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JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/S2949-7329(24)00025-5
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引用次数: 0
The Longitudinal Relationship Between Brain Morphology and Obsessive-Compulsive Symptoms in Children From the General Population 普通人群中儿童的大脑形态与强迫症症状之间的纵向关系
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2023.11.003
Cees J. Weeland MD, PhD , Chris Vriend PhD , Henning Tiemeier PhD , Odile A. van den Heuvel MD, PhD , Tonya White MD, PhD

Objective

Cross-sectional studies in children with obsessive-compulsive disorder (OCD) have found larger thalamic volume, which is not found at later ages. We previously found that 9- to 12-year-old children from the general population with clinical-level obsessive-compulsive symptoms (OCS) also have a larger thalamus. Thus, using a longitudinal design, we studied the relationship among thalamic volume, cortical maturation, and the course of OCS.

Method

Children from the population-based Generation R Study underwent 1 or 2 (N = 2,552) magnetic resonance imaging (MRI) scans between the age of 9 and 16 years (baseline 9-12 years, follow-up 13-16 years). OCS were assessed with the Short Obsessive-Compulsive Disorder Screener (SOCS) questionnaire using both continuous and clinical cut-off measures to identify children with “probable OCD.” We applied linear regression models to investigate the cross-sectional relationship between brain morphology and OCS at age 13 to 16 years. Linear mixed-effect models were fitted to model the bidirectional longitudinal relationship between thalamus and OCS and the thalamus and cortical morphology.

Results

Thalamic volume was not different between probable OCD cases and controls at age 13 to 16 years. Higher baseline thalamic volume predicted a relative persistence of OCS and a flatter slope of thinning in 12 cortical regions.

Conclusion

Larger thalamic volume may be a subtle biomarker for persistent OCS symptoms. The persistence of OCS and cortical thickness in relation to earlier larger thalamic volume may reflect being at an earlier stage in neurodevelopment. Longitudinal designs with repeated multimodal brain imaging are warranted to improve our understanding of the neurodevelopmental processes underlying OCS and OCD.

Plain language summary

In this study utilizing Generation R data, 2,552 children from the general population underwent brain scans and assessment of obsessive-compulsive symptoms on 2 occasions between the ages of 10 and 16 years. The brain scans were used to measure the size and shape of various brain regions, including the thalamus and cortical morphology. Although there were no case-control differences, larger baseline thalamic volume predicted persistence of obsessive compulsive symptoms and a flatter slope of thinning of 12 cortical regions. These findings suggest that brain anatomy, and the thalamus in particular, may be a subtle biomarker for persistent symptoms that occur in obsessive-compulsive disorder.

Study preregistration information

Relationship between obsessive-compulsive symptoms and brain morphology in school-aged children in the general population; https://osf.io/; y6vs2.

目的对患有强迫症（OCD）的儿童进行的横断面研究发现，他们的丘脑体积较大，但在较高年龄段却没有发现这种现象。我们以前曾发现，9 至 12 岁具有临床水平强迫症状（OCS）的普通儿童丘脑体积也较大。因此，我们采用纵向设计，研究了丘脑体积、皮质成熟度和强迫症病程之间的关系。方法：基于人群的R世代研究（Generation R Study）中的儿童在9至16岁期间（基线9至12岁，随访13至16岁）接受了1次或2次（N = 2,552）磁共振成像（MRI）扫描。强迫症通过简短强迫症筛查（SOCS）问卷进行评估，采用连续性和临床临界值来识别 "可能患有强迫症 "的儿童。我们采用线性回归模型来研究 13 至 16 岁时大脑形态与 OCS 之间的横截面关系。我们还采用线性混合效应模型来模拟丘脑与 OCS 之间的双向纵向关系，以及丘脑与大脑皮层形态之间的双向纵向关系。结论丘脑体积较大可能是持续性 OCS 症状的一个微妙生物标志。丘脑体积增大可能是持续性 OCS 症状的微妙生物标志物。OCS 症状的持续性和皮质厚度与丘脑体积增大的关系可能反映了患者处于神经发育的早期阶段。这项研究利用 R 世代数据，对 2552 名来自普通人群的儿童进行了脑部扫描，并对他们在 10 到 16 岁期间的强迫症状进行了两次评估。脑部扫描用于测量不同脑区的大小和形状，包括丘脑和皮层形态。虽然没有病例对照差异，但丘脑基线体积越大，预示强迫症状越持久，12 个皮质区域变薄的斜率越平坦。这些研究结果表明，大脑解剖学，尤其是丘脑，可能是强迫症持续症状的一个微妙的生物标志物。研究登记前信息：普通人群中学龄儿童的强迫症症状与大脑形态之间的关系；https://osf.io/; y6vs2。
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引用次数: 0
Risk of Newly Diagnosed Psychotic Symptoms in Youth Receiving Medications for Attention-Deficit/Hyperactivity Disorder 接受注意力缺陷/多动症药物治疗的青少年新诊断出精神病症状的风险
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2024.01.003
Rana Elmaghraby MD , Andrew Pines MD, MA , Jennifer R. Geske MS , Brandon J. Coombes PhD , Jonathan G. Leung PharmD , Paul E. Croarkin DO, MS , Matej Markota MD , William V. Bobo MD, MPH

Objective

Epidemiological studies suggest that patients with attention-deficit/hyperactivity disorder (ADHD) treated with amphetamines have an increased risk of newly diagnosed psychosis. This risk in youth is poorly understood. This investigation studied the potential risk of newly diagnosed psychotic symptoms associated with exposure to 4 classes of ADHD medications.

Method

This retrospective study used a medical records–linkage system from a cohort of youth (age 6-18 years) with diagnosed ADHD who were prescribed amphetamines, methylphenidate, atomoxetine, or α-2 agonists. Cohort members with any diagnosis of psychosis before their first ADHD medication were excluded. The primary outcome was newly diagnosed psychotic symptoms. The risk for psychotic symptoms for each medication (vs the remaining medication classes combined) was estimated using a multivariable time-varying covariate Cox proportional hazard regression model that adjusted for sex and age at ADHD diagnosis.

Results

Of 5,171 youth (68.6% male), 134 (2.6 %) had newly diagnosed psychotic symptoms. Exposure to amphetamine (vs amphetamine nonexposure, hazard ratio 1.41, 95% CI 1.15-2.26) and atomoxetine (vs atomoxetine nonexposure, hazard ratio 2.01, 95% CI 1.38-2.92) was associated with increased risk of newly diagnosed psychotic symptoms. Secondary analysis showed that the frequency of newly diagnosed psychotic symptoms was higher with atomoxetine/stimulant lifetime combination therapy (12.5% with amphetamines, 7.7% with methylphenidate) than atomoxetine monotherapy (1.2%).

Conclusion

Risk of newly diagnosed psychotic symptoms was low. These results suggest that cumulative exposure to amphetamines or atomoxetine/stimulant lifetime combination therapy may be associated with an increased risk of newly diagnosed psychotic symptoms in youth with ADHD.

Plain language summary

This retrospective study, using the Rochester Epidemiology Project, looked at the risk of developing newly diagnosed psychotic symptoms in youth (n = 5,171 between 6- to 18-years-old) with attention-deficit/hyperactivity disorder (ADHD) treated with 4 different classes of US FDA approved medications. The authors found that the overall absolute risk of psychosis was low. The risk of newly diagnosed psychotic symptoms was higher in youth treated with amphetamines and atomoxetine. In addition, this risk was observed when atomoxetine was combined with methylphenidate, amphetamine, or both. Authors suggest that this association may be related to attentional difficulties presenting as a prodromal symptom of psychosis or related to polypharmacy in youth with treatment-resistant ADHD.

Diversity & Inclusion Statement

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepare

目的流行病学研究表明，接受苯丙胺类药物治疗的注意力缺陷/多动障碍（ADHD）患者新诊断出精神病的风险增加。人们对青少年的这一风险知之甚少。本调查研究了与接触 4 类 ADHD 药物有关的新诊断出精神病症状的潜在风险。方法这项回顾性研究使用了一个医疗记录链接系统，该系统来自一组确诊为 ADHD 的青少年（6-18 岁），他们被处方安非他明、哌醋甲酯、阿托西汀或 α-2 激动剂。在首次服用ADHD药物之前被诊断出患有精神病的组群成员不包括在内。主要结果是新诊断出的精神病症状。使用多变量时变协变量考克斯比例危险回归模型估算了每种药物（与其余药物类别相比较）导致精神病症状的风险，该模型对诊断为ADHD时的性别和年龄进行了调整。接触苯丙胺（与未接触苯丙胺相比，危险比为1.41，95% CI为1.15-2.26）和阿托西汀（与未接触阿托西汀相比，危险比为2.01，95% CI为1.38-2.92）与新诊断出精神病性症状的风险增加有关。二次分析表明，与阿托西汀单一疗法（1.2%）相比，阿托西汀/兴奋剂终生联合疗法（苯丙胺类药物为 12.5%，哌醋甲酯为 7.7%）新诊断出精神病性症状的频率更高。这些结果表明，累计暴露于苯丙胺类药物或阿托西汀/兴奋剂终生联合疗法可能与患有注意力缺陷/多动障碍（ADHD）的青少年新诊断出精神病性症状的风险增加有关。作者发现，精神病的总体绝对风险较低。接受苯丙胺和阿托西汀治疗的青少年新诊断出精神病症状的风险较高。此外，当阿托西汀与哌醋甲酯、苯丙胺或两者合用时，也会出现这种风险。作者认为，这种关联可能与作为精神病前驱症状出现的注意力障碍有关，或者与患有难治性多动症的青少年使用多种药物有关。我们努力确保以包容的方式准备研究问卷。在招募人类参与者时，我们努力确保性别平衡。本论文的一位或多位作者自认为是一个或多个历史上在科学领域代表性不足的种族和/或民族群体的成员。本文的一位或多位作者获得了旨在提高科学领域少数群体代表性的计划的支持。我们积极致力于促进作者群体的性别平衡。在我们的作者群中，我们积极致力于促进科学领域中历来代表性不足的种族和/或民族群体的融入。在引用与本项工作科学相关的参考文献时，我们还积极努力在参考文献列表中促进性别和性 别平衡。在引用与本研究相关的科学参考文献的同时，我们还积极致力于促进在参考文献列表中纳入在科学领域中历来代表性不足的种族和/或民族群体。本论文的作者名单包括来自研究所在地和/或社区的参与数据收集、设计、分析和/或解释工作的人员。
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引用次数: 0
Independent Contributions of Callous-Unemotional Behaviors and Quantitative Autistic Traits to Aggression in Early Childhood 冷酷无情的情绪化行为和自闭症定量特征对幼儿期攻击行为的独立影响
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2023.12.005
Kristen Lineback BS , Holly C. Baer BA Candidate , Yi Zhang MS , David Hartenbach BA Candidate , W. Roger Mills-Koonce PhD , Michael T. Willoughby PhD , Anne L. Glowinski MD, MPE , John N. Constantino MD , Natasha Marrus MD, PhD

Objective

Callous-unemotional (CU) behaviors and quantitative autistic traits (QATs), heritable domains implicated in social development, are both associated with reduced prosocial behavior and increased aggression at their clinical extremes. However, they are hypothesized to contribute to aggression through separate mechanisms. This study tested whether CU behaviors and QATs exhibited distinct profiles of heritable influences as well as independent contributions to early childhood aggression in a general population sample with enhanced sensitivity to clarify these relationships.

Method

Parents of 3- to 4-year-old epidemiologically representative twins ascertained from birth records (N = 113 pairs) completed questionnaires measuring CU behaviors, QATs, and aggression. Correlation coefficients indexed overlap across behaviors. Intraclass correlations were compared between monozygotic and dizygotic twins to characterize relative genetic and environmental influences. Generalized estimating equations tested contributions of CU subdomains, verified via factor analysis, and QATs to aggression.

Results

Total CU scores strongly correlated with QATs (r = 0.54) and aggression (r = 0.55), while QATs correlated moderately with aggression (r = 0.38). Among 3 identified CU factors, the uncaring factor strongly correlated with QATs (r = 0.52), while unemotional and callous factors showed small correlations (r = 0.25 and r = 0.16, respectively). QATs, aggression, and all CU factors except the callous factor showed heritable influences. Uncaring and callous factors as well as QATs demonstrated unique and shared contributions to aggression, with the callous factor being moderated by sex.

Conclusion

Partially overlapping relations support distinct mechanisms whereby CU behaviors, in particular the callous factor, and QATs contribute to early aggression. In-depth social developmental assessment may enhance personalized intervention for aggression in early childhood.

Plain language summary

In this cross-sectional dimensional approach, authors evaluated the extent to which callous unemotional behaviors and quantitative autistic traits showed independent contributions to aggression at age 3 to 4 years based on heritable and environmental influences that set the stage for future outcomes. In 224 preschool-aged twins, callous-unemotional behaviors and quantitative autistic traits were independently associated with reduced prosocial behavior and increased aggression, accounting for almost 30% of the variance in aggression and evidence of some shared genetic influences. Callous-unemotional behaviors accounted for a greater unique contribution to variation in aggression than autistic traits. Callous behavior is also strongly influenced by environmental factors and showed a stronger relationship with aggress

目的自闭症行为（CU）和定量自闭症特质（QAT）是与社会发展有关的遗传领域，在临床极端情况下，它们都与亲社会行为减少和攻击行为增加有关。然而，根据假设，它们是通过不同的机制导致攻击行为的。本研究测试了在普通人群样本中，CU 行为和 QATs 是否表现出不同的遗传影响特征，以及对儿童早期攻击行为的独立贡献，并提高了阐明这些关系的敏感性。方法：根据出生记录确定的具有流行病学代表性的 3-4 岁双胞胎（N = 113 对）的父母填写了测量 CU 行为、QATs 和攻击行为的问卷。相关系数反映了不同行为之间的重叠。比较了单卵双胞胎和异卵双胞胎的类内相关性，以确定遗传和环境的相对影响。结果CU总分与QATs（r = 0.54）和攻击性（r = 0.55）密切相关，而QATs与攻击性（r = 0.38）适度相关。在 3 个已确定的 CU 因子中，无爱心因子与 QATs 有很强的相关性（r = 0.52），而无情感因子和冷酷因子的相关性较小（r = 0.25 和 r = 0.16）。除冷酷无情因子外，QAT、攻击性和所有 CU 因子都有遗传影响。结论部分重叠的关系支持不同的机制，即CU行为（尤其是冷酷无情因子）和QAT对早期攻击行为起作用。在这项横断面维度研究中，作者根据为未来结果奠定基础的遗传和环境影响因素，评估了冷酷无情的非情感行为和定量自闭症特质在多大程度上对 3-4 岁儿童的攻击行为有独立影响。在 224 对学龄前双胞胎中，冷酷无情的非情感行为和定量自闭症特征与亲社会行为减少和攻击行为增加独立相关，占攻击行为变异的近 30%，并证明存在一些共同的遗传影响。与自闭症特征相比，胼胝-非情感行为对攻击性变异的独特贡献更大。冷酷行为还受到环境因素的强烈影响，并且在男孩身上比在女孩身上表现出更强的攻击性关系。这些结果表明，在幼儿期，自闭症的定量特征和冷酷无情的非情感行为可能代表了不同的攻击行为途径。在选择非人类受试者时，我们努力确保性别平衡。本文的一位或多位作者自认为是一个或多个历史上在科学领域代表性不足的种族和/或民族群体的成员。
{"title":"Independent Contributions of Callous-Unemotional Behaviors and Quantitative Autistic Traits to Aggression in Early Childhood","authors":"Kristen Lineback BS ,&nbsp;Holly C. Baer BA Candidate ,&nbsp;Yi Zhang MS ,&nbsp;David Hartenbach BA Candidate ,&nbsp;W. Roger Mills-Koonce PhD ,&nbsp;Michael T. Willoughby PhD ,&nbsp;Anne L. Glowinski MD, MPE ,&nbsp;John N. Constantino MD ,&nbsp;Natasha Marrus MD, PhD","doi":"10.1016/j.jaacop.2023.12.005","DOIUrl":"10.1016/j.jaacop.2023.12.005","url":null,"abstract":"<div><h3>Objective</h3><p>Callous-unemotional (CU) behaviors and quantitative autistic traits (QATs), heritable domains implicated in social development, are both associated with reduced prosocial behavior and increased aggression at their clinical extremes. However, they are hypothesized to contribute to aggression through separate mechanisms. This study tested whether CU behaviors and QATs exhibited distinct profiles of heritable influences as well as independent contributions to early childhood aggression in a general population sample with enhanced sensitivity to clarify these relationships.</p></div><div><h3>Method</h3><p>Parents of 3- to 4-year-old epidemiologically representative twins ascertained from birth records (N = 113 pairs) completed questionnaires measuring CU behaviors, QATs, and aggression. Correlation coefficients indexed overlap across behaviors. Intraclass correlations were compared between monozygotic and dizygotic twins to characterize relative genetic and environmental influences. Generalized estimating equations tested contributions of CU subdomains, verified via factor analysis, and QATs to aggression.</p></div><div><h3>Results</h3><p>Total CU scores strongly correlated with QATs (<em>r</em> = 0.54) and aggression (<em>r</em> = 0.55), while QATs correlated moderately with aggression (<em>r</em> = 0.38). Among 3 identified CU factors, the uncaring factor strongly correlated with QATs (<em>r</em> = 0.52), while unemotional and callous factors showed small correlations (<em>r</em> = 0.25 and <em>r</em> = 0.16, respectively). QATs, aggression, and all CU factors except the callous factor showed heritable influences. Uncaring and callous factors as well as QATs demonstrated unique and shared contributions to aggression, with the callous factor being moderated by sex.</p></div><div><h3>Conclusion</h3><p>Partially overlapping relations support distinct mechanisms whereby CU behaviors, in particular the callous factor, and QATs contribute to early aggression. In-depth social developmental assessment may enhance personalized intervention for aggression in early childhood.</p></div><div><h3>Plain language summary</h3><p>In this cross-sectional dimensional approach, authors evaluated the extent to which callous unemotional behaviors and quantitative autistic traits showed independent contributions to aggression at age 3 to 4 years based on heritable and environmental influences that set the stage for future outcomes. In 224 preschool-aged twins, callous-unemotional behaviors and quantitative autistic traits were independently associated with reduced prosocial behavior and increased aggression, accounting for almost 30% of the variance in aggression and evidence of some shared genetic influences. Callous-unemotional behaviors accounted for a greater unique contribution to variation in aggression than autistic traits. Callous behavior is also strongly influenced by environmental factors and showed a stronger relationship with aggress","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"2 2","pages":"Pages 100-111"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949732923000674/pdfft?md5=ee50f41e088faa5f55b9e7fc183b6cfd&pid=1-s2.0-S2949732923000674-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social Learning and Preferences in Adolescents With Conduct Problems and Varying Levels of Callous-Unemotional Traits 行为问题青少年的社交学习和偏好以及不同程度的冷酷-不情感特质
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2023.12.008
Anne Gaule PhD , Leonardo Bevilacqua PhD , Lucas Molleman PhD , Wouter van den Bos PhD , Anna C. van Duijvenvoorde PhD , Ruth Roberts PhD , Christopher R. Pease PhD , Eamon McCrory DClinPsy, PhD , Essi Viding PhD

Objective

Learning to successfully navigate the social world, in particular when to trust others and how to work together with them, is crucial to well-adjusted social development. This is especially the case during adolescence, when individuals are undergoing significant biological and social changes. Adolescents with conduct problems (CP) tend to have difficulties in social relationships and to display aggressive behaviors as well as reduced cooperation with others. This pattern appears to be particularly pronounced in adolescents with CP and high callous-unemotional traits (CP/HCU). However, very little is currently known about the mechanisms that might drive reduced cooperative behaviors in adolescent CP, and whether these differ for individuals with high vs low levels of CU traits.

Method

We used a series of economic games to assess how adolescents with CP/HCU (n = 46), CP, and lower levels of CU traits (CP/LCU) (n = 46), and typically developing adolescents (TD) (n = 59) interacted with social (human) and non-social (computer) partners that varied in their degree of cooperation (trustworthy vs untrustworthy and friendly vs unfriendly), and whether this related to group differences in social preferences (aversion to inequality) and prior beliefs.

Results

Adolescents with CP (both HCU and LCU) had more difficulty than TD adolescents in differentiating between trustworthy and untrustworthy social environments in our task. Adolescents with CP/LCU also had more difficulty coordinating with friendly and unfriendly social partners to produce rewarding outcomes than TD adolescents. Surprisingly, we saw no relationship between participants’ inequality aversion or prior beliefs and social learning in our games.

Conclusion

These findings indicate that, under controlled experimental conditions, adolescents with CP have more difficulty learning to differentiate between social environments that vary in cooperation, particularly adolescents with CP/LCU. These findings were not explained by inequality aversion or prior beliefs. Our findings also raise important questions regarding methods used to understand the mechanisms underlying social behaviors in adolescents with CP.

Plain language summary

In this interesting study of 151 boys between the ages of 11 and 16 years, authors used economic games to investigate how adolescents with conduct problems learn to cooperate with social (human) and nonsocial (computer) partners under various social environments. The authors found that, relative to peers without any conduct problems, adolescents with conduct problems had difficulty gauging trustworthiness in social environments and coordinating with social partners to achieve rewarding outcomes. These findings were not explained by social preferences or prior beliefs. Adolescents with conduct problems and conduct problems with low callous unemotional

目标学会成功地在社会世界中游刃有余，尤其是学会何时信任他人以及如何与他人合作，这对适应良好的社会发展至关重要。尤其是在青春期，个体正经历着重大的生理和社会变化。有行为问题（CP）的青少年往往在社会关系中遇到困难，表现出攻击性行为，并减少与他人的合作。这种模式似乎在具有行为问题和高冷漠-不情感特征（CP/HCU）的青少年中尤为明显。然而，目前人们对可能导致青少年CP合作行为减少的机制，以及高CU特质和低CU特质个体的合作行为是否存在差异知之甚少。方法我们使用一系列经济游戏来评估患有慢性阻塞性肺病/慢性阻塞性肺病（CP/HCU）的青少年（n = 46）、患有慢性阻塞性肺病且CU特质水平较低（CP/LCU）的青少年（n = 46）和发育正常的青少年（TD）（n = 59）如何与合作程度不同（值得信赖与不值得信赖、友好与不友好）的社会（人类）和非社会（计算机）伙伴进行互动，以及这是否与社会偏好（厌恶不平等）和先前信念的群体差异有关。结果在我们的任务中，CP 青少年（包括 HCU 和 LCU）比 TD 青少年更难区分值得信任和不值得信任的社会环境。与TD青少年相比，患有CP/LCU的青少年也更难与友好和不友好的社会伙伴协调，以产生有益的结果。令人惊讶的是，在我们的游戏中，我们没有发现参与者的不平等厌恶或先前信念与社会学习之间有任何关系。结论这些研究结果表明，在受控实验条件下，患有先天性脑瘫的青少年，尤其是患有先天性脑瘫/后天性脑瘫的青少年，更难学会区分合作程度不同的社会环境。这些发现无法用不平等厌恶或先验信念来解释。在这项针对 151 名 11 至 16 岁男孩的有趣研究中，作者利用经济游戏研究了有行为问题的青少年如何在各种社会环境下学习与社会（人类）和非社会（计算机）伙伴合作。作者发现，与没有任何行为问题的同龄人相比，有行为问题的青少年很难衡量社会环境中的可信度，也很难与社会伙伴协调以获得回报。这些发现无法用社会偏好或先前的信念来解释。有品行问题的青少年和有品行问题且冷酷无情的青少年可能更难判断谁是值得信赖的人，谁是友好的人，这可能导致他们依赖攻击行为来应对这些困难。
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引用次数: 0
Reactive, Proactive, Relational, and Slow Dissipation of Aggression in Children 儿童攻击行为的反应性、主动性、关系性和缓慢消散性
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2023.12.007
Daniel A. Waschbusch PhD , Susan D. Mayes PhD , James G. Waxmonsky MD , Dara E. Babinski PhD , Raman Baweja MD, MS

Objective

This study investigated the associations between aggression subtypes (reactive, proactive, relational, and slow dissipation of aggression), callous-unemotional traits (CU), irritability (IRR), and sex among children.

Method

The sample included 508 children 5 to 12 years of age, rated by their mothers.

Results

A 4-factor model of aggression subtypes (reactive, proactive, relational, slow dissipation) provided a good fit to the data. Correlations between aggression subtypes and demographic variables were generally nonsignificant, except for a unique association between relational aggression and sex, with girls exhibiting higher scores, and proactive aggression was associated with younger age. Both CU and IRR correlated positively with all types of aggression. Slow dissipation of aggression showed a unique association with IRR, whereas reactive aggression was uniquely associated with both CU and IRR. Regressions showed an interaction between CU, IRR, and sex for slow dissipation and relational aggression. Interactions showed that boys with high levels of both CU and IRR demonstrated slower dissipation of aggression, indicating a tendency to hold grudges, and that sex differences in relational aggression depended on the co-occurrence of CU and IRR.

Conclusion

This study sheds light on the interplay among aggression subtypes, CU, IRR, and sex in children. Findings emphasize the need for psychiatrists and other mental health professionals to consider the multifaceted nature of aggressive behavior and the role of CU and IRR when assessing aggressive children or developing treatment plans for them. Further research is warranted to examine these relationships longitudinally and across diverse populations.

Plain language summary

In this study of 508 children between age 5 to 12, maternal ratings were used to distinguish 4 different types of aggression in their children: reactive (like hitting back when teased), proactive (starting fights), relational (spreading rumors), and slow to cool down (holding grudges). Girls were found to be more relational aggressors, and proactive aggression was more common in younger children. Results also showed that children with certain emotional traits (callous and irritable) were more likely to show all types of aggression, and boys who were both callous and irritable held onto their anger. All 4 types of aggression were associated with externalizing disorders: attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder.

Clinical guidance

  • •

    Recognize the different types of aggression: Look beyond angry outbursts and consider reactive, proactive, relational, and slow dissipation of aggression to target intervention.

  • •

    Emotional traits matter: Assess for callous-unemotiona

结果 攻击亚型的 4 因子模型（反应型、主动型、关系型和缓慢消散型）与数据拟合良好。攻击行为亚型与人口统计学变量之间的相关性一般不显著，但关系型攻击行为与性别之间存在独特的关联，即女孩得分更高，而主动型攻击行为则与年龄较小有关。CU和IRR与所有攻击类型都呈正相关。缓慢消散的攻击行为与 IRR 有独特的关联，而反应性攻击行为与 CU 和 IRR 都有独特的关联。回归结果显示，CU、IRR 和性别之间对慢速消散和关系攻击存在交互作用。交互作用显示，CU 和 IRR 水平均较高的男孩的攻击性消散较慢，这表明他们有记仇的倾向，而关系攻击的性别差异取决于 CU 和 IRR 的共同出现。研究结果强调，精神科医生和其他心理健康专业人员在评估攻击性儿童或为其制定治疗计划时，需要考虑攻击行为的多面性以及 CU 和 IRR 的作用。在这项针对 508 名 5 至 12 岁儿童的研究中，母亲的评分被用来区分孩子的四种不同类型的攻击行为：反应性攻击行为（如被取笑时还手）、主动性攻击行为（挑起争斗）、关系性攻击行为（散布谣言）和迟缓性攻击行为（记仇）。结果发现，女孩更喜欢关系攻击，而主动攻击在年龄较小的儿童中更为常见。结果还显示，具有某些情绪特征（冷酷无情和易怒）的儿童更有可能表现出各种类型的攻击行为，而既冷酷无情又易怒的男孩则会将怒火憋在心里。所有四种类型的攻击行为都与外化障碍有关：注意力缺陷/多动障碍、对立违抗障碍和行为障碍：临床指导--认识不同类型的攻击行为：除了愤怒爆发外，还要考虑攻击行为的反应性、主动性、关系性和缓慢消散性，以便有针对性地进行干预：情绪特征很重要：在评估攻击行为的同时，也要评估冷酷无情的情绪特征和易怒性。两者的高水平，尤其是男孩，可能表明他们更难控制愤怒和记仇：女孩可能比男孩更容易产生关系攻击行为。相应地调整干预措施。
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引用次数: 0
Early Childhood Aggression in Autistic and Non-Autistic Preschoolers: Prevalence, Topography, and Relationship to Emotional Reactivity 自闭症和非自闭症学龄前儿童的早期攻击行为：自闭症和非自闭症学龄前儿童的早期攻击行为：发生率、特征以及与情绪反应的关系
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2023.12.003
Shalini Sivathasan PhD , Safaa Eldeeb PhD , Jessie B. Northrup PhD , Ligia Antezana PhD , Amy Ionadi PhD , Lauren S. Wakschlag PhD , Carla A. Mazefsky PhD

Objective

Despite heightened rates of aggressive behaviors among older autistic youth relative to non-autistic peers, less is known about these behaviors during early childhood. This study included 3 objectives to address this gap: (1) to establish the prevalence and topography (frequency, severity, type, context) of aggressive behaviors in a large sample of preschool-aged children using a developmentally sensitive parent-report measure; (2) to identify clinical correlates of aggression; and (3) to investigate whether different subgroups of autistic children can be identified based on their profiles of aggression, emotional reactivity, and autism traits.

Method

Data were analyzed from parents of 1,199 children 2 to 5 years of age (n = 622 autistic children) who completed the Multidimensional Assessment Profiles Scales (MAPS) aggression subscale and the Emotion Dysregulation Inventory–Young Child (EDI-YC) reactivity subscale.

Results

Autistic preschoolers had 2 to 6 times higher odds of experiencing frequent aggression (more days than not) compared with non-autistic preschoolers. Hierarchical multiple regression analyses revealed that autism diagnosis, traits, and suspected and diagnosed attention-deficit/hyperactivity disorder (ADHD) were positively associated with aggression; however, heightened emotional reactivity explained the greatest degree of added variance in aggression total scores. Machine learning clustering techniques revealed 3 distinct subgroups of autistic preschoolers, with cluster membership driven primarily by aggression and reactivity scores, and less so by autism traits.

Conclusion

Autistic preschoolers display more frequent parent-reported aggressive behaviors, and emotional reactivity may play an important role in aggressive behavior presentation. Future developmental screening and early intervention tailoring for aggression may benefit from assessing reactivity early in development.

Plain language summary

In this study of 1,199 children aged 2 to 5 years of age (n = 622 autistic children), parents completed validated questionnaires quantifying disruptive behaviors and emotion dysregulation to evaluate prevalence and topography of aggressive behaviors, identifying clinical correlates of aggression, and determining distinct subgroups of children with autism based on patterns of aggression, reactivity, and autism traits. The authors found that preschoolers with autism had higher rates of frequent aggressive behaviors compared to non-autistic children. Although more aggression was associated with having an autism diagnosis, greater levels of autism traits, and attention-deficit/hyperactivity disorder, high levels of aggression were most strongly associated with heightened emotional reactivity. Subgroups of preschoolers with autism emerged principally on their aggression and emotional reactivity scores, rather than

目标尽管与非自闭症同龄人相比，大龄自闭症青少年的攻击性行为发生率更高，但人们对幼儿期的这些行为却知之甚少。为了弥补这一不足，本研究提出了三个目标：（1）使用对发育敏感的家长报告测量方法，确定大样本学龄前儿童攻击行为的发生率和地形（频率、严重程度、类型、背景）；（2）确定攻击行为的临床相关性；（3）研究是否可以根据攻击行为、情绪反应性和自闭症特征的特征识别出不同的自闭症儿童亚群。方法对 1,199 名 2 至 5 岁儿童（n = 622 名自闭症儿童）的家长提供的数据进行分析，这些家长填写了多维评估档案量表（MAPS）攻击性分量表和情绪失调清单-幼儿（EDI-YC）反应性分量表。结果与非自闭症学龄前儿童相比，自闭症学龄前儿童经常发生攻击行为（比不发生攻击行为的天数多）的几率要高出 2 至 6 倍。层次多元回归分析表明，自闭症诊断、特质以及疑似和确诊的注意力缺陷/多动障碍（ADHD）与攻击行为呈正相关；然而，情绪反应性的增强在最大程度上解释了攻击行为总分的新增差异。机器学习聚类技术揭示了自闭症学龄前儿童的 3 个不同亚组，聚类成员主要由攻击性和反应性得分驱动，而自闭症特质驱动较少。在这项针对 1,199 名 2 至 5 岁儿童（n = 622 名自闭症儿童）的研究中，家长填写了量化破坏性行为和情绪失调的有效问卷，以评估攻击行为的发生率和地形，确定攻击行为的临床相关性，并根据攻击行为、反应性和自闭症特质的模式确定不同的自闭症儿童亚组。作者发现，与非自闭症儿童相比，学龄前自闭症儿童频繁出现攻击行为的比例更高。虽然更多的攻击行为与自闭症诊断、更多的自闭症特征和注意力缺陷/多动障碍有关，但高水平的攻击行为与情绪反应性的增强关系最为密切。自闭症学龄前儿童亚群的形成主要取决于他们的攻击性和情绪反应得分，而不是他们的自闭症特征水平。本文的一位或多位作者自认为是一个或多个历史上在科学领域代表性不足的性和/或性别群体的成员。本文的一位或多位作者自我认定为残疾人。本论文的作者名单包括来自研究所在地和/或社区的参与数据收集、设计、分析和/或解释工作的人员。
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引用次数: 0
Prospective Follow-Up of Adolescents With and at Risk for Depression: Protocol and Methods of the Identifying Depression Early in Adolescence Risk Stratified Cohort Longitudinal Assessments 对患有抑郁症和有抑郁症风险的青少年进行前瞻性随访：青少年早期抑郁风险分层队列（IDEA-RiSCo）纵向评估的方案和方法
JAACAP open
Pub Date : 2024-06-01 DOI: 10.1016/j.jaacop.2023.11.002
Jader Piccin MD , Anna Viduani MSc , Claudia Buchweitz MA , Rivka B. Pereira BA , Aline Zimerman BA , Guilherme R. Amando MSc , Victor Cosenza BS , Leonardo Z. Ferreira PhD , Natália A.G. McMahon HSD , Ramásio F. Melo PhD , Danyella Richter BA , Frederico D.S. Reckziegel HSD , Fernanda Rohrsetzer MSc , Laila Souza MD , André C. Tonon MD, PhD , Marina Tuerlinckx Costa-Valle PhD , Zuzanna Zajkowska PhD , Ricardo Matsumura Araújo PhD , Tobias U. Hauser PhD , Alastair van Heerden PhD , Christian Kieling MD, PhD

Objective

To present the protocol and methods for the prospective longitudinal assessments—including clinical and digital phenotyping approaches—of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) study, which comprises Brazilian adolescents stratified at baseline by risk of developing depression or presence of depression.

Method

Of 7,720 screened adolescents aged 14 to 16 years, we recruited 150 participants (75 boys, 75 girls) based on a composite risk score: 50 with low risk for developing depression (LR), 50 with high risk for developing depression (HR), and 50 with an active untreated major depressive episode (MDD). Three annual follow-up assessments were conducted, involving clinical measures (parent- and adolescent-reported questionnaires and psychiatrist assessments), active and passive data sensing via smartphones, and neurobiological measures (neuroimaging and biological material samples). Retention rates were 96% (Wave 1), 94% (Wave 2), and 88% (Wave 3), with no significant differences by sex or group (p > .05). Participants highlighted their familiarity with the research team and assessment process as a motivator for sustained engagement.

Discussion

This protocol relied on novel aspects, such as the use of a WhatsApp bot, which is particularly pertinent for low- to-middle-income countries, and the collection of information from diverse sources in a longitudinal design, encompassing clinical data, self-reports, parental reports, Global Positioning System (GPS) data, and ecological momentary assessments. The study engaged adolescents over an extensive period and demonstrated the feasibility of conducting a prospective follow-up study with a risk-enriched cohort of adolescents in a middle-income country, integrating mobile technology with traditional methodologies to enhance longitudinal data collection.

Plain language summary

This article details the study protocol and methods used in the longitudinal assessment of 150 Brazilian teenagers with depression and at risk for depression as part of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo). Over 3 years, the authors collected clinical and digital data using innovative mobile technology, including a WhatsApp bot. Most adolescents participated in all the study phases, showing feasibility of prospective follow-up in a middle-income country. This approach allowed for a deeper understanding of depression in young populations, particularly in areas where mental health research is scarce.

目的介绍青少年早期抑郁风险分层队列（IDEA-RiSCo）研究的前瞻性纵向评估方案和方法，包括临床和数字表型方法。研究方法：在 7720 名接受筛查的 14-16 岁青少年中，我们根据综合风险评分招募了 150 名参与者（75 名男生和 75 名女生）：50 名抑郁症低风险患者（LR）、50 名抑郁症高风险患者（HR）和 50 名重度抑郁发作（MDD）患者。每年进行三次随访评估，包括临床测量（家长和青少年报告的问卷和精神科医生评估）、通过智能手机进行的主动和被动数据传感以及神经生物学测量（神经影像学和生物材料样本）。留存率分别为 96%（第 1 波）、94%（第 2 波）和 88%（第 3 波），性别或组别差异不大（p > .05）。参与者强调，他们对研究团队和评估过程的熟悉程度是促使他们持续参与的一个因素。讨论该方案依赖于一些新颖的方面，例如使用 WhatsApp 机器人（这对中低收入国家尤为重要），以及在纵向设计中从不同来源收集信息，包括临床数据、自我报告、父母报告、全球定位系统 (GPS) 数据和生态瞬间评估。本文详细介绍了对150名患有抑郁症和有抑郁症风险的巴西青少年进行纵向评估的研究方案和方法，这些青少年是 "青少年早期抑郁症风险分层队列"（IDEA-RiSCo）的一部分。在 3 年时间里，作者利用创新移动技术（包括 WhatsApp 机器人）收集了临床和数字数据。大多数青少年参与了所有研究阶段，这表明在中等收入国家进行前瞻性随访是可行的。这种方法有助于深入了解年轻人群中的抑郁症，尤其是在心理健康研究稀缺的地区。
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引用次数: 0
Parent/Guardian- and Self-Report Versions of the Irritability Domain of the Concise Associated Symptom Tracking Scale: Evaluation of Psychometric Properties and Potential Clinical Utility in the Texas Youth Depression and Suicide Research Network 简明相关症状追踪量表易激惹领域的家长/监护人和自我报告版本：德克萨斯州青少年抑郁与自杀研究网络对心理测量特性和潜在临床实用性的评估
JAACAP open
Pub Date : 2024-05-01 DOI: 10.1016/j.jaacop.2024.04.002
M. Jha, Abu T. Minhajuddin, Regina B. Baronia, Joseph C. Blader, T. Mayes, Michaella A. Petrosky, Holli M. Slater, Sarah M. Wakefield, Madhukar H. Trivedi
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引用次数: 0
Narrative Review: A Neurobiological Perspective on Resilience in Youth 叙事回顾：从神经生物学角度看青少年的复原力
JAACAP open
Pub Date : 2024-05-01 DOI: 10.1016/j.jaacop.2024.05.001
Kiran Khalid, Huma Baqir, Hanna E. Stevens
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引用次数: 0
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