviews provided information in the primary developmental areas. Findings indicated that children who had been exposed prenatally to alcohol along with postnatal traumatic experience had lower intelligence scores and more severe neurodevelopmental deficits in language, memory, visual processing, motor skills, and attention than did traumatized children without prenatal alcohol exposure, as well as greater oppositional/defiant behavior, inattention, hyperactivity, impulsivity, and social problems. Successful teacher and speech-language pathologist interventions with traumatized children with prenatal alcohol exposure demand a paradigm shift that requires the development of new perspectives and ongoing training.

  11. The etiology of associations between negative emotionality and childhood externalizing disorders.

    PubMed

    Singh, Amber L; Waldman, Irwin D

    2010-05-01

    Despite consistent documentation of associations between childhood negative emotionality and externalizing psychopathology, few genetically informative studies have investigated the etiology of that association. The goal of the current study was to delineate the etiology of the covariation of negative emotionality and childhood externalizing problems (e.g., oppositional defiant disorder, conduct disorder, inattention, and hyperactivity/impulsivity). Twin families were recruited from Georgia state birth records and completed parental report questionnaires of negative emotionality and common Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) child psychiatric disorders. Results suggest both genetic and environmental influences underlying negative emotionality and each externalizing symptom dimension, with additional evidence for sibling competition/rater contrast effects for inattention and hyperactivity/impulsivity. Bivariate model-fitting analyses indicated that a portion of the additive (43%-75%) and nonadditive (26%-100%) genetic influences underlying each symptom dimension was accounted for by the genetic influences underlying negative emotionality. Finally, an independent pathways model examining the etiology of the association between negative emotionality and the externalizing dimensions indicated that a substantial portion of the additive genetic, nonadditive genetic, and nonshared environmental influences underlying externalizing behavior is shared with negative emotionality.

  12. Pediatric emotional dysregulation and behavioral disruptiveness treated with hypnosis: a time-series design.

    PubMed

    Iglesias, Alex; Iglesias, Adam

    2014-01-01

    A case of pediatric oppositional defiant disorder (ODD) with concomitant emotional dysregulation and secondary behavioral disruptiveness was treated with hypnosis by means of the hypnotic hold, a method adapted by the authors. An A-B-A-B time-series design with multiple replications was employed to measure the relationship of the hypnotic treatment to the dependent measure: episodes of emotional dysregulation with accompanying behavioral disruptiveness. The findings indicated a statistically significant relationship between the degree of change from phase to phase and the treatment. Follow-up at 6 months indicated a significant reduction of the frequency of targeted episodes of emotional dysregulation and behavioral disruptiveness at home.

  13. Evidence-based treatment of attention deficit/hyperactivity disorder in a preschool-age child: a case study.

    PubMed

    Verduin, Timothy L; Abikoff, Howard; Kurtz, Steven M S

    2008-04-01

    This case study illustrates a behavioral treatment of "Peter," a 4-year-old male with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder. Multiple evidence-based treatment procedures were implemented, affording the opportunity to explore issues common to the clinical application of empirically supported interventions. Among the strategies utilized were behavioral parent training, school consultation and behavioral training of educators, school-based contingency management, and a behavioral daily report card. Numerous issues are discussed, including the limited evidence regarding interventions for preschool-age children with ADHD, factors influencing treatment planning and sequencing, collaboration with schools and parents, and evidence-based assessment of treatment gains.

  14. Stability and Predictive Validity of the Parent-Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers.

    PubMed

    Barrios, Chelsey S; Jay, Samantha Y; Smith, Victoria C; Alfano, Candice A; Dougherty, Lea R

    2018-01-01

    Little research has examined the processes underlying children's persistent sleep problems and links with later psychopathology. The current study examined the stability of parent-child sleep interactions as assessed with the parent-reported Parent-Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3-5 years (T1) and again when they were 6-9 years (T2). The PSIS includes three subscales-Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent-child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)-and a total score. Higher scores indicate more problematic bedtime interactions. Children's sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children's sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent-child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent-child sleep interactions may serve as a useful target for interventions.

  15. Relations between Response Trajectories on the Continuous Performance Test and Teacher-Rated Problem Behaviors in Preschoolers

    PubMed Central

    Allan, Darcey M.; Lonigan, Christopher J.

    2014-01-01

    Although both the Continuous Performance Test (CPT) and behavior rating scales are used in both practice and research to assess inattentive and hyperactive/impulsive behaviors, the correlations between performance on the CPT and teachers' ratings are typically only small-to-moderate. This study examined trajectories of performance on a low target-frequency visual CPT in a sample of preschool children and how these trajectories were associated with teacher-ratings of problem behaviors (i.e., inattention, hyperactivity/impulsivity [H/I], and oppositional/defiant behavior). Participants included 399 preschool children (Mean age = 56 months; 49.4% female; 73.7% White/Caucasian). An ADHD-rating scale was completed by teachers, and the CPT was completed by the preschoolers. Results showed that children's performance across four temporal blocks on the CPT was not stable across the duration of the task, with error rates generally increasing from initial to later blocks. The predictive relations of teacher-rated problem behaviors to performance trajectories on the CPT were examined using growth curve models. Higher rates of teacher-reported inattention and H/I were uniquely associated with higher rates of initial omission errors and initial commission errors, respectively. Higher rates of teacher-reported overall problem behaviors were associated with increasing rates of omission but not commission errors during the CPT; however, the relation was not specific to one type of problem behavior. The results of this study indicate that the pattern of errors on the CPT in preschool samples is complex and may be determined by multiple behavioral factors. These findings have implications for the interpretation of CPT performance in young children. PMID:25419645

  16. Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT.

    PubMed

    Young, Andrea S; Arnold, L Eugene; Wolfson, Hannah L; Fristad, Mary A

    2017-07-01

    This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7-14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.

  17. Relations between response trajectories on the continuous performance test and teacher-rated problem behaviors in preschoolers.

    PubMed

    Allan, Darcey M; Lonigan, Christopher J

    2015-06-01

    Although both the continuous performance test (CPT) and behavior rating scales are used in both practice and research to assess inattentive and hyperactive/impulsive behaviors, the correlations between performance on the CPT and teachers' ratings are typically only small-to-moderate. This study examined trajectories of performance on a low target-frequency visual CPT in a sample of preschool children and how these trajectories were associated with teacher-ratings of problem behaviors (i.e., inattention, hyperactivity/impulsivity [H/I], and oppositional/defiant behavior). Participants included 399 preschool children (mean age = 56 months; 49.4% female; 73.7% White/Caucasian). An attention deficit/hyperactivity disorder (ADHD) rating scale was completed by teachers, and the CPT was completed by the preschoolers. Results showed that children's performance across 4 temporal blocks on the CPT was not stable across the duration of the task, with error rates generally increasing from initial to later blocks. The predictive relations of teacher-rated problem behaviors to performance trajectories on the CPT were examined using growth curve models. Higher rates of teacher-reported inattention and H/I were uniquely associated with higher rates of initial omission errors and initial commission errors, respectively. Higher rates of teacher-reported overall problem behaviors were associated with increasing rates of omission but not commission errors during the CPT; however, the relation was not specific to 1 type of problem behavior. The results of this study indicate that the pattern of errors on the CPT in preschool samples is complex and may be determined by multiple behavioral factors. These findings have implications for the interpretation of CPT performance in young children. (c) 2015 APA, all rights reserved).

  18. Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder.

    PubMed

    Lin, Yu-Ju; Yang, Li-Kuang; Gau, Susan Shur-Fen

    2016-06-01

    We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset <7 years (early-onset); (2) attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental disorders, 5th edition would not over-diagnose attention-deficit/hyperactivity disorder in the adult population. Recalled childhood attention-deficit/hyperactivity disorder symptom severity was correlated with conduct disorder, oppositional defiant disorder, dysthymia and sleep disorders. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  19. Substance use disorders in adolescents with attention deficit hyperactivity disorder: a 4-year follow-up study.

    PubMed

    Groenman, Annabeth P; Oosterlaan, Jaap; Rommelse, Nanda; Franke, Barbara; Roeyers, Herbert; Oades, Robert D; Sergeant, Joseph A; Buitelaar, Jan K; Faraone, Stephen V

    2013-08-01

    To examine the relationship between a childhood diagnosis of attention deficit hyperactivity disorder (ADHD) with or without oppositional defiant disorder (ODD)/conduct disorder (CD) and the development of later alcohol/drug use disorder [psychoactive substance use disorder (PSUD)] and nicotine dependence in a large European sample of ADHD probands, their siblings and healthy control subjects. Subjects (n = 1017) were participants in the Belgian, Dutch and German part of the International Multicenter ADHD Genetics (IMAGE) study. IMAGE families were identified through ADHD probands aged 5-17 years attending out-patient clinics, and control subjects from the same geographic areas. After a follow-up period (mean: 4.4 years) this subsample was re-assessed at a mean age of 16.4 years. PSUD and nicotine dependence were assessed using the Diagnostic Interview Schedule for Children, Alcohol Use Disorders Identification Test, Drug Abuse Screening Test and Fagerström test for Nicotine Dependence. The ADHD sample was at higher risk of developing PSUD [hazard ratio (HR) = 1.77, 95% confidence interval (CI) = 1.05-3.00] and nicotine dependence (HR = 8.61, 95% CI = 2.44-30.34) than healthy controls. The rates of these disorders were highest for ADHD youth who also had CD, but could not be accounted for by this comorbidity. We did not find an increased risk of developing PSUD (HR = 1.18, 95% CI = 0.62-2.27) or nicotine dependence (HR = 1.89, 95% CI = 0.46-7.77) among unaffected siblings of ADHD youth. A childhood diagnosis of attention deficit hyperactivity disorder is a risk factor for psychoactive substance use disorder and nicotine dependence in adolescence and comorbid conduct disorder, but not oppositional defiant disorder, further increases the risk of developing psychoactive substance use disorder and nicotine dependence. © 2013 Society for the Study of Addiction.

  20. Which dimension of parenting predicts the change of callous unemotional traits in children with disruptive behavior disorder?

    PubMed

    Muratori, Pietro; Lochman, John E; Lai, Elisa; Milone, Annarita; Nocentini, Annalaura; Pisano, Simone; Righini, Elisabetta; Masi, Gabriele

    2016-08-01

    Several studies suggested that in addition to child-driven factors (i.e., temperamental style), parenting behavior can, at least in part, influence the maintenance of Callous Unemotional (CU) traits in children; however, more information is needed to distinguish which styles (negative parenting or lack of positive parenting) predict increased levels of CU traits. The aim of the present treatment study was to examine which components of parenting are longitudinally associated with levels of CU traits in children with a disruptive behavior disorder diagnosis. The current study examined cross-lagged reciprocal effects models between positive and negative parenting practices, and the levels of child CU traits over three time points, including both positive and negative dimensions of parenting in the same model. Participants were 126 Italian children with diagnosis of disruptive behavior disorder (oppositional defiant disorder or conduct disorder), 113 boys and 13 girls, 110 Caucasian, 48 with conduct disorder, and 78 with oppositional defiant disorder, treated with a multi-component intervention, based on cognitive behavioral principles and practices. Participants were all 9-10 years of age at the beginning of the study, and were followed-up until the age of 11-12 years (24 months in total, the first 12 under treatment) using parent report (Alabama Parenting Questionnaire and Child Behavior Check List) and child report (Inventory of Callous-Unemotional Traits) measures. No significant cross-lagged path was found between negative parenting and CU traits; these two variables were also unrelated when positive parenting was considered in the same model. In contrast, reciprocal effects between positive parenting and CU were found: higher levels of positive parenting predicted lower levels of CU traits. The current findings suggest that the positive dimension of parenting may need to be targeted in the treatment of DBD children with higher CU traits. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample.

    PubMed

    Bussing, Regina; Mason, Dana M; Bell, Lindsay; Porter, Phillip; Garvan, Cynthia

    2010-06-01

    To describe adolescent outcomes of childhood attention-deficit/hyperactivity disorder (ADHD) in a diverse community sample. ADHD screening of a school district sample of 1,615 students aged 5 to 11 years was followed by a case-control study 8 years later. High-risk youths meeting full (n = 94) and subthreshold (n = 75) DSM-IV ADHD criteria were matched with demographically similar low-risk peers (n = 163). Outcomes domains included symptom, functional impairment, quality of life, substance use, educational outcomes, and juvenile justice involvement. In all, 44% of youths with childhood ADHD had not experienced remission. Compared with unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (odds ratio [OR] = 12.9, 95% confidence interval [CI] 5.6-30.0), anxiety/depression (OR = 10.3, 95% CI 2.7-39.3), significant functional impairment (OR = 3.4, 95% CI 1.7-6.9), reduced quality of life (OR = 2.5, 95% CI 1.3-4.7), and involvement with the juvenile justice system (OR = 3.1, 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies. 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Risperidone added to parent training and stimulant medication: effects on attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, and peer aggression.

    PubMed

    Gadow, Kenneth D; Arnold, L Eugene; Molina, Brooke S G; Findling, Robert L; Bukstein, Oscar G; Brown, Nicole V; McNamara, Nora K; Rundberg-Rivera, E Victoria; Li, Xiaobai; Kipp, Heidi L; Schneider, Jayne; Farmer, Cristan A; Baker, Jennifer L; Sprafkin, Joyce; Rice, Robert R; Bangalore, Srihari S; Butter, Eric M; Buchan-Page, Kristin A; Hurt, Elizabeth A; Austin, Adrienne B; Grondhuis, Sabrina N; Aman, Michael G

    2014-09-01

    In this study, we aimed to expand on our prior research into the relative efficacy of combining parent training, stimulant medication, and placebo (Basic therapy) versus parent training, stimulant, and risperidone (Augmented therapy) by examining treatment effects for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and peer aggression, symptom-induced impairment, and informant discrepancy. Children (6-12 years of age; N = 168) with severe physical aggression, ADHD, and co-occurring ODD/CD received an open trial of parent training and stimulant medication for 3 weeks. Participants failing to show optimal clinical response were randomly assigned to Basic or Augmented therapy for an additional 6 weeks. Compared with Basic therapy, children receiving Augmented therapy experienced greater reduction in parent-rated ODD severity (p = .002, Cohen's d = 0.27) and peer aggression (p = .02, Cohen's d = 0.32) but not ADHD or CD symptoms. Fewer children receiving Augmented (16%) than Basic (40%) therapy were rated by their parents as impaired by ODD symptoms at week 9/endpoint (p = .008). Teacher ratings indicated greater reduction in ADHD severity (p = .02, Cohen's d = 0.61) with Augmented therapy, but not for ODD or CD symptoms or peer aggression. Although both interventions were associated with marked symptom reduction, a relatively large percentage of children were rated as impaired for at least 1 targeted disorder at week 9/endpoint by parents (Basic 47%; Augmented 27%) and teachers (Basic 48%; Augmented 38%). Augmented therapy was superior to Basic therapy in reducing severity of ADHD and ODD symptoms, peer aggression, and symptom-induced impairment, but clinical improvement was generally context specific, and effect sizes ranged from small to moderate. Clinical trial registration information-Treatment of Severe Childhood Aggression (The TOSCA Study); http://clinicaltrials.gov/; NCT00796302. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. [Girls detained under civil and criminal law in juvenile detention centres; psychiatric disorders, trauma and psychosocial problems].

    PubMed

    Hamerlynck, S M J J; Doreleijers, Th A H; Vermeiren, R R J M; Cohen-Kettenis, P T

    2009-01-01

    As from 2008, juveniles sentenced under civil law and juveniles sentenced under criminal law can no longer be assigned to the same juvenile detention centres. The reasoning runs as follows: the centres are unlikely to provide adequate treatment for the 'civil' group, and the 'criminal' group may exert a negative influence on the 'civil' group. Hitherto, there has been no research into the question of whether the problems and treatment requirements of girls in the two categories call for detention in the same detention centres or in different ones. The aim of this study is to investigate differences between the two groups of girls with regard to offence history, sociodemographic characteristics, contact with the social services, psychiatric disorders and trauma. Investigation of a representative sample of 211 female minors in three juvenile detention centres using standard instruments. results 82% of the girls were detained under civil law, 18% under criminal law. There were strong similarities between the groups. However, the 'criminal' group more often had a violent history of delinquency and a non-Dutch background, whereas the 'civil' group more often had a background of residential placements, oppositional-defiant disorder, suicidality and self-harm. Girls detained under civil and under criminal law differed in characteristics such as criminal record, but there were striking similarities in the girls' behavioural problems and psychiatric disorders. It is argued that assignment to a particular type of detention centre should depend on treatment requirements rather than on measures imposed by civil or criminal law.

  4. Differential Association of Youth Attention-Deficit/Hyperactivity Disorder and Anxiety With Delinquency and Aggression.

    PubMed

    Falk, Avital E; Lee, Steve S; Chorpita, Bruce F

    2017-01-01

    Although attention-deficit/hyperactivity disorder (ADHD) is independently associated with both anxiety and conduct problems, it is unclear how co-occurring ADHD + anxiety are associated with different forms of conduct problems. That is, there is relatively little evidence how ADHD and co-occurring anxiety, relative to ADHD only and anxiety only, are associated with aggression and delinquency. Controlling for age, sex, oppositional defiant disorder diagnostic status and total psychopathology, we compared children with anxiety only, ADHD only, ADHD + anxiety, and a clinic-referred comparison group on measures of conduct problems. Three hundred eighty ethnically diverse boys and girls ages 5 to 17 (M = 11.62) were evaluated using a semistructured diagnostic interview for ADHD and anxiety; aggressive and delinquent behavior were evaluated using the Child Behavior Checklist. Children with anxiety only (n = 119) did not differ from clinic-referred comparisons (i.e., no DSM-IV diagnosis; n = 95) on aggression or delinquency; children with ADHD only (n = 130) were significantly more aggressive and delinquent than children with anxiety only. Children with ADHD + anxiety (n = 36) were significantly less aggressive than children with ADHD only, but they did not differ with respect to delinquency. These preliminary data suggest that ADHD, in the presence of anxiety, may be associated with significantly less aggression but not less delinquency. We discuss these findings from a developmental psychopathology framework and stress the need for further study to support possible implications for intervention and prevention.

  5. A serious game for children with Attention Deficit Hyperactivity Disorder: Who benefits the most?

    PubMed Central

    Franken, Ingmar H. A.; Maras, Athanasios

    2018-01-01

    Objective The aim of the current study was to identify which subgroups of children with Attention Deficit Hyperactivity Disorder (ADHD) benefitted the most from playing a Serious Game (SG) intervention shown in a randomized trial to improve behavioral outcomes. Method Pre-intervention characteristics [i.e., gender, age, intellectual level of functioning, medication use, computer experience, ADHD subtype, severity of inattention problems, severity of hyperactivity/impulsivity problems, comorbid Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) symptoms] were explored as potential moderators in a Virtual Twins (VT) analysis to identify subgroups for whom the SG intervention was most effective. Primary outcome measures were parent-reported time management, planning/organizing and cooperation skills. Results Two subgroups were identified. Girls (n = 26) were identified as the subgroup that was most likely to show greater improvements in planning/organizing skills as compared to the estimated treatment effect of the total group of participants. Furthermore, among the boys, those (n = 47) with lower baseline levels of hyperactivity and higher levels of CD symptoms showed more improvements in their planning/organizing skills when they played the SG intervention as compared to the estimated treatment effect of the total group of participants. Conclusion Using a VT analysis two subgroups of children with ADHD, girls, and boys with both higher levels of CD and lower levels of hyperactivity, were identified. These subgroups mostly benefit from playing the SG intervention developed to improve ADHD related behavioral problems. Our results imply that these subgroups have a higher chance of treatment success. PMID:29543891

  6. Your Defiant Child: 8 Steps to Better Behavior.

    ERIC Educational Resources Information Center

    Barkley, Russell A.; Benton, Christine M.

    Every child has "ornery" moments, but more than 1 in 20 American children exhibit behavioral problems that are out of control. This book was written to help parents struggling with an unyielding or combative child. The book's eight-step program emphasizes consistency and cooperation, promoting changes through a system of praise, rewards,…

  7. Revisiting the treatment of conduct problems in children with callous-unemotional traits.

    PubMed

    Hawes, David J; Dadds, Mark R; Brennan, John; Rhodes, Tracy; Cauchi, Avril

    2013-07-01

    This study examined whether the diminished treatment response previously reported for children with conduct problems and high levels of callous-unemotional (CU) traits is evident when these traits are indexed using multi-informant data collected from mothers, fathers, and teachers. It also tested whether treatment outcomes associated with CU traits are independent of overlap between CU traits and autism spectrum disorder (ASD) symptoms. Diagnostic data on oppositional defiant disorder (ODD) severity were collected pre-treatment (time 1) and at 6-month follow-up (time 2) in a sample of children (N = 95; 67 boys, 28 girls) aged 3-9 years with clinic-referred conduct problems and comorbid symptoms in a range of diagnostic domains. Time 1 measures of CU traits and ASD symptoms were tested as predictors of time 2 ODD severity using structural equation modeling, with multi-informant ratings of CU traits modeled as a single latent variable. Compared to children with low levels of CU traits, those with high levels exhibited more severe ODD symptoms at follow-up (β = 0.33, SE = 0.08, p < 0.05), after controlling for pre-treatment severity, socio-economic status, other demographics (age, gender), and parameters of treatment (number of treatment sessions, medication status). Although CU traits and ASD symptoms were positively correlated, ASD symptoms showed no association with change in ODD severity from pre-treatment to follow-up. Likewise, the association between CU traits and ODD outcomes held when controlling for covariation between CU traits and ASD symptoms. Our findings replicate previous evidence that CU traits are uniquely associated with poor clinical outcomes among children treated for conduct problems, and show for the first time that this association is not accounted for by symptoms of ASD.

  8. No objectively measured sleep disturbances in children with attention-deficit/hyperactivity disorder.

    PubMed

    Bergwerff, Catharina E; Luman, Marjolein; Oosterlaan, Jaap

    2016-10-01

    The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep. © 2016 European Sleep Research Society.

  9. Home environment: association with hyperactivity/impulsivity in children with ADHD and their non-ADHD siblings

    PubMed Central

    Mulligan, Aisling; Anney, Richard; Butler, Louise; O’Regan, Myra; Richardson, Thomas; Tulewicz, Edyta Maria; Fitzgerald, Michael; Gill, Michael

    2011-01-01

    Objective We wished to ascertain if there is an association between symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and home environment in children with ADHD and non-ADHD siblings, controlling for other environmental measures. Method 96 children with ADHD combined type (ADHD-CT) and their siblings participated in the study. Parent and teacher Conners’ rating scales were completed and home environment was assessed using the Middle Childhood and Early Adolescent Home Observation for Measurement of the Environment (HOME). ADHD symptoms were assessed for correlation with HOME in children with ADHD-CT and non-ADHD siblings and multiple regression analysis was used to control for gender, socio-economic status, exposure to nicotine, exposure to alcohol in utero, birth weight, gestational age, pregnancy and perinatal risk factors. The presence of oppositional disorders was assessed for association with HOME score in those with ADHD-CT. The multiple regression analysis was repeated controlling for environmental factors and for oppositional disorders in those with ADHD-CT. Oppositional symptoms were assessed for correlation with HOME score in non-ADHD siblings. Results Teacher-rated hyperactive/impulsive scores correlated with HOME (r = −.27, p <.01) in children with ADHD-CT. This association remained significant when other environmental factors and oppositional disorders were controlled for. Environmental factors and gender contributed to 30% of the variance of ADHD symptoms in ADHD-CT. Parent-rated hyperactive/impulsive scores also correlated with HOME (r = −.28, p < .05) for non-ADHD siblings. An association between HOME and diagnosis of oppositional defiant disorder or CD was found for children with ADHD-CT and between HOME and oppositional symptoms in non-ADHD siblings. Conclusions The home environment has a small but significant association with hyperactive/impulsive symptoms in children with ADHD-CT and non-ADHD siblings. This association remained when other environmental factors were taken into account. Oppositional symptoms are associated with home environment in ADHD-CT and in non-ADHD siblings. PMID:22168816

  10. Suicide attempt by hanging in preadolescent children: a case series.

    PubMed

    Omigbodun, O O; Adejumo, O A; Babalola, O O

    2008-10-01

    Suicide is now among the five top causes of death in youth worldwide. However, during the preadolescent period, suicidal behaviour is rare and difficult to define because the cognitive level of young children limits their ability to plan and understand the consequences or the finality of suicide. There is virtually no information about preadolescent suicidal behaviour in Nigeria. To illustrate the presentation and psychosocial issues associated with preadolescent suicidal attempt using the 'hanging' method in Nigeria. Three case scenarios of suicide attempt by hanging in preadolescents seen at the University College Hospital, Ibadan between 2005 and 2006 were interviewed in detail along with mental state and physical examination. Family and individual therapies were embarked upon. Types of psychopathology found in the preadolescents include depressive symptoms, conduct and oppositional defiant disorder and impulse control problems. Stressful life events such as family disruption, physical abuse, and bullying at school were factors associated with suicidal behaviour. The influence of the media in providing information about 'hanging' as a method of suicide was evident. Therapy yield varying results. High risk parameters for suicide in children should be known to all health professionals. The importance of intervention strategies particularly media education, monitoring systems and further research on suicidal behaviour in this environment is apparent.

  11. Mediators and Moderators of the Relation Between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms

    PubMed Central

    Breaux, Rosanna P.; Brown, Hallie R.; Harvey, Elizabeth A.

    2016-01-01

    The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children’s ADHD. PMID:27752934

  12. Construct validity of the parent-child sleep interactions scale (PSIS): associations with parenting, family stress, and maternal and child psychopathology.

    PubMed

    Smith, Victoria C; Leppert, Katherine A; Alfano, Candice A; Dougherty, Lea R

    2014-08-01

    Using a multi-method design, this study examined the construct validity of the Parent-Child Sleep Interactions Scale (PSIS; Alfano et al., 2013), which measures sleep-related parenting behaviors and interactions that contribute to preschoolers' sleep problems. Participants included a community sample of 155 preschoolers (ages 3-5years; 51.6% female). Primary caregivers completed the PSIS. Parenting styles and behaviors were assessed with laboratory observations and parent reports. Parent and child psychopathology and family life stress were assessed with clinical interviews and parent reports. Bivariate correlations revealed significant associations between the PSIS and a number of variables, including lower observed parental support and quality of instruction; higher observed parental intrusiveness; authoritative, authoritarian, and permissive parenting styles; current maternal depressive and/or anxiety disorders and depressive symptomatology; increased stressful life events; lower marital satisfaction; and higher child depressive, anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms. The patterns of association varied based on the specific PSIS scale. The PSIS demonstrates meaningful associations with parenting, maternal psychopathology, family stress, and child psychopathology and functioning. Findings suggest that the PSIS is a valid measure for assessing sleep-related parent/child behaviors and interactions among preschoolers, suited to real-world settings. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. The Effects of the Fast Track Preventive Intervention on the Development of Conduct Disorder Across Childhood

    PubMed Central

    2013-01-01

    The impact of the Fast Track intervention on externalizing disorders across childhood was examined. Eight hundred-ninety-one early-starting children (69% male; 51% African American) were randomly assigned by matched sets of schools to intervention or control conditions. The 10-year intervention addressed parent behavior-management, child social cognitive skills, reading, home visiting, mentoring, and classroom curricula. Outcomes included psychiatric diagnoses after grades 3, 6, 9, and 12 for conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, and any externalizing disorder. Significant interaction effects between intervention and initial risk level indicated that intervention prevented the lifetime prevalence of all diagnoses, but only among those at highest initial risk, suggesting that targeted intervention can prevent externalizing disorders to promote the raising of healthy children. PMID:21291445

  14. Time perception and reproduction in young adults with attention deficit hyperactivity disorder.

    PubMed

    Barkley, R A; Murphy, K R; Bush, T

    2001-07-01

    Adults with attention deficit hyperactivity disorder (ADHD; n = 104) were compared with a control group (n = 64) on time estimation and reproduction tasks. Results were unaffected by ADHD subtype or gender. The ADHD group provided larger time estimations than the control group, particularly at long intervals. This became nonsignificant after controlling for IQ. The ADHD group made shorter reproductions than did the control group (15- and 60-s intervals) and greater reproduction errors (12-, 45-, 60-s durations). These differences remained after controlling for IQ and comorbid oppositional defiant disorder, depression, and anxiety. Only the level of anxiety contributed to errors (at 12-s duration) beyond the level of ADHD. Results extended findings on time perception in ADHD children to adults and ruled out comorbidity as the basis of the errors.

  15. A multitrait-multisource confirmatory factor analytic approach to the construct validity of ADHD and ODD rating scales with Malaysian children.

    PubMed

    Gomez, Rapson; Burns, G Leonard; Walsh, James A; Hafetz, Nina

    2005-04-01

    Confirmatory factor analysis (CFA) was used to model a multitrait by multisource matrix to determine the convergent and discriminant validity of measures of attention-deficit hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) in 917 Malaysian elementary school children. The three trait factors were ADHD-IN, ADHDHI, and ODD. The two source factors were parents and teachers. Similar to earlier studies with Australian and Brazilian children, the parent and teacher measures failed to show convergent and discriminant validity with Malaysian children. The study outlines the implications of such strong source effects in ADHD-IN, ADHD-HI, and ODD measures for the use of such parent and teacher scales to study the symptom dimensions.

  16. Does Patient Race/Ethnicity Influence Physician Decision-Making for Diagnosis and Treatment of Childhood Disruptive Behavior Problems?

    PubMed

    Garland, Ann F; Taylor, Robin; Brookman-Frazee, Lauren; Baker-Ericzen, Mary; Haine-Schlagel, Rachel; Liu, Yi Hui; Wong, Sarina

    2015-06-01

    Race/ethnic disparities in utilization of children's mental health care have been well documented and are particularly concerning given the long-term risks of untreated mental health problems (Institute of Medicine, 2003; Kessler et al. Am J Psychiatry 152:10026-1032, 1995). Research investigating the higher rates of unmet need among race/ethnic minority youths has focused primarily on policy, fiscal, and individual child or family factors that can influence service access and use. Alternatively, this study examines provider behavior as a potential influence on race/ethnic disparities in mental health care. The goal of the study was to examine whether patient (family) race/ethnicity influences physician diagnostic and treatment decision-making for childhood disruptive behavior problems. The study utilized an internet-based video vignette with corresponding survey of 371 randomly selected physicians from across the USA representing specialties likely to treat these patients (pediatricians, family physicians, general and child psychiatrists). Participants viewed a video vignette in which only race/ethnicity of the mother randomly varied (non-Hispanic White, Hispanic, and African American) and then responded to questions about diagnosis and recommended treatments. Physicians assigned diagnoses such as oppositional defiant disorder (48 %) and attention deficit disorder (63 %) to the child, but there were no differences in diagnosis based on race/ethnicity. The majority of respondents recommended psychosocial treatment (98 %) and/or psychoactive medication treatment (60 %), but there were no significant differences based on race/ethnicity. Thus, in this study using mock patient stimuli and controlling for other factors, such as insurance coverage, we did not find major differences in physician diagnostic or treatment decision-making based on patient race/ethnicity.

  17. Serious child and adolescent behaviour disorders; a valuation study by professionals, youth and parents.

    PubMed

    Vermeulen, Karin M; Jansen, Daniëlle E M C; Buskens, Erik; Knorth, Erik J; Reijneveld, Sijmen A

    2017-06-02

    In child and youth care, quantitative estimates of the impact of serious behaviour problems have not yet been made. Such input is needed to support decision making on investments in treatment. The aim of this paper was to elicit valuations of social and conduct disorders in children and adolescents from three different perspectives: professionals, youth, and parents. We obtained valuations from 25 youth care professionals, 50 children (age 9-10) without serious behaviour problems and 36 adolescents (age 16-17) with and without serious behaviour disorders, and 46 parents with children in the aforementioned age categories. Valuations were estimated from 18 descriptions of behaviour disorders in youth aged 9 and 15 years. Descriptions included Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Disruptive Behaviour Disorder (DBD). Comorbid conditions were Attention Deficit Hyperactivity Disorder and substance abuse. Valuations were obtained with the EuroQol questionnaire (EQ-5D-3 L) and a visual analogue scale (VAS). Valuations were generally severe; problems were by and large reported to worsen quality of life by 50% compared to being fully healthy. Professionals regarded DBD with substance abuse as most severe (VAS values 0.41 for children, and 0.43 for adolescents, i.e. less than half of normal). They rated ODD as least severe (VAS values 0.58 for children, 0.59 for adolescents). Children, adolescents and parents gave lower valuations than professionals, and had a wider range of scores, particularly at the lower end of the scale. Behaviour disorders pose a formidable burden from the perspectives of professionals as well as children, adolescents and parents. These results may support medical decision making to set priorities with regard to prevention and treatment based on perceived severity.

  18. Refinements in the hierarchical structure of externalizing psychiatric disorders: Patterns of lifetime liability from mid-adolescence through early adulthood.

    PubMed

    Farmer, Richard F; Seeley, John R; Kosty, Derek B; Lewinsohn, Peter M

    2009-11-01

    Research on hierarchical modeling of psychopathology has frequently identified 2 higher order latent factors, internalizing and externalizing. When based on the comorbidity of psychiatric diagnoses, the externalizing domain has usually been modeled as a single latent factor. Multivariate studies of externalizing symptom features, however, suggest multidimensionality. To address this apparent contradiction, confirmatory factor analytic methods and information-theoretic criteria were used to evaluate 4 theoretically plausible measurement models based on lifetime comorbidity patterns of 7 putative externalizing disorders. Diagnostic information was collected at 4 assessment waves from an age-based cohort of 816 persons between the ages of 14 and 33. A 2-factor model that distinguished oppositional behavior disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder) from social norm violation disorders (conduct disorder, adult antisocial behavior, alcohol use disorder, cannabis use disorder, hard drug use disorder) demonstrated consistently good fit and superior approximating abilities. Analyses of psychosocial outcomes measured at the last assessment wave supported the validity of this 2-factor model. Implications of this research for the theoretical understanding of domain-related disorders and the organization of classification systems are discussed. PsycINFO Database Record 2009 APA, all rights reserved.

  19. Testing the specificity of executive functioning impairments in adolescents with ADHD, ODD/CD and ASD.

    PubMed

    Carter Leno, Virginia; Chandler, Susie; White, Pippa; Pickles, Andrew; Baird, Gillian; Hobson, Chris; Smith, Anna B; Charman, Tony; Rubia, Katya; Simonoff, Emily

    2017-12-09

    Current diagnostic systems conceptualise attention deficit hyperactivity disorder (ADHD), oppositional defiant/conduct disorder (ODD/CD) and autism spectrum disorder (ASD) as separate diagnoses. However, all three demonstrate executive functioning (EF) impairments. Whether these impairments are trans-diagnostic or disorder-specific remains relatively unexplored. Four groups of 10-16 year-olds [typically developing (TD; N = 43), individuals clinically diagnosed with ADHD (N = 21), ODD/CD (N = 26) and ASD (N = 41)] completed Go/NoGo and Switch tasks. Group differences were tested using analysis of co-variance (ANCOVA) including age, IQ, sex, conduct problems and ADHD symptoms as co-variates. Results indicated some disorder-specificity as only the ASD group demonstrated decreased probability of inhibition in the Go/NoGo task compared to all other groups. However, shared impairments were also found; all three diagnostic groups demonstrated increased reaction time variability (RTV) compared to the TD group, and both the ODD/CD and the ASD group demonstrated increased premature responses. When controlling for ADHD symptoms and conduct problems, group differences in RTV were no longer significant; however, the ASD group continued to demonstrate increased premature responses. No group differences were found in cognitive flexibility in the Switch task. A more varied response style was present across all clinical groups, although this appeared to be accounted for by sub-threshold ODD/CD and ADHD symptoms. Only the ASD group was impaired in response inhibition and premature responsiveness relative to TD adolescents. The findings suggest that some EF impairments typically associated with ADHD may also be found in individuals with ASD.

  20. Late-onset ADHD in adults: milder, but still dysfunctional.

    PubMed

    Karam, Rafael G; Bau, Claiton H D; Salgado, Carlos A I; Kalil, Katiane L S; Victor, Marcelo M; Sousa, Nyvia O; Vitola, Eduardo S; Picon, Felipe A; Zeni, Gregory D; Rohde, Luis A; Belmonte-de-Abreu, Paulo; Grevet, Eugenio H

    2009-04-01

    The requirement in classificatory systems that some impairment from attention-deficit/hyperactivity disorder (ADHD) symptoms starts before 7 years of age (age of onset of impairment criteria - AOC) has been harshly criticized. Although there is evidence that late-onset ADHD is a valid diagnosis, little is known about the role of age of onset of impairment on the clinical profile of adult patients. The diagnoses of 349 adults with ADHD followed DSM-IV criteria. ADHD and oppositional defiant disorder (ODD) were evaluated with the K-SADS-E, and other comorbidities with the SCID-IV and the MINI. Subjects were divided in early and late-onset groups (age of onset of impairment between 7 and 12 years old). The effect of age of onset over clinical and demographic characteristics was tested by regression models. Late-onset subjects were diagnosed later (P=0.04), had a lower frequency of problems with authority and discipline (P=0.004), and lower scores in SNAP-IV (P<0.001) and in Barkley's scale for problems in areas of life activities (P=0.03). On the other hand, late-onset patients presented a higher prevalence of comorbid general anxiety disorder (GAD) (P=0.01). Both groups had a similar profile in the remaining comorbidities and sociodemographic characteristics. This study provides initial evidence that adults with late-onset ADHD have less severity, lower frequency of externalizing symptoms and increased comorbidity with GAD, but similar profile in other comorbidities. In addition, the data suggest that late-onset patients have a higher probability of delayed diagnosis despite the significant impairment of their condition.

  1. Chronotype-related differences in childhood and adolescent aggression and antisocial behavior--a review of the literature.

    PubMed

    Schlarb, Angelika A; Sopp, Roxanne; Ambiel, David; Grünwald, Julia

    2014-02-01

    Eveningness has been found to negatively affect adolescents' sleep and daytime functioning. Furthermore, eveningness is associated with greater impulsivity than morningness. Externalizing behavior could be chronotype-related, implying that the alteration of the circadian rhythm itself is connected to aspects of emotion and emotion regulation. The present study investigated chronotype-related differences in emotional and behavioral problems, especially aggression and antisocial behavior in children and adolescents. We conducted a comprehensive search via web of knowledge (MEDLINE, web of science), EBSCO, Ovid, PubMed, Google Scholar and PsycINDEX using the keywords: chronotype, chronobiology, morningness, eveningness, owls and larks as well as diurnal preference to fully capture every aspect of chronotype. For aggression we used the search terms: aggression, anger, hostility, violence, anti-social behavior, conduct disorder, oppositional defiant disorder, delinquency, social adjustment and externalizing behavior. N = 13 studies were included concerning chronotype, childhood, adolescence and antisocial behavior. Results showed that children and adolescents being E-types were more affected by daytime impairments. Additionally, behavioral and emotional problems as aggression or antisocial behavior were more pronounced in E- than in M-types. Our findings support an association of eveningness and the impact of aggression on children and adolescents. Longitudinal investigations should be conducted in order to insure causality of the effects in question. In addition, the elevated vulnerability toward aggression in evening types demonstrates the need for prevention and intervention programs that educate youths in proper sleep hygiene and evoke an awareness of the consequences of a habitually diminished sleep quality.

  2. The ESSENCE in child psychiatry: Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations.

    PubMed

    Gillberg, Christopher

    2010-01-01

    Co-existence of disorders--including attention-deficit/hyperactivity disorder, oppositional defiant disorder, tic disorder, developmental coordination disorder, and autism spectrum disorder--and sharing of symptoms across disorders (sometimes referred to as comorbidity) is the rule rather than the exception in child psychiatry and developmental medicine. The acronym ESSENCE refers to Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations. It is a term I have coined to refer to the reality of children (and their parents) presenting in clinical settings with impairing child symptoms before age 3 (-5) years in the fields of (a) general development, (b) communication and language, (c) social inter-relatedness, (d) motor coordination, (e) attention, (f) activity, (g) behaviour, (h) mood, and/or (i) sleep. Children with major difficulties in one or more (usually several) of these fields, will be referred to and seen by health visitors, nurses, social workers, education specialists, pediatricians, GPs, speech and language therapists, child neurologists, child psychiatrists, psychologists, neurophysiologists, dentists, clinical geneticists, occupational therapists and physiotherapists, but, usually they will be seen only by one of these specialists, when they would have needed the input of two or more of the experts referred to. Major problems in at least one ESSENCE domain before age 5 years often signals major problems in the same or overlapping domains years later. There is no time to wait; something needs to be done, and that something is unlikely to be just in the area of speech and language, just in the area of autism or just in special education. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Developing a Multiple Caregiver Group for Caregivers of Adolescents With Disruptive Behaviors.

    PubMed

    Oruche, Ukamaka M; Robb, Sheri L; Aalsma, Matt; Pescosolido, Bernice; Brown-Podgorski, Brittany; Draucker, Claire Burke

    2017-12-01

    This article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Preschoolers’ Observed Temperament and Psychiatric Disorders Assessed with a Parent Diagnostic Interview

    PubMed Central

    Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Dyson, Margaret; Olino, Thomas M.; Durbin, C. Emily; Klein, Daniel N.

    2011-01-01

    Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured diagnostic interview on preschool psychopathology. In bivariate analyses, temperamental dysphoria and low exuberance were associated with depression; fear, low exuberance, and low sociability were associated with anxiety disorders; and disinhibition and dysphoria were associated with oppositional defiant disorder. Although there were no bivariate associations between temperament and attention-deficit/hyperactivity disorder, disinhibition emerged as a unique predictor in multivariate analyses. Findings indicate that the pattern of relations between temperament and psychopathology in older youth and adults is evident as early as age 3. PMID:21391025

  5. Latent Profiles of Externalizing Psychopathology and Their Relation to Children's Aggression and Social Behavior.

    PubMed

    Andrade, Brendan F; Wade, Mark

    2016-01-01

    This study identified profiles of clinic-referred children with disruptive behavior and determined the association between identified profiles and children's aggression, peer problems, and prosocial skills. Parents and teachers of 208 children (163 boys) aged 6 to 12 years (Mage = 8.80, SD = 1.75) completed measures to assess children's callous-unemotional (CU) traits, inattentive-impulsive-overactive (IO) and oppositional-defiant (OD) behavior, aggression, and social behaviors. Latent class analysis was used to identify the profiles, and the pseudoclass draw method to test the equality of means for each of the aggression and social behavioral outcomes across the latent classes. Five profiles were identified: (1) Low (35.6% of children), with relatively low levels of CU traits and IO and OD behavior; (2) Low-Moderate (30.8%), with low-moderate levels of CU traits, low IO and moderate OD behavior; (3) Moderate (21.6%), with moderate levels of CU traits and IO and moderate-high OD behavior; (4) Moderate-High (7.2%), with moderate-high levels of CU traits, high IO and moderate-high OD behavior; and (5) High (4.8%), with high levels of CU traits, IO and OD behavior. Children categorized into profiles showed important differences in level of aggression and social behavior. The overlap between CU traits, IO, and OD behavior add to understanding of child psychopathology that influences behavior and clinical outcomes.

  6. Evaluation of a Booster Intervention Three Years after Acute Treatment for Early-Onset Disruptive Behavior Disorders

    PubMed Central

    Lindhiem, Oliver; Hart, Jonathan; Bukstein, Oscar G.

    2013-01-01

    This study examines the impact of a brief booster treatment administered three years after the delivery of an acute treatment in a group (N = 118) of clinically referred boys and girls (ages 6 to 11) originally diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD). At the conclusion of the acute treatment and three-year follow-up period (i.e., study month 42), the sample was re-randomized into Booster treatment or Enhanced Usual Care and then assessed at four later timepoints (i.e., post-booster, and 6-, 12- and 24-month booster follow-up). Booster treatment was directed towards addressing individualized problems and some unique developmental issues of adolescence based on the same original protocol content and treatment setting, whereas the no-booster condition involved providing clinical recommendations based on the assessment and an outside referral for services. HLM analyses identified no significant group differences and few time effects across child, parent, and teacher reports on a broad range of child functioning and impairment outcomes. Analyses examining the role of putative moderators or mediators (e.g., severity of externalizing behavior, dose of treatment) were likewise non-significant. We discuss the nature and implications of these novel findings regarding the role and timing of booster treatment to address the continuity of DBD over time. PMID:23494526

  7. Irritability and Anxiety Severity Among Youth With Anxiety

    PubMed Central

    Cornacchio, Danielle; Crum, Kathleen I.; Coxe, Stefany; Pincus, Donna B.; Comer, Jonathan S.

    2015-01-01

    Objective Most research on irritability and child psychopathology has focused on depressive disorders, bipolar disorder, and/or oppositional defiant disorder (ODD). Less is known about relationships between child anxiety and irritability and moderators of such associations. Method Structural equation modeling (SEM) examined associations between anxiety severity and irritability in a large sample of treatment-seeking youth with anxiety disorders (N=663, ages 7–19 years, M=12.25), after accounting for comorbid depressive disorders and ODD. Additional analyses examined whether associations were moderated by child gender, age, and generalized anxiety disorder (GAD) status. Results There was a direct link between child anxiety and irritability even after accounting for comorbid depressive disorders and ODD. Links between child anxiety and irritability were robust across child gender and age. Further, relationships between child anxiety and irritability were comparable across youth with and without GAD, suggesting that the anxiety–irritability link is relevant across child anxiety disorders and not circumscribed to youth with GAD. Conclusion Findings add to an increasing body of evidence linking child irritability to a range of internalizing and externalizing psychopathologies, and suggest that child anxiety assessment should systematically incorporate irritability evaluations. Further, youth in clinical settings displaying irritability should be assessed for the presence of anxiety. Moreover, treatments for childhood anxiety may do well to incorporate new treatment modules as needed that specifically target problems of irritability. PMID:26703910

  8. Distilling Common History and Practice Elements to Inform Dissemination: Hanf-Model BPT Programs as an Example

    PubMed Central

    Kaehler, Laura A.; Jacobs, Mary; Jones, Deborah J.

    2016-01-01

    There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically-supported interventions in general and the core components of specific approaches in particular. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early-onset disruptive behavior disorders (Oppositional Defiant Disorder and Conduct Disorder), which frequently co-occur with Attention Deficit Hyperactivity Disorder, is well-established; yet, an ahistorical, program-specific lens tells little regarding how leaders, including Constance Hanf at the University of Oregon, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; Cunningham, Bremner, & Boyle, 1995; Cunningham, Bremner, Secord, & Harrison, 2009), Defiant Children (DC; Barkley 1987; Barkley, 2013), Helping the Noncompliant Child (HNC; Forehand & McMahon, 1981; McMahon & Forehand, 2003), Parent-Child Interaction Therapy (PCIT; Eyberg, & Robinson, 1982; Eyberg, 1988; Eyberg & Funderburk, 2011), and the Incredible Years (IY; Webster-Stratton, 1981; 1982; 2008). Our goal is not to provide an exhaustive review of the evidence-base for the Hanf-Model programs; rather, our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed. PMID:27389606

  9. Lack of Effect of Stimulant Combination with Second-Generation Antipsychotics on Weight Gain, Metabolic Changes, Prolactin Levels, and Sedation in Youth with Clinically Relevant Aggression or Oppositionality

    PubMed Central

    Penzner, Julie B.; Dudas, Melissa; Saito, Ema; Olshanskiy, Vladimir; Parikh, Umesh H.; Kapoor, Sandeep; Chekuri, Raja; Gadaleta, Dominick; Avedon, Jennifer; Sheridan, Eva M.; Randell, Jane; Malhotra, Anil K.; Kane, John M.

    2009-01-01

    Abstract Background Second-generation antipsychotics (SGAs) are associated with weight gain, metabolic abnormalities, sedation/sleep disturbance, and prolactin abnormalities, especially in youths. Although stimulants have opposing dopamine receptor and adverse effects, it is unclear whether stimulant co-treatment counteracts the therapeutic or side effects of antipsychotics. Methods This was a naturalistic cohort study including 153 antipsychotic trials in youths aged 4–19 (mean, 11.3 ± 3.0) years, started on an SGA for clinically significant aggression or oppositionality associated with oppositional defiant disorder, conduct disorder, disruptive behavior disorder not otherwise specified (NOS), impulse control disorder NOS, intermittent explosive disorder, Tourette's disorder, autistic disorder, and pervasive developmental disorder NOS. Patients underwent fasting assessments of body composition, lipids, glucose, insulin, prolactin, sedation, and general efficacy at baseline, weeks 4, 8, and 12, comparing patients co-prescribed stimulants (n = 71) with those not co-prescribed stimulants (n = 82). Results Patients received risperidone (33.3%), aripiprazole (29.4%), quetiapine (18.4%), olanzapine (11.8%), ziprasidone (5.9%), or clozapine (0.7%). With and without adjustment for differences in baseline variables (sex, prior stimulant use, primary Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV] disorders, co-morbid attention-deficit/hyperactivity disorder [ADHD], present in 46.3% of youths not receiving stimulants, and some body composition parameters), patients on versus off stimulants did not differ on any of the assessed outcomes (all p values ≥ 0.1). Conclusions In contrast to guidelines, stimulant use did not precede or accompany antipsychotic use during the current episode of aggression/oppositionality in almost half of those youths who had aggressive/oppositional behavior and a DSM-IV diagnosis of ADHD. At the clinically prescribed doses, stimulant co-treatment of SGAs did not seem to significantly reduce antipsychotic effects on body composition, metabolic parameters, prolactin, sedation, and broad efficacy. PMID:19877981

  10. Fifty Strategies for Counseling Defiant, Aggressive Adolescents: Reaching, Accepting, and Relating.

    ERIC Educational Resources Information Center

    Hanna, Fred J.; Hanna, Constance A.; Keys, Susan G.

    1999-01-01

    Takes a transtheoretical approach using ideas from cognitive behavioral, existential, Gestalt, psychodynamic, and multicultural therapies to describe both new and established strategies for relationships building with defiant youth. Arranges strategies in three categories: reaching, accepting, and relating. Suggestions for counselors when working…

  11. Affective decision-making and externalizing behaviors: the role of autonomic activity.

    PubMed

    Bubier, Jennifer L; Drabick, Deborah A G

    2008-08-01

    We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms, and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls.

  12. Call for research: detecting early vulnerability for psychiatric hospitalization.

    PubMed

    Prince, Jonathan D

    2013-01-01

    This study delineated the extent to which a broad set of risk factors in youth, a period well suited to primary prevention strategies, influences the likelihood and timing of first lifetime psychiatric hospitalizations. Logistic regression was used to delineate early risk factors for psychiatric hospitalization among Americans in a nationally representative survey (NCS-R, Part II, 2001-2003: N = 5,692). Results suggest that inpatient stay is more common and happens at earlier ages among Americans who report growing up with versus without: (1) depressed parents or caregivers, (2) family members who victimized them, or (3) one of three child mental illnesses (conduct, oppositional defiant, or separation anxiety disorder). In order to prevent inpatient stay, findings call for longitudinal research on early vulnerability for psychiatric hospitalization among families with: (1) depressed parents of children or adolescents, (2) violence against children, and (3) children that have externalizing or separation anxiety disorders.

  13. Play therapy: a case-based example of a nondirective approach.

    PubMed

    Lawver, Timothy; Blankenship, Kelly

    2008-10-01

    Play therapy is a treatment modality in which the therapist engages in play with the child. Its use has been documented in a variety of settings and with a variety of diagnoses. Treating within the context of play brings the therapist and the therapy to the level of the child. By way of an introduction to this approach, a case is presented of a six-year-old boy with oppositional defiant disorder. The presentation focuses on the events and interactions of a typical session with an established patient. The primary issues of the session are aggression, self worth, and self efficacy. These themes manifest themselves through the content of the child's play and narration of his actions. The therapist then reflects these back to the child while gently encouraging the child toward more positive play. Though the example is one of nondirective play therapy, a wide range of variation exists under the heading of play therapy.

  14. Play Therapy

    PubMed Central

    Lawver, Timothy; Blankenship, Kelly

    2008-01-01

    Play therapy is a treatment modality in which the therapist engages in play with the child. Its use has been documented in a variety of settings and with a variety of diagnoses. Treating within the context of play brings the therapist and the therapy to the level of the child. By way of an introduction to this approach, a case is presented of a six-year-old boy with oppositional defiant disorder. The presentation focuses on the events and interactions of a typical session with an established patient. The primary issues of the session are aggression, self worth, and self efficacy. These themes manifest themselves through the content of the child’s play and narration of his actions. The therapist then reflects these back to the child while gently encouraging the child toward more positive play. Though the example is one of nondirective play therapy, a wide range of variation exists under the heading of play therapy. PMID:19724720

  15. Attention deficit hyperactivity disorder and the behavior of "Che" Guevara.

    PubMed

    Teive, Hélio A G; Zavala, Jorge A; Munhoz, Renato P; Lara, Diogo R; Lima, Pedro; Palmini, André

    2009-09-01

    Attention deficit hyperactivity disorder (ADHD) is a childhood onset neuropsychiatric disorder characterized by inattention, hyperactivity and impulsivity. ADHD is related to several co-morbidities, such as opposition defiant disorder, conduct disorder, mood and anxiety disturbances, as well as tics and Tourette's syndrome. The objective of this report is to shed an alternative light on the personality of Ernesto "Che" Guevara, discussing whether he might have had ADHD. Several published biographies of Che Guevara were reviewed. Established ADHD criteria (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), were used as a framework to evaluate Che's behaviour. In addition, we compared the main features of Che's reported behaviour to the set of abnormalities leading to the diagnosis of ADHD in adults proposed by Wender and colleagues and known as the UTAH ADHD criteria. Analysis of the most renowned biographies of Ernesto "Che" Guevara suggests that he may have had ADHD.

  16. [Aggressive and prosocial behavior in childhood psychopathology].

    PubMed

    Vida, Péter; Halász, József; Gádoros, Júlia

    2013-01-01

    Aggressive/attacking and helpful/emphatic/prosocial behaviors are extremely important in human relationships. Both high levels of aggression and deficits of prosociality play important role in the development and conservation of mental disorders. We review the measurement options and clinical importance of aggressive and prosocial behavior. The typical developmental pathways and the genetic and environmental background of these behaviors are presented. The clinical tools used in the measurement of aggression and prosociality are summarized in the present paper, with specific attention on questionnaires applied in Hungarian practice. The connections between diagnostic categories (conduct disorder, oppositional-defiant disorder, attention deficit and hyperactive disorder, autism spectrum disorders) and the two behaviors are evaluated. In the end, we present those additional research projects that explore the cognitive-emotional background of aggressive or prosocial behavior with clinical relevance either in the diagnosis or in the treatment of child psychiatric diseases.

  17. Distinctive findings in a boy with Simpson-Golabi-Behmel syndrome.

    PubMed

    Halayem, Soumeyya; Hamza, Mariem; Maazoul, Faouzi; Ben Turkia, Hadhemi; Touati, Maissa; Tebib, Neji; Mrad, Ridha; Bouden, Asma

    2016-04-01

    Simpson-Golabi-Behmel syndrome (SGBS) is an X-linked condition characterized by pre and post natal overgrowth, facial malformations, and visceral, skeletal, and neurological anomalies. The physical characteristics of SGBS have been well documented; however there is a lack of description regarding the behavioral phenotype. We report the case of a 6-year-old boy, with confirmed deletion of 6-8 exons of the glypican-3 gene (GPC3) who presents three distinctive findings: the persistence of the craniopharyngeal canal, an immune-allergic specificity, and a scarcely behavioral phenotype consisting in the association of Austim Spectrum Disorder with accompanying mild intellectual disability and language impairments. He also fulfilled the criteria of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder according to DSM 5 criteria. The specificities of the case are discussed in the light of recent pathophysiological data. © 2015 Wiley Periodicals, Inc.

  18. The discriminative capacity of CBCL/1½-5-DSM5 scales to identify disruptive and internalizing disorders in preschool children.

    PubMed

    de la Osa, Nuria; Granero, Roser; Trepat, Esther; Domenech, Josep Maria; Ezpeleta, Lourdes

    2016-01-01

    This paper studies the discriminative capacity of CBCL/1½-5 (Manual for the ASEBA Preschool-Age Forms & Profiles, University of Vermont, Research Center for Children, Youth, & Families, Burlington, 2000) DSM5 scales attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety and depressive problems for detecting the presence of DSM5 (DSM5 diagnostic and statistical manual of mental disorders, APA, Arlington, 2013) disorders, ADHD, ODD, Anxiety and Mood disorders, assessed through diagnostic interview, in children aged 3-5. Additionally, we compare the clinical utility of the CBCL/1½-5-DSM5 scales with respect to analogous CBCL/1½-5 syndrome scales. A large community sample of 616 preschool children was longitudinally assessed for the stated age group. Statistical analysis was based on ROC procedures and binary logistic regressions. ADHD and ODD CBCL/1½-5-DSM5 scales achieved good discriminative ability to identify ADHD and ODD interview's diagnoses, at any age. CBCL/1½-5-DSM5 Anxiety scale discriminative capacity was fair for unspecific anxiety disorders in all age groups. CBCL/1½-5-DSM5 depressive problems' scale showed the poorest discriminative capacity for mood disorders (including depressive episode with insufficient symptoms), oscillating into the poor-to-fair range. As a whole, DSM5-oriented scales generally did not provide evidence better for discriminative capacity than syndrome scales in identifying DSM5 diagnoses. CBCL/1½-5-DSM5 scales discriminate externalizing disorders better than internalizing disorders for ages 3-5. Scores on the ADHD and ODD CBCL/1½-5-DSM5 scales can be used to screen for DSM5 ADHD and ODD disorders in general populations of preschool children.

  19. Interpersonal Callousness and Co-Occurring Anxiety: Developmental Validity of an Adolescent Taxonomy

    PubMed Central

    2016-01-01

    Growing evidence suggests heterogeneity within interpersonal-callous (IC) youth based on co-occurring anxiety. The developmental validity of this proposed taxonomy remains unclear however, as most previous research is cross-sectional and/or limited to adolescence. We aimed to identify low-anxiety (IC/ANX−) and high-anxiety (IC/ANX+) IC variants, and compare these groups on (a) early risk exposures, (b) psychiatric symptoms from midchildhood to early adolescence, and (c) school-based functioning. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective epidemiological birth cohort, model-based cluster analysis was performed on children with complete age-13 IC and anxiety scores (n = 6,791). Analysis of variance was used to compare resulting clusters on (a) prenatal and postnatal family adversity and maternal psychopathology, and harsh parenting; (b) developmental differences in attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), emotional difficulties, and low pro-social behavior at 7, 10, and 13 years; and (c) teacher-reported discipline problems, along with standardized test performance. We identified a 4-cluster solution: “typical,” “low,” “IC/ANX−”, and “IC/ANX+.” IC/ANX+ youth showed the highest prenatal and postnatal levels of family adversity and maternal psychopathology, highest levels of ADHD, CD, ODD, and emotional difficulties, greatest discipline problems, and lowest national test scores (all p < .001). IC/ANX+ also showed a distinct pattern of increasing psychopathology from age 7 to 13 years. Adolescent IC subtypes were successfully validated in ALSPAC across multiple raters using prenatal and early postnatal risk, repeated measures of psychopathology, and school-based outcomes. Greater prenatal environmental risk among IC/ANX+ youth suggests an important target for early intervention. PMID:27977232

  20. Understanding the associations between psychosocial factors and severity of crime in juvenile delinquency: a cross-sectional study.

    PubMed

    Taşkıran, Sarper; Mutluer, Tuba; Tufan, Ali Evren; Semerci, Bengi

    2017-01-01

    Juvenile delinquency is a serious and common problem. To date, several studies have focused on possible psychosocial risk factors for delinquency among youths and on the implications of childhood mental illness on child criminality. However, the literature on prevalence of psychopathology and predictors of crime severity among delinquent youths in Turkey is sparse. Therefore, the aim of this study was to show the associations between crime severity and psychosocial factors such as gender, age, criminal history, concomitant attention deficit hyperactivity disorder (ADHD) and other comorbid psychiatric conditions, along with behavioral problem domains of Child Behavior Checklist (CBCL). This analytical cross-sectional study sample consisted of 52 individuals (30 females and 22 males) who were sent to a pilot detention facility in Istanbul, Turkey. The participants' age ranged from 8 to 18 years ( M =13.4; SD =2.9). Self-rating scales were administered in an interview format, and the crime severity information was provided by participants' admission documents. No differences were found in terms of gender, age, children's past history of crime and substance abuse. However, family crime history was significantly higher in the high severity crime group ( P =0.026). Having one or more comorbid psychiatric disorder was associated with high crime severity ( P =0.018). The most common psychiatric disorders were found to be ADHD, oppositional defiant disorder, conduct disorder (CD) and anxiety disorder. Findings suggest that a family history of crime comes across as a very strong predictor of severity of crime. Among psychiatric factors, ADHD and CD were associated with commitment of more severe crimes in delinquent youths in our sample. Anxious/depressed traits as depicted by CBCL are found to be associated with less severe crimes.

  1. Understanding the associations between psychosocial factors and severity of crime in juvenile delinquency: a cross-sectional study

    PubMed Central

    Taşkıran, Sarper; Mutluer, Tuba; Tufan, Ali Evren; Semerci, Bengi

    2017-01-01

    Purpose Juvenile delinquency is a serious and common problem. To date, several studies have focused on possible psychosocial risk factors for delinquency among youths and on the implications of childhood mental illness on child criminality. However, the literature on prevalence of psychopathology and predictors of crime severity among delinquent youths in Turkey is sparse. Therefore, the aim of this study was to show the associations between crime severity and psychosocial factors such as gender, age, criminal history, concomitant attention deficit hyperactivity disorder (ADHD) and other comorbid psychiatric conditions, along with behavioral problem domains of Child Behavior Checklist (CBCL). Participants and methods This analytical cross-sectional study sample consisted of 52 individuals (30 females and 22 males) who were sent to a pilot detention facility in Istanbul, Turkey. The participants’ age ranged from 8 to 18 years (M =13.4; SD =2.9). Self-rating scales were administered in an interview format, and the crime severity information was provided by participants’ admission documents. Results No differences were found in terms of gender, age, children’s past history of crime and substance abuse. However, family crime history was significantly higher in the high severity crime group (P=0.026). Having one or more comorbid psychiatric disorder was associated with high crime severity (P=0.018). The most common psychiatric disorders were found to be ADHD, oppositional defiant disorder, conduct disorder (CD) and anxiety disorder. Conclusion Findings suggest that a family history of crime comes across as a very strong predictor of severity of crime. Among psychiatric factors, ADHD and CD were associated with commitment of more severe crimes in delinquent youths in our sample. Anxious/depressed traits as depicted by CBCL are found to be associated with less severe crimes. PMID:28572731

  2. Preservice Teachers' Knowledge of Effective Classroom Management Strategies: Defiant Behavior.

    ERIC Educational Resources Information Center

    Kher, Neelam; Lacina-Gifford, Lorna J.; Yandell, Sonya

    This study identified preservice teachers' knowledge about effective and ineffective classroom management strategies for defiant behavior. Data in the form of extended written responses were obtained from student teachers in a rural, southern teacher education program at the end of their student teaching experience in the spring semester.…

  3. Enjoyment and Consumption of Defiant Rock Music as a Function of Adolescent Rebelliousness.

    ERIC Educational Resources Information Center

    Bleich, Susan; And Others

    1991-01-01

    Discussion of adolescent rebelliousness highlights a study of high school students that explored the relationship between rebelliousness as a personality trait and the enjoyment of defiant rock music. Hypotheses tested are discussed, the use of MTV concept music videos is explained, gender differences are considered, and further research is…

  4. Defiant Teens: A Clinician's Manual for Assessment and Family Intervention.

    ERIC Educational Resources Information Center

    Barkley, Russell A.; Edwards, Gwenyth H.; Robin, Arthur L.

    This manual presents an 18-step program designed both to teach parents the skills they need to manage difficult adolescent behavior and to improve family relationships overall. Steps 1 through 9 modify the approach presented in Russell Barkley's earlier edition, "Defiant Children," to focus on developmental concerns of adolescence. Clear…

  5. Evidence for the Trait-Impulsivity Etiological Model in a Clinical Sample: Bifactor Structure and Its Relation to Impairment and Environmental Risk.

    PubMed

    Rodenacker, Klaas; Hautmann, Christopher; Görtz-Dorten, Anja; Döpfner, Manfred

    2018-05-01

    The trait-impulsivity etiological model assumes that a general factor (trait-impulsivity) underlies attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and other externalizing disorders. We investigated the plausibility of this assumption by testing the factor structure of ADHD and ODD in a bifactor framework for a clinical sample of 1420 children between 6 and 18 years of age (M = 9.99, SD = 3.34; 85% male). Further, the trait-impulsivity etiological model assumes that ODD emerges only if environmental risk factors are present. Our results support the validity of the trait-impulsivity etiological model, as they confirm that ADHD and ODD share a strong general factor of disruptive behavior (DB) in this clinical sample. Furthermore, unlike the subdimensions of ADHD, we found that the specific ODD factor explained as much true score variance as the general DB factor. This suggests that a common scale of ADHD and ODD may prove to be as important as a separate ODD subscale to assess externalizing problems in school-age children. However, all other subscales of ADHD may not explain sufficient true score variance once the impact of the general DB factor has been taken into consideration. In accordance with the trait-impulsivity model, we also showed that all factors, but predominantly the general factor and specific inattention factor, predicted parent-rated impairment, and that predominantly ODD and impulsivity are predicted by environmental risk factors.

  6. Recalled Initiation and Duration of Maternal Breastfeeding Among Children with and Without ADHD in a Well Characterized Case-Control Sample.

    PubMed

    Stadler, Diane D; Musser, Erica D; Holton, Kathleen F; Shannon, Jackilen; Nigg, Joel T

    2016-02-01

    Early environmental influences are increasingly of interest in understanding ADHD as a neurodevelopmental condition, particularly in light of recognition that gene by environment interplay are likely involved in this condition. Breastfeeding duration predicts cognitive development, as well as development of brain white matter connectivity, in areas similar to those seen in ADHD. Prior studies show an association between breastfeeding and ADHD but without adequate evaluation of ADHD. A case control cohort of 474 children aged 7-13 years was examined, 291 with well characterized ADHD (71.5 % male) and the rest typically developing controls (51.9 % male). Mothers retrospectively reported on breast feeding initiation and duration. Initiation of breastfeeding was not associated with child ADHD, but shorter duration of breastfeeding was associated with child ADHD with a medium effect size (d = 0.40, p < 0.05); this effect held after covarying a broad set of potential confounders, including child oppositional defiant and conduct problems and including maternal and paternal ADHD symptoms. Effects were replicated across both parent and teacher ratings of child ADHD symptoms. Shorter duration of breastfeeding is among several risk factors in early life associated with future ADHD, or else longer duration is protective. The direction of this effect is unknown, however. It may be that some children are more difficult to breastfeed or that breastfeeding provides nutrients or other benefits that reduce future chance of ADHD.

  7. Frequency of ICD-10 psychiatric diagnosis in children with intellectual disability in Lahore, Pakistan & Caregivers Perspective.

    PubMed

    Imran, Nazish; Azeem, Muhammad Waqar; Sattar, Ahsan; Bhatti, Mohammad Riaz

    2015-01-01

    Association between Intellectual disability (ID) and psychiatric disorders in children & adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup. Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised & ICD-10 diagnostic criteria was used to assess children (age range 6 - 16 years) with suspected ID along with identification of behaviors found to be difficult to manage by caregivers. 150 children were assessed with mean age of 10.7 years (males 70 %). Majority (72%) had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder (14%) and Hyperkinetic Disorders (10%). Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors (e.g. disinhibition), sleep & feeding difficulties were the significant areas identified by the caregivers as a cause of major concern. Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family.

  8. Frequency of ICD-10 psychiatric diagnosis in children with intellectual disability in Lahore, Pakistan & Caregivers Perspective

    PubMed Central

    Imran, Nazish; Azeem, Muhammad Waqar; Sattar, Ahsan; Bhatti, Mohammad Riaz

    2015-01-01

    Objective: Association between Intellectual disability (ID) and psychiatric disorders in children & adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup. Methods: Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised & ICD-10 diagnostic criteria was used to assess children (age range 6 – 16 years) with suspected ID along with identification of behaviors found to be difficult to manage by caregivers. Results: 150 children were assessed with mean age of 10.7 years (males 70 %). Majority (72%) had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder (14%) and Hyperkinetic Disorders (10%). Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors (e.g. disinhibition), sleep & feeding difficulties were the significant areas identified by the caregivers as a cause of major concern. Conclusions: Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family. PMID:26101476

  9. Co-Occurrence of ODD and CD in Preschool Children With Symptoms of ADHD.

    PubMed

    Bendiksen, Bothild; Svensson, Elisabeth; Aase, Heidi; Reichborn-Kjennerud, Ted; Friis, Svein; Myhre, Anne M; Zeiner, Pål

    2017-07-01

    Patterns of co-occurrence between ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) were examined in a sample of non-referred preschool children. ADHD subtypes and sex differences were also explored. Children aged 3.5 years ( n = 1,048) with high scores on ADHD characteristics were recruited from the Norwegian Mother and Child Cohort Study and clinically assessed, including a semi-structured psychiatric interview. In children with ADHD, concurrent ODD was present more often than CD (31% vs. 10%), but having ADHD gave higher increase in the odds of CD than of ODD (ODD: odds ratio [OR] = 6.7, 95% confidence interval [CI] = [4.2, 10.8]; CD: OR = 17.6, 95% CI = [5.9, 52.9]). We found a greater proportion of children having the combined ADHD subtype as well as more severe inattentiveness among children with co-occurring CD compared with ODD. Sex differences were minor. There are important differences in co-occurring patterns of ODD and CD in preschool children with ADHD.

  10. Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders.

    PubMed

    Pelham, W E; Gnagy, E M; Greenslade, K E; Milich, R

    1992-03-01

    Ratings were collected on a rating scale comprised of the DSM-III-R diagnostic criteria for disruptive behavior disorders. Teacher ratings were obtained for 931 boys in regular classrooms in grades K through 8 from around North America. Means and standard deviations for attention-deficit hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), and conduct disorder (CD) scales are reported by age. Frequencies of DSM-III-R symptoms are reported by age, and suggested diagnostic cutoffs are discussed. A factor analysis revealed three factors: one reflecting ODD and several CD symptoms, one on which ADHD symptoms of inattention loaded, and one comprised of ADHD impulsivity/overactivity symptoms. Conditional probability analyses revealed that several hallmark symptoms of ADHD had very poor predictive power, whereas combinations of symptoms from the two ADHD factors had good predictive power. Combinations of ODD symptoms also had very high predictive power. The limited utility of teacher ratings in assessing symptoms of conduct disorder in this age range is discussed.

  11. Suicide ideation and attempts in children with psychiatric disorders and typical development.

    PubMed

    Dickerson Mayes, Susan; Calhoun, Susan L; Baweja, Raman; Mahr, Fauzia

    2015-01-01

    Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6-18 years of age. For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0-4% of patients in the other psychiatric groups. It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.

  12. A Pilot Study: Attention Deficit Hyperactivity Disorder, Sensation Seeking, and Pubertal Changes

    PubMed Central

    Martin, Catherine A.; Guenthner, Greg; Bingcang, Christopher; Smith, W. Jackson; Curry, Thomas; Omar, Hatim A.; Raynes, Mary Kay; Kelly, Thomas H.

    2006-01-01

    This study was designed to examine the relationship of pubertal changes and sensation seeking (SS) in adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Patients with current or past histories of uncomplicated stimulant medication use for ADHD between the ages of 11 and 15 (13 ± 1.5) were recruited from a Child Psychiatry and a General Pediatric Clinic. SS was measured using the SS Scale for Children. Pubertal development was measured using Tanner staging, free testosterone, and DHEAS. Subjects and their parent were interviewed with the Diagnostic Interview Schedule for Children (DISC). SS total score was correlated with Tanner stage, free testosterone, and DHEAS (p ≤ 0.01). The combined parent and child reports of symptoms of Oppositional Defiant Disorder from the DISC were inversely related to age (p ≤ 0.05). Understanding SS in ADHD adolescents as they move through puberty will aid clinicians in monitoring ADHD adolescents and their trajectory into high-risk behaviors. PMID:16832566

  13. Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings.

    PubMed

    Dichter, Gabriel S; Damiano, Cara A; Allen, John A

    2012-07-06

    This review summarizes evidence of dysregulated reward circuitry function in a range of neurodevelopmental and psychiatric disorders and genetic syndromes. First, the contribution of identifying a core mechanistic process across disparate disorders to disease classification is discussed, followed by a review of the neurobiology of reward circuitry. We next consider preclinical animal models and clinical evidence of reward-pathway dysfunction in a range of disorders, including psychiatric disorders (i.e., substance-use disorders, affective disorders, eating disorders, and obsessive compulsive disorders), neurodevelopmental disorders (i.e., schizophrenia, attention-deficit/hyperactivity disorder, autism spectrum disorders, Tourette's syndrome, conduct disorder/oppositional defiant disorder), and genetic syndromes (i.e., Fragile X syndrome, Prader-Willi syndrome, Williams syndrome, Angelman syndrome, and Rett syndrome). We also provide brief overviews of effective psychopharmacologic agents that have an effect on the dopamine system in these disorders. This review concludes with methodological considerations for future research designed to more clearly probe reward-circuitry dysfunction, with the ultimate goal of improved intervention strategies.

  14. Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings

    PubMed Central

    2012-01-01

    This review summarizes evidence of dysregulated reward circuitry function in a range of neurodevelopmental and psychiatric disorders and genetic syndromes. First, the contribution of identifying a core mechanistic process across disparate disorders to disease classification is discussed, followed by a review of the neurobiology of reward circuitry. We next consider preclinical animal models and clinical evidence of reward-pathway dysfunction in a range of disorders, including psychiatric disorders (i.e., substance-use disorders, affective disorders, eating disorders, and obsessive compulsive disorders), neurodevelopmental disorders (i.e., schizophrenia, attention-deficit/hyperactivity disorder, autism spectrum disorders, Tourette’s syndrome, conduct disorder/oppositional defiant disorder), and genetic syndromes (i.e., Fragile X syndrome, Prader–Willi syndrome, Williams syndrome, Angelman syndrome, and Rett syndrome). We also provide brief overviews of effective psychopharmacologic agents that have an effect on the dopamine system in these disorders. This review concludes with methodological considerations for future research designed to more clearly probe reward-circuitry dysfunction, with the ultimate goal of improved intervention strategies. PMID:22958744

  15. A Zero- and K-Inflated Mixture Model for Health Questionnaire Data

    PubMed Central

    Finkelman, Matthew D.; Green, Jennifer Greif; Gruber, Michael J.; Zaslavsky, Alan M.

    2011-01-01

    In psychiatric assessment, Item Response Theory (IRT) is a popular tool to formalize the relation between the severity of a disorder and associated responses to questionnaire items. Practitioners of IRT sometimes make the assumption of normally distributed severities within a population; while convenient, this assumption is often violated when measuring psychiatric disorders. Specifically, there may be a sizable group of respondents whose answers place them at an extreme of the latent trait spectrum. In this article, a zero- and K-inflated mixture model is developed to account for the presence of such respondents. The model is fitted using an expectation-maximization (E-M) algorithm to estimate the percentage of the population at each end of the continuum, concurrently analyzing the remaining “graded component” via IRT. A method to perform factor analysis for only the graded component is introduced. In assessments of oppositional defiant disorder and conduct disorder, the zero- and K-inflated model exhibited better fit than the standard IRT model. PMID:21365673

  16. Household task demands for quiet and focused behavior facilitate performance by ADHD youth.

    PubMed

    Mendes, Camila Guimarães; Drummond, Adriana F; Miranda, Débora M; Costa, Danielle S; Mancini, Marisa C

    2016-07-01

    This study evaluated the associations among symptoms of attention-deficit/hyperactivity disorder (ADHD) and of oppositional defiant disorder (ODD) in children and adolescents' performance in household tasks and assistance provided by caregivers. Parents of children from 6 to 14 years old with ADHD (n = 67) were interviewed with the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES) instrument. Significant correlations were found between symptoms of ODD and assistance in self-care tasks (r = -0.31; p = 0.01); symptoms of hyperactivity correlated with assistance in self-care (r = -0.30, p = 0.01); and family-care (r = -0.25, p = 0.04) tasks. Age was directly associated with the number of tasks performed by children and inversely related to the assistance provided by caregivers. A greater number of ODD symptoms resulted in more household assistance from caregivers. Characteristics of ODD symptoms, such as disobedience and hostility in the face of authority, may limit these children in accessing household tasks by their own initiative, requiring assistance from caregivers.

  17. Psychopathology and Related Psychosocial Factors in Children with Office Discipline Referrals at School: Evidence from a Developing Country.

    PubMed

    Esin, İbrahim Selçuk; Dursun, Onur Burak; Acemoğlu, Hamit; Baykara, Burak

    2015-10-01

    Many childhood psychiatric disorders present their first symptoms as challenging behaviors at school. Evidence from cross-national studies enhance the understanding of the biological and cultural variables underlying these behaviours. In this study, we aim to identify the psychopathology among children with office disciplinary referrals and assess psychosocial risk factors related to this situation. Forty-seven students who had received an office discipline referral and eighty-three controls who had never been given an office disciplinary referral participated in this study. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime, socio-demographic data form were administered to children to assess their respective psychopathologies and psychosocial risk factors. Attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and obsessive compulsive disorder were significantly higher in children with Office discipline referrals. Psychiatric assessment should be one of the first steps in the evaluation processes of assessing challenging behaviors at school.

  18. Evidence-Based School Behavior Assessment of Externalizing Behavior in Young Children.

    PubMed

    Bagner, Daniel M; Boggs, Stephen R; Eyberg, Sheila M

    2010-02-01

    This study examined the psychometric properties of the Revised Edition of the School Observation Coding System (REDSOCS). Participants were 68 children ages 3 to 6 who completed parent-child interaction therapy for Oppositional Defiant Disorder as part of a larger efficacy trial. Interobserver reliability on REDSOCS categories was moderate to high, with percent agreement ranging from 47% to 90% (M = 67%) and Cohen's kappa coefficients ranging from .69 to .95 (M = .82). Convergent validity of the REDSOCS categories was supported by significant correlations with the Intensity Scale of the Sutter-Eyberg Student Behavior Inventory-Revised and related subscales of the Conners' Teacher Rating Scale-Revised: Long Version (CTRS-R: L). Divergent validity was indicated by nonsignificant correlations between REDSOCS categories and scales on the CTRS-R: L expected not to relate to disruptive classroom behavior. Treatment sensitivity was demonstrated for two of the three primary REDSOCS categories by significant pre to posttreatment changes. This study provides psychometric support for the designation of REDSOCS as an evidence-based assessment procedure for young children.

  19. Validity of Sluggish Cognitive Tempo in South America: An Initial Examination Using Mother and Teacher Ratings of Chilean Children.

    PubMed

    Belmar, Marta; Servera, Mateu; Becker, Stephen P; Burns, G Leonard

    2017-06-01

    To examine the validity of sluggish cognitive tempo (SCT) and ADHD-inattention (ADHD-IN) symptoms in children from Chile. Mothers and teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (ADHD-HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection (teachers only) in 652 Chilean children (55% boys) aged 6 to 14 years. For both mother and teacher ratings, the eight SCT symptoms and nine ADHD-IN symptoms showed substantial loadings on their respective factors (convergent validity) along with loadings close to zero on the alternative factor (discriminant validity). ADHD-IN showed a uniquely stronger relationship than SCT with ADHD-HI and ODD whereas SCT showed a uniquely stronger relationship than ADHD-IN with anxiety and depression. Although ADHD-IN uniquely predicted academic impairment and social difficulties, SCT did not. This study provides the first evidence for the validity of SCT among children outside of North America or Western Europe.

  20. The link between callous-unemotional traits and neural mechanisms of reward processing: An fMRI study.

    PubMed

    Veroude, Kim; von Rhein, Daniel; Chauvin, Roselyne J M; van Dongen, Eelco V; Mennes, Maarten J J; Franke, Barbara; Heslenfeld, Dirk J; Oosterlaan, Jaap; Hartman, Catharina A; Hoekstra, Pieter J; Glennon, Jeffrey C; Buitelaar, Jan K

    2016-09-30

    Callous-unemotional (CU) traits, i.e., unconcernedness and lack of prosocial feelings, may manifest in Conduct Disorder (CD), but also in Oppositional Defiant Disorder (ODD) and Attention Deficit Hyperactivity Disorder (ADHD). These disorders have been associated with aberrant reward processing, while the influence of CU traits is unclear. Using functional Magnetic Resonance Imaging (fMRI), we examined whether CU traits affect the neural circuit for reward. A Monetary Incentive Delay (MID) task was administered to 328 adolescents and young adults with varying levels of CU traits: 40 participants with ODD/CD plus ADHD, 101 participants with ADHD only, 84 siblings of probands with ADHD and 103 typically developing (TD) individuals. During reward anticipation, CU traits related negatively to medial prefrontal cortex (mPFC) activity, independent of ADHD symptoms and ODD/CD diagnosis. Our results indicate that CU traits are a valuable dimension for assessing the neural basis of reward processing. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Symptoms of attention deficit hyperactivity disorder in children are associated with cortisol responses to psychosocial stress but not with daily cortisol levels.

    PubMed

    Pesonen, Anu-Katriina; Kajantie, Eero; Jones, Alexander; Pyhälä, Riikka; Lahti, Jari; Heinonen, Kati; Eriksson, Johan G; Strandberg, Timo E; Räikkönen, Katri

    2011-11-01

    We tested associations of diurnal hypothalamic-pituitary adrenal axis (HPAA) activity and its response to stress with behavioral symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among 272 eight-year-old children. We measured their diurnal salivary cortisol and salivary cortisol responses to the Trier Social Stress Test for Children (TSST-C). Mothers rated their child's behavior with the ADHD-IV Rating Scale and the Child Behavior Checklist (CBCL). There were no significant associations between ADHD symptoms and diurnal cortisol concentrations. The boys with predominantly inattentive symptoms of ADHD (ADHD-I; scores at or above the 90th percentile) had 26% lower mean salivary cortisol levels during the TSST-C than the boys with scores below this cutoff. In the girls with symptoms of ADHD-I, initial salivary cortisol levels prior to the TSST-C were higher and fell more rapidly during and after the TSST-C, which was not seen in the remaining girls (P = 0.007 for interaction 'ADHD-I × sampling time'). Controlling for Oppositional Defiant Disorder/Conduct Disorder and Anxiety Disorder or excluding children with these comorbid problems did not substantially affect these findings. We conclude that the boys and the girls with behavioral symptoms of ADHD-I had reduced HPAA responsiveness to stress, which is also seen in people after traumatic events or with chronic stress. Their diurnal cortisol rhythm was not affected. Thus, ADHD-I may be associated with dysregulation of the HPAA or reduced engagement with stressful stimuli. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.

    PubMed

    Biederman, Joseph; Petty, Carter R; Day, Helen; Goldin, Rachel L; Spencer, Thomas; Faraone, Stephen V; Surman, Craig B H; Wozniak, Janet

    2012-04-01

    We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD). Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but <210 (1 SD) on the AAA scales of the CBCL (CBCL-DESR) and Severe Dysregulation as an aggregate cutoff score of ≥210 on the same scales (CBCL-Severe Dysregulation). All subjects were assessed with structured diagnostic interviews and a range of functional measures. Thirty-six percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (p < .001) and 19% had a positive CBCL-Severe Dysregulation profile versus 0% of controls (p < .001). The subjects positive for the CBCL-Severe Dysregulation profile differed selectively from those with the CBCL-DESR profile in having higher rates of unipolar and bipolar mood disorders, oppositional defiant and conduct disorders, psychiatric hospitalization at both baseline and follow-up assessments, and a higher rate of the CBCL-Severe Dysregulation in siblings. In contrast, the CBCL-DESR was associated with higher rates of comorbid disruptive behavior, anxiety disorders, and impaired interpersonal functioning compared with other ADHD children. Severity scores of the AAA CBCL profiles can help distinguish 2 groups of emotional regulation problems in children with ADHD.

  3. Moderators, mediators, and other predictors of risperidone response in children with autistic disorder and irritability.

    PubMed

    Arnold, L Eugene; Farmer, Cristan; Kraemer, Helena Chmura; Davies, Mark; Witwer, Andrea; Chuang, Shirley; DiSilvestro, Robert; McDougle, Christopher J; McCracken, James; Vitiello, Benedetto; Aman, Michael G; Scahill, Lawrence; Posey, David J; Swiezy, Naomi B

    2010-04-01

    The National Institute of Mental Health (NIMH) Research Units on Pediatric Psychopharmacology (RUPP) Autism Network found an effect size of d = 1.2 in favor of risperidone on the main outcome measure in an 8-week double-blind, placebo-controlled trial for irritability in autistic disorder. This paper explores moderators and mediators of this effect. Intention-to-treat (ITT) analyses were conducted with suspected moderators and mediators entered into the regression equations. MacArthur Foundation Network subgroup guidelines were followed in the evaluation of the results. Only baseline severity moderated treatment response: Higher severity showed greater improvement for risperidone but not for placebo. Weight gain mediated treatment response negatively: those who gained more weight improved less with risperidone and more with placebo. Compliance correlated with outcome for risperidone but not placebo. Higher dose correlated with worse outcome for placebo, but not risperidone. Of nonspecific predictors, parent education, family income, and low baseline prolactin positively predicted outcome; anxiety, bipolar symptoms, oppositional-defiant symptoms, stereotypy, and hyperactivity negatively predicted outcome. Risperidone moderated the effect of change in 5'-nucleotidase, a marker of zinc status, for which decrease was associated with improvement only with risperidone, not with placebo. The benefit-risk ratio of risperidone is better with greater symptom severity. Risperidone can be individually titrated to optimal dosage for excellent response in the majority of children. Weight gain is not necessary for risperidone benefit and may even detract from it. Socioeconomic advantage, low prolactin, and absence of co-morbid problems nonspecifically predict better outcome. Mineral interactions with risperidone deserve further study.

  4. Predictive validity of callous-unemotional traits measured in early adolescence with respect to multiple antisocial outcomes.

    PubMed

    McMahon, Robert J; Witkiewitz, Katie; Kotler, Julie S

    2010-11-01

    This study investigated the predictive validity of youth callous-unemotional (CU) traits, as measured in early adolescence (Grade 7) by the Antisocial Process Screening Device (APSD; Frick & Hare, 2001), in a longitudinal sample (N = 754). Antisocial outcomes, assessed in adolescence and early adulthood, included self-reported general delinquency from 7th grade through 2 years post-high school, self-reported serious crimes through 2 years post-high school, juvenile and adult arrest records through 1 year post-high school, and antisocial personality disorder symptoms and diagnosis at 2 years post-high school. CU traits measured in 7th grade were highly predictive of 5 of the 6 antisocial outcomes-general delinquency, juvenile and adult arrests, and early adult antisocial personality disorder criterion count and diagnosis-over and above prior and concurrent conduct problem behavior (i.e., criterion counts of oppositional defiant disorder and conduct disorder) and attention-deficit/hyperactivity disorder (criterion count). Incorporating a CU traits specifier for those with a diagnosis of conduct disorder improved the positive prediction of antisocial outcomes, with a very low false-positive rate. There was minimal evidence of moderation by sex, race, or urban/rural status. Urban/rural status moderated one finding, with being from an urban area associated with stronger relations between CU traits and adult arrests. Findings clearly support the inclusion of CU traits as a specifier for the diagnosis of conduct disorder, at least with respect to predictive validity. PsycINFO Database Record (c) 2010 APA, all rights reserved

  5. Familial clustering of epilepsy and behavioral disorders: Evidence for a shared genetic basis

    PubMed Central

    Hesdorffer, Dale C.; Caplan, Rochelle; Berg, Anne T.

    2011-01-01

    Purpose To examine whether family history of unprovoked seizures is associated with behavioral disorders in epilepsy probands, thereby supporting the hypothesis of shared underlying genetic susceptibility to these disorders. Methods We conducted an analysis of the 308 probands with childhood onset epilepsy from the Connecticut Study of Epilepsy with information on first degree family history of unprovoked seizures and of febrile seizures whose parents completed the Child Behavior Checklist (CBCL) at the 9-year follow-up. Clinical cut-offs for CBCL problem and DSM-Oriented scales were examined. The association between first degree family history of unprovoked seizure and behavioral disorders was assessed separately in uncomplicated and complicated epilepsy and separately for first degree family history of febrile seizures. A subanalysis, accounting for the tendency for behavioral disorders to run in families, adjusted for siblings with the same disorder as the proband. Prevalence ratios were used to describe the associations. Key findings In probands with uncomplicated epilepsy, first degree family history of unprovoked seizure was significantly associated with clinical cut-offs for Total Problems and Internalizing Disorders. Among Internalizing Disorders, clinical cut-offs for Withdrawn/Depressed, and DSM-Oriented scales for Affective Disorder and Anxiety Disorder were significantly associated with family history of unprovoked seizures. Clinical cut-offs for Aggressive Behavior and Delinquent Behavior, and DSM-Oriented scales for Conduct Disorder and Oppositional Defiant Disorder were significantly associated with family history of unprovoked seizure. Adjustment for siblings with the same disorder revealed significant associations for the relationship between first degree family history of unprovoked seizure and Total Problems and Agressive Behavior in probands with uncomplicated epilepsy; marginally significant results were seen for Internalizing Disorder, Withdrawn/Depressed and Anxiety Disorder. There was no association between family history of unprovoked seizure and behavioral problems in probands with complicated epilepsy. First degree family history of febrile seizure was not associated with behavioral problems in probands with uncomplicated or in those with complicated epilepsy. Significance Increased occurrence of behavioral disorders in probands with uncomplicated epilepsy and first degree family history of unprovoked seizure suggests familial clustering of these disorders. This supports the idea that behavioral disorders may be another manifestation of the underlying pathophysiology involved in epilepsy or closely related to it. PMID:22191626

  6. Familial clustering of epilepsy and behavioral disorders: evidence for a shared genetic basis.

    PubMed

    Hesdorffer, Dale C; Caplan, Rochelle; Berg, Anne T

    2012-02-01

    To examine whether family history of unprovoked seizures is associated with behavioral disorders in epilepsy probands, thereby supporting the hypothesis of shared underlying genetic susceptibility to these disorders. We conducted an analysis of the 308 probands with childhood onset epilepsy from the Connecticut Study of Epilepsy with information on first-degree family history of unprovoked seizures and of febrile seizures whose parents completed the Child Behavior Checklist (CBCL) at the 9-year follow-up. Clinical cutoffs for CBCL problem and Diagnostic and Statistical Manual of Mental Disorders (DSM)-Oriented scales were examined. The association between first-degree family history of unprovoked seizure and behavioral disorders was assessed separately in uncomplicated and complicated epilepsy and separately for first-degree family history of febrile seizures. A subanalysis, accounting for the tendency for behavioral disorders to run in families, was adjusted for siblings with the same disorder as the proband. Prevalence ratios were used to describe the associations. In probands with uncomplicated epilepsy, first-degree family history of unprovoked seizure was significantly associated with clinical cutoffs for Total Problems and Internalizing Disorders. Among Internalizing Disorders, clinical cutoffs for Withdrawn/Depressed, and DSM-Oriented scales for Affective Disorder and Anxiety Disorder were significantly associated with family history of unprovoked seizures. Clinical cutoffs for Aggressive Behavior and Delinquent Behavior, and DSM-Oriented scales for Conduct Disorder and Oppositional Defiant Disorder were significantly associated with family history of unprovoked seizure. Adjustment for siblings with the same disorder revealed significant associations for the relationship between first-degree family history of unprovoked seizure and Total Problems and Aggressive Behavior in probands with uncomplicated epilepsy; marginally significant results were seen for Internalizing Disorder, Withdrawn/Depressed, and Anxiety Disorder. There was no association between family history of unprovoked seizure and behavioral problems in probands with complicated epilepsy. First-degree family history of febrile seizure was not associated with behavioral problems in probands with uncomplicated or in those with complicated epilepsy. Increased occurrence of behavioral disorders in probands with uncomplicated epilepsy and first degree family history of unprovoked seizure suggests familial clustering of these disorders. This supports the idea that behavioral disorders may be another manifestation of the underlying pathophysiology involved in epilepsy or closely related to it. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  7. Psychiatric morbidity in Egyptian children with acute lymphoblastic leukemia and their care providers.

    PubMed

    Khalifa, Ahmed S; Bishry, Zeinab; Tantawy, Azza A G; Ghanem, Mohammed H; Effat, Safia M; El Shahawy, Heba; Ebeid, Fatma S E

    2014-06-01

    To evaluate the psychological morbidity of acute lymphoblastic leukemia (ALL) on children and their parents at different stages of illness and to assess the crucial contribution of the psychologist in the pediatric oncology team. We recruited 103 children with ALL and their 96 parents, and divided them into five groups according to disease phase: diagnosis, initial remission, active treatment, survival and relapsing. We compared these to 22 healthy controls and their parents. Patients and controls were subjected to clinical assessments, the symptoms checklist of the International Classification of Disease ICD (ICD-10), and the Wechsler Intelligence Scale for Children The parents of patients and controls underwent a general health questionnaire, the ICD-10 symptoms checklist, rating scales for anxiety and depression, post-traumatic stress disorder (PTSD) assessment scale, and the physical cognitive affective social economic ego problems (PCASEE) questionnaire for quality of life (QOL) rating. Psychiatric morbidity was evident in nearly 60% of leukemic children and their parents and was significantly increased in comparison to controls. Children mostly suffered from adjustment and oppositional defiant disorders. The most common discriminators between patient groups were conduct and attention problems being lowest in newly diagnosed patients, and social aggression being lowest in patients in remission. The three parameters were highest in relapsed patients whose parents mostly had adjustment and depressive disorders. Risk factors for child psychopathology were older age, female gender, and parental psychopathology. Mothers and parents with lower education and professional level were found to be vulnerable. Performance and total intelligence quotient (IQ) were significantly lower in leukemic children, and these were most pronounced in the survivor group. Risk factors for cognitive dysfunction were younger age, longer chemotherapy duration, and lower parental education level. Most patients and their caregivers suffered from significant psychiatric morbidity, highlighting the need for routine screening to improve psychological outcomes in such cases. Copyright © 2014 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

  8. "...because I am something special" or "I think I will be something like a guinea pig": information and assent of legal minors in clinical trials – assessment of understanding, appreciation and reasoning

    PubMed Central

    Koelch, Michael; Singer, Hanneke; Prestel, Anja; Burkert, Jessica; Schulze, Ulrike; Fegert, Jörg M

    2009-01-01

    Background The aim of this study is to assess and evaluate the capacities for understanding, appreciation and reasoning of legal minors with psychiatric disorders and their parents and their competence to consent or assent to participation in clinical trials. The beliefs, fears, motivation and influencing factors for decision-making of legal minors and parents were also examined. Methods Using the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), an instrument developed for adults whose capacities to consent are unclear, we provided information about clinical trials and assessed understanding, appreciation and reasoning. We adapted this tool for legal minors and examined 19 children and adolescents between the ages of 7 and 15 with attention deficit/hyperactivity disorder (ADHD) or ADHD combined with oppositional defiant disorder (DSM-IV 314.00/314.01/312.8) enrolled in clinical trials. Parents were also examined using the MacCAT-CR. Results Facts such as the procedures involved in trials or their duration were well understood by legal minors, but more abstract issues like the primary purpose of the trial were not understood by children and adolescents or by many parents. Legal minors also had difficulties understanding the nature of placebo and the probability of receiving placebo. Children's and adolescents' decisions were influenced by fears about their disorder worsening and by problems in their relationship with their parents. Parents wanted the best therapy for their children in order to minimize problems in school. Conclusion Legal minors and parents need to be informed more precisely about specific issues like placebo and the primary purpose of trials. In general, the reasoning of children and adolescents was influenced by their experience with their disorder and decision making was based on reasonable arguments. Their fears were based on everyday experiences such as school performance or family relationships. PMID:19175905

  9. The Link between Peer Relations, Prosocial Behavior, and ODD/ADHD Symptoms in 7-9-Year-Old Children.

    PubMed

    Paap, Muirne C S; Haraldsen, Ira R; Breivik, Kyrre; Butcher, Phillipa R; Hellem, Frøydis M; Stormark, Kjell M

    2013-01-01

    Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms that hinder successful positive interaction with peers. The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7-9-year-old children who show symptoms typical of ADHD and/or ODD. Furthermore, the possible interaction with sex was investigated. We used data collected in the first wave of The Bergen Child Study of mental health (BCS), a prospective longitudinal total population study of children's developmental and mental health. The target population consisted of children in the second to the fourth, in all public, private, and special schools in Bergen, Norway, in the fall of 2002 (N = 9430). All 79 primary schools in Bergen participated in the study. Both teacher (8809 complete cases) and parent (6253 complete cases) report were used in the analyses. ADHD and ODD scores were estimated using the Swanson Noland and Pelham rating scale version IV (SNAP-IV), and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children. Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity. For ADHD this effect was only found in the teacher report of the children. A sex effect for ODD symptoms was found only using the parent report: boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms. Since this effect was not found using the teacher data, it may imply a situational effect (school/home) for girls with high levels of ODD. The moderator effect of ODD/ADHD was comparable for boys and girls. Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships, this is not necessarily accompanied by an increase in prosocial behavior.

  10. Disruptive Mood Dysregulation Disorder in a Community Mental Health Clinic: Prevalence, Comorbidity and Correlates.

    PubMed

    Freeman, Andrew J; Youngstrom, Eric A; Youngstrom, Jennifer K; Findling, Robert L

    2016-03-01

    The revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) added a new diagnosis of disruptive mood dysregulation disorder (DMDD) to depressive disorders. This study examines the prevalence, comorbidity, and correlates of the new disorder, with a particular focus on its overlap with oppositional defiant disorder (ODD), with which DMDD shares core symptoms. Data were obtained from 597 youth 6-18 years of age who participated in a systematic assessment of symptoms offered to all intakes at a community mental health center (sample accrued from July 2003 to March 2008). Assessment included diagnostic, symptomatic, and functional measures. DMDD was diagnosed using a post-hoc definition from item-level ratings on the Schedule for Affective Disorders and Schizophrenia for School-Age Children that closely matches the DSM-5 definition. Caregivers rated youth on the Child Behavior Checklist. Approximately 31% of youth met the operational definition of DMDD, and 40% had Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) diagnoses of ODD. Youth with DMDD almost always had ODD (odds ratio [OR] = 53.84) and displayed higher rates of comorbidity with attention-deficit/hyperactivity disorder (ADHD) and conduct disorder than youth without DMDD. Caregivers of youth with DMDD reported more symptoms of aggressive behavior, rule-breaking, social problems, anxiety/depression, attention problems, and thought problems than all other youth without DMDD. Compared with youth with ODD, youth with DMDD were not significantly different in terms of categorical or dimensional approaches to comorbidity and impairment. The new diagnosis of DMDD might be common in community mental health clinics. Youth with DMDD displayed more severe symptoms and poorer functioning than youth without DMDD. However, DMDD almost entirely overlaps with ODD and youth with DMDD were not significantly different than youth with ODD. These findings raise concerns about the potentially confusing effects of using DMDD in clinical settings, particularly given that DSM-5 groups DMDD with depressive disorders, but ODD remains a disruptive behavior disorder, potentially changing the decision-making framework that clinicians use to select treatments.

  11. Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth.

    PubMed

    Thomas, Hannah J; Connor, Jason P; Lawrence, David M; Hafekost, Jennifer M; Zubrick, Stephen R; Scott, James G

    2017-09-01

    Bullying prevalence studies are limited by varied measurement methods and a lack of representative samples. This study estimated the national prevalence of bullying victimisation, perpetration and combined victim-perpetration experiences in a representative population-based sample of Australian youth. The relationships between the three types of bullying involvement with a range of mental health symptoms and diagnoses were also examined. A randomly selected nationally representative sample aged 11-17 years ( N = 2967, M age = 14.6 years; 51.6% male) completed the youth component of the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing (Young Minds Matter). Parents or carers also completed a structured face-to-face interview that asked questions about a single randomly selected child in the household. The youth survey comprised self-reported bullying victimisation and perpetration (Olweus Bully-Victim Questionnaire-adapted), psychological distress (K10), emotional and behavioural problems (Strengths and Difficulties Questionnaire), as well as self-harm, suicide attempts and substance use. Modules from the Diagnostic Interview Schedule for Children Version IV were administered to all youth and parents to assess for mental disorder diagnoses (major depressive disorder, any anxiety disorder and any externalising disorder [attention-deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder]). The 12-month prevalence of bullying victimisation was 13.3%, perpetration 1.6% and victim-perpetration 1.9%. Logistic regression models showed all forms of involvement in bullying were associated with increased risk of psychological distress, emotional and behavioural problems, substance use, self-harm and attempted suicide. Victimisation and victim-perpetration were associated with youth-reported major depressive disorder. There were also significant associations between bullying involvement and parent-reported diagnoses of major depressive disorder, any anxiety disorder and any externalising disorder. Bullying continues to be frequently experienced by Australian adolescents. The current findings showed that involvement in any bullying behaviour was associated with increased risk of concurrent mental health problems. This evidence can be used to inform decisions concerning the allocation of resources to address this important health issue.

  12. The Link between Peer Relations, Prosocial Behavior, and ODD/ADHD Symptoms in 7–9-Year-Old Children

    PubMed Central

    Paap, Muirne C. S.; Haraldsen, Ira R.; Breivik, Kyrre; Butcher, Phillipa R.; Hellem, Frøydis M.; Stormark, Kjell M.

    2013-01-01

    Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms that hinder successful positive interaction with peers. The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7–9-year-old children who show symptoms typical of ADHD and/or ODD. Furthermore, the possible interaction with sex was investigated. We used data collected in the first wave of The Bergen Child Study of mental health (BCS), a prospective longitudinal total population study of children's developmental and mental health. The target population consisted of children in the second to the fourth, in all public, private, and special schools in Bergen, Norway, in the fall of 2002 (N = 9430). All 79 primary schools in Bergen participated in the study. Both teacher (8809 complete cases) and parent (6253 complete cases) report were used in the analyses. ADHD and ODD scores were estimated using the Swanson Noland and Pelham rating scale version IV (SNAP-IV), and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children. Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity. For ADHD this effect was only found in the teacher report of the children. A sex effect for ODD symptoms was found only using the parent report: boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms. Since this effect was not found using the teacher data, it may imply a situational effect (school/home) for girls with high levels of ODD. The moderator effect of ODD/ADHD was comparable for boys and girls. Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships, this is not necessarily accompanied by an increase in prosocial behavior. PMID:24286065

  13. The implications of different developmental patterns of disruptive behavior problems for school adjustment

    PubMed Central

    STORMSHAK, ELIZABETH A.; BIERMAN, KAREN L.

    2009-01-01

    Based upon developmental models of disruptive behavior problems, this study examined the hypothesis that the nature of a child’s externalizing problems at home may be important in predicting the probability of and nature of school adjustment problems at school entry. Parent ratings were collected for a sample of 631 behaviorally disruptive children using the Child Behavior Checklist. Confirmatory factor analyses revealed differentiated ratings of oppositional, aggressive, and hyperactive/inattentive behaviors at home. Teacher and peer nominations assessed school adjustment at the end of first grade. As expected from a developmental perspective, aggressive behaviors indicated more severe dysfunction and were more likely to generalize to the school setting than were oppositional behaviors. Hyperactive/inattentive behaviors at home led to more classroom disruption than did aggressive or oppositional behaviors. Co-occurring patterns of oppositional/aggressive and hyperactive/inattentive behaviors were more common than were single-problem patterns, and were associated with broad dysfunction in the social and classroom contexts. The results were interpreted within a developmental framework, in which oppositional, aggressive, and hyperactive/inattentive behaviors may reflect distinct (as well as shared) developmental processes that have implications for the home-to-school generalization of behavior problems and subsequent school adjustment. PMID:9741677

  14. Emotional Abilities in Children with Oppositional Defiant Disorder (ODD): Impairments in Perspective-Taking and Understanding Mixed Emotions are Associated with High Callous-Unemotional Traits.

    PubMed

    O'Kearney, Richard; Salmon, Karen; Liwag, Maria; Fortune, Clare-Ann; Dawel, Amy

    2017-04-01

    Most studies of emotion abilities in disruptive children focus on emotion expression recognition. This study compared 74 children aged 4-8 years with ODD to 45 comparison children (33 healthy; 12 with an anxiety disorder) on behaviourally assessed measures of emotion perception, emotion perspective-taking, knowledge of emotions causes and understanding ambivalent emotions and on parent-reported cognitive and affective empathy. Adjusting for child's sex, age and expressive language ODD children showed a paucity in attributing causes to emotions but no other deficits relative to the comparison groups. ODD boys with high levels of callous-unemotional traits (CU) (n = 22) showed deficits relative to low CU ODD boys (n = 25) in emotion perspective-taking and in understanding ambivalent emotions. Low CU ODD boys did not differ from the healthy typically developing boys (n = 12). Impairments in emotion perceptive-taking and understanding mixed emotions in ODD boys are associated with the presence of a high level of CU.

  15. Parent- and Teacher-Reported Symptoms of ADHD in School-Aged Children With Active Epilepsy: A Population-Based Study.

    PubMed

    Reilly, Colin; Atkinson, Patricia; Das, Krishna B; Chin, Richard F M; Aylett, Sarah E; Burch, Victoria; Gillberg, Christopher; Scott, Rod C; Neville, Brian G R

    2017-09-01

    Provide data on the distribution of parent- and teacher-reported symptoms of ADHD in childhood epilepsy and describe coexisting cognitive and behavioral disorders in children with both epilepsy and ADHD. Eighty-five (74% of those eligible) children (5-15 years) in a population-based sample with active epilepsy underwent psychological assessment. The ADHD Rating Scale-IV (ADHD-RS-IV) scale was completed by parents ( n = 69) and teachers ( n = 67) of participating children with an IQ > 34. ADHD was diagnosed with respect to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Parents reported significantly more symptoms of ADHD than teachers ( p < .001). Symptoms of inattention were more commonly reported than symptoms of hyperactivity-impulsivity ( p < .001). Neurobehavioral comorbidity was similar in those with ADHD and non-ADHD with the exception of oppositional defiant disorder (ODD) and developmental coordination disorder (DCD), which were more common in those with both epilepsy and ADHD. Symptoms of ADHD are very common in childhood epilepsy but prevalence is influenced by informant.

  16. The Reciprocal Influence of Callous-Unemotional Traits, Oppositional Defiant Disorder and Parenting Practices in Preschoolers.

    PubMed

    Brown, Caitlin A; Granero, Roser; Ezpeleta, Lourdes

    2017-04-01

    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.

  17. Risk factors of abuse of parents by their ADHD children.

    PubMed

    Ghanizadeh, Ahmad; Jafari, Peyman

    2010-01-01

    It is interesting that there is scant research of abuse of parents by their children and no study was found on the abuse of parents by their attention deficit hyperactivity disorder (ADHD) children. Seventy-four children and adolescents suffering from ADHD and their parents were interviewed. The diagnoses were made according to DSM-IV diagnostic criteria. A questionnaire was developed to assess the children's abuse toward parents. More than half of the parents are suffering from at least one of the forms of abuse by their ADHD children. Scores of parental abuse were not related to gender. Different types of abuse correlated with oppositional defiant disorder (ODD), tic, and separation anxiety disorder (SAD). Fathers' and mothers' age, the level of education, and type of occupation were not risk factors of the abuse scores. ODD and mother's major depressive disorder were predictors of the abuse. There was a very disturbing high rate of abuse by children against parents. There is an interrelation of different forms of abuse. This study contributes to increasing awareness on the abuse of parents by their ADHD children.

  18. The Direct/Indirect Association of ADHD/ODD Symptoms with Self-esteem, Self-perception, and Depression in Early Adolescents.

    PubMed

    Kita, Yosuke; Inoue, Yuki

    2017-01-01

    The present study aimed to reveal the influences of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms on self-esteem and self-perception during early adolescence and to clarify the spillover effect of self-esteem on depressive symptoms. ADHD symptoms in 564 early adolescents were evaluated via teacher-rating scales. Self-esteem and depressive symptoms were assessed via self-reported scales. We analyzed the relationships among these symptoms using structural equation modeling. Severe inattentive symptoms decreased self-esteem and hyperactive-impulsive symptoms affected self-perception for non-academic domains. Although these ADHD symptoms did not directly affect depressive symptoms, low self-esteem led to severe depression. ODD symptoms had a direct impact on depression without the mediating effects of self-esteem. These results indicated that inattentive symptoms had a negative impact on self-esteem and an indirect negative effect on depressive symptoms in adolescents, even if ADHD symptoms were subthreshold. Severe ODD symptoms can be directly associated with depressive symptoms during early adolescence.

  19. The Direct/Indirect Association of ADHD/ODD Symptoms with Self-esteem, Self-perception, and Depression in Early Adolescents

    PubMed Central

    Kita, Yosuke; Inoue, Yuki

    2017-01-01

    The present study aimed to reveal the influences of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms on self-esteem and self-perception during early adolescence and to clarify the spillover effect of self-esteem on depressive symptoms. ADHD symptoms in 564 early adolescents were evaluated via teacher-rating scales. Self-esteem and depressive symptoms were assessed via self-reported scales. We analyzed the relationships among these symptoms using structural equation modeling. Severe inattentive symptoms decreased self-esteem and hyperactive–impulsive symptoms affected self-perception for non-academic domains. Although these ADHD symptoms did not directly affect depressive symptoms, low self-esteem led to severe depression. ODD symptoms had a direct impact on depression without the mediating effects of self-esteem. These results indicated that inattentive symptoms had a negative impact on self-esteem and an indirect negative effect on depressive symptoms in adolescents, even if ADHD symptoms were subthreshold. Severe ODD symptoms can be directly associated with depressive symptoms during early adolescence. PMID:28824468

  20. Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents

    PubMed Central

    Patton, Susana

    2016-01-01

    Abstract Background: Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. Methods: The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. Results: The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Conclusions: Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities. PMID:26745607

  1. Does Comorbid Disruptive Behavior Modify the Effects of Atomoxetine on ADHD Symptoms as Measured by a Continuous Performance Test and a Motion Tracking Device?

    PubMed

    Wehmeier, Peter M; Kipp, Laura; Banaschewski, Tobias; Dittmann, Ralf W; Schacht, Alexander

    2015-07-01

    To compare the reduction of ADHD symptoms under atomoxetine in patients with and without comorbid oppositional defiant disorder (ODD) or conduct disorder (CD) using a computer-based continuous performance test (cb-CPT) combined with an infrared motion tracking (MT) device. Secondary analysis of a placebo-controlled study in ADHD patients (6-12 years old) treated with atomoxetine (target dose: 1.2 mg/kg per day). Cb-CPT/MT scores were analyzed using ANCOVA (last observation carried forward [LOCF]). The data (N = 125) suggested a more pronounced atomoxetine effect in the group with comorbid ODD/CD as measured by all cb-CPT/MT parameters except for "normalized variation of reaction time" (nVRT). The results showed that atomoxetine reduced ADHD severity as measured by cb-CPT and MT parameters regardless of whether comorbid ODD/CD was present. The treatment effect of atomoxetine on hyperactivity appears to be more pronounced in the subgroup of patients with comorbid ODD/CD than in the subgroup without this comorbidity. © 2012 SAGE Publications.

  2. Measurement and structural invariance of parent ratings of ADHD and ODD symptoms across gender for American and Malaysian children.

    PubMed

    Burns, G Leonard; Walsh, James A; Gomez, Rapson; Hafetz, Nina

    2006-12-01

    The purpose of this study was to examine the measurement (configural, metric, scalar, and residual) and structural (factor variance, factor covariance, and factor means) invariance of parent ratings of the attention-deficit/hyperactivity disorder - inattention (ADHD-IN), ADHD - hyperactivity/impulsivity (ADHD-HI), and oppositional defiant disorder (ODD) symptoms as described in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) across boys and girls. In an American pediatric sample (N = 1,015) and a Malaysian elementary school-age sample (N = 928), there was strong support for configural, metric, scalar, residual, factor variance, and covariance invariance across gender within each sample. Both American and Malaysian boys had significantly higher scores on the ADHD-IN and ADHD-HI factor means than did girls, whereas only in the American sample did boys score significantly higher on the ODD factor than did girls. The implications of the results for the study of gender, ethnic, and cultural differences associated with ADHD and ODD are discussed. (c) 2006 APA, all rights reserved

  3. P3 event-related potential impairments in antisocial and psychopathic individuals: a meta-analysis.

    PubMed

    Gao, Yu; Raine, Adrian

    2009-12-01

    Prior findings on P3 event-related potential deficits in antisocial populations are mixed and it has been suggested that these abnormalities may not apply to psychopaths. A meta-analysis of 38 studies (total N=2616) was conducted to investigate the relationship of P3 measures to antisocial behavior. Reduced P3 amplitudes (d=0.252, p<.001) and longer P3 latencies (d=0.130, p=.019) were significantly associated with antisocial behavior across all electrode sites, and when using both normal and non-normal control groups. A significant moderating effect of electrode site indicated longer latencies at Fz but not Pz. Compared to non-psychopathic offenders, psychopathic offenders showed P3 amplitudes impairments in standard oddball tasks, but not other tasks. Findings suggest that reduced P3 amplitudes and prolonged P3 latencies may reflect inefficient deployment of neural resources in processing cognitive task-relevant information in individuals characterized with generic antisocial behavior (i.e., aggression, antisocial personality disorder, conduct disorder/oppositional-defiant disorder, and psychopathy), whereas this association in psychopaths may be moderated by the type of tasks.

  4. Using Videoconferencing to Deliver Individual Therapy and Pediatric Psychology Interventions with Children and Adolescents.

    PubMed

    Nelson, Eve-Lynn; Patton, Susana

    2016-04-01

    Because of the widening access gap between need for individual and pediatric psychology services and child specialist availability, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. The authors summarize real-time videoconferencing evidence to date across individual therapy with children and pediatric psychology interventions using videoconferencing. The authors summarize emerging guidelines that inform best practices for individual child therapy over videoconferencing. The authors present three case examples to illustrate best practices. The first behavioral pediatrics case summarizes evidence-based approaches in treating a rural young adolescent with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and hearing impairment. The second pediatric psychology case describes similarities and difference between on-site and videoconferencing services in treating a rural child with toileting concerns. The third adolescent case describes treatment of an urban honors student with depression. Videoconferencing is an effective approach to improving access to individual and pediatric psychology interventions for children and adolescents. Videoconferencing approaches are well accepted by families and show promise for disseminating evidence-based treatments to underserved communities.

  5. Evidence-Based School Behavior Assessment of Externalizing Behavior in Young Children

    PubMed Central

    Bagner, Daniel M.; Boggs, Stephen R.; Eyberg, Sheila M.

    2011-01-01

    This study examined the psychometric properties of the Revised Edition of the School Observation Coding System (REDSOCS). Participants were 68 children ages 3 to 6 who completed parent-child interaction therapy for Oppositional Defiant Disorder as part of a larger efficacy trial. Interobserver reliability on REDSOCS categories was moderate to high, with percent agreement ranging from 47% to 90% (M = 67%) and Cohen’s kappa coefficients ranging from .69 to .95 (M = .82). Convergent validity of the REDSOCS categories was supported by significant correlations with the Intensity Scale of the Sutter-Eyberg Student Behavior Inventory-Revised and related subscales of the Conners’ Teacher Rating Scale-Revised: Long Version (CTRS-R: L). Divergent validity was indicated by nonsignificant correlations between REDSOCS categories and scales on the CTRS-R: L expected not to relate to disruptive classroom behavior. Treatment sensitivity was demonstrated for two of the three primary REDSOCS categories by significant pre to posttreatment changes. This study provides psychometric support for the designation of REDSOCS as an evidence-based assessment procedure for young children. PMID:21687781

  6. Parent-Child DRD4 Genotype as a Potential Biomarker for Oppositional, Anxiety, and Repetitive Behaviors in Children with Autism Spectrum Disorder

    PubMed Central

    Gadow, Kenneth D.; DeVincent, Carla J.; Pisarevskaya, Victoria; Olvet, Doreen M.; Xu, Wenjie; Mendell, Nancy; Finch, Stephen J.; Hatchwell, Eli

    2010-01-01

    The primary objective of the present study was to examine whether a combination of parent-child DRD4 genotypes results in more informative prognostic biomarkers of oppositional, separation anxiety, and repetitive behaviors in children with autism spectrum disorder (ASD). Based on prior research indicating the 7-repeat allele as a potential risk variant, participants were sorted into one of four combinations of parent-child genotypes. Owing to the possibility of parent-of-origin effects, analyses were conducted separately for mother-child (MC) and father-child (FC) dyads. Mothers completed a validated DSM-IV-referenced rating scale. Partial eta-squared (ηp2) was used to determine the magnitude of group differences: 0.01–0.06=small, 0.06–0.14=moderate, and >0.14=large. Analyses indicated that children in MC dyads with matched genotypes had the least (7−/7−) and most (7+/7+) severe mother-rated oppositional-defiant (ηp2=0.11) and separation anxiety (ηp2=0.19) symptoms. Conversely, youths in FC dyads with matched genotypes had the least (7−/7−) and most (7+/7+) severe obsessive-compulsive behaviors (ηp2=0.19) and tics (ηp2=0.18). Youths whose parents were both noncarriers had less severe tics than peers with at least one parental carrier, and the effect size was large (ηp2=0.16). There was little evidence that noncarrier children were rated more severely by mothers who were carriers versus noncarriers. Transmission Disequilibrium Test analyses provided preliminary evidence for undertransmission of the 2-repeat allele in youths with more severe tics (p=0.02). Parent genotype may be helpful in constructing prognostic biomarkers for behavioral disturbances in ASD; however, findings are tentative pending replication with larger, independent samples. PMID:20600463

  7. Effect of OROS methylphenidate on encopresis in children with attention-deficit/hyperactivity disorder.

    PubMed

    Yılmaz, Savaş; Bilgiç, Ayhan; Hergüner, Sabri

    2014-04-01

    Although encopresis shows a high rate of comorbidity in patients with attention-deficit/hyperactivity disorder (ADHD), the etiologic origin of this relationship and the effect of ADHD drugs on encopresis are unclear. In this chart review, we explored the effect of OROS long-acting methylphenidate (MPH) treatment on encopresis in children with ADHD. We also evaluated the relationship between the clinical variables of ADHD and encopresis. The sample consisted of 21 children and adolescents (20 boys and 1 girl) with encopresis and coexisting ADHD 7-15 years of age. Their clinical characteristics and baseline (visit 1) and end of the second months' (visit 2) Conners' Parent Rating Scale (CPRS) subscores were recorded. Retrospective clinician determinations were made using the Clinical Global Impressions-Severity subscale (CGI-S) for encopresis severity and the Clinical Global Impressions-Improvement subscale (CGI-I) for encopresis response. According to the CGI-I, 14 subjects (71.4 %) showed much or very much improvement in their encopresis at the second visit. All of the CPRS scores showed a significant reduction during the second visit. No association was found between the CGI-I score and the changes in any of the CPRS scores. Baseline oppositional defiant disorder (ODD) and conduct disorder (CD) scores were correlated with the CGI-S score; however, no association was found between core ADHD symptom severity and the CGI-S score. With regard to the encopresis outcome, the baseline CD score was negatively correlated with the CGI-I score, and the baseline ODD score was prone to show a negative correlation with the CGI-I score. These results suggest that coexisting behavioral problems may be a vulnerability factor based on the severity of encopresis, and that MPH treatment may have a positive effect on encopresis in children and adolescents with ADHD.

  8. Effects of atomoxetine with and without behavior therapy on the school and home functioning of children with attention-deficit/hyperactivity disorder.

    PubMed

    Waxmonsky, James G; Waschbusch, Daniel A; Pelham, William E; Draganac-Cardona, Lillian; Rotella, Bryan; Ryan, Lynn

    2010-11-01

    To evaluate the effects of atomoxetine alone and in combination with behavior therapy on the school functioning of children with attention-deficit/hyperactivity disorder (ADHD). Most atomoxetine studies have not assessed school functioning other than by measuring the change in ADHD symptoms. Combining behavior therapy with atomoxetine may be particularly beneficial for the academic domain as medication has not been found to produce sustained benefits in this realm. However, there is little research examining the effects of combining atomoxetine and behavior therapy. In an 8-week open-label trial, 56 children aged 6-12 years with ADHD diagnosed according to DSM-IV-TR were randomly assigned to receive atomoxetine and behavior therapy or atomoxetine alone. Behavior therapy consisted of an 8-week parenting course, a child social skills course, and a teacher-implemented daily report card of classroom behavior. The primary outcome was direct observation of the subject's classroom behavior. Secondary outcomes included change in ADHD symptoms and functioning at home and school. All data were collected between March 2007 and May 2008. Classroom observations showed that atomoxetine decreased rule violations (P < .0001). Moreover, atomoxetine was associated with significant improvements in ADHD and oppositional defiant disorder symptoms at home and school and enhanced functioning in both domains (Impairment Rating Scale: all P < .001). Combined treatment led to greater improvements in parent-rated symptoms of inattention (P < .01), problem behaviors (P < .001), and academic impairment (P < .05). However, teachers did not report significant group differences. Atomoxetine improved ADHD symptoms and classroom functioning as measured by parents, teachers, and direct observation. The addition of behavior therapy led to further improvements at home but not at school. clinicaltrials.gov Identifier: NCT00918567. © Copyright 2010 Physicians Postgraduate Press, Inc.

  9. Parenting style influences bullying: A longitudinal study comparing children with and without behavioural problems

    PubMed Central

    Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M.

    2015-01-01

    Background More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4 to 5 years was associated with changes in bullying over the next 4 years among children with Attention-deficit/Hyperactivity Disorder (ADHD) with and without comorbid Oppositional Defiant Disorder (ODD) relative to children without these disorders. Method Children from the New York metropolitan area (n = 162) were prospectively studied over 6 annual assessment points between preschool and 9 years of age. Parenting was assessed by laboratory observations of the parent and child; teachers rated child bullying, and parents reported on children's diagnostic status (Neither ADHD nor ODD, ADHD but not ODD, both ADHD and ODD). Results Children with comorbid ADHD and ODD were more likely to bully than the other two groups. Hierarchical linear modeling revealed a fall in bullying over five-years. Diagnostic status was significantly associated with initial levels of bullying. Irrespective of diagnostic group, children receiving more parent support for child autonomy at age 4 to 5 years showed a significantly greater decline in bullying than those provided with little support for autonomy. There was no longitudinal link between parent negative affect, emotionally supportive parenting and quality of parent-child interactions with bullying. Conclusions Greater parent support for child autonomy at age 4 to 5 years is related to reduced bullying. Interventions that encourage parent support for child autonomy at the time of entry into school may reduce bullying during early school years. PMID:26053670

  10. The evaluation of mood condition among depressed adolescent students in Isfahan after 6 years

    PubMed Central

    Shakibaei, Fereshteh; Alikhani, Mahmood; Mahaki, Behzad; Sichani, Naeimeh Karimian; Tabatabaei, Haleh Dormiani

    2016-01-01

    Background: This study has carried out to find the recovery rate, depression recurrence, changing of diagnose into bipolar mood disorder (BMD) and appearing other psychiatric disorders including obsessive compulsive disorder, oppositional defiant disorder (ODD), substance induced disorders, attention deficit and hyperactivity disorder, and anxiety disorders after 6 years among students having major depression disorder in Isfahan and its relation to some demographic factors. Materials and Methods: In this historical cohort study, 278 students studying in guidance school, in 2006 being 11–16-year-old and were diagnosed to have major depressive disorder participated. Data collection was done by completing children depression on inventory, Young Maria Rating Scale and also final diagnosis determination through interview by psychiatrists. To analyze the data, in addition to use descriptive statistics, multinomial and multiple logistic regressions were used to evaluate the relationships. All the analyses were done using SPSS 20. Results: About 34.9 of adolescents have suffered from depression after 6 years. Depression in 12.2% has been changed into BMD. The BMD morbidity chance was less in girls rather than depression one. The ratio of drug abuse in girls was less than boys (odds ratio [OR] = 0.471, P = 0.046). Students received no treatment or only pharmacotherapy, were more caught by ODD in comparison with those cases who received both pharmacotherapy and psychotherapy (P = 0.005, 0.038 and OR = 4.29 and 5.88). Conclusion: About half of students after 6 years are caught by depression or BMD. It reveals the importance of this disorder and its role in making behavioral problems for adolescents in their future. PMID:27308266

  11. Parenting style influences bullying: a longitudinal study comparing children with and without behavioral problems.

    PubMed

    Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M

    2016-02-01

    More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4-5 years was associated with changes in bullying over the next 4 years among children with Attention-deficit/Hyperactivity Disorder (ADHD) with and without comorbid Oppositional Defiant Disorder (ODD) relative to children without these disorders. Children from the New York metropolitan area (n = 162) were prospectively studied over six annual assessment points between preschool and 9 years of age. Parenting was assessed by laboratory observations of the parent and child; teachers rated child bullying, and parents reported on children's diagnostic status (Neither ADHD nor ODD, ADHD but not ODD, both ADHD and ODD). Children with comorbid ADHD and ODD were more likely to bully than the other two groups. Hierarchical linear modeling revealed a fall in bullying over five years. Diagnostic status was significantly associated with initial levels of bullying. Irrespective of diagnostic group, children receiving more parent support for child autonomy at age 4 to 5 years showed a significantly greater decline in bullying than those provided with little support for autonomy. There was no longitudinal link between parent negative affect, emotionally supportive parenting and quality of parent-child interactions with bullying. Greater parent support for child autonomy at age 4-5 years is related to reduced bullying. Interventions that encourage parent support for child autonomy at the time of entry into school may reduce bullying during early school years. © 2015 Association for Child and Adolescent Mental Health.

  12. Mental health disparities between Roma and non-Roma children in Romania and Bulgaria.

    PubMed

    Lee, Eric J; Keyes, Katherine; Bitfoi, Adina; Mihova, Zlatka; Pez, Ondine; Yoon, Elisha; Masfety, Viviane Kovess

    2014-11-18

    The Roma population, one of the largest minority groups in Europe, experience discrimination and stigma associated with marginalized social position. Few studies have examined mental illnesses in the Roma, and none have examined the Roma children. The present study estimates mental health and behavioral disorders among Roma children in comparison to non-Roma children in educational institutions. Data were drawn from the School Children Mental Health Study in Europe (SCHME) study in Romania (Roma children identified by parent report, N = 70; non-Roma, N = 925) and Bulgaria (Roma children identified by exclusively-Roma schools, N = 65; non-Roma, N = 1312). The Strengths and Difficulties Questionnaire was given to the parents and teachers to measure child mental health; children reported on their mental health through the Dominique Interactive. Control covariates included child sex and age, and parental characteristics when parent reports were available. Based on the child's own report, Roma children had a higher odds of any internalizing disorder (OR = 2.99, 95% C.I. 2.07-4.30), phobias (OR = 4.84, 95% C.I. 3.19-7.35), separation anxiety disorder (OR = 2.54, 95% C.I. 1.72-3.76), generalized anxiety disorder (OR = 2.95, 95% C.I. 1.75-4.96), and major depressive disorder (OR = 3.86, 95% C.I. 2.31-6.37). Further Roma children had a higher odds of any externalizing disorder (OR = 2.84, 95% C.I. 1.78-4.54), oppositional defiant disorder (OR = 3.35, 95% C.I. 1.93-5.82), ADHD (OR = 2.37, 95% C.I. 1.26-4.46), and conduct disorder (OR = 3.63, 95% C.I. 2.04-6.46). Based on the report of teachers, Roma children had higher odds of emotional problems (OR = 2.03, 95% C.I. 1.20-3.44), peer-relational problems (OR = 2.76, 95% C.I. 1.73-4.41) and prosocial behavior (OR = 2.75, 95% C.I. 1.75-4.33). Roma children experience a higher burden of mental health problems compared with their non-Roma counterparts. Attention to child health and mental health among the Roma is urgently needed, as these children experience a constellation of health problems associated with poverty as well as experiences of stigma and discrimination.

  13. Coercive Family Process and Early-Onset Conduct Problems From Age 2 to School Entry

    PubMed Central

    Smith, Justin D.; Dishion, Thomas J.; Shaw, Daniel S.; Wilson, Melvin N.; Winter, Charlotte C.; Patterson, Gerald R.

    2013-01-01

    The emergence and persistence of conduct problems during early childhood is a robust predictor of behavior problems in school and future maladaptation. In this study we examined the reciprocal influences between observed coercive interactions between children and caregivers, oppositional and aggressive behavior, and growth in parent report of early childhood (ages 2–5) and school-age conduct problems (age 7.5 and 8.5). Participants were drawn from the Early Steps multisite randomized prevention trial that includes an ethnically diverse sample of male and female children and their families (N = 731). A parallel process growth model combining latent trajectory and cross-lagged approaches revealed the amplifying effect of observed coercive caregiver–child interactions on children's noncompliance, whereas child oppositional and aggressive behaviors did not consistently predict increased coercion. The slope and initial levels of child oppositional and aggressive behaviors and the stability of caregiver–child coercion were predictive of teacher-reported oppositional behavior at school age. Families assigned to the Family Check-Up condition had significantly steeper declines in child oppositional and aggressive behavior and moderate reductions in oppositional behavior in school and in coercion at age 3. Results were not moderated by child gender, race/ethnicity, or assignment to the intervention condition. The implications of these findings are discussed with respect to understanding the early development of conduct problems and to designing optimal strategies for reducing problem behavior in early childhood with families most in need. PMID:24690305

  14. The Boundary Identity of Exact Opposites: A Simple Solution to the Age- Old Philosophical Problem of Change

    DTIC Science & Technology

    1975-10-08

    Aristotle Parmenides Philosophy Union of opposites...the union of opposites. Even in Heraclitus’s day, however, opinion on the problem of change was sharply divided; e.g., Parmenides regarded change...challenge. Also, if one closely examines the reasoning of Parmenides , one can advance it one step further. It is perfectly logical to state that

  15. [The course of attention deficit hyperactivity disorder (ADHD) over the life span].

    PubMed

    Koumoula, A

    2012-06-01

    Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder, associated with the maturation of the nervous system and appearing on a standard proceeding with special cognitive impairments. For many years ADHD was concerned as a typical childhood disorder. Long-term studies though, showed that an important percentage of children with ADHD grew as adults with ADHD. The clinical picture varies with the developmental stage. In pre-school years (3-5 years) the clinical picture is characterized by excessive physical activity, difficulty in cooperation with peers and non-compliance to the recommendations of adults. In school age (6-12 years), apart from the nuclear symptoms of the disorder, as described in the classification systems, i.e. inattention, hyperactivity and impulsivity, oppositional behavior often occurs, conflicts with peers and academic problems. In adolescence hyperactivity lessens, conflicts with parents continue and high risk behaviors often appear. In adults physical activity usually decreases significantly, while inattention and impulsivity still remain. With the passing of time the number of symptoms are usually reduced, however the impact and impairment caused by the disorder remain. The diagnosis of ADHD in adults requires a retrospective diagnosis of ADHD in childhood. Since childhood, comorbid disorders are common, most times continuing until adult life. The Oppositional Defiant Disorder during childhood is related to the presenting of Antisocial Personality Disorder in adults. On the other hand, emotional disorders, which are also rather common in children, adolescents and adults with ADHD, can be due to either common biological mechanisms or the long-standing effect of psychosocial and environmental factors which follow people with ADHD. The relationship between ADHD and substance abuse has been a subject of research, with the view of the existence of Conduct Disorder being necessary for a person to present a Substance Use Disorder, currently prevailing. Smoking and alcohol drinking do not seem to require this mediation and ADHD can be itself a predictor for smoking and alcoholism. Stimulant treatment in childhood offers some protective effect against drug abuse and alcoholism in adolescence. The diagnosis of Borderline Personality Disorder is common in adults with ADHD and the most common reason is the overlap of symptoms between the two disorders. The question is whether the diagnosis of Borderline Personality Disorder in adults is appropriate and useful in the presence of ADHD, because when ADHD proceeds the symptoms and the impairment in functioning are due to this disorder. In general, when another diagnosis or several symptoms as a part of another disorder are also present, treatment of the primary disorder, i.e. ADHD, is beneficial and effective for all the presenting problems.

  16. Trajectories of Global Self-Worth in Adolescents with ADHD: Associations with Academic, Emotional, and Social Outcomes.

    PubMed

    Dvorsky, Melissa R; Langberg, Joshua M; Becker, Stephen P; Evans, Steven W

    2018-05-01

    Resilience models suggest that there are likely to be multiple trajectories of self-worth and that despite experiencing impairment, some youth with attention deficit/hyperactivity disorder (ADHD) may maintain a positive self-worth, which could buffer them against negative outcomes. The present study used a cohort-sequential longitudinal design to evaluate developmental trajectories of global self-worth in a sample of 324 middle-school-age adolescents (71% male) diagnosed with ADHD between ages 11 and 14 in predicting outcomes at age 15. Sex, medication status, and ADHD/oppositional defiant disorder symptom severity were included as covariates in the models. Using growth mixture modeling, 3 distinct self-worth trajectory groups were identified: (a) high and increasing (44.4% of participants), (b) moderate and decreasing (48.8%), and (c) low and decreasing (6.8%). Participants with high and increasing global self-worth were less likely to exhibit co-occurring depressive symptoms and had better social functioning and higher grades at age 15 relative to those in either decreasing trajectory. Implications of these findings for monitoring and supporting positive global self-worth for adolescents with ADHD are discussed.

  17. Psychosocial risk factors underlie the link between attention deficit hyperactivity symptoms and overweight at school entry.

    PubMed

    Pauli-Pott, Ursula; Reinhardt, Alexander; Bagus, Elena; Wollenberg, Birgit; Schroer, Andrea; Heinzel-Gutenbrunner, Monika; Becker, Katja

    2017-01-01

    The link between symptoms of attention deficit hyperactivity disorder (ADHD) and increased body weight is well established, while the underlying mechanisms are not yet clear. Since increased body weight and ADHD symptoms have been found to be associated with psychosocial risk factors in childhood, we analyzed whether the psychosocial risks explain the association between the two conditions. The sample consisted of 360 children (age range 6-7 years, 173 boys) attending the obligatory medical health exam before school entry. The childrens' height and weight were measured during the examination. ADHD symptoms were ascertained by parent-report questionnaires. Psychosocial risks were ascertained by a structured interview. The link between ADHD symptoms and body weight could be completely explained by cumulative psychosocial risks while controlling for gender, symptoms of depression/anxiety and oppositional defiant disorder of the child, maternal smoking during pregnancy, parental body mass index, and potential diagnosis of ADHD in the parents. In current models pertaining to the etiology of overweight/obesity and ADHD, chronic stress caused by psychosocial adversity is assumed to act as a trigger for these conditions. Psychosocial risks experienced during childhood may activate processes that specifically lead to the combined ADHD-overweight phenotype.

  18. Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

    PubMed

    Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

    2016-05-01

    Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p < 0.001) and all personality traits (range, p = 0.03 to p = 0.001) improved, but there was almost no correlation between changes on these 2 measures. Conversely, of 11 Wisconsin Personality Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms.

  19. Psychopathology and Special Education Enrollment in Children with Prenatal Cocaine Exposure

    PubMed Central

    Levine, Todd P.; Lester, Barry; Lagasse, Linda; Shankaran, Seetha; Bada, Henrietta S.; Bauer, Charles R.; Whitaker, Toni M.; Higgins, Rosemary; Hammond, Jane; Roberts, Mary B.

    2012-01-01

    Objective This study evaluated how enrollment in special education services in 11 year old children relates to prenatal cocaine exposure, psychopathology, and other risk factors. Method Participants were 498 children enrolled in The Maternal Lifestyle Study, a prospective, longitudinal, multisite study examining outcomes of children with prenatal cocaine exposure. Logistic regression was used to examine the effect of prenatal cocaine exposure and psychopathology on enrollment in an individualized education plan (a designation specific to children with special education needs), with environmental, maternal, and infant medical variables as covariates. Results Prenatal cocaine exposure, an interaction of prenatal cocaine exposure and Oppositional Defiant Disorder, child Attention Deficit Hyperactivity Disorder, parent-reported internalizing behaviors, and teacher-reported externalizing behaviors, predicted enrollment in an individualized education plan. Other statistically significant variables in the model were male gender, low birth weight, being small for gestational age, white race, caregiver change, low socio-economic status, low child intelligence quotient, caregiver depression, and prenatal marijuana exposure. Conclusions Prenatal cocaine exposure increased the likelihood of receiving an individualized education plan with adjustment for covariates. Psychopathology also predicted this special education outcome, in combination with and independent of prenatal cocaine exposure. PMID:22487696

  20. [Pre- and perinatal risk factors in autism spectrum disorder and attention deficit/hyperactivity disorder].

    PubMed

    Schmitz, Johanna C; Cholemkery, Hannah; Medda, Juliane; Freitag, Christine M

    2017-01-01

    Epidemiological studies indicate the relevance of pre- and perinatal risk factors for the genesis of attention deficit/hyperactivity disorder and autism spectrum disorder. This study compares potential risk factors in a clinical sample of children with ADHD, ASD, the combination of both diseases, ADHD and oppositional defiant or conduct disorder (ADHD & ODD/CD) and examined whether the existence of additional risk factors promotes the occurrence of combined diseases. We compared the pre- and perinatal risk factors of 341 patients (299 boys, 42 girls) from a clinical population, differentiating between children with ADHD (n=80), ASD (n=122), ADHD & ASD (n=55), or ADHD & ODD/CD (n=84). We observed a higher rate of maternal smoking, a higher rate of migration, and lower parental education among the children with ADHD & ODD/CD compared to those with ASD or ADHD. The rate of migration background was higher among the children with ASD compared to children with ADHD. Miscarriage was a specific risk factor for ADHD & ASD. Numerous risk factors described in epidemiological studies occurred only rarely in our clinical sample. The distribution of most risk factors was comparable between the examined diseases.

  1. Writing abilities longitudinally predict academic outcomes of adolescents with ADHD.

    PubMed

    Molitor, Stephen J; Langberg, Joshua M; Bourchtein, Elizaveta; Eddy, Laura D; Dvorsky, Melissa R; Evans, Steven W

    2016-09-01

    Students with attention-deficit/hyperactivity disorder (ADHD) often experience a host of negative academic outcomes, and deficits in reading and mathematics abilities contribute to these academic impairments. Students with ADHD may also have difficulties with written expression, but there has been minimal research in this area and it is not clear whether written expression abilities uniquely contribute to the academic functioning of students with ADHD. The current study included a sample of 104 middle school students diagnosed with ADHD (Grades 6-8). Participants were followed longitudinally to evaluate whether written expression abilities at baseline predicted student grade point average (GPA) and parent ratings of academic impairment 18 months later, after controlling for reading ability and additional relevant covariates. Written expression abilities longitudinally predicted both academic outcomes above and beyond ADHD and oppositional defiant disorder symptoms, medication use, reading ability, and baseline values of GPA and parent-rated academic impairment. Follow-up analyses revealed that no single aspect of written expression was demonstrably more impactful on academic outcomes than the others, suggesting that writing as an entire process should be the focus of intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. A comparative study of axis I antecedents before age 18 of unipolar depression, bipolar disorder and schizophrenia.

    PubMed

    Rubino, I Alex; Frank, Ellen; Croce Nanni, Roberta; Pozzi, Daniela; Lanza di Scalea, Teresa; Siracusano, Alberto

    2009-01-01

    Despite a large scientific literature on early clinical precursors of schizophrenia, bipolar disorder and unipolar depression, few data are available on axis I disorders preceding the adult onset of these illnesses. Disorders before the age of 18 years were retrospectively assessed with a structured interview in 3 groups of consecutive adult inpatients with DSM-IV diagnoses of schizophrenia (n = 197), major depressive disorder (n = 287) and bipolar disorder (n = 132). Only patients with adult onset of schizophrenia and of mania/hypomania were included. A sample of the general population served as control group (n = 300). The clinical groups significantly outnumbered the control sample on the majority of early axis I diagnoses. Schizophrenia was significantly associated (1) with attention deficit hyperactivity disorder (ADHD), ADHD inattentive subtype, ADHD hyperactive subtype and primary nocturnal enuresis, compared to unipolar depression, and (2) with social phobia and ADHD inattentive subtype, compared to bipolar disorder. Oppositional defiant disorder was significantly associated with bipolar disorder, compared to the other clinical and control groups. The ADHD hyperactive subtype predicted the adult onset of bipolar disorder compared to unipolar depression. Externalizing disorders seem of special importance as regards the clinical pathways toward schizophrenia.

  3. Dopamine D2 receptor gene polymorphisms and externalizing behaviors in children and adolescents.

    PubMed

    Della Torre, Osmar Henrique; Paes, Lúcia Arisaka; Henriques, Taciane Barbosa; de Mello, Maricilda Palandi; Celeri, Eloisa Helena Rubello Valler; Dalgalarrondo, Paulo; Guerra-Júnior, Gil; Santos-Júnior, Amilton Dos

    2018-05-02

    Dopamine is involved in several cerebral physiological processes, and single nucleotide polymorphisms (SNP) in the dopamine D2 receptor gene (DRD2) have been associated with numerous neurological and mental disorders, including those involving alterations in cognitive and emotional processes. The aim of this study was to evaluate the association between the SNPs c.957C > T (rs6277) and c.-585A > G (rs1799978) in the DRD2 gene and behavioral characteristics of children and adolescents based on an inventory of the Child Behavior Checklist (CBCL). Children and adolescents between 8 and 20 years old who were clinically followed-up were genotyped for the SNPs c.957C > T and c.-585A > G, and related to data of the CBCL/6-18 scale assessment performed with the help of caregivers. The chi-squared test was used to assess the differences in the frequencies of the C and T alleles in the polymorphism c.957C > T and of the A and G alleles in the polymorphism c.-585A > G with respect to the grouped CBCL scores at a significance level of 5%. Multiple logistic regression models were performed, to control whether sex and/or ethnicity could influence the results. Eighty-five patients were assessed overall, and the presence of the T allele (C/T and T/T) of DRD2 c.957C > T polymorphism was found to be significantly associated with the occurrence of defiant and oppositional problems and with attention and hyperactivity problems. There were no associations detected with polymorphism DRD2 c.-585A > G polymorphism. Both SNPs were in Hardy-Weinberg-equilibrium. Although the findings of this study are preliminary, due to its small number of participants, the presence of T allele (C/T, T/T) in c.957C > T SNP was associated with difficulty in impulse control, self-control of emotions, and conduct adjustment, which can contribute to improving the identification of mental and behavioral phenotypes associated with gene expression.

  4. Coercive family process and early-onset conduct problems from age 2 to school entry.

    PubMed

    Smith, Justin D; Dishion, Thomas J; Shaw, Daniel S; Wilson, Melvin N; Winter, Charlotte C; Patterson, Gerald R

    2014-11-01

    The emergence and persistence of conduct problems (CPs) during early childhood is a robust predictor of behavior problems in school and of future maladaptation. In this study we examined the reciprocal influences between observed coercive interactions between children and caregivers, oppositional and aggressive behavior, and growth in parent report of early childhood (ages 2-5) and school-age CPs (ages 7.5 and 8.5). Participants were drawn from the Early Steps multisite randomized prevention trial that includes an ethnically diverse sample of male and female children and their families (N = 731). A parallel-process growth model combining latent trajectory and cross-lagged approaches revealed the amplifying effect of observed coercive caregiver-child interactions on children's noncompliance, whereas child oppositional and aggressive behaviors did not consistently predict increased coercion. The slope and initial levels of child oppositional and aggressive behaviors and the stability of caregiver-child coercion were predictive of teacher-reported oppositional behavior at school age. Families assigned to the Family Check-Up condition had significantly steeper declines in child oppositional and aggressive behavior and moderate reductions in oppositional behavior in school and in coercion at age 3. Results were not moderated by child gender, race/ethnicity, or assignment to the intervention condition. The implications of these findings are discussed with respect to understanding the early development of CPs and to designing optimal strategies for reducing problem behavior in early childhood with families most in need.

  5. Parenting Practices and Child Disruptive Behavior Problems in Early Elementary School

    PubMed Central

    Stormshak, Elizabeth A.; Bierman, Karen L.; McMahon, Robert J.; Lengua, Liliana J.

    2009-01-01

    Examined the hypothesis that distinct parenting practices may be associated with type and profile of a child’s disruptive behavior problems (e.g., oppositional, aggressive, hyperactive). Parents of 631 behaviorally disruptive children described the extent to which they experienced warm and involved interactions with their children and the extent to which their discipline strategies were inconsistent and punitive and involved spanking and physical aggression. As expected from a developmental perspective, parenting practices that included punitive interactions were associated with elevated rates of all child disruptive behavior problems. Low levels of warm involvement were particularly characteristic of parents of children who showed elevated levels of oppositional behaviors. Physically aggressive parenting was linked more specifically with child aggression. In general, parenting practices contributed more to the prediction of oppositional and aggressive behavior problems than to hyperactive behavior problems, and parenting influences were fairly consistent across ethnic groups and sex. PMID:10693029

  6. [Discipline styles and co-morbid disorders of adolescents with attention deficit hyperactivity disorder: a longitudinal study].

    PubMed

    Colomer-Diago, Carla; Berenguer-Forner, Carmen; Tárraga-Mínguez, Raúl; Miranda-Casas, Ana

    2014-02-24

    Problems in cognitive functioning, social and educational development of children with attention deficit hyperactivity disorder (ADHD) continue to be present in adolescence and adulthood. Although the literature shows a significant relationship between the use of dysfunctional discipline methods and severity in the course of ADHD, follow-up studies have been rare. To analyze parenting style and ADHD symptomatology assessed in childhood (time 1) to predict the oppositional behavior and cognitive problems in early adolescence (time 2), and to study, depending on the use of dysfunctional parenting style, the course of oppositional behavior and cognitive problems. Forty-five children with ADHD-combined presentation were assessed in two different moments: time 1 (ages: 6-13) and time 2 (ages: 8-16). Oppositionism and cognitive problems in the follow-up were predicted by dysfunctional discipline styles and ADHD severity (assessed in time 1). Oppositional behavior increased between time 1 and time 2 in children with a dysfunctional parenting, whereas a decrease on oppositional symptoms was observed in the functional parenting group (time x discipline interaction effect). Dysfunctional parenting practices in childhood predicted cognitive and behavioral problems associated in adolescence. The findings have implications for the planning of interventions.

  7. The effect of omega-3 polyunsaturated fatty acid supplementation on emotional dysregulation, oppositional behaviour and conduct problems in ADHD: A systematic review and meta-analysis.

    PubMed

    Cooper, Ruth E; Tye, Charlotte; Kuntsi, Jonna; Vassos, Evangelos; Asherson, Philip

    2016-01-15

    A number of randomised controlled trials report a beneficial effect of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on emotional lability (EL) and related domains (e.g. oppositional behaviour, conduct problems). Given that n-3 PUFA supplementation shows a significant effect on reducing symptoms of attention-deficit/hyperactivity disorder (ADHD) and that EL and related behaviours commonly co-occurs with ADHD, it is important that there is a more conclusive picture as to the effect of n-3 PUFA on these co-occurring clinical domains. Databases (Ovid Medline, Embase, Psychinfo) were searched for trials assessing the effects of n-3 PUFA on EL, oppositional behaviour, aggression and conduct problems. We included trials in children who had ADHD or a related neurodevelopmental disorder. Of the 1775 identified studies, 10 were included in the meta-analysis. In the primary analyses n-3 PUFA supplementation did not show improvements in measures of EL, oppositional behaviour, conduct problems or aggression. However subgroup analyses of higher quality studies and those meeting strict inclusion criteria found a significant reduction in EL and oppositional behaviour. A number of treatment effects may have failed to reach statistical significance due to small sample sizes and within and between study heterogeneity in terms of design and study participants. These results exclude the possibility of moderate to large effects. They provide suggestive evidence of small effects of n-3 PUFA on reducing EL and oppositional behaviour in subgroups of children with ADHD. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. A case-control study of the difficulties in daily functioning experienced by children with depressive disorder.

    PubMed

    Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Ushijima, Hirokage; Kodaira, Masaki; Okada, Takashi; Sasayama, Daimei; Sugiyama, Nobuhiro; Saito, Kazuhiko

    2015-07-01

    The parent-assessed children-with-difficulties questionnaire (Questionnaire-Children with Difficulties; QCD) is designed to evaluate a child׳s difficulties in functioning during specific periods of the day. This study aimed to use the QCD to evaluate the difficulties in daily functioning experienced by children with depressive disorders. A case-control design was used. The cases comprised 90 junior high school students with depressive disorder, whereas a community sample of 363 junior high school students was enrolled as controls. Behaviors were assessed using the QCD, Depression Self-Rating Scale (DSRS), Tokyo Autistic Behavior Scale (TABS), attention deficit hyperactivity disorder-rating scale (ADHD-RS), and Oppositional Defiant Behavior Inventory (ODBI). We then analyzed the effects of sex and diagnosis on the QCD scores as well as the correlation coefficients between the QCD and the other questionnaires. We included 90 cases (33 boys, 57 girls) with depressive disorders and 363 controls (180 boys, 183 girls). The QCD scores for the children with depressive disorders were significantly lower compared with those from the community sample (P<0.001). The morning, school-time, and night subscores of the QCD were lower for the children with both depressive disorders and truancy problems than for those with depressive disorders alone (P<0.001). Significant correlations were observed between the following: the night QCD subscore and the DSRS scores among boys, the morning QCD subscore and ADHD-RS inattention scores for all groups, and the evening QCD subscore and the TABS score. Parents reported that children with depressive disorders experienced greater difficulties in completing basic daily activities compared with community controls. These difficulties were dependent on sex, symptoms, and the time of day. The use of QCD to assess children with depressive disorders enables clinicians to clarify the time periods at which the children face difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Latent Class Symptom Profiles of Selective Mutism: Identification and Linkage to Temperamental and Social Constructs.

    PubMed

    Diliberto, Rachele; Kearney, Christopher A

    2017-11-21

    Selective mutism (SM) is a stable, debilitating psychiatric disorder in which a child fails to speak in most public situations. Considerable debate exists as to the typology of this population, with empirically-based studies pointing to possible dimensions of anxiety, oppositionality, and communication problems, among other aspects. Little work has juxtaposed identified symptom profiles with key temperamental and social constructs often implicated in SM. The present study examined a large, diverse, non-clinical, international sample of children aged 6-10 years with SM to empirically identify symptom profiles and to link these profiles to key aspects of temperament (i.e., emotionality, shyness, sociability, activity) and social functioning (i.e., social problems, social competence). Exploratory and confirmatory factor analysis revealed anxiety/distress, oppositionality, and inattention domains. In addition, latent class analysis revealed nuanced profiles labeled as (1) moderately anxious, oppositional, and inattentive, (2) highly anxious, and moderately oppositional and inattentive, and (3) mildly to moderately anxious, and mildly oppositional and inattentive. Class 2 was the most impaired group and was associated with greater emotionality, shyness, and social problems. Class 3 was the least impaired group and was associated with better sociability and social competence and activity. Class 1 was largely between the other classes, demonstrating less shyness and social problems than Class 2. The results help confirm previous findings of anxiety and oppositional profiles among children with SM but that nuanced classes may indicate subtle variations in impairment. The results have implications not only for subtyping this population but also for refining assessment and case conceptualization strategies and pursuing personalized and perhaps less lengthy treatment.

  10. Effective one-dimensional approach to the source reconstruction problem of three-dimensional inverse optoacoustics

    NASA Astrophysics Data System (ADS)

    Stritzel, J.; Melchert, O.; Wollweber, M.; Roth, B.

    2017-09-01

    The direct problem of optoacoustic signal generation in biological media consists of solving an inhomogeneous three-dimensional (3D) wave equation for an initial acoustic stress profile. In contrast, the more defiant inverse problem requires the reconstruction of the initial stress profile from a proper set of observed signals. In this article, we consider an effectively 1D approach, based on the assumption of a Gaussian transverse irradiation source profile and plane acoustic waves, in which the effects of acoustic diffraction are described in terms of a linear integral equation. The respective inverse problem along the beam axis can be cast into a Volterra integral equation of the second kind for which we explore here efficient numerical schemes in order to reconstruct initial stress profiles from observed signals, constituting a methodical progress of computational aspects of optoacoustics. In this regard, we explore the validity as well as the limits of the inversion scheme via numerical experiments, with parameters geared toward actual optoacoustic problem instances. The considered inversion input consists of synthetic data, obtained in terms of the effectively 1D approach, and, more generally, a solution of the 3D optoacoustic wave equation. Finally, we also analyze the effect of noise and different detector-to-sample distances on the optoacoustic signal and the reconstructed pressure profiles.

  11. Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children.

    PubMed

    Chacko, A; Bedard, A-C V; Marks, D; Gopalan, G; Feirsen, N; Uderman, J; Chimiklis, A; Heber, E; Cornwell, M; Anderson, L; Zwilling, A; Ramon, M

    2018-05-01

    The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent-child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study's limitations, and future directions for research are further discussed.

  12. Preschool Neuropsychological Measures as Predictors of Later Attention Deficit Hyperactivity Disorder

    PubMed Central

    Breaux, Rosanna P.; Griffith, Shayl F.; Harvey, Elizabeth A.

    2016-01-01

    The present study examined preschool neuropsychological measures as predictors of school-age attention deficit hyperactivity disorder (ADHD). Participants included 168 children (91 males) who completed neuropsychological measures at ages 3 and 4, and who were evaluated for ADHD and oppositional defiant disorder at age 6. The Conners’ Kiddie Continuous Performance Test (K-CPT), NEPSY Statue subtest, and a delay aversion task significantly distinguished at-risk children who later did and did not meet criteria for ADHD, with poor to fair overall predictive power, specificity, and sensitivity. However, only the K-CPT ADHD Confidence Index and battery added incremental predictive validity beyond early ADHD symptoms. This battery approach, which required impairment on at least 2 of the 3 significant measures, yielded fair overall predictive power, specificity, and sensitivity, and correctly classified 67% of children. In addition, there was some support for the specificity hypothesis, with evidence that cool executive function measures (K-CPT and Statue subtest) tended to predict inattentive symptoms. These findings suggest that neuropsychological deficits are evident by preschool-age in children with ADHD, but neuropsychological tests may still misclassify approximately one-third of children if used alone. Thus, neuropsychological measures may be a useful component of early ADHD assessments, but should be used with caution and in combination with other assessment methods. PMID:26936037

  13. Psychopharmacology of aggression in children and adolescents with primary neuropsychiatric disorders: a review of current and potentially promising treatment options.

    PubMed

    Nevels, Robert M; Dehon, Erin E; Alexander, Katrina; Gontkovsky, Samuel T

    2010-04-01

    Research examining the role of pharmacological therapy in the treatment of children and adolescents with clinical disorders is growing. Clinical disorders that present with comorbid aggression can add a challenge to treatment. Child and adolescent neuropsychiatric disorders associated with aggression include attention-deficit hyperactivity disorder, various mood disorders and in particular bipolar disorders/pediatric mania, schizophrenia, mental retardation, oppositional defiant disorder, conduct disorder, and autism spectrum disorders. This review describes the psychopharmacy to treat these disorders and the aggression that often appears comorbidly. Existing literature regarding the efficacy and safety of psychotropics for youth with neuropsychiatric disorders also is discussed. In addition, general guidelines for psychopharmacy of aggression in children and adolescents are presented. Studies reviewed in this article provide evidence for the use of psychostimulants, alpha-2 agonists, beta blockers, lithium, anticonvulsant mood-stabilizers, atypical antipsychotics, traditional antipsychotics, and selective serotonin reuptake inhibitors in treating pediatric aggression with the choice of medication dependent on symptomology. Despite increased support for pediatric psychotropic use, there is a need for more long-term safety and efficacy studies of existing medications and newer, safer, and more effective agents with fewer side effects for the pharmacological treatment of all childhood disorders in which aggression is prominent. 2010 APA, all rights reserved

  14. Psychopathology, trauma and delinquency: subtypes of aggression and their relevance for understanding young offenders.

    PubMed

    Steiner, Hans; Silverman, Melissa; Karnik, Niranjan S; Huemer, Julia; Plattner, Belinda; Clark, Christina E; Blair, James R; Haapanen, Rudy

    2011-06-29

    To examine the implications of an ontology of aggressive behavior which divides aggression into reactive, affective, defensive, impulsive (RADI) or "emotionally hot"; and planned, instrumental, predatory (PIP) or "emotionally cold." Recent epidemiological, criminological, clinical and neuroscience studies converge to support a connection between emotional and trauma related psychopathology and disturbances in the emotions, self-regulation and aggressive behavior which has important implications for diagnosis and treatment, especially for delinquent populations. Selective review of preclinical and clinical studies in normal, clinical and delinquent populations. In delinquent populations we observe an increase in psychopathology, and especially trauma related psychopathology which impacts emotions and self-regulation in a manner that hotly emotionally charged acts of aggression become more likely. The identification of these disturbances can be supported by findings in cognitive neuroscience. These hot aggressive acts can be delineated from planned or emotionally cold aggression. Our findings support a typology of diagnostic labels for disruptive behaviors, such as conduct disorder and oppositional defiant disorder, as it appears that these acts of hot emotional aggression are a legitimate target for psychopharmacological and other trauma specific interventions. The identification of this subtype of disruptive behavior disorders leads to more specific clinical interventions which in turn promise to improve hitherto unimpressive treatment outcomes of delinquents and patients with disruptive behavior.

  15. The adoption and implementation of an evidence based practice in child and family mental health services organizations: a pilot study of functional family therapy in New York State.

    PubMed

    Zazzali, James L; Sherbourne, Cathy; Hoagwood, Kimberly Eaton; Greene, Deborah; Bigley, Michael F; Sexton, Thomas L

    2008-03-01

    Numerous challenges persist in providing evidence-based treatments to children and families in community-based settings. Functional Family Therapy (FFT), one such evidence-based treatment, is a family prevention and intervention program for adolescents with conduct disorder or oppositional defiant disorder. This paper presents pilot data in support of a conceptual framework explaining the adoption and implementation of FFT in a small sample of family and child mental health services organizations in New York State. The conceptual framework is grounded in the diffusion of innovations and the organizational behavior literatures, as well as previously published accounts of the adoption and implementation of evidence-based treatments in mental health. Pilot study data demonstrated that factors associated with the adoption of FFT included: The program fitting with the mission of the organization, as well as the organization having a strong interest in evidence-based treatments. Once a decision to adopt FFT was made, the degree to which it fit with organizational characteristics (e.g., available resource sets, organizational structure, and culture) influenced the ease with which it was implemented. Implications for the adoption and implementation of other evidence-based treatments are discussed.

  16. Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children

    PubMed Central

    Ni, Hsing-Chang; Liang, Sophie Hsin-Yi; Lin, Hsiang-Yuan; Lin, Chiao-Fan; Tseng, Yu-Han

    2017-01-01

    Parent and teacher ratings of child behaviors are often discrepant, and these discrepancies may be correlated with parenting stress. The present study explored whether various parenting stress factors are associated with discrepancies between parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) as well as internalizing symptoms in preschool children. We recruited 299 Taiwanese preschool children (aged 4–6 years) from the community or via clinical referrals. A structural equation modeling was used to analyze the relationships among three factors derived from the Parenting Stress Index-Short Form and informant discrepancies on symptoms of inattention, hyperactivity/impulsivity, ODD, and internalizing behaviors. Scores reported by parents were higher for each of the symptoms examined than those reported by teachers, and the degree of agreement between informants ranged from low to moderate. The parental distress factor of parenting stress was associated only with parent ratings, whereas other factors of parenting stress—parent-child dysfunctional interaction and parents’ stress resulted from their child’s temperament—were correlated with both parent and teacher ratings. Only parental distress factor predicted informant discrepancies for all behavioral symptoms assessed. Our findings suggest that parental distress should be considered when parent rating scores show significant discrepancies from that of teacher rating scores. PMID:29016602

  17. Cognitive behavioral treatment outcomes in adolescent ADHD.

    PubMed

    Antshel, Kevin M; Faraone, Stephen V; Gordon, Michael

    2014-08-01

    To assess the efficacy of cognitive behavioral therapy (CBT) for managing adolescent ADHD. A total of 68 adolescents with ADHD and associated psychiatric comorbidities completed a manualized CBT treatment protocol. The intervention used in the study was a downward extension of the Safren et al. program for adults with ADHD who have symptoms unresolved by medication. Outcome variables consisted of narrow band (ADHD) and broadband (e.g., mood, anxiety, conduct) symptom measures (Behavior Assessment System for Children-2nd edition and ADHD-Rating Scales) as well as functioning measures (parent/teacher ratings and several ecologically real-world measures). Treatment effects emerged on the medication dosage, parent rating of pharmacotherapy adherence, adolescent self-report of personal adjustment (e.g., self-esteem), parent and teacher ratings of inattentive symptoms, school attendance, school tardiness, parent report of peer, family and academic functioning and teacher report of adolescent relationship with teacher, academic progress, and adolescent self-esteem. Adolescents with ADHD with oppositional defiant disorder were rated by parents and teachers as benefiting less from the CBT intervention. Adolescents with ADHD and comorbid anxiety/depression were rated by parents and teachers as benefiting more from the CBT intervention. A downward extension of an empirically validated adult ADHD CBT protocol can benefit some adolescents with ADHD. © 2012 SAGE Publications.

  18. Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness.

    PubMed

    Battagliese, Gemma; Caccetta, Maria; Luppino, Olga Ines; Baglioni, Chiara; Cardi, Valentina; Mancini, Francesco; Buonanno, Carlo

    2015-12-01

    Externalizing disorders are the most common and persistent forms of maladjustment in childhood. The aim of this study was to conduct a meta-analysis evaluating the effectiveness of Cognitive Behavioral Therapy (CBT) to reduce externalizing symptoms in two disorders: Attention Deficit Hyperactivity Disorder (ADHD) and Oppositive Defiant Disorder (ODD). The efficacy of CBT to improve social competence and positive parenting and reduce internalizing behaviors, parent stress and maternal depression was also explored. The database PsycInfo, PsycARTICLES, Medline and PubMed were searched to identify relevant studies. Twenty-one trials met the inclusion criteria. Results showed that the biggest improvement, after CBT, was in ODD symptoms (-0.879) followed by parental stress (-0.607), externalizing symptoms (-0.52), parenting skills (-0.381), social competence (-0.390) and ADHD symptoms (-0.343). CBT was also associated with improved attention (-0.378), aggressive behaviors (-0.284), internalizing symptoms (-0.272) and maternal depressive symptoms (-0.231). Overall, CBT is an effective treatment option for externalizing disorders and is also associated with reduced parental distress and maternal depressive symptoms. Multimodal treatments targeting both children and caregivers' symptoms (e.g. maternal depressive symptoms) appear important to produce sustained and generalized benefits. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. [Attention deficit hyperactivity disorder and its relation to social skills and leadership evaluated with an evaluation system of the behavior of children and adolescents (BASC)].

    PubMed

    Fernández-Jaén, Alberto; Fernández-Mayoralas, Daniel M; López-Arribas, Sonia; García-Savaté, Carolina; Muñiz-Borrega, Blanca; Pardos-Véglia, Alexandra; Prados-Parra, Baldomero; Calleja-Pérez, Beatriz; Muñoz-Jareño, Nuria

    2011-01-01

    Numerous studies have documented that children with attention deficit hyperactivity disorder (ADHD) show a low social competence. To compare the symptomatic severity of ADHD, as well as associations to different subtypes, sex and comorbidities, with social functioning ("ability" and "leadership") estimated through a Behavior Assessment System for Children (BASC) for parents and teachers. We have retrospectively analyzed 170 patients with ADHD, diagnosed between 2007 and 2010. Social "ability," "leadership," "hyperactivity" and "attention deficit" sections of BASC and cardinal symptoms of ADHD measured through a Spanish scale for de evaluation of DHD (E-DHD) were registered. Results of these variables are analyzed according to the normative data by age and sex, and processed in Z values. The ratings for social skills were significantly lower in patients with conduct disorder or oppositional defiant disorder as informed by parents (p<0.05). Symptomatic intensity of ADHD showed significant (p<0,001) and inverse relation with social "ability" as parents. "Attention-deficit" scores were related with social "ability" and "leadership" as parents and teachers. Intensity of attention deficit was the only variable that showed a significant relation with the social skills and leadership according to the BASC scores, independently of the informer.

  20. Disruptive behaviour disorders: a systematic review of environmental antenatal and early years risk factors.

    PubMed

    Latimer, K; Wilson, P; Kemp, J; Thompson, L; Sim, F; Gillberg, C; Puckering, C; Minnis, H

    2012-09-01

    Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables. © 2012 Blackwell Publishing Ltd.

  1. The impact of reinforcement contingencies on AD/HD: a review and theoretical appraisal.

    PubMed

    Luman, Marjolein; Oosterlaan, Jaap; Sergeant, Joseph A

    2005-02-01

    One of the core deficits in attention deficit/hyperactivity disorder (AD/HD) is thought to be an aberrant sensitivity to reinforcement, such as reward and response cost. Twenty-two studies (N=1181 children) employing AD/HD and reinforcement contingencies are reviewed from vantage points: task performance, motivation, and psychophysiology. Results indicate that reinforcement contingencies have a positive impact on task performance and levels of motivation for both children with AD/HD and normal controls. There is evidence that the effect related to task performance is somewhat more prominent in AD/HD. There is some evidence that a high intensity of reinforcement is highly effective in AD/HD. Children with AD/HD prefer immediate over delayed reward. From a psychophysiological point of view, children with AD/HD seem less sensitive to reinforcement compared to controls. While comorbid disorders are suggested to be confounders of the dependent variables, many studies do not examine the effect of oppositional defiant disorder (ODD) and conduct disorder (CD). We discuss the implications of the findings for five theoretical frameworks, including the model by, the cognitive-energetic model (CEM), the dual-pathway model and the BIS/BAS model. Results show a discrepancy between the theoretical models and the behavioural findings.

  2. Children’s Sympathy for Peers Who Are the Targets of Peer Aggression

    PubMed Central

    Leff, Stephen S.

    2014-01-01

    Although a goal of many aggression intervention programs is to increase children’s concern (often termed sympathy or empathy) for their peers as a means of ultimately reducing aggressive behavior, there are no measures specifically of children’s concern for peers who are the targets of peer aggression. A participatory action research (PAR) model was used to create a culturally-sensitive measure of urban African American children’s sympathy for peers who are the targets of physical aggression, relational or social aggression, verbal aggression, and property damage. In Study 1, 40 children (Mage =9.71 years; 47.5 % female) were interviewed about the types of incidents that lead them to feel sympathy for a peer. Based upon these findings, the 15-item Peer Sympathy Scale (PSS) was developed. In Study 2, the PSS was administered to 517 children (Mage=9.82 years; 47.4 % female) to examine the psychometric properties of the measure and to explore the association between children’s sympathy for their peers and their social behavior. Greater sympathy was associated with less overt and relational aggression according to both peer and teacher reports as well as with less oppositional-defiant behavior according to teacher reports. The clinical utility of the PSS as an outcome assessment tool for social skills intervention programs is discussed. PMID:22556114

  3. Cognitive-motivational deficits in ADHD: development of a classification system.

    PubMed

    Gupta, Rashmi; Kar, Bhoomika R; Srinivasan, Narayanan

    2011-01-01

    The classification systems developed so far to detect attention deficit/hyperactivity disorder (ADHD) do not have high sensitivity and specificity. We have developed a classification system based on several neuropsychological tests that measure cognitive-motivational functions that are specifically impaired in ADHD children. A total of 240 (120 ADHD children and 120 healthy controls) children in the age range of 6-9 years and 32 Oppositional Defiant Disorder (ODD) children (aged 9 years) participated in the study. Stop-Signal, Task-Switching, Attentional Network, and Choice Delay tests were administered to all the participants. Receiver operating characteristic (ROC) analysis indicated that percentage choice of long-delay reward best classified the ADHD children from healthy controls. Single parameters were not helpful in making a differential classification of ADHD with ODD. Multinominal logistic regression (MLR) was performed with multiple parameters (data fusion) that produced improved overall classification accuracy. A combination of stop-signal reaction time, posterror-slowing, mean delay, switch cost, and percentage choice of long-delay reward produced an overall classification accuracy of 97.8%; with internal validation, the overall accuracy was 92.2%. Combining parameters from different tests of control functions not only enabled us to accurately classify ADHD children from healthy controls but also in making a differential classification with ODD. These results have implications for the theories of ADHD.

  4. Friends with benefits: the evolved psychology of same- and opposite-sex friendship.

    PubMed

    Lewis, David M G; Conroy-Beam, Daniel; Al-Shawaf, Laith; Raja, Annia; DeKay, Todd; Buss, David M

    2011-12-08

    During human evolution, men and women faced distinct adaptive problems, including pregnancy, hunting, childcare, and warfare. Due to these sex-linked adaptive problems, natural selection would have favored psychological mechanisms that oriented men and women toward forming friendships with individuals possessing characteristics valuable for solving these problems. The current study explored sex-differentiated friend preferences and the psychological design features of same- and opposite-sex friendship in two tasks. In Task 1, participants (N = 121) categorized their same-sex friends (SSFs) and opposite-sex friends (OSFs) according to the functions these friends serve in their lives. In Task 2, participants designed their ideal SSFs and OSFs using limited budgets that forced them to make trade-offs between the characteristics they desire in their friends. In Task 1, men, more than women, reported maintaining SSFs for functions related to athleticism and status enhancement and OSFs for mating opportunities. In Task 2, both sexes prioritized agreeableness and dependability in their ideal SSFs, but men prioritized physical attractiveness in their OSFs, whereas women prioritized economic resources and physical prowess. These findings suggest that friend preferences may have evolved to solve ancestrally sex-linked adaptive problems, and that opposite-sex friendship may directly or indirectly serve mating functions.

  5. Differential associations of early callous-unemotional, oppositional, and ADHD behaviors: multiple domains within early-starting conduct problems?

    PubMed

    Waller, Rebecca; Hyde, Luke W; Grabell, Adam S; Alves, Martha L; Olson, Sheryl L

    2015-06-01

    Early-starting child conduct problems (CP) are linked to the development of persistent antisocial behavior. Researchers have theorized multiple pathways to CP and that CP comprise separable domains, marked by callous-unemotional (CU) behavior, oppositional behavior, or ADHD symptoms. However, a lack of empirical evidence exists from studies that have examined whether there are unique correlates of these domains. We examined differential correlates of CU, oppositional, and ADHD behaviors during the preschool years to test their potentially distinct nomological networks. Multimethod data, including parent and teacher reports and observations of child behavior, were drawn from a prospective, longitudinal study of children assessed at age 3 and age 6 (N = 240; 48% female). Dimensions of CU, oppositional, and ADHD behaviors were separable within Confirmatory Factor Analyses across mother and father reports. There were differential associations between CU, oppositional, and ADHD behaviors and socioemotional, cognitive, and behavioral outcomes: CU behavior was uniquely related to lower moral regulation, guilt, and empathy. ADHD was uniquely related to lower attentional focusing and observed effortful control. Finally, CU behavior uniquely predicted increases in teacher-reported externalizing from ages 3-6 over and above covariates, and ADHD and oppositional behavior. Consistent with theory, dimensions of CU, ADHD, and oppositional behavior demonstrated separable nomological networks representing separable facets within early-starting CP. © 2014 Association for Child and Adolescent Mental Health.

  6. Mental health problems in male young offenders in custodial versus community based-programs: implications for juvenile justice interventions.

    PubMed

    Rijo, Daniel; Brazão, Nélio; Barroso, Ricardo; da Silva, Diana Ribeiro; Vagos, Paula; Vieira, Ana; Lavado, Ana; Macedo, Ana Margarida

    2016-01-01

    Young offenders are known to be a population with high prevalence of mental health disorders. In most cases, these disorders are neither identified nor treated properly, with the majority of them being chronic and difficult to treat. In many countries, the prevalence rates of psychopathology in male young offenders are still unknown and no psychotherapeutic interventions are delivered. Therefore, the main goal of the present study was to assess mental health problems in Portuguese male young offenders placed in either custodial or community-based programs and discuss treatment implications within the juvenile justice interventions. Participants in this study included 217 male young offenders aged between 14 and 20 years old that were randomly selected using a random number table. From the total sample, 122 (56.3 %) participants were placed in juvenile detention facilities, and 95 (43.7 %) were receiving community-based programs. Participants were interviewed with the Mini-International Neuropsychiatric Interview for Children and Adolescents, a structured interview that assesses DSM-IV Axis I Mental Disorders. Participants aged 18 years or older were also assessed with the antisocial personality disorder section from the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Results showed a high prevalence of mental health disorders, with a global prevalence of 91.2 % in the total sample. In both groups, global prevalence rates were equally high (93.4 % in youth in custodial versus 88.4 % in youth in community-based programs). Substance-related disorders were more prevalent in youth placed in juvenile facilities, whereas anxiety and mood disorders were more often found in the community-based group. Moreover, oppositional defiant disorder was more prevalent in youth from the community, whereas antisocial personality disorder and conduct disorder were less prevalent than expected in this same group. A high comorbidity rate was also found, with the majority of participants from both groups' fulfilling criteria for two or more disorders. Additionally, participants with conduct disorder were over four times more likely to fulfill criteria for substance abuse. Our findings inform about specific needs concerning mental health intervention that should be taken into account when deciding and planning rehabilitation programs for male young offenders, either from custodial or community-based programs.

  7. Poverty and behavior problems trajectories from 1.5 to 8 years of age: Is the gap widening between poor and non-poor children?

    PubMed

    Mazza, Julia Rachel S E; Boivin, Michel; Tremblay, Richard E; Michel, Gregory; Salla, Julie; Lambert, Jean; Zunzunegui, Maria Victoria; Côté, Sylvana M

    2016-08-01

    Poverty has been associated with high levels of behavior problems across childhood, yet patterns of associations over time remain understudied. This study aims: (a) to examine whether poverty predicts changes in behavior problems between 1.5 and 8 years of age; (b) to estimate potential selection bias for the observed associations. We used the 1998-2006 waves of the Quebec Longitudinal Study of Child Development (N = 2120). Main outcomes were maternal ratings of hyperactivity, opposition and physical aggression from 1.5 to 8 years of age. Linear mixed-effects models were used to assess the longitudinal association between poverty and behavior problems. Models were re-estimated adjusting for wave nonresponse and using multiple imputation to account for attrition. Poverty predicted higher levels of behavior problems between 1.5 and 8 years of age. Poverty predicted hyperactivity and opposition in a time dependent manner. Hyperactivity [Bpoverty*age = 0.052; CI 95 % (0.002; 0.101)] and opposition [Bpoverty*age = 0.049; CI 95 % (0.018; 0.079)] increased at a faster rate up to age 5 years, and then decreased at a slower rate for poor than non-poor children. Physical aggression decreased at a steady rate over time for all children [Bpoverty*age = -0.030; p = 0.064). Estimates remained similar when accounting for attrition. Poverty predicted higher levels of behavior problems between 1.5 and 8 years of age. The difference between poor and non-poor children was stable over time for physical aggression, but increased with age for hyperactivity and opposition. Attrition among poor children did not compromise the validity of results.

  8. Childhood Trajectories of Inattention, Hyperactivity and Oppositional Behaviors and Prediction of Substance Abuse/Dependence: A 15-Year Longitudinal Population-Based Study

    PubMed Central

    Pingault, Jean-Baptiste; Côté, Sylvana M.; Galéra, Cédric; Genolini, Christophe; Falissard, Bruno; Vitaro, Frank; Tremblay, Richard E.

    2014-01-01

    Numerous prospective studies have shown that children diagnosed with ADHD are at higher risk of long-term substance abuse/dependence. However, there are two important limits to these studies: a) most did not differentiate the role of hyperactivity and inattention; b) most did not control for associated behavioral problems; c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1804 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1 % for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (OR: 2.25; 95% CI: 1.63–3.11) and opposition (OR: 1.65; 95%: 1.20–2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40–3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06–8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98–1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained a key predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature. PMID:22733124

  9. Childhood trajectories of inattention, hyperactivity and oppositional behaviors and prediction of substance abuse/dependence: a 15-year longitudinal population-based study.

    PubMed

    Pingault, J-B; Côté, S M; Galéra, C; Genolini, C; Falissard, B; Vitaro, F; Tremblay, R E

    2013-07-01

    Numerous prospective studies have shown that children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at higher risk of long-term substance abuse/dependence. However, there are three important limits to these studies: (a) most did not differentiate the role of hyperactivity and inattention; (b) most did not control for associated behavioral problems; and (c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1803 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1% for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (odds ratio (OR): 2.25; 95% confidence interval (CI): 1.63-3.11) and opposition (OR: 1.65; 95%: 1.20-2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40-3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06-8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98-1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained an important predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature.

  10. What Type of Communication during Conflict is Beneficial for Intimate Relationships?

    PubMed Central

    Overall, Nickola C.; McNulty, James K.

    2016-01-01

    What constitutes effective communication during conflict? Answering this question requires (a) clarifying whether communication expresses opposition versus cooperation and is direct versus indirect, (b) assessing the mechanisms through which communication effects relationships, and (c) identifying the contextual factors that determine the impact of communication. Recent research incorporating these components illustrates that direct opposition is beneficial when serious problems need to be addressed and partners are able to change, but can be harmful when partners are not confident or secure enough to be responsive. In contrast, cooperative communication involving affection and validation can be harmful when serious problems need to changed, but may be beneficial when problems are minor, cannot be changed, or involve partners whose defensiveness curtails problem solving. PMID:28025652

  11. Treating Depression and Oppositional Behavior in Adolescents

    ERIC Educational Resources Information Center

    Jacobs, Rachel H.; Becker-Weidman, Emily G.; Reinecke, Mark A.; Jordan, Neil; Silva, Susan G.; Rohde, Paul; March, John S.

    2010-01-01

    Adolescents with depression and high levels of oppositionality often are particularly difficult to treat. Few studies, however, have examined treatment outcomes among youth with both externalizing and internalizing problems. This study examines the effect of fluoxetine, cognitive behavior therapy (CBT), the combination of fluoxetine and CBT, and…

  12. An examination of the parent report version of the inventory of callous-unemotional traits in a community sample of first-grade children.

    PubMed

    Willoughby, Michael T; Mills-Koonce, W Roger; Waschbusch, Daniel A; Gottfredson, Nisha C

    2015-02-01

    The Inventory of Callous-Unemotional Traits is a self- and other report questionnaire of callous-unemotional behaviors that is increasingly widely used in research and clinical settings. Nonetheless, questions about the factor structure and validity of scales remain. This study provided the first large-scale (N = 1,078) investigation of the parent report version of the Inventory of Callous-Unemotional Traits in a community sample of school-age (first-grade) children. Confirmatory factor analysis indicated that a two-factor model that distinguished empathic-prosocial (EP) from callous-unemotional (CU) behaviors provided the best fit to the data. EP and CU were moderately to strongly correlated with each other (ϕ = -.67, p < .001) and with oppositional defiant disorder and conduct disorder (ODD/CD) behaviors (ϕODD/CD, EP = -.55; ϕODD/CD, CU = .71, ps < .001). Individual differences in EP and CU behaviors explained unique variation, beyond that attributable to ODD/CD behaviors, in peer-, teacher-, and parent relationship quality. Moreover, whereas EP moderated the effects of ODD/CD in the prediction of student-teacher relationship quality, CU moderated the effects of ODD/CD in the prediction of peer and parent relationship quality. Results are discussed with respect to the use of the ICU with school-age children. © The Author(s) 2014.

  13. The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders.

    PubMed

    Costello, E J; Angold, A; Burns, B J; Stangl, D K; Tweed, D L; Erkanli, A; Worthman, C M

    1996-12-01

    The Great Smoky Mountains Study of youth focuses on the relationship between the development of psychiatric disorder and the need for and use of mental health services. A multistage, overlapping cohorts design was used, in which 4500 of the 11758 children aged 9, 11, and 13 years in an 11-county area of the southeastern United States were randomly selected for screening for psychiatric symptoms. Children who scored in the top 25% on the screening questionnaire, together with a 1 in 10 random sample of the rest, were recruited for 4 waves of intensive, annual interviews (n = 1015 at wave 1). In a parallel study, all American Indian children aged 9, 11, and 13 years were recruited (N = 323 at wave 1). The 3-month prevalence (+/-SE) of any DSM-III-R axis I disorder in the main sample, weighted to reflect population prevalence rates, was 20.3% +/- 1.7%. The most common diagnoses were anxiety disorders (5.7% +/- 1.0%), enuresis (5.1% +/- 1.0%), tic disorders (4.2% +/- 0.9%), conduct disorder (3.3% +/- 0.6%), oppositional defiant disorder (2.7% +/- 0.4%), and hyperactivity (1.9% +/- 0.4%). The prevalence of psychiatric disorder in this rural sample was similar to rates reported in other recent studies. Poverty was the strongest demographic correlate of diagnosis, in both urban and rural children.

  14. Exploratory factor analysis of borderline personality disorder criteria in hospitalized adolescents.

    PubMed

    Becker, Daniel F; McGlashan, Thomas H; Grilo, Carlos M

    2006-01-01

    The authors examined the factor structure of borderline personality disorder (BPD) in hospitalized adolescents and also sought to add to the theoretical and clinical understanding of any homogeneous components by determining whether they may be related to specific forms of Axis I pathology. Subjects were 123 adolescent inpatients, who were reliably assessed with structured diagnostic interviews for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Axes I and II disorders. Exploratory factor analysis identified BPD components, and logistic regression analyses tested whether these components were predictive of specific Axis I disorders. Factor analysis revealed a 4-factor solution that accounted for 67.0% of the variance. Factor 1 ("suicidal threats or gestures" and "emptiness or boredom") predicted depressive disorders and alcohol use disorders. Factor 2 ("affective instability," "uncontrolled anger," and "identity disturbance") predicted anxiety disorders and oppositional defiant disorder. Factor 3 ("unstable relationships" and "abandonment fears") predicted only anxiety disorders. Factor 4 ("impulsiveness" and "identity disturbance") predicted conduct disorder and substance use disorders. Exploratory factor analysis of BPD criteria in adolescent inpatients revealed 4 BPD factors that appear to differ from those reported for similar studies of adults. The factors represent components of self-negation, irritability, poorly modulated relationships, and impulsivity--each of which is associated with characteristic Axis I pathology. These findings shed light on the nature of BPD in adolescents and may also have implications for treatment.

  15. Childhood symptoms of inattention-hyperactivity predict cannabis use in first episode psychosis.

    PubMed

    Cassidy, Clifford M; Joober, Ridha; King, Suzanne; Malla, Ashok K

    2011-11-01

    A history of childhood symptoms of inattention-hyperactivity is often reported in first episode psychosis (FEP) as is cannabis use. In the general population childhood ADHD predicts future cannabis use but the relationship has not been tested in FEP. Parents of patients with a first episode of psychosis (n=75) retrospectively assessed their affected child for symptoms of early-life disorders, namely, attention deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD) using the Child Behaviour Checklist (CBCL). Assessments were made prospectively of cannabis use over two years following a FEP and of SCID diagnosis of cannabis-use disorder. Childhood hyperactivity-inattention symptoms predicted inability to maintain abstinence from cannabis following treatment (Wald=8.4, p=.004) and lifetime cannabis-use diagnosis (Wald=5.3, p=.022) in a logistic regression controlling for relevant covariates including symptoms of CD and ODD from ages 12 to 18. When the symptom of inattention was considered in place of the hyperactivity-inattention syndrome it predicted cannabis-use diagnosis (Wald=6.4, p=.011) and persistent abstinence from cannabis (Wald=5.3, p=.021). Symptoms of CD and ODD did not predict cannabis use when hyperactivity-inattention symptoms were controlled for. Symptoms of childhood inattention-hyperactivity predict subsequent cannabis use in FEP. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Shared genetic and environmental influences on early temperament and preschool psychiatric disorders in Hispanic twins

    PubMed Central

    Silberg, Judy L.; Gillespie, Nathan; Moore, Ashlee A.; Eaves, Lindon J.; Bates, John; Aggen, Steven; Pfister, Elizabeth; Canino, Glorisa

    2015-01-01

    Objective Despite an increasing recognition that psychiatric disorders can be diagnosed as early as preschool, little is known how early genetic and environmental risk factors contribute to the development of psychiatric disorders during this very early period of development. Method We assessed infant temperament at age 1, and attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and separation anxiety disorder (SAD) at ages 3 through 5 years in a sample of Hispanic twins. Genetic, shared, and non-shared environmental effects were estimated for each temperamental construct and psychiatric disorder using the statistical program MX. Multivariate genetic models were fitted to determine whether the same or different sets of genes and environments account for the co-occurrence between early temperament and preschool psychiatric disorders. Results Additive genetic factors accounted for 61% of the variance in ADHD, 21% in ODD, and 28% in SAD. Shared environmental factors accounted for 34% of the variance in ODD and 15% of SAD. The genetic influence on difficult temperament was significantly associated with preschool ADHD, SAD, and ODD. The association between ODD and SAD was due to both genetic and family environmental factors. The temperamental trait of resistance to control was entirely accounted for by the shared family environment. Conclusions There are different genetic and family environmental pathways between infant temperament and psychiatric diagnoses in this sample of Puerto Rican preschool age children. PMID:25728588

  17. Shared genetic and environmental influences on early temperament and preschool psychiatric disorders in Hispanic twins.

    PubMed

    Silberg, Judy L; Gillespie, Nathan; Moore, Ashlee A; Eaves, Lindon J; Bates, John; Aggen, Steven; Pfister, Elizabeth; Canino, Glorisa

    2015-04-01

    Despite an increasing recognition that psychiatric disorders can be diagnosed as early as preschool, little is known how early genetic and environmental risk factors contribute to the development of psychiatric disorders during this very early period of development. We assessed infant temperament at age 1, and attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and separation anxiety disorder (SAD) at ages 3 through 5 years in a sample of Hispanic twins. Genetic, shared, and non-shared environmental effects were estimated for each temperamental construct and psychiatric disorder using the statistical program MX. Multivariate genetic models were fitted to determine whether the same or different sets of genes and environments account for the co-occurrence between early temperament and preschool psychiatric disorders. Additive genetic factors accounted for 61% of the variance in ADHD, 21% in ODD, and 28% in SAD. Shared environmental factors accounted for 34% of the variance in ODD and 15% of SAD. The genetic influence on difficult temperament was significantly associated with preschool ADHD, SAD, and ODD. The association between ODD and SAD was due to both genetic and family environmental factors. The temperamental trait of resistance to control was entirely accounted for by the shared family environment. There are different genetic and family environmental pathways between infant temperament and psychiatric diagnoses in this sample of Puerto Rican preschool age children.

  18. Fear extinction, persistent disruptive behavior and psychopathic traits: fMRI in late adolescence.

    PubMed

    Cohn, Moran D; van Lith, Koen; Kindt, Merel; Pape, Louise E; Doreleijers, Theo A H; van den Brink, Wim; Veltman, Dick J; Popma, Arne

    2016-07-01

    Children diagnosed with a Disruptive Behavior Disorder (DBD, i.e. Oppositional Defiant Disorder or Conduct Disorder), especially those with psychopathic traits, are at risk of developing persistent and severe antisocial behavior. Reduced fear conditioning has been proposed to underlie persistent antisocial development. However, we have recently shown that both DBD persisters and desisters are characterized by increased fear conditioning compared with healthy controls (HCs). In this study, we investigated whether brain function during fear extinction is associated with DBD subgroup-membership and psychopathic traits. Adolescents from a childhood arrestee cohort (mean age 17.6 years, s.d. 1.4) who met criteria for a DBD diagnosis during previous assessments were re-assessed and categorized as persistent DBD (n = 25) or desistent DBD (n = 25). Functional MRI during the extinction phase of a classical fear-conditioning task was used to compare regional brain function between these subgroups and 25 matched controls. Both DBD persisters and desisters showed hyperreactivity during fear extinction, when compared with HCs. Impulsive-irresponsible psychopathic traits were positively associated with responses in the fear neurocircuitry and mediated the association between neural activation and group membership. These results suggest that fear acquisition and fear extinction deficits may provide an endophenotype for an emotionally hyperreactive subtype of antisocial development. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  19. Appetitive motivation and negative emotion reactivity among remitted depressed youth.

    PubMed

    Hankin, Benjamin L; Wetter, Emily K; Flory, Kate

    2012-01-01

    Depression has been characterized as involving altered appetitive motivation and emotional reactivity. Yet no study has examined objective indices of emotional reactivity when the appetitive/approach system is suppressed in response to failure to attain a self-relevant goal and desired reward. Three groups of youth (N = 98, ages 9-15; remitted depressed, n = 34; externalizing disordered without depression, n = 30; and healthy controls, n = 34) participated in a novel reward striving task designed to activate the appetitive/approach motivation system. Objective facial expressions of emotion were videotaped and coded throughout both failure (i.e., nonreward) and control (success and reward) conditions. Observational coding of facial expressions as well as youths' subjective emotion reports showed that the remitted depressed youth specifically exhibited more negative emotional reactivity to failure in the reward striving task, but not the control condition. Neither externalizing disordered (i.e., attention deficit hyperactivity disorder, conduct disorder, and/or oppositional defiant disorder) nor control youth displayed greater negative emotional reactivity in either the failure or control condition. Findings suggest that depression among youth is related to dysregulated appetitive motivation and associated negative emotional reactivity after failing to achieve an important, self-relevant goal and not attaining reward. These deficits in reward processing appear to be specific to depression as externalizing disordered youth did not display negative emotional reactivity to failure after their appetitive motivation system was activated.

  20. The effect of methylphenidate treatment on suspiciousness in children with ADHD alone or comorbid with ODD.

    PubMed

    Golubchik, Pavel; Weizman, Abraham

    2018-06-01

    To assess the level of the suspiciousness in children with attention deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD) in comparison to ADHD alone and the response of suspiciousness symptoms to methylphenidate (MPH) treatment. In this open-label comparative study, children with DSM-IV-TR ADHD, aged 8-18 years, with (N = 30) or without (N = 30) ODD received MPH treatment for 12 weeks. The severity of ODD symptoms was assessed by the Kiddie-Schedule for Affective Disorders and Schizophrenia. The severity of ADHD symptoms was assessed by the ADHD-Rating-Scale-IV and suspiciousness was assessed at baseline and at endpoint by a scale designed especially for assessment of suspiciousness and named Suspiciousness Rating Scale (SRS). Significant reductions in SRS scores were detected in both groups following MPH treatment (before and after: p = .0012 and p = .0273, respectively). Only in the ADHD/ODD group a significant correlation was found between the rate of improvement in ADHD, as assessed by the ADHD-RS, and the reduction in suspiciousness, as assessed by the SRS (Spearman r = 0.48, p =  .0066). In addition to the beneficial effect of MPH treatment on ADHD and ODD symptoms it also diminishes suspiciousness. However, due to the small sample size further studies are needed to confirm the present results.

  1. A four-year follow-up controlled study of stress response and symptom persistence in Brazilian children and adolescents with attention deficit disorder and hyperactivity (ADHD).

    PubMed

    Palma, Sonia Maria Motta; Natale, Ana Carolina Motta Palma; Calil, Helena Maria

    2015-12-15

    This study evaluated children and adolescents with Attention Deficit Disorder andHyperactivity Disorder (ADHD), reassessing them at a four-year follow-up. Their cortisol response to a stress stimulus was measured twice. ADHD symptom persistence, development of comorbidities, and psychostimulant usage were also reassessed. The initial sample consisted of 38 ADHD patients and 38 healthy controls, age ranging 6-14. At the follow-up, there were 37 ADHD patients and 22 healthy controls, age ranging 10-18. ADHD was classified as persistent if the patients fulfilled all DSM IV criteria for syndromic or subthreshold or had functional impairment. Salivary cortisol samples were collected prior to the application of a cognitive stressor (Continuous Performance Test - CPT), and at three time intervals afterwards at baseline and at the follow-up. Their reassessment showed that 75% had persistent symptoms, psychiatric comorbidities (oppositional defiant and behavioral disorders), functional and academic impairement. Only seven patients were on medication. The ADHD group's cortisol levels were lower than those measured four years earlier, but cortisol concentrations were similar for both ADHD and control groups at the four-year follow-up. The cortisol results suggest that HPA axis reactivity could be a marker differentiating ADHD from ADHD with comorbidities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Short-term effect of American summer treatment program for Japanese children with attention deficit hyperactivity disorder.

    PubMed

    Yamashita, Yushiro; Mukasa, Akiko; Honda, Yuko; Anai, Chizuru; Kunisaki, Chie; Koutaki, Jun-ichi; Motoyama, Satoko; Miura, Naoki; Sugimoto, Ami; Ohya, Takashi; Nakashima, Masayuki; Nagamitsu, Shin-ichiro; Gnagy, Elizabeth M; Greiner, Andrew R; Pelham, William E; Matsuishi, Toyojiro

    2010-02-01

    We reported the results of the 3-week summer treatment program (STP) for children with attention deficit hyperactivity disorder (ADHD) in 2006. The STP was based on methods established by Professor Pelham in Buffalo, NY and has been used in a number of studies and at a number of sites in the U.S. This is the first STP outside North America. Thirty-six children age 6-12 years with ADHD participated. The collection of evidence-based behavioral modification techniques that comprises the STP's behavioral program (e.g., point system, daily report card, positive reinforcement, time out) was used. Most children showed positive behavioral changes in multiple domains of functioning, demonstrated by significant improvement in points earned daily, which reflect behavior frequencies. Only one child with ADHD co-morbid with pervasive developmental disorder required an individualized program for excessive time outs. The ADHD rating scale, symptoms of oppositional defiant disorder, and hyperactivity/inattention in Strength and Difficulties Questionnaires evaluated by parents significantly improved after STP. Although the 3-week STP was much shorter than most STPs run in the U.S., the program is more intensive than typical outpatient treatment, providing 105h of intervenion in 3 weeks. The short-term effect of the STP was demonstrated for Japanese children with ADHD. 2008 Elsevier B.V. All rights reserved.

  3. Ethnic Disparities in School-Based Behavioral Health Service Use for Children With Psychiatric Disorders.

    PubMed

    Locke, Jill; Kang-Yi, Christina D; Pellecchia, Melanie; Marcus, Steven; Hadley, Trevor; Mandell, David S

    2017-01-01

    We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders. Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD], conduct/oppositional defiant disorder, and "other") and by race/ethnicity (African-American, Hispanic, white, and other). Logistic and generalized linear regression analyses were used. Differences in service use by racial/ethnic group were identified within and across diagnostic groups, both for in-school service use and out-of-school service use. For all disorders, Hispanic children had significantly lower use of in-school services than white children. Among children with ADHD, African-American children were less likely to receive in-school services than white children; however, there were no differences in adjusted annual mean Medicaid expenditures for in-school services by race/ethnicity or psychiatric disorders. Statistically significant differences by race/ethnicity were found for out-of-school service use for children with ADHD and other psychiatric disorders. There were significant differences by race/ethnicity in out-of-school service use for each diagnostic group. Differences in the use of school-based behavioral health services by racial and ethnic groups suggest the need for culturally appropriate outreach and tailoring of services to improve service utilization. © 2016, American School Health Association.

  4. Disentangling the relative contribution of parental antisociality and family discord to child disruptive disorders.

    PubMed

    Bornovalova, Marina A; Blazei, Ryan; Malone, Stephen H; McGue, Matt; Iacono, William G

    2013-07-01

    A number of familial risk factors for childhood disruptive disorders have been identified. However, many of these risk factors often co-occur with parental antisociality, which by itself may account for both the familial risk factors and the increased likelihood of offspring disruptive behavior disorders (DBDs). The current study aimed to examine the association of parenting behaviors, marital conflict, and divorce with child DBDs while accounting for (a) coparent parenting behaviors, and (b) parental adult antisocial behavior (AAB). A series of regressions tested the association between family-level variables (namely, parent-child relationship quality, parental willingness to use physical punishment, marital adjustment, and history of divorce) and DBDs (attention deficit hyperactivity disorder, conduct disorder, and oppositional defiant disorder) alone and after statistically adjusting for coparent variables and parental AAB. Results indicated that parents with AAB were more likely to engage in various forms of maladaptive parenting, to divorce, and to have conflictual marriages. Maladaptive parenting, marital conflict, and divorce were associated with heightened rates of child DBDs, and these associations persisted after adjusting for coparent parenting and parental AAB. Finally, the mother's parenting behaviors had a higher impact on child DBDs than the father's parenting behaviors. Thus, familial variables continue to have an effect on childhood DBDs even after accounting for confounding influences. These variables should be a focus of research on etiology and intervention.

  5. [Association Between Parenting Styles and Symptoms of Attention Deficit Hyperactivity Disorder].

    PubMed

    Çöp, Esra; Çengel Kültür, S Ebru; Şenses Dinç, Gülser

    2017-01-01

    We aimed to study characteristics of child and mother reported parenting styles of children with Attention Deficit Hyperacitivity Disorder (ADHD) and association of parenting styles of mothers with demographic and clinical variables like ADHD symptoms, sex, age, ADHD subtype, and comorbidity. 58 children with ADHD and 30 healthy children were included in this study. All children were assessed by The Schedule for Affective Disorders and Schizophrenia for School Aged Children- Present and Lifetime Version. ADHD symptom severity was assessed by The Conners Parent Rating Scale and The Conners Teacher Rating Scale. The Parenting Style Inventory (PSI) and The Parental Attitude Research Instrument (PARI) were used to assess parenting styles of mothers. ADHD group had lower scores on two subscales of PSI (acceptance/involvement and strictness/supervision) and democratic attitude and equality subscale of PARI and higher scores on strict discipline subscale of PARI compared to control group. In ADHD group, higher symptoms of oppositional defiant disorder were associated with higher mother's strict discipline scores and lower child reported mother's acceptance/involvement scores. Our findings supported the idea that there may be an association between parenting attitudes and ADHD symptoms in families having a child with ADHD. These results indicated the importance of integrated approach to ADHD diagnosis and treatment and evaluating the child with ADHD in the context of family environment.

  6. Decreased Callosal Thickness in Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Luders, Eileen; Narr, Katherine L.; Hamilton, Liberty S.; Phillips, Owen R.; Thompson, Paul M.; Valle, Jessica S.; Del'Homme, Melissa; Strickland, Tony; McCracken, James T.; Toga, Arthur W.; Levitt, Jennifer G.

    2009-01-01

    Background Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed structural abnormalities in the brains of affected individuals. One of the most replicated alterations is a significantly smaller corpus callosum (CC), for which conflicting reports exist with respect to the affected callosal segments. Methods We applied novel surface-based geometrical modeling methods to establish the presence, direction, and exact location of callosal alterations in ADHD at high spatial resolution. For this purpose, we calculated the thickness of the CC at 100 equidistant midsagittal points in an age-matched male sample of 19 individuals with ADHD and 19 typically developing control subjects. Results In close agreement with many prior observations, the CC was shown to be significantly thinner in ADHD subjects in anterior and, particularly, posterior callosal sections. Covarying for intelligence did not significantly alter the observed ADHD effects. However, group differences were no longer present in anterior sections when covarying for brain volume and after excluding ADHD subjects comorbid for oppositional defiant disorder. Conclusions Decreased callosal thickness may be associated with fewer fibers or a decrease in the myelination of fibers connecting the parietal and prefrontal cortices. This might affect interhemispheric communication channels that are necessary to sustain attention or motor control, thus contributing to symptoms of hyperactivity and impulsivity, or inattention, observed in ADHD. Future studies are necessary to determine whether callosal abnormalities reflect maturational delays or persist into adulthood. PMID:18842255

  7. Disentangling the Relative Contribution of Parental Antisociality and Family Discord to Child Disruptive Disorders

    PubMed Central

    Bornovalova, Marina A.; Blazei, Ryan; Malone, Steve; McGue, Matt; Iacono, William G.

    2012-01-01

    A number of familial risk factors for childhood disruptive disorders have been identified. However, many of these risk factors often co-occur with parental antisociality, which by itself may account for both the familial risk factors and the increased likelihood of offspring disruptive behavior disorders (DBDs). The current study aimed to examine the association of parenting behaviors, marital conflict, and divorce with child DBDs while accounting for a) co-parent parenting behaviors, and b) parental adult antisocial behavior (AAB). A series of regressions tested the association between family-level variables (namely, parent-child relationship quality, parental willingness to use physical punishment, marital adjustment, and history of divorce) and DBDs (attention-deficit hyperactivity disorder, conduct disorder, and oppositional defiant disorder) alone and after statistically adjusting for co-parent variables and parental AAB. Results indicated that parents with AAB were more likely to engage in various forms of maladaptive parenting, to divorce, and to have conflictual marriages. Maladaptive parenting, marital conflict, and divorce were associated with heightened rates of child DBDs, and these associations persisted after adjusting for co-parent parenting and parental AAB. Finally, the mother’s parenting behaviors had a higher impact on child DBDs than the father’s parenting behaviors. Thus, familial variables continue to have an effect on childhood DBDs even after accounting for confounding influences. These variables should be a focus of research on etiology and intervention. PMID:22888991

  8. Psychiatric disorders in preschoolers: the structure of DSM-IV symptoms and profiles of comorbidity.

    PubMed

    Wichstrøm, Lars; Berg-Nielsen, Turid Suzanne

    2014-07-01

    Psychiatric disorders have been increasingly recognized in preschool children; at present, however, we know comparatively less about how well current diagnostic manuals capture the symptoms described in this age group and how comorbidity is patterned. Therefore, this study aimed to investigate whether the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) load on their respective disorders, examine whether individual symptoms exist that load particularly high or low on the disorder they allegedly define, and analyze how comorbidity clusters in individual children. Parents of a community sample of Norwegian 4-year-olds (N = 995) were interviewed using the Preschool Age Psychiatric Assessment. A confirmatory factor analysis (CFA) and a latent profile analysis (LPA) were performed on the symptoms of seven DSM disorders: attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, major depressive disorder (MDD), generalized anxiety disorder (GAD), social phobia, and separation anxiety disorder. The results showed that the CFA solution that closely resembled the disorders delineated in the DSM-IV fitted the data best. However, vegetative symptoms did not define preschool depression. The LPA identified nine symptom profiles among preschoolers, of which four showed evidence of psychopathology: comorbid MDD/GAD ? ADHD combined type, comorbid MDD/GAD ? ADHD hyperactive/impulsive type, separation anxiety only, and social phobia only. In conclusion, the symptoms observed in preschoolers fit the DSM-IV well, and comorbidity followed specific patterns.

  9. Stability of sleep disorders from preschool to first grade and their bidirectional relationship with psychiatric symptoms.

    PubMed

    Steinsbekk, Silje; Wichstrøm, Lars

    2015-05-01

    To examine the prevalence and stability of DSM-4-defined sleep disorders from preschool to first grade and to explore the bidirectional relationship between sleep disorders and symptoms of psychiatric disorders. All children born in 2003 or 2004 in Trondheim, Norway, who attended regular community health checkups for 4-year-olds, were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) in this study. The authors recruited a screen-stratified subsample of 1250 children and interviewed 994 parents (79.6%) using a structured diagnostic interview (the Preschool Age Psychiatric Assessment). Two years later, 795 of the parents completed the interview. There was stability in insomnia (adjusted odds ratio [OR] = 4.03, confidence interval [CI] = 2.83-5.75) and sleepwalking (adjusted OR = 19.28, CI = 4.53-82.10), whereas none of the children with hypersomnia or nightmare disorder at age 4 had the same disorder 2 years later. Insomnia increased the risk for developing symptoms of conduct disorder, major depressive disorder (MDD), and social phobia when the initial levels of insomnia were adjusted for. Symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, and MDD at age 4 were statistically linked to insomnia at age 6. Sleepwalking predicted later separation anxiety disorder, whereas hypersomnia was unrelated to symptoms of psychiatric disorders. Insomnia is a prevalent and stable disorder in children and is bidirectionally related to psychiatric symptoms.

  10. Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up.

    PubMed

    Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo

    2015-05-30

    The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Isolation of medical students: communication barrier and its effect on career.

    PubMed

    Gul, Mahwish; Rasool, Ahsan; Khalid, Laiba Binte; Rasool, Maleeha; Khan, Farmanullah; Ayub, Muhammad; Marwat, Salim

    2012-01-01

    Communication barriers affect student-student interaction and student-patient interaction. This study is aimed at exploring the social, cultural and academic spheres where medical students feel getting isolated. Questionnaire based cross-sectional survey was undertaken at Ayub Medical College, Abbottabad in the month of July, 2013. Cluster sampling technique was employed. Linguistic problems in the college greatly affected medical students. Female medical student are comparatively more affected. These problems were less common in 1st year and most common in 3rd year where clinical classes are started. There are distinct gender based problems in communicating among male and female student with as many as 37.2% reported feeling difficulty in communicating with students of opposite gender. However this difficulty in communication gradually faded on proceeding from 1st year towards final year. About frank interaction with opposite gender, 65.9% students felt that society had negative impact upon it. While communicating with patients of opposite gender, almost a quarter of students (27.3%) reported facing difficulties, 56.9% students reported to have abject apathy towards the colleagues of opposite gender. Linguistic issues, gender discrimination, negative impact of society and lack of concern for fellow colleagues is affecting student-student interaction and student-patient interaction. There is need to create student friendly environment.

  12. Beyond the Binary: Dexterous Teaching and Knowing in Mathematics Education

    ERIC Educational Resources Information Center

    Adam, Raoul; Chigeza, Philemon

    2015-01-01

    This paper identifies binary oppositions in the discourse of mathematics education and introduces a binary-epistemic model for (re)conceptualising these oppositions and the epistemic-pedagogic problems they represent. The model is attentive to the contextual relationships between pedagogically relevant binaries (e.g., traditional/progressive,…

  13. The Gulf Moment: Arab Relations Since 2011

    DTIC Science & Technology

    2015-05-01

    announced major investment projects in Egypt amounting to $18 billion, including tourism , energy, and industry. This was a new development, as...to falsifying news.50 Egyptian national television began to broadcast sports events for which Aljazeera held the rights, defiantly declaring that

  14. Optimal Battery Sizing in Photovoltaic Based Distributed Generation Using Enhanced Opposition-Based Firefly Algorithm for Voltage Rise Mitigation

    PubMed Central

    Wong, Ling Ai; Shareef, Hussain; Mohamed, Azah; Ibrahim, Ahmad Asrul

    2014-01-01

    This paper presents the application of enhanced opposition-based firefly algorithm in obtaining the optimal battery energy storage systems (BESS) sizing in photovoltaic generation integrated radial distribution network in order to mitigate the voltage rise problem. Initially, the performance of the original firefly algorithm is enhanced by utilizing the opposition-based learning and introducing inertia weight. After evaluating the performance of the enhanced opposition-based firefly algorithm (EOFA) with fifteen benchmark functions, it is then adopted to determine the optimal size for BESS. Two optimization processes are conducted where the first optimization aims to obtain the optimal battery output power on hourly basis and the second optimization aims to obtain the optimal BESS capacity by considering the state of charge constraint of BESS. The effectiveness of the proposed method is validated by applying the algorithm to the 69-bus distribution system and by comparing the performance of EOFA with conventional firefly algorithm and gravitational search algorithm. Results show that EOFA has the best performance comparatively in terms of mitigating the voltage rise problem. PMID:25054184

  15. Optimal battery sizing in photovoltaic based distributed generation using enhanced opposition-based firefly algorithm for voltage rise mitigation.

    PubMed

    Wong, Ling Ai; Shareef, Hussain; Mohamed, Azah; Ibrahim, Ahmad Asrul

    2014-01-01

    This paper presents the application of enhanced opposition-based firefly algorithm in obtaining the optimal battery energy storage systems (BESS) sizing in photovoltaic generation integrated radial distribution network in order to mitigate the voltage rise problem. Initially, the performance of the original firefly algorithm is enhanced by utilizing the opposition-based learning and introducing inertia weight. After evaluating the performance of the enhanced opposition-based firefly algorithm (EOFA) with fifteen benchmark functions, it is then adopted to determine the optimal size for BESS. Two optimization processes are conducted where the first optimization aims to obtain the optimal battery output power on hourly basis and the second optimization aims to obtain the optimal BESS capacity by considering the state of charge constraint of BESS. The effectiveness of the proposed method is validated by applying the algorithm to the 69-bus distribution system and by comparing the performance of EOFA with conventional firefly algorithm and gravitational search algorithm. Results show that EOFA has the best performance comparatively in terms of mitigating the voltage rise problem.

  16. Prevalence of Attention Deficit Hyperactivity Disorder among School Children and Associated Co-morbidities - A Hospital Based Descriptive Study.

    PubMed

    Rimal, H; Pokharel, A

    Attention Deficit Hyperactivity Disorder is the most common neuro- developmental disorders of childhood characterized by the core symptoms including inattentiveness and distractibility and frequently involve impairments in executive functioning, increased impulsivity, and restlessness. Objective To find out the prevalence of Attention Deficit Hyperactivity Disorder among school aged children Presented to Pediatric clinic and also to investigate associated comorbidities. Method This study was conducted at Nobel Medical College Teaching Hospital, Biratnagar during April 2014 - March 2015. Attention Deficit Hyperactivity Disorder was diagnosed by the developmental Pediatrician after taking relevant history and the clinical assessment using Attention Deficit Hyperactivity Disorder rating scale with diagnostic criteria consistent with Diagnostic Statistical Manual - IV classification. Spence anxiety scale child and parent rated version and Strength and Difficulty Questionnaire were also used. Result Result showed the yearly prevalence of Attention Deficit Hyperactivity Disorder being 41(11.7%) with male: female ratio of 4:1. The study reported that Attention Deficit Hyperactivity Disorder combined type was the commonest type that was 26(63%) cases followed by Inattentive type 9(22%) cases and 6(15%) were hyperactive type. The mean age for Attention Deficit Hyperactivity Disorder was 7 years and 5 months. The most common co-morbidities were sleep problem 12(29.3%), Learning difficulty 10(24.4%), Anxiety disorder 10(24.4), Oppositional Defiant Disorder 9(22%), Autism Spectrum Disorder 5(12%), speech delay 6(14.6%), and 4(10%) had associated tics. There was abnormal SDQ prevalence of 29.3% across the area of emotional distress. The mean abnormal SDQ score in total difficulty area 8 (20.7%), socializing with peer 9(22%), behavioral difficulty 11(26.8%), hyperactivity/inattention 23(56.1%) and impact of difficulties in young person's life being 5(12.2%). Conclusion There is high prevalence of Attention Deficit Hyperactivity Disorder in children and adolescents in Nepal. This study has also looked at co-morbidities associated with Attention Deficit Hyperactivity Disorder and the findings of the study have thrown lights on the mental health and other developmental issues associated with it.

  17. The clinical presentation of attention deficit-hyperactivity disorder (ADHD) in children with 22q11.2 deletion syndrome.

    PubMed

    Niarchou, Maria; Martin, Joanna; Thapar, Anita; Owen, Michael J; van den Bree, Marianne B M

    2015-12-01

    Although attention deficit-hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children with 22q11.2DS, it remains unclear whether its clinical presentation is similar to that in children with idiopathic ADHD. The aim of this study is to compare the ADHD phenotype in children with and without 22q11.2DS by examining ADHD symptom scores, patterns of psychiatric comorbidity, IQ and gender distribution. Forty-four children with 22q11.2DS and ADHD (mean age = 9.6), 600 clinic children (mean age = 10.8) and 77 children with ADHD from a population cohort (mean age = 10.8) participated in the study. Psychopathology was assessed using parent-report research diagnostic instruments. There was a higher proportion of females in the 22q11.2DS ADHD sample in relation to the clinical sample (χ(2)  = 18.2, P < 0.001). The 22q11.2DS group showed a higher rate of ADHD inattentive subtype (χ(2)  = 114.76, P < 0.001), and fewer hyperactive-impulsive symptoms compared to the clinical group (z = 8.43, P < 0.001). The 22q11.2DS ADHD group parents reported fewer oppositional defiant disorder/conduct disorder symptoms (z = 6.33, P < 0.001) and a higher rate of generalized anxiety disorder (χ(2)  = 4.56, P = 0.03) in relation to the clinical group. Two percent of the 22q11.2 DS ADHD sample had received ADHD treatment. The results were similar when the 22q11.2 ADHD group was compared to the population cohort ADHD group. The clinical presentation of ADHD and patterns of co-morbidity in 22q11.2DS is different from that in idiopathic ADHD. This could lead to clinical under-recognition of ADHD in this group. Examining psychopathology in 22q11.2DS can provide insights into the genetic origins of psychiatric problems with implications beyond the 22q11.2DS population. © 2015 Wiley Periodicals, Inc.

  18. Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada).

    PubMed

    McGrath, Patrick J; Sourander, Andre; Lingley-Pottie, Patricia; Ristkari, Terja; Cunningham, Charles; Huttunen, Jukka; Filbert, Katharine; Aromaa, Minna; Corkum, Penny; Hinkka-Yli-Salomäki, Susanna; Kinnunen, Malin; Lampi, Katja; Penttinen, Anne; Sinokki, Atte; Unruh, Anita; Vuorio, Jenni; Watters, Carolyn

    2013-10-21

    Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest Families Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent-child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour. This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child's sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization. The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems. ClinicalTrials.gov # NCT01750996.

  19. Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada)

    PubMed Central

    2013-01-01

    Background Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest Families™ Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent–child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour. Methods/design This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child’s sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization. Discussion The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems. Trial registration ClinicalTrials.gov # NCT01750996 PMID:24139323

  20. Neuropsychological Profiles Correlated with Clinical and Behavioral Impairments in a Sample of Brazilian Children with Attention-Deficit Hyperactivity Disorder

    PubMed Central

    Rizzutti, Sueli; Schuch, Viviane; Augusto, Bruno Muszkat; Coimbra, Caio Colturato; Pereira, João Pedro Cabrera; Bueno, Orlando Francisco Amodeo

    2015-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that implies several-step process, and there is no single test to diagnose both ADHD and associated comorbidities, such as oppositional-defiant disorder (ODD), anxiety disorder, depression, and certain types of learning disabilities. The purpose of the present study was to examine correlations between behavioral and clinical symptoms by administering an extensive neuropsychological battery to a sample of children and adolescents from a developing country. The sample was divided into three groups: non-ADHD, ADHD-non-comorbid, and ADHD + comorbidity. A full neuropsychological battery and clinical assessment found that 105 children met DSM-5 criteria, of whom 46.6% had the predominantly inattentive presentation, 37.3% had combined presentation, and 16% were predominantly hyperactive/impulsive presentation. The internal correlation between neuropsychological tests did not reach statistical significance in the comparison between ADHD and non-ADHD cases (p < 0.17). Clinical ADHD cases, including both + comorbidity and non-comorbid groups, performed substantially worse on continuous performance test (CPT), working memory. Comparing ADHD-non-comorbid and ADHD + comorbidity groups, the latter did significantly worse on inhibitory control, time processing, and the level of perseveration response on CPT indexes, as well as on working memory performance and child behavior checklist (CBCL) tests particularly the CBCL-deficient emotional self-regulation test in the ADHD + comorbidity group. Children diagnosed as ODD or with conduct disorder showed close correlations between clinical CBCL profiles and externalized symptoms. Our findings suggest that ADHD + comorbidity and ADHD non-comorbid cases may be differentiated by a number of neuropsychological measures, such as processing speed, inhibitory control, and working memory, that may reflect different levels of involvement of the hot and cool executive domains, which are more impaired in cases of severe symptomatic-externalized behavior and emotional regulation problems. Therefore, profiles based on clinical and behavioral findings can help clinicians select better strategies for detecting neuropsychological impairment in Brazilian children with ADHD. PMID:26635638

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