Seija Sandberg

Hyperactive behavior in English schoolchildren: a questionnaire survey.

The differences in apparent prevalence of childhood hyperactivity between England and North America are more than 20-fold. This paper seeks to illuminate the reasons for the difference by applying a standard measure [Conners Teacher Rating Scale] to 437 English schoolchildren, aged 6 to 9 years, and comparing them with published surveys from the United States and Australasia. The rating scale had moderate interrater reliability and stability over time; it distinguished between children referred for psychiatric treatment and normal schoolchildren. Component analysis yielded a factor of hyperactivity-inattentiveness, distinct from conduct disorder. The mean hyperactivity scores of English children were higher than in most U.S. surveys but lower than in New Zealand. The national differences in rates of diagnosed hyperactivity are likely to reflect diagnostic inconsistency rather than true differences in childrens behavior.

Inattentive Behavior in Childhood Epidemiology and Implications for Development

Poor concentration is a relatively common childhood problem. The current North American psychiatric diagnostic classification system (Diagnostic and Statistical Manual of Mental Disorders, fourth edition; DSM-IV), American Psychological Association, 1994) differentiates children whose problems are distinguished primarily by symptoms of inattention (ADHD-I) from those whose difficulties are characterized by overactive, impulsive behavior by providing various subtypes within a broad diagnostic category. Yet, comparatively little is known about children who exhibit purely inattentive behavior. This study aims to redress this issue by using a large, community-based, epidemiological sample of 7-year-old children to compare the developmental functioning, social, and environmental backgrounds of children with pure inattentive behavior to that of children with pure overactive behavior and combined problems of inattentive and overactive behavior. Five hypotheses, centered on the validity of distinguishing inattentive behavior from overactivity, are tested. Children with pure inattentive behavior were more likely to have general cognitive delays, particularly in the area of language development, and were more likely to come from a family in which the father was of low occupational status. The results are discussed in relation to the implications for research and the identification of needs and intervention with children who exhibit pure inattentive behavior.

Severe Life Events and Chronic Adversities as Antecedents to Anxiety in Children: A Matched Control Study

The present study compared the number of severe life events and chronic adversities as reported retrospectively by mothers of children with an anxiety disorder (nu2009=u200939) prior to the onset of their most recent episode, with controls (nu2009=u200939) matched for age and sex. The parent version of the Psychosocial Assessment of Childhood Experiences (PACE) was used to assess chronic adversities (long-term experiences with negative impact on child) and severe life events (discrete life events with high long-term threat). A significantly greater number of severe life events and chronic adversities were assessed prior to onset for anxious children compared to controls. The finding for severe life events held regardless of whether impact ratings were assigned by mothers or a panel of independent raters, suggesting the findings reflect actual as opposed to perceived differences. Results suggest that both discrete and chronic stressors may constitute risk for future episodes of anxiety in children.

Use of services and associated costs for young adults with childhood hyperactivity/conduct problems: 20-year follow-up

BACKGROUNDnAlthough childhood hyperactivity and conduct problems are associated with difficulties in adulthood, little is known about later service use or public expenditure costs in the UK.nnnAIMSnTo describe the use of services and calculate recent (past 6 months) and early adulthood (since the age of 18 years) public expenditure costs incurred by young adults who had hyperactivity and/or conduct problems during childhood.nnnMETHODnA 20-year follow-up of a community sample of 6- to 7-year-old boys (n = 83) with hyperactivity only, conduct problems only, mixed hyperactivity and conduct problems, and no behaviour problems (control). Information was obtained about service use; recent (past 6 months), and early adulthood (since age 18 years) public expenditure costs were calculated.nnnRESULTSnHigh levels of childhood conduct problems were associated with a two- to threefold increase in early adulthood costs, mainly driven by criminal justice contacts. Although the mixed problems group had the highest recent costs in terms of receipt of benefits and health and social care, they had the lowest criminal justice costs.nnnCONCLUSIONSnHigh levels of early childhood conduct problems are particularly associated with increased health, social care and criminal justice costs in adulthood.

The impact of persisting hyperactivity on social relationships: A community-based, controlled 20-year-follow-up study

Objective: The purpose of this study was to examine whether persisting hyperactivity into adulthood was associated with impaired family, friendship, and partner relationships or poor coping skills in everyday life. Method: A 20-year community-based follow-up of 6- to 7-year-old boys showing pervasive hyperactivity (n = 40) and unaffected controls (n = 25) was conducted. At age 27 years, participants were assessed with detailed interview techniques as well as self-report ratings. Results: ADHD in adulthood was associated with problems in intimate relationships and negotiation skills. Antisocial behavior did not influence the association, but remitting childhood hyperactivity was not associated with social relationship difficulties in adulthood. Conclusion: In an untreated, community-based sample of hyperactive children, the risk for unsatisfactory social relationships is largely confined to those patients who still show ADHD in adulthood. The majority of patients who experience childhood hyperactivity have positive social relationships in adulthood.

Parent–child and spousal relationships in families with a young child with end-stage renal disease

BackgroundEnd-stage renal disease (ESRD) leads to the need for dialysis and renal transplantation (Tx). Peritoneal dialysis (PD) of young children is normally performed at home by the parents and affects the whole family. We studied the coping of families with a young child with ESRD by interviewing the parents of 19 children.MethodsThe spousal and parent–child relationships were assessed by using the Psychosocial Assessment of Childhood Experiences (PACE) and the Brief Measure of Expressed Emotion, respectively. A control group of 22 families with a healthy child was used for the parent–child relationship evaluation.ResultsThe spousal relationship at the start of PD was good or fairly good in most of the families and remained good in half of the families following renal Tx. Lack of support from close relatives and renal Tx were associated with a poorer relationship quality. Almost all parents expressed much or fairly much emotional warmth towards the child throughout the study, but there was a trend towards increased criticism over time. No differences in the degree of expressed warmth or criticism were noted between the index parents and controls.ConclusionsOverall, the study families appeared to cope well despite the serious illness of their child and the demands of the treatments.

Parent-dependent stressors and the onset of anxiety disorders in children: links with parental psychopathology

Exposure to stressors is associated with an increased risk for child anxiety. Investigating the family origins of stressors may provide promising avenues for identifying and intervening with children at risk for the onset of anxiety disorders and their families. The aim of this study was to compare the frequency of parent-dependent negative life events and chronic adversities experienced by children with an anxiety disorder (nxa0=xa034) in the 12xa0months prior to the onset of the child’s most recent episode, compared to healthy controls (nxa0=xa034). Life events and chronic adversities were assessed using maternal report during an investigator-based interview, which provided independent panel ratings of the extent that reported experiences were related to parent behaviour. There were no group differences in the number of parent-dependent negative life events for anxious children compared to controls. However, significantly more parent-dependent chronic adversities were present for anxious children compared to controls. Findings suggest that parents contribute to an increased frequency of chronic adversities but not negative life events prior to their child’s most recent onset of anxiety. Furthermore, increased child exposure to parent-dependent chronic adversities was related to parental history of mental disorder.