Social problem-solving skills in boys with conduct and oppositional defiant disorders

The current study compared the social problem-solving skills of a clinic-based sample of 30 boys diagnosed with conduct disorder (CD) and 25 boys diagnosed with oppositional defiant disorder (ODD). Past research has indicated that contextual factors influence children's social problem-solving; thus, three hypothetical conflict situations (i.e., child-child, teacher-child, and parent-child) and situations which differed by degree of negative intent of the provocateur (i.e., hostile vs. Ambiguous intent) were examined. Problem-solving strategies were aggregated into three broad dimensions: 1) aggressive/antisocial solutions; 2) nonverbal-nonaggressive solutions; and 3) verbal-nonaggressive solutions. Compared to ODD boys, CD boys proposed more aggressive/antisocial solutions in parent-child conflicts when parental intent was ambiguous and in teacher-child conflicts regardless of intent. Compared to ODD boys, CD boys proposed fewer verbal-nonaggressive solutions in child-child conflicts. The implications of these findings for treatment intervention with CD and ODD boys were discussed. Aggr. Behav. 23:457–469, 1997. © 1997 Wiley-Liss, Inc.     

Irritability and parenting practices as mediational variables between temperament and affective,anxiety, and oppositional defiant problems

Irritability and parenting are potential targets for transdiagnostic studies to identify the common and core dysfunctional characteristics underlying several diagnostic pictures with the goal of addressing these issues in treatment. Our objective was to investigate the different paths from temperament to child psychopathology (affective, anxiety, and oppositional problems) through irritability and parenting using a prospective design from ages 3 to 7. A sample of 614 3-year-old preschoolers was followed at ages 4, 6, and 7. Parents answered questionnaires about temperament (age 3), irritability (age 4), parenting practices (age 6), and psychopathology (age 7). Statistical analyses were carried out through structural equation modeling (SEM) to test the mediation effect of irritability and parenting practices from temperament (negative affectivity and effortful control) through to affective, anxious, and oppositional problems. The proposed model fit the data well. SEM showed (a) an indirect effect from temperament to affective problems, via irritability and positive parenting; (b) a direct effect from negative affectivity to anxiety, plus an indirect effect from both temperament dimensions, via irritability and autonomy parenting practices; and (c) an indirect effect from temperament to oppositional problems, via irritability and punitive parenting. Irritability and parenting are transdiagnostic mediational variables that should be focused on in intervention programs for affective, anxiety, and oppositional problems.     

Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family,parenting, and behavioral correlates

This community study assigned 129 4-year-olds to groups at risk for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), both ADHD and ODD, or no problems. Mothers of children at risk for ODD reported more family dysfunction, felt less competent as parents, suggested fewer solutions to child behavior problems, demonstrated a less assertive approach to child management, and reported more child internalizing problems than did mothers of children not elevated on ODD symptoms. Mothers of children at risk for ADHD reported higher personal depression scores than did those of the non-ADHD subgroup. Children at risk for ADHD evidenced the most difficulties in school where teachers reported more social behavior, classroom management, and internalizing problems relative to other children not at risk for ADHD. When solving child management problems, mothers of children in all groups suggested twice as many controlling/negative management strategies as positive/preventive strategies. In addition, faced with oppositional and conduct problems, mothers of children in all groups increased controlling/negative suggestions and decreased positive/preventive suggestions. Mothers of girls at risk for ADHD, ODD, and ADHD/ODD gave more rewards per positive behavior than did mothers of boys.     

The influence of ADHD-hyperactivity/impulsivity symptoms on the development of oppositional defiant disorder symptoms in a 2-year longitudinal study

The structural relations among ADHD–inattention (IN), ADHD–hyperactivity/impulsivity (H/I), and oppositional defiant disorder (ODD) factors were examined in a 2-year longitudinal study with 752 children. Structural equation procedures showed that higher scores on the H/I factor in Year 1 were associated with higher scores on ODD factor in Years 2 and 3. Higher scores on the H/I factor in Year 2 were also associated with higher scores on ODD factor in Year 3. The ODD factor did not predict the H/I and IN factors in subsequent years. The IN factor did not predict the ODD and H/I factors in subsequent years and the H/I factor did not predict the IN factor. The ability of the H/I factor to predict the subsequent ODD factor occurred even after taking into account the ability of the ODD, H/I, and IN factors to predict themselves across time. These results suggest that the H/I aspect of ADHD influences the development of ODD behavior.     

Psychodynamic psychotherapy for children with disruptive disorders

Findings from a clinical project aiming to make psychodynamic psychotherapy more effective for children with disruptive disorders are summarised and discussed. In this project a supportive expressive model was used and the therapists worked with both children and parents. Nine boys aged 6 – 10 years were treated; all were reported to function better socially after therapy, but improvements were less marked in those boys who in addition to the initial diagnoses of ODD or CD had ADHD. Collaborative meetings with school teachers were associated with more positive effects.     

Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children

Numerous studies have revealed autonomic underarousal in conduct-disordered adolescents and antisocial adults. It is unknown, however, whether similar autonomic markers are present in at-risk preschoolers. In this study, the authors compared autonomic profiles of 4- to 6-year-old children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD; n = 18) with those of age-matched controls (n = 20). Children with ADHD and ODD exhibited fewer electrodermal responses and lengthened cardiac preejection periods at baseline and during reward. Although group differences were not found in baseline respiratory sinus arrhythmia, heart rate changes among ADHD and ODD participants were mediated exclusively by parasympathetic withdrawal, with no independent sympathetic contribution. Heart rate changes among controls were mediated by both autonomic branches. These results suggest that at-risk preschoolers are autonomically similar to older externalizing children.     

The effects of the Triple P-Positive Parenting Program on preschool children with co-occurring disruptive behavior and attentional/hyperactive difficulties

Two variants of a behavioral family intervention (BFI) program known as Triple P were compared using 87 preschoolers with co-occurring disruptive behavior and attentional/hyperactive difficulties. Families were randomly allocated to enhanced BFI (EBFI), standard BFI (SBFI), or a waitlist (WL) control group. At postintervention both BFI programs were associated with significantly lower levels of parent-reported child behavior problems, lower levels of dysfunctional parenting, and greater parental competence than the WL condition. The EBFI condition was also associated with significantly less observed child negative behavior in comparison to the WL. The gains achieved at postintervention were maintained at 1-year follow-up. Contrary to predictions, the enhanced program was not shown to be superior to the standard program using any of the outcome measures at either postintervention or follow-up. Each of the programs produced significant reductions in children's co-occurring disruptive behavior and attentional/hyperactive difficulties with 80% of the children showing clinically reliable improvement in observed negative behavior from preintervention to follow-up.     

Anxiety sensitivity within the anxiety disorders: disorder-specific sensitivities and depression comorbidity

The tendency to perceive anxious states as aversive and harmful is hypothesized to confer vulnerability to the development of anxiety disorders. The most commonly used measure of anxiety sensitivity, the Anxiety Sensitivity Index [ASI; Reiss, S., Peterson, R.A., Gursky, D.M., & McNally R.J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behavior Research and Therapy, 24, 1-8], is composed of multiple lower-order factors, assessing fear of physical symptoms, fear of publicly observable anxious symptoms, and fear of cognitive dyscontrol. This study examined the convergent validity of the lower-order anxiety sensitivity dimensions in DSM-IV diagnosed anxiety disorders. Participants with primary diagnoses of panic disorder with agoraphobia, social phobia, and generalized anxiety disorder (GAD) completed the ASI and measures of anxiety and depression severity. Support was found for the convergent validity of all ASI dimensions in reference to thematically related anxiety disorders and in the identification of patients presenting with and without secondary major depressive disorder (MDD). The ASI-fear of cognitive dyscontrol dimension displayed strong and nonredundant associations with GAD, dimensional depression scores, and secondary diagnoses of MDD. The conceptual implications of the shared importance of fear of cognitive dyscontrol in GAD and MDD are discussed.     

Emotional,behavioral, and cognitive factors that differentiate obsessive-compulsive disorder and other anxiety disorders in youth

Abstract

The current study examined specific emotional, behavioral, and cognitive variables that may distinguish obsessive-compulsive disorder (OCD) from generalized anxiety disorder (GAD), social phobia (SoP), and separation anxiety disorder (SAD) in youth. Youth with OCD (n=26) and other anxiety disorders (ADs; n=31), aged 7–12 years (56.1% males), and their parents participated. The study compared the two anxious groups on levels of emotional, behavioral, and cognitive functioning, as well as impairment associated with the disorder. Results indicated that in comparison to youth with GAD, SoP, or SAD, youth with OCD were found to have poorer emotion regulation skills, as well as greater oppositionality, cognitive problems/inattention, and parent impairment associated with the disorder. The findings suggest that there are unique characteristics of OCD that may differentiate this disorder from other ADs in youth. Potential clinical implications and directions for future research are discussed.     

The influence of comorbidity on treatment outcome for children and adolescents with anxiety disorders

There have been a growing number of studies showing that cognitive behavioural treatment packages for children with anxiety disorders are highly effective. Clinically, it is often assumed that treatment outcome is less successful, or that treatment needs to be altered when faced with the existence of comorbid conditions. To date, only one study has directly addressed this question in the child anxiety literature. The present study compared the treatment outcome and maintenance following a brief, group program for the reduction of child and adolescent anxiety disorders in anxious children with versus without comorbid disorders. There was no significant difference in response to treatment at the end of the program and few differences at 12-month follow-up. The only indication of an impact of comorbidity was a suggestion that children with a comorbid condition did not do as well at follow-up. However, this result was only shown on some parent-report measures and not on self-report measures. Overall, the results indicate that treatment for child and adolescent anxiety disorders produces broadly comparable results regardless of the existence of comorbid disorders.     

Heightened sensitivity to emotional expressions in generalised anxiety disorder,compared to social anxiety disorder,and controls

Few studies have examined potential differences between social anxiety disorder (SAD) and generalised anxiety disorder (GAD) in the sensitivity to detect emotional expressions. The present study aims to compare the detection of emotional expressions in SAD and GAD. Participants with a primary diagnosis of GAD (n?=?46), SAD (n?=?70), and controls (n?=?118) completed a morph movies task. The task presented faces expressing increasing degrees of emotional intensity, slowly changing from a neutral to a full-intensity happy, sad, or angry expressions. Participants used a slide bar to view the movie frames from left to right, and to stop at the first frame where they perceived an emotion. The frame selected thus indicated the intensity of emotion required to identify the facial expression. Participants with GAD detected the onset of facial emotions at lower intensity of emotion than participants with SAD (p?=?0.002) and controls (p?=?0.039). In a multiple regression analysis controlling for age, race, and depressive symptom severity, lower frame at which the emotion was detected was independently associated and GAD diagnosis (B?=?–5.73, SE?=?1.74, p?相似文献   

Relation of Age of Onset to the Type and Severity of Child and Adolescent Conduct Problems

In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, youths with earlier ages of onset of conduct problems engaged in more conduct problems than youths with later ages of onset when current age and gender were controlled. Specifically, youths with earlier ages of onset were more likely to engage in several types of physical aggression, frequent lying, theft, and vandalism and were less likely to engage in only truancy. There also was an inverse relation between age of onset and level of functional impairment, mental health service use, and meeting diagnostic criteria for conduct disorder, attention-deficit hyperactivity disorder, and oppositional defiant disorder. Within the limits of cross-sectional data, these results support the hypothesis that key aspects of the heterogeneity of conduct problems among youths are related to the age of onset of conduct problems.     

Perceived parental rearing behaviour and anxiety disorders symptoms in normal children

The present study examined the relationship between perceptions of parental rearing behaviours and anxiety disorders symptomatology in a sample of normal school children. 45 children, aged 8 to 12 years, completed the EMBU for children, a questionnaire that measures perceptions of parental rearing practices. Additionally, they filled in the Screen of Child Anxiety Related Emotional Disorders (SCARED), an index of DSM-defined anxiety disorders symptoms. Significant and positive relationships were found between anxious rearing behaviours and parental control, on the one hand, and anxiety disorders symptomatology, in particular symptoms of generalized anxiety disorder, separation anxiety disorder and environmental–situational phobia, on the other hand.     

The prevalence of specific learning disorder in mathematics and comorbidity with other developmental disorders in primary school-age children

Mathematics difficulties are common in both children and adults, and they can have a great impact on people's lives. A specific learning disorder in mathematics (SLDM or developmental dyscalculia) is a special case of persistent mathematics difficulties, where the problems with maths cannot be attributed to environmental factors, intellectual disability, or mental, neurological or physical disorders. The aim of the current study was to estimate the prevalence rate of SLDM, any gender differences in SLDM, and the most common comorbid conditions. The DSM-5 provides details regarding these only for specific learning disorders in general, but not specifically for SLDM. We also compared the prevalence rates obtained on the basis of the DSM-IV and DSM-5 criteria. We investigated the performance of 2,421 primary school children on standardized tests of mathematics, English, and IQ, and several demographic factors over the primary school years. We applied the DSM-5 diagnostic criteria to identify children with a potential diagnosis of SLDM. Six per cent of our sample had persistent, severe difficulties with mathematics, and, after applying the exclusion criteria, 5.7% were identified as having an SLDM profile. Both persistent maths difficulties and consistently exceptionally high performance in maths were equally common in males and females. About half of the children with an SLDM profile had some form of language or communication difficulty. Some of these children also had a diagnosis of autism, social, emotional, and behavioural difficulties or attention deficit and hyperactivity disorder. Our findings have important implications for research and intervention purposes, which we discuss in the study.     

Understanding the Covariation Among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder,Attention Deficit Hyperactivity Disorder,and Oppositional Defiant Disorder Symptoms

Conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) are common childhood externalizing disorders that frequently co-occur. However, the causes of their comorbidity are not well understood. To address that question, we analyzed data from > 600 Finnish twin pairs, who completed standardized interviews at age 14. Behavior genetic methods were used to examine how genetic/environmental factors contribute to each disorders symptoms and to their covariation. We found significant genetic effects on each disorder with only modest evidence of shared environmental influences. Our data suggest the comorbidity among CD, ADHD, and ODD is primarily explained by shared genetic influences; however, each disorder was also under unique genetic influence, supporting the distinction of each disorder.     

注意缺陷多动障碍-发展性阅读障碍共患儿童的干预效果及其内在机理

注意缺陷多动障碍和发展性阅读障碍是两类常见的儿童神经发育障碍, 二者共患率高达25%~48%。共患问题不仅使儿童自身面临着严重的认知、行为和心理损害, 还给家庭、学校和社会带来了沉重的负担, 对共患儿童的干预是极为必要且重要的。以共患病理机制假说为基础, 可将既往共患儿童的干预研究划分为以下两大类：(1)基于表型假说的干预方案, 如药物干预、阅读干预以及二者联合干预, 相应方案干预效果的迁移性和稳定性均有待深入考究; (2)基于共同缺陷假说的干预方案, 如针对核心共同认知缺陷之一的加工速度问题的干预已初显成效, 但相关研究较少, 干预效果需更多研究进一步系统性地考察。最后就共患儿童的干预方案现状进行了反思和展望。     

An examination of the interactions between mothers and children with anxiety disorders

This study examined the association between parenting styles and mother and child anxiety. Maternal overinvolvement and negativity/criticism were evaluated during a speech preparation task (N = 135 dyads) and a Five Minute Speech Sample (FMSS) from mothers (N = 155). During the speech task interaction, mothers of anxious children (aged 4–16 years), regardless of their own anxiety, were observed to be more overinvolved than mothers of nonanxious children. Similarly, the FMSS showed that mothers of anxious children (aged 4–17 years) were more overprotective, self-sacrificing, or nonobjective than mothers of nonanxious children, irrespective of maternal anxiety status. No differences in maternal negativity were found on the speech task between any of the groups. However, the FMSS showed that mothers of anxious children were more critical than mothers of nonanxious children, regardless of maternal anxiety status. These results support the relationship between overinvolved, critical parenting and child anxiety, but suggest that maternal anxiety is not associated with increased overinvolvement or criticism. Theoretical implications are discussed.     

Executive functioning deficits in relation to symptoms of ADHD and/or ODD in preschool children

The present study investigated the relation between executive functioning and symptoms of Attention‐Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) in children aged 4–6. A population‐based sample (n=201) was used and laboratory measures of inhibition, working memory and verbal fluency and teacher ratings of disruptive behaviour problems were collected. Both group differences and linear relations were studied and comorbidity was controlled for dimensionally. In both categorical and dimensional analyses, executive functioning was associated with symptoms of ADHD, but not with symptoms of ODD when controlling for comorbidity, and no significant interactive effects of ADHD and ODD symptoms were found. Effect sizes for significant effects were generally in the medium range. Regarding sex differences, the control for comorbid ODD symptoms appeared to affect the relation between ADHD symptoms and executive functioning somewhat more for girls compared with boys. In conclusion, poor executive functioning in preschool appears to be primarily related to symptoms of ADHD, whereas the relation to symptoms of ODD can be attributed to the large overlap between these two disruptive disorders. Copyright © 2006 John Wiley & Sons, Ltd.     

Factor structure and stability of the Anxiety Sensitivity Index in a longitudinal study of anxiety disorder patients

The past decade witnessed considerable debate over the factor structure of the Anxiety Sensitivity Index (ASI), with an eventual consensus emerging that supported a hierarchically organized factor structure. The present study attempted to replicate and examine the overall stability and utility of the hierarchical ASI factor pattern using a large sample of outpatients participating in an ongoing longitudinal study of anxiety disorders. Results supported a hierarchical factor structure for the ASI consisting of three lower-order factors measuring physical concerns, mental incapacitation concerns, and social concerns, all of which loaded significantly on a single second-order factor. Correlational analyses show good test-retest reliability and consistent patterns of intercorrelation for these factor-derived subscales across a 10-month time frame. Additional analyses provide support for the discriminant validity of the ASI subscales with regard to individuals with specific anxiety disorders. The theoretical implications of these findings for future evaluations of anxiety sensitivity are discussed.     

The role of avoidance of emotional material in the anxiety disorders

Many psychotherapeutic traditions have conceptualized clinical levels of anxiety as resulting from the avoidance of threatening or emotional material. In this paper, we examine behavioral models of avoidance of emotions and emotional material, integrating findings that support established behavioral theories of emotional avoidance and anxiety, and that extend these theories to further explain the intense, intrusive, and interfering nature of clinical anxiety. Research on the suppression and avoidance of emotional material suggests that emotional avoidance and thought suppression may not only hinder the learning process and maintain anxious responding, but may also (a) paradoxically heighten anxious responding to threatening cues and (b) interfere with emotion functionality, thereby further impeding adaptive responding. Findings are discussed in terms of future research and implications for clinical treatment of anxiety disorders.