Identification of Patterns of Hospitalizations in Child and Adolescent Mental Health Service.

Adolescence is a time of increased vulnerability to mental health conditions, which may necessitate hospitalization. This study sought to identify and characterize patterns of adolescent (re-)hospitalizations. The one-year (re-)hospitalization patterns of 233 adolescents were analyzed. The sequences of hospitalization and discharge was examined using cluster analyses. Results revealed five distinct (re-)hospitalization patterns or clusters: Cluster A represented brief hospitalizations with 56 cases (24.03%) averaging 7.71 days; cluster B consisted of repetitive short hospitalizations involving 97 cases (41.63%) with an average of 19.90 days; cluster C encompassed repetitive medium hospitalizations included 66 cases (28.33%) averaging 41.33 days; cluster D included long hospitalizations with 11 cases (4.72%) and an average of 99.36 days; cluster E depicted chronic hospitalizations, accounting for 3 cases (1.29%) with an average stay of 138.67 days. Despite no age-based differences across clusters, distinctions were noted in terms of sex, diagnoses, and severity of clinical and psychosocial difficulties. The study identified characteristics of both regular and atypical adolescent hospitalization users, emphasizing the distribution of hospitalization days and their associated clinical attributes. Such insights are pivotal for enhancing the organization of child and adolescent mental health services to cater to the growing care requirements of this age group.

Self-regulatory control processes in youths: A temporal network analysis approach.

Objective: This study aimed to better understand the temporal interrelationships among self-control, response inhibition, and anger (i.e., momentary state and rumination) on both the within- and between-person levels in male adolescents. Method: We applied temporal network analyses among 62 male adolescents with a wide range of behavioral difficulties. Self-control, momentary anger, and anger rumination were mapped by self-report measures, whereas we measured response inhibition through an ambulatory Go/No-go task (two measures a day-morning and afternoon-over a 9-day period). Results: Temporal network analysis, at the within-person level, revealed that morning measures of response inhibition, anger rumination, and self-control were related to the corresponding measure in the afternoon. More efficient response inhibition in the morning was associated with higher self-control in the afternoon. Higher anger rumination in the morning led to higher momentary anger in the afternoon. In a concurrent within-person network, higher momentary anger was reciprocally associated with lower self-control. At the between-person level, higher momentary anger was correlated to higher anger rumination, lower response inhibition, and lower self-control. Discussion: This study provides insight into the dynamic interactions among self-control, response inhibition, and anger (momentary state and rumination) in male adolescents, advancing the understanding of self-regulatory control functioning.

Assessment of Multiple Dimensions of Psychological Well-Being in Swiss Youth Born with a Unilateral Cleft Lip and Palate.

OBJECTIVE: This study examines the psychological well-being of Swiss youths born with a unilateral cleft lip and palate (UCLP), in a multi-dimensional and clinical perspective. DESIGN: Retrospective cross-sectional study. SETTING: Self-report questionnaires completed by youths born with UCLP, followed at a specialized cleft clinic in Switzerland, and by peers without UCLP, recruited in schools of the Vaud county, Switzerland. PARTICIPANTS: Youths aged 7.5 to 16, born with UCLP (clinical group, n = 41, 29.2% female) or without UCLP (control group, n = 56, 49.0% female). OUTCOME MEASURES: Adverse life events (ALE; Adverse Life Events), behavioral and emotional symptoms (Strengths and Difficulties Questionnaire and Post-Traumatic Checklist Scale), bodily self-esteem (Body Esteem Scale), quality of life (Kidscreen-27), emotion regulation (Cognitive Emotion Regulation Questionnaire), social support (Sarason's Social Support Questionnaire). RESULTS: Most outcomes showed no significant group-difference. Compared to matched peers, youths with UCLP reported lower psychological quality of life and social support satisfaction, along with positive factors of fewer ALE and lower non-adaptive emotion regulation. In youths with UCLP, higher scores for ALE were associated with higher total scores for behavioral and emotional symptoms. Higher scores for bodily self-esteem were associated with higher scores for satisfaction of social support and adaptive emotion regulation. CONCLUSIONS: Youths with UCLP show globally similar psychological well-being as matched peers. We observed some vulnerabilities but also protective factors, which support the need for psychological perspective within multidisciplinary care. The relationships between dimensions suggest specific targets that may have an impact in context of intervention.

Bullying in Swiss Youth Born with a Unilateral Cleft lip and Palate by Self- and Parent-Report.

OBJECTIVE: This study aimed to gain a better understanding of bullying as victims and aggressors in youths born with unilateral cleft lip and palate (UCLP). DESIGN: This is an observational study comparing youths with UCLP (ages 8-16) and their parents with a control group (CG) of children in state schools and their parents. PARTICIPANTS: Forty-one youths (43% female; mean age 12.4 ± 2.3 years) and their parents (n = 40) composed the UCLP group and 56 youths (47% female; mean age 12.4 ± 1.2 years) and their parents (n = 33) were in the CG. MAIN OUTCOME MEASURE: The Olweus Bully/Victim questionnaire self- and parent-report was used to assess victims and aggressors involved in bullying behaviors. RESULTS: About 30% of all youths reported being a frequent victim of bullying at least 2-3 times a month and an additional 32.3% were bullied 1-2 times in the last 2-3 months. For the total sample, parents significantly (P < .05) underestimated any bullying, both as a victim (youths 62.5% vs parents 45.7%) and as an aggressor (youths 53.1% vs parents 37.1%). There were no significant group differences in experiencing any bullying between the youths with UCLP (52.5%) and the CG youths (69.6%) or in its perception by their parents (43.2% and 48.5%, respectively). There were no group differences between the combinations of victim and aggressor. CONCLUSIONS: While there were no differences in bullying prevalence in our sample between youths with UCLP and their peers, this study highlights differences in bullying perceptions between parents and their children.

On the complex and dimensional relationship of maternal posttraumatic stress disorder during early childhood and child outcomes at school-age.

BACKGROUND: Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, psychopathology, and interactive behavior with toddlers and outcome measures at school-age. METHODS: This study involved a prospective, longitudinal investigation of 62 mothers and examined the relationship between maternal variables measured when children were in early childhood (mean age 27 months), and child outcomes when children were school-age (age mean = 83.2 months) while retaining a focus on the context of maternal PTSD. To identify and weigh associated dimensions comparatively, we employed sparse canonical correlation analysis (sCCA) aimed at associating dimensions of a dataset of 20 maternal variables in early childhood with that of more than 20 child outcome variables (i.e., child psychopathology, life-events, and socioemotional skills) at school-age. RESULTS: Phase 1 variables with the highest weights were those of maternal psychopathology: PTSD, depressive and dissociative symptoms, and self-report of parental stress. The highest weighted Phase 2 child outcome measures were those of child psychopathology: PTSD, anxiety, and depressive symptoms as well as peer bullying and victimization. CONCLUSIONS: sCCA revealed that trauma-related concepts in mothers were significantly and reliably associated with child psychopathology and other indicators of risk for intergenerational transmission of violence and victimization. The results highlight the dimensional and multifaceted nature-both for mothers as well as children-of the intergenerational transmission of violence and associated psychopathology.

The added value of a micro-level ecological approach when mapping self-regulatory control processes and externalizing symptoms during adolescence: a systematic review.

Deficits in self-regulatory control (SRC) represent a core characteristic of externalizing (EXT) symptoms (e.g., rule-breaking behavior or aggressive behaviors) in adolescents. This review aims to specify the added value of ecologically valid assessments at a micro-level when examining the associations between SRC and EXT symptoms in adolescents. This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. The search strategy addressed the added value of (1) naturalistic assessment for the understanding of the relationship between (2) SRC and (3) EXT symptoms in (4) adolescents. We conducted comprehensive searches in bibliographic databases. An additional search was conducted in Google Scholar and supplementary studies were identified through backward and forward citation tracking. Twenty-four studies (n = 4071 adolescents) met the inclusion criteria. The methods used to assess naturalistic aspects included the experience sampling method (ecological momentary- or ambulatory assessment) and the time-course approach (i.e., real-time assessment of SRC processes referring to situations approximating real-life experience where SRC are to be engaged such as in frustrating situations). Micro-level ecological assessments, when mapping the intra-individual relationships between SRC processes and EXT symptoms over time in adolescents within their natural context (i.e., real world) of expression in real time, added a finer-grained observation alongside with a higher ecological validity. Micro-level approaches may enhance the understanding of the complex interplay between SRC and EXT symptoms in adolescence, especially in interventional studies, allowing for the acquisition of endpoints with a higher relevance for everyday functioning.

[Questionnaire on Treatment Satisfaction in Inpatient Child and Adolescent Psychiatry (FBZ-KJP) - Results of a Swiss Pilot Study]. / Fragebogen zur Behandlungszufriedenheit in der stationären Kinder- und Jugendpsychiatrie (FBZ-KJP).

Questionnaire on Treatment Satisfaction in Inpatient Child and Adolescent Psychiatry (FBZ-KJP) - Results of a Swiss Pilot Study Abstract: Objectives: Patient satisfaction is an established indicator for medical interventions. Existing questionnaires for the assessment of patient satisfaction in child and adolescent psychiatry are too global to target quality improvement in child and adolescent psychiatric hospitals. The assessment of patient satisfaction in child and adolescent psychiatry is very challenging because specific demands (development status, role of parents in treatment) have been taken into account. Therefore, an expert team leaded by the Swiss Society of Child and Adolescent Psychiatry developed a targeted instrument to assess patient satisfaction in both language regions (i. e., German and French). Methods: The article reviews the development of a new child and adolescent psychiatric questionnaire for the assessment of patient satisfaction as well as the findings of a survey conducted in a representative sample of 174 patients and 145 parents in six hospitals. Results: The internal consistency (Cronbach's α = .93) is excellent. The questionnaire has high levels of both convergence and face validity, and the correlation with the Client Satisfaction Questionnaire (CSQ-8) is ρ = .80 (patient-report) and .83 (parent-report). Furthermore, this questionnaire reveals the relative strengths and weaknesses of individual hospitals. The correlation between patient and parent assessment is, as expected, moderate (ρ = .29, for the total score and ρ = .39 for the CSQ-8). Conclusions: The Patient Satisfaction Questionnaire can be recommended to professionals as a standard for collecting data on client satisfaction within child and adolescent psychiatry.

Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum.

Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. METHODS: One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. RESULTS: Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. CONCLUSIONS: At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.

Examination of the importance of anger/irritability and limited prosocial emotion/callous-unemotional traits to understand externalizing symptoms and adjustment problems in adolescence: A 10-year longitudinal study.

Objective: Within a longitudinal study (10-year follow-up), we aim to examine the role of anger/irritability and limited prosocial emotion/callous-unemotional traits in predicting externalizing symptoms and adjustment problems in individuals formerly in youth residential care institutions. Method: These dimensions were assessed in 203 young adults, with baseline assessments during youth residential care and a follow-up 10 years later. Results: In general, emotional problems and psychopathological symptoms did not reduce over time. Analyses of regression revealed that a younger age at baseline, anger/irritability both at baseline assessment, and regarding their aggravation over time refer to significant predictors of the level of externalizing symptoms at 10-year follow-up (R 2 = 0.431) and the worsening of externalizing symptoms over time (R 2 = 0.638). Anger/irritability has been observed to be a significant predictors of both the level of adjustment problems at 10-year follow-up (R 2 = 0.471) and its worsening over time (R 2 = 0.656). Discussion: Our results suggest that dysregulation of anger/irritability is a key factor in the prediction of long-term externalizing symptoms and adjustment problems as well as its worsening over time. Possible implications for intervention and prevention are discussed.

The role of self-regulatory control processes in understanding aggressive ideations and behaviors: An experience sampling method study.

Introduction: In this study, we aimed to examine the association between aggressive ideations and aggressive behaviors in everyday life, as well as the role of processes related to self-regulatory control (i.e., self-control, ego depletion, and emotional states), using experience sampling methods (ESM). Methods: A total of 62 male adolescents performed a baseline measure of aggression, violent ideations (trait level), and ESM assessments, including four measures per day during nine consecutive days. Results: At a state level, aggressive ideations were associated with higher negative emotions during the previous day as well as with lower self-control and stronger anger rumination at the moment. Aggressive behaviors were related to higher anger rumination at the moment and to the manifestation of higher intensity of aggressive ideations derived in the previous measure. Higher self-control was related to a lower probability of aggressive behavior. Discussion: This study highlights the temporal link between aggressive ideations and behaviors in everyday life as well as the role of self-control in understanding aggressivity in the lap of time. Furthermore, we observed that expressions of anger (i.e., reactivity, as well as rumination) were central in the understanding of aggressive ideations and behaviors in the everyday life (i.e., at within-person variability at the state level).

Non-Pharmaceutical Interventions for Self-Regulatory Failures in Adolescents Suffering from Externalizing Symptoms: A Scoping Review.

INTRODUCTION: Deficits of self-regulation (SR) are a hallmark of externalizing (EXT: offending or aggressive behaviors) symptoms in adolescence. OBJECTIVES: This scoping review aims (1) to map non-pharmaceutical interventions targeting SR processes to reduce EXT symptoms in adolescents and (2) to identify research gaps, both of which will provide recommendations for future studies. METHODS: Systematic searches were carried out in eight bibliographic databases up to March 2021, combining the following concepts: self-regulation, externalizing symptoms, adolescents, and non-pharmaceutical interventions. RESULTS: We identified 239 studies, including 24,180 youths, mainly from North America, which described a plethora of non-pharmaceutical interventions targeting SR to alleviate EXT symptoms in adolescents (10-18 years of age). The majority of studies (about 70%, k = 162) represent samples with interventions exposed to "selective" or "indicated" prevention. Curriculum-based (i.e., multiple approaches targeting several domains such as emotion, cognition, and social) interventions (31.4%) were the most common type of intervention. Moreover, studies on cognitive-based interventions, mind-based interventions, and emotional-based interventions have increased over the last decades. Network analyses allowed us to identify several hubs between curriculum-based interventions, cognitive SR processes, as well as aggressiveness, conduct problems, and irritability/anger dysregulation. In addition, we identified gaps of studies concerning the physiological SR processes and on some types of interventions (i.e., body-based interventions and externally mediated interventions) or, more specifically, on promising tools, such as biofeedback, neurofeedback, as well as programs targeting neuropsychological processes (e.g., cognitive remediation). CONCLUSIONS: This scoping review stresses the plethora of interventions, identified hubs, and emerging fields, as well as some gaps in the literature, which together may orient future studies.

The impact of disease severity on the psychological well-being of youth affected by an inborn error of metabolism and their families: A one-year longitudinal study.

BACKGROUND: Inborn errors of metabolism (IEMs) refer to rare heterogeneous genetic disorders with various clinical manifestations that can cause serious physical and psychological sequelae. Results of previous studies on the impact of an IEM on health-related quality of life (HR-QoL) were incongruent and only few studies considered more broadly the psychological well-being of children with IEM and their families. Our objectives were to examine: (1) the impact of the IEM severity on the HR-QoL and psychological functioning of patients and their parents at baseline; and (2) its evolution over time; and (3) the correlation between parental and children's perspectives. Methods: The sample included 69 pediatric patients (mean age = 7.55 y, SD = 4.59) with evaluations at baseline and after one year. We collected data on HR-QoL, child mental health and emotional regulation as well as on parental mood and stress using different validated questionnaires. IEM severity was rated by a clinician through the biological subdomain of the pediatric INTERMED instrument. Results: Two groups of patients based on IEM severity scores were created (n = 31 with low and n = 38 with moderate/high IEM severity). The two groups differed with respect to age, diet and supplement intake. IEM severity had an impact on HR-QoL and behavioral symptoms in children, as well as on HR-QoL and stress in parents. For patients with moderate/high IEM severity, child and parental HR-QoL improved after 1-year of follow-up. We did not observe any significant difference between evaluations by patients versus parents. Conclusions: Our findings demonstrate that moderate/high IEM severity altered child and parental psychological well-being, but also revealed a significant improvement after one-year follow-up. This observation suggests that patients with a moderate/high IEM severity and their families benefit from the care of an interdisciplinary team including a child psychologist specialized in IEMs. Moreover, in patients with higher IEM severity there may also be more room for improvement compared to patients with low IEM severity. Future studies should focus on observations over a larger time span, particularly during adolescence, and should include objective measurements.

Associations Between Maternal Post-traumatic Stress Disorder and Traumatic Events With Child Psychopathology: Results From a Prospective Longitudinal Study.

Introduction: Exposure to interpersonal violence (IPV) can lead to post-traumatic stress disorder (PTSD) in mothers, and in turn adversely affect the mother-child relationship during early development, as well as the mental health of their children. Our objectives are to assess: (1) the association of maternal IPV-PTSD to child psychopathology, (2) the association of maternal IPV independently of PTSD to child psychopathology, and (3) the relationship between child exposure to violence to the psychopathology of these children. Methods: We used data from the longitudinal Geneva Early Childhood Stress Project. The sample included 64 children [mean age at Phase 1 = 2.4 (1.0-3.7) years] of mothers with or without IPV-PTSD. Data on mothers was collected during Phase 1, using the Clinical Administered PTSD Scale (CAPS), the Brief Physical and Sexual Abuse Questionnaire (BPSAQ) and the Conflict Tactics Scale (CTS2). Modules of a semi-structured diagnostic interview, and the Violence Exposure Scale were used to collect information on child at Phase 2, when children were older [mean age = 7.02 (4.7-10)]. Results: A higher CAPS score in mothers when children were toddler-age was associated with an increased risk of symptoms of attention deficit/hyperactivity disorder (ADHD; ß = 0.33, p = 0.014) and PTSD in school-age children. The association between maternal IPV-PTSD and child PTSD (ß = 0.48, p < 0.001) symptoms remained significant after adjustment for potential confounders. Among children, exposure to violence was associated with an increased risk of symptoms of generalized anxiety (ß = 0.37, p = 0.006), major depressive (ß = 0.24, p = 0.039), ADHD (ß = 0.27, p = 0.040), PTSD (ß = 0.52, p < 0.001), conduct (ß = 0.58, p = 0.003) and oppositional defiant (ß = 0.34, p = 0.032) disorders. Conclusion: Our longitudinal findings suggest that maternal IPV-PTSD during the period of child development exert an influence on the development of psychopathology in school-aged children. Mothers' IPV was associated with child psychopathology, independently of PTSD. Child lifetime exposure to violence had an additional impact on the development of psychopathology. Careful evaluation of maternal life-events is essential during early childhood to reduce the risk for the development of child psychopathology. Early efforts to curb exposure to violence in children and early intervention are both needed to reduce further risk for intergenerational transmission of trauma, violence, and related psychopathology.

Consequences of Prematurity on Cortisol Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study.

A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child's birth and children's adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child's development and health.

Anticipatory feelings: Neural correlates and linguistic markers.

This review introduces anticipatory feelings (AF) as a new construct related to the process of anticipation and prediction of future events. AF, defined as the state of awareness of physiological and neurocognitive changes that occur within an oganism in the form of a process of adapting to future events, are an important component of anticipation and expectancy. They encompass bodily-related interoceptive and affective components and are influenced by intrapersonal and dispositional factors, such as optimism, hope, pessimism, or worry. In the present review, we consider evidence from animal and human research, including neuroimaging studies, to characterize the brain structures and brain networks involved in AF. The majority of studies reviewed revealed three brain regions involved in future oriented feelings: 1) the insula; 2) the ventromedial prefrontal cortex (vmPFC); and 3) the amygdala. Moreover, these brain regions were confirmed by a meta-analysis, using a platform for large-scale, automated synthesis of fMRI data. Finally, by adopting a neurolinguistic and a big data approach, we illustrate how AF are expressed in language.

The interplay between prematurity, maternal stress and children's intelligence quotient at age 11: A longitudinal study.

Very premature children (<33 weeks of gestational age (GA)) experience greater academic difficulties and have lower, though normal-range, intelligence quotients (IQs) versus their full-term peers. These differences are often attributed to GA or familial socio-economic status (SES). However, additional factors are increasingly recognized as likely contributors. Parental stress after a child's premature birth can present as post-traumatic stress disorder (PTSD) symptoms and can in turn reinforce difficulties in parent-child interaction pattern. Following a longitudinal design, we studied the interplay between a premature child's perinatal history and maternal PTSD symptoms on intelligence abilities assessed at 11 years of age. Thirty-three very preterm and 21 full-term mother-children dyads partook in the study. Children's perinatal risk was evaluated at hospital discharge, maternal PTSD symptoms were assessed when the children were 18 months old, and children's IQ was measured at 11 years old. IQ was significantly lower for preterm than full-term children, without reliable influences from perinatal risk scores. However, lower maternal PTSD symptoms predicted higher IQ in preterm children. This preliminary study highlights the importance detecting maternal PTSD symptoms after a preterm birth and suggests interventions should target reducing maternal PTSD symptoms during early childhood to enhance very preterm children's intelligence development.

Clinical significance of assertive community treatment among adolescents.

PURPOSE: The efficacy of assertive community treatment for children and adolescents is proven in the United States, but remains controversial in Europe. Moreover, most studies showing positive outcomes of assertive community treatment are limited to statistically significant differences and do not consider whether the treatment is also subjectively clinically meaningful for the patient. Using a naturalistic sample, the present study aims to assess statistical and clinical significance of an assertive community treatment unit for adolescents in Europe. METHODS: Linear mixed-effects models and reliable change indices were used to respectively assess the statistical and clinical significance of assertive community treatment in 179 adolescents (mean age = 15.76, SD = 1.76) with severe mental illnesses. RESULTS: Difficulties related to mental health (measured by the Health of the Nation Outcome Scales for Children and Adolescents, HoNOSCA) and overall functioning (measured by the Global Assessment of Functioning scale) statistically improved (all ps < 0.001) from admission to discharge. Additionally, a considerable proportion of patients (from 14% to 21%) clinically recovered to functional levels. CONCLUSION: Our results support the fact that assertive community treatment can have convincing and positive clinical outcomes in European settings.

Cognitive Working Memory Training (CWMT) in adolescents suffering from Attention-Deficit/Hyperactivity Disorder (ADHD): A controlled trial taking into account concomitant medication effects.

Although, cognitive working memory training (CWMT) has been reported to enhance working memory functioning in youths with attention-deficit/ hyperactivity disorder (ADHD), few studies take into account the concomitant effects of medication. Sixty adolescents aged from 11 to 15 years were randomly assigned to CWMT treatment, whereas medication was either continued or not introduced (no randomization performed). Results revealed beneficial effects of CWMT on the different components of working memory (WM), namely the phonological loop, the visuospatial sketchpad and the central executive. In particular, CWMT allowed participants to obtain a level of performance similar to the typically-developing adolescents for the phonological loop (i.e., forward digit span) as well as for the visuospatial sketchpad (i.e., board span). For the central executive (i.e., backward digit span) the concomitant effects of CWMT and medication allows participants to obtain the performance level of the typically-developing adolescents. Although, no transfers were observed with respect to other cognitive functions, in medicated patients with ADHD, CWMT reduced hyperactivity / impulsivity symptoms at 2-month follow-up. The present study gives evidence of the efficacy of CWMT to enhance WM performance, as well as, to reduce symptoms. The overall results highlight the usefulness of multimodal interventions.

Substance-use disorders, personality traits, and sex differences in institutionalized adolescents.

BACKGROUND: Substance-use disorder (SUD) was found to be an aggravating factor to delinquency and is closely related to personality disorders (PDs). OBJECTIVES: The aim of this study was to investigate sex differences in the relationship between PD traits and SUD in adolescents institutionalized in child welfare and juvenile justice institutions. METHODS: PD traits were measured dimensionally in a sample of 282 boys (69 with an SUD diagnosis) and 143 girls (45 with an SUD diagnosis) from child welfare and juvenile-justice institutions. RESULTS: Logistic regressions showed that antisocial, borderline, and paranoid personality traits were positively associated with SUD, while obsessive compulsive personality traits were negatively related with SUD. Additionally, in institutionalized girls, self-defeating personality traits were associated with less risk of SUD. CONCLUSION: This study provides a relative evidence for sex specificities in the relation between PD traits and SUD.

Perinatal stress moderates the link between early and later emotional skills in very preterm-born children: An 11-year-long longitudinal study.

BACKGROUND: Very preterm (VPT) birth refers to an early stressful event putting children at heightened risk for emotional difficulties. However, there is an important individual variability, leaving unexplained why some VPT children do not develop emotional difficulties, while others develop such difficulties in the early years or later in life. AIM: In this study, we examined whether perinatal stress is a risk factor explaining heterogeneities in emotional problems in VPT children. METHODS: Thirty-six VPT children and 22 full-term born (FT) children participated in an 11 year-long study. Risk for perinatal stress was assessed at birth with the Perinatal Risk Inventory. Mothers reported children's emotional difficulties at 18 months of child age on the Symptom Checklist and at 11 years on the Child Behavior Checklist. RESULTS: Results indicated significant differences in emotional scores at 11 years not only between VPT and FT children but also between the low and high perinatal stress groups. More importantly, emotional scores at 18 months influenced variability in internalizing scores at 11 years only in VPT children with high perinatal stress. CONCLUSION: Although prematurity affects the emotional abilities of preadolescents, the link between emotional skills in early and later childhood is moderated by the severity of perinatal stress. In particular, VPT children who are born with more complications, and as such experience a more stressful perinatal environment, are more likely to show emotional difficulties at preadolescence.