Psychometric properties of the Hungarian childhood trauma questionnaire short form and its validity in patients with adult attention-deficit hyperactivity disorder or borderline personality disorder.

BACKGROUND: Compelling evidence supports the role of childhood traumatization in the etiology of psychiatric disorders, including adult attention-deficit hyperactivity disorder (aADHD) and borderline personality disorder (BPD). The aim of this study was to examine the psychometric properties of the Hungarian version of the Childhood Trauma Questionnaire Short Form (H-CTQ-SF) and to investigate the differences between patients diagnosed with aADHD and BPD in terms of early traumatization. METHODS: Altogether 765 (mean age = 32.8 years, 67.7% women) patients and control subjects were enrolled from different areas of Hungary. Principal component analysis and confirmatory factor analysis were carried out to explore the factor structure of H-CTQ-SF and test the validity of the five-factor structure. Discriminative validity was assessed by comparing clinical and non-clinical samples. Subsequently, aADHD and BPD subgroups were compared with healthy controls to test for the role of early trauma in aADHD without comorbid BPD. Convergent validity was explored by measuring correlations with subscales of the Personality Inventory for DSM-5 (PID-5). RESULTS: The five scales of the H-CTQ-SF demonstrated adequate internal consistency and reliability values. The five-factor model fitted the Hungarian version well after exclusion of one item from the physical neglect scale because of its cross-loading onto the emotional neglect subscale. The H-CTQ-SF effectively differentiated between the clinical and non-clinical samples. The BPD, but not the aADHD group showed significant differences in each CTQ domain compared with the healthy control group. All CTQ domains, except for physical abuse, demonstrated medium to high correlations with PID-5 emotional lability, anxiousness, separation insecurity, withdrawal, intimacy avoidance, anhedonia, depressivity, suspiciousness, and hostility subscales. CONCLUSIONS: Our study confirmed the psychometric properties of the H-CTQ-SF, an easy-to-administer, non-invasive, ethically sound questionnaire. In aADHD patients without comorbid BPD, low levels of traumatization in every CTQ domain were comparable to those of healthy control individuals. Thus, the increased level of traumatization found in previous studies of aADHD might be associated with the presence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.

[Transdiagnostic study of impulsivity dimensions. Comparative analysis of impulsivity profiles in adult Attention Deficit Hyperactivity Disorder and Borderline Personality Disorder].

INTRODUCTION: High levels of impulsivity represent a core feature of various psychiatric conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), Borderline Personality Disorder (BPD), Impulse Control and Conduct Disorders, Bulimia Nervosa, Substance Use Disorders, and other maladaptive behaviors, like non-suicidal self-harm and suicidal behavior. The overall aim of our research is to carry out a trans-diagnostic study of impulsivity as a common behavioral risk factor, taking into consideration the different dimensions of impulsivity (motor, attentional, non-planning). The project investigates inhibitory neurocognitive deficits, electrophysiological correlates, childhood adversities and genetic vulnerability factors in the background of impulsivity. METHODS: In this report, we describe the results of our pilot study which aims to compare impulsivity profiles, personality traits, and levels of aggression in patients with adult ADHD (aADHD) and BPD primary diagnoses, and healthy control subjects, based on self report questionnaires (Barratt Impulivity Scale, Cloninger Temperament and Character Inventory). We have also carried out analyses on the role of childhood adverse events in the background of impulsivity. Because of the predominance of female participants in the BPD group, we restrict our analyses to only female subjects (N=111 out of 152 patients overall). RESULTS: Comparing the three groups significant differences were observed in each impulsivity domain: higher levels of attentional and motor impulsivity were present in aADHD, while non-planning impulsivity was more characteristic to BPD (p<0.001). Using the Cloninger Temperament and Character Inventory aADHD patients reached significant higher levels on six subscales (novelty seeking, harm avoidance, reward dependency, perseverance, selfdirection, cooperation) than BPD patients (p<001). Childhood emotional neglect results in higher levels of impulsivity in adulthood (R=0.54, p<0.001) regardless of diagnosis. CONCLUSION: Impulsivity, as a diagnostic criterion of different psychiatric disorders is a heterogenous construct. Different characteristics of impulsivity are pronounced with respect to the condition it is part of. Studying impulsivity can improve our understanding of the etiology of different psychiatric conditions, which can result in more specific and effective therapeutic interventions.

[Clinical characteristics of children with Tourette's Syndrome].

INTRODUCTION: Tourette Syndrome (TS) is a neurodevelopmental disorder presenting with motor and vocal tics. Although TS influences the everyday life of children, we only have fragmented knowledge on the topic of the developmental and comorbidity profile, symptom severity and genetical/environmental background. The aim of this article is to present the demographical characteristics, comorbidity profile and the tic symptom types and severity of patients from the Tourette Syndrome Outpatient Clinic of Vadaskert Child and Adolescent Psychiatry Hospital, Budapest. METHODS: Our sample consists of all the patients (N=137), who visited the Tourette Syndrome Outpatient Clinic between February, 2012, and July, 2013. Patients were in the age range of 3 to 18 years. We recorded demographical and tic-specific data (age, symptom onset, TS in the family, comorbidity, adverse pre-/peri-/postnatal events) of the participants, and administered the Yale Global Tic Severity Scale (YGTSS). RESULTS: The average age at symptom onset was 5.9 years. Average symptom severity (measured by the YGTSS) was 22.4 points. Comorbid Attention Deficit and Hyperactivity Disorder (ADHD) was reported in 31%, Obsessive-Compulsive Disorder (OCD) in 10%, and Autism Spectrum Disorders (ASD) in 10% of the sample. The most common tic types were simple head tics (blinking, shaking of head). Symptom severity correlated positively with age (p <0.05), but not with gender, age at symptom onset, positive family history for TS, or adverse pre-, peri-, and postnatal events. CONCLUSION: The characteristics of our sample does not show any major differences from international reports of similar samples. Comorbidity is an exception: our sample shows lower rates of comorbidities than usually reported.

A pilot study of early onset obsessive-compulsive disorder: Symptom dimensions and association analysis with polymorphisms of the serotonin transporter gene.

Our aim was to introduce more homogenous phenotypes for studying genetic variations in the clinically heterogeneous obsessive compulsive disorder (OCD) beside classical case-control analysis. Symptoms were assessed with Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and principle component analysis of the lifetime symptom categories yielded four factors (Cleaning, Obsessive, Compulsive, Sexual). The comparison of serotonin transporter linked polymorphic region (5-HTTLPR) in 102 OCD patients and 223 controls showed an increased L-allele frequency but no difference was observed when rs25531 was included. Intronic variants of the serotonin transporter gene did not show association with either OCD, nor with the obtained factors.

[Genetic factors in obsessive-compulsive disorder: summary of genetic studies]. / Orökletes tényezõk a kényszeres zavar hátterében: genetikai vizsgálatok összefoglalása.

Obsessive-compulsive disorder (OCD) affects children and adults. As in most psychiatric disorders, genetic and environmental factors play an important role in the development of OCD. The symptom onset occurs at early age (before 18 years) in 80% of the cases; this early onset OCD has different clinical features compared to the adult form. Family studies suggest that childhood onset OCD is more heritable. In addition, there is male preponderance and a higher rate of comorbid tic and attention deficit hyperactivity disorder in the early onset OCD. These data imply that the early onset OCD might have different etiological background. In this review article we will shortly describe OCD symptoms, possible endophenotypes and neurobiological theories. After an overview of the applied genetic methods, we will summarize the genetic results of the OCD literature, especially candidate gene association studies. Finally, we will outline the possible future trends in psychiatric genetics.