Sandplay therapy in the treatment of children with Oppositional Defiant Disorder and Conduct Disorder / A terapia de sandplay no tratamento de crianças com Transtorno Opositivo-Desafiador e Transtorno de Conduta

The study aimed at assessing the effectiveness of sandplay therapy in the treatment of children with symptoms of oppositional defiant disorder and/or conduct disorder. The intervention consisted of twelve weekly sessions of sandplay therapy. The Child Behavior Checklist 6-18 was used to assess symptoms before and after the intervention. Participants were 41 children of both sexes, randomly divided into two groups. The control group remained on hold while experimental group 1 underwent the intervention. After three months, control group participants who still met the inclusion criteria were placed in experimental group 2. Results were analyzed statistically, in order to compare the control group and experimental group 1, as well as to assess the evolution of the total experimental group, which included experimental groups 1 and 2. Results pointed to the effectiveness of sandplay therapy in reducing symptoms of oppositional defiant disorder and conduct disorder.

O estudo visou avaliar a efetividade da terapia de sandplay no tratamento de crianças com sintomas de Transtorno Opositivo-Desafiador e/ou Transtorno de Conduta. A intervenção consistiu de 12 sessões semanais de terapia de sandplay. O Child Behavior Checklist 6-18 foi o instrumento utilizado para avaliar os sintomas antes e após a intervenção. Participaram do estudo 41 crianças de ambos os sexos, divididas randomicamente em dois grupos. O grupo controle permaneceu em espera enquanto o grupo experimental 1 passava pela intervenção. Após três meses de intervenção, os participantes do grupo controle que ainda atendiam aos critérios de inclusão formaram o grupo experimental 2. Os resultados obtidos foram analisados estatisticamente, de modo a comparar o grupo controle e o grupo experimental 1 bem como avaliar a evolução do grupo experimental total, que incluiu os grupos experimentais 1 e 2. Os resultados indicam que a terapia de sandplay foi eficiente na redução dos sintomas dos transtornos em questão.

Revisão da literatura sobre Transtorno Opositivo Desafiador e Transtorno de Conduta: causas/proteção, estratégia escolar e relação com a criminalidade / Literature review about Oppositional Defiant Disorder and Conduct Disorder: causes / protection, teaching school and relationship with crime

De acordo com variados estudos científicos, nas idades escolares os estudantes podem apresentar diferentes distúrbios comportamentais. Assim, este artigo tem como objetivo apresentar uma revisão da literatura sobre o Transtorno Opositivo Desafiador (TOD) e o Transtorno de Conduta (TC) de modo a favorecer o diagnóstico e intervenções escolares. Para isso, realizou-se busca por descritores no Portal da Capes e no Google Acadêmico em que foram selecionados trabalhos mais recentes escritos em português e inglês que continham no título dos manuscritos os termos da busca e os conteúdos destes foram divididos em categorias, tais como, fatores de causa/proteção; estratégias de trabalho com alunos acometidos de TOD e TC e a relação que os distúrbios podem apresentar com o cometimento de atos infracionais. Verificou-se que os autores abordam que ambos os distúrbios podem desenvolver-se pela influência do ambiente social das crianças e adolescentes, e que o professor pode exercer influência sobre o comportamento e rendimento escolar destes estudantes. O presente estudo contribui, portanto para a compreensão dos distúrbios a partir da exposição do debate de diversos autores o que pode auxiliar professores, alunos e pais no trabalho com pessoas acometidas de TOD e TC.

According to several scientific studies, at school age, students may have different behavioral disorders. Thus, this article aims to present a literature review on Oppositional Defiant Disorder (ODD) and Conduct Disorder (CT) to favourdiagnosis and school interventions. A search for descriptors in Capes Portal and Google Scholar was carried out, in which more recent works written in Portuguese and English that contained the search terms in the title of the manuscripts and their contents were divided into categories, such as causative/protective factors; work strategies with students suffering from ODD and CT, and the relationship that the disorders can present with infractions. We found that the authors state that both disorders can develop under the influence of the children's and adolescents' social environment and that the teacher can influence their behavior and academic performance. Therefore, the present study contributes to the understanding of disorders from the discussion of several authors' debates, which can help teachers, students, and parents work with people with ODD and CT.

Effect of oxytocin on empathy in male adolescents with conduct disorder / 中华行为医学与脑科学杂志

Objective:To investigate the effect of intranasal oxytocin administration on empathy in male adolescents with conduct disorder.Methods:The male adolescents with conduct disorder in the Psychological Counseling Clinic of the Second Xiangya Hospital of Central South University from September 2015 to August 2016 were selected.And they were randomly assigned to oxytocin group ( n=46) and placebo group ( n=51) by random number table. Subjects in oxytocin group were given nasal spray of 24 IU oxytocin twice per day for two weeks, while those in placebo group were given nasal spray of 0.9% sodium chloride solution for two weeks. The empathy of patients was assessed with a pain-related empathy task and interpersonal reactivity index (IRI) before and after two weeks′ administration. SPSS 20.0 software was used for statistical analysis, and repeated measurement analysis of variance was used to compare the empathy ability of the two groups before and after intervention. Results:Repeated measurement analysis of variance showed that there were significant time×group interaction effects in the scores of painful expressions during the pain-related empathy task ( F=13.86, P<0.001), IRI ( F=5.59, P=0.020) and empathic concern subscale ( F=4.99, P=0.028). There was significant between-group effect in the score of perspective-taking subscale of IRI( F=4.22, P=0.043). Simple effect analysis revealed that after two weeks of intervention, the score of needle-pain expression in oxytocin group was significantly higher than that at baseline ( t=-2.08, P=0.040). And the score of needle-pain expression in oxytocin group was significantly higher than that in placebo group ( t=2.33, P=0.022). After two weeks of intervention, the total IRI score ( t=-2.58, P=0.011) and empathy factor score ( t=-3.15, P=0.002) of oxytocin group were both higher than those at baseline. After intervention, the total IRI score ( t=2.30, P=0.024) and perspective-taking factor score ( t=2.57, P=0.012) in oxytocin group were higher than those in placebo group, and the differences were statistically significant. Conclusions:Oxytocin may improve the cognitive and emotional empathy in male adolescents with conduct disorder.

Gender differences in the association between theory of mind, empathy and conduct disorder: A cross-sectional study / Diferencias de género en la asociación entre teoría de la mente, empatía y trastorno de conducta: Un estudio transversal

Abstract The purpose of this research was to explore gender differences regarding theory of mind and empathy abilities in a sample of adolescents with conduct disorder (n=46; males=28 and females=18). Empathy (cognitive and emotional dimensions) and theory of mind (reading the mind through the eyes) were tested based on an observational method with a crosssectional design. Statistical analysis included: description of variables according to their type, assessment of quantitative correlations and logistic multivariate modelling for identifying variables that differentiate female from male patients. The results demonstrated significant gender differences in empathy and theory of mind evaluations. Particularly, women showed different scores for cognitive/emotional empathy and in the Reading the Mind through the Eyes test, with a lower number of behavioural symptoms. The results are discussed in light of the current empirical evidence, and some future directions in the study of conduct disorder are suggested.

Resumen El objetivo de este estudio fue explorar las diferencias de género en habilidades de teoría de la mente y empatía en una muestra de adolescentes con trastorno de conducta (n=46; 28 hombres y 18 mujeres). Se determinó un abordaje observacional con un diseño de corte transversal mediante el cual se evaluó la empatía (dimensiones cognitiva y afectiva) y teoría de la mente (lectura de la mirada). El análisis estadístico incluyó la descripción de las variables de acuerdo con su naturaleza, la evaluación de correlaciones cuantitativas, y el diseño de un modelo logístico multivariado para identificar las variables que diferencian los pacientes según su género. Los resultados indicaron diferencias significativas por género tanto en empatía como en teoría de la mente. Las mujeres presentaron de manera consistente diferencias en los niveles de empatía cognitiva/afectiva y test de la mirada, con un menor número de síntomas de conducta. Los resultados se discuten a la luz de la evidencia empírica actual y se sugieren algunas direcciones futuras en el estudio del trastorno de conducta.

Behavior Disorders: knowledge and actions of health professionals and social work / Trastornos de la Conducta: conocimiento y acciones de los profesionales de la salud y asistencia social / Transtornos do Comportamento: conhecimentos e ações de profissionais de saúde e assistência social

ABSTRACT Objective: to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders. Method: a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis. Results: three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care. Final considerations: the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.

RESUMEN Objetivo: identificar los conocimientos de los profesionales de los servicios de salud mental y asistencia social en Trastornos de la Conducta (TC) en la infancia y la adolescencia, y analizar sus acciones en la atención a niños y adolescentes con tales trastornos. Método: estudio cualitativo, descriptivo-exploratorio con 13 profesionales de dos servicios de salud mental y dos consejos de tutoría. Los datos fueron recolectados en entrevistas y sometidos a análisis de contenido temático. Resultados: de las entrevistas surgieron tres categorías: "Conocimiento sobre trastornos de conducta", que define la TC como desviaciones de la normalidad y la falta de límites. "Atención integrada y grupal", que explica las acciones integradas, multidisciplinares y grupales. "Atención especializada y jurídica", que explica las acciones a través de la atención especializada, médica y judicial. Consideraciones finales: los resultados señalan las debilidades y las brechas de conocimiento de los profesionales, causando un daño potencial en la programación de acciones efectivas, como la identificación, la referencia y la planificación terapéutica.

RESUMO Objetivo: identificar o conhecimento dos profissionais de serviços de saúde mental e assistência social sobre os Transtornos de Comportamento (TC) na infância e adolescência, e analisar suas ações na atenção a crianças e adolescentes com tais transtornos. Método: estudo qualitativo, descritivo-exploratório com 13 profissionais de dois serviços de saúde mental e dois conselhos tutelares. Os dados foram coletados em entrevistas e submetidos à análise de conteúdo temático. Resultados: três categorias emergiram das entrevistas: "Conhecimentos acerca dos transtornos de comportamento", que define os TC como desvios da normalidade e falta de limites. "O cuidado integrado e em grupo", que explica as ações integradas, multidisciplinares e através de grupos. "O cuidado especializado e jurídico", que explica as ações através do cuidado especializado, medicamentoso e judicial. Considerações finais: os resultados apontam fragilidades e lacunas de conhecimento dos profissionais acarretando potenciais prejuízos na programação de ações eficazes, como identificação, encaminhamento e planejamento terapêutico.

Youth homicide: a study of homicide predictor factors in adolescent offenders in custody in the south of Brazil / Homicídio juvenil: fatores preditores em adolescentes privados de liberdade no sul do Brasil

Abstract Objectives To assess the sociodemographic, psychiatric and criminal profile of adolescent offenders complying with temporary custody for homicide/homicide attempt and to compare it to that of the population of adolescents in custody for other crimes. Methods This cross-sectional study was based on the review of the medical records of 74 juvenile offenders in temporary custody at socioeducational agency Fundação de Atendimento Sócio-Educativo do Rio Grande do Sul. For the analysis, variables that presented p < 0.2 were included in multivariate adjustment through logistic regression. Results The sample comprised males only, mostly with white skin color (55.6 vs. 57.9% for homicidal and non-homicidal, respectively) and with a high prevalence of school failure (77.8 vs. 91.2%). There was a high prevalence of family history of delinquency (88 vs. 81%). Only years of study and belonging or not to a criminal organization remained statistically significant in the multivariate model. Conclusion The results show that having fewer years of study and denying belonging to a criminal organization are predictive factors of homicidal behavior in adolescent offenders (both with statistical relevance). The other variables were not statistically significant for this outcome. The present study may serve as a basis for further research, which may improve our understanding of risk factors for juvenile homicide.

Resumo Objetivos Avaliar o perfil sociodemográfico, psiquiátrico e criminal de adolescentes infratores que cumprem internação provisória por homicídio ou tentativa de homicídio e compará-los aos adolescentes privados de liberdade por outros atos infracionais. Métodos Este estudo transversal baseou-se na revisão dos prontuários médicos de 74 adolescentes infratores em internação provisória na Fundação de Atendimento Sócio-Educativo do Rio Grande do Sul. Para a análise, variáveis que apresentaram p <0,2 foram incluídas no ajuste multivariado por meio de regressão logística. Resultados A amostra foi composta apenas por homens, a maioria de pele branca (55,6 versus 57,9% para homicidas e não-homicidas, respectivamente) e com alta prevalência de reprovações escolares (77,8 vs. 91,2%). Houve alta prevalência de antecedentes familiares de delinquência (88 versus 81%). Apenas anos de estudo e pertencimento ou não a uma organização criminosa permaneceram estatisticamente significantes no modelo multivariado. Conclusão Os resultados mostram que ter menos anos de estudo e negar pertencer a uma organização criminosa foram fatores preditivos de comportamento homicida em adolescentes infratores (ambos com relevância estatística). As demais variáveis não foram estatisticamente significativas para esse desfecho. O presente estudo pode servir como base para futuras pesquisas, o que pode melhorar nossa compreensão dos fatores de risco para o homicídio juvenil.

Transtorno de Déficit de Atenção e Hiperatividade e Transtorno de Conduta em adolescentes concluintes do ensino fundamental de Caxias do Sul / Attention Deficit Hyperactivity Disorder and Behavioral Disorder in adolescents who completed elementary education in Caxias do Sul

O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) é uma das comorbidades neuropsiquiátricas mais comuns entre crianças e adolescentes, e caracteriza-se por sintomas de desatenção, hiperatividade e impulsividade. O presente estudo tem por objetivo determinar a prevalência de TDAH em uma amostra de adolescentes na cidade de Caxias do Sul. Trata-se de um estudo transversal realizado com uma amostra de 272 escolares. Como instrumento para triagem do TDAH foi utilizada a versão brasileira do questionário Child Behavior Check List. A prevalência de TDAH foi de 3,7 %; nessa amostra também foi avaliada a prevalência do Transtorno de Conduta que foi de 6,2 %. O Transtorno de Conduta se mostrou mais prevalente em escolares com TDAH. (p=0,019). O presente estudo evidenciou que o TDAH é uma patologia comum entre os adolescentes, apresentando importante associação com Transtorno de Conduta.(AU)

Attention Deficit Hyperactivity Disorder (ADHD) is considered one of the most common neuropsychiatric disorders among children and adolescents and is characterized by symptoms of inattention, hyperactivity and impulsivity. The present study aims to determine the prevalence of ADHD in a sample of adolescents in Caxias do Sul. A cross-sectional study was conducted in a sample of 272 students. The instrument used for screening ADHD was the Brazilian version of the questionnaire Child Behavior Checklist. The prevalence of ADHD was 3.7%; in this sample we also evaluated the prevalence of Conduct Disorder that was 6.2%. Conduct Disorder was more common in students with ADHD. (p = 0.019). The present study evidenced that ADHD is a common comorbidity in adolescents, presenting an important association with Conduct Disorder.(AU)

Empathic skills and theory of mind in female adolescents with conduct disorder

Objective: Most studies on conduct disorder (CD) have focused on male adolescents, disregarding analysis of this psychopathology in women. The purpose of this study was to identify differences in empathy and theory of mind (ToM) in a group of adolescent women with CD and a control group. Method: Thirty-six adolescent women were selected from an initial sample of 239 adolescents (CD group = 18, control group = 18). Empathy and ToM were evaluated through objective instruments. Mean comparisons and multivariate analysis were performed to ascertain differences between cases and controls and to propose a prediction model based on clinical status. Results: Significant differences in empathic abilities and ToM were found between the groups. The model that differentiated both groups was composed of eye-reading ability, perspective taking, and personal distress. Conclusion: These findings are consistent with previous studies. Capacity to take the other's perspective and the recognition of emotions in the face are protective factors against CD in women.

Serial Progression from Attention-Deficit/Hyperactivity Disorder to Alcohol Use Disorder: Serial Multiple Mediated Effects of Externalizing Disorders and Depression

OBJECTIVE: Externalizing disorders such as attention-deficit/hyperactivity disorder (ADHD), conduct disorder and antisocial personality disorder, as well as depression are common comorbidities in alcohol use disorder (AUD). The current study focused on the temporal relationship between the onsets of these disorders and AUD, and investigated the serial multiple mediator model of externalizing disorders (e.g., ADHD) and depression on AUD. METHODS: We analyzed the mediated effects of the Adult ADHD Self-Report Scale (ASRS), the Barratt Impulsiveness Scale motor (BIS_M) and the Beck Depression Inventory (BDI) on Korean version of the Alcohol Dependence Scale (ADS_K) using the multiple-step multiple mediation procedure regression analysis. In addition, we comparatively analyzed different clinical characteristics in relation to conduct problems. RESULTS: The multiple-step multiple mediation procedure found the serial multiple mediated effects of the BIS_M and the BDI on the relationship between the ASRS and the ADS_K. Also, the group with conduct problem was significantly high in ADHD symptoms, depression, anxiety, impulsivity, legal problems and alcohol-related problems, compared to the group without conduct problems. CONCLUSION: To sum up, the results of this study show that ADHD symptoms in childhood could exert significant effects on the severity of AUD in adulthood, and both disorders might be mediated by the externalizing disorders characterized by the core feature of motor impulsivity, and depression serially. Thus, the treatment of preceding disorders in accordance with developmental stages is an overarching clinical component for preventing the subsequent development of AUD and for its treatment.

Concepções e práticas de profissionais da saúde e assistência social acerca dos transtornos de comportamento em crianças e adolescentes / Conceptions and practices of health and social welfare professionals about behavior disorders in children and teenagers

Nesta dissertação, procuramos compreender os sentidos e significados que os profissionais de serviços de saúde e de assistência social de um município do interior paulista têm acerca dos transtornos de comportamento em crianças e adolescentes. Para tanto, foi realizado um estudo qualitativo em dois serviços de saúde e 2 conselhos tutelares de um município do interior paulista. Participaram do estudo 13 profissionais. A coleta de dados foi realizada através de uma entrevista semiestruturada realizada em local escolhido pelos participantes. Para a organização e tratamento dos dados foi utilizada a técnica de análise de conteúdo de Bardin, que nos permitiu construir três categorias temáticas: "Transtornos de comportamento: que comportamento é esse?" "Transtornos de comportamento: como se desenvolvem?" "Ações (des)articuladas entre os setores saúde e assistência no atendimento à crianças e adolescentes com transtorno de comportamento". Verificamos que o conhecimento acerca da aplicabilidade diagnóstica dos transtornos de comportamento não é clara para os profissionais de nosso estudo, o que acaba dificultando a identificação e o encaminhamento dessas crianças e adolescentes aos serviços de saúde mental e assistência social. Para os profissionais de nosso estudo, os principais fatores de risco atribuídos ao desenvolvimento dos transtornos de comportamento em crianças e adolescentes são aqueles que ocorrem nas relações entre as crianças e seus familiares, como a violência doméstica, a desestruturação familiar, a falta de afeto e as práticas educativas, fatores que podem inclusive potencializar ou não a predisposição genética da criança ou adolescente a desenvolver transtornos de comportamento. Já os fatores macrossociais, como as condições sociais e culturais, a ação do estado e as características da sociedade nas quais vivem as crianças e adolescentes são pormenorizados como colaboradores para o desenvolvimento de transtornos de comportamento pelos profissionais de nosso estudo. Por fim, constatamos que as ações de prevenção à violência juvenil e de atendimento à crianças e adolescentes com transtornos de comportamento dos profissionais de nosso estudo não atendem às diretrizes e normas estabelecidas pela OMS e pelas políticas nacionais de prevenção à violência no que diz respeito ao trabalho integrado e intersetorial, no desenvolvimento de ações preventivas, na consolidação do atendimento pré-hospitalar sistematizado, hierarquizado e subsidiado por práticas baseadas em evidências e na capacitação adequada dos recursos humanos

Nesta dissertação, procuramos compreender os sentidos e significados que os profissionais de serviços de saúde e de assistência social de um município do interior paulista têm acerca dos transtornos de comportamento em crianças e adolescentes. Para tanto, foi realizado um estudo qualitativo em dois serviços de saúde e 2 conselhos tutelares de um município do interior paulista. Participaram do estudo 13 profissionais. A coleta de dados foi realizada através de uma entrevista semiestruturada realizada em local escolhido pelos participantes. Para a organização e tratamento dos dados foi utilizada a técnica de análise de conteúdo de Bardin, que nos permitiu construir três categorias temáticas: "Transtornos de comportamento: que comportamento é esse?" "Transtornos de comportamento: como se desenvolvem?" "Ações (des)articuladas entre os setores saúde e assistência no atendimento à crianças e adolescentes com transtorno de comportamento". Verificamos que o conhecimento acerca da aplicabilidade diagnóstica dos transtornos de comportamento não é clara para os profissionais de nosso estudo, o que acaba dificultando a identificação e o encaminhamento dessas crianças e adolescentes aos serviços de saúde mental e assistência social. Para os profissionais de nosso estudo, os principais fatores de risco atribuídos ao desenvolvimento dos transtornos de comportamento em crianças e adolescentes são aqueles que ocorrem nas relações entre as crianças e seus familiares, como a violência doméstica, a desestruturação familiar, a falta de afeto e as práticas educativas, fatores que podem inclusive potencializar ou não a predisposição genética da criança ou adolescente a desenvolver transtornos de comportamento. Já os fatores macrossociais, como as condições sociais e culturais, a ação do estado e as características da sociedade nas quais vivem as crianças e adolescentes são pormenorizados como colaboradores para o desenvolvimento de transtornos de comportamento pelos profissionais de nosso estudo. Por fim, constatamos que as ações de prevenção à violência juvenil e de atendimento à crianças e adolescentes com transtornos de comportamento dos profissionais de nosso estudo não atendem às diretrizes e normas estabelecidas pela OMS e pelas políticas nacionais de prevenção à violência no que diz respeito ao trabalho integrado e intersetorial, no desenvolvimento de ações preventivas, na consolidação do atendimento pré-hospitalar sistematizado, hierarquizado e subsidiado por práticas baseadas em evidências e na capacitação adequada dos recursos humanos

Toma de decisiones en menores con factores de riesgo para el Trastorno Disocial de la Conducta / Decision making in minors with risk factor of dissocial behavior disorder

Introducción. Existe la hipótesis de que las emociones participan del proceso cognitivo de la toma de decisiones guiando la conducta y dotando a la experiencia de una cualidad positiva o negativa que permite la adaptación del individuo al medio social. Método: La muestra estuvo conformada por 81 menores de edad (48 que cumplían con uno o dos criterios del DSM-IV y 33 sin alteraciones de comportamiento). Se utilizó la Escala Muldimensional de la Conducta, el SNAP IV y el Check list para TDC como instrumentos de tamizaje para su selección, posteriormente se realizó la evaluación con la versión computarizada de la IGT (Iowa Gambling Task). Resultados: Se dan diferencias estadísticamente significativas entre el grupo estudio y de comparación para la selección de las barajas desventajosas B durante la ejecución de la tarea. Los menores en riesgo presentaron un desempeño menor para la prueba general de toma de decisiones. Discusión: Los resultados indican la presencia de alteraciones en los procesos de toma de decisiones de los menores que presentan uno o dos criterios clínicos para desarrollar el TDC.

Introduction: There is a hypothesis that proposes that emotions take part in the cognitive process related to decision-making behavior; such processes provide experience of a positive or negative quality that allows the adaptation of a human being to a social background. Methods: There were 81 minors participants (48 qualified with one or two standards of DSM-IV and 33 without conduct disorders). We used Multidimensional Scale of Conduct, SNAP IV, and checklist for CD as screening instruments for its selection, and later we performed the assessment with the online version of IGT (Iowa Gambling Task). Results: A statistically significant difference was present between study and control groups in the selection of unfavorable decks of cards. Those children affected by behavioral disorders presented lower results in the general decision-making test. Conclusions: Results suggest the presence of disorders in decision-making in minors that present one or two clinical criteria to develop CD. This could be due to difficulties in contingency processing for unfavorable decisions, which prevented them from generating somatic states based on the possible future consequences.

Resting-state fMRI study of adolescents with conduct disorder: an ALFF analysis / 中华行为医学与脑科学杂志

Objective To investigate the functional characteristic of adolescents with conduct disorder (CD) in the resting state.Methods Resting-sate fMRI (rs-fMRI) scans were administered to 28 male adolescents with CD and 28 age-,gender-and IQ-matched healthy controls (HCs).The rs-fMRI data were subjected to amplitude of low-frequency fluctuation (ALFF) analysis and ALFF values were compared between the two groups.Additionally,the region ROIs showed significant difference and correlation analysis was conducted between ALFF in each ROI and Barratt's scores.Results ① Compared to HCs,the CD group showed decreased ALFF (P＜0.005) bilaterally in the superior frontal gyrus,right middle frontal gyrus,right posterior cingulate gyrus,right inferior parietal lobule (MNI coordinates:-21,48,27;21,24,48;36,24,33 6,-36,39;48,-45,57 respectively) as well as increased ALFF (P＜O.005) in the left thalamus and left lingual gyrus (MNI coordinates:-15,-27,-3;-18,-87,-12 respectively).② There was no significant correlation between ALFF and Barratt's scores in ROIs.Conclusion The results suggest that CD is associated with abnormal intrinsic brain activity,mainly in frontal-parietal-occipital-limbic cortices,which is related to emotional and cognitive processing and behavioral functions.

A Retrospective Study of Long Acting Risperidone Use to Support Treatment Adherence in Youth with Conduct Disorder

OBJECTIVE: Risperidone has been widely used to control aggression and conduct disorder (CD) in youth; however, treatment compliance is a major problem in CD. Our aim is to evaluate the effectiveness and tolerability of long-acting risperidone (LAR) in treating nonadherent cases. METHODS: The medical records of children and adolescents who had CD and were nonadherent to conventional drugs and psychosocial interventions (and therefore taking LAR) were reviewed. Informed consent on offlabel use of LAR was obtained from the parents. Clinical Global Impression (CGI) Severity (CGI-S) and CGI-Improvement scales were used and baseline and end points were compared. RESULTS: The study comprised 14 children and adolescents (5 girls, 9 boys). All had comorbid disorders: substance use disorder (n=8), attention deficit hyperactivity disorder (n=6), and major depression (n=2). Mean duration of LAR use was 3.1 months (1.5–8 months). We observed significant improvements in the baseline and endpoint CGI-S scores for CD in all but one patient (Z=−3.198; p < 0.001). Only mild adverse effects were observed: weight gain (n=2), sedation (n=1), leg cramps (n=1), and increased appetite with no weight gain (n=1). CONCLUSION: LAR is effective and tolerable for patients with CD who can’t be medicated with oral preparations due to non-adherence to treatment. Even short-term LAR use is effective to get compliance. As CD predicts numerous problems in adulthood, appropriate treatment is crucial. To our knowledge, this is the first study on LAR use in youth with CD. The use of LAR deserves careful consideration and further controlled studies are needed to confirm our findings.

Parenting Experience of Mother of Teenage Girls with Conduct Disorder: A Parse's Method Study / 정신간호학회지

PURPOSE: The aim of this study was to identify the parenting experience of mothers who have teenage girls with conduct disorders and to identify the meaning and structure of their experiences. METHODS: This study was a qualitative research based on Parse's research method. Participants were 9 mothers who had a daughter diagnosed with conduct disorder at a community hospital in the central region of South Korea. RESULTS: The core concept on the parenting experiences of mothers of teenage girls with conduct disorder were survival against a violent environment, a sense of guilt related to the conduct disorder, confusion and frustration concerning mother's role, and hope for the future. The experiences of these mothers can be defined as the process of human becoming with powering and transforming while connecting-separating and enabling-limiting with valuing. CONCLUSION: This research is expected to contribute to understanding of mothers' suffering and struggling and be useful in developing nursing care for clients with conduct disorder and their mothers.

Estudio de asociación del trastorno del desarrollo de la coordinación con los problemas de conducta en niños de la ciudad de Bucaramanga, Colombia / Cross-Sectional Study of Developmental Coordination Disorder with Behavior Problems in Children from Bucaramanga City, Colombia / Estudo de associação do trastorno do desenvolvimento da coordenação com os problemas de conduta em crianças da cidade de Bucaramanga, Colômbia

Introducción: el trastorno del desarrollo de la coordinación TDC en la infancia es una problemática importante desde la salud pública, ya que tiene repercusiones para el desarrollo infantil desde las dimensiones motora, cognitiva, psicosocial y emocional y, al mismo tiempo, son frecuentes sus comorbilidades con otros trastornos del desarrollo infantil. El presente estudio analiza la asociación de características de TDC con los problemas de conducta en niños de la ciudad de Bucaramanga, Colombia. Materiales y métodos: Estudio transversal, descriptivo y de asociación, en una muestra de 140 niños de 6 a 12 años de edad, aleatorizados en instituciones educativas. Se realizó entrevista estructurada y aplicación de cuestionarios para determinar la presencia de características de TDC y de problemas de conducta. Se realizó análisis descriptivo univariado para la caracterización sociodemográfica y pruebas de asociación con coeficiente de correlación de Spearman. Resultados: se encontró una prevalencia del 3,6% de características de TDC en la población estudiada, y una asociación de Rho = -0,263 con p valor = 0,002 entre características de TDC y problemas de conducta referidos por los padres. Discusión: la prevalencia de características de TDC para Bucaramanga fue menor en relación con la mayoría que se reporta a nivel internacional. La asociación entre características de TDC y problemas de conducta en esta ciudad es baja pero estadísticamente significativa.

Introduction: Developmental Coordination Disorder (DCD) in childhood is a major public health issue due to its consequences for child development from the motor, cognitive, psychosocial and emotional perspectives, and its comorbidities are common with other developmental disorders in children as well. This study characterizes the association of DCD features with behavior problems in children from Bucaramanga city, Colombia. Materials and methods: This cross-sectional study was conducted in a random sample of 140 children aged 6 to 12 years old that belonged to educational institutions. A structured interview and questionnaires were applied in order to determine the presence of DCD features and behavior problems. A univariate descriptive analysis led to a socio demographic characterization and a Spearman's rank correlation coefficient. Results: Results showed a prevalence of 3.6% of DCD features in the population, and a negative association of Rho = -0,263 with p value = 0,002 among DCD features and behavior problems reported by parents. Discussion: The prevalence of DCD features in Bucaramanga was lower concerning the prevalence reported internationally. The association among DCD features and behavior problems in this city is low but statistically significant.

Introdução: o transtorno do Desenvolvimento da Coordenação TDC na infância é uma problemática importante desde a saúde pública, já que tem repercussões para o desenvolvimento infantil desde as dimensões motoras, cognitiva, psicossocial e emocional, e ao mesmo tempo são frequentes suas comorbilidades com outros transtornos do desenvolvimento infantil. O presente estudo analisa a associação de características de TDC com os problemas de conduta em crianças da cidade de Bucaramanga, Colômbia. Materiais e métodos: estudo transversal, descritivo e de associação em uma amostra de 140 crianças de 6 a 12 anos, aleatorizados em instituições educativas. Se realizou entrevista estruturada e aplicação de questionários para determinar a presença de características de TDC e de problemas de conduta. Realizou-se análise descritiva univariada para a caracterização sociodemográfica e provas de associação com coeficiente de correlação de Spearman. Resultados: se encontrou uma prevalência do 3,6% de características de TDC na população estudada, e uma associação negativa de Rho = -0,263 com p valor = 0,002 entre características de TDC e problemas de conduta referidos pelos pais. Discussão: a prevalência de características de TDC para Bucaramanga foi menor em relação à maioria que se reporta ao nível internacional. A associação entre características de TDC e problemas de conduta nesta cidade é baixa, mas estatisticamente significativa.

An ERP study on response inhibition in high-risk antisocial personality / 中华行为医学与脑科学杂志

Objective To explore the time course of response inhibition function in juvenile delin-quents with antisocial personality characteristics.Methods The healthy control group ( n=21),juvenile delinquents with antisocial personality characteristics ( CD +AP ) ( n=18) and juvenile delinquents ( CD) ( n=18) were selected in current study by recording the event-related potentials in a Go/Nogo task.N2 and P3 components of event-related potentials were analyzed.Results Behavioral results showed that Nogo cor-rection rate of control group ((93.13±2.71)%) were significantly higher than CD group ((87.51±2.82)%, P<0.01) and CD +AP group((85.63±2.45)%, P<0.01).In CD+AP group,the amplitude of the N2nogo ( (-1.82±1.64)μV) was significantly lower than control group ( (-6.36±2.93)μV, P<0.01) ,and the am-plitude of the P3nogo ((5.52±2.79)μV) was significantly decreased than healthy control ((11.26±4.92)μV, P<0.01).In CD group,the amplitude of P3nogo ((5.20±3.17)μV) was significantly reduced than healthy control ((11.26±4.92)μV, P<0.01).Conclusion N2nogo and N2d are associated with the early phases of response inhibition and reflected response conflict.P3nogo and P3d are associated with the late phases of response inhibition and monitored inhibitory control.These data suggest that CD+AP participants exhibited im-paired response conflict and inhibitory control.This may be associated with persistent antisocial behavior.

Social Conduct Scale (SCS): a psychometric investigation

Abstract The social conduct of an individual comprises all the interpersonal behaviors that he or she exhibits in the social contexts he or she is exposed to. The Social Conduct Scale (SCS) is a self-report instrument developed to provide researchers and clinicians with information on prosocial, antisocial and oppositional-defiant tendencies of Portuguese-speaking children and adolescents. In the present study, we conducted an analysis of the criterion validity of the SCS by comparing the scores obtained from a large population-based sample (N= 1,172) against an offender (N= 129), a scholar (N= 31), and a clinic-referred (N= 24) sample of adolescents with marked previous conduct problems. As expected, antisocial youths had significantly higher means on antisocial behaviors and lower means on prosocial tendencies when compared to the population-based sample. Overall, findings supported the hypothesized criterion validity of the SCS. The instrument might play a role as a helpful resource for researchers, clinicians and practitioners interested in assessing the social conduct of Brazilian children and adolescents. (AU)

Diferencias entre adolescentes con trastorno disocial de inicio infantil e inicio adolescente / Differences between adolescents with childhoodonset vs. adolescent-onset conduct disorder

Se comparó un grupo de adolescentes con trastorno disocial de inicio infantil (TD-I), con un grupo de adolescentes con Trastorno Disocial de Inicio Adolescente (TD-A), en relación con un conjunto de variables neuropsicológicas, biográficas, psicológicas, familiares y comunitarias, y la frecuencia general y por síntoma de trastorno disocial. Participaron 60 hombres y 11 mujeres, de 11 a 18 años de edad, 24 con TD-I y 47 con TD-A. Los participantes con TD-I informaron una frecuencia mayor de conductas disociales, presenciaron más conductas violentas entre sus padres, informaron una edad promedio más baja de consumo de bebidas alcohólicas y reportaron más problemas en el colegio como consecuencia de dichas conductas. Estos resultados tienden a confirmar que los individuos con TD-I presentan un perfil más negativo de síntomas y dificultades asociadas a dicho trastorno.

We compared a group of adolescents with childhood-onset conduct disorder (C-CD), with a group of teenagers with adolescent-onset conduct disorder (A-CD), in relation to a set of neuropsychological, biographical, psychological, family, and community variables, and the overall and specific frequency of symptoms. Participants were 60 men and 11 women, 24 with C-CD and 47 with A-CD. Statistical analyzes depended on the type of variable analyzed. Participants with C-CD reported a higher frequency of antisocial behaviors, more violent behavior witnessed between their parents, a lower age of alcohol consumption, and more problems in school as a consequence of antisocial behaviors. These results tend to confirm that individuals with C-CD have a more negative profile of symptoms and associated difficulties.

Onset of psychosis at age 81? With regard to frontal lobe syndromes / Psicose inaugural aos 81 anos? A propósito das síndromes do lobo frontal

When the frontal lobe of the brain is affected important behavioral changes may occur mainly at the level of executive functioning, i.e., planning, decision-making, judgment and self-perception. However, the behavioral changes may be of different nature with marked indifference and apathy. We report a clinical case of an 81-year-old patient with sudden onset of behavioral changes that were initially interpreted as an acute confusional episode of infectious etiology, but actually they were due to an ischemic lesion in the frontal lobe.

O lobo frontal, quando afetado, pode provocar alterações importantes do comportamento, principalmente na função executiva: planejamento, tomada de decisões, juízo e autopercepção. Contudo, as alterações podem ser de outra natureza, caracterizando-se por marcada indiferença e apatia. É relatado aqui o caso de uma paciente de 81 anos, com alterações súbitas do comportamento, que foram interpretadas inicialmente como um quadro confusional agudo de natureza infecciosa, mas que se mostraram provocadas por uma lesão isquêmica na região frontal.

Homicidas juveniles en Bogotá, estudio de grupos focales / Young murderers in Bogotá, a focus groups study

Antecedentes. La violencia ha sido declarada un problema de salud pública mundial. En los últimos años, se ha visto un incremento alarmante de la violencia causada por adolescentes, reflejado en indicadores como el número de homicidios. Los adolescentes son victimarios y víctimas de muchos de estos actos violentos. Colombia no escapa a este fenómeno -donde el homicidio es la principal manera de muerte violenta- y se cuenta con pocos estudios en población homicida juvenil. Objetivo. Explorar comportamientos asociados a cometer homicidio en jóvenes escolarizados y población no escolarizada. Materiales y métodos. Estudio cualitativo mediante técnica de grupos focales. Resultados. Se encontró como el factor de riesgo más implicado la disponibilidad y uso de armas. Otros factores de riesgo afectan la disposición del joven homicida para tener un comportamiento criminal y las estrategias de control que son elegidas por el individuo. Dichos factores son apreciados de maneras distintas por los jóvenes homicidas y los no homicidas. Conclusión. Este estudio arroja información clave que puede ser utilizada en el diseño e implementación de estrategias para enfrentar el homicidio juvenil como problema de salud pública.

Background. Violence has been declared as a public health problem in the world. In the last years, there has been an alarming increase of the violence caused by adolescents. This has been reflected in several indicators as the number of homicides. Adolescents are both criminals and victims of many of these violent acts. Colombia has not escaped this phenomenon -being homicide its main way of violent death- and there is little specific data on juvenile homicidal population. Objective. To explore likely risk factors linked to homicide committed by two young populations: a schooled one and non-schooled one. Materials and methods. A qualitative study of two focus groups: one composed by young murderers and another by young non-murderers. Results. Studies show that the main risk factor is the access to and the use of weapons. Other risk factors affect the young's murder disposition to develop a criminal behaviour and the control strategies chosen by them. Such factors are interpreted in different ways by young murderers and non-murderers. Conclusions. This study gives important data which can be used in order to design and establish strategies to handle juvenile murder as a public health issue.