Psychopathic traits and maltreatment: Relations with aggression and mental health problems in detained boys.

Psychopathic traits and a history of maltreatment are well-known risk factors for mental health problems and aggression. A better insight in the impact of such risk factors on juvenile delinquents is likely to help tailoring treatment. Therefore, this study aimed to examine mental health problems and aggression in detained delinquent youths with various levels of psychopathic traits and maltreatment. Standardized questionnaires were used to assign 439 detained male adolescents (N = 439; from 13 to 18years of age) to one of six mutually exclusive groups: adolescents with (1) low psychopathic traits without maltreatment; (2) low psychopathic traits and one type of maltreatment; (3) low psychopathic traits and multiple types of maltreatment; (4) high psychopathic traits without maltreatment; (5) high psychopathic traits and one type of maltreatment and finally (6) high psychopathic traits and multiple types of maltreatment. Next, groups were compared on mental health problems, mental disorders and reactive and proactive aggression. Findings indicated that compared to the low psychopathic traits groups, high psychopathic traits groups had markedly higher levels of externalizing mental health problems (such as attention deficit/hyperactivity, substance abuse, rule-breaking), proactive and reactive aggression, but not of internalizing mental health problems (anxiety and depression). Mental health problems in boys with a low level of psychopathic traits increased with the number of types of maltreatment in their history. In boys with a high level of psychopathic traits, group differences did not reach significance. Levels of proactive and reactive aggression increased with the number of types of maltreatment in boys with low levels of psychopathic traits, but not in those with high psychopathic traits. Thus, in detained adolescents both psychopathic traits and the number of maltreatment types are related to the severity of mental health problems and types of aggression. When used in routine screening procedures, these risk factors may thus improve identification and support targeted treatment-allocation of detained adolescents with serious clinical problems.

Standardized Screening for Mental Health Needs of Detained Youths from Various Ethnic Origins: The Dutch Massachusetts Youth Screening Instrument-Second Version (MAYSI-2).

In the U.S., the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) has been shown to be a reliable and valid tool to identify youth with mental health needs upon entry in detention facilities. The present study examined the factor structure, internal consistency, and convergent validity of the Dutch MAYSI-2 administered as part of routine clinical assessments in up to 955 detained male adolescents. Standardized mental health screening questionnaires (Youth Self-Report and Strengths and Difficulties Questionnaire) were used to test the convergent validity of the Dutch MAYSI-2. Confirmatory factor analyses showed that the factor structure of the original MAYSI-2 could be replicated with the Dutch MAYSI-2. Internal consistency indices showed that the Dutch MAYSI-2 provides a reliable screening of mental health needs. In addition, the Dutch MAYSI-2 scales were related with conceptually parallel measures of the same targeted mental health needs in the total group. With a few exceptions, the internal consistency and convergent validity was supported across ethnic groups as well. Overall, these results suggest the psychometric properties of the Dutch MAYSI-2 to be promising. Implications and limitations of the current study's findings and directions for future research are discussed.

Neural correlates of social decision-making in severely antisocial adolescents.

Neurobiological and behavioral findings suggest that the development of delinquent behavior is associated with atypical social-affective processing. However, to date, no study has examined neural processes associated with social interactions in severely antisocial adolescents. In this study we investigated the behavioral and neural processes underlying social interactions of juvenile delinquents and a matched control group. Participants played the mini-Ultimatum Game as a responder while in the MRI scanner. Participants rejected unfair offers significantly less when the other player had 'no alternative' compared with a 'fair' alternative, suggesting that they took the intentions of the other player into account. However, this effect was reduced in the juvenile delinquents. The neuroimaging results revealed that juvenile delinquents showed less activation in the temporal parietal junction (TPJ) and inferior frontal gyrus (IFG). However, the groups showed similar activation levels in the dorsal anterior cingulate cortex (dACC) and the right anterior insula (AI) when norms were violated. These results indicate that juvenile delinquents with severe antisocial behavior process norm violations adequately, but may have difficulties with attending spontaneously to relevant features of the social context during interactions.

Psychopathic-like traits in detained adolescents: clinical usefulness of self-report.

Studies have demonstrated that self-report tools can be used to reliably and validly examine psychopathic-like traits in adolescents. However, it is unclear if self-report instruments are still reliable and valid when confidentiality cannot be guaranteed, such as during routine assessments in juvenile detention centres. To address this issue, the current study used data from the routine mental health screening of 365 detained male adolescents (12-18 years) in two juvenile detention centres. With the intention of gaining insight in the clinical usefulness of self-reported psychopathic-like traits, we examined relations known from literature with emotional and behavioural features. Self-reported psychopathic-like traits, measured by the Youth Psychopathic Traits Inventory-Short version (YPI-S), were uniquely associated with substance abuse, anger/irritability, conduct problems and hyperactivity, but not with internalizing problems. YPI-S-dimensions showed several specific relationships with variables of interest. For example, only the callous unemotional dimension was negatively related with prosocial behaviour and only the behavioural dimension was positively related with hyperactivity. In conclusion, self-reported psychopathic-like traits showed expected relations with relevant variables. These findings suggest that self-report can be used to identify detained youths with high levels of psychopathic-like traits outside a research context, thus, even when anonymity and confidentiality are not guaranteed.

Psychiatric disorder in detained male adolescents as risk factor for serious recidivism.

OBJECTIVE: A growing body of research consistently shows that detained minors bear substantial mental health needs. However, the relation between mental disorder and criminal recidivism has largely remained unexplored. Our study examines whether psychiatric disorders increase the likelihood of recidivism after controlling for time at risk, criminal history, and the presence of other disorders. METHOD: Participants (n = 232) were detained male adolescents from all 3 youth detention centres in Flanders, Belgium, who were interviewed with the Diagnostic Interview Schedule for Children, Version IV. Two to 4 years later, information on serious recidivism was retrieved from the official judicial registration system. Serious recidivism was defined as having at least one arrest charge for violent, severe property crime, or substance-related offences. RESULTS: Serious recidivism was high, with 81% (n = 191) of the participants being rearrested. Psychiatric disorders predicted neither serious recidivism in general nor violent and severe property recidivism. However, other drug use disorder (OR 2.41; 95% CI 1.22 to 4.75) and general comorbidity (OR 2.64; 95% CI 1.40 to 4.99) were significantly predictive of substance-related recidivism. CONCLUSION: Common psychiatric disorders in detained male adolescents do not significantly increase the likelihood of subsequent arrests, with the exception that substance use disorders appear to increase the risk of later substance-related recidivism. Effective treatment of these disorders may prevent detained juveniles to experience the detrimental outcomes associated with substance-related crimes as adults (for example, mental illness).

Temperament and parental child-rearing style: unique contributions to clinical anxiety disorders in childhood.

Both temperament and parental child-rearing style are found to be associated with childhood anxiety disorders in population studies. This study investigates the contribution of not only temperament but also parental child-rearing to clinical childhood anxiety disorders. It also investigates whether the contribution of temperament is moderated by child-rearing style, as is suggested by some studies in the general population. Fifty children were included (25 with anxiety disorders and 25 non-clinical controls). Child-rearing and the child's temperament were assessed by means of parental questionnaire (Child Rearing Practices Report (CRPR) (Block in The Child-Rearing Practices Report. Institute of Human Development. University of California, Berkely, 1965; The Child-Rearing Practices Report (CRPR): a set of Q items for the description of parental socialisation attitudes and values. Unpublished manuscript. Institute of Human Development. University of California, Berkely, 1981), EAS Temperament Survey for Children (Boer and Westenberg in J Pers Assess 62:537-551, 1994; Buss and Plomin in Temperament: early developing personality traits. Lawrence Erlbaum Associates, Inc, Hillsdale, 1984s). Analysis of variance showed that anxiety-disordered children scored significantly higher on the temperamental characteristics emotionality and shyness than non-clinical control children. Hierarchical logistic regression analyses showed that temperament (emotionality and shyness) and child-rearing style (more parental negative affect, and less encouraging independence of the child) both accounted for a unique proportion of the variance of anxiety disorders. Preliminary results suggest that child-rearing style did not moderate the association between children's temperament and childhood anxiety disorders. The limited sample size might have been underpowered to assess this interaction.

Childrearing style in families of anxiety-disordered children: between-family and within-family differences.

This study examined whether (1) parents of anxiety-disordered (AD) children differed from those of non-clinical controls in their childrearing style, and whether (2) the child-rearing style of parents towards AD children is different from that towards their siblings. A clinical sample of 25 AD children, age range 8-13 years, was compared with 25 siblings and a non-clinical control group (n = 25). Childrearing was assessed by means of parental self-report, child report and through an expressed emotion interview measure. AD children perceived more parental rejection than non-clinical control children or the AD children's siblings. High-expressed emotion was scored significantly more often towards AD children than non-clinical control children, or their siblings. On [Symbol: see text]care' and [Symbol: see text]control' parental self-report showed some differences regarding AD children on the one hand and non-clinical control children or siblings of AD children on the other. These results suggest that the rearing of AD children differs significantly both from the rearing of their siblings and that of non-clinical control children.

Parenting and parental anxiety and depression as predictors of treatment outcome for childhood anxiety disorders: has the role of fathers been underestimated?

A substantial percentage of children with anxiety disorders do not respond adequately to Cognitive Behavioral Therapy (CBT). Examination of parental factors related to treatment outcome could contribute to a further understanding of treatment outcome responses. This study investigated the predictive value of paternal and maternal emotional warmth, rejection, overprotection, anxiety, and depression for CBT outcome in clinic-referred anxious children (ages 8-12). Levels of maternal emotional warmth, paternal rejection and anxiety, and depressive symptoms predicted treatment success and failure. A higher level of maternal emotional warmth was associated with a less favorable treatment outcome. Higher levels of paternal rejection, anxiety, and depressive symptoms were consistently associated with a less favorable treatment outcome.

Childrearing style of anxiety-disordered parents.

This study investigated whether anxiety-disordered (AD) parents differ in their childrearing style from non-disordered parents. A clinical sample of 36 AD parents with children aged 6-18 was compared with a normal control sample of 36 parents. Childrearing was assessed through parent report and child report. The results demonstrated significant differences in childrearing style between AD parents and non-disordered control parents, both from the perspective of the parent and from that of the child. AD parents reported a less nurturing and more restrictive rearing style than control parents. Their children did not report more rejection or less warmth than children of control parents; they did, however, report significantly more overprotection than children of control parents. The findings, from parental as well as child reports, apply to both AD mothers and AD fathers.

Sibling relationships of anxiety disordered children--a research note.

There is a paucity of knowledge on the role of sibling relationships in internalizing disorders. Research in nonclinical populations suggests an association between internalizing problems in children and negative sibling interactions. Further, an association is reported between internalizing problems and actual or perceived parental differential treatment. This study examines sibling relationship qualities and perceived parental differential treatment in a clinical sample. Participants included 24 anxiety disordered children (ages 8-13 years) and 25 nondisordered control children (ages 7-13 years). Anxiety disordered and nondisordered children do not differ with regard to perceived affection or hostility from a sibling. Anxiety disordered children, however, report significantly more parental differential treatment than do nondisordered children.

Negative life events of anxiety disordered children: bad fortune, vulnerability, or reporter bias?

This article seeks to examine the nature of negative life events of anxiety-disordered children: to what extent are they unique, to what extent are they shared with siblings, and when they are shared, is the impact similar or different? Twenty-five anxiety-disordered children aged 8 to 13 years, referred to a child psychiatric clinic, were compared with matched non-clinical controls, and with their nearest in age nonreferred sibling aged 6 to 13 years on the number of parent-reported stressful life events. Anxiety-disordered children differ significantly from well controls in the number of negative life events reported by their parents over their lifetime, and the year preceding referral. Anxiety disordered children also differ significantly from their non-referred nearest in age sibling in the number of negative life events, both non-shared and shared. The difference in shared events is due to differences in appraisal by the parents of the impact of a shared event on the respective children. The often reported finding that children with anxiety disorders have experienced more negative life events than their healthy peers is partially due to objective differences in the occurrence of these events, but may also reflect heightened vulnerability or reporter bias.

Evolución de los casos que ameritaron estudios complementarios en el marco del PRONACAM: Centro de Salud Unión (UAMAEH, MSP) / Evolution of the cases that needed complementary studies in PRONACAM: Union Health Center (UAMAEH, MSP)

En el período comprendido entre enero/92 y agosto/93 se practicaron 591 exámenes mamarios preventivos en el Centro de Salud Unión, complementándolos con la debida instrucción del autoexámen. 215 mujeres correspondieron al grupo etario de 30 a 65 años, 49 de ellas (15por ciento) ameritaron la realización de estudios paraclínicos. Se logró un 63 por ciento de resultados de los estudios solicitados, siendo en todos los casos (20/20) normales o evidenciando patología mamaria de aspecto benigno