Scandinavian Journal of Child and Adolescent Psychiatry and Psychology最新文献

Background: Autism Spectrum Disorder (ASD) is a heterogeneous condition, influencing participation in activity and occupation. Approximately, 1% of Australian children have an ASD diagnosis, with many of these families living in remote and regional areas. Given the environments role in facilitating or hindering participation, there is a need to understand how geographical location impacts the participation profiles of children with ASD.

Objective: This study aims to describe the participation profiles, and environmental barriers and facilitators to participation for children with ASD living in regional or remote Western Australia.

Methods: A total of 32 families completed a questionnaire pack including a socio-demographic questionnaire and the Participation and Environment Measure - Children and Youth.

Results: Children with ASD had reduced participation in community activities. Within the home, children most commonly participated in computer and video games, and in school settings, children participated rarely in non-classroom and extracurricular activities. Parents reported a desire for their children to decrease time spent engaging in video games and increase time spent in the community, socializing, engaging in extracurricular activities, and completing chores. Parents reported a number of barriers to participation across community, home, and school settings.

Conclusion: Children with ASD living in regional areas had restricted participation profiles and a number of barriers to participation as reported by their parents. There is a need for additional support and services in non-metropolitan areas for families of children with ASD to increase participation. This study also highlights the need to expand the definition of participation in the International Classification of Functioning, Disability and Health to include aspects of involvement.

Background: Information on individuals' functioning and disability is needed for numerous purposes in social and health care.

Objective: The purpose of the study was to assess the perceived health-related quality of life of Finnish schoolchildren aged from 7 to 17 years. We were interested to ascertain if changes of health-related quality of life with age could be discovered.

Method: The quality of life data (N = 4,776) were collected using Revidierter KINDer Lebensqualitätsfragebogen (KINDL-R). The survey was conducted in several comprehensive schools using tablet computers. The response rate was 95%. The quality of life data are presented as means and standard deviations. The rating scale was 0 to 100 points.

Results: The mean of respondents' (N = 4,776) health-related quality of life points was 72.1 (SD 11.0). Family as a factor impacting on the quality of life scored the highest points 78.2 (SD 16.1), while self-esteem got the lowest points 62.5 (SD 17.9). Adolescent girls' school-related quality of life points were 60.2 (SD 15.0) and adolescent boys' points were 61.7 (SD 14.4). Lower graders' and upper graders' quality of life differed very significantly so that the ratings of the lower graders were higher than the ratings of the upper graders. Finnish girls' quality of life as a whole was poorer than that of Finnish boys. The physical and emotional welfare as well as the self-esteem of young Finnish girls were poorer than those of their male peers.

Conclusions: The poor well-being of adolescents is recognized and accepted as a development-related phenomenon. Poor health-related quality of life experienced by adolescents may be interpreted as a symptom of a disease. Deterioration in health-related quality of life among adolescents should not be accepted as a development-related factor; that phenomenon should be further investigated and necessary measures taken to improve the quality of adolescent's life.

Background: The quality of peer relations is linked to mental health in childhood and adolescence, but few studies have investigated its clinical relevance. In particular, the potential mediating role of peer functioning in the associations between different dimensions of symptoms and quality of life (QoL) has not been sufficiently examined.

Objective: In a clinical sample of adolescents, we examined peer relations in light of psychiatric diagnoses, as well as QoL and symptoms of mental health problems, with particular focus on symptoms of anxiety, depression, and ADHD. We also examined the potential mediating role of peer problems in the relationship between such symptoms and QoL.

Methods: The sample consisted of 603 adolescents (ages 13-18) referred to clinical assessment. Psychiatric diagnoses according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, were collected from participants' clinical charts. Symptoms of disorders, QoL, and quality of peer relations were measured by self-report questionnaires.

Results: Adolescents diagnosed with anxiety/depressive disorder reported more peer problems and lower QoL than adolescents with attention deficit/hyperactivity disorder. These findings were supported with symptom ratings. A path model with bootstrapping was used to assess the potential mediating role of peer problems in the association between symptoms and QoL, showing that peer problems partly mediated the relationship between emotional symptoms and QoL, but not the relationship between ADHD-symptoms and QoL.

Conclusion: Improvement of peer relations may be a fruitful path for enhancing QoL among adolescents with symptoms of anxiety and depression.

Background: Pediatric bipolar (BP) disorder is a prevalent and highly morbid disorder. While structured diagnostic interviews have been developed to aide in the diagnosis of pediatric BP disorder, these tools are lengthy, costly, and not widely available. One possible diagnostic aid is the Child Behavior Checklist (CBCL).

Objective: To assess the diagnostic utility of the Child Behavior Checklist (CBCL)-Bipolar (BP) profile to identify children with a diagnosis of BP-I disorder.

Method: Subjects were derived from four independent datasets of children and adolescents with and without attention deficit hyperactivity disorder (ADHD) and BP-I. Subjects were recruited from pediatric and psychiatric clinics and the community. All subjects had structured clinical interviews with raters blinded to subject ascertainment status. We used an empirically-derived profile from the CBCL consisting of an aggregate t-score from the Attention, Anxiety/Depression, and Aggression subscales (CBCL-BP profile) to operationalize the presence or absence of bipolar symptoms. Receiver operating characteristic (ROC) curves were used to examine the ability of the CBCL-BP profile to identify children with and without a structured interview diagnosis of BP-I disorder.

Results: The sample consisted of 661 subjects (mean age: 11.7 ± 3.3 years, 57% male, and 94% Caucasian). Twenty percent of participants (N=130) met structured interview criteria for a full diagnosis of BP-I disorder. The ROC analysis of the CBCL-BP profile yielded an area under the curve of 0.91. A t-score of ≥195 on the CBCL-BP profile correctly classified 86% of subjects with BP-I disorder with 80% sensitivity, 87% specificity, 61% positive predictive value, 95% negative predictive value.

Conclusion: The CBCL-BP profile efficiently discriminated pediatric subjects with and without a structured interview diagnosis of BP-I disorder. Findings suggest that the CBCL-BP profile may be an efficient tool to help identify children who are very likely to suffer from BP-I disorder.

Background: Difficulties in facial emotion recognition (ER) skills are linked to autism spectrum disorder (ASD) in studies performed in Western and Eastern Asian countries. However, there is a paucity of research examining ER skills in Arab countries, where face-covering veils are more common than in Western countries.

Objective: Our aim was to examine basic ER and ER error patterns in Egyptian and Finnish children with and without ASD.

Method: We employed the eye-submodule of the Frankfurt Test and Training of Facial Affect Recognition (FEFA) and the Autism Spectrum Screening Questionnaire (ASSQ).

Results: Arab children with ASD (n = 34, M age = 8.6 years, FSIQ = 96.7) recognized correctly fewer emotions than did Scandinavian children with ASD (n = 32, M age = 12.5 years, FSIQ = 102.8) and Arab typically developing (TD) children (n = 34, M age = 10.3 years, FSIQ = 123.4) in general and specifically on surprise, disgust and neutral scales as well as on a blended emotion scale. Scandinavian children with ASD demonstrated a lower ability to recognize emotions in general and specifically happiness than did Scandinavian TD children. There were no differences between Arab and Scandinavian (n = 28, M age = 13.9 years) TD children in ER accuracy. We found country specific differences in ER error patterns in happiness, sadness and anger: Arab children interpreted these emotions more often as another emotion (happiness = sadness, sadness = anger, anger = sadness and surprise), whereas Scandinavian children interpreted happiness and sadness as neutral expression and anger as disgust. Arab children with ASD labeled sadness and anger in their ER error patterns more negatively than did Arab TD children, but there were no differences between Scandinavian children with ASD and TD in ER error patterns.

Conclusions: The differences between the Arab and Scandinavian children may reflect cultural differences in ER and ER error patterns.