Genetic and Environmental Influences on Parent–Child Conflict and Child Depression Through Late Adolescence

Few studies have investigated potential gender differences in the genetic and environmental influences on the prospective associations between parent–child conflict and later depression, a notable gap given substantial gender differences in rates of depression and suggestive evidence of differences in the etiology of depression among females and males. To fill this gap, we evaluated whether the prospective relationship between parent–child conflict and major depressive disorder symptoms varied as a function of parent–child gender composition. A combined twin and adoption sample was used (53% female; 85% European ancestry), containing 1,627 adolescent sibling pairs (789 monozygotic twin pairs, 594 dizygotic/full-biological pairs, 244 genetically unrelated pairs) with assessments at two time points in adolescence (approximate ages 15 and 18). Prospective associations between parent–child conflict and subsequent adolescent depression were explained predominately through common genetic influences for mother–daughter and mother–son pairs but less so for father–daughter and father–son pairs. Results support the notion that processes of gene–environment correlation involved in the prospective associations between parent–child conflict, and later adolescent depression appear to be less relevant to father–child relationships in comparison to mother–child relationships. Notably, results did not show that parent–child conflict was more relevant to the etiology of major depressive disorder (MDD) for girls than boys; gender differences in depression do not appear to be due to differences in the associations between parent–child conflict and child depression.     

Parents’ Attributions for Negative and Positive Child Behavior in Relation to Parenting and Child Problems

Previous research has stressed the importance of parents’ attributions and parenting for child problems. Based on social cognitive models, studies have focused on the interrelations among parents’ child-responsibility attributions for negative behavior, harsh parenting, and child problems. Little is known about the extent to which child-responsibility attributions for positive behavior and other types of parenting play a role in these models. The purpose of this study was to examine whether parents’ child-responsibility attributions for positive and negative child behaviors are related to child problems, and whether these relations are mediated by harsh, lax, and positive parenting. Mothers’ and fathers’ attributions and parenting were examined separately. A community sample of 148 couples and their 9- to 12-year-old child (50% boys) participated in the study. Mothers and children participated by completing questionnaires and a laboratory interaction task. Fathers participated by completing the same questionnaires as mothers. Harsh parenting was the only parenting variable that uniquely mediated the relations between more child-responsibility attributions for (a) negative child behaviors and child problems for both parents and (b) the inverse relation between attributions for positive child behaviors and child problems for fathers. Findings confirm the importance of harsh parenting and demonstrate the importance of parents’ attributions for positive child behaviors in relation to decreasing harsh parenting and child problems. Clinically, it may be useful not only to reduce child-responsibility attributions for negative behaviors but also to increase the extent to which parents give their child credit for positive behaviors.     

Transactional Associations Among Maternal Depression,Parent–Child Coercion,and Child Conduct Problems During Early Childhood

Maternal depression is among the most consistent and well-replicated risk factors for negative child outcomes, particularly in early childhood. Although children of depressed mothers are at an increased risk of adjustment problems, conversely, children with emotional or behavioral problems also have been found to adversely compromise maternal functioning, including increasing maternal depression. The purpose of this investigation was to examine transactional associations among maternal depression, parent–child coercive interaction, and children’s conduct and emotional problems in early childhood using a cross-lagged panel model. Participants were 731 toddlers and families that were part of the Early Steps Multisite Study, a sample of diverse ethnic backgrounds and communities (i.e., rural, urban, suburban) recruited from Women, Infants, and Children Nutritional Supplement Centers. Analyses provided support for the existence of some modest transactional relations between parent–child coercion and maternal depression and between maternal depression and child conduct problems. Cross-lagged effects were somewhat stronger between children age 2–3 than age 3–4. Similar patterns were observed in the model with child emotional problems replacing conduct problems, but relations between coercion and maternal depression were attenuated in this model. In addition, the transactional hypothesis was more strongly supported when maternal versus secondary caregiver reports were used for child problem behavior. The findings have implications for the need to support caregivers and reinforce positive parenting practices within family-centered interventions in early childhood.     

Cushing’s Syndrome in a Child with Pancreatic Acinar Cell Carcinoma

A case of pancreatic acinar cell tumor (ACC) is presented in a 10-year-old boy. The tumor manifested clinically with Cushing’s syndrome, high serum adrenocorticotropic hormone (ACTH) and cortisol concentrations. In addition, excessive serum levels of alpha-fetoprotein (AFP) were detected. Surgical resection was not possible due to retroperitoneal invasion. Biopsy of the mass showed a solid, poorly differentiated ACC of the pancreas. Periodic acid Schiff positive cytoplasmic granules, trypsinogen, keratins, alpha-1-antitrypsin, and AFP were identified in the tumor cells. Electron microscopy demonstrated zymogen granules as well as isolated dense core granules. Using immunochemiluminometric assay, a high quantity of ACTH was found in the fresh frozen tumor extract. ACTH, chromogranin A, and corticotropin-releasing factor were identified only in a few cells by immunohistochemistry. Combined radiochemotherapy was temporarily effective in reducing the tumor mass and serum AFP. Serum ACTH and cortisol levels dropped progressively and definitively to normal values after chemotherapy, and the Cushing’s syndrome subsided. Two years later, the patient died with metastatic disease. The presented case of ACC is interesting due to high serum AFP values and ectopic ACTH secretion resulting in Cushing’s syndrome. Andrea Luczay is working now at the Second Department of Pediatrics, Semmelweis University, Budapest, Hungary.     

Chronic Granulomatous Disease-Like Presentation of a Child with Autosomal Recessive PKCδ Deficiency

Journal of Clinical Immunology - Autosomal recessive (AR) PKCδ deficiency is a rare inborn error of immunity (IEI) characterized by autoimmunity and susceptibility to bacterial, fungal, and...     

A Longitudinal Look at Parent–Child Diagnostic Agreement in Youth Treated for Anxiety Disorders

This study examined diagnostic agreement between children and their parents for seventy 9- to 13-year-olds (45 boys and 25 girls) who had received cognitive–behavioral treatment for anxiety disorders. Parent-child diagnostic rates and agreements for generalized anxiety disorder, separation anxiety disorder, and social phobia were evaluated at 3 time points: pretreatment, posttreatment, and 7.4-year follow-up. Results indicate that parent–child diagnostic agreement was typically poor to moderate (κ = –.03 to .64) and that estimates of agreement remained relatively unchanged (a) following treatment and (b) as the children enter adolescence and young adulthood. Parent–daughter agreement was better than parent–son agreement in some cases. Although it remains unclear whether parent or child diagnostic information is most accurate, positive treatment outcome appears to be possible despite poor parent–child diagnostic agreement.     

Effectiveness of Web-Based Tailored Advice on Parents’ Child Safety Behaviors: Randomized Controlled Trial

Background

Injuries at home are a major cause of death, disability, and loss of quality of life among young children. Despite current safety education, required safety behavior of parents is often lacking. To prevent various childhood disorders, the application of Web-based tools has increased the effectiveness of health promotion efforts. Therefore, an intervention with Web-based, tailored, safety advice combined with personal counseling (E-Health4Uth home safety) was developed and applied.

Objective

To evaluate the effect of E-Health4Uth home safety on parents’ safety behaviors with regard to the prevention of falls, poisoning, drowning, and burns.

Methods

A randomized controlled trial was conducted (2009-2011) among parents visiting well-baby clinics in the Netherlands. Parents were randomly assigned to the intervention group (E-Health4Uth home safety intervention) or to the control condition consisting of usual care. Parents in the intervention condition completed a Web-based safety behavior assessment questionnaire; the resulting tailored safety advice was discussed with their child health care professional at a well-baby visit (age approximately 11 months). Parents in the control condition received counseling using generic safety information leaflets at this well-baby visit. Parents’ child safety behaviors were derived from self-report questionnaires at baseline (age 7 months) and at follow-up (age 17 months). Each specific safety behavior was classified as safe/unsafe and a total risk score was calculated. Logistic and linear regression analyses were used to reveal differences in safety behavior between the intervention and the control condition at follow-up.

Results

A total of 1292 parents (response rate 44.79%) were analyzed. At follow-up, parents in the intervention condition (n=643) showed significantly less unsafe behavior compared to parents in the control condition (n=649): top of staircase (23.91% vs 32.19%; OR 0.65, 95% CI 0.50-0.85); bottom of staircase (63.53% vs 71.94%; OR 0.69, 95% CI 0.53-0.88); top and bottom of staircase (68.94% vs 78.28%; OR 0.62, 95% CI 0.48-0.81); storage of cleaning products (30.33% vs 39.91%; OR 0.67, 95% CI 0.53-0.85); bathing of the child (23.46% vs 32.25%; OR 0.65, 95% CI 0.51-0.84); drinking hot fluids (34.84% vs 41.73%; OR 0.76, 95% CI 0.61-0.96); using rear hotplates (79.34% vs 85.27%; OR 0.67, 95% CI 0.50-0.90); and the total risk score in which a higher score indicates more unsafe behavior (mean 13.63, SD 6.12 vs mean 15.34, SD 6.07; beta –1.59, 95% CI –2.26 to –0.93). There were no significant differences for other specific behaviors between the two study conditions.

Conclusions

Compared to generic written materials, the E-Health4Uth home safety intervention seems more effective in promoting parents’ safety behavior for safe staircases, storage of cleaning products, bathing, drinking hot fluids, and cooking. This study supports the application of Web-based, tailored, safety advice for the prevention of unintentional injuries in the youth health care setting.

Trial Registration

Nederlands Trial Register: NTR1836; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1836 (Archived by WebCite at http://www.webcitation.org/6MPIGQxpx).     

The Utility of Measures of Child and Adolescent Anxiety: A Meta-Analytic Review of the Revised Children's Manifest Anxiety Scale,the State–Trait Anxiety Inventory for Children,and the Child Behavior Checklist

We evaluated the ability of the Revised Children's Manifest Anxiety Scale (RCMAS), the State–Trait Anxiety Inventory for Children (STAIC), and the Child Behavior Checklist (CBCL) to (a) discriminate between youth with an anxiety disorder and youth without a disorder, (b) discriminate between youth with an anxiety disorder and youth with either externalizing disorders or affective disorders, and (c) measure treatment change. In addition, variables, including age and sex, were explored as possible moderators of instrument utility. A meta-analysis of 43 articles was conducted. A large effect size was found when the instruments were used to compare youth with an anxiety disorder to youth without a disorder. When comparing anxious youth to psychiatric control groups, the picture was mixed; the instruments were found to be useful when discriminating between youth with an anxiety disorder and youth with an externalizing disorder, but not between youth with an anxiety disorder and children and adolescents with an affective disorder. The RCMAS, STAIC, and CBCL were found to be moderately sensitive to treatment gains.     

Differences in Clinical Manifestations and Outcomes between Adult and Child Patients with Henoch-Sch?nlein Purpura

We aimed to investigate differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura (HSP), and to analyze the factors associated with poor prognosis for HSP nephritis. This retrospective 10-yr study enrolled 160 patients with HSP who visited Severance Hospital. Purpura was mostly detected in lower extremities, but purpura in upper extremities was more frequently observed in adults than children (41.7% vs 19.3%). Children had a greater frequency of arthralgia (55.4% vs 27.1%), while adults had a greater frequency of diarrhea (20% vs 1.6%). Anemia, elevated C-reactive protein, and level of IgA were more frequently observed in adults (25% vs 7.1%, 65.6% vs 38.4%, 26.3% vs 3.5%). Renal involvement in adults was more severe than in children (79.2% vs 30.4%). Chronic renal failure showed a significant difference in outcomes of HSP between adults (10.4%) and children (1.8%) after a follow up period of an average of 27 months. Furthermore, renal insufficiency at diagnosis was significantly related to the progression to chronic renal failure. Our results showed several differences in the clinical features of HSP between adults and children. Adults with HSP had a higher frequency of renal insufficiency and worse renal outcomes than children. Renal insufficiency at diagnosis might be of predictive value for the progression to chronic renal failure in HSP patients.

Graphical Abstract

相似文献   

Parental Expressions of Anxiety and Child Temperament in Toddlerhood Jointly Predict Preschoolers’ Avoidance of Novelty

This study investigated the link between (a) parents’ social trait and state anxiety and (b) children’s fear and avoidance in social referencing situations in a longitudinal design and considered the modulating role of child temperament in these links. Children were confronted with a stranger and a robot, separately with their father and mother at 1 (N = 122), at 2.5 (N = 117), and at 4.5 (N = 111) years of age. Behavioral inhibition (BI) was separately observed at 1 and 2.5 years. Parents’ social anxiety disorder (SAD) severity was assessed via interviews prenatally and at 4.5 years. More expressed anxiety by parents at 4.5 years was not significantly linked to more fear or avoidance at 4.5 years. High BI children were more avoidant at 4.5 years if their parents expressed more anxiety at 2.5 years, and they were more fearful if the parents had more severe forms of lifetime SAD. More severe lifetime forms of SAD were also related to more pronounced increases in child fear and avoidance over time, whereas parents’ expressions of anxiety predicted more pronounced increases in avoidance only from 2.5 to 4.5 years. High BI toddlers of parents with higher state and trait anxiety become more avoidant of novelty as preschoolers, illustrating the importance of considering child temperamental dispositions in the links between child and parent anxiety. Moreover, children of parents with more trait and state anxiety showed more pronounced increases in fear and avoidance over time, highlighting the importance of early interventions targeting parents’ SAD.     

Therapist Verbal Behavior Early in Treatment: Relation to Successful Completion of Parent–Child Interaction Therapy

We examined the role of specific therapist verbal behaviors in predicting successful completion of Parent–Child Interaction Therapy (PCIT) in 22 families, including 11 families that successfully completed treatment and 11 that discontinued treatment prematurely. The children were 3 to 6 years old and diagnosed with oppositional defiant disorder (ODD). Chamberlain et al.'s (1986) Therapy Process Code (TPC) was used to measure therapist verbalizations during therapist–parent interactions during the initial clinical interview and the second treatment session. Results indicated that therapists' use of the categories Question, Facilitate, and Support during these sessions accurately predicted treatment dropout versus completion for 73% of families. Findings suggest that the early therapist–parent relationship in PCIT may be critical to successful treatment completion.     

Factor Structure of the Eyberg Child Behavior Inventory: Unidimensional or Multidimensional Measure of Disruptive Behavior?

Presents evidence from two recent studies that the Eyberg Child Behavior Inventory (ECBI) is better conceptualized as a multidimensional than as a unidimensional measure of disruptive behavior. In Study 1, with a sample of 1,526 children and adolescents from five pediatric clinics in four states, factor analysis suggested three separate dimensions. The first dimension was similar to the Diagnostic and Statistical Manual for Mental Disorders (3rd ed., rev.; DSM-III-R; American Psychiatric Association, 1987)oppositional defiant disorder category, the second dimension to the attention deficit hyperactivity disorder category, and the third dimension to the conduct disorder category. Study 2 found three similar dimensions in a stratified random sample of 1,003 children and adolescents from an urban school district. Implications of these results for the use of the ECBI are discussed. Presents evidence from two recent studies that the Eyberg Child Behavior Inventory (ECBI) is better conceptualized as a multidimensional than as a unidimensional measure of disruptive behavior. In Study 1, with a sample of 1,526 children and adolescents from five pediatric clinics in four states, factor analysis suggested three separate dimensions. The first dimension was similar to the Diagnostic and Statistical Manual for Mental Disorders (3rd ed., rev.; DSM-III-R; American Psychiatric Association, 1987)oppositional defiant disorder category, the second dimension to the attention deficit hyperactivity disorder category, and the third dimension to the conduct disorder category. Study 2 found three similar dimensions in a stratified random sample of 1,003 children and adolescents from an urban school district. Implications of these results for the use of the ECBI are discussed.     

Does 5HTTLPR Genotype Moderate the Association of Family Environment With Child Attention-Deficit Hyperactivity Disorder Symptomatology?

Problematic family dynamics are common among youth with attention-deficit hyperactivity disorder (ADHD). Multiple mechanisms, including diathesis-stress (vulnerability) and differential susceptibility Gene × Environment interaction effects (G × E), have been proposed to account for this association. G × E effects for ADHD were examined via interactions between a genetic marker hypothesized to influence sensitivity to the environment (the promoter polymorphism of the serotonin transporter gene ?5HTTLPR) and family conflict and cohesion in predicting ADHD symptoms. There were 498 youth ages 6–17 years (251 ADHD, 213 non-ADHD) and their parents who completed a multistage, multi-informant assessment (including parent and youth reports on the Family Environment Scale), and saliva sample collection for genotyping. Linear regression analyses examined interactions between 5HTTLPR genotype and the Family Environment Scale scales of conflict and cohesion reported by parent and child. Criteria laid out by Roisman et al. (2012 Roisman, G. I., Newman, D. A., Fraley, R. C., Haltigan, J. D., Groh, A. M. &; Haydon, K. C. (2012). Distinguishing differential susceptibility from diathesis–stress: Recommendations for evaluating interaction effects. Development and Psychopathology, 24, 389–409. doi:10.1017/s0954579412000065[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) were applied to evaluate diathesis stress versus differential susceptibility G × E mechanisms. Results demonstrated interactions between 5HTTLPR genotype and both conflict and cohesion in predicting inattention but not hyperactivity-impulsivity. Both interactions were highly consistent with differential susceptibility models of G × E effects. 5HTTLPR genotype appeared to moderate the relationship between family conflict/cohesion and inattentive symptoms. Interactions highlight the role of 5HTTLPR genotype as a potential marker of environmental sensitivity and provide support for differential susceptibility models of G × E effects for ADHD.     

Pineal Germinoma in a Child with Interferon-γ Receptor 1 Deficiency. Case Report and Literature Review

Interferon-γ receptor 1 (IFN-γR1) deficiency is one of the primary immunodeficiencies conferring Mendelian Susceptibility to Mycobacterial Disease (MSMD). Some cases of neoplasms have been recently reported in patients with MSMD, underlying the already known link between immunodeficiency and carcinogenesis. We report the first case of intracranial tumour, i.e. pineal germinoma, in a 11-year-old patient with complete IFN-γR1 deficiency. The first clinical presentation of the genetic immunodeficiency dates back to when the child was aged 2 y and 10 mo, when he presented a multi-focal osteomyelitis caused by Mycobacterium scrofulaceum. The diagnosis of IFN-γR1 deficiency (523delT/523delT in IFNGR1 gene) was subsequently made. The child responded to antibiotic therapy and remained in stable clinical condition until the age of 11 years, when he started complaining of frontal, chronic headache. MRI revealed a solid pineal region mass lesion measuring 20 × 29 × 36 mm. Histological findings revealed a diagnosis of pineal germinoma. The patient received chemotherapy followed by local whole ventricular irradiation with boost on pineal site, experiencing complete remission, and to date he is tumor-free at four years follow-up. Four other cases of tumors have been reported in patients affected by MSMD in our knowledge: a case of Kaposi sarcoma, a case of B-cell lymphoma, a case of cutaneous squamous cell carcinoma and a case of oesophageal squamous cell carcinoma. In conclusion, in patients with MSMD, not only the surveillance of infectious diseases, but also that of tumors is important.     

Does Working with Child Abuse Cases Affect Professionals’ Parenting and the Psychological Well-Being of Their Children?

Work in the field of sexual abuse is extremely stressful and may arouse negative personal reactions. Although these secondary trauma effects are well described on a personal level, there is not enough evidence to understand whether these professionals carry these effects to their homes, families, and offspring. This study aims to identify the effects of working with child abuse cases on the anxiety level and parenting styles of childhood trauma workers and on their children’s well-being. A total of 43 health and legal system workers who worked with abused children in any step of their process and who had children constituted the study group, and 50 control cases, each working in the same institution and having the same occupation as 1 of the participants from the study group and having children but not working directly with children and child abuse cases, were included in the study. Participants were asked to fill out a sociodemographic form, the Parental Attitude Research Instrument, the trait portion of the State-Trait Anxiety Inventory, and an age-appropriate form of the Child Behavior Checklist for each child they had. Professionals in the study working with child abuse cases demonstrated significantly higher democratic parenting attitudes. Law enforcement workers working with child abuse cases demonstrated stricter and more authoritarian parenting strategies, as well as more democratic attitudes, than their colleagues. There was not a statistically significant relationship between child abuse workers’ anxiety level and their children’s well-being among control subjects.     

Validity and reliability of the Turkish version of the DSM-5 Dissociative Symptoms Severity Scale–Child Form

The goal of this study was to assess the validity and reliability of the Turkish version of the DSM–5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) Dissociative Symptoms Severity Scale–Child Form. The scale was prepared by translating and then back-translating the DSM–5 Dissociative Symptoms Severity Scale. The study groups included one group of 30 patients diagnosed with posttraumatic stress disorder who were treated in a child and adolescent psychiatry unit and another group of 83 healthy volunteers from middle and high schools in the community. For assessment, the Adolescent Dissociative Experiences Scale (ADES) was used in addition to the DSM–5 Dissociative Symptoms Severity Scale. Regarding the reliability of the DSM–5 Dissociative Symptoms Severity Scale, Cronbach’s alpha was .824 and item–total score correlation coefficients were between .464 and .648. The test–retest correlation coefficient was calculated to be r = .784. In terms of construct validity, one factor accounted for 45.2% of the variance. Furthermore, in terms of concurrent validity, the scale showed a high correlation with the ADES. In conclusion, the Turkish version of the DSM–5 Dissociative Symptoms Severity Scale–Child Form is a valid and reliable tool for both clinical practice and research.     

Stability and Predictive Validity of the Parent–Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers

Little research has examined the processes underlying children’s persistent sleep problems and links with later psychopathology. The current study examined the stability of parent–child sleep interactions as assessed with the parent-reported Parent–Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3–5 years (T1) and again when they were 6–9 years (T2). The PSIS includes three subscales—Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent–child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)—and a total score. Higher scores indicate more problematic bedtime interactions. Children’s sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children’s sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent–child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent–child sleep interactions may serve as a useful target for interventions.