Josep M. Domènech

Inventory of Callous-Unemotional Traits in a Community Sample of Preschoolers

The purpose of this study was to test the factor structure of the Inventory of Callous-Unemotional Traits (ICU; Frick, 2004) and to study the relation between the derived dimensions and external variables in a community sample of preschool children. A total of 622 children 3 and 4 years of age were assessed with a semistructured diagnostic interview, the ICU, and other questionnaires on psychopathology, temperament, and executive functioning, completed by parents and teachers. Confirmatory factor analysis derived from teachers’ ICU responses yielded three dimensions: Callousness, Uncaring, and Unemotional. Callousness and Uncaring subscale scores correlated with the specific scales related to aggressive behavior, temperament, executive functioning, and conduct problems. The ICU scale scores discriminated cross-sectionally oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses, aggressive and nonaggressive symptoms of CD, use of services, and ODD/CD-related family burden. Longitudinally, Callousness subscale score at age 3 predicted ODD or CD diagnosis at age 4. Unemotional was not associated with aggressive measures, but it was linked to anxiety disorders cross-sectionally and longitudinally. Callous-Unemotional traits contributed significantly to predicting disruptive behavior disorders controlling for sex, temperament, and executive functioning (predictive accuracy between 3 and 5%). The ICU is a promising questionnaire for identifying early Callous and Uncaring traits in preschool years that may help in the identification of a subset of preschool children who might have severe behavioral problems.

Dimensions of oppositional defiant disorder in 3-year-old preschoolers.

BACKGROUND To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. METHOD A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semi-structured interview and questionnaires on psychopathology, temperament and executive functioning completed by parents and teachers. RESULTS Using categorical and dimensional symptoms of ODD it was possible to confirm, cross-informant and cross-method, distinct dimensions for defining the structure of ODD: one made up of irritable and headstrong and the other of negative affect, oppositional behaviour and antagonistic behaviour. Specific associations with DSM-IV disorders were found, and irritable was associated with anxiety disorders, whereas headstrong was associated with disruptive disorders, including aggressive and non-aggressive CD symptoms. Also, negative affect was associated with anxiety disorders and non-aggressive CD symptoms, oppositional behaviour with disruptive disorders and aggressive CD symptoms, and antagonistic behaviours with disruptive disorders and, in boys, with mood disorders. The dimensions correlated with specific scales of psychopathology, temperament and executive functioning. CONCLUSIONS Oppositional defiant disorder is a heterogeneous disorder from preschool age. Different dimensions, with moderate to acceptable reliability and convergent and discriminant validity with other psychological constructs, can be identified early in life.

The Diagnostic Interview of Children and Adolescents for Parents of Preschool and Young Children: Psychometric Properties in the general Population

There is a need for reliable and well-validated diagnostic measures for studying psychopathology in preschool and young children. The goal is to study the psychometric properties of the Diagnostic Interview for Children and Adolescents for Parents of Preschool and Young Children (DICA-PPYC) in the general population. A sample of 852 Spanish school children, aged 3 to 7 years, were randomly selected and screened for a double phase design. A total of 251 families were interviewed with the DICA-PPYC and 244 participated in a test-retest design. Different measures of psychopathology and functional impairment were also administered. Test-retest agreement with a mean interval of 8.8 days ranged from excellent to slight (kappa from 1 to 0.39) for DSM-IV-TR and from good to fair (kappa from 0.77 to 0.49) for Research Diagnostic Criteria-Preschool Age diagnoses. Attenuation between test and retest was not significant for the prevalence of diagnoses, although it was significant for the number of externalising and total symptoms in the interview. The diagnoses converged moderately with the CBCL and Dominic scores. The presence of diagnoses in the DICA-PPYC significantly differentiated preschoolers and young children who had used mental health services, were more impaired, and presented more severe psychopathology measured by dimensional scales. The DICA-PPYC is a reliable and valid semi-structured interview schedule for preschool and young children, and can serve to advance the knowledge and mental health care of this population.

Degree of Exposure to Domestic Violence, Psychopathology, and Functional Impairment in Children and Adolescents

There are discrepancies about whether children who witness and suffer domestic violence (DV) have similar outcomes in terms of psychopathology. This work examines the relationship between different types of exposure to DV and child psychopathology and functional impairment. One hundred and forty-four Spanish children aged from 4 to 17 years and exposed to DV were evaluated using a diagnostic interview and other instruments of psychopathology and functional impairment. The participants were classified in three groups according to the degree of exposure: witness (n = 72), involved (n = 52), and victim (n = 20). According to mothers’ self-reports and mother—child combined information, DV equally affects psychopathology and functional impairment regardless of the degree of the exposure. Children’s self-reports showed a linear trend to present greater psychopathology as a victim than as a witness. The differential effect of exposure to DV measured in this study depended on the informant, which underlines the importance of obtaining information from the children exposed to violence at home.

Differential effects of psychological maltreatment on children of mothers exposed to intimate partner violence

OBJECTIVE Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV). METHOD Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations. RESULTS Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in childrens psychopathology or functioning in this population. IMPLICATIONS The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs.OBJECTIVE This study assessed the co-occurrence of child maltreatment and intimate partner violence (IPV) and examined the association between them. METHOD The cross-sectional study recruited a population-based sample of 1,094 children aged 12-17 years in Hong Kong. Structured questionnaires were used to collect data from the children. The prevalence of occurrence of child abuse and neglect by parents and exposure to IPV in both the past year and lifetime was examined, and their correlates were assessed using univariate and multivariate logistic regression. RESULTS The results show that 26% and 14.6% of child participants had been exposed to IPV physical assault, and 44.4% and 22.6% had been subjected to a parents corporal punishment or to physical maltreatment from a parent in their lifetime and the year preceding the study, respectively. Among those families characterized by IPV, 54.4% and 46.5% were involved in child physical maltreatment over the childs lifetime and in the preceding year, respectively. CONCLUSIONS Multivariate logistic regression analyses revealed that children exposed to IPV were at higher risk of being victims of neglect, corporal punishment, and physical maltreatment or severe physical maltreatment by their parents than children who were not exposed to IPV, even when child and parent demographic factors were controlled for. PRACTICAL IMPLICATIONS The higher risk of child physical maltreatment associated with IPV highlights the need for an integrated assessment to screen for the presence of multiple forms of family violence within the family, and for intervention to assess effective responses to both IPV and child maltreatment by child protective service workers and domestic violence agencies.

Behavior Rating Inventory of Executive Functioning–Preschool (BRIEF-P) Applied to Teachers Psychometric Properties and Usefulness for Disruptive Disorders in 3-Year-Old Preschoolers

Objective: We provide validation data on the Behavior Rating Inventory of Executive Functioning–Preschool version (BRIEF-P) in preschool children. Method: Teachers of a community sample of six hundred and twenty 3-year-olds, who were followed up at age 4, responded to the BRIEF-P, and parents and children answered different psychological measures. Results: Confirmatory factor analysis achieved adequate fit of the original structure (five-first-order-factor plus three-second-order-factor model) after excluding four items. The derived dimensions obtained satisfactory internal consistency, moderate convergent validity with psychopathology and temperament, and good ability to discriminate between children with ADHD. BRIEF-P scales were not associated with a performance-based measure of attention. The teacher’s BRIEF-P adds significant clinical information for the diagnosis of ADHD (ΔR2 from 5.3 to 15.3) when used with other instruments for the assessment of psychopathology, functional impairment, or performance-based attention. Conclusion: The BRIEF-P may be useful in the identification of preschool children, specifically those with ADHD, who might have a dysfunction in executive functioning.

Differential contextual factors of comorbid conduct and depressive disorders in Spanish children

ObjectiveThe aim of this study was to clarify the validity of the mixed conduct/depressive disorder in young people to justify its place in ICD-10 by examining a wide range of risk factors, school performance and other contextual variables.MethodData on risk factors and other school and family variables were compared between 66 referred children with depressive disorders without conduct disorder, 135 with conduct or oppositional defiant disorder without depressive disorders, and 90 with both. Data were obtained through structured diagnostic interviews with parents and children and questionnaires.ResultsMarked differences emerged between depressive and comorbid groups in rearing style, school and friends. Comorbid conduct-depression and pure conduct disorders share similar contextual factors; the differences are larger in school, where the pure conduct group has more difficulties.ConclusionsBased on contextual factors, pure depression is different from conduct-depressive disorder, but pure conduct disorder is similar to the comorbid condition. The results have implications for nosology and treatment of these disorders.

The short and very short forms of the Children's Behavior Questionnaire in a community sample of preschoolers.

The aim was to test the internal structure of scores on the short and very short forms of the Children’s Behavior Questionnaire (CBQ) scale and to study the relationship between the dimensions derived and external variables previously related to extreme temperament in a Spanish community sample. The sample comprised of 622 three-year-old children participating in a longitudinal study. Data were obtained from parents and teachers through a semistructured diagnostic interview and questionnaires evaluating children’s characteristics and psychological states. Results showed a three-factor structure and moderate reliability of the scale scores for both the short and very short forms. Associations were found between the Surgency/Extraversion dimension and attention-deficit/hyperactivity disorder and externalizing problems, between Negative Affect and internalizing and emotional problems, and between Effortful Control and attention, externalizing, and social problems and other executive function measures. Salient temperamental characteristics predicted psychopathological disorders and impairment at ages 3 and 4. The short forms of the CBQ provide reliable and valid scores for assessing temperamental characteristics in the preschool years.

Clinical Characteristics of Preschool Children with Oppositional Defiant Disorder and Callous-Unemotional Traits

There is a need to know whether callous-unemotional (CU) traits identify a more severe group of oppositional defiant children (ODD). The aim of this study is to ascertain cross-sectionally and longitudinally the specific contribution of CU levels and the presence of ODD in the psychological state of preschool children from the general population. A total of 622 children were assessed longitudinally at ages 3 and 5 with a semi-structured diagnostic interview and questionnaires filled out by parents and teachers. In multivariate models simultaneously including ODD diagnosis and CU levels, controlling by socioeconomic status, ethnicity, sex, severity of conduct disorder symptoms and other comorbidity, high CU scores were related to higher levels of aggression, withdrawn, externalizing and global symptomatology, functional impairment and higher probability of comorbid disorders and use of services. The contribution of CU traits on children’s psychological state was not moderated by the presence/absence of ODD. Stability for CU traits and number of ODD-symptoms between ages 3 and 5 was statistically significant but moderate-low (intra-class correlation under .40). Assessment and identification of CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems.

The discriminative capacity of CBCL/1½-5-DSM5 scales to identify disruptive and internalizing disorders in preschool children

This paper studies the discriminative capacity of CBCL/1½-5 (Manual for the ASEBA Preschool-Age Forms & Profiles, University of Vermont, Research Center for Children, Youth, & Families, Burlington, 2000) DSM5 scales attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety and depressive problems for detecting the presence of DSM5 (DSM5 diagnostic and statistical manual of mental disorders, APA, Arlington, 2013) disorders, ADHD, ODD, Anxiety and Mood disorders, assessed through diagnostic interview, in children aged 3–5. Additionally, we compare the clinical utility of the CBCL/1½-5-DSM5 scales with respect to analogous CBCL/1½-5 syndrome scales. A large community sample of 616 preschool children was longitudinally assessed for the stated age group. Statistical analysis was based on ROC procedures and binary logistic regressions. ADHD and ODD CBCL/1½-5-DSM5 scales achieved good discriminative ability to identify ADHD and ODD interview’s diagnoses, at any age. CBCL/1½-5-DSM5 Anxiety scale discriminative capacity was fair for unspecific anxiety disorders in all age groups. CBCL/1½-5-DSM5 depressive problems’ scale showed the poorest discriminative capacity for mood disorders (including depressive episode with insufficient symptoms), oscillating into the poor-to-fair range. As a whole, DSM5-oriented scales generally did not provide evidence better for discriminative capacity than syndrome scales in identifying DSM5 diagnoses. CBCL/1½-5-DSM5 scales discriminate externalizing disorders better than internalizing disorders for ages 3–5. Scores on the ADHD and ODD CBCL/1½-5-DSM5 scales can be used to screen for DSM5 ADHD and ODD disorders in general populations of preschool children.