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Objective: Despite theoretical discrepancies between different concepts of temperament, some core dimensions are thought to be common to the various models. We compared temperamental traits derived from the New York Longitudinal Study (NYLS) model and the Cloninger dimensions in the developmental course and investigated the associations of temperament with sex as well as with obstetric risks or psychosocial risks present at birth. - Methods: Participants were 151 boys and 157 girls born at differing degrees of obstetric and psychosocial risk from a longitudinal study on a high-risk community sample. In infancy and childhood, NYLS-derived temperamental characteristics were assessed by a highly structured parent interview and standardized behavioral observations. At age 15 years, the Junior Temperament and Character Inventory/1218 was administered. - Results: Moderate correlations were found between Junior Temperament and Character Inventory scales in adolescence and NYLS-derived factors in childhood. The psychosocial risk load seemed to influence the expression of novelty seeking or corresponding NYLS-derived factors, whereas the obstetric risks did not contribute to variation in temperament. Our findings further support highly sex-specific gene x environment interactions on temperament in the developmental course. - Conclusion: The content of our NYLS-derived factors and the specific type of association across different temperament constructs fit into the increasing consensus regarding a small number of higher-order temperamental traits. (c) 2007 Elsevier Inc. All rights reserved.
Neurofeedback treatment has been demonstrated to reduce inattention, impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder (ADHD). However, previous studies did not adequately control confounding variables or did not employ a randomized reinforcer-controlled design. This study addresses those methodological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD: EEG neurofeedback (NF) aiming at theta/beta ratio reduction and EMG biofeedback (BF) aiming at forehead muscle relaxation. Thirty-five children with ADHD (26 boys, 9 girls; 6-14 years old) were randomly assigned to either the therapy group (NF; n = 18) or the control group (BF; n = 17). Treatment for both groups consisted of 30 sessions. Pre- and post-treatment assessment consisted of psychophysiological measures, behavioural rating scales completed by parents and teachers, as well as psychometric measures. Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups, respectively. Parents reported significant reductions in primary ADHD symptoms, and inattention improvements in the NF group were higher compared to the control intervention (BF, dcorr = -.94). NF training also improved attention and reaction times on the psychometric measures. The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests. However, regarding hyperactivity and impulsivity symptoms, the results imply that non-specific factors, such as behavioural contingencies, self-efficacy, structured learning environment and feed-forward processes, may also contribute to the positive behavioural effects induced by neurofeedback training.
Psychotherapeutic interventions require empirical as well as scientific assessment. Specifically, the proven efficacy of psychotherapy for children and adolescents is essential. Thus, studies examining treatment efficacy and meta- analyses are necessary to compare effect sizes of individual therapeutic interventions between treatment groups and waiting control groups. Assessment of 138 primary studies from 1993-2009 documented the efficacy of psychotherapy for children and adolescents. Furthermore, behavioural therapy outperformed non-behavioural interventions, as 90 % of behavioural interventions showed larger effect sizes compared to non-behavioural psychotherapy. Analysis of moderator variables demonstrated an improved treatment efficacy for individual therapy, inclusion of the family, treatment of internalised disorders, and in clinical samples. Stability of psychotherapeutic treatment effects over time was demonstrated.
Recent studies have identified a Child Behavior Checklist profile that characterizes children with severe affective and behavioral dysregulation (CBCL-dysregulation profile, CBCL-DP). In two recent longitudinal studies the CBCL-DP in childhood was associated with heightened rates of comorbid psychiatric disorders, among them bipolar disorder, an increased risk for suicidality, and marked psychosocial impairment at young-adult follow-up. This is the first study outside the US that examines the longitudinal course of the CBCL-DP. Methods: We studied the diagnostic and functional trajectories and the predictive utility of the CBCL-DP in the Mannheim Study of Children at Risk, an epidemiological cohort study on the outcome of early risk factors from birth into adulthood. A total of 325 young adults (151 males, 174 females) participated in the 19-year assessment. Results: Young adults with a higher CBCL-DP score in childhood were at increased risk for substance use disorders, suicidality and poorer overall functioning at age 19, even after adjustment for parental education, family income, impairment and psychiatric disorders at baseline. Childhood dysregulation was not related to bipolar disorder in young adulthood. The CBCL-DP was neither a precursor of a specific pattern of comorbidity nor of comorbidity in general. Conclusions: Children with high CBCL-DP values are at risk for later severe, psychiatric symptomatology. The different developmental trajectories suggest that the CBCL-DP is not simply an early manifestation of a single disease process but might rather be an early developmental risk marker of a persisting deficit of self-regulation of affect and behavior.
Objectives: The prospective longitudinal Mannheim Study of Children at Risk followed the development of children from the age of 2 years up to the age of 8 years. Are there differences between the developmental risk load in toddlers (psychopathology, cognition, motor or neurological development. and educational differences) who suffer from a hyperactive disorder at age 8 and that of undisturbed children of the same age? Are there specific harbingers of hyperkinetic disorders for the group concerned? Methods: In terms of their developmental risk load at the age of 2 years, 26 primary school children with hyperkinetic disorders were compared to 241 healthy primary school children, as well as to 25 children of the same age with emotional disturbances and 30 children of the same age with socially disruptive behavior. Results: A significant combination of predictors of later hyperkinetic disorders at primary school age proved to be increased fidgetiness and irritability, as well as a reduced language comprehension, at the age of two. Conclusions: The predictive value of symptoms in early childhood for later hyperkinetic disorder in children of primaryschool age is higher than that of symptoms assessed in infancy, which although expected is without relevant specificity.
Psychische Störungen bei Kindern und Jugendlichen : Häufigkeit, Versorgungslage und Prävention
(2007)
Objectives: Are there any differences (organic, psychosocial, psychopathological, cognitive or educational, respectively differences in the motor or neurological development) between infants who later on at the age of 8 years suffer from a hyperactive disorder and those who later on at the same age are undisturbed? Are there specific harbingers for hyperactive disorders in the group concerned? Methods: With regard to their developmental risk load at the age of 3 months, 26 primary school children with hyperactive disorders were compared with 241 healthy children, 25 children with emotional disturbances, and 30 children with socially disruptive behaviour, all of the same age. Results: Identified as the most important predictors for the onset of hyperactive disorders were a reduced birth weight, the mother's origin from a shattered family, early contact impairments on the part of the child, and the mother's neglect of the infant. Conclusions: Altogether, however, the prediction of later hyperactivity in primary school children on the basis of salient features in the infant children remains unsatisfactory and unspecific.