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May 2015
See also CAMH
Volume
20
Issue
2
May 2017
Volume
58
Issue
5
Pages 634

Table of Contents

Title:
Editorial: Process to progress? Investigative trials, mechanism and clinical science
Article first published online:
22 Dec 2014
DOI:
10.1111/jcpp.12377
Abstract
In 2002 Helena Kraemer and colleagues published an important article on the analysis of clinical trials in mental health, which advocated a planned focus on mechanisms to investigate the processes behind treatment effects. Kraemer et al. considered not only new approaches to mediation analysis, but also a theoretical approach to factors, both pre-treatment and during treatment, that might moderate this mediation. Trials should not just be about whether a treatment ‘worked’, but how it worked; with the results informing modification of the intervention for the next trial by discarding aspects that were not effective and reinforcing aspects that were – an iterative procedure towards greater effectiveness. Can we enjoy similar ambitions for complex interventions within mental health? It is not so long ago when the received wisdom within the clinical and much of the research community was that it was simply impossible in practice to mount randomised controlled trials relevant to the kind of psychosocial interventions we use in child and adolescent mental health (CAMHS). How different the situation is now, with burgeoning interest in a systematic evidence base for psychological treatment and the possibilities for unexpected advances (as well as unexpected harms). Nevertheless it is probably still fair to say that the systematic use of process and mechanism study within trials in our field is the exception rather than the rule. What are the possibilities and implications for our field?
Title:
Editorial: Distinguishing between the challenges posed by surface and deep forms of heterogeneity to diagnostic systems: do we need a new approach to subtyping of child and adolescent psychiatric disorders.
Article first published online:
14 Dec 2015
DOI:
10.1111/jcpp.12506
Abstract
Diagnostic formulations attempt to impose order on the messy reality of psychopathological phenomena. By doing this, so their advocates argue, they provide both the platform necessary for systematic scientific study, and, crucially, the bridge of shared terms and concepts vital if psychiatric science is to be truly translational; where scientific endeavour is guided by clinical priorities and, in-turn, scientific findings innovate clinical practice. The diagnostic schemes we currently work with, taking DSM-5 as the obvious case, are the product of an interesting historical process of ongoing revision – at the same time pragmatic and scientific. On the one hand, it is a process both anchored firmly in historical precedent and constrained by the practical needs of clinicians, patients and health insurance companies. On the other hand, it is a process open to new empirical data about how to best cluster symptomatic expressions and differentiate clinical presentations – so that over historical time diagnostic categories achieve an increasingly accurate mapping of the taxonomy (i.e., underlying structure), and related pathophysiology, of psychiatric phenomenon. Resolving the inevitable tensions that arise when trying to reconcile these pragmatic (economic and professional) and scientific priorities has proved to be both challenging and contentious. The study of heterogeneity as exemplified by the articles highlighted in this editorial indicate a range of different approaches that can be effectively used to refine psychiatric taxonomies by incorporating developmental and pathophysiological data to help identify new putative subtypes of potential therapeutic significance.
Title:
Editorial: Science unskewed – acknowledging and reducing ‘risk of bias’ in parenting research
Article first published online:
16 Dec 2016
DOI:
10.1111/jcpp.12676
Abstract
There is a growing awareness that ‘risk of bias’ distorts the process of generating and interpreting evidence and threatens the validity of psychological and psychiatric research at a number of different levels (Rutter & Pickles, ). Such threats are likely to be greatest in fields of study focused on socially/politically contentious issues where beliefs and values are strongly held – especially where there is a lack of methodological rigour.
Title:
Editorial: Bridging gaps between basic research and clinical practice
Article first published online:
14 Dec 2013
DOI:
10.1111/jcpp.12192
Abstract
Over the past several decades, child psychology and psychiatry has witnessed an explosion in the volume of, and a decided quickening in the pace of, dissemination of research findings. On the one hand, this has led us to an enviable position.
Title:
Editorial: Integrating neurobiological, genetic, and environmental risk factors in cognitive and behavioral conditions
Article first published online:
17 Dec 2012
DOI:
10.1111/jcpp.12038
Title:
Commentary: Are alpha-2 agonist really effective in children with tics with comorbid ADHD? A commentary on Whittington et al. (2016)
Article first published online:
18 Aug 2016
DOI:
10.1111/jcpp.12592
Abstract
In this issue, Whittington et al. (2016) present a systematic review that reports the efficacy of three primary treatments for children with Tourette syndrome (TS) – (a) α2-adrenergic receptor agonists; (b) antipsychotic medications; and (c) habit reversal training/comprehensive behavioral intervention. In this commentary, we highlight the large degree of heterogeneity observed in the meta-analysis of trials involving alpha-2 agonist medications and present possible explanations for the observed heterogeneity. Among these possible explanations is the possibility that presence of comorbid ADHD may moderate the efficacy of alpha-2 agonists in the treatment of tic disorder with the medications being more effective in patients with both conditions. The commentary reviews the evidence supporting this possible moderating effect of ADHD and discusses the implications for such a relationship.
Title:
Executive functions in girls with and without childhood ADHD: developmental trajectories and associations with symptom change
Article first published online:
19 Apr 2013
DOI:
10.1111/jcpp.12074
Abstract
Background We prospectively followed an ethnically and socioeconomically diverse sample of girls with attention-deficit/hyperactivity disorder (ADHD) (n = 140) and a matched comparison sample (n = 88) from childhood through young adulthood to evaluate developmental trajectories of executive functions (EF) and associations between EF trajectories and dimensional measures of ADHD symptoms. We hypothesized that (a) EF trajectories would be similar in girls both with and without childhood ADHD, with the ADHD group showing greater impairment across time; and (b) changes in EF abilities would predict changes in ADHD symptoms across time, consistent with the theory that ADHD symptom reductions partially result from prefrontally mediated EF development. Method Latent growth curve models were used to evaluate development of sustained attention, response inhibition, working memory, and global EF abilities, and associations between EF trajectories and ADHD symptom trajectories. Results Girls with childhood-diagnosed ADHD showed greater improvement across development on measures of sustained attention and global EF, but similar rates of improvement on measures of working memory and response inhibition. Changes in the global EF measure predicted changes in both inattentive and hyperactive-impulsive symptoms across time, whereas changes in response inhibition predicted changes in hyperactive-impulsive symptoms; associations between changes in other EF variables and symptoms were not significant. Conclusions Findings suggest variability in patterns of EF improvement over time in females with ADHD histories and indicate that EF development may play a role in symptom change.
Title:
Contextual variation in young children's observed disruptive behavior on the DB-DOS: implications for early identification
Article first published online:
12 Jun 2015
DOI:
10.1111/jcpp.12430
Abstract
Background Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Methods Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment (PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale (FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Results Observed disruptive behavior on the DB-DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. Conclusions The DB-DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research.
Title:
Frequent daytime naps predict vocabulary growth in early childhood
Article first published online:
20 Jun 2016
DOI:
10.1111/jcpp.12583
Abstract
Background The facilitating role of sleep for language learning is well-attested in adults and to a lesser extent in infants and toddlers. However, the longitudinal relationship between sleep patterns and early vocabulary development is not well understood. Methods This study investigates how measures of sleep are related to the development of vocabulary size in infants and toddlers. Day and night-time sleeping patterns of infants and toddlers were compared with their concurrent and subsequent vocabulary development. Sleep assessments were conducted using a sleep diary specifically designed to facilitate accurate parental report. Sleep measures were used as predictors in a multilevel growth curve analysis of vocabulary development. Results The number of daytime naps was positively associated with both predicted expressive (p = .062) and receptive vocabulary growth (p = .006), whereas the length of night-time sleep was negatively associated with rate of predicted expressive vocabulary growth (p = .045). Sleep efficiency was also positively associated with both predicted receptive (p = .001) and expressive vocabulary growth (p = .068). Conclusions These results point to a longitudinal relationship between sleep and language development, with a particular emphasis on the importance of napping at this age.
Title:
Pupillary reactivity to emotional stimuli in children of depressed and anxious mothers
Article first published online:
17 Mar 2014
DOI:
10.1111/jcpp.12225
Abstract
Background The primary aim of this study was to examine differences in physiological reactivity (measured via pupillometry) to emotional stimuli between children of depressed versus nondepressed mothers. A second goal was to examine differences in pupil dilation to emotional stimuli between children of anxious versus nonanxious mothers. Method Participants included 117 mother–child pairs drawn from the community. Children were between the ages of 8 and 14. Pupil dilation was assessed using an eye-tracker while participants viewed angry, happy, or sad faces. Results Children of mothers with a history of major depression (MDD) exhibited increased pupil dilation to sad, but not happy or angry, faces compared with children of nondepressed mothers. Second, we found that children of anxious mothers exhibited increased pupil dilation to angry, but not happy or sad, faces compared to youth of nonanxious mothers. Conclusions The current findings add to the growing body of research suggesting that differences in physiological reactivity to depression- and anxiety-relevant cues may represent an important mechanism in the intergenerational transmission of MDD and anxiety.

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