Stability and Change of ODD,CD and ADHD Diagnosis in Referred Preschool Children

Longitudinal studies have shown that preschool children’s diagnosis of Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are likely to persist into school age. However, limited attention has been paid to instability of diagnosis. The aim of the present study, therefore, was to investigate both stability and change of ODD, CD and ADHD diagnosis in children aged 3.5–5.5 years. For diagnosing these disorders, a semi-structured diagnostic parent interview, i.e., the Kiddie-Disruptive Behavior Disorder Schedule (K-DBDS), was used at the first assessment and at follow-up assessments (9 and 18 months). Five diagnostic stability groups (chronic, partial remission, full remission, new onset, no diagnosis) were compared with regard to impairment and number of symptoms. Participants were referred preschool children with externalizing behavioral problems (N?=?193; 83 % male) and typically developing (TD) children (N?=?58; 71 % male). Follow-up assessments allowed to distinguish children belonging to the chronic group of ODD, CD or ADHD from those belonging to one of the remission groups. In addition, there was a substantial number of children with a new onset diagnosis. In conclusion, as a complement to studies showing stability of ODD, CD and ADHD diagnosis into school age, present findings point to changes of diagnosis in the preschool and early school period. Diagnostic reassessments therefore are needed in this age group.     

Changes in ADHD Symptom Endorsement: Preschool to School Age

To investigate endorsement patterns among the 18 DSM-IV symptoms of ADHD in a longitudinal sample of children with and without ADHD (n?=?144), as assessed at ages 4-5, 5-6, and 6-7 years. Symptom endorsements and diagnoses were determined at all time-points via K-SADS-PL interview administered to parents and supplemented by teacher questionnaires and clinician observations. Changes in endorsement patterns over time for each of the 18 DSM-IV symptoms were ascertained. Several symptoms, particularly those of inattention, were infrequently endorsed and of apparently limited diagnostic utility at ages 4-5; hyperactive/impulsive symptoms were more frequently endorsed among young children with ADHD than were inattentive symptoms. However, by ages 6-7, inattention items were somewhat superior at discriminating ADHD from Non-ADHD children. Several DSM-IV and now DSM-V symptoms provide limited diagnostic differentiation prior to school-age, particularly those most commonly observed in the context of formal schooling. Consideration should be made in future iterations of the DSM that account for such developmental and contextual differences.     

Self-Competence and Depressive Symptom Trajectories during Adolescence

The purpose of this study was to examine the relationship between self-competence and subsequent depressive symptom trajectories, by gender, in a community sample of adolescents (N = 753; 53% female; 65% non-Hispanic White). Data were collected annually for three years beginning when adolescents were in the 10th and 11th grades (Age: M = 16.09, SD = 0.72 years). Adolescents provided self-reports of self-competence at baseline and depressive symptoms every year. In latent growth curve models examining the overall trajectory of depressive symptoms, higher global self-worth and self-competence in close friendships were significantly associated with greater decreases in depressive symptoms (ps < 0.05). In contrast, higher academic self-competence was associated with more attenuated decreases in depressive symptoms (p = 0.001). When examining subgroups of latent depressive symptom trajectories within the context of growth mixture modeling, higher self-competence in physical appearance was associated with a decreased likelihood of membership in trajectory classes characterized by high initial, then decreasing depressive symptoms or and low initial, then increasing depressive symptoms (ps < 0.01). Among girls, higher global self-worth and self-competence in close friendship and academic domains were associated with membership in a trajectory class distinguished by high stable depressive symptoms (ps < 0.01); these associations were not observed among boys (ps > 0.05). Findings suggest that the competence-based model of depression is valid and applicable during middle-to-late adolescence, and emphasize the importance of considering gender and individual differences in the developmental course of depressive symptoms to gain a more nuanced understanding of the role of self-competence in depressive symptom trajectories.     

Preschool children's eye‐movements during pictorial recall

We investigated eye‐movements during preschool children's pictorial recall of seen objects. Thirteen 3‐ to 4‐year‐old children completed a perceptual encoding and a pictorial recall task. First, they were exposed to 16 pictorial objects, which were positioned in one of four distinct areas on the computer screen. Subsequently, they had to recall these pictorial objects from memory in order to respond to specific questions about visual details. We found that children spent more time fixating the areas in which the pictorial objects were previously displayed. We conclude that as early as age 3–4 years old, children show specific eye‐movements when they recall pictorial contents of previously seen objects.     

Risk Taking and Sensitivity to Punishment in Children with ADHD,ODD, ADHD+ODD,and Controls

We used the Balloon Analog Risk Task (BART) to examine risk taking and sensitivity to punishment, two relevant aspects of behavioral inhibition, in 203 school-age children with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), ADHD+ODD, and controls. Participants earned points on the BART by pumping 30 separate balloons that exploded at variable intervals. No points were earned on a trial when a balloon exploded. The number of pumps across all balloons estimated risk taking and the reduction in pumps following balloon explosions was interpreted as an indicator of sensitivity to negative punishment. We found that all groups significantly differed from one another on risk taking. The ADHD+ODD group pumped the most, followed by the ODD, ADHD, and the control group, respectively. For sensitivity to negative punishment, all groups performed differently, with the ODD group showing the least sensitivity to an exploded balloon, followed by the ADHD, control, and ADHD+ODD groups, respectively. Children with ADHD+ODD demonstrated significantly different patterns of risk taking and sensitivity to negative punishment than children with either ADHD-only or ODD-only. ADHD youth with comorbid ODD had the greatest levels of risk taking, but they were also the most sensitive to negative punishment. The relationship between ADHD and ODD, as well as the nature of comorbidity in constructs related to risk taking and related behaviors, are discussed.     

Preschool children's joint block building during a guided play activity

Although children build in block areas both individually and jointly, little is known about the nature of children's behavior and communication in this play context with peers. We observed 4- and 5-year-old same-age, same-sex dyads (n = 38) during a guided play activity, which involved building a house with large colorful blocks. We analyzed children's communication and building behaviors, as well as the role of their coordinated behavior in the structures that they built. Children's spatial talk was associated with the features of a house included in structures, whereas children's building behavior was associated with the complexity of the structures. However, children's coordinated behavior during the interaction mediated the relations between spatial talk and the structures they built. Results are discussed in terms of the importance of encouraging joint guided block play activities in early childhood classrooms to provide children with opportunities to practice and expand their language, math, and spatial skills.     

Construct Validity of ADHD/ODD Rating Scales: Recommendations for the Evaluation of Forthcoming DSM-V ADHD/ODD Scales

Exploratory structural equation modeling (SEM) was applied to a multiple indicator (26 individual symptom ratings) by multitrait (ADHD-IN, ADHD-HI and ODD factors) by multiple source (mothers, fathers and teachers) model to test the invariance, convergent and discriminant validity of the Child and Adolescent Disruptive Behavior Inventory with 872 Thai adolescents and the ADHD Rating Scale-IV and ODD scale of the Disruptive Behavior Inventory with 1,749 Spanish children. Most of the individual ADHD/ODD symptoms showed convergent and discriminant validity with the loadings and thresholds being invariant over mothers, fathers and teachers in both samples (the three latent factor means were higher for parents than teachers). The ADHD-IN, ADHD-HI and ODD latent factors demonstrated convergent and discriminant validity between mothers and fathers within the two samples. Convergent and discriminant validity between parents and teachers for the three factors was either absent (Thai sample) or only partial (Spanish sample). The application of exploratory SEM to a multiple indicator by multitrait by multisource model should prove useful for the evaluation of the construct validity of the forthcoming DSM-V ADHD/ODD rating scales.     

运动视觉的奇次倍频现象

当刺激图形为高速运动的方波光栅时,可观测到一种新的奇次谐波现象。当被试光栅为某些临界时间频率时,奇次谐波光栅静止不动,稍微偏离这些临界值,谐波光栅开始运动,其表现运动方向,或者与被试光栅相同,或者相反,这取决于被试光栅的时间频率高于或低于临界频率。本文使用视觉时空采样假设和付氏分析,初步解释了这一现象。     

Mother–Toddler Affect Exchanges and Children's Mastery Behaviours during Preschool Years

This study examined the longitudinal relations of mother–child affect exchanges at 18 months with children's mastery motivation at 39 months. Observation and questionnaire data were collected from mother–child dyads when children were 18 months; 43 mothers again rated their children's mastery motivation at 39 months. Results suggested that after controlling for gender and the corresponding 18‐month mastery aspect, positive affect exchanges had long‐term positive relationships with children's persistence and competence, whereas dismissed affect exchanges had long‐term negative relationships with children's persistence and independent mastery. Findings suggest that children's autonomous mastery‐oriented endeavours have deep roots in their early mother–child affective interactions. Copyright © 2013 John Wiley & Sons, Ltd.     

Eating Disorder Symptom and Fear Change Trajectories During Imaginal Exposure Therapy: A Slope Network Analysis

Eating disorders (EDs) are characterized by fears related to food, body image, and social evaluation. Exposure-based interventions hold promise for targeting a range of ED fears and reducing ED psychopathology. We investigated change mechanisms and optimal fear targets in imaginal exposure therapy for EDs using a novel approach to network analysis. Individuals with an ED (N = 143) completed up to four online imaginal exposure sessions. Participants reported ED symptoms and fears at pretreatment, posttreatment, and 6-month follow-up. We constructed networks of symptoms (Model 1), fears (Model 2), and combined symptoms and fears (Model 3). Change trajectory networks from the slopes of symptoms/fears across timepoints were estimated to identify how change in specific ED symptoms/fears related to change in other ED symptoms/fears. The most central changing symptoms and fears were feeling fat, fear of weight gain, guilt about one’s weight/shape, and feared concerns about consequences of eating. In Model 3, change in ED fears bridged to change in desire to lose weight, desiring a flat stomach, following food rules, concern about eating with others, and guilt. As slope networks present averages of symptom/fear change slopes over the course of imaginal exposure therapy, further studies are needed to examine causal relationships between symptom changes and heterogeneity of change trajectories. Fears of weight gain and consequences of eating may be optimal targets for ED exposure therapy, as changes in these fears were associated with maximal change in ED pathology. Slope networks may elucidate change mechanisms for EDs and other psychiatric illnesses.     

Negative Halo Effects in Parent Ratings of ADHD and ODD

Parent ratings of ADHD and ODD symptoms depicted in written vignettes were examined for negative halo effects. Participants were 82 parents of children ages 6–12. Both unidirectional and bidirectional halo effects were found but to a lesser extent than in similar studies with teacher and college student raters. Specifically, parents were more likely to: (a) rate a child as inattentive in the presence of hyperactivity symptoms; (b) more likely to rate a child as oppositional in the presence of inattention and hyperactivity symptoms; and (c) more likely to rate a child as inattentive and hyperactive in the presence of oppositionality symptoms. Several specific symptoms were also found to be particularly susceptible to halo effects. Results suggest that parents may be more discerning raters of disruptive behavior disorders than teachers or college students and less prone to negative halo effects. Implications for clinical practice and future research directions are discussed.     

Defensiveness and Symptom Reporting

This investigation examined whether high levels of defensiveness were associated with lower levels of reporting symptoms of ill health. Participants completed questionnaires measuring defensiveness, trait anxiety (neuroticism), and health. Analyses revealed that overall high defensiveness was significantly associated with lower levels of symptom reporting, and that among individuals high in neuroticism (a trait normally associated with high levels of symptom reporting), those individuals also high in defensiveness reported significantly lower levels of symptoms. The results suggest that defensiveness may act as a buffer against the perception and reporting of the symptoms of illness.     

A sequential analysis of the mother-adolescent interactions of ADHD,ADHD/ODD,and normal teenagers during neutral and conflict discussions

The sequential interactions of three groups of teenagers conversing with their mothers during both neutral and conflict discussion situations were evaluated. Groups consisted of (1) attention deficit hyperactivity disorder (ADHD) alone (n =21), (2) ADHD with comorbid oppositional defiant disorder (ADHD/ODD; n =40), and (3) a community control group of adolescents (n =49). All groups had been followed concurrently for the past 8 to 10 years before being reevaluated in this study. Results indicated that (1) teens and parents in all groups interacted in a tightly linked manner, with the behavior of each member being significantly related only to the immediate antecedent behavior of the other; (2) mothers in all groups were more likely than teens to initiate positive behaviors; (3) teen interactions could be characterized as tit-for-tat while mothers could be typified as be-nice-and-forgive; (4) mother-teen dyads in the ADHD/ODD group displayed significantly higher rates of conflict behaviors than dyads in the other two groups, who did not differ significantly from each other on most measures; and (5) mothers in the ADHD/ODD group responded in a manner similar to their teens (greater negativity) and less like that of mothers in the other groups. The majority of conflict between ADHD children and their parents seemed due to comorbid ODD and such ODD is a family, not just a teen, characteristic.