ABSTRACT
Empirical findings regarding childhood traumatic stress are placed within a developmental life-trajectory model that incorporates a tripartite etiology of posttrauma distress. This approach recognizes an intricate matrix of child-intrinsic factors, developmental maturation and experience, life events, and evolving family and social ecologies. Of central developmental importance in the field of traumatic stress is the ontogenesis of appraisal, emotional response, emotional and physiological regulation, and consideration of protective action with regard to danger. The complexity of traumatic situations and their aftermath suggests the relevance of multiple stress diatheses in understanding individual variability in proximal and distal effects. Neurobiological systems that subserve danger mature over childhood and adolescence. Neurophysiological and neurohormonal studies among traumatized children and adolescents suggest potential neurodevelopmental stage-related vulnerabilities within these systems. Advances in child development and traumatic stress provide tools for investigating proximal and distal interplay of psychopathology, disturbances in the acquisition and maintenance of developmental competencies, and life-trajectory outcomes. A developmental psychopathology model suggests different avenues by which dangerous circumstances, childhood traumatic experiences, and posttraumatic stress disorder (PTSD) can intersect with other anxiety disorders over the life span.
Subject(s)
Anxiety Disorders/psychology , Models, Psychological , Psychopathology , Stress Disorders, Post-Traumatic/psychology , Adult , Child , HumansABSTRACT
OBJECTIVE: The sensitivity of the Diagnostic Interview Schedule for Children, second edition (DISC-2.1) was examined for certain "rare" disorders: eating disorders, major depressive episode, obsessive compulsive disorder, psychosis, tic disorders, and substance use disorders. METHOD: Subjects recruited from specialized centers were interviewed with the DISC-2.1; the centers' diagnoses served as the criterion measure. RESULTS: Overall the DISC showed good to excellent sensitivity (range = 0.73 to 1.0). Used alone, the DISC-P (parent interview) was generally more sensitive than the DISC-C (child interview). Areas for additional instrument revision were identified. Recommendations about informant choice by diagnosis are offered. CONCLUSIONS: The strategy used in this study was useful for assessing the DISC's sensitivity for these disorders. Additional work examining specificity of the DISC remains to be done. The DISC should prove a useful adjunct in clinical settings given the ease and relatively low cost of administration.
Subject(s)
Mental Disorders/diagnosis , Psychiatric Status Rating Scales/standards , Adolescent , Age Factors , Algorithms , Child , Depressive Disorder/diagnosis , Feeding and Eating Disorders/diagnosis , Female , Humans , Male , Obsessive-Compulsive Disorder/diagnosis , Psychiatric Status Rating Scales/statistics & numerical data , Psychotic Disorders/diagnosis , Sensitivity and Specificity , Substance-Related Disorders/diagnosis , Tic Disorders/diagnosisABSTRACT
Optimizing methods of combining discrepant diagnostic information from multiple sources is one of the more daunting tasks facing the field of child psychopathology. Several researchers have asserted that complex information-combining schemes, those in which certain information or sources of information are weighted differently from others, are preferable. This study provides theoretical and empirical evidence that simple information-combining schemes, those in which all information from all sources is weighted equally, will as a rule work as well as complex schemes and may even work better. The implications of these findings for diagnostic instrument and algorithm design are discussed. A two-step diagnostic procedure utilizing a simple information-combining scheme is presented.
Subject(s)
Algorithms , Data Interpretation, Statistical , Child Psychiatry , Data Collection , Humans , Mental Disorders/diagnosisABSTRACT
The biological mothers of 100 outpatient children aged 6-13 years completed the Minnesota Multiphasic Personality Inventory (MMPI). Mothers of children given DSM-III diagnoses of conduct disorder (CD; n = 13) had significantly higher scores on MMPI scales associated with antisocial behavior (Pd and Ma), histrionic behavior (Hs and Hy), and disturbed adjustment (Sc). In contrast, the children's diagnosis of attention deficit disorder with hyperactivity (ADD/H; n = 22) was not significantly associated with any maternal MMPI elevations, and the CD x ADD/H interactions were not significant for any MMPI scale. These results indicate that CD is linked to maternal personality disorder, but ADD/H is not.
Subject(s)
Attention Deficit Disorder with Hyperactivity/psychology , Child Behavior Disorders/psychology , Mother-Child Relations , Mothers/psychology , Personality Disorders/psychology , Adolescent , Adult , Child , Female , Humans , MMPI , Male , Risk FactorsABSTRACT
The Luria-Nebraska Neuropsychological Battery-Children's Revision (LNNB-CR) was administered to 54 clinic-referred children aged 8-12 years. Children reliably diagnosed as attention deficit disorder with hyperactivity were compared with children diagnosed as attention deficit disorder without hyperactivity and with a clinic control group diagnosed with internalizing disorders. Both attention deficit disorder groups were lower than the control group in verbal and Full Scale IQ scores but did not differ from one another. The groups did not differ significantly on any of the LNNB-CR clinical scales, on the right or left hemisphere scores, or on the pathognomonic score using analyses of variance or analyses of covariance with both Full Scale IQ and age as covariates. These findings failed to support the hypothesis that attention deficit disorder, either with or without hyperactivity, is associated with neuropsychological dysfunction as measured by the LNNB-CR.
