Factors associated with parent-teacher hyperactivity/inattention screening discrepancy: Findings from a UK national sample.

BACKGROUND: To fulfil the diagnostic criteria of Attention Deficit Hyperactivity Disorder in the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms should be observed in two or more settings. This implies that diagnostic procedures require observations reported from informants in different settings, such as teachers in school and caregivers at home. This study examined parent-teacher agreement in reporting hyperactivity/inattention and its relationship with child's, parent's, and family's characteristics. METHOD: We used data from the 2004 United Kingdom Mental Health of Children and Young People survey, including 7977 children aged 4-17, to investigate cross-informant agreement between parents and teachers on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. The characteristics of different patterns of informant agreement were assessed using multinomial logistic regression. RESULTS: Cross-informant agreement of parent and teacher was low (weighted kappa = .34, 95% C.I.: .31, .37). Some characteristics, such as male child and parental emotional distress, were associated with higher likelihood of parent-teacher discrepancy. CONCLUSION: We found low informant agreement in the hyperactive/inattention subscale, as hypothesised and consistent with previous studies. The current study has found several factors that predict discrepancy, which were partly consistent with previous research. Possible explanation, implications, and further research on parent-teacher informant discrepancy in reporting hyperactivity/inattention were discussed.

Impulsivity and self-regulation: A dual-process model of risky driving in young drivers in Iran.

The dual-process model of risky driving (Lazuras, Rowe, Poulter, Powell, & Ypsilanti, 2019) suggested that regulatory processes mediate the effect of impulsivity on risky driving. The current study aimed to examine the cross-cultural generalisability of this model to Iranian drivers, who are from a country with a markedly higher rate of traffic collisions. We sampled 458 Iranian drivers aged 18 to 25 using an online survey measuring impulsive processes including impulsivity, normlessness and sensation-seeking, and regulatory processes comprising emotion-regulation, trait self-regulation, driving self-regulation, executive functions, reflective functioning and attitudes toward driving. In addition, we used the Driver Behaviour Questionnaire to measure driving violations and errors. Executive functions and driving self-regulation mediated the effect of attention impulsivity on driving errors. Executive functions, reflective functioning, and driving self-regulation mediated the relationship between motor impulsivity and driving errors. Finally, attitudes toward driving safety significantly mediated the relationship of both normlessness and sensation-seeking with driving violations. These results support the mediatory role of cognitive and self-regulatory capacities in the connection between impulsive processes and driving errors and violations. Overall, the present study confirmed the validity of the dual-process model of risky driving in a sample of young drivers in Iran. Implications for educating drivers and implementing policies and interventions based on this model are discussed.

Comparison of Person-Centered and Cumulative Risk Approaches in Explaining the Relationship Between Adverse Childhood Experiences and Behavioral and Emotional Problems.

Adverse childhood experiences (ACEs) commonly co-occur, and researchers often estimate their impact using a cumulative risk approach. The person-centered approach offers another approach to operationalize the co-occurrence of ACEs. This study aims to estimate latent classes of ACEs in a sample of U.K. children, examine their relationship with emotional and behavioral problems, and compare the explanatory value of the latent classes to cumulative risk scores. Data were collected among a general population sample of British 10-year-old children extracted from the U.K. Household Longitudinal Study (N = 601). Seven items characterized ACEs, comprising parent-report physical discipline, emotional abuse, supervisory neglect, maternal psychological distress, child-report parental educational disinterest, bullying victimization, and adverse neighborhood. Outcome measures were derived from the self-report Strengths and Difficulties Questionnaire including total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. Latent class analysis resulted in a three-class solution: low ACEs, household challenges, and community challenges. Compared to the other classes, the community challenges class scored substantially worse on total difficulties, emotional symptoms, and peer subscales. The cumulative risk score was associated with all outcomes except prosocial behavior. Cumulative risk models accounted for a larger proportion of variance compared with the latent class models, except for peer problems which the person-centered model explained better. This study confirms that ACEs are associated with impairment in child functioning, and that both person-centered and cumulative risk approaches can capture this relationship well. Specifically, the person-centered approach demonstrated how co-occurring risk factors in the community challenges class produced particularly poor internalizing outcomes.

Commentary: The potential of sleep research to contribute to our understanding on antisocial behaviour - a reflection on Brown, Beardslee, Frick, Steinberg and Cauffman (2022).

A growing body of work indicates that sleep problems are associated with antisocial behaviour in young people. This opens up the opportunity for interventions that improve sleep to reduce antisocial behaviour. Brown et al. (2022) provide important new leads that can help to target interventions, highlighting that the relationship may be most relevant to aggressive offending and that it is consistent across adolescence and young adulthood. The within-individual design adopted in this study has a number of methodological strengths. This commentary evaluates the effectiveness of the approach in terms of accounting for confounding effects and addressing temporal ordering. Directions for future research to build on the target paper are considered.

Links of Adversity in Childhood With Mental and Physical Health Outcomes: A Systematic Review of Longitudinal Mediating and Moderating Mechanisms.

Adverse childhood experiences (ACEs) have been associated with causes of early death, addiction, mental illness, and poor health. However, studies investigating underlying mechanisms often rely on cross-sectional data or inappropriate study designs. To prevent the negative sequelae associated with ACEs, it is imperative to understand the mechanisms underlying the prospective relationship. The aim of this present review was to provide a synthesis and critical evaluation of the literature regarding the mechanisms underlying this relationship. A search in SCOPUS, MedLine via Ovid, PsycINFO via Ovid, and Web of Science was performed. Studies that utilised a prospective design assessing ACEs in childhood or adolescence, outcomes in adulthood, and analysed either a mediating or moderating relationship were included, unless the study relied on informant report or official records to assess childhood maltreatment types of ACEs. Twenty-two studies examining a longitudinal mediation or moderation were included in a systematic review. A review of the studies found links to psychopathology, delinquent and problem behaviours, poor physical health, and poor socioeconomic outcomes. A clear image of underlying mechanisms is not forthcoming due to (a) poor study design in relation to assessing longitudinal mechanisms, and (b) heterogeneity in the adversities, mechanisms, and outcomes assessed. Based on the review, several gaps and limitations are highlighted and discussed.

Self-Affirmation and Image/Performance Enhancing Drug Use in Recreational Exercise.

Objectives: The use of image and performance enhancement drugs (IPEDs) in recreational sport represents an emerging public health and societal problem. The present study investigated whether self-affirmation changed exercisers' intentions to use IPEDs, via the effects of mental construal and message acceptance. Method: Sixty-eight exercisers who self-reported IPEDs use participated in the study and were randomly assigned to either a self-affirmation or a control group. All participants read a health-related message about the 10 consequences of IPEDs and subsequently completed a survey measuring message acceptance, mental construal, doping intentions and IPEDs-related social cognitive variables. Results: There were no significant differences between the self-affirmed and the control groups. Hierarchical linear regression analysis further showed that message acceptance, subjective norms, and situational temptation were significantly associated with intentions to use IPEDs. Conclusion: Our findings raise the possibility that for recreational exercisers IPED's use is seen mostly as a health-related matter than a socio-moral transgression.

Measurement invariance of the strengths and difficulties questionnaire across socioeconomic status and ethnicity from ages 3 to 17 years: A population cohort study.

Mental health inequalities along ethnic and socioeconomic groupings are well documented. The extent to which these observed inequalities are genuine or reflect measurement differences is unclear. In the current study we sought to investigate this in a large population-based sample of children and adolescents in the United Kingdom. The main objective of the study was to establish whether the parent-report Strengths and Difficulties Questionnaire (SDQ) was invariant across ethnicity and socioeconomic status groupings at six time points from 3 to 17 years (maximum N = 17,274). First, we fitted a series of confirmatory factor analysis models to the data and confirmed that the five-factor structure (emotional problems; peer problems; conduct problems; hyperactivity/inattention; and prosocial behaviour) had acceptable fit at ages 5, 7, 11, and 14 years. Next, we tested configural, metric, and scalar invariance at these time points and demonstrated scalar invariance across household income, parent highest education, and ethnicity categories. The five-factor structure did not fit well at ages 3 and 17 years; therefore invariance was not tested at these ages. These findings suggest the parent-report SDQ can be used to measure socioeconomic and ethnic inequalities in mental health from ages 5-14 years but more consideration is required outside these ages.

Why are newly qualified motorists at high crash risk? Modelling driving behaviours across the first six months of driving.

OBJECTIVE: Novice driver crash risk diminishes steeply over the first few months of driving. We explore the characteristics of driving over this period to identify behaviours that might underlie this change in risk. METHODS: We conducted a cross-sectional study of 1456 UK drivers aged 17-21 within six months of gaining their licence. We examined how various forms of driving exposure, such as weekly mileage and driving at night, were related to duration of licencing. We explored the factor structure of the Early Driving Development Questionnaire (EDD-Q); a new instrument designed to measure safety relevant attitudes and behaviours in recently qualified drivers. We examined the relationship of the derived factors to licence duration. RESULTS: There was little evidence that greater exposure to risky driving situations was more common in those with shorter licence durations. Exploratory and Confirmatory Factor Analyses identified EDD-Q factors measuring risky style (12 items), skill deficiencies (8 items) and driving confidence (4 items). Licence duration was positively correlated with both risky style and confidence, with these relationships stronger for older novices. Licence duration was also negatively related to skill deficiencies (i.e., positively correlated with perceived driving skill development): this relationship was stronger in younger novices. CONCLUSIONS: The negative correlation between license duration and skill deficiencies is consistent with the observation of decreasing novice crash involvement as experience is gained. The EDD-Q offers a new brief measure of aberrant driving that is specifically tailored for newly qualified drivers.

Working memory guidance of visual attention to threat in offenders.

Aggression and trait anger have been linked to attentional biases toward angry faces and attribution of hostile intent in ambiguous social situations. Memory and emotion play a crucial role in social-cognitive models of aggression but their mechanisms of influence are not fully understood. Combining a memory task and a visual search task, this study investigated the guidance of attention allocation toward naturalistic face targets during visual search by visual working memory (WM) templates in 113 participants who self-reported having served a custodial sentence. Searches were faster when angry faces were held in working memory regardless of the emotional valence of the visual search target. Higher aggression and trait anger predicted increased working memory modulated attentional bias. These results are consistent with the Social-Information Processing model, demonstrating that internal representations bias attention allocation to threat and that the bias is linked to aggression and trait anger.

The efficacy of interactive group psychoeducation for children with leukaemia: A randomised controlled trial.

OBJECTIVE: To evaluate an interactive group psychoeducation programme for children treated for leukaemia. METHODS: A longitudinal randomised controlled study across four UK hospitals with an immediate (N = 26) and delay control group (N = 32). The intervention covered the pathophysiology of leukaemia, its treatment, side effects and the importance of positive health behaviours. Primary outcomes were parent-reported child health related quality of life (HRQoL) and behavioural difficulties. Secondary outcomes were child-reported HRQoL, cancer-specific HRQoL, child confidence, caregiver burden, and treatment anxiety. Measures were completed pre- and immediately post-intervention, and at 13 and 26-weeks follow-up. Change over time was analysed using multilevel modelling. Acceptability questionnaires rated the intervention on benefits, recommendations, and barriers to participation. RESULTS: The intervention significantly improved parent-reported child HRQoL but did not have a significant effect on other outcomes. Acceptability of the intervention was high. CONCLUSIONS: This study provides initial evidence that interactive group psychoeducation is acceptable to families and improves HRQoL in children with leukaemia. Difficulties with recruitment removed power to detect effect sizes that are plausible for psychoeducational interventions. PRACTISE IMPLICATIONS: Further studies to explore the potential of psychoeducation to improve outcomes for children with leukaemia and an examination of barriers to participation within this population are warranted.

Understanding intentions to override intelligent speed assistance prior to widespread availability: An application of the theory of planned behaviour.

Intelligent Speed Assistance (ISA) offers a technological solution to reduce speeding that will become more common in vehicles in the short to medium term. Many implementations allow drivers to override the system's speed control and minimising such interventions can optimise safety benefits. This paper aims to inform behaviour change interventions to reduce ISA overriding targeted to drivers as they obtain vehicles fitted with ISA. We explore the beliefs underlying intentions to override ISA to exceed the speed limit in drivers with limited ISA experience using the Theory of Planned Behaviour. In a sample of 121 drivers (mean age 36 years), regression modelling showed that attitudes strongly predicted intentions with an additional contribution from subjective norms but not perceived behavioural control. Behavioural beliefs underlying attitudes addressed overriding ISA for (1) responsibly controlling the car to minimise crash risk and (2) reducing journey times and enjoying fast driving. Salient normative beliefs focussed on groups that would disapprove of overriding ISA including emergency services and parents. We discuss how these beliefs might be addressed in interventions to maximise the safe adoption of ISA.

Association between symptoms of sleep apnea and problem behaviors in young adult twins and siblings.

BACKGROUND: Sleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors. METHODS: In a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors. RESULTS: Our results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22-0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea. CONCLUSIONS: Genetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

External validation of a bifactor model of oppositional defiant disorder.

Dimensions of irritability and defiant behavior, though correlated within the structure of ODD, convey separable developmental risks through adolescence and adulthood. Irritability predicts depression and anxiety, whereas defiant behavior is a precursor to antisocial outcomes. Previously we demonstrated that a bifactor model comprising irritability and defiant behavior dimensions, in addition to a general factor, provided the best-fitting structure of ODD symptoms in five large datasets. Herein we extend our previous work by externally validating the bifactor model of ODD using multiple regression and multivariate behavior genetic analyses. We used parent ratings of DSM IV ODD symptoms, and symptom dimensions for ADHD (i.e., inattention and hyperactivity-impulsivity), conduct disorder (CD), depression/dysthymia, and generalized anxiety disorder (GAD) from 846 6-18-year-old twin pairs. We found that the ODD irritability factor was associated only with depression/dysthymia and GAD and the ODD defiant behavior factor was associated only with inattention, hyperactivity-impulsivity, and CD, whereas the ODD general factor was associated with all five symptom dimensions. Multivariate behavior genetic analyses found all five symptom dimensions shared genetic influences in common with the ODD general, irritability, and defiant behavior factors. In contrast, the defiant behavior factor shared genetic influences uniquely with inattention and hyperactivity-impulsivity, whereas the irritability factor shared genetic influences uniquely with depression/dysthymia and GAD, but not vice versa. This suggests that genes that influence irritability in early childhood also predispose to depression and anxiety in adolescence and adulthood. These multivariate genetic findings also support the external validity of the three ODD dimensions at the etiological level. Our study provides additional support for subtyping ODD based on these symptom dimensions, as in the revisions in the ICD-11, and suggests potential mechanisms underlying the development from ODD to behavioral or affective disorders.

How can adolescent aggression be reduced? A multi-level meta-analysis.

Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.

Psychoeducation for Children with Chronic Conditions: A Systematic Review and Meta-analysis.

OBJECTIVE: This systematic review and meta-analysis evaluated the effectiveness of psychoeducational interventions in improving quality of life (QoL) for children with chronic conditions. METHODS: We identified 25 randomized controlled trials of psychoeducational interventions for children with chronic conditions that reported a QoL outcome and were published 1980-2018. Due to small numbers of interventions in other chronic conditions, comparisons between chronic conditions were limited to 17 studies addressing interventions for asthma and diabetes. RESULTS: Psychoeducational interventions were associated with a small, statistically significant improvement in QoL (standardized mean difference = 0.14; 95% confidence interval: 0.06-0.23). The effect was significantly larger for asthma interventions compared to diabetes interventions, and in interventions delivered to younger (under 12 years) rather than older children (12 years and over). CONCLUSIONS: These results suggest that currently evaluated psychoeducational interventions improve QoL for children with asthma but not for children with diabetes. Children with diabetes may require tailored interventions with additional components alongside psychoeducation. Further intervention studies are needed to generalize to other conditions and to draw conclusions about which settings and modes of delivery are most effective in improving QoL.

Impulsive and Self-Regulatory Processes in Risky Driving Among Young People: A Dual Process Model.

The present study empirically examined a novel dual process model of self-reported aberrant driving behavior in young and novice drivers that incorporates both impulsive and self-regulatory processes. Four hundred and nine participants aged 18-25 years (M age = 21.18 years, SD = 2.12; 65.5% females) completed online questionnaires on impulsivity, normlessness, sensation seeking, emotion and self-regulation, and attitudes toward driving safety. Path analysis showed that motor impulsivity was associated with self-reported driving violations, errors, and lapses, whereas sensation seeking was uniquely directly associated with self-reported errors. Non-planning impulsivity, normlessness and sensation seeking had significant indirect effects on self-reported errors, via self-regulation. Finally, motor impulsivity and normlessness had a significant indirect effect on self-reported violations, errors and lapses, via attitudes to driving safety. Based on our findings we suggest that a dual-process approach is relevant to the study of aberrant driving behavior in young and novice drivers, and the results of the present study have important implications for initiatives to promote driving safety in this population.

Behavioral influences on driver crash risks in Ghana: A qualitative study of commercial passenger drivers.

OBJECTIVES: Though there is a growing body of literature on crash risks in the developed world, little is known about how well these models apply to motoring in developing countries, the context in which the majority of road traffic fatalities occur. This qualitative study explores factors perceived to influence crash risks for commercial drivers in Ghana. METHOD: Twenty commercial drivers of varied ages and experience were sampled from 7 major lorry terminals in 3 regions (Greater Accra, Ashanti, and Volta) of Ghana. Data were collected through semistructured interviews. RESULTS: The participants identified some issues that are shared with drivers in the developed world, though moderated by the Ghanaian context. These included work pressures (e.g., fatigued driving), speeding, distracted driving, and inadequate vehicle maintenance. Other factors identified by participants are less frequently considered in research addressing driving behavior in developed countries. These included aggressive competition over passengers and corruption (e.g., improper licensing practices), among others. CONCLUSION: The findings have implications for building a research base to support the development of road safety policy and interventions in developing countries.

Mechanisms underlying social gradients in child and adolescent antisocial behaviour.

OBJECTIVE: A number of studies demonstrate a social gradient in behavioural problems, with children from low-socioeconomic backgrounds experiencing more behavioural difficulties than those from high-socioeconomic families. Antisocial behaviour is a heterogeneous concept which includes diverse behaviours such as physical fighting, vandalism, lying, disobedience and irritability. It remains unclear whether the mechanisms underlying social inequalities are similar across these different subtypes of antisocial behaviour. This study aimed to simultaneously test a range of individual, family and neighbourhood factors as mediators of the relationship between income and subtypes of antisocial behaviour. METHOD: Data on a UK representative sample of 7977 children and adolescents, aged 5-16, was analysed in a series of nested structural equation models. A range of antisocial outcomes, including irritability, aggression, and callous-unemotional traits, were measured. Income quintiles were used to indicate family socioeconomic status. A range of potentially mediating or confounding variables, such as family functioning and parental mental health, were also measured. RESULTS: Analyses revealed that unhealthy family functioning, neighbourhood disadvantage, stressful life events and children's literacy difficulties were mediating variables contributing to the indirect effect of income on a range of antisocial behaviours. CONCLUSION: As expected family functioning accounted for a substantial proportion of the association between SES and antisocial behaviour, we also found evidence that child cognitive functioning might perform an important role. Our findings emphasise the importance of addressing the mechanisms underlying the association between SES and behavioural problems.

Why do drivers become safer over the first three months of driving? A longitudinal qualitative study.

Drivers are at high crash risk when they begin independent driving, with liability decreasing steeply over the first three months. Their behavioural development, and other changes underlying improved safety are not well understood. We adopted an innovative longitudinal qualitative design, with thirteen newly qualified drivers completing a total of 36 semi-structured interviews, one, two and three months after acquiring a full UK driving license. The interviews probed high-risk factors for new drivers, as well as allowing space for generating novel road safety issues. Analysis adopted a dual deductive and inductive interpretative thematic approach, identifying three super-ordinate themes: (1) Improvements in car control skills and situation awareness; (2) A reduction in the thrill of taking risks when driving against a background of generally increasing driving speed; (3) Early concerns about their social status in the eyes of other road users during the early stages of driving, which may put pressure on them to drive faster than they felt comfortable with. The study provides important new leads towards understanding how novice driving becomes safer over the first few months of driving, including how well-studied concepts of driving skill and style may change during development of independent driving, and bringing the less rigorously studied concept of social status into focus.