Stability of posttraumatic stress reaction factors and their relation to general mental health problems in children: a longitudinal study

The aim of this study was to evaluate the structure of posttraumatic stress reaction factors and their relation to general mental health problems in Norwegian children exposed to the tsunami on December 26, 2004. A total of 133 children and adolescents (ages 6-17) were interviewed 10 months posttsunami using the UCLA PTSD Reaction Index, and 104 were interviewed again 2.5 years after the tsunami. Confirmatory factor analyses supported the theory of a four-factor model of intrusion, active avoidance, numbing, and arousal as a better division of symptoms than the three-factor model used in the present diagnostic criteria. The factors of intrusion and active avoidance were highly correlated 2.5 years posttsunami. This association may be due to nonspecificity in these trauma-related factors as posttraumatic stress reaction levels diminish over time. General mental health problems were highly related to arousal at both assessments, supporting the theory that some symptoms of posttraumatic stress reactions overlap with other, concurrent mental problems.     

A psychometric and behavioral comparison of delinquents who were abused as children with their non-abused peers.

Investigated responses of abused and non-abused juvenile delinquents to Bell's Adjustment Inventory and Gough's California Psychological Inventory, and information with regard to several related behavioral measures. The Ss were 52 institutionalized adolescent males and females. Results indicated that the abused Ss scored significantly higher than the non-abused group on the Home Adjustment Scale (indicative of poorer adjustment) and significantly lower than the non-abused group on the Flexibility, Tolerance, and Socialization Scales. Subsequent analysis showed a significant interaction effect on the behavioral measure with regard to the number of runaway attempts; abused males made significantly more attempts than abused females and non-abused males and females.     

Perception of benefits and costs during SARS outbreak: An 18-month prospective study

In this study, the authors examined perceived benefits and costs of the outbreak of severe acute respiratory syndrome (SARS). Mixed accounts of benefits and costs, rather than exclusive accounts of only benefits or costs, were proposed to be characterized by nondefensiveness and enduring changes in psychosocial resources. Participants were 70 SARS recoverers, 59 family members of SARS recoverers, and 172 healthy adults residing in Hong Kong--a SARS-affected region. Results show that participants giving an exclusive account of benefits had higher levels of defensiveness than those giving a mixed account and those giving an exclusive account of costs. Only the perceived impact of benefits given in mixed accounts were related to future accruements in personal and social resources over an 18-month period.     

Alpha biofeedback therapy in alcoholics: An 18-month follow-up

In an earlier study on patients with alcohol problems, an experimental group given 10 hour-long alpha biofeedback training sessions showed greater improvement on State and Trait Anxiety scores than did a control sample. In the present study an 18-month follow-up was done on those Ss. The differences between the experimentals and controls in State and Trait Anxiety after 18 months were essentially identical to the differences between them immediately after treatment, which indicates that alpha training had longrange therapeutic effects. A difference between the groups on the Alcohol Rehabilitation Followup Questionnaire also suggested that alpha training may have been associated with some reduction in alcohol consumption as well.     

Brief treatment for elementary school children with disaster-related posttraumatic stress disorder: a field study.

Effective psychological intervention is needed to help children recover from disaster-related posttraumatic stress disorder (PTSD). This controlled study evaluated the effectiveness of a brief intervention for disaster-related PTSD. At one-year follow-up of a prior intervention for disaster-related symptoms, some previously treated children were still suffering significant trauma symptoms. Using a randomized lagged-groups design, we provided three sessions of Eye Movement Desensitization and Reprocessing (EMDR) treatment to 32 of these children who met clinical criteria for PTSD. The Children's Reaction Inventory (CRI) was the primary measure of the treatment's effect on PTSD symptoms. Associated symptoms were measured using the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). Treatment resulted in substantial reductions in both groups' CRI scores and in significant, though more modest, reductions in RCMAS and CDI scores. Gains were maintained at six-month follow-up. Health visits to the school nurse were significantly reduced following treatment. Psychosocial intervention appears useful for children suffering disaster-related PTSD. Conducting controlled studies of children's treatment in the postdisaster environment appears feasible.     

The identification of psychiatric disorders in children who fail to attend school: a cluster analysis of a non-clinical population

Interviews were conducted with parents of 100 children taken to a 'school attendance committee', because of persistent failure to attend school. Clinical assessment of the attendance problem was carried out so that children were categorized as 'school refusers' (N = 24), 'truants' (N = 53), 'both refusers and truants' (N = 9), or as 'neither' (N = 14). Any ICD-9 psychiatric disorder was separately identified. Cluster analysis of information collected in a standard way indicated that there was a group of children with the features of 'school refusal' who often had generalized neurotic disorders as well and who were mostly girls, another group with the features of 'truancy' all of whom had conduct disorders who were mainly boys, and a third cluster of children who were usually 'truants' but less often psychiatrically disturbed. The study provided evidence for the existence of school refusal with and without generalized neurotic disturbance in a non-clinical population.     

Personality and outcome in depression: an 18-month prospective follow-up study

BACKGROUND: The relationship between personality and depressive illness is complex. The aim of this study was to assess whether the presence of a personality disorder or high neuroticism (N) scores predicted longer times to discharge or remission onset or higher risks of relapse for a cohort of depressed subjects admitted for the first time. METHODS: 100 consecutive subjects with ICD-10-defined depression were recruited on admission and followed up prospectively over an 18-month period. Personality function was rated using the informant-rated Standard Assessment of Personality in addition to the self-rated Maudsley Personality Inventory. Remission onset and relapse were defined operationally by scores on the Hamilton Rating Scale using recommended criteria. RESULTS: The presence of a personality disorder predicted longer times to remission onset. Personality trait accentuation did not. Higher end N-scores correlated with longer times to remission onset. Neither personality disorder nor high N-scores predicted relapse or discharge risk. Subjects with a personality disorder were treated as aggressively as those without but those with higher N-scores were not. LIMITATIONS: It is an in-patient sample. Fifteen subjects dropped out of follow-up and those who did so were more likely to have met criteria for two or more personality disorder categories or four or more traits from one personality disorder category. The analysis assumes that state and scar effects on N-scores were minimised. Treatment decisions were not controlled. CONCLUSIONS: These findings support the view that the presence of a personality disorder and high N-scores modify the short-term course to remission onset in depression.     

Correlates of increased risk of eating disorders in Irish school children

Currently there are no large-scale data on the prevalence of disordered eating behaviours in Irish children and adolescents. We examined the 2002 Health Behaviour in School Aged Children (HBSC) study to estimate those Irish children who are potentially at risk of developing an eating disorder. Body Mass Index (BMI) data, based on self-reported height and weight were available for 2,469 pupils (29% of all participants). This analysis showed that 32.2% of adolescents were underweight (BMI < 18.5 kg m(-2)) and 10.7% of this group 'thought they were too fat'. These latter (n-86) were identified as the 'risk' group and compared with group 2 (n = 717) who reported they were underweight and had indeed a low BMI and group 3, (n = 856) those with a normal range BMI (18.5-25Kg/m2). Those at risk were significantly more likely to choose a large silhouette, be unhappy, poorly satisfied with life and perceive themselves as not good looking, to have diet concerns, be bullied at least twice per month and feel they were average/below average in their academic work (all p < 0.001). These data indicate psycho-social associations with an important potentially pathological population sub-group of at risk children.     

Remission onset and relapse in depression. An 18-month prospective study of course for 100 first admission patients

BACKGROUND: Few prospective studies of course for first admission depressives are reported. METHODS: One hundred consecutive depressed inpatients were followed prospectively over 18 months. Course was defined operationally using the Hamilton Depression scale and ICD-10 criteria. Results were analysed using life-tables. RESULTS: The cumulative probabilities of remission onset by 3 and 18 months were 0.67 (95% C.I.=0.57-0.77) and 0.82 (95% C.I.=0.74-0.90). The cumulative probability of relapse was 0.25 (95% C.I.=0.15-0.35); 53% of those relapsing did so in the first 2 months. Younger age at onset, longer illness length, higher depression and anxiety ratings, predicted delayed remission onset. ICD-10 episode severity predicted relapse. CONCLUSIONS: The chances of remission onset at 3 months and relapse were increased relative to other studies; risk of chronicity was similar. Predictors of outcome to emerge were similar to other studies. CLINICAL IMPLICATIONS: Adoption of these remission onset criteria may identify earlier (at 3 months), subjects at high risk of chronicity. After remission onset, subjects with severe illnesses warrant careful follow-up to detect relapse, particularly during the first 2 months. LIMITATIONS: The operational criteria used were different to other prospective studies. Relatively few psychosocial variables were included in the analysis.     

Risk factors and neuropsychological recovery in clients with alcohol use disorders who were exposed to different treatments

Risk covariates of neuropsychological ability (NA) at treatment entry and neuropsychological recovery (NR) across 15 months were examined and replicated in 2 samples (Ns = 952 and 774) from Project MATCH, a multisite study of alcoholism treatments. NA at treatment entry was associated with age, education, and other covariates. Statistically significant mean increases in NA over time had small effect sizes, suggesting limited clinical significance of NR in the samples as a whole. However, initial NA and a combination of risk factors in direct and mediated pathways predicted a large proportion of individual differences in NR. Statistically significant but modest differential treatment effects on NR suggest that addiction treatments may need to be modified or developed to facilitate this important aspect of recovery.     

Academic performance of school children with behavioural disorders in Uyo, Nigeria

Introduction

Behavioural disorders can have a negative influence on the academic performance of school children. There are no similiar published is no known studies in Nigeria.

Objective

To compare the academic performance of primary school children with behavioural disorders with that of their controls.

Methods

A total of 132 primary school pupils aged 6–12 years with behavioural disorders using Rutter scale for teachers (Scale B₂) and their matched-controls were selected. Their academic performance was assessed and compared using the overall scores achieved in the first and second term examinations in the 2005/2006 academic sessions, as well as the scores in individual subjects. Number of days absent from school was documented.

Results

While 26.5% and 12.9% pupils with behavioural disorders had high and poor academic performance respectively, 38.6% and 9.1% pupils without such disorders had high and poor performances respectively. The difference in the ooverall academic performance was statistically significant (p=0.04). The mean scores of the pupils with behavioural disorders on four core subjects compared well with those of the controls. Pupils with antisocial behaviour underachieved more than others. School absence rate had no significant influence on their performance.

Conclusion

Behavioural disorders are associated with poor academic performance in school children in Uyo.     

Association of dopamine transporter genotype with disruptive behavior disorders in an eight-year longitudinal study of children and adolescents.

Associations between dopamine transporter (DAT1) variable number tandem repeats (VNTR), genotypes, and disruptive behavior were examined in an 8-year longitudinal study of children (n = 183). Half of the children met criteria for attention-deficit/hyperactivity disorder (ADHD) at 4-6 years and half were non-referred comparison children. Consistent with several studies, the non-additive association for the 10-repeat allele was significant for hyperactivity-impulsivity (HI) symptoms. However, consistent with other studies, exploratory analyses of the non-additive association of the 9-repeat allele of DAT1 with HI and oppositional defiant disorder (ODD) symptoms also were significant. The inconsistent association between DAT1 and child behavior problems in this and other samples may reflect joint influence of the 10-repeat and 9-repeat alleles.     

An etiological survey of the severely retarded Hertfordshire children who were born between January 1, 1965 and December 31, 1967

An etiological survey is presented of all severely retarded children living in Hertfordshire, at home and in residential care, born between January 1, 1965, and December 31, 1967. One hundred and forty-six children (87 boys and 59 girls) were ascertained, out of a total population of 46,960, with a prevalence of 1 in 320 or 3.1 per 1,000. Approximately 1/3 (47) had the Down syndrome, 1 per 1,000 population. It was possible to establish a diagnosis in a further 45 cases, which included 1 additional case of autosomal chromosome abnormality and 7 each of autosomal dominant, recessive and X-linked conditions; 17 were associated with presumed multifactorial etiological factors; in 6 the condition was thought to have been caused by an environmental agent. It was not possible to establish a cause in the remaining 54 cases. Recurrence risks of severe mental retardation in cases where it is impossible to establish a definite diagnosis are discussed and the potential value, for genetic counseling purposes, of categorizing such patients into broad symptomatological groups, is suggested.     

Adaptive style and symptoms of posttraumatic stress in children with cancer and their parents

OBJECTIVE: To examine symptom levels of posttraumatic stress (PTS) in children with cancer and their parents as a function of patient and parent adaptive style. METHOD: Participants included 162 pediatric cancer patients and their parents. Patients completed self-report measures of PTS and adaptive style. Parents reported on their own adaptive style and PTS, as well as levels of PTS in their child. RESULTS: Adaptive style was a significant correlate of PTS. Children identified as low anxious (LA) or repressors (REP) obtained lower levels of PTS than did high anxious (HA) children, both by self-report and parent report. Parents identified as LA or REP self-reported lower levels of PTS than HA and also reported lower levels of PTS in their children. CONCLUSIONS: Patient and parent adaptive style are significant determinants of PTS in the pediatric oncology setting. These findings, in combination with the generally low levels of PTS in the pediatric oncology population, raise questions about the utility of the posttraumatic stress model for understanding the experiences of children with cancer, although such a model may be more applicable to parental response.     

Memory,attention, and school problems in children with seizure disorders

This study investigated memory and attention abilities in children with seizure disorders. First, children with different types of seizure disorders were evaluated for differences in memory (Rey Auditory‐Verbal Learning Test and Color Span Test) and attention (Continuous Performance Test‐2). From a total group of 51 children with seizure disorders, 35 children were classified into three subgroups based on seizure type and medication (Absence/Valproic Acid, n = 12; Complex Partial/Carbamazepine, n = 12; and Tonic‐Clonic/Carbamazep‐ine, n = 11). Results suggested no significant differences among the three subgroups on the memory or attention tasks, although trends toward lower memory scores for the absence subgroup and lower memory scores for all three subgroups compared with norms were noted. Second, the original group of 51 children were regrouped into two subgroups based on school problems (No School Problems, n = 17; School Problems, n = 26). Results indicated that children with school problems had more memory difficulties and a greater variability in attention abilities. The discussion addresses the significance of the results, limitations of the study, and questions for future research.     

Unrealistic expectations of parents who maltreat their children: An educational deficit that pertains to child development

Forty-one parents estimated when their own child and an “average” child would attain a number of different developmental milestones. These milestones and the accompanying normative data were derived from the Vineland Social Maturity Scale (Doll, 1965). Parents were divided into three groups on the basis of a prior history of child abuse, child neglect, or no previous background of abuse or neglect. Results indicate that both the abuse and neglect groups differed from the comparison group when absolute difference scores from the normative data were analyzed. When directionality of scores were analyzed (i.e., too high or too low expectations for the child), no differences were found among the groups. Implications of an educational deficit model of unrealistic parental expectations were discussed.     

Stressful life events and onset of mood disorders in children of bipolar parents during 14-month follow-up

BACKGROUND: Although multiple studies have examined the association between stressful life events (SLEs) and the development of mood disorders, the exact nature of the association and the degree to which it is independent from familial loading (FL) and gender-specific are still not fully elucidated. AIMS: To study the association between person-independent and -dependent SLEs and first onset or recurrence of a DSM-IV mood disorder episode (MDE) in offspring of bipolar parents. To examine interaction effects of SLEs with familial loading and gender. METHOD: Offspring of bipolar parents (N=132) were assessed with the K-LEDS, the FHRDC and the K-SADS. Logistic regression analysis was used to examine main and interaction effects of various operationalizations of SLEs, familial loading and gender. RESULTS: Dependent SLEs were more likely to occur before onset among the 13 offspring who had a MDE onset during the 14-month follow-up (39%) than in a comparable period among the 67 controls without any lifetime diagnosis (10%). Associations were slightly stronger for first onsets than for recurrences. The association between SLEs and MDE onset/recurrence was independent of socio-demographic characteristics and familial loading, but disappeared when adjusted for baseline anxious/depressive symptoms. Gender and familial loading did not modify the influence of any SLE measure on the development of mood disorders. CONCLUSIONS: In this sample of bipolar offspring dependent stressful SLEs triggered the onset of MDEs, but this association disappeared after adjustment of prior anxious/depressive symptoms, indicating that the association between SLEs and MDE is probably a spurious association. No interaction was found between SLE and FL and gender. Prior anxious/depressive symptoms seem to increase the risk for both occurrence of dependent SLEs and MDE onset or recurrence. LIMITATIONS: Limited statistical power due to small number of MDE onsets.     

An etiological survey of the severely retarded Hertfordshire children who were born between January 1, 1965 and December 31, 1967.

An etiological survey is presented of all suveryl retarded children living in Hertfordshire, at home and in residential care, born between January 1, 1965, and December 31, 1967. One hundred and forty-six children (87 boys and 59 girls) were ascertained, out of a total population of 46,960, with a prevalence of 1 in 320 or 3.1 per 1,000. Approximately 1/3 (47) had the Down syndrome, 1 per 1,000 population. It was possible to establish a diagnosis in a further 45 cases, which included 1 additional case of autosomal chromosome abnormality and 7 each of autosomal dominant, recessive and X-linked conditions; 17 were associated with presumed multifactorial etiological factors; in 6 the condition was thought to have been caused by an environmental agent. It was not possible to establish a cause in the remaining 54 cases. Recurrence risks of severe mental retardation in cases where it is possible to establish a definite diagnosis are discussed and the potential value, for genetic counseling purposes, of a categorizing such patients into broad symptomatological groups, is suggested.