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Journal Article Reviews. 期刊文章评论。
Pub Date : 2019-06-01 DOI: 10.1097/DBP.0000000000000692
Carol C Weitzman, Oana DeVinck-Baroody, Cristina E. Farrell, Cy B. Nadler, Jennifer K. Poon
Autism, Communication English MS, Tenenbaum EJ, Levine TP, et al. Perception of cry characteristics in 1-month-old infants later diagnosed with autism spectrum disorder. J Autism Dev Disord. 2019;49:834–844. Evidence suggests that the preverbal vocalizations of children with autism spectrum disorder (ASD) differ from children without ASD, but the extent to which parents of children with and without ASD perceive these differences is unknown. This study recruited mothers of children with ASD (n 5 22) or typically developing controls (TD; n 5 20) to rate their perceptions of the cries of 1-month-old infants, some of whom would later be diagnosed with ASD. Audio recordings of cries were standardized 15-second samples obtained from a previous study and matched on developmental level and prenatal exposures. Mothers of children with ASD and TD children both rated the cries of children later diagnosed with ASD to be more distressing [F(1, 36) 5 45.62, p , 0.01], atypical [F(1, 37) 5 18.57, p , 0.01], and more reflective of pain [F(1, 39) 5 32.20, p , 0.01]. Parents of children with ASD had higher scores on a measure of broader autism phenotype (BAP) [t(40) 5 22.16, p 5 0.04], but BAP scores were not significantly correlated with parent perceptions of infant cries. While based on a small sample size, these results support the hypothesis that biomarkers associated with later ASD diagnosis are present in early infancy; moreover, the results do not support that exposure to a child with ASD or elevated BAP is associated with atypical perception of infant cries. Studies with more parent raters, more samples of infant cries, and acoustic analyses to characterize differences in infant cries in ASD are needed. C.B.N.
孤独症,交际英语MS, Tenenbaum EJ, Levine TP,等。诊断为自闭症谱系障碍的1个月大婴儿的哭泣特征感知。自闭症发展障碍[J]; 2019;49(1):834 - 844。有证据表明,自闭症谱系障碍(ASD)儿童的言语前发声与非ASD儿童不同,但自闭症儿童和非自闭症儿童的父母在多大程度上感知到这些差异尚不清楚。这项研究招募了自闭症儿童的母亲(522名)或典型发育对照(TD;2005年,他们对1个月大的婴儿的哭声进行了评估,其中一些婴儿后来被诊断为自闭症谱系障碍。哭声的录音是标准化的15秒样本,从以前的研究中获得,并与发育水平和产前暴露相匹配。ASD和TD患儿的母亲都认为后来诊断为ASD的患儿的哭声更令人痛苦[F(1,36) 5 45.62, p, 0.01],非典型[F(1,37) 5 18.57, p, 0.01],更能反映疼痛[F(1,39) 5 32.20, p, 0.01]。自闭症儿童的父母在广义自闭症表型(BAP)方面得分较高[t(40) 5 22.16, p 5 0.04],但BAP得分与父母对婴儿哭声的感知没有显著相关。虽然样本量小,但这些结果支持了与后期ASD诊断相关的生物标志物在婴儿早期存在的假设;此外,研究结果也不支持与患有ASD或BAP升高的儿童接触与婴儿哭声的非典型感知有关。需要更多的父母评分者,更多的婴儿哭声样本,以及声学分析来表征ASD婴儿哭声的差异。C.B.N.
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引用次数: 0
An Infant's Gratitude. 婴儿的感恩。
Pub Date : 2019-06-01 DOI: 10.1097/DBP.0000000000000688
P. Gorski
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引用次数: 0
In Remembrance: Murray Kappelman 纪念:Murray Kappelman
Pub Date : 2019-05-01 DOI: 10.1097/DBP.0000000000000673
L. Grossman
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引用次数: 0
Journal Article Reviews. 期刊文章评论。
Pub Date : 2019-05-01 DOI: 10.1097/DBP.0000000000000672
Carol C Weitzman, Cy B. Nadler, J. H. Sia, Jennifer K. Poon
Adolescent Victimization, Brain Development Quinlan EB, Barker ED, Luo Q, Banaschewski T, Bokde ALW, Bromberg U, et al. Peer victimization and its impact on adolescent brain development and psychopathology. Mol Psychiatry. Published online December 2018. There is limited neuroimaging research on peer victimization (PV). The aim of this study was to determine the relationship between chronic PV and regional brain volumes. Participants (n 5 682, 46% male) were from the IMAGEN project, a multisite, longitudinal study of adolescent brain development and mental health. At 14, 16, and 19 years of age, PV was assessed using a questionnaire, and a brain MRI was performed. At the age of 19 years, psychopathology symptoms were assessed using the computer-administered Developmental and Well-Being Assessment (DAWBA) and Strengths and Difficulties Questionnaire (SDQ). Results showed the following PV scores (mean [SD, range]) at 14, 16, and 19 years of age, respectively: (4.0 [1.6, 3–13]); (3.5 [1.2, 3–13]); and (3.3 [1.0, 3–15]), respectively. In the latent profile analysis, there were 2 groups identified with no significant difference in sex: chronically high PV (high peer victimization [HPV], n 5 36, 38% male) and low PV (low peer victimization [LPV], n 5 646, 46% male). Compared with the LPV group, the HPV group had higher SDQ scores (emotional symptoms: U 5 7829.0, r 5 20.13, p 5 0.001; hyperactivity: U 5 8223.0, r 5 20.11, p 5 0.003) and higher DAWBA scores (depression: U 5 6557.0, r 5 20.13, p 5 0.001; generalized anxiety: U 5 9101.5, r 5 20.10, p 5 0.006). Further analysis showed that HPV participants had larger left putamen volume at 14 years (t522.966, p5 0.003, d 5 0.49) but not at 19 years (t 5 21.834, p 5 0.067, d 5 0.30), suggesting greater decreases in putamen volume over time compared with LPV, even after controlling for confounders such as sex and childhood trauma. There was also a negative relationship between generalized anxiety and change in putamen volume (t 5 22.31, p 5 0.021). In the indirect effects analysis, PV was indirectly associated with generalized anxiety by decreases in putamen volume (b 5 0.439, 95% confidence interval [95% CI], 0.004–0.109) and decreases in caudate volume (b 5 0.036, [95% CI], 0.002–0.099). The authors concluded that adolescent mental health is related to PV mediated by structural brain changes. These have implications for early intervention among HPV adolescents to prevent PVassociated pathological brain changes. J.H.S.
张建军,张建军,张建军,张建军,等。青少年心理伤害与大脑发育的关系。同伴伤害及其对青少年大脑发育和精神病理的影响。摩尔精神病学。2018年12月在线发布。同伴受害(PV)的神经影像学研究有限。本研究的目的是确定慢性PV与区域脑容量之间的关系。参与者(5682人,46%为男性)来自IMAGEN项目,这是一项针对青少年大脑发育和心理健康的多地点纵向研究。在14岁、16岁和19岁时,使用问卷评估PV,并进行脑MRI。在19岁时,使用计算机管理的发展与幸福评估(DAWBA)和优势与困难问卷(SDQ)评估精神病理症状。结果显示:14、16、19岁患者PV评分(mean [SD, range])分别为4.0 [1.6,3-13];(3.5 [1.2, 3-13]);和(3.3[1.0,3-15])。在潜在特征分析中,有两组在性别上没有显著差异:长期高PV(高同伴受害[HPV], n 5 36,男性38%)和低PV(低同伴受害[LPV], n 5 646,男性46%)。与LPV组相比,HPV组的SDQ评分更高(情绪症状:U 5 7829.0, r 5 20.13, p 5 0.001;多动症:U 58223.0, r 5.20.11, p 5.0.003)和更高的DAWBA评分(抑郁症:U 556557.0, r 5.20.13, p 5.0.001;广泛性焦虑:U 9101.5, r 520.10, p 50.006)。进一步分析表明,HPV参与者在14岁时左侧壳核体积较大(t522.966, p5 0.003, d 5 0.49),但在19岁时则没有(t5 21.834, p5 0.067, d 5 0.30),这表明即使在控制了性别和童年创伤等混杂因素后,与LPV相比,壳核体积随时间的减少幅度更大。广泛性焦虑与壳核体积变化呈负相关(p < 0.05, p < 0.05)。在间接效应分析中,PV与广泛性焦虑的间接关联是壳核体积减少(b5 0.439, 95%可信区间[95% CI], 0.004-0.109)和尾状核体积减少(b5 0.036, [95% CI], 0.002-0.099)。作者认为,青少年心理健康与脑结构变化介导的PV有关。这对早期干预HPV青少年预防与pvv相关的病理性脑改变具有重要意义。J.H.S.
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引用次数: 0
Journal Article Reviews. 期刊文章评论。
Pub Date : 2019-02-01 DOI: 10.1097/DBP.0000000000000649
Carol C Weitzman, Cristina E. Farrell, Sarah S Nyp, J. H. Sia
ADOLESCENT COGNITION AND SUBSTANCE USE Morin JG, Afzali MH, Bourque J, Stewart SH, Séguin JR, O’Leary-Barrett M, and Conrod PJ. A population-based analysis of the relationship between substance use and adolescent cognitive development. AJP. Published online October 2018. Studies have shown a relationship between alcohol and cannabis misuse and cognitive functioning, but the results are mixed. The authors aimed at determining the relationship between adolescent cognition and substance use over time. Data from the Co-Venture study (a longitudinal study on the efficacy of a drug and alcohol prevention program) were used. In September 2012 or 2013, participating 7th graders in the Montreal area [n 5 3826; 53% male; mean (SD) age 5 12.7 y (0.5); 58% European] completed an annual web-based testing for 4 years to assess cognition (spatial working memory, delayed recall memory, perceptual reasoning, and inhibitory control) and substance use (Detection of Alcohol and Drug Problems in Adolescents questionnaire). Cannabis use at least 33/week was observed in 0.69%, 0.91%, 2.47%, and 3.81% of participants during 7th, 8th, 9th, and 10th grade, respectively, whereas alcohol use at least 33/week was observed in 0.31%, 0.34%, 0.36%, and 0.90% of participants during 7th, 8th, 9th, and 10th grade, respectively. After controlling for covariates (socioeconomic status, ethnicity, and family intactness), results showed that cannabis use was associated with poorer working memory (b 5 0.51, SE 5 0.25, p 5 0.04), perceptual reasoning (b 5 20.25, SE 5 0.08, p 5 0.001), and inhibition (b 5 1.19, SE 5 0.48, p , 0.01) during the same period. Further impairment in inhibition a year later was predicted by increases in cannabis use (b5 1.05, SE 5 0.41, p 5 0.01). Alcohol use was associated with lower spatial working memory (b 5 0.09, SE 5 0.05, p , 0.05), lower perceptual reasoning scores (b 5 20.06, SE 5 0.02, p , 0.01), and poorer inhibition (b 5 0.27, SE 5 0.09, p , 0.01) during the same period. Lagged effects were not observed for alcohol. The authors concluded that cannabis use is associated with more significant concurrent and lasting effects than alcohol use in adolescent cognitive functions. The results have implications on making policies that protect youths from substance use. J.H.S. ADOLESCENT DEPRESSION AND RISK BEHAVIORS Bai S, Zeledon LR, D’Amico EJ, Shoptaw S, Avina C, LaBorde AP, et al. Reducing health risk behaviors and improving depression in adolescents: a randomized controlled trial in primary care clinics. J Pedi Psych. October 2018. Health risk behaviors (HRBs) occur frequently with adolescent depression. The effectiveness of addressing multiple HRBs in primary care (PC) to reduce depressive symptoms has not been well studied. The aims of this study were to determine whether a PC intervention would decrease adolescent HRBs and improve depression and to determine associations between HRBs and depression. Adolescents (age: 16.06 6 1.45 years, 43% male) from
陈晓明,陈晓明,陈晓明,陈晓明。青少年认知与物质使用的关系。基于人群的物质使用与青少年认知发展关系分析。美国精神。2018年10月在线发布。研究表明,酒精和大麻滥用与认知功能之间存在关系,但结果好坏参半。作者的目的是确定青少年认知和长期药物使用之间的关系。数据来自于Co-Venture研究(一项关于药物和酒精预防项目有效性的纵向研究)。2012年9月或2013年9月,蒙特利尔地区参加的七年级学生[n 5 3826;男性53%;平均(SD) 5岁12.7 y (0.5);58%的欧洲人]完成了为期4年的年度网络测试,以评估认知(空间工作记忆、延迟回忆记忆、感知推理和抑制控制)和物质使用(青少年酒精和毒品问题检测问卷)。在7年级、8年级、9年级和10年级期间,分别有0.69%、0.91%、2.47%和3.81%的参与者每周至少使用33次大麻,而在7年级、8年级、9年级和10年级期间,分别有0.31%、0.34%、0.36%和0.90%的参与者每周至少使用33次酒精。在控制了协变量(社会经济地位、种族和家庭完整性)后,结果显示大麻使用与同期较差的工作记忆(b5.0.51, SE 5.0.25, p 5.0.04)、知觉推理(b5.20.25, SE 5.0.08, p 5.0.001)和抑制(b5.1.19, SE 5.0.48, p, 0.01)相关。一年后,大麻使用的增加预示着抑制能力的进一步损害(b5.1.05, SE 5.0.41, p 5.0.01)。在同一时间段内,饮酒与空间工作记忆降低(b5.0.09, SE 5.0.05, p, 0.05)、知觉推理得分降低(b5.20.06, SE 5.0.02, p, 0.01)和抑制能力降低(b5.0.27, SE 5.0.09, p, 0.01)相关。未观察到酒精的滞后效应。作者得出结论,大麻的使用比酒精对青少年认知功能的影响更显著,更持久。研究结果对制定保护青少年远离药物使用的政策具有启示意义。张晓明,张晓明,张晓明,等。青少年抑郁与风险行为的关系。减少青少年健康风险行为和改善抑郁:初级保健诊所的随机对照试验。[J]儿科心理学。2018年10月。健康危险行为(HRBs)在青少年抑郁症中经常发生。在初级保健(PC)中处理多重hrb以减轻抑郁症状的有效性尚未得到很好的研究。本研究的目的是确定PC干预是否会减少青少年hrb和改善抑郁症,并确定hrb和抑郁症之间的关系。青少年(年龄:来自2家PC诊所的患者(年龄为16.06 - 1.45岁,43%男性),经综合国际诊断访谈确定为过去一年可能/可能患有抑郁症,或目前患有抑郁症[根据流行病学研究中心抑郁量表(ses - d)或儿童诊断访谈表(DISC)],但未服用精神药物,且至少有1项针对性HRB(吸烟、药物使用、不安全性行为和肥胖风险),随机接受健康青少年干预[HT:动机策略和认知行为方法的结合,由心理治疗师病例管理人员(CMs)提供的建模和指导,每周10次,每次1小时,在PC诊所或PC附近的办公室进行;[595]或加强常规护理(UC1):向PC临床医生提供抑郁症治疗信息;N 5 92)。HT参与者继续接受UC1。在基线、6个月和12个月时进行青少年和父母评估,青少年完成自我报告问卷。主要终点为HRB指数[HRBI (0-4);hrb的总和]。次要结果是CES-D评分。在年龄、性别、基线HRBI (1.42 6 0.94 vs 1.396 1.07)、DISC标准抑郁症(51% vs 52%)和CES-D“严重”评分(34% vs 29%)方面(HT vs UC1)没有显著的组间差异,尽管UC1组中有更多的拉丁裔/西班牙裔参与者(p 0.05)。HT的平均出勤率为3.69次(SD 5 3.19);30.5%没有参加任何会议。A组(CMs纳入PC诊所)的参与者出勤率高于B组(平均[SD]: 4.18[3.14] vs 2.63 [3.10], p 5 0.028)。分析显示,在6个月和12个月时,尽管所有参与者的hrb随着时间的推移有所减少(12个月校正优势比为5.0.32,95%可信区间[CI] 0.15-0.72, p . 5.0.006),但组间无显著差异
{"title":"Journal Article Reviews.","authors":"Carol C Weitzman, Cristina E. Farrell, Sarah S Nyp, J. H. Sia","doi":"10.1097/DBP.0000000000000649","DOIUrl":"https://doi.org/10.1097/DBP.0000000000000649","url":null,"abstract":"ADOLESCENT COGNITION AND SUBSTANCE USE Morin JG, Afzali MH, Bourque J, Stewart SH, Séguin JR, O’Leary-Barrett M, and Conrod PJ. A population-based analysis of the relationship between substance use and adolescent cognitive development. AJP. Published online October 2018. Studies have shown a relationship between alcohol and cannabis misuse and cognitive functioning, but the results are mixed. The authors aimed at determining the relationship between adolescent cognition and substance use over time. Data from the Co-Venture study (a longitudinal study on the efficacy of a drug and alcohol prevention program) were used. In September 2012 or 2013, participating 7th graders in the Montreal area [n 5 3826; 53% male; mean (SD) age 5 12.7 y (0.5); 58% European] completed an annual web-based testing for 4 years to assess cognition (spatial working memory, delayed recall memory, perceptual reasoning, and inhibitory control) and substance use (Detection of Alcohol and Drug Problems in Adolescents questionnaire). Cannabis use at least 33/week was observed in 0.69%, 0.91%, 2.47%, and 3.81% of participants during 7th, 8th, 9th, and 10th grade, respectively, whereas alcohol use at least 33/week was observed in 0.31%, 0.34%, 0.36%, and 0.90% of participants during 7th, 8th, 9th, and 10th grade, respectively. After controlling for covariates (socioeconomic status, ethnicity, and family intactness), results showed that cannabis use was associated with poorer working memory (b 5 0.51, SE 5 0.25, p 5 0.04), perceptual reasoning (b 5 20.25, SE 5 0.08, p 5 0.001), and inhibition (b 5 1.19, SE 5 0.48, p , 0.01) during the same period. Further impairment in inhibition a year later was predicted by increases in cannabis use (b5 1.05, SE 5 0.41, p 5 0.01). Alcohol use was associated with lower spatial working memory (b 5 0.09, SE 5 0.05, p , 0.05), lower perceptual reasoning scores (b 5 20.06, SE 5 0.02, p , 0.01), and poorer inhibition (b 5 0.27, SE 5 0.09, p , 0.01) during the same period. Lagged effects were not observed for alcohol. The authors concluded that cannabis use is associated with more significant concurrent and lasting effects than alcohol use in adolescent cognitive functions. The results have implications on making policies that protect youths from substance use. J.H.S. ADOLESCENT DEPRESSION AND RISK BEHAVIORS Bai S, Zeledon LR, D’Amico EJ, Shoptaw S, Avina C, LaBorde AP, et al. Reducing health risk behaviors and improving depression in adolescents: a randomized controlled trial in primary care clinics. J Pedi Psych. October 2018. Health risk behaviors (HRBs) occur frequently with adolescent depression. The effectiveness of addressing multiple HRBs in primary care (PC) to reduce depressive symptoms has not been well studied. The aims of this study were to determine whether a PC intervention would decrease adolescent HRBs and improve depression and to determine associations between HRBs and depression. Adolescents (age: 16.06 6 1.45 years, 43% male) from ","PeriodicalId":15655,"journal":{"name":"Journal of Developmental & Behavioral Pediatrics","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75150503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Longitudinal Relationship Between Time-Out and Child Emotional and Behavioral Functioning. 暂停与儿童情绪和行为功能的纵向关系。
Pub Date : 2019-01-01 DOI: 10.1097/DBP.0000000000000725
R. Knight, Jeremy J. Albright, Lindsay A. Deling, Dawn Dore-Stites, Amy K. Drayton
OBJECTIVE Time-out is a widely used child discipline strategy and one of the only strategies currently recommended by the American Academy of Pediatrics. Despite its widespread use and significant evidence to support its effectiveness in decreasing problem behavior, time-out is often suggested to be harmful or ineffective by the popular media and select professional organizations. Empirical evidence regarding possible side effects of time-out is limited. The present study examined the relationship between reported use of time-out and child emotional and behavioral functioning and parent-child relationships using longitudinal, archival data. METHODS The study used archival, longitudinal data from the Early Head Start Research and Evaluation study. This study tracked families with children in Early Head Start at 3 different time points as follows: baseline (aged 0-3 years), pre-kindergarten, and fifth grade. Parent interviews, including questions on the use of time-out, were conducted when the children were 36 months old. Indicators of child emotional and behavioral health were measured at 36 months, pre-K, and fifth grade. Statistical analyses were completed to assess for potential side effects of time-out on child behavioral and emotional functioning and parent-child relationships. RESULTS Analyses for all outcome variables suggest no significant difference for children whose parents reported using time-out versus those who did not. CONCLUSION Parental reported use of time-out was not associated with long-term negative outcomes. Further research in this area is necessary to continue to address the multitude of concerns related to time-out that are presented by the media.
目的暂停是一种广泛使用的儿童管教策略,也是美国儿科学会目前推荐的唯一策略之一。尽管暂停被广泛使用,而且有大量证据支持它在减少问题行为方面的有效性,但大众媒体和一些专业组织经常认为它是有害的或无效的。关于超时可能产生的副作用的经验证据有限。本研究使用纵向档案数据检验了报告的暂停使用与儿童情绪和行为功能以及亲子关系之间的关系。方法:本研究采用早期开端研究与评价研究的档案、纵向数据。这项研究在以下三个不同的时间点跟踪了有孩子的家庭:基线(0-3岁)、学前班和五年级。在孩子36个月大的时候,对父母进行了访谈,包括关于暂停使用的问题。在36个月大、学前班和五年级时测量儿童情绪和行为健康指标。通过统计分析来评估暂停对儿童行为和情感功能以及亲子关系的潜在副作用。结果对所有结果变量的分析表明,父母报告使用暂停的儿童与未报告使用暂停的儿童之间没有显著差异。结论家长报告的暂停使用与长期负面结果无关。有必要在这一领域进行进一步研究,以继续解决媒体提出的与暂停有关的众多问题。
{"title":"Longitudinal Relationship Between Time-Out and Child Emotional and Behavioral Functioning.","authors":"R. Knight, Jeremy J. Albright, Lindsay A. Deling, Dawn Dore-Stites, Amy K. Drayton","doi":"10.1097/DBP.0000000000000725","DOIUrl":"https://doi.org/10.1097/DBP.0000000000000725","url":null,"abstract":"OBJECTIVE Time-out is a widely used child discipline strategy and one of the only strategies currently recommended by the American Academy of Pediatrics. Despite its widespread use and significant evidence to support its effectiveness in decreasing problem behavior, time-out is often suggested to be harmful or ineffective by the popular media and select professional organizations. Empirical evidence regarding possible side effects of time-out is limited. The present study examined the relationship between reported use of time-out and child emotional and behavioral functioning and parent-child relationships using longitudinal, archival data. METHODS The study used archival, longitudinal data from the Early Head Start Research and Evaluation study. This study tracked families with children in Early Head Start at 3 different time points as follows: baseline (aged 0-3 years), pre-kindergarten, and fifth grade. Parent interviews, including questions on the use of time-out, were conducted when the children were 36 months old. Indicators of child emotional and behavioral health were measured at 36 months, pre-K, and fifth grade. Statistical analyses were completed to assess for potential side effects of time-out on child behavioral and emotional functioning and parent-child relationships. RESULTS Analyses for all outcome variables suggest no significant difference for children whose parents reported using time-out versus those who did not. CONCLUSION Parental reported use of time-out was not associated with long-term negative outcomes. Further research in this area is necessary to continue to address the multitude of concerns related to time-out that are presented by the media.","PeriodicalId":15655,"journal":{"name":"Journal of Developmental & Behavioral Pediatrics","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90723613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
DBP Evaluations in DBPNet Sites: Is Race/Ethnicity a Significant Factor in Care? DBPNet站点的DBP评估:种族/民族是护理的重要因素吗?
Pub Date : 2019-01-01 DOI: 10.1097/DBP.0000000000000710
M. Augustyn, E. Silver, N. Blum, P. High, N. Roizen, R. Stein
OBJECTIVE To examine whether there are differences between non-Hispanic white (NHW) and nonwhite (NW) children in referral questions, evaluations, and diagnoses during developmental behavioral pediatrician (DBP) evaluations at academic medical centers and the potential role of socioeconomic factors in any disparities noted. DESIGN/METHODS This observational study used survey data from 56 DBPs at 12 sites participating in DBPNet. Child race and ethnicity were obtained from DBP report. Mixed-model logistic and linear regression analyses controlling for site, provider, and socioeconomic proxy variables (insurance type, parent education, and language spoken at home) were used to compare groups on referral concerns, evaluation procedures, and diagnoses. RESULTS Among the patients evaluated, 349 were NHW, 406 were NW (187 Hispanic, 135 black, 58 Asian/Pacific Islander, and 26 other/mixed), and 29 were missing race/ethnicity data. The mean waiting time controlling for site and provider was 20.4 weeks for NHW children and 20.5 weeks for NW children. Reasons for referral were similar in the NWH and NW groups, with only sleep problem concerns being more frequent among NHW children (9.2% vs 3.4% NW, p = 0.01). Patients also had similar evaluations in the 2 groups; the only differences found were that more NHW than NW children had genetic testing (33.1% vs 19.3%, p = 0.02), ophthalmology evaluations (8.7% vs 3.4%, p = 0.03), and psychopharmacologic evaluations (19.1% vs 9.7%, p = 0.008). Numbers and types of diagnoses did not vary by race/ethnicity. CONCLUSION This study suggests little inequality between NHW and NW children in wait time to care, reasons for referral, workup, or final diagnosis for initial DBP evaluation at these 12 academic DBP centers when socioeconomic factors are considered. Nevertheless, because differences in these related factors may be mechanisms through which racial/ethnic disparities can arise, it will be important to consider them in planning models and care protocols for underserved communities.
目的探讨非西班牙裔白人(NHW)和非白人(NW)儿童在学术医疗中心发展行为儿科医生(DBP)评估中的转诊问题、评估和诊断是否存在差异,以及社会经济因素在任何差异中所起的潜在作用。设计/方法本观察性研究使用了参与DBPNet的12个站点的56个dbp的调查数据。儿童种族和民族来自DBP报告。混合模型logistic和线性回归分析控制了地点、提供者和社会经济代理变量(保险类型、父母教育和家庭语言),用于比较两组在转诊关注、评估程序和诊断方面的差异。结果在评估的患者中,349例NHW, 406例NW(187例西班牙裔,135例黑人,58例亚洲/太平洋岛民,26例其他/混合),29例缺少种族/族裔数据。控制地点和提供者的平均等待时间NHW儿童为20.4周,NW儿童为20.5周。NWH组和NW组的转诊原因相似,只有睡眠问题在NW组儿童中更常见(9.2% vs 3.4% NW, p = 0.01)。两组患者的评价也相似;唯一的差异是NHW儿童比NW儿童有更多的基因检测(33.1%比19.3%,p = 0.02)、眼科评估(8.7%比3.4%,p = 0.03)和精神药理学评估(19.1%比9.7%,p = 0.008)。诊断的数量和类型没有因种族/民族而异。结论本研究表明,当考虑到社会经济因素时,在12个DBP学术中心,NHW和NW儿童在等待护理时间、转诊原因、随访或初始DBP评估的最终诊断方面几乎没有不平等。然而,由于这些相关因素的差异可能是产生种族/民族差异的机制,因此在为服务不足的社区规划模式和护理协议时考虑这些因素将是重要的。
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引用次数: 5
Journal Article Reviews. 期刊文章评论。
Pub Date : 2019-01-01 DOI: 10.1097/DBP.0000000000000633
Carol C Weitzman, Rachel M. Moore, Sarah S Nyp, J. H. Sia
ADHD Dvorsky MR, Langberg JM, Evans SW, et al. The protective effects of social factors on the academic functioning of adolescents with ADHD. J Clin Child Adolesc Psychol. 2018;47:713–726. Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience clinically significant academic disadvantages (e.g., lower grades and standardized test scores, increased likelihood of school dropout). Research suggests that healthy social functioning (e.g., maintenance of close interpersonal relationships, appropriate use of prosocial behavior and skills, and social acceptance) during middle school may be an important protective factor for youth with ADHD because it has previously been associated with higher academic achievement and school involvement. The current study included adolescents (n 5 93; 72% male students, 78% Caucasian) with clinically confirmed ADHD (n 5 50 ADHD inattentive type [ADHD-I]; n 5 43 ADHD combined type) assessed in fifth (39.9%), sixth (31.1%), or seventh (29%) grade; adolescents were all assessed 18 months later. Approximately 47% of participants were prescribed medication. Comorbid conditions included 45% oppositional defiant disorder or conduct disorder, 27% anxiety, and 14% depressive disorder. Outcomes included selfand parent-reported measures of ADHD and oppositional symptoms, social skills, and perceived social acceptance. Academic outcomes included both objective (e.g., grade point average [GPA]) and subjective (e.g., teacher reported impairment ratings) functioning. Results showed that neither parentnor adolescent-rated social skills demonstrated protective effects for any academic outcome. Only ADHD-I was a significant risk factor for poor grades (b5 20.21, p 5 0.02) and teacher-rated impairment (b 5 0.28, p 5 0.04). The relationship between inattention and grades (e.g., mean GPA 5 2.47) was attenuated for adolescents with high social acceptance as reported both by parents (b 5 0.28, p 5 0.006) and the adolescents (b 5 0.32, p 5 0.04). For adolescents with low parent-reported social acceptance, the relationship between inattention and low grades (e.g., mean GPA 5 1.54) was stronger (t(93) 5 22.01, p 5 0.04). The authors stress the importance of considering the role of specific protective factors; pediatricians for youth with ADHD can encourage participation in interest-specific social groups or clubs. R.M. ADHD, prematurity Ask H, Gustavson K, Ystrom E, et al. Association of gestational age at birth with symptoms of attentiondeficit/hyperactivity disorder in children. JAMA Pediatr. 2018;172:749–756. Previous studies have demonstrated an association between prematurity and attention-deficit/hyperactivity disorder (ADHD). This study is unique in that it sought to explore differences in the association between ADHD symptoms and gestational age at 5 and 8 years of age and the potential impact of maternal/perinatal factors and sex on the association between symptoms of ADHD and gestational age at birth. The Norwe
ADHD Dvorsky MR, Langberg JM, Evans SW等。社会因素对ADHD青少年学业功能的保护作用。儿童心理学报,2018;47(1):713 - 726。患有注意力缺陷/多动障碍(ADHD)的青少年通常会经历临床上显著的学业劣势(例如,较低的成绩和标准化考试分数,退学的可能性增加)。研究表明,在中学时期健康的社会功能(例如,维持密切的人际关系,适当使用亲社会行为和技能,以及社会接受)可能是青少年多动症的一个重要保护因素,因为它以前与较高的学业成绩和学校参与有关。目前的研究包括青少年(1993年5月;72%男学生,78%白种人)临床确诊ADHD(共550例ADHD注意力不集中型[ADHD- i];(5 43例ADHD合并型)在第5级(39.9%)、第6级(31.1%)或第7级(29%)进行评估;所有青少年在18个月后接受评估。大约47%的参与者服用处方药。合并症包括45%的对立违抗性障碍或行为障碍,27%的焦虑和14%的抑郁障碍。结果包括自我和父母报告的ADHD和对立症状、社交技能和感知的社会接受度的测量。学业成绩包括客观(例如,平均绩点[GPA])和主观(例如,教师报告的损伤评级)功能。结果显示,父母和青少年评定的社交技能都没有显示出对学业成绩的保护作用。只有ADHD-I是导致成绩差(b5 20.21, p 5 0.02)和教师评定的损害(b5 0.28, p 5 0.04)的显著危险因素。在父母(b5.0.28, p 5.0.006)和青少年(b5.0.32, p 5.0.04)报告的社会接受度较高的青少年中,注意力不集中与成绩(如平均GPA 5.2.47)的关系减弱。对于父母报告的社会接受度低的青少年,注意力不集中与成绩差(例如平均GPA为1.54)之间的关系更强(t(93) 5 22.01, p 5 0.04)。作者强调了考虑特定保护因素作用的重要性;患有多动症的青少年儿科医生可以鼓励他们参加特定兴趣的社会团体或俱乐部。刘建军,刘建军,刘建军,等。出生胎龄与儿童注意缺陷/多动障碍症状的关系美国儿科杂志,2018;172:749-756。先前的研究已经证明了早产和注意力缺陷/多动障碍(ADHD)之间的联系。这项研究的独特之处在于,它试图探索ADHD症状与5岁和8岁时胎龄之间的关联差异,以及母体/围产期因素和性别对ADHD症状与出生胎龄之间关联的潜在影响。本研究采用挪威母婴队列研究,包括1999年1月1日至2008年12月31日期间出生的113,227名儿童(49%为女孩,28%为足月出生)的数据。该样本包括33,081名同性、暴露不一致的兄弟姐妹(49%为女孩,29%为足月出生)。在怀孕22到33周之间出生的婴儿被认为是早期早产。怀孕39至40周出生的婴儿被认为是足月。ADHD症状在5岁时用家长填写的Conner父母评定量表进行测量,在8岁时用家长/老师破坏性行为障碍评定量表进行测量。婴儿性别、多胎状态、出生时小于胎龄状态、先天性畸形、母体胎次和妊娠第13周前母体阴道出血被评估为潜在的混杂变量。与先前的研究一致,早产胎龄早期出生的儿童比足月出生的儿童更有可能出现ADHD(5岁时优势比[OR] 1.55[95%置信区间[CI], 1.29-1.85])、注意力不集中(8岁时优势比[OR] 1.85 [95% CI, 1.55 - 2.14])和多动/冲动(8岁时优势比[OR] 1.52 [95% CI, 1.29-1.79])等症状。当校正妊娠/母亲风险因素后,早产儿童继续表现出ADHD(5岁时OR为1.63 [95% CI 1.24-2.57])、注意力不集中(8岁时OR为1.79 [95% CI, 1.24-2.57])和多动/冲动(8岁时OR为1.66 [95% CI, 1.14-2.43])的症状增加。与足月出生的兄弟姐妹相比,经妊娠相关危险因素调整后,早产儿童更有可能出现ADHD(5岁时OR为1.79 [95% CI, 1.04-3.08])和注意力不集中(8岁时OR为1.75 [95% CI, 1.09-2.81])的症状,但没有多动症(OR为0.95 [95% CI,
{"title":"Journal Article Reviews.","authors":"Carol C Weitzman, Rachel M. Moore, Sarah S Nyp, J. H. Sia","doi":"10.1097/DBP.0000000000000633","DOIUrl":"https://doi.org/10.1097/DBP.0000000000000633","url":null,"abstract":"ADHD Dvorsky MR, Langberg JM, Evans SW, et al. The protective effects of social factors on the academic functioning of adolescents with ADHD. J Clin Child Adolesc Psychol. 2018;47:713–726. Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience clinically significant academic disadvantages (e.g., lower grades and standardized test scores, increased likelihood of school dropout). Research suggests that healthy social functioning (e.g., maintenance of close interpersonal relationships, appropriate use of prosocial behavior and skills, and social acceptance) during middle school may be an important protective factor for youth with ADHD because it has previously been associated with higher academic achievement and school involvement. The current study included adolescents (n 5 93; 72% male students, 78% Caucasian) with clinically confirmed ADHD (n 5 50 ADHD inattentive type [ADHD-I]; n 5 43 ADHD combined type) assessed in fifth (39.9%), sixth (31.1%), or seventh (29%) grade; adolescents were all assessed 18 months later. Approximately 47% of participants were prescribed medication. Comorbid conditions included 45% oppositional defiant disorder or conduct disorder, 27% anxiety, and 14% depressive disorder. Outcomes included selfand parent-reported measures of ADHD and oppositional symptoms, social skills, and perceived social acceptance. Academic outcomes included both objective (e.g., grade point average [GPA]) and subjective (e.g., teacher reported impairment ratings) functioning. Results showed that neither parentnor adolescent-rated social skills demonstrated protective effects for any academic outcome. Only ADHD-I was a significant risk factor for poor grades (b5 20.21, p 5 0.02) and teacher-rated impairment (b 5 0.28, p 5 0.04). The relationship between inattention and grades (e.g., mean GPA 5 2.47) was attenuated for adolescents with high social acceptance as reported both by parents (b 5 0.28, p 5 0.006) and the adolescents (b 5 0.32, p 5 0.04). For adolescents with low parent-reported social acceptance, the relationship between inattention and low grades (e.g., mean GPA 5 1.54) was stronger (t(93) 5 22.01, p 5 0.04). The authors stress the importance of considering the role of specific protective factors; pediatricians for youth with ADHD can encourage participation in interest-specific social groups or clubs. R.M. ADHD, prematurity Ask H, Gustavson K, Ystrom E, et al. Association of gestational age at birth with symptoms of attentiondeficit/hyperactivity disorder in children. JAMA Pediatr. 2018;172:749–756. Previous studies have demonstrated an association between prematurity and attention-deficit/hyperactivity disorder (ADHD). This study is unique in that it sought to explore differences in the association between ADHD symptoms and gestational age at 5 and 8 years of age and the potential impact of maternal/perinatal factors and sex on the association between symptoms of ADHD and gestational age at birth. The Norwe","PeriodicalId":15655,"journal":{"name":"Journal of Developmental & Behavioral Pediatrics","volume":"244 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76531269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Care Coordination Needs for Families of Children with Special Health Care Needs. 特殊卫生保健需要儿童家庭护理协调需求分析
Pub Date : 2019-01-01 DOI: 10.1097/DBP.0000000000000734
Susan B Roman, P. Dworkin, P. Dickinson, Steven C. Rogers
OBJECTIVES To identify the diverse services required by families of children with special health care needs (CSHCN) and identify the specific care coordination (CC) efforts associated with the most common types of observed diagnoses. Requested services were categorized into specific sectors, and CC efforts were quantified by observed diagnoses and defined sectors. METHODS CC service data were extracted and analyzed from patient encounters over 4 years (2009-2013) in a department database. This included descriptive information about referrals and linkages to medical, dental, and behavioral health providers and to state, private, and community agencies. Diagnostic classifications and CC sectors were defined to enable categorization. RESULTS A total of 2682 CSHCN records were reviewed. The majority (59%) required services/resources in 1 to 2 sectors, 24% required services/resources in 3 to 5 sectors, and 17% required services/resources in 6 or more sectors. Including informational service, the most frequently required sectors across the study population were education, financial, medical/dental, social connections, and advocacy. Children diagnosed with autism spectrum disorder had the highest needs across all sectors. CONCLUSION Most CSHCN and their families use a substantial amount of CC time and effort to secure services from diverse sectors. High-quality and efficient CC requires an understanding of the specific needs of these CSHCN and their families and how to link them to a diverse array of services and resources.
目的确定有特殊保健需要的儿童(CSHCN)家庭所需的各种服务,并确定与观察到的最常见诊断类型相关的特殊保健协调(CC)努力。所要求的服务被分类到特定的部门,CC的努力通过观察到的诊断和定义的部门进行量化。方法从某科室数据库中提取4年(2009-2013年)就诊患者的scc服务数据并进行分析。这包括关于转诊的描述性信息,以及与医疗、牙科和行为健康提供者以及州、私人和社区机构的联系。定义了诊断分类和CC扇区以实现分类。结果共审核了2682份CSHCN记录。大多数(59%)需要1至2个行业的服务/资源,24%需要3至5个行业的服务/资源,17%需要6个或更多行业的服务/资源。包括信息服务在内,研究人群中最常需要的部门是教育、金融、医疗/牙科、社会关系和宣传。被诊断为自闭症谱系障碍的儿童在所有领域的需求最高。结论:大多数青少年青少年和他们的家庭花费了大量的CC时间和精力从不同的部门获得服务。高质量和高效率的CC需要了解这些儿童残疾儿童及其家庭的具体需求,以及如何将他们与各种服务和资源联系起来。
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引用次数: 14
Barriers to Treatment Adherence Among College Students with Attention-Deficit/Hyperactivity Disorder. 注意缺陷/多动障碍大学生治疗依从性的障碍
Pub Date : 2019-01-01 DOI: 10.1097/DBP.0000000000000723
Scott T. Wagoner, Megan R. Schaefer, Alana Rawlinson, S. Shapiro, J. Kavookjian, W. Gray
OBJECTIVE The current study sought to obtain a longitudinal perspective of and quantitatively assess barriers to medication adherence experienced by college students with attention-deficit/hyperactivity disorder (ADHD). Thus, we examined semester-long trends in barriers to adherence in addition to the relationships between barriers and medication adherence and barriers and quality of life. METHODS Participants were college students diagnosed with ADHD. Throughout a Fall semester, participants completed 4 sets of online questionnaires and attended 4 in-person visits, which included pill counts and written questionnaires. Participants completed measures assessing barriers to adherence and health-related quality of life, and adherence was measured via pill counts. Mean values of barriers, adherence rate, and quality of life were used for all analyses. RESULTS Of the 45 students surveyed, mean adherence rate was 56.70%, and 84.45% of participants reported at least 1 barrier. Across the semester, participants reported experiencing an average of 3.07 barriers, and a consistent barrier reported was not realizing when pills run out. Although reported barriers were unrelated to adherence, the results showed that barriers were associated with lowered quality of life, specifically lower overall quality of life in addition to lower emotional functioning, psychosocial health, school functioning, and physical functioning. CONCLUSION Barriers to adherence appear to be common in college students with ADHD, and certain barriers are consistent with the planning difficulties observed in individuals with ADHD. Because students experiencing more barriers had lower quality of life, interventions are needed to improve students' overall illness management experience.
目的:本研究旨在对患有注意力缺陷/多动障碍(ADHD)的大学生的药物依从性进行纵向观察和定量评估。因此,除了障碍与药物依从性以及障碍与生活质量之间的关系之外,我们还研究了坚持治疗障碍的学期趋势。方法研究对象为被诊断患有ADHD的大学生。在整个秋季学期中,参与者完成了四套在线问卷,并参加了四次亲自访问,其中包括药片计数和书面问卷。参与者完成了评估依从性障碍和健康相关生活质量的措施,并通过药丸计数来衡量依从性。所有分析均采用障碍、依从率和生活质量的平均值。结果在接受调查的45名学生中,平均依从率为56.70%,84.45%的参与者报告至少有一个障碍。在整个学期中,参与者报告平均经历了3.07次障碍,并且一致的障碍报告没有意识到药片什么时候用完了。尽管所报道的障碍与依从性无关,但结果表明,障碍与生活质量下降有关,特别是整体生活质量下降,以及情绪功能、社会心理健康、学校功能和身体功能下降。结论依从性障碍在ADHD大学生中普遍存在,某些障碍与ADHD个体的计划困难一致。由于遇到更多障碍的学生生活质量较低,因此需要干预措施来改善学生的整体疾病管理体验。
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引用次数: 1
期刊
Journal of Developmental & Behavioral Pediatrics
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