Jessie Anderson

DSM-III Disorders from Age 11 to Age 15 Years

Although research into the continuity of disorder from childhood to adolescence is sparse, results from both longitudinal and cross sectional studies suggest that the prevalence of disorder increases for girls but may remain more stable for boys. In this paper, the methodologies of two assessment phases of the Dunedin longitudinal study have been equated to estimate the continuity of DSM-III disorder from ages 11 to 15. Although the overall prevalence of disorder doubled between the ages, this was primarily because of an increase in nonaggressive conduct disorder and major depressive episode. The sex ratios in disorder had largely reversed from a male predominance at 11 to a female predominance at 15. In terms of persistence, over 40% of those with disorder at age 11 were also identified at age 15. However, over 80% of those identified with disorder at 15 did not have a history of disorder at 11. Significant sex differences were also found in the continuity of internalizing and externalizing disorders, with externalizing disorders showing more continuity for boys, and internalizing for girls. Logistic regression models were employed to evaluate the roles family background, academic and social competence, and early histories of behavior problems may play in the determination of disorder continuity.

Prevalence of Childhood Sexual Abuse Experiences in a Community Sample of Women

OBJECTIVE The study was designed to ascertain the prevalence and nature of sexual abuse in childhood for a community sample of women. METHOD A two-stage design, using questionnaires and face-to-face interviews, was employed, providing information on prevalence rates, types of abuse, ages of victims, relationship to the abuser, and cohort effects. RESULTS Nearly one woman in three reported having one or more unwanted sexual experiences before age 16 years. A significant number of these experiences (70%) involved genital contact or more severe abuse, and 12% of those abused were subjected to sexual intercourse. The abusers were usually known to the victim, being family members in 38.3% of cases and acquaintances in another 46.3%. Stranger abuse accounted for 15% of all abuse experiences. Most of the abusers were young men, disclosure of the abuse was infrequent, and only 7% of all abuse was ever officially reported. Prevalence rates showed no urban/rural differences, no cohort effect with subject age, and no age differences in disclosure rates. CONCLUSIONS Child sexual abuse is common, serious, infrequently reported, and the abuser is usually known to the child. Preadolescent girls are at greatest risk.

Asking about child sexual abuse: Methodological implications of a two stage survey☆

In a two stage retrospective survey on child sexual abuse (CSA), a majority of CSA incidents were reported at both postal and interview stages of the survey. Incidents that involved genital contact were most likely to be reported at both stages. A significant number of women reported abuse by a close family member in the postal questionnaire but not at interview. In contrast, incidents mentioned only at interview were more likely to be carried out by a stranger. At interview, many women who replied negatively to a general screening question on CSA went on to report abuse in response to detailed descriptive questions. This was especially true for noncontact experiences. Increasingly restrictive definitions of CSA lowered the prevalence rate for CSA under the age of 16 years from 34.4% to 19.7%. The implication of these findings for the design of future studies is discussed.

A comparison of 13-year-old boys with attention deficit and/or reading disorder on neuropsychological measures.

This study compared 13 year-old-boys with attention deficit disorder (ADD) and/or reading disability (RD), and controls with neither disorder on a battery of verbal and nonverbal neuropsychological measures. The aim was to examine whether ADD was associated with a qualitatively distinct pattern of deficits compared with RD. None of the measures differentiated the boys with ADD-only from the controls; the only deficit associated with ADD was slightly lower IQ. RD, on the other hand, was associated with deficits in memory and verbal skills.

Risk Factors for Behavioral and Emotional Disorder in Preadolescent Children

The relationship between risk factors and behavioral and emotional disorder was examined in 792 11-year-old children. Background characteristics such as sex, maternal depression, marital status of the parents, and reading problems distinguished between children with and without disorder. It also appeared that disorder was related to the number of risk factors experienced. This study, like others, failed to provide strong support for differences in background characteristics among children with different diagnoses. This may reflect the degree of overlap among disorders, because even children with only a single disorder may not be entirely free of the symptomatology of other disorders. For this reason it is important to assess children for multiple disorders or at least consider impaired functioning in other dimensions.

Cognitive and social correlates of DSM-III disorders in preadolescent children.

The relationships between some cognitive and social measures and the major syndromes found in a large preadolescent sample of children from the general population are described. The measures discriminated between disorder-no disorder for most variables examined and between the broad groups of externalizing and internalizing disorders, but not between individual diagnostic categories. An important exception was that ADDH and conduct disorder occurring as single disorders could be distinguished, but the frequent comorbidity of these and other disorders complicated many between-group comparisons.

Comorbidity of Depression in Children and Adolescents

Interest in the coexistence of depressive disorders with other behavioral and emotional problems in childhood and adolescence is relatively recent (Caron & Rutter, 1991; Biederman, Newcorn, & Sprich, 1991). This interest has followed the recognition of depression in young people (Carlson & Cantwell, 1980a) as a symptom and as a disorder and the availability of standardized interview schedules for affective disorders in younger subjects, in both patient and nonpatient populations (for reviews, see Angold, 1988; A. J. Costello, 1986; E. J. Costello & Angold, 1988; Edelbrock & Costello, 1988; Strober & Werry, 1987). Historically, the question of whether a syndrome similar to the affective disorders in adults also exists for children has been the subject of considerable discussion in the psychiatric literature. The major focus of this discussion has been on depressive disorders, largely major depressive disorder (MDD), rather than on dysthymic disorder, adjustment disorders, with depressed mood, or mania. There has been some inclusion of the other depressive disorders in research by Kovacs and colleagues (Kovacs, Feinberg, Crouse-Novak, Paulauskas, & Finkelstein, 1984a; Kovacs et al., 1984b), but still relatively little interest in mania.

Cognitive correlates of depressive symptoms in 11-year-old children.

Self-reports of depressive symptoms were obtained for 792 11-year-old New Zealand children using a structured interview. The aim of the present study was to test the hypothesis that depressive symptomatology in children is associated with impairment on cognitive tasks. The results did not support this hypothesis. Depression was unrelated to performance on various subscales of the WISCR, whereas self-reported inattention was associated with poor performance. Depressive symptoms, however, were significantly related to lower self-esteem and a poorer self-perception of scholastic ability.

Hyperactivity and serum and hair zinc levels in 11-year-old children from the general population

H ~ v i t y or attention deficit disorder (ADD) is characterized by symptoms of inappropriate inattention, impulsivity, and overactivity, according to DSM-HI criteria. Colquhon and Bunday (1981) have hypoS:sized that many hyperactive children have impairt~ents in fat absorption which may be related to low zinc levels. They found that hair samples in 31 of 46 hyperactive children showed zinc levels below the normal range. Unfortunately, the results are not reported in any detail and there was no control group. Zinc deficiency has been implicated in the metabolism of dietary essential fatty acids to form prostaglandins (Horrobin and Cunnane 1980). Furthermore, there are ~ported observations of children with problems of fat absorption who show symptoms of hyperactivity and irritability (Conners 1984). Among the clinical manifestations of zinc deficiency may be jitteriness, impaired concentration, and altered behavior (Aggett and Harries !.979). Recently, Brophy (1986) has hypothesized that zinc de-

The long-term impact of the physical, emotional and sexual abuse of children: A community study

The associations between giving a history of physical, emotional, and sexual abuse in children and a range of mental health, interpersonal, and sexual problems in adult life were examined in a community sample of women. Abuse was defined to establish groups giving histories of unequivocal victimization. A history of any form of abuse was associated with increased rates of psychopathology, sexual difficulties, decreased self-esteem, and interpersonal problems. The similarities between the three forms of abuse in terms of their association with negative adult outcomes was more apparent than any differences, though there was a trend for sexual abuse to be particularly associated to sexual problems, emotional abuse to low self-esteem, and physical abuse to marital breakdown. Abuse of all types was more frequent in those from disturbed and disrupted family backgrounds. The background factors associated with reports of abuse were themselves often associated to the same range of negative adult outcomes as for abuse. Logistic regressions indicated that some, though not all, of the apparent associations between abuse and adult problems was accounted for by this matrix of childhood disadvantage from which abuse so often emerged.