Clinical Psychology in the Era of Research Diagnostic Criteria (RDoC): Reconciling Individually-Focused Practice with a Broader Biopsychosocial Context.

There is growing consensus that diagnostic labels are insufficient to describe the individual child's psychiatric profile, much less inform the precise combination of interventions that will minimize the impact of risk and/or bolster protective factors over the course of a particular child's development. Moreover, investigations of neurobiological and genetic mechanisms associated with psychopathology have revealed considerable cross-diagnostic overlap, undermining the validity of models that propose a 1:1 relationship between risk and psychiatric disorder. Accordingly, recent publications have advocated for neurodevelopmental models that utilize trait-based measurement, as well as increased emphasis on integration of biological and experiential mechanisms. Despite an expanding body of literature supporting this conceptual shift, the practical implications remain unclear. In this special issue, we compile a collection of novel empirical research papers and reviews that build on the trans-diagnostic principles of the RDoC framework.

Epigenetics applied to child and adolescent mental health: Progress, challenges and opportunities.

Background: Epigenetic processes are fast emerging as a promising molecular system in the search for both biomarkers and mechanisms underlying human health and disease risk, including psychopathology. Methods: In this review, we discuss the application of epigenetics (specifically DNA methylation) to research in child and adolescent mental health, with a focus on the use of developmentally sensitive datasets, such as prospective, population-based cohorts. We look back at lessons learned to date, highlight current developments in the field and areas of priority for future research. We also reflect on why epigenetic research on child and adolescent mental health currently lags behind other areas of epigenetic research and what we can do to overcome existing barriers. Results: To move the field forward, we advocate for the need of large-scale, harmonized, collaborative efforts that explicitly account for the time-varying nature of epigenetic and mental health data across development. Conclusion: We conclude with a perspective on what the future may hold in terms of translational applications as more robust signals emerge from epigenetic research on child and adolescent mental health.

Contexto familiar y desarrollo infanto-juvenil: el papel de la interacción filio-parental en la salud mental / Context familiar i desenvolupament infantil i juvenil: el paper de la interacció filioparental en la salut mental / Family context and child and adolescent development: the role of child-parent interaction in mental health

El presenteestudio explora la relación entre prácticas educativas parentales y/o estilos educativos parentales sobre conductasinternalizantes y externalizantes. Se evaluaron las prácticas educativas parentales en una muestra constituida por 43niños y adolescentes de 7-14 años, los estilos educativos parentales y la psicopatología mediante el APQ y el CBCL, res-pectivamente. Los resultados sugieren que menor implicación parental, elevada inconsistencia en la disciplina y uso decastigo corporal se relacionan con conductas externalizantes. Asimismo, los estilos educativos autoritarios, permisivosy/o negligentes se relacionan con conductas internalizantes y externalizantes. En conclusión, se manifiesta la relevan-cia de promocionar prácticas educativas parentales adaptativas, contribuyendo en la implementación de programasespecíficos basados en la evidencia para progenitores.(AU)

Thepresent study explores the relationship between parental educational practices and/or parental educational styles oninternalizing and externalising behaviours. Parental educational practices, parental educational styles, and psycho-pathology were assessed in a sample consisted of 43 children and adolescents aged between 7-14 years using theAPQ and the CBCL, respectively. The results suggest that less parental involvement, high inconsistency in discipline,and use of corporal punishment are related to externalising behaviours. Likewise, authoritarian, permissive, and/ornegligent educational styles are related to internalising and externalising behaviours. In conclusion, the relevance ofpromoting adaptive parental educational practices, contributing to the implementation of specific evidence-basedprogrammes for parents, is evident.(AU)

Aquest estudi explora la relació entre pràctiques educatives parentals i/o estils educatius parentals sobre conduc-tes internalitzants i externalitzants. Es van avaluar les pràctiques educatives parentals, els estils educatius parentalsi la psicopatologia en una mostra constituïda per 43 nens i adolescents de 7 a 14 anys mitjançant l’APQ i el CBCL,respectivament. Els resultats suggereixen que menor implicació parental, elevada inconsistència a la disciplina i úsde càstig corporal es relacionen amb conductes externalitzants. Així mateix, els estils educatius autoritaris, permis-sius i/o negligents es relacionen amb conductes internalitzants i externalitzants. En conclusió, es manifesta la relle-vància de promocionar pràctiques educatives parentals adaptatives, contribuint a la implementació de programesespecífics basats en l’evidència per a progenitors.(AU)

La video intervención terapéutica: una psicoterapia de apego y mentalización en la asistencia pública / La videointervenció terapèutica: una psicoteràpia d’aferrament i mentalització en l’assistència pública / Video Intervention Therapy: attachment and mentalization psychotherapy in public care

La VideoIntervención Terapéutica (VIT), de George Downing, tiene evidencia científica y, a diferencia de otros métodosútiles para niños pequeños, puede aplicarse a lo largo de la infancia y adolescencia. Es flexible y puede indicarsecomo tratamiento único o como parte de un plan de tratamiento. Estas cualidades lo hacen idóneo para incluirseen la cartera de servicios de la asistencia pública. En la primera parte de este artículo, se describe el método VIT,su procedimiento, características, conceptos operativos esenciales y algunas aplicaciones clínicas. En la segundaparte, se presenta un estudio retrospectivo de la aplicación VIT en un Centro de Salud Mental Infanto-juvenil.(AU)

George Downing’sVideo Intervention Therapy (VIT) has scientific evidence and, unlike other methods useful for young children, itcan be applied throughout childhood and adolescence. It is flexible and can be used as a stand-alone treatmentor as part of a treatment plan. These qualities make it suitable for inclusion in the public health care portfolio. Inthe first part of this article, the VIT method, its procedure, characteristics, essential operational concepts, andsome clinical applications are described. In the second part, a retrospective study of the VIT application in aChild and Adolescent Mental Health Centre is presented.(AU)

Lavideointervenció terapèutica (VIT), de George Downing, té evidència científica i, a diferència d’altres mètodesútils per a nens petits, es pot aplicar al llarg de la infància i adolescència. És flexible i es pot indicar com atractament únic o com a part d’un pla de tractament. Aquestes qualitats la fan idònia per incloure-la en la carterade serveis de l’assistència pública. A la primera part d’aquest article, es descriu el mètode VIT, el procediment,característiques, conceptes operatius essencials i algunes aplicacions clíniques. A la segona part, es presentaun estudi retrospectiu de l’aplicació VIT en un centre de salut mental infantil i juvenil.(AU)

Computerized Adaptive Tests for Rapid and Accurate Assessment of Psychopathology Dimensions in Youth.

OBJECTIVE: At least half of youths with mental disorders are unrecognized and untreated. Rapid, accurate assessment of child mental disorders could facilitate identification and referral and potentially reduce the occurrence of functional disability that stems from early-onset mental disorders. METHOD: Computerized adaptive tests (CATs) based on multidimensional item response theory were developed for depression, anxiety, mania/hypomania, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, and suicidality, based on parent and child ratings of 1,060 items each. In phase 1, CATs were developed from 801 participants. In phase 2, predictive, discriminant, and convergent validity were tested against semi-structured research interviews for diagnoses and suicidality in 497 patients and 104 healthy controls. Overall strength of association was determined by area under the receiver operating characteristic curve (AUC). RESULTS: The child and parent independently completed the Kiddie-Computerized Adaptive Tests (K-CATs) in a median time of 7.56 and 5.03 minutes, respectively, with an average of 7 items per domain. The K-CATs accurately captured the presence of diagnoses (AUCs from 0.83 for generalized anxiety disorder to 0.92 for major depressive disorder) and suicidal ideation (AUC = 0.996). Strong correlations with extant measures were found (r ≥ 0.60). Test-retest reliability averaged r = 0.80. CONCLUSION: These K-CATs provide a new approach to child psychopathology screening and measurement. Testing can be completed by child and parent in less than 8 minutes and yields results that are highly convergent with much more time-consuming structured clinical interviews and dimensional severity assessment and measurement. Testing of the implementation of the K-CAT is now indicated.

Validación de la escala de problemas emocionales y del comportamiento youth self report (YSR/11-18) en una muestra de adolescentes chilenos / Validation of the scale of emotional and behavioral problems youth self report (YSR / 11-18) in Chilean adolescents

El objetivo de este estudio fue realizar la validación y confiabilidad del Youth Self Report (YSR/11-18) en población adolescente chilena. La muestra estuvo conformada por 816 adolescentes, entre 11 y 18 años, provenientes de un colegio particular de la ciudad de Calama a quienes se les aplicó la versión latina del cuestionario. Se realizo un análisis factorial de componentes principales, para la derivación de los síndromes de primer y segundo orden, siguiendo los pasos descritos por Achenbach. Los resultados encontrados demuestran la alta consistencia y validez del instrumento, lo que sumado a los antecedentes reportados convierten al YSR/11-18 en un instrumento de probado valor predictivo en Chile, permitiendo no sólo evaluar competencias sociales y conductuales, sino que podría transformase en un instrumento que permitiese la detección precoz de riesgos en la población adolescente.

The aim of this study was to validate and determine the reliability of Youth Self Report (YSR/11-18) in Chilean adolescents. The sample consisted of 816 adolescents, aged 11 to 18 years, from a private school in the city of Calama, where we applied and the Latin version of the questionnaire. Following the steps outlined by Achenbach, was made a principal components analysis for the derivation of the syndromes of first and second order. The results show high consistency and validity of the instrument, which makes the YSR/11-18 a test of predictive value in Chile, allowing not only to assess social and behavioral skills, but could be transformed into an instrument that would allow the early identification of risks in the adolescent population.

Parental Expressed Emotion and Youth Psychopathology: New Directions for an Old Construct.

Levels of parental expressed emotion (EE) are prospectively associated with the symptomatic course of a range of childhood psychiatric disorders. This article reviews the literature linking parental EE to youth psychopathology and proposes a novel framework for understanding its mechanisms of action. We find that, despite noteworthy methodological limitations, parental EE is linked consistently to a more deleterious course of mood, anxiety, and psychotic disorders in youth. Its mechanism of action is unknown. Models of "toxic family stress" (referring to frequent, sustained, and uncontrollable stress without protective influences) provide one framework for understanding how high EE environments interact with individual biological vulnerabilities to promote illness onset and recurrence. Research aimed at understanding biological responses (e.g., stress reactivity, arousal) to familial EE is needed. Such work may inform efforts to understand how EE affects the course of psychiatric disorders and may guide the development of novel interventions emphasizing emotion regulation strategies.

Misperceptions of facial emotions among youth aged 9-14 years who present multiple antecedents of schizophrenia.

Similar to adults with schizophrenia, youth at high risk for developing schizophrenia present difficulties in recognizing emotions in faces. These difficulties might index vulnerability for schizophrenia and play a role in the development of the illness. Facial emotion recognition (FER) impairments have been implicated in declining social functioning during the prodromal phase of illness and are thus a potential target for early intervention efforts. This study examined 9- to 14-year-old children: 34 children who presented a triad of well-replicated antecedents of schizophrenia (ASz), including motor and/or speech delays, clinically relevant internalizing and/or externalizing problems, and psychotic-like experiences (PLEs), and 34 typically developing (TD) children who presented none of these antecedents. An established FER task (ER40) was used to assess correct recognition of happy, sad, angry, fearful, and neutral expressions, and facial emotion misperception responses were made for each emotion type. Relative to TD children, ASz children presented an overall impairment in FER. Further, ASz children misattributed neutral expressions to face displaying other emotions and also more often mislabeled a neutral expression as sad compared with healthy peers. The inability to accurately discriminate subtle differences in facial emotion and the misinterpretation of neutral expressions as sad may contribute to the initiation and/or persistence of PLEs. Interventions that are effective in teaching adults to recognize emotions in faces could potentially benefit children presenting with antecedents of schizophrenia.

Multiple mediators of the relationships among maternal childhood abuse, intimate partner violence, and offspring psychopathology.

The aim of the study was to examine whether maternal depression, mothers' and fathers' parenting, child physical punishment and negative life events (NLE) mediate the effect of maternal childhood abuse (CA), intimate partner violence (IPV) and cumulative violence (both CA and IPV) on Spanish children's and adolescents' psychopathology. Furthermore, multiple mediator models examine whether IPV mediates the effect of CA on the contextual and family factors mentioned above. Three hundred and eighteen Spanish outpatients aged 7 to 18 and their parents were assessed using a structured interview and other instruments for measuring the study variables. Structural equation models (SEMs) showed multiple pathways explaining psychopathological problems among offspring of mothers who suffered CA, IPV and both of these violent experiences. In particular, mothers' depression mediated the link between maternal CA, IPV, cumulative violence and children's externalizing, and total behavior problems. Child NLE was an important pathway between maternal CA and total behavior problems, as well as between cumulative violence and both externalizing and total problems. IPV contributed to explaining the link between maternal CA and contextual and family factors, such as child physical punishment and NLE, which were in turn, associated with children's behavior problems. Findings show the complex interconnections between different types of violence and their harmful effects on the mental health of women and their offspring, as well as the need to extend our knowledge on this subject.

Parent- and self-reported dimensions of oppositionality in youth: construct validity, concurrent validity, and the prediction of criminal outcomes in adulthood.

BACKGROUND: Different dimensions of oppositional defiant disorder (ODD) have been found as valid predictors of further mental health problems and antisocial behaviors in youth. The present study aimed at testing the construct, concurrent, and predictive validity of ODD dimensions derived from parent- and self-report measures. METHOD: Confirmatory factor analyses were performed to test a three-dimensional model (ODD-irritability, ODD-headstrong, and ODD-hurtful) and a two-dimensional model (ODD-irritability, ODD-headstrong/hurtful) based on items of the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR) collected in a Swiss community study of 1,031 adolescents (519 boys, 512 girls) aged between 10.7 and 17.9 (M = 13.85, SD = 1.63) years. Logistic regression analyses were applied to predict scores in the clinical range of concurrent CBCL/YSR-anxiety/depression, CBCL/YSR-attention problems, and CBCL/YSR-delinquent behavior and depression as measured by the Center for Epidemiological Studies Depression Scale (CES-D) as well as to predict the presence of adult criminal convictions. RESULTS: CFA findings were in favor of a three-dimensional model rather than a two-dimensional model of ODD. The CBCL/YSR-ODD-irritability scale was related to concurrent self-reported depression, but also to attention problems and delinquent behavior. CBCL/YSR-ODD-hurtful and less strongly also the combined YSR-headstrong/hurtful scale predicted adult criminal outcomes. CONCLUSIONS: As proposed by the DSM-5 workgroup, different ODD-dimensions were confirmed by the present study. ODD-irritability predicts psychiatric comorbidity and ODD-hurtful symptoms should be specifically considered in youth at risk for criminal outcomes.