Longitudinal Genetic Analysis of Problem Behaviors in Biologically Related and Unrelated Adoptees

The genetic and environmental influences on problem behaviors at two assessment points, three years apart, and their stability were studied in a sample of international adoptees, initially aged 10 to 15 years. Parents of 111 pairs of adopted biological siblings, 221 pairs of adopted nonbiological siblings and 1484 adopted singletons completed the Child Behavior Checklist (75 pairs, 154 pairs and 1080 singletons respectively at second assessment). At first assessment, genetic factors accounted for more than 50% of the variance in the Externalizing, Aggressive Behavior, Attention Problems and Social Problems scales. Shared environmental influences explained 40% of the variance in the Total Problem scale and less for all other scales. Nonshared environmental influences were most important for the Internalizing scale and its subscales, and for the Thought Problems and Delinquent Behavior scales. At the second assessment, genetic factors explained most of the variance in the Total Problem, Externalizing and Aggressive Behavior scales, while nonshared environmental influences explained most of the variance in all other scales. Shared environmental influences explained 33% of the variance in the Internalizing scale and less for the other scales. The stability of the Externalizing scale over time was caused mostly by genetic factors, while nonshared environmental factors mostly caused the stability of the Internalizing scale.     

Using Shared and Unique Parental Views to Study the Etiology of 7-Year-Old Twins' Internalizing and Externalizing Problems

In a sample of 1,940 Dutch 7-year-old twin pairs we studied the etiology of individual differences in Internalizing and Externalizing behavioral problems. For the majority of twins in the sample, both maternal and paternal ratings of behavioral problems were obtained from the Child Behavior Checklist. This made it possible to take into account processes underlying agreement and disagreement between maternal and paternal ratings. For both problem behaviors, a Psychometric model fitted the data better than a Rater Bias model, implying that parents, in addition to the behaviors they similarly observed, also assessed unique aspects of their children's behaviors. Relatively large genetic influences were found for Externalizing problems, explaining over 50% of the variance in both boys and girls. For internalizing problems, the heritability was over 30% in both sexes. Shared environmental factors were nearly as important as genetic influences in explaining the variation in behavioral problems. For both Externalizing and Internalizing problems, around 30% of the variance was accounted for by the shared environmental factors.     

异常行为量表中文版在儿童孤独症群体中的信效度

目的:引进并探讨异常行为量表(Aberrant Behavior Checklist,ABC)在我国儿童孤独症群体的适用性。方法:对206例孤独症儿童(1.5~14.0岁)进行ABC评定,其中49例患儿由父母分别填写ABC,30例患儿于2~4周后由同一位家长再次评定,以检验评定者信度和重测信度;根据适用年龄范围对部分患儿评定儿童孤独症评定量表、孤独症行为评定量表、Conner父母评定量表及Achenbach儿童行为量表,经比较检验ABC的校标效度;对ABC结构模型进行验证性因素分析以检验结构效度。结果:ABC中文版各因子的评定者信度(ICC)在0.820~0.898之间(P<0.001),重测信度(ICC)0.873~0.944(P<0.001),各因子及总量表的内部一致性系数为0.748~0.951;ABC中文版各因子与儿童孤独症评定量表、孤独症行为评定量表、Conner父母评定量表及Achenbach儿童行为量表的相应因子间呈正相关(r=0.27~0.67,均P<0.01);验证性因素分析检验了结构的有效性(χ2/df=1.91,RMSEA=0.060,GFI=0.704,NFI=0.62,CFI=0.77)。结论:异常行为量表中文版的信、效度较好,适用于儿童孤独症的量化评估,但仍需进一步修订完善。     

The Role of Maternal Employment and Depression in the Psychological Adjustment of Chronically Ill, Mentally Retarded, and Well Children

Used path analysis to test a conceptual model of the relationshipamong maternal employment status, maternal depression, and reportedchild behavior problems. Ss were 95 mothers of children in 4conditions: cystic fibrosis, diabetes, mental retardation, andwell. Regardless of child chronic condition or family SES, mothersnot employed outside the home had higher levels of depressionthan employed mothers. Maternal depression, in turn, was associatedwith higher levels of reported child behavior problems. Controllingfor SES and maternal depression, mental retardation was associatedwith more child behavior problems, but chronic illness (cysticfibrosis and diabetes) was not associated with more behaviorproblems. The findings underscore the need to examine the adjustmentof children with chronic disorders in the context of their mothers'well-being, particularly when mothers are the principal informantsregarding child adjustment.     

A Twin Study of Competence and Behavioral/Emotional Problems Among Adolescents in Taiwan

This work reports on a study to evaluate the relative contributions of genetic and environmental factors to both competence scales and behavioral/emotional syndromes as assessed by the Child Behavior Checklist (CBCL). A total of 279 pairs of twins and same-sex sib-pairs aged 12-16 years were recruited from 51 junior high schools in Taipei City, Taiwan. Twins' zygosity was determined by a combination of DNA typing and physical similarity. The Mx program was used to estimate parameters for a full model that contains effects from sex-specific additive genes, shared environment, and nonshared environment for the majority of the scales. The shared environment in the full model was replaced with nonadditive genetic factors for some scales when indicated. All girls' competence and behavioral/emotional syndromes exhibited a substantial heritability (h2 > 0.4), except for Social Competence and Withdrawn. For boys, though the heritability was also >0.4 for some scales (Social and School Competence, Thought Problems, Attention Problems, Delinquent Behavior, and Total Behavior Problems), environmental influences, especially shared environment, were predominant for most of the scales (10 out of 15 scales). Genetic factors are important for explaining adolescent behavioral problems, especially for girls, while shared environmental influences cannot be ignored for boys. Gender differences in heritability exist for various CBCL-based competence and behavioral/emotional problems.     

A study of problem behaviors in 10- to 15-year-old biologically related and unrelated international adoptees

Genetic and environmental influences on problem behaviors were studied in a sample of international adoptees. Parental ratings of childrens' problem behaviors were obtained with the Child Behavior Checklist (CBCL). The sample (mean age, 12.4 years) comprised a group of biological siblings (111 pairs), a group of nonbiological siblings (221 pairs), and a group of singletons (94). Nonshared environmental influences were most important for problem behaviors studied in this paper. Genetic influences were substantial for Externalizing behaviors but unimportant for Internalizing behaviors. For the CBCL total problem score, Attention Problems, and Externalizing behaviors, the results of the present study were in agreement with findings from twin studies. The lack of genetic influences on Internalizing behaviors contrasts with results from twin studies. For the total problem score, the Externalizing grouping, Delinquent Behavior, and Aggressive Behavior, variances for singletons were significantly smaller than for siblings. Model fit indices indicated that these differences in variances are better attributed to smaller effects of factors associated with sibship size than to active influences of siblings on each other. Significant sex differences were found for 8 of the 10 scales. The larger variances for boys on the Externalizing grouping and Aggressive Behavior could be explained by genetic influences.     

Personality profiles of children and adolescents with neurofibromatosis type 1

The personality profile of 44 youngsters (24 males, 20 females; mean age 11 years, 3 months) with neurofibromatosis type 1 (NF1) was compared with a group of 220 non-NF1 control youngsters (matched on age and gender). Personality characteristics of each youngster were rated by both parents, using the California Child Q-set (CCQ); [Block and Block, 1980]. The scores on eight personality dimensions were compared, i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability, Openness, Motor Activity, Irritability, and Dependency. Moreover, personality of NF1 youngsters was related to IQ level, severity of medical problems, the presence or absence of visible cosmetic disfiguring, and de novo versus familial origin of NF1. The personality profile of NF1 youngsters was markedly different from the non-NF1 youngsters. Compared to the 220 control children, they were equally agreeable, but less conscientious, less emotionally stable, less open for new experience, with less motor activity, and more extravert, more dependent, and more irritable. Personality characteristics were similar for children with maternally or paternally inherited NF1, or for children with a new mutation. There was no association with gender, the severity of medical and cosmetic problems, and IQ.     

Anxiety in children and adolescents with autism spectrum disorders

Anxiety and poor stress management are common concerns in clinical samples of children with autism spectrum disorders (ASD). Anxiety may worsen during adolescence, as young people face an increasingly complex social milieu and often become more aware of their differences and interpersonal difficulties. This review summarizes the state of research on the prevalence, phenomenology, and treatment of anxiety in youth with autism and related conditions such as Asperger's Disorder. Using search words autism, asperger(s), or pervasive developmental disorder and anxiety or anxious to find reports published between 1990 and 2008, this review identified 40 papers. The results of the review suggest that anxiety, whether measured categorically or dimensionally, is indeed common in children and adolescents with autism spectrum disorders and may be a source of additional morbidity. The assessment of anxiety disorders in ASD should be conducted using multiple informants and modalities, as children with ASD often do not display age-typical symptoms of anxiety. To date, relatively few controlled intervention studies using well-characterized samples have been conducted despite preliminary evidence for efficacy of select pharmacological and psychosocial approaches. Recommendations for future applied research are presented and clinical implications are explored.     

A Study of Genetic and Environmental Influences on Maternal and Paternal CBCL Syndrome Scores in a Large Sample of 3-Year-Old Dutch Twins

Background. There is increasing evidence that behavioral problems are common in very young children, yet little is known about the etiology of individual differences in these problems. It is unclear to what degree environmental and genetic factors influence the development of early child psychopathology. In this paper, we focus on the following issues. Firstly, to what degree do genetic and environmental factors influence variation in behavioral problems? Secondly, to what degree are these underlying etiological factors moderated by sex and informant? We investigate these issues by analyzing Child Behavior Checklist (CBCL) data on 9689 3-year-old twin pairs.Methods. Rater Bias and Psychometric Models were fitted to CBCL/2-3 data obtained from mothers and fathers to determine the genetic and environmental contributions to the five CBCL syndromes:aggressive, oppositional, overactive, withdrawn, and anxious/depressed behavior.Results. Parental ratings are influenced by aspects of the child's behavior that are experienced in the same way by both parents and by aspects of the child's behavior that are experienced uniquely by each parent. There is evidence for high genetic contributions to all CBCL syndromes. Shared and non-shared environmental influences play significant roles as well. One exception is overactive behavior, which is influenced by genetic and non-shared environmental influences only.Conclusions. Variation in behavior problems in the very young shows high heritability.Individual raters offer unique perspectives that can have an impact on estimates of problem behavior and genetic architecture. Therefore, multi-informant approaches in the assessment of the very young will be useful to clinicians and researchers alike.     

Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis

OBJECTIVE: Findings in the literature are inconsistent on the impact of congenital heart disease (CHD) on the psychological and cognitive functioning of children and adolescents. The aim of the present study was to systematically review this empirical body of literature. METHODS: We conducted a meta-analysis to review studies on behavior problems and cognitive functioning in CHD. RESULTS: Only older children and adolescents with CHD displayed an increased risk of overall, internalizing, and to a lesser extent externalizing behavior problems. In addition, patients with severe CHD exhibited lower cognitive functioning than patients with less severe CHD, specifically with respect to performance intelligence. Moreover, decreased cognitive functioning remained relatively stable across different age groups. CONCLUSIONS: Children with severe heart disease may benefit from interventions specifically targeting perceptual organizational abilities, such as visual-spatial abilities. Moreover, older children and adolescents with CHD may benefit from psychological interventions reducing anxiety symptoms and depression.     

异常行为量表评估干细胞治疗儿童孤独症的临床疗效及效度评价

目的探索脐血单核细胞（CBMNCs）与脐带间充质干细胞（UCMSCs）治疗儿童孤独症的初步疗效,并对异常行为量表（ABC）的效度进行评价。方法选取2009年3月-2009年9月在山东省交通医院住院行干细胞治疗的儿童孤独症患者23例,分为CBMNCs＋康复训练治疗组（脐血组）和CBMNCs联合UCMSCs＋康复训练治疗组（混合组）;选取在济南明天儿童康复中心行康复训练治疗的儿童孤独症患者14例为对照组。治疗组患者共接受4次干细胞治疗,每周1次,分别收集患者基线、首次治疗后2、4、8、16、24周的儿童孤独症评定量表（CARS）及ABC评分结果,评价干细胞治疗儿童孤独症的临床疗效,并检验ABC量表评价儿童孤独症临床疗效的效度。结果①混合组、脐血组与对照组ABC评分在随访时间内均有一定程度的下降,24周时下降百分比分别为59．9％、38．0％、17．4％,三组间ABC评分比较差异具有统计学意义（P〈0．05）;②ABC分项分析：嗜睡、刻板行为因子6个月时混合组与脐血组和对照组比较,差异均具有统计学意义（P〈0．05）;混合组评分（16．00±7．92,9．33±5．81）明显低于脐血组（24．14±9．65,17．07±9．93）和对照组（30．54±5．03,17．31±4．05）;③ABC评分与CARS评分呈正相关,6个月时,两者之间相关系数r=0．87（P〈0．001）。结论应用干细胞联合康复训练治疗儿童孤独症疗效显著高于单纯康复训练治疗;对于ABC量表中嗜睡与刻板行为因子分析,三组都有显著改善,且CBMNCs联合UCMSCs＋康复治疗组的疗效最好;ABC量表在评价儿童孤独症临床疗效时具有较高的效度。     

Memory effects of sleep,emotional valence,arousal and novelty in children

Effectiveness of memory consolidation is determined by multiple factors, including sleep after learning, emotional valence, arousal and novelty. Few studies investigated how the effect of sleep compares with (and interacts with) these other factors, of which virtually none are in children. The present study did so by repeated assessment of declarative memory in 386 children (45% boys) aged 9–11 years through an online word‐pair task. Children were randomly assigned to either a morning or evening learning session of 30 unrelated word‐pairs with positive, neutral or negative valenced cues and neutral targets. After immediately assessing baseline recognition, delayed recognition was recorded either 12 or 24 h later, resulting in four different assessment schedules. One week later, the procedure was repeated with exactly the same word‐pairs to evaluate whether effects differed for relearning versus original novel learning. Mixed‐effect logistic regression models were used to evaluate how the probability of correct recognition was affected by sleep, valence, arousal, novelty and their interactions. Both immediate and delayed recognition were worse for pairs with negatively valenced or less arousing cue words. Relearning improved immediate and delayed word‐pair recognition. In contrast to these effects, sleep did not affect recognition, nor did sleep moderate the effects of arousal, valence and novelty. The findings suggest a robust inclination of children to specifically forget the pairing of words to negatively valenced cue words. In agreement with a recent meta‐analysis, children seem to depend less on sleep for the consolidation of information than has been reported for adults, irrespective of the emotional valence, arousal and novelty of word‐pairs.     

Effects of written emotional disclosure on caregivers of children and adolescents with chronic illness

OBJECTIVE: Tested feasibility of a written emotional disclosure intervention with caregivers of youths with chronic illness and its effects on measures of mood, physical symptoms, health-related quality of life, distress, and caregiver appraisal of stress and efficacy. METHODS: Measures were administered prior to and immediately after writing and 4 months later. Experimental group (n = 29) wrote about traumas and stressors while the control group (n = 25) wrote about summer activities for 20 minutes on three different days. RESULTS: Consistent with hypotheses, the experimental group experienced less positive affect, F(1, 54) = 4.68, p <.05, and more negative affect, F(1, 54) = 7.92, p <.01, and physical symptoms, F(1, 54) = 4.30, p <.05, immediately following writing than the control group. There were no significant Group x Time interactions on long-term mood, distress, health-related quality of life, or caregiver appraisal. Contrary to hypotheses, the control group had more vitality over time, F(1, 53) = 21.29, p <.001, than the experimental group. CONCLUSIONS: Recommendations include modifying the procedures to attain more control in applied settings and identifying specific processes that contribute to the efficacy of written emotional disclosure on well-being.     

Gender differences in the longitudinal structure of cognitive diatheses for depression in children and adolescents

In a school-based, four-wave, longitudinal study, children (grades 4–7) and young adolescents (grades 6–9) completed questionnaires measuring depressive symptoms and depressive cognitions, including positive and negative cognitions on the Cognitive Triad Inventory for Children (CTI-C; Kaslow, Stark, Printz, Livingston, & Tsai, 1992) and self-perceived competence on the Self-Perception Profile for Children (SPPC; Harter, 1985). Application of the Trait-State-Occasion model (Cole, Martin, & Steiger, 2005) revealed the existence of a time-invariant trait factor and a set of time-varying occasion factors. Gender differences emerged, indicating that some cognitive diatheses were more trait-like for girls than for boys (i.e., positive and negative cognitions on the CTI-C; self-perceived physical appearance and global self-worth on the SPPC). Implications focus on the emergent gender difference in depression, the design of longitudinal studies, and clinical decisions about the implementation of prevention versus intervention programs. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1–15, 2009.     

A meta-analysis of the effects of psychotherapy with sexually abused children and adolescents

This paper presents a meta-analysis of the psychotherapy treatment outcome studies for sexually abused children and adolescents. There were 39 studies included, most of which aimed to treat the psychological effects of childhood sexual abuse. Separate meta-analyses were conducted according to study design and outcome domain, in keeping with meta-analytic conventions. However, given heterogeneity across studies and the need for sufficient n in each category for meaningful moderator analyses, the study designs were pooled into a repeated measures meta-analysis. There were large effect sizes for global outcomes (g = 1.37) and PTSD/trauma outcomes (g = 1.12). More moderate effect sizes were evident for internalizing symptoms (g = 0.74), self-appraisal (g = 0.63), externalizing symptoms (g = 0.52), and sexualized behavior (g = 0.49), while small effects were found for measures of coping/functioning (g = 0.44), caregiver outcomes (g = 0.43), and social skills/competence (g = 0.38). Effects were maintained at follow-up more than six months after treatment for some outcome domains but not others. Studies represented diverse treatment approaches, and most treatments were effective in symptom reduction. Presence of probable moderators of treatment outcome varied across symptom domains, reflecting importance of targeting therapy to individual needs.     

Preliminary psychometric properties of a measure of Karen Horney's Tridimensional theory in children and adolescents

This study established the psychometric properties of a child and adolescent version of the Horney-Coolidge Tridimensional Inventory (HCTI), which assesses psychoanalyst Karen Horney's theory of neurotic types. Parents of 302 children (ages 5 to 17 years; median age = 12.0 years) completed the new 45-item version of the HCTI and the Coolidge Personality and Neuropsychological Inventory (CPNI) about their children. The three main scales (Compliance, Aggression, and Detachment) had good internal scale reliability and excellent test-retest reliability. Principal components analysis supported Horney's three dimensions and a six-component substructure. There was also sufficient construct validity with personality disorder scales from the CPNI with the three HCTI dimensions and their six components. The implications of the findings are discussed for Horneyan theory.     

Evidence of association between Val66Met polymorphism at BDNF gene and anxiety disorders in a community sample of children and adolescents

Different lines of evidence support BDNF as a candidate gene in mood and anxiety modulation. More recently, the Met allele of the BDNF Val66Met polymorphism has been implicated in anxiety in animal models and anxiety-traits in humans. The aim of this study is to evaluate the a priori hypothesis that the association between anxiety disorders and Val66Met polymorphism at the BDNF gene would be replicated in a community sample of children and adolescents. 240 subjects from a total sample of 2457 children and adolescents aged 10-17 years from the public schools in the catchment area of the primary care unit of a university hospital participated in this case-control study and were assessed for psychopathology using the K-SADS-PL. A sample of saliva was collected for DNA analysis of Val66Met polymorphism. BDNF was the single gene evaluated in this sample. We found a significant association between carrying one copy of the Met allele and higher chance of anxiety disorders in children and adolescents. The association remained positive even after the adjustment for potential confounders (228 subjects; OR = 3.53 (CI95% 1.77-7.06; p < 0.001)). Our results support the a priori hypothesis of an association between anxiety and the polymorphism Val66Met. To our knowledge, this is the first study documenting a potential role of this polymorphism in a community sample of anxious children and adolescents.     

Psychiatric comorbidity in Korean children and adolescents with attention-deficit hyperactivity disorder: psychopathology according to subtype

It is well-known that more than 50% of attention-deficit hyperactivity disorder (ADHD) cases also have comorbid psychiatric disorders. We evaluated the comorbid psychopathology of Korean children and adolescents with ADHD using a standardized diagnostic instrument. The Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL-K) was administered and completed in 105 patients who had been referred to the outpatient and inpatient clinics at the Samsung Medical Center from March 2004 to May 2005. All of the cases were diagnosed as ADHD according to DSM-IV criteria. We analyzed their clinical characteristics and psychiatric comorbidities, and assessed the correlation of any comorbidity with gender, age and ADHD subtype. Among our 105 participants, 70 (66.7%) subjects were diagnosed with combined-type ADHD, 22 (21.0%) were the predominantly inattentive type, only 1 (1.0%) was determined to have the predominantly hyperactive-impulsive type of ADHD, and 12 (11.4%) were classified as not otherwise specified (NOS) ADHD. Eighty (76.2%) subjects had at least one comorbid disorder such as oppositional defiant disorder (n = 53, 50.5%), anxiety disorders (n = 35, 33.3%) and affective disorders (n = 15, 14.3%). Our patients ranged in age from five to 16 years. Among the factors including gender, age, and ADHD subtype, ADHD subtype was the only one significant to comorbidity in our study. The results of this study suggest that psychiatric comorbidity in Korean children with ADHD is similar to the results of previous studies in western countries. Out of all the ADHD subtypes, the combined-type group had a significantly higher ratio of comorbid disorders and psychopathologies.