ADHD and delinquency--a developmental perspective.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood and adolescence. Until now, it has been unclear whether ADHD by itself constitutes a risk factor for later delinquency or does so only in combination with other disruptive symptoms. This article seeks to give a comprehensive account of the literature to shed light on the developmental pathway from childhood ADHD to adult criminality. Comorbid ADHD and conduct disorder (CD) are significantly related to a range of biological and environmental risk factors such as neurocognitive impairment, high parental psychopathology, poor social functioning, and other comorbid mental disorders, particularly substance abuse, that are described in this review. In addition, the results of treatment studies are presented, with a special focus on the results of the Multimodal Treatment Study of Children with ADHD (MTA). Although treatment programs, including medication and psychosocial treatment, can be very effective in improving the functioning of children with ADHD in the social and academic domains in the short term, there is no conclusive evidence that such treatments lower the risk for developing delinquency in adulthood.

No association between affective and behavioral dysregulation and parameters of thyroid function in youths.

OBJECTIVE: Evidence from adults suggests that changes in thyroid function are associated with the development of bipolar disorder (BD) and severe mood dysregulation. A dysregulation profile based on the Child Behavior Checklist (CBCL-DP) describes a phenotype with severe mood problems in youth. The present study investigated whether altered thyroid functioning in youths is associated with the severe mood dysregulation symptoms characterized by the CBCL-DP. METHODS: We analyzed the thyroid function data from 262 children and adolescents (n = 262 for serum TSH, n = 148 for free triiodothyronine [fT3] and n = 153 for free thyroxine [fT4]) with their CBCL-DP composite score. We created and compared high CBCL-DP and low CBCL-DP subgroups with regard to their serum TSH, fT3 and fT4 concentrations as well as the presence or absence of subclinical hypothyroidism. RESULTS: We did not detect between-group differences in serum TSH, fT3 and fT4 concentrations, nor were there significant correlations between youths' CBCL-DP scores and their serum TSH, fT3 and fT4 concentrations for either the whole sample or any subgroup. Post-hoc power analyses indicated that adequate to moderate power existed to detect between-group differences in fT3 and fT4 concentrations, respectively, but that larger TSH samples would be required to detect the same differences in those concentrations. LIMITATIONS: This study had a retrospective design, fewer females than males, and reduced power with respect to TSH concentrations. CONCLUSIONS: The present investigation does not support the association between elevated serum-TSH concentrations and severe mood dysregulation in youths. However, these findings should be confirmed in future large-scale studies.

[Development of antisocial disorders--impact of the autonomic stress system]. / Entwicklungsfaktoren dissozialer Störungen--die Bedeutung des autonomen Stresssystems.

The current selective review emphasizes the heterogeneity of antisocial behaviour in children and adolescents. It focuses on the development of children of the early-starter subtype of conduct disorder who are at high risk for the development of an antisocial personality disorder. Especially the autonomic stress system seems to have an important impact on symptoms and the prognosis of antisocial individuals. While autonomic hypoarousal and a reduced autonomic reagibility seem to be associated with more proactive aggressiveness and a negative outcome, increased autonomic arousal and reagibility might be related to reactive aggressiveness and constitutes possibly a protective trait. Data of the current psychophysiological and neuroendocrinological literature are summarized. Moreover, the impact of comorbid attention deficit hyperactivity disorder and anxiety disorders on dissocial development is illustrated. Particularly early diagnostic assessment of the individual's extent of trait anxiety might help to specify therapeutic opportunities and could thereby improve therapeutic efficiency.

[Predictors of antisocial behaviour. Peripheral psychophysiological findings in children and adults with conduct disorder]. / Prädiktoren dissozialen Verhaltens. Periphere psychophysiologische Befunde bei Kindern und Erwachsenen mit Störungen des Sozialverhaltens.

Many studies have shown that psychophysiological parameters of processing emotional stimuli are associated with different personality traits in children, adolescents, and adults. Individuals with low autonomic baseline arousal, low orienting reaction, accelerated habituation, and reduced excitability particularly to punishing stimuli are characterised by a reduced experience of anxiety, decreased behaviour inhibition, and increased sensation seeking. These characteristics seem to raise the likelihood of dis-social behavior and are perceived as prognostically favourable for the development of antisocial personality disorders in childhood and adolescence. In contrast, an increased disposition towards anxiety, which is associated with increased autonomic reactivity, is recognised as a protective factor. Current data have shown that through special training, child and adolescent autonomic reactivity could be enhanced. Due to its versatility, this biological marker might be used for prevention in children at greater risk of developing antisocial behaviour.