Psychopathological Profile in Children with Chronic Tic Disorder and Co-existing ADHD: Additive Effects

The nature of the co-occurrence of chronic tic disorders (CTD) and attention deficit hyperactivity disorder (ADHD) is unclear. Especially in the field of psychopathology, the relationship of CTD and ADHD remains to be clarified. Thus, the aim of the present chart review study was to specify the contribution of CTD and/or ADHD to the psychopathological profile of the comorbid group (CTD+ADHD). The psychopathological profiles of four large groups (CTD-only (n=112), CTD+ADHD (n=82), ADHD-only (n=129), controls (n=144)) were measured by the eight subscales of the Child Behavior Checklist (CBCL) and analyzed by a 2×2 factorial design followed by contrasts. There were main effects of ADHD diagnosis on all but one subscale of the CBCL (Somatic Complaints). For CTD diagnosis, main effects were found for Attention Problems, Anxious/Depressed, Thought Problems, Social Problems and Somatic Complaints. The only interaction effect was seen for Somatic Complaints. While CTD and ADHD were both related to internalizing psychopathology of children in the CTD+ADHD group, ADHD had the largest effect on externalizing psychopathology in the comorbid group. At the level of psychopathology, an additive model for the co-occurrence of CTD and ADHD is strongly supported. In the comorbid group (CTD+ADHD), the ADHD diagnosis shows the strongest relation to externalizing psychopathology.     

Neuropsychological Functioning in Children with Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) has been associated with deficits in the areas of verbal memory and learning, executive functioning, working memory, and attention in adults. Findings have been less consistent in the few studies examining neuropsychological functioning in childhood PTSD, which are often limited by comparing children with PTSD to children without trauma histories, making it unclear whether observed neuropsychological deficits are related to trauma exposure or to PTSD symptomatology. In an ethnically diverse sample of 62 children who witnessed intimate partner violence (n = 27 PTSD+ and 35 PTSD?), children with PTSD exhibited slower and less effective learning, heightened sensitivity to interference, and impaired effect of rehearsal on memory acquisition on the California Verbal Learning Test – Children's Version, a word list learning task. Both groups performed in the below average range on measures of executive functioning, attention, and intellectual ability.     

Initial Psychometric Properties of a Brief Parent-Report Instrument for Assessing Tic Severity in Children with Chronic Tic Disorders

This article describes the development and initial psychometric properties of the Parent Tic Questionnaire (PTQ)—a new measure assessing the number, frequency, and intensity of motor and vocal tics in children and adolescents with Chronic Tic Disorder (CTD). Parents of 40 children with a CTD completed the PTQ as part of a larger assessment battery. Results show the PTQ to have excellent internal consistency and good to excellent 2-week test-retest reliability. The motor tic severity subscale, vocal tic severity subscale, and total severity score of the PTQ correlated highly with the corresponding scales of the gold-standard clinician-rated Yale Global Tic Severity Scale (YGTSS), indicating excellent convergent validity. Correlations between the YGTSS and PTQ remained strong after controlling for measures of obsessive-compulsive disorder and inattention, suggesting good discriminant validity. The PTQ is a promising supplement to current methods for assessing tic severity and further research on the validity, reliability, and clinical utility of the scale are warranted.     

Neuropsychological Dysfunction in Children with Borderline Personality Disorder Features: A Preliminary Investigation

Borderline personality disorder (BPD) is often linked to neuropsychological deficits, yet few studies have examined BPD or its features and concomitant neuropsychological dysfunction in childhood. This study examined children with borderline features (n = 21) using the Coolidge Personality and Neuropsychological Inventory for Children and compared them to controls (n = 21) with features of at least one personality disorder, but not BPD. As hypothesized, the BPD group scored significantly higher than the control group on the Attention Deficit/Hyperactivity Disorder, Executive Functions Deficits, Mild Neurocognitive Disorder, Conduct Disorder, and Oppositional Defiant Disorder scales. It appears that behavioral disturbances associated with BPD are linked strongly with neuropsychological dysfunction. Because none of the children with BPD features in the present sample had a history of traumatic brain injury (TBI), it appears likely that TBI in the histories of adult BPD patients may not be the cause of BPD, but traits such as anger and impulsivity in BPD may cause TBI. Clinical implications and future research directions are discussed.     

The Impact of Chronic Pesticide Exposure on Neuropsychological Functioning

The Psychological Record - This study compared neuropsychological test performance of individuals (n = 18) with an occupational history of pesticide exposure to individuals (n = 35) with no such...     

The Predictive Power of Combined Neuropsychological Measures for Attention-Deficit/Hyperactivity Disorder in Children

The present study explores the predictive power of seven neuropsychological assessment tools used in combination in classifying children with attention-deficit/hyperactivity disorder (ADHD). Twenty-one ADHD boys and 22 community control children participated. Group differences were significant on the continuous performance test only; however, battery analysis did increase overall predictive power, which was moderate. This study highlights the difficulty in identifying consistent mean differences on tests of frontal/executive functioning across studies, as well as the need to assess the predictive validity of these tests in classifying children with ADHD. The study suggests that these tests may provide greater predictive validity when used in combination. Inconsistencies in the literature are discussed, with consideration of research methodology, the heterogeneity of the ADHD population, and comorbid diagnoses.     

Attention and Short-Term Memory in Normal Children,Aggressive Children,and Non-Aggressive Children with Attention-Deficit Disorder

In the present study, fifteen 7- to 9-year-old male school children with attention deficit disorder (ADD) as well as matched groups of aggressive and normal children were compared on scores obtained for initial acquisition of information and its maintenance in the short-term score under various attentional loads. Bi-colored, alphanumeric arrays were used in a partial-report technique. Retention was measured 0, 5, 10, and 20 s, after pre- and postexposure under both rehearsal and nonrehearsal conditions. ADD children (a) were deficient in original acquisition, (b) were unable to take sufficient advantage of decreased load conditions, and (c) showed decrements over time that paralleled those of the control group (CG). The results have been interpreted in light of maturational lag and the differences between ADD and aggressive groups.     

Dysfunctional Cognitions in Children with Social Phobia, Separation Anxiety Disorder, and Generalized Anxiety Disorder

According to cognitive theories of anxiety, anxious adults interpret ambiguous situations in a negative way: They overestimate danger and underestimate their abilities to cope with danger. The present study investigated whether children with social phobia, separation anxiety disorder, and generalized anxiety disorder have such a bias, compared to a clinical and a normal control group. Children were exposed to stories in which ambiguous situations were described, and asked to give their interpretations, using open and closed responses. Results showed that anxious children reported more negative cognitions than control children. However, anxious children did not overestimate danger on the free responses, but they did judge the situations as more dangerous on the closed responses. Anxious children had lower estimations of their own competency to cope with danger than the control groups on both open and closed responses. The results indicate that children with anxiety disorders have dysfunctional cognitions about ambiguous situations.     

幼儿的自我投射能力对情景预见的影响:来自典型发展儿童和孤独症谱系障碍儿童的证据

情景预见是个体将自我投射到未来某个特定时间和地点预先体验可能发生的未来事件的一种能力。为了考察幼儿的自我投射能力在情景预见中的可能作用,本研究通过两个实验比较了从自己的视角和从他人视角完成情景预见任务时幼儿的表现。实验1选取236名3~5.5岁典型发展（Typically Developing,TD）幼儿,采用被试间设计发现,总体而言,幼儿为他人做预见优于为自己做预见。实验2采用被试内设计,在TD儿童身上验证了实验1的结果,同时发现,孤独症谱系障碍（Autism Spectrum Disorder,ASD）儿童为自己做预见与为他人做预见没有差异。综上,幼儿不成熟的自我投射能力会干扰其自我卷入的情景预见,而自我投射能力受损的ASD儿童则没有表现出这种影响。     

Motor, Emotional, and Cognitive Empathy in Children and Adolescents with Autism Spectrum Disorder and Conduct Disorder

It is unclear which aspects of empathy are shared and which are uniquely affected in autism spectrum disorder (ASD) and conduct disorder (CD) as are the neurobiological correlates of these empathy impairments. The aim of this systematic review is to describe the overlap and specificity of motor, emotional, and cognitive aspects of empathy in children and adolescents with ASD or CD. Motor and cognitive empathy impairments are found in both ASD and CD, yet the specificity seems to differ. In ASD facial mimicry and emotion recognition may be impaired for all basic emotions, whereas in CD this is only the case for negative emotions. Emotional empathy and the role of attention to the eyes therein need further investigation. We hypothesize that impaired motor and cognitive empathy in both disorders are a consequence of lack of attention to the eyes. However, we hypothesize major differences in emotional empathy deficits between ASD and CD, probably due to emotional autonomic and amygdala hyper-responsivity in ASD versus hypo-responsivity in CD, both resulting in lack of attention to the eyes.     

Autism,Attachment and Parenting: A Comparison of Children with Autism Spectrum Disorder,Mental Retardation,Language Disorder,and Non-clinical Children

Children with Autism Spectrum Disorder (ASD) have severe and pervasive impairments in the development of social interaction, which may affect the attachment relationship with their parents and may have an impact on parenting. In the current investigation 89 families with young children (mean age 26.5 months) were involved, who were diagnosed as ASD, mentally retarded (MR), or language delayed (LD), or part of a non-clinical comparison group. Attachment security was observed with the Brief Attachment Screening Questionnaire, and several parental self-report questionnaires assessed the parenting style, parental efficacy, parental experiences of daily hassles, social support, and psychological problems. Children with ASD were rated as less secure compared to the other clinical and normal comparison groups. Parents of non-clinical children reported higher levels of authoritative parenting than parents in the ASD group and in the total clinical group, and they also received less social support. Parents of children with ASD coped remarkably well with the challenges of raising a child with ASD.     

Peer Difficulties in Children with Epilepsy: Association with Seizure,Neuropsychological, Academic,and Behavioral Variables

Purpose/Objective: A developmental psychopathology framework was used to examine variables associated with peer problems in children with epilepsy (CWE). Variables commonly associated with peer difficulties in typically developing children, such as inattentive behavior, anxious behavior, and academic achievement were investigated. Neuropsychological functioning, age at epilepsy onset, and seizure status were also examined.

Research Method/Design: Participants were 173 CWE, ages 8–15. Structural equation modeling (SEM) was used to determine which variables predicted peer problems in CWE and to test hypothesized interrelations among variables.

Results: The SEM revealed that anxious behavior mediated relations between neuropsychological functioning and peer difficulties and seizure status and peer difficulties. Inattentive behavior mediated the association between neuropsychological functioning and peer difficulties. Neuropsychological functioning mediated the relation between age at epilepsy onset and inattentive behavior, anxious behavior, and academic achievement.

Conclusions/Implications: As seen with typically developing children, inattentive and anxious behaviors are related to peer difficulties in CWE. Neuropsychological functioning, age at epilepsy onset, and seizure status are indirectly associated with peer difficulties; therefore, these variables are important to examine in CWE who are experiencing peer problems.     

Predictors of Reading Comprehension in Children with Cerebral Palsy and Typically Developing Children

Predictors of reading comprehension were evaluated in 41 children with cerebral palsy and 74 typically developing children between the ages of 6 and 12 years. Regression analyses were conducted to determine the relative contributions of measures of phonemic awareness, receptive vocabulary, and general reasoning to variance in reading comprehension. All three independent variables were statistically significant predictors of reading comprehension in both groups of participants. The impact of phonemic awareness on reading comprehension was moderated by age, but only in the typically developing group. Within the group with cerebral palsy, there was an indirect effect of functional expressive ability on reading comprehension, mediated by phonemic awareness. It is concluded that largely the same variables predict reading comprehension in children with cerebral palsy as in typically developing children, but that children with cerebral palsy continue to rely on phonological processing for a more protracted period of time.     

Negative Thoughts in Children with Symptoms of Anxiety and Depression

This study examined whether negative thoughts are different in anxious, depressed, and chronically ill children. Screening of 1,316 children on anxiety, depression, and asthma resulted in the selection of 118 children. Four groups were formed: (1) a high anxiety group, (2) a high anxiety/depression group, (3) an asthma group, and (4) a low anxiety, low depression, and no chronic disease (control) group. The data yielded no pure depression group. Subsequently, the Negative Affectivity Self-Statement Questionnaire (NASSQ) and a Worry scale were administered. Results showed that cognitive scores were different in all groups. Highest scores were obtained from the high anxiety/depression group, and lowest from the control group. Children with asthma scored high on anxiety, not on depression. High correlations between scores on negative thoughts and conventional measures of negative emotions suggested that negative thoughts provided no unique information about the problems underlying emotional states in different groups of children. Implications for cognitive assessment in emotionally disturbed children are discussed.     

The Underlying Role of Negative Affect in the Association between PTSD,Major Depressive Disorder,and Generalized Anxiety Disorder

Clinicians and researchers have found differential diagnosis to be difficult, particularly for conceptually similar disorders. One category of particular interest has been distress or internalizing disorders, theorized to be related via an underlying construct of generalized distress or negative affect. The present study attempted to address the comorbidity of three distress disorders - posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) - using latent analyses by controlling for the variance attributable to negative affect. The sample consisted of 265 trauma-exposed individuals who completed self-report measures of PTSD, MDD, GAD, and negative affect. Confirmatory factor analysis was used to test initial model fit. Next, the model was re-computed, controlling for negative affect by regressing negative affectivity at the item-level. Results indicated that a significant amount of variance within and between these diagnostic categories is attributable to negative affect at both the item- and factor-level. The hypothesis that MDD’s non-somatic/affective factor and the GAD factor would have the highest attenuations in factor loadings after controlling for negative affect was supported. Therefore, negative affect significantly influences the co-occurrence of PTSD, MDD, and GAD clinically, emphasizing the need for transdiagnostic interventions for trauma victims.     

Assessing Effort During Neuropsychological Evaluation with the TOMM in Children and Adolescents with Epilepsy

Effort assessment is of particular importance in pediatric epilepsy where neuropsychological findings may influence treatment decisions, especially if surgical interventions are being considered. The present investigation examines the Test of Memory Malingering (TOMM) in 60 children and adolescents with epilepsy. The overall pass rate for the sample was 90%. TOMM scores were unrelated to age, though there was a significant correlation between TOMM Trial 2 scores and intelligence estimates. Overall, the TOMM appears to be a valid measure of effort in young epilepsy patients, though caution should be used when interpreting scores for those with very low IQ, especially if behavioral problems are also evident. Caution should also be exercised in interpreting scores in children with ongoing interictal epileptiform activity that may disrupt attention.