rss_2.0Scandinavian Journal of Child and Adolescent Psychiatry and Psychology FeedSciendo RSS Feed for Scandinavian Journal of Child and Adolescent Psychiatry and Psychology Journal of Child and Adolescent Psychiatry and Psychology Feed Review of Environmental and Psychosocial Risk Factors associated with Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder in Children and Adolescents<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>In the majority of cases, attention deficit hyperactivity disorder (ADHD) is accompanied by one or more comorbid disorders, with the oppositional defiant disorder (ODD) being one of the most frequently diagnosed comorbid disorders. There is a lack of systematic reviews addressing the evidence for an association between the independent environmental and psychosocial risk factors associated with ADHD, ODD, and Conduct Disorder (CD).</p> </sec> <sec> <title style='display:none'>Objective</title> <p>This study aims to determine the link between ADHD and ODD/CD, specifically in terms of the most up-to-date environmental and psychosocial risk factors in the development of these illnesses.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Eleven studies were included in this systematic review. Among these, ten studies involved environmental risk factors, and only one involved socioeconomic risk factors as exposure. Of the ten studies highlighting the environmental risk factors, six studies reported perinatal risk factors, three reported Atopic diseases as exposure measures, and one involved exposure to energy and coffee drinks. We have found that the most common risk factors associated with ADHD, ODD and CD in Europe and North America were Perinatal risk factors. In contrast, the risk factors of Atopic diseases were more common in Asia.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Most of the studies included in our systematic review fall within the scope of environmental risk factors were perinatal risk factors and atopic diseases are the most common risk factors. However, only one article highlighted the association of socioeconomic risk factors as an exposure. Our review results suggest the need for more research focused on psychosocial risk factors for ADHD and comorbid ODD/CD. Further research is required with the primary objective of investigating this association in greater depth and examining the possible mechanisms at varying levels is needed.</p> </sec> </abstract>ARTICLEtrue properties of the Observing Mediational Interactions (OMI) coding system during mother-adolescent conflict discussions<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Observational assessments of parent-adolescent conflict can guide interventions to prevent and reduce conflict and mental health problems. The authors identified the Observing Mediational Interactions (OMI) as a particularly useful coding system for examining parent-adolescent conflict. The OMI is the observational measure used in the Mediational Intervention for Sensitizing Caregivers (MISC) and quantifies emotional (attachment-based) and cognitive (learning-based) behaviors during caregiver-child interactions.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>The overall aim of the current study was to tailor and evaluate the OMI specifically for observing conflict interactions.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Conflict discussions between 56 clinical youth aged 10-15 years and their mothers were coded using the OMI. Reliability, construct validity, and associations with affect following the conflict discussion were examined.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Analyses revealed that the OMI demonstrated adequate internal consistency, interrater reliability, and construct validity in terms of associations with an alternate observational measure and parent-reported family functioning and stress. Additionally, mothers who engaged in fewer negative parenting behaviors reported greater positive affect following the conflict discussion, controlling for baseline affect.</p> </sec> <sec> <title style='display:none'>Conclusions</title> <p>Taken together, findings support the use of the OMI in future studies. While further research should attempt to extend findings to other populations and settings and elaborate the coding instructions as needed, researchers can use the OMI to inform ongoing adaptations of MISC and identify targets for prevention and intervention more broadly.</p> </sec> </abstract>ARTICLEtrue effects of sexual abuse on female adolescent brain structures<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Objective</title> <p>Sexual abuse (SA) is known for its effects on brain structures in adolescents. We aimed to explore if SA has any effect on limbic and prefrontal cortex (PFC) structures. We hypothesized that children with SA would have a thinner PFC with larger amygdala and hippocampus that lead to aberrations in threat detection, orientation and response circuit; that would be highly adaptive in a dangerous environment in the short term.</p> </sec> <sec> <title style='display:none'>Method</title> <p>We included 57 SA and 33 healthy control (HC) female participants. In addition to psychiatric evaluation, we acquired 3 T MR images from all participants. We compared prefrontal cortical thicknesses, hippocampus and amygdala volumes between groups.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The age and education levels of study groups were matched, however, IQ scores and socioeconomic status (SES) scores of the SA group were lower than the controls. Total CTQ scores of the SA group were higher than the HC. Nevertheless, the mean value of sexual abuse scores was above the cut-off scores only for the SA participants. SA participants had larger right and left hippocampus and right amygdala volumes than the controls. SA group had reduced inferior frontal gyrus cortical thickness (T=3.5, p&lt;0.01, cluster size=694 mm2, x=51 y=-30 z=6) than HC group. None of the structural findings were correlated with total or sexual abuse CTQ scores.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Children with SA history has structural abnormalities in threat detection, orientation and response circuit. SA victims with no psychiatric diagnosis have a high probability of psychiatric problems with a possible contribution of these aberrations. SA cases that do not have a diagnosis must not be overlooked as they may have structural changes in emotion related brain regions. Careful follow-up is needed for all of all SA cases.</p> </sec> </abstract>ARTICLEtrue Cortical Thicknesses of Adolescents with Bipolar Disorder and Relationship with Brain-derived Neurotrophic Factor<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Cortical thickness (CT) and brain-derived neurotrophic factor (BDNF) were widely investigated in bipolar disorder (BD). Previous studies focused on the association between the volume of subcortical regions and neurotrophic factor levels.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>In this study, we aimed to evaluate the association of the CT in youth with early-onset BD with BDNF levels as a potential peripheral marker of neuronal integrity.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Twenty-three euthymic patients having a clinical diagnosis of BD and 17 healthy subjects as an age-matched control group with neuroimaging and blood BDNF levels were found eligible for CT measurement. A structural magnetic resonance scan (MRI) and timely blood samples were drawn.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Youth with BD exhibited lower cortical thickness in caudal part of left (L) middle frontal gyrus, right (R) paracentral gyrus, triangular part of R inferior frontal gyrus, R pericalcarine region, R precentral gyrus, L precentral gyrus, R superior frontal gyrus and L superior frontal gyrus when compared to healthy controls. The effect sizes of these differences were moderate to large (d=0.67-0.98) There was a significant correlation between BDNF levels with caudal part of the R anterior cingulate gyrus (CPRACG) in adolescents with BD (r=0.49, p=0.023).</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>As a special region for mood regulation, the CT of the caudal part of the R anterior cingulate gyrus had a positive correlation with BDNF. Regarding the key role of CPRACG for affective regulation skills, our results should be replicated in future follow-up studies, investigating a predictive neuroimaging biomarker for the early-onset BD.</p> </sec> </abstract>ARTICLEtrue Motor Skills in Children with Tourette Syndrome and their Unaffected First-degree Siblings<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>The exact etiology of Tourette Syndrome (TS) remains unclear, making the search for impaired neuropsychological functions possibly connected to the underlying cause of TS as important as it is challenging. One neuropsychological domain of interest is fine motor skills.</p> </sec> <sec> <title style='display:none'>Method</title> <p>This study compared fine motor skill performance on the Purdue Pegboard Task (PPT) in 18 children with TS, 24 unaffected first-degree siblings and 20 controls. A set of screening questionnaires was administered to determine comorbid psychiatric illness.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Children with TS, their siblings and controls did not differ significantly in fine motor skills as measured with the PPT. Performance on the PPT was not correlated with tic severity; however, we found an inverse correlation with severity of attention-deficit/hyperactivity disorder (ADHD) symptoms, as assessed by parent reported ADHD symptoms. Children with TS were found to have significantly higher parent reported ADHD symptoms compared to controls, yet only two out of the 18 participants had been diagnosed with ADHD.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>This study suggests that fine motor skill impairment in children with TS may be more strongly correlated with comorbid ADHD than to TS and tics.</p> </sec> </abstract>ARTICLEtrue and Acceptability of Using FirstPlay® to Enhance Mother–Child Interaction: A pilot study of mothers’ perspectives<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Although there is evidence that human touch facilitates mother–child bonding, mothers’ understanding of how to connect with and develop the emotional regulation of their babies remains unclear.</p> </sec> <sec> <title style='display:none'>Objectives</title> <p>This study used a Storytelling Massage program to investigate mothers’ experience of practicing reciprocal interactions with their children. Specifically, it explored the efficacy of multi-sensory activities for building healthy parent–child bonds.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Participants included 12 mothers with children between 8 and 23 months. These mothers participated in a 6-session program on FirstPlay Infant Storytelling-Massage Intervention (FirstPlay Therapy) and attended an individual semi-structured interview after the program. Data were analyzed using a phenomenological approach.</p> </sec> <sec> <title style='display:none'>Results</title> <p>The FirstPlay program positively affected the participants’ self-efficacy in parent–child bonding and parenting beliefs. Five themes were identified: “bonding with the child—connect and engage,” “attending to the child’s uniqueness and needs,” “developing a structure and a daily routine,” “feeling calm and relaxed as a person,” and “gaining confidence as a mom.”</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>The results of this study further support the need for low-cost, high-impact programs that enhance parent–child interactions. Limitations of this study are discussed. Future research and practical implications are also suggested.</p> </sec> </abstract>ARTICLEtrue Evidence of an Association Between a Positive Child Behavior Checklist-Bipolar Profile and a Diagnosis of Pediatric Bipolar Disorder: A Meta-Analysis<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Previous research has found that a unique profile of the Child Behavior Checklist comprising of aggregate elevations of the Attention, Anxiety/Depression and Aggression scales (A-A-A profile, CBCL-Bipolar (BP) profile, CBCL-Dysregulation profile (DP); henceforth CBCL-BP/DP profile) is associated with a clinical diagnosis of pediatric bipolar (BP) disorder.</p> </sec> <sec> <title style='display:none'>Objective</title> <p>The main aim of the study is to evaluate the strength of the association between the CBCL-BP/DP profile and the clinical diagnosis of pediatric BP disorder through a meta-analysis.</p> </sec> <sec> <title style='display:none'>Methods</title> <p>A literature search was performed to identify studies that examined the association between a positive CBCL-BP/DP profile and a clinical diagnosis of pediatric BP disorder. The meta-analyses first examined studies assessing the rates of a positive CBCL-BP/DP profile in youth with BP disorder versus those with 1) ADHD, anxiety/depression, or disruptive behavior disorders (DBDs), and 2) non-bipolar controls. The second analysis evaluated studies examining the rates of pediatric BP disorder in youth with and without a positive CBCL-BP/DP profile.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Eighteen articles met our inclusion and exclusion criteria, and fifteen articles had adequate data for meta-analysis. Results showed that BP youth were at significantly increased odds of having a positive CBCL-BP/DP profile compared to those with other psychiatric disorders (i.e., ADHD, anxiety/depression, or DBDs) (pooled OR=4.34, 95% CI=2.82, 8.27; p&lt;0.001) and healthy control groups (pooled OR=34.77, 95% CI=2.87, 420.95; p=0.005). Further, meta-analysis results showed that youth with a positive CBCL-BP/DP profile were at significantly increased odds of having a BP disorder diagnosis compared to those without (pooled OR=4.25, 95% CI=2.12, 8.52; p&lt;0.001).</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Our systematic review and meta-analysis of the extant literature provides strong support for the association between the CBCL-BP/DP profile and pediatric BP disorder.</p> </sec> </abstract>ARTICLEtrue Book Review on Handbook of Positive Youth Development: Advancing Research, Policy, and Practice in Global Contexts. Radosveta Dimitrova and Nora Wiium (Eds.) (Cham, Switzerland: Springer), 2021, 754 pages, ISBN 978-3-030-70261-8 of the pandemic on the mental health of children and clinical practice in Turkey: a narrative review with recommendations effects of perceived discrimination, social support and ethnic identity on mental health of immigrant adolescents<abstract> <title style='display:none'>Abstract</title> <p> <bold>Background</bold>: The number of immigrants has been increasing. Immigrant adolescents experience an acculturation process that affects particularly their ethnic identity, perceived discrimination, and relationships with their peers, which would have significant impact on their mental health. The ethnic composition of social environments might affect this relationship.</p> <p> <bold>Objective:</bold> The main purpose of the current research is to examine the effect of peer attachment, social support, ethnic identity, and perceived discrimination on immigrant adolescents’ mental health.</p> <p> <bold>Method:</bold> The sample included 226 Syrian immigrants (X<sup>̄</sup> <sub>age</sub> = 13.31, SD=1.67, 70.8 % girls). Adolescents live in a homogenous social environment where proportion of Syrian is higher. Two hierarchical regression models were used to predict depression and emotional problems. In both models, the predictive roles of social and psychological factors were examined in separate steps.</p> <p> <bold>Results:</bold> The regression analysis results for depression emphasized peer attachment, social support, and ethnic identity did not affect the depression after controlling the effect of emotional problems. Similarly, regression analysis results for emotional problems showed that peer attachment, social support, and ethnic identity did not affect depression after controlling the effect of emotional problems. The results also revealed that perceived discrimination was a risk factor for both depression and emotional problems.</p> <p> <bold>Conclusions:</bold> The results underlined the importance of psychological variables on immigrant adolescents’ depression. Past research emphasized that ethnic identity and peer support had a buffering effect on mental health. The current study participants were living in a different area where they attended schools for only immigrants. The social environment was totally different from the host culture. These reasons may account for why social support from ethnic peers and ethnic identity development did not emerge as a protective factor in the present study. The results will further be discussed in terms of the importance of interaction between ethnic and host culture.</p> </abstract>ARTICLEtrue morbidity in children and adolescents with dermatological disorders<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Understanding the existence of a cycle, where psychological disturbances cause skin diseases and in turn, skin diseases cause psychological disorders, provides the basis for good dermatological practice.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>The aim of this case-control study is to examine the psychiatric morbidity of dermatological disorders in children and adolescents with no history of psychiatric disorders.</p> </sec> <sec> <title style='display:none'>Method:</title> <p>In this study, 502 participants (251 patients and 251 healthy individuals) were evaluated according to DSM-IV criteria. All participants were interviewed and evaluated using the Turkish version of the Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (K-SADS-PL) and the State-Trait Anxiety Inventory for Children (STAI-1 and STAI-2), the Childhood Depression Inventory (CDI), adolescent and parent forms of the Strengths and Difficulties Questionnaire (SDQ-A and SDQ-P) and a questionnaire evaluating child’s level of school success.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Our results indicated that the rates of general psychiatric comorbidity, mood disorders, anxiety disorders, and adjustment disorders were significantly higher in the study group compared to the control group. The CDI, STAI-1, STAI-2, and SDQ (and subscales) scores were significantly higher in the study group. Moreover, psychiatric comorbidity was higher in inflammatory and allergic dermatoses compared to other dermatological subgroups. Having a dermatological disease restricts physical activity thus increasing the risk of psychiatric comorbidity.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Investigating the education, attitudes, and awareness of dermatologists about psychocutaneous disorders might contribute to the development of new educational strategies and elicit appropriate biopsychosocial approaches.</p> </sec> </abstract>ARTICLEtrue to diagnostic investigation of a child with comorbid psychiatric conditions<abstract> <title style='display:none'>Abstract</title> <p>Presented here is the unique case of diagnostic investigation for a 16 year old male presenting in an acute state of apparent psychosis. The patient had a long history of previous specialist work-ups, tentative diagnoses, multiple emergency department admissions, and medication trials, all of which failed to produce significant lasting relief. While initial encounters diagnostically centered on autoimmune encephalitis, comprehensive work-ups always drove the differential towards a likely psychiatric disorder. Despite this consistent professional opinion, tentative diagnosis of schizophrenia with underlying Autism Spectrum Disorder was delayed for many years, due to a variety of complicating factors. Overall, this case highlights many different considerations that might assist in avoiding a protracted road to diagnosis, including navigating the obstacles that parental interaction with a complex healthcare system can pose during diagnostic evaluation and recommended treatment as well as, the role of re-interpreting past test results within the context of new literature, and the complexities of diagnosing comorbid psychiatric conditions.</p> </abstract>ARTICLEtrue mentalizing in adolescents with anorexia nervosa and borderline personality disorder: A comparative study of psychiatric inpatients and healthy controls<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Impaired mentalizing, i.e., difficulties in understanding oneself and others in terms of mental states, has been associated with the development of Anorexia Nervosa (AN), mainly among adults. However, few studies have addressed this question in clinical samples of adolescents with AN. Moreover, no study has explored mentalizing abilities among inpatient adolescents presenting with AN and Borderline Personality Disorder (BPD), despite their high comorbidity in a highly relevant age group.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>This study attempted, for the first time, to further examine differences in mentalizing abilities and to identify specific mentalizing impairments in different psychiatric inpatient groups and healthy adolescents.</p> </sec> <sec> <title style='display:none'>Methods:</title> <p>Using samples of female adolescents aged 12–17, comparison analyses were performed between psychiatric inpatient adolescents with AN (<italic>n</italic> = 44), BPD (<italic>n</italic> = 101), AN+BPD (<italic>n</italic> = 48), other psychopathology (<italic>n</italic> = 163) and healthy adolescents (<italic>n</italic> = 129). Structured and semi-structured clinical interviews, and two experimental tasks were administered to assess AN, BPD and mentalizing, respectively.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Comparison analyses showed that patients with BPD and other psychiatric disorders evidenced higher levels of hypermentalizing compared to healthy adolescents. Hypermentalizing was also reported among inpatients with AN+BPD, although to a lesser extent. BPD and AN scores were positively correlated with hypermentalizing responses.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Our results suggest that hypermentalizing is a specific mentalization impairment in inpatient adolescents, particularly with BPD and both AN+BPD. Further investigation into the efficacy of mentalization based treatments for adolescents with BPD and AN+BPD is recommended. Prospective studies are needed to assess mentalizing using experimental tasks among adolescents with AN, taking into account the potential influence of temporality and severity of the disorders’ symptoms.</p> </sec> </abstract>ARTICLEtrue trust in adolescents with psychiatric disorders and borderline pathology<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Adolescents with features of borderline personality disorder (BPD) may experience deficits in interpersonal trust; however, a simultaneous comparison of interpersonal trust among adolescents with BPD, other psychiatric disorders, and no psychiatric conditions (healthy controls) has never been conducted.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>The aims of this study were to 1) explore differences in interpersonal trust (emotional trust, honesty beliefs, and reliability beliefs) between these three groups, and 2) examine the incremental value of BPD features in association with interpersonal trust over and above internalizing and externalizing.</p> </sec> <sec> <title style='display:none'>Method:</title> <p>Adolescents (<italic>N</italic> = 445, 67.9% female, <italic>M</italic> <italic> <sub>age</sub> </italic> = 15.13) recruited from two psychiatric hospitals (psychiatric sample, n = 280) and community organizations (healthy sample, n = 165) completed measures of BPD features, interpersonal trust, and internalizing and externalizing psychopathology. Psychiatric adolescents also completed an interview assessing BPD (n = 83 BPD). ANCOVA and hierarchical linear regression were used for analyses.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Emotional trust differed significantly across all three groups, with the lowest level of emotional trust in adolescents with BPD. Reliability was also lower in the two psychiatric groups relative to healthy controls. BPD features were significantly, inversely associated with emotional trust and reliability beliefs when controlling for internalizing and externalizing pathology. Post-hoc analyses testing specificity of the three forms of trust found that lower emotional trust predicted BPD diagnosis over and above the other two forms of trust.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Findings highlight emotional trust as a correlate and important target of intervention for adolescents with BPD, and add to knowledge on interpersonal trust deficits for adolescents with psychiatric disorders more broadly.</p> </sec> </abstract>ARTICLEtrue evaluation of the Swedish Child Sheehan Disability Scale in adolescent psychiatric patients<abstract> <title style='display:none'>Abstract</title> <p> <bold>Background:</bold> Assessment of disability is part of the psychiatric diagnostic process, and validated scales are needed for the assessment of functioning. The Swedish translations of the Child Sheehan Disability Scale (CSDS) for adolescents and parents (CSDS-P) have been adapted for use in psychiatric settings.</p> <p> <bold>Objective:</bold> The purpose of the study was to explore the psychometric properties of the Swedish CSDS and the CSDS-P among adolescent psychiatric patients.</p> <p> <bold>Method:</bold> Patients (n = 107) were assessed with the CSDS, the Strengths and Difficulties Questionnaire (SDQ adolescent), and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) diagnostic interview. Their parents participated in the interview and completed the CSDS-P and SDQ parent.</p> <p> <bold>Results:</bold> Internal consistency was α =.813 for the CSDS (three items) and α =.842 for the CSDS-P (five items). For both scales, principal component analyses showed one component. The correlations between the total scores of the CSDS and CSDS-P in relation to a general K-SADS-PL symptom summation index were <italic>r<sub>s</sub> </italic> = .332, <italic>p</italic> &lt; .001 and <italic>r<sub>s</sub> </italic> = .237, <italic>p</italic> = .014, respectively. Correlations with the total K-SADS function summation index were <italic>r<sub>s</sub> </italic> &lt; .300 for both. The correlation between the CSDS and the total difficulties score on the SDQ was <italic>r<sub>s</sub> </italic> = .433, <italic>p</italic> &lt; .001.</p> <p> <bold>Conclusions:</bold> The Swedish translations of the CSDS and CSDS-P had similar psychometric properties to Whiteside’s CSDS and the Adult Sheehan Disability Scale. Concurrent validity and correlation between the CSDS and CSDS-P were weak.</p> </abstract>ARTICLEtrue in affect integration in children with and without internalizing difficulties<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Affect represents an important source of information about our internal state and the external world that can motivate and vitalize us. When affect is poorly integrated, this can lead to problems with self-regulation and psychopathology. Few studies have investigated affect integration in children.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>This study investigates differences in affect integration in children with and without internalizing difficulties.</p> </sec> <sec> <title style='display:none'>Method:</title> <p>Thirty-three Norwegian children (aged 9–13) with and 24 children without internalizing difficulties were interviewed with the Affect Consciousness Interview (ACI), a measure of affect integration. Data from the ACI was analyzed across nine affective categories (Interest/Excitement, Enjoyment/Joy, Fear/Panic, Anger/Rage, Shame/Humiliation, Sadness/Despair, Envy/Jealousy, Guilt/Remorse, and Tenderness/Care), and four dimensions (Awareness, Tolerance, Emotional, and Conceptual expressivity).</p> </sec> <sec> <title style='display:none'>Results:</title> <p>The children differed significantly in affect integration across all dimensions and all assessed affects, both positive and negative. Emotional Expressivity, Anger/Rage, and Sadness/Despair were particularly less integrated in the children with internalizing problems.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Assessment of affect integration can provide useful information on possible underlying factors in internalizing problems in children and may help guide and personalize therapeutic interventions. Based on knowledge from empirical infant psychology interventions mimicking rich, early intersubjective experiences are recommended to increase affect integration.</p> </sec> </abstract>ARTICLEtrue longitudinal investigation of cognitive functioning and its relationship to symptom severity and academic functioning in treatment seeking youth with ADHD<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Children with ADHD tend to present with poorer cognitive functioning leaving them more vulnerable to a range of negative outcomes. To date, only a handful of longitudinal studies have examined the stability of Wechsler composite scores in children and adolescents with ADHD, and none of them used a more recent version of the Wechsler Intelligence Scales for Children (WISC), than the WISC-III.</p> </sec> <sec> <title style='display:none'>Objective:</title> <p>The present study investigates the cognitive stability and its longitudinal relationship with the severity of the child’s ADHD symptoms and school grades.</p> </sec> <sec> <title style='display:none'>Method:</title> <p>Cognitive functioning was measured with the fourth editions of the WISC-IV or the Wechsler Adult Intelligence Scales (WAIS-IV) at baseline and at a 3-4-year follow-up in children with ADHD (n = 125, mean age = 11.40 years, SD = 3.27) and a Control group of schoolchildren (n = 59, mean age = 11.97 years, SD = 2.15). The stability of cognitive functioning and the relationship between cognitive functioning, ADHD and grades were evaluated using linear mixed models and logistic regression.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Standardized composite scores of Full scale IQ, Verbal Comprehension, and Processing Speed declined between baseline and follow-up in the ADHD group. ADHD symptom scores were associated with Working Memory scores. Together, the severity of concurrent ADHD symptoms and lower scores for verbal comprehension at baseline and follow-up were associated with an increased risk of not achieving grades at follow-up in youth with ADHD.</p> </sec> <sec> <title style='display:none'>Conclusions:</title> <p>Youth with ADHD often present with cognitive impairments, not improved over time. Together these increase the risk of poorer academic outcomes. Concurrent evaluation of symptom severity and cognitive functions can add potentially useful information in terms of treatment planning, and school supports to prevent school failure.</p> </sec> </abstract>ARTICLEtrue of treatment effects by parent-adolescent conflict in a randomised controlled trial of Attachment Based Family Therapy for adolescent Depression. practice for students with neurodevelopmental disorders in Sweden<abstract> <title style='display:none'>Abstract</title> <p>‘Inclusion’ aims to achieve adaptation of the environment to the diverse prerequisites and needs of individuals, instead of demanding of individuals to cope with the challenges of a given context themselves exclusively. All Scandinavian countries have made formal decisions to enhance inclusive practice for children and adolescents with disabilities in educational settings, seeking to implement international conventions. We investigated current inclusive practice for students with neurodevelopmental disorders (NDDs) in Swedish primary, secondary and high-schools using the 61-item INCLUSIO scale among N=4778 school staff with educational responsibilities in 68 public and private schools across 11 municipalities. Overall, school staff reported not to be well prepared to teach students with NDDs and that their school’s implementation of concrete inclusive practice was limited. Findings indicate a gap between inclusive educational ambitions and current practice for students with NDDs. Enriched teacher education and supervision for NDDs, a shift in pedagogical views of NDDs and better collaboration between community services, as well as systematic evidence-based implementation plans driven by policy makers and educational authorities may help improve inclusive practice.</p> </abstract>ARTICLEtrue“Less stress”: a pilot study on a cognitive behavioral treatment program for anxiety in children with autism spectrum disorders<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background:</title> <p>Comorbid anxiety disorders are prevalent in children with autism spectrum disorders (ASD), but only a minority receives adequate treatment for anxiety. Cognitive behavioral therapy (CBT) has been shown to be effective in treating anxiety disorders. The objectives of the present pilot study were to test the feasibility of the CBT program “Less stress” for comorbid anxiety disorders in children with ASD and explore whether an improvement in diagnostic outcomes for anxiety disorders and symptoms of anxiety was found after treatment.</p> </sec> <sec> <title style='display:none'>Methods:</title> <p>Participants were ten children diagnosed with ASD and anxiety disorders (eight boys, mean age = 9.5 years, range 8 - 12 years). The “Less Stress” program includes three months of weekly treatment sessions followed by three monthly booster sessions. Five therapists participated. A standardized semi-structured diagnostic interview with the mothers was used to assess comorbid disorders. Child anxiety symptoms were measured with the Revised Child Anxiety and Depression Scale (RCADS).</p> </sec> <sec> <title style='display:none'>Results:</title> <p>The therapists found the manual easy to use but adaptations were necessary, particularly shorter sessions due to frequent (n = 7) comorbid Attention-Deficit/Hyperactivity Disorder. The participants found the program useful and the parents noted that they had learned methods they could continue using after the end of the program.</p> <p>Eight of ten children completed the treatment. Seven of the eight completers benefited from the program. Five of those seven children were free from all anxiety disorders, while two had fewer anxiety disorders. On a group level, a significant mean reduction of anxiety symptoms (RCADS) was found after treatment.</p> </sec> <sec> <title style='display:none'>Conclusion:</title> <p>The therapists found the “Less stress” program to be a feasible intervention in a sample of children with ASD and comorbid anxiety. The significant reduction of anxiety after treatment is promising, but a replication in a larger and more rigorous study is needed to investigate the effectiveness of the intervention.</p> </sec> </abstract>ARTICLEtrue