Interrater agreement on behavioral executive function measures in adolescents with Attention Deficit Hyperactivity Disorder

Background/ObjectiveThough most children with Attention Deficit Hyperactivity Disorder (ADHD) show difficulties in behavioral measures of executive functions (EF), few studies have examined interrater agreement in these measures.Objective: To analyze the agreement between parents, teachers and self-reports of behavioral EF in adolescents with ADHD and controls. Method: A sample of 118 adolescents (75 with ADHD and 43 controls) was rated by parents, teachers and the adolescents themselves using the Comprehensive Executive Function Inventory. The intraclass correlation coefficient (ICC) and Bland and Altman methods were used to evaluate agreement. Results: The ICC between parents, teachers and self-report was poor or moderate in the group with ADHD; in the control group the agreement was fair to good. The Bland and Altman graphs show that, in the control group, most of the scores are below to the clinical cut-off point, while in the group with ADHD they are above. Conclusions: Agreement between all raters was low. Parents, teachers and adolescents agreed on the absence of deficits in behavioral EF in the control group, and on the presence of deficits in the group with ADHD, although they did not agree on the frequency of these deficits.     

Predictive factors of quality of life in acquired brain injury

Background/ObjectiveThe sequelae and the disability and dependence that follow an acquired brain injury (ABI) may result in a significant reduction in the quality of life (QoL) of those affected. The objective was to assess the QoL of a sample of Spanish patients with an ABI and analyze the influence of certain sociodemographic and injury-related variables on their QoL. Method: The sample comprised 421 adults (60% male; M_age = 53.12; SD = 14.87). Professionals and relatives assessed the patients’ QoL through the CAVIDACE scale, an ABI-specific tool based on the eight-domain QoL model. Results: Univariate analyses showed statistically significant differences in the QoL scores in several sociodemographic (age, civil status, education level, prior employment status, type of home, level of supports, loss of legal capacity, recognized dependence, and degree of dependence) and injury-related (time since the injury, location of the injury, and presence of post-traumatic amnesia) variables. The multiple linear regression showed that loss of legal capacity, time since the injury, prior employment status, location of the injury, and degree of dependence were significant QoL predictors. Conclusions: These findings provide knowledge for the development of programs aimed at reducing the negative impact of ABI on QoL.     

Posttraumatic Stress Disorder and executive dysfunction among children and adolescents: A Latent Profile Analysis

Background/ObjectiveThe current study aimed to examine the relationship between Posttraumatic Stress Disorder (PTSD) symptoms and executive dysfunction in children and adolescents after psychological trauma.MethodParticipants were 13,438 of children and adolescents aged 6 to 18 years exposed to the 2008 Wenchuan earthquake. PTSD and dysexecutive symptoms were assessed using the UCLA PTSD Reaction Index for Children and the Self-Report Dysexecutive Questionnaire. Latent Profile Analysis (LPA) was conducted using Mplus version 7.4. Subgroup differences in trauma exposure and quality of life were calculated using ANCOVA.ResultsA 4-class parallel model was found to best describe latent PTSD symptom profiles and executive dysfunction. Individuals in higher symptom groups showed more trauma exposure and lower quality of life.ConclusionsThis LPA study shed light on the relationship between PTSD and executive dysfunction symptoms in children and adolescents. The correlation between PTSD and executive dysfunction was maintained after individual differences were taken into consideration. Our findings provide a new view on how PTSD relates to executive dysfunction and several suggestions for treating child and adolescent PTSD patients.     

Empathy in informal dementia caregivers and its relationship with depression,anxiety, and burden

Background/Objective: Recent interventions aim to heighten informal caregivers’ empathy levels assuming that this will lead to better well-being. However, previous studies have explored linear associations between empathy and aspects of well-being and yielded mixed results. We hypothesized that quadratic models may be more fitting to describe these relationships. Method: A cross-sectional study, with two groups (201 informal caregivers, and 187 non-caregivers) was conducted. Participants completed questionnaires on cognitive and affective empathy, and depression, anxiety, and caregiver burden. AN(C)OVA's and multiple hierarchical regression analyses including linear and quadratic terms were used to analyze the data. Results: For caregivers, there was a negative quadratic relationship between depression and cognitive empathy, and a positive linear relationship between anxiety and affective empathy, irrespective of sociodemographic characteristics. For non-caregivers, there were positive quadratic relationships between depression and cognitive and affective empathy, and between anxiety and affective empathy. The empathy levels did not differ between the groups. Conclusions: While caregivers and non-caregivers had the same amount of empathy, the relationships between empathy and depression and anxiety differed between the groups. Interventions for informal caregivers could aim to heighten cognitive empathy and to lower affective empathy to diminish depression and anxiety symptoms.     

Short‐term psychodynamic infant–parent interventions at Child health centers: Outcomes on parental depression and infant social–emotional functioning

Randomized controlled trials (RCTs) demonstrate efficacy of parent–infant psychotherapy, but its applicability and effectiveness in public health care are less known. The method followed is Naturalistic study evaluating Short‐term Psychodynamic Infant–Parent Interventions at Child Health Centers (SPIPIC) in Stockholm, Sweden. One hundred distressed mothers with infants were recruited by supervised nurses. Six therapists provided 4.3 therapy sessions on average (SD = 3.3). Sessions typically included the mothers, often with the baby present, while fathers rarely attended sessions. The Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stages Questionnaire: Social–Emotional (ASQ: SE) were distributed at baseline and at 3 and 9 months later. Data from a nonclinical group were collected simultaneously to provide norm data. Multilevel growth models on the mothers’ questionnaire scores showed significant decreases over time on both measures. Nine months after baseline, 50% achieved a reliable change on the EPDS and 14% on the ASQ: SE. Prepost effect‐sizes (d) were 0.70 and 0.40 for EPDS and ASQ: SE, figures that are comparable to results of other controlled studies. Psychotherapists integrated with public health care seem to achieve good results when supporting distressed mothers with brief interventions in the postnatal period. SPIPIC needs to be compared with other modalities and organizational frameworks.     

The Children's Social Vulnerability Questionnaire (CSVQ): Validation,relationship with psychosocial functioning,and age-related differences

Background/Objective: Social vulnerability refers to difficulties detecting potentially harmful interpersonal situations. Although it is an important predictor of psychosocial and interpersonal difficulties in clinical samples, research investigating this construct is scarce. We aimed to (a) develop a brief measure for assessing social vulnerability in typically developing children, the Children's Social Vulnerability Questionnaire (CSVQ) (b) examine the relationship between social vulnerability and psychosocial functioning, (c) explore age-related differences, and (d) explore levels of social vulnerability amongst children with clinical needs. Method: Data were gathered on two samples. Participants were parents (n = 790) of elementary school-aged children (3-12 years), and parents and teachers of a second sample (n = 96). Results: Results provide strong reliability and validity evidence. Social vulnerability showed moderate relationships with emotional and behavioural problems, and only a weak relationship with social skills. Parents perceived greater social vulnerability in younger than older children, and amongst children with clinical needs. Parents’ and teachers’ scores were correlated. Conclusions: Social vulnerability is not simply a lack of social skill; rather, it is a valuable construct for understanding psychosocial risk, especially for young and clinical samples of children.     

Global Collaborative Team Performance for the Revision of the International Classification of Diseases: A Case Study of the World Health Organization Field Studies Coordination Group

Background/Objective: Collaborative teamwork in global mental health presents unique challenges, including the formation and management of international teams composed of multicultural and multilingual professionals with different backgrounds in terms of their training, scientific expertise, and life experience. The purpose of the study was to analyze the performance of the World Health Organization (WHO) Field Studies Coordination Group (FSCG) using an input-processes-output (IPO) team science model to better understand the team's challenges, limitations, and successes in developing the eleventh revision of the International Classification of Diseases (ICD). Method: We thematically analyzed a collection of written texts, including FSCG documents and open-ended qualitative questionnaires, according to the conceptualization of the input-processes-output model of team performance. Results: The FSCG leadership and its members experienced and overcame numerous barriers to become an effective international team and to successfully achieve the goals set forth by WHO. Conclusions: Research is necessary regarding global mental health collaboration to understand and facilitate international collaborations with the goal of contributing to a deeper understanding of mental health and to reduce the global burden of mental disorders around the world.     

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS

Symptoms of depression negatively impact on mother?infant relationships and child outcomes. We evaluated a novel, 10‐session mother?infant therapeutic playgroup—Community HUGS (CHUGS)—which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother?infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait‐list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self‐Efficacy subscale; J. Gibaud‐Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self‐efficacy, p < .001, all showed improvements, as did observer‐rated mother?infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait‐list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self‐efficacy, depression, anxiety, stress, and mother?infant interactions that supported the program's acceptability and the utility of further rollout.     

A Longitudinal Study of Parental Depressive Symptoms and Coparenting in the First 18 Months

Although the negative impact of postpartum depression on parenting behaviors has been well established—albeit separately—for mothers and fathers, the respective and joint impact of both parents' mood on family‐group interactive behaviors, such as coparenting support and conflict behaviors between the parents, have not yet been investigated. The aim of this study was to examine the association between parental depressive symptoms and coparenting behaviors in a low‐risk sample of families with infants, exploring reciprocity between the variables, as well as gender differences between mothers and fathers regarding these links. At 3 (T1), 9 (T2), and 18 months postpartum (T3), we assessed both parents' depressive symptoms with a self‐report questionnaire and observed coparenting support and conflict during triadic mother–father–child interactions. The results revealed that higher maternal depressive symptoms at T1 were associated with lower support at T1 and T2. Conflict at T3 was associated with higher maternal depressive symptoms at T3 and, more surprisingly, with less depressive symptoms in mothers at T2 and fathers at T3. Cross‐lagged associations suggested that parental depressive symptoms were more likely to influence coparenting than the reverse. Moreover, maternal depressive symptoms were more likely to be linked to coparenting behaviors than were paternal depressive symptoms. These results confirm that parental—mostly maternal—depressive symptoms, even of mild intensity, may jeopardize the development of healthy family‐level relations, which previous research has shown to be crucial for child development.     

Psychometric properties of the Conners-3 and Conners Early Childhood Indexes in a Spanish school population

Ba#ckground/Obje#ctive: To examine the psychometric properties of the Conners 3 ADHD Index (Conners 3 AI) and the Conners Early Children Global Index (Conners ECGI) parents’ form (PF) and teachers’ form (TF) in Spanish schoolers. Method: Two-phase cross-sectional study. In the first phase, information was gathered from teachers (n = 1,796) and parents (n = 882) of 4-5 and 10-11 year-old children. In the second phase (n = 196), children at risk of ADHD and controls were individually assessed. Results: The results confirmed the two-factor structure of the Conners 3 ADHD Index, which contains hyperactive-impulsive and inattentive symptoms, and the two-factor structure of the Conners ECGI PF, consisting of emotional lability and restless-impulsive symptoms. In contrast with the original version, the Conners ECGI TF presented an additional inattentive factor. Moderate-to-high rates of evidence of convergent validity with Child Behavior Checklist and Kiddie-Schedule for Affective Disorders & Schizophrenia, and evidence of external validity (academic achievement) were found. Scores were significantly higher in boys than in girls, for both indexes. Raw scores corresponding to clinical T-scores were higher than the original version. Conclusions: The Conners indexes may be considered reliable and valid instruments for detecting ADHD symptoms in Spanish populations.