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| Publications of adrian c. angold :chronological alphabetical combined listing:%% Journal Articles @article{fds344702, Author = {Copeland, WE and Worthman, C and Shanahan, L and Costello, EJ and Angold, A}, Title = {Early Pubertal Timing and Testosterone Associated With Higher Levels of Adolescent Depression in Girls.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {58}, Number = {12}, Pages = {1197-1206}, Year = {2019}, Month = {December}, url = {http://dx.doi.org/10.1016/j.jaac.2019.02.007}, Abstract = {OBJECTIVE: The prevalence of depression increases dramatically during puberty in girls. Earlier work in this sample reported that the sex steroids estradiol and testosterone were associated with increased depression in girls. Using three additional data waves (983 new observations), we retest the relative contributions of pubertal timing, pubertal status, and sex hormones on the increases in female depression. METHOD: Eight waves of data from the prospective, representative Great Smoky Mountains Study were used covering female participants in the community who were 9 to 16 years of age (3,005 assessments of 630 girls; 1993-2000). Structured interviews assessed depressive disorders. Youth rated their pubertal status using Tanner stage drawings, and sex steroids were assayed from dried blood spots. RESULTS: Risk for depression during puberty was associated with both age and Tanner stage in univariate models. In adjusted models accounting for pubertal timing and sex steroids, the apparent effects of age and Tanner stage were attenuated both in terms of statistical significance and effect size. The only significant predictors of change in depression status during puberty were early pubertal timing (odds ratio = 5.8, 95% CI = 1.9-17.9, p = .002 after age 12 years) and higher testosterone levels (odds ratio = 2.0, 95% CI = 1.1-3.8, p = .03 for quartile-split variable). CONCLUSION: The added observations have modified the original conclusions, implicating the following: testosterone only, but not estradiol; and early pubertal timing, but not age or pubertal status per se. These findings argue for multiple pubertal determinants of depression risk, including factors that are socially and biologically mediated.}, Doi = {10.1016/j.jaac.2019.02.007}, Key = {fds344702} } @article{fds322746, Author = {Costello, EJ and Copeland, W and Angold, A}, Title = {The Great Smoky Mountains Study: developmental epidemiology in the southeastern United States.}, Journal = {Soc Psychiatry Psychiatr Epidemiol}, Volume = {51}, Number = {5}, Pages = {639-646}, Year = {2016}, Month = {May}, url = {http://dx.doi.org/10.1007/s00127-015-1168-1}, Abstract = {AIMS: To describe the Great Smoky Mountains Study (GSMS). METHODS: GSMS is a longitudinal study of child psychiatric disorders that began in 1992 to look at need for mental health services in a rural area of the USA. Over 20 years it has expanded its range to include developmental epidemiology more generally, not only the development of psychiatric and substance abuse problems but also their correlates and predictors: family and environmental risk, physical development including puberty, stress and stress-related hormones, trauma, the impact of poverty, genetic markers, and epigenetics. Now that participants are in their 30s the focus has shifted to adult outcomes of childhood psychopathology and risk, and early physical, cognitive, and psychological markers of aging. RESULTS: This paper describes the results from over 11,000 interviews, examples of the study's contributions to science and policy, and plans for the future. CONCLUSIONS: Longitudinal studies can provide insights that aid in policy planning.}, Doi = {10.1007/s00127-015-1168-1}, Key = {fds322746} } @article{fds270273, Author = {Zucker, N and Copeland, W and Franz, L and Carpenter, K and Keeling, L and Angold, A and Egger, H}, Title = {Psychological and Psychosocial Impairment in Preschoolers With Selective Eating.}, Journal = {Pediatrics}, Volume = {136}, Number = {3}, Pages = {e582-e590}, Year = {2015}, Month = {September}, ISSN = {0031-4005}, url = {http://dx.doi.org/10.1542/peds.2014-2386}, Abstract = {OBJECTIVE: We examined the clinical significance of moderate and severe selective eating (SE). Two levels of SE were examined in relation to concurrent psychiatric symptoms and as a risk factor for the emergence of later psychiatric symptoms. Findings are intended to guide health care providers to recognize when SE is a problem worthy of intervention. METHODS: A population cohort sample of 917 children aged 24 to 71 months and designated caregivers were recruited via primary care practices at a major medical center in the Southeast as part of an epidemiologic study of preschool anxiety. Caregivers were administered structured diagnostic interviews (the Preschool Age Psychiatric Assessment) regarding the child's eating and related self-regulatory capacities, psychiatric symptoms, functioning, and home environment variables. A subset of 188 dyads were assessed a second time ∼24.7 months from the initial assessment. RESULTS: Both moderate and severe levels of SE were associated with psychopathological symptoms (anxiety, depression, attention-deficit/hyperactivity disorder) both concurrently and prospectively. However, the severity of psychopathological symptoms worsened as SE became more severe. Impairment in family functioning was reported at both levels of SE, as was sensory sensitivity in domains outside of food and the experience of food aversion. CONCLUSIONS: Findings suggest that health care providers should intervene at even moderate levels of SE. SE associated with impairment in function should now be diagnosed as avoidant/restrictive food intake disorder, an eating disorder that encapsulates maladaptive food restriction, which is new to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.}, Doi = {10.1542/peds.2014-2386}, Key = {fds270273} } @article{fds270275, Author = {Adkins, DE and Clark, SL and Copeland, WE and Kennedy, M and Conway, K and Angold, A and Maes, H and Liu, Y and Kumar, G and Erkanli, A and Patkar, AA and Silberg, J and Brown, TH and Fergusson, DM and Horwood, LJ and Eaves, L and van den Oord, EJCG and Sullivan, PF and Costello, EJ}, Title = {Genome-Wide Meta-Analysis of Longitudinal Alcohol Consumption Across Youth and Early Adulthood.}, Journal = {Twin Research and Human Genetics : the Official Journal of the International Society for Twin Studies}, Volume = {18}, Number = {4}, Pages = {335-347}, Year = {2015}, Month = {August}, ISSN = {1832-4274}, url = {http://dx.doi.org/10.1017/thg.2015.36}, Abstract = {The public health burden of alcohol is unevenly distributed across the life course, with levels of use, abuse, and dependence increasing across adolescence and peaking in early adulthood. Here, we leverage this temporal patterning to search for common genetic variants predicting developmental trajectories of alcohol consumption. Comparable psychiatric evaluations measuring alcohol consumption were collected in three longitudinal community samples (N=2,126, obs=12,166). Consumption-repeated measurements spanning adolescence and early adulthood were analyzed using linear mixed models, estimating individual consumption trajectories, which were then tested for association with Illumina 660W-Quad genotype data (866,099 SNPs after imputation and QC). Association results were combined across samples using standard meta-analysis methods. Four meta-analysis associations satisfied our pre-determined genome-wide significance criterion (FDR<0.1) and six others met our 'suggestive' criterion (FDR<0.2). Genome-wide significant associations were highly biological plausible, including associations within GABA transporter 1, SLC6A1 (solute carrier family 6, member 1), and exonic hits in LOC100129340 (mitofusin-1-like). Pathway analyses elaborated single marker results, indicating significant enriched associations to intuitive biological mechanisms, including neurotransmission, xenobiotic pharmacodynamics, and nuclear hormone receptors (NHR). These findings underscore the value of combining longitudinal behavioral data and genome-wide genotype information in order to study developmental patterns and improve statistical power in genomic studies.}, Doi = {10.1017/thg.2015.36}, Key = {fds270275} } @article{fds270276, Author = {Copeland, WE and Shanahan, L and Davis, M and Burns, BJ and Angold, A and Costello, EJ}, Title = {Increase in untreated cases of psychiatric disorders during the transition to adulthood.}, Journal = {Psychiatr Serv}, Volume = {66}, Number = {4}, Pages = {397-403}, Year = {2015}, Month = {April}, ISSN = {1075-2730}, url = {http://dx.doi.org/10.1176/appi.ps.201300541}, Abstract = {OBJECTIVE: During the transition to adulthood, youths face challenges that may limit their likelihood of obtaining services for psychiatric problems. The goal of this analysis was to estimate changes in rates of service use and untreated psychiatric disorders during the transition from adolescence to adulthood. METHODS: In a prospective, population-based study, participants were assessed up to four times in adolescence (ages 13-16; 3,983 observations of 1,297 participants, 1993-2000) and three times in young adulthood (ages 19, 21, and 24-26; 3,215 observations of 1,273 participants, 1999-2010). Structured diagnostic interviews were used to assess service need (participants meeting DSM-IV diagnostic criteria for a psychiatric disorder) and use of behavioral services in 21 service settings in the past three months. RESULTS: During young adulthood, 28.9% of cases of psychiatric disorders were associated with some treatment, compared with a rate of 50.9% for the same participants during adolescence. This decrease included a near-complete drop in use of educational and vocational services as well as declines in use of specialty behavioral services. Young adults most frequently accessed services in specialty behavioral or general medical settings. Males, African Americans, participants with substance dependence, and participants living independently were least likely to get treatment. For cases of psychiatric disorders among young adults, insurance and poverty status were unrelated to likelihood of service use. CONCLUSIONS: Young adults were much less likely to receive treatment for psychiatric problems than they were as adolescents. Public policy must address gaps in service use during the transition to adulthood.}, Doi = {10.1176/appi.ps.201300541}, Key = {fds270276} } @article{fds270274, Author = {Carpenter, KLH and Angold, A and Chen, N-K and Copeland, WE and Gaur, P and Pelphrey, K and Song, AW and Egger, HL}, Title = {Preschool anxiety disorders predict different patterns of amygdala-prefrontal connectivity at school-age.}, Journal = {Plos One}, Volume = {10}, Number = {1}, Pages = {e0116854}, Year = {2015}, url = {http://hdl.handle.net/10161/9486 Duke open access}, Abstract = {OBJECTIVE: In this prospective, longitudinal study of young children, we examined whether a history of preschool generalized anxiety, separation anxiety, and/or social phobia is associated with amygdala-prefrontal dysregulation at school-age. As an exploratory analysis, we investigated whether distinct anxiety disorders differ in the patterns of this amygdala-prefrontal dysregulation. METHODS: Participants were children taking part in a 5-year study of early childhood brain development and anxiety disorders. Preschool symptoms of generalized anxiety, separation anxiety, and social phobia were assessed with the Preschool Age Psychiatric Assessment (PAPA) in the first wave of the study when the children were between 2 and 5 years old. The PAPA was repeated at age 6. We conducted functional MRIs when the children were 5.5 to 9.5 year old to assess neural responses to viewing of angry and fearful faces. RESULTS: A history of preschool social phobia predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces. Preschool generalized anxiety predicted less functional connectivity between the amygdala and dorsal prefrontal cortices in response to fearful faces. Finally, a history of preschool separation anxiety predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces and greater school-age functional connectivity between the amygdala and dorsal prefrontal cortices to angry faces. CONCLUSIONS: Our results suggest that there are enduring neurobiological effects associated with a history of preschool anxiety, which occur over-and-above the effect of subsequent emotional symptoms. Our results also provide preliminary evidence for the neurobiological differentiation of specific preschool anxiety disorders.}, Doi = {10.1371/journal.pone.0116854}, Key = {fds270274} } @article{fds270272, Author = {Shanahan, L and Zucker, N and Copeland, WE and Costello, EJ and Angold, A}, Title = {Are children and adolescents with food allergies at increased risk for psychopathology?}, Journal = {J Psychosom Res}, Volume = {77}, Number = {6}, Pages = {468-473}, Year = {2014}, Month = {December}, ISSN = {0022-3999}, url = {http://dx.doi.org/10.1016/j.jpsychores.2014.10.005}, Abstract = {OBJECTIVE: Living with food allergy is a unique and potentially life-threatening stressor that requires constant vigilance to food-related stimuli, but little is known about whether adolescents with food allergies are at increased risk for psychopathology-concurrently and over time. METHODS: Data came from the prospective-longitudinal Great Smoky Mountains Study. Adolescents (N=1420) were recruited from the community, and interviewed up to six times between ages 10 and 16 for the purpose of the present analyses. At each assessment, adolescents and one parent were interviewed using the Child and Adolescent Psychiatric Assessment, resulting in N=5165 pairs of interviews. RESULTS: Cross-sectionally, food allergies were associated with more symptoms of separation and generalized anxiety, disorder, attention deficit and hyperactivity disorder, and anorexia nervosa. Longitudinally, adolescents with food allergy experienced increases in symptoms of generalized anxiety disorder and depression from one assessment to the next. Food allergies were not, however, associated with a higher likelihood of meeting diagnostic criteria for a psychiatric disorder. CONCLUSION: The unique constellation of adolescents' increased symptoms of psychopathology in the context of food allergy likely reflects an adaptive increase in vigilance rather than cohesive syndromes of psychopathology. Support and guidance from health care providers is needed to help adolescents with food allergies and their caregivers achieve an optimal balance between necessary vigilance and hypervigilance and unnecessary restriction.}, Doi = {10.1016/j.jpsychores.2014.10.005}, Key = {fds270272} } @article{fds270278, Author = {Copeland, WE and Shanahan, L and Egger, H and Angold, A and Costello, EJ}, Title = {Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder.}, Journal = {American Journal of Psychiatry}, Volume = {171}, Number = {6}, Pages = {668-674}, Year = {2014}, Month = {June}, ISSN = {0002-953X}, url = {http://dx.doi.org/10.1176/appi.ajp.2014.13091213}, Abstract = {OBJECTIVE: Disruptive mood dysregulation disorder (DMDD) is a new disorder for DSM-5 that is uncommon and frequently co-occurs with other psychiatric disorders. Here, the authors test whether meeting diagnostic criteria for this disorder in childhood predicts adult diagnostic and functional outcomes. METHOD: In a prospective, population-based study, individuals were assessed with structured interviews up to six times in childhood and adolescence (ages 10 to 16 years; 5,336 observations of 1,420 youths) for symptoms of DMDD and three times in young adulthood (ages 19, 21, and 24-26 years; 3,215 observations of 1,273 young adults) for psychiatric and functional outcomes (health, risky/illegal behavior, financial/educational functioning, and social functioning). RESULTS: Young adults with a history of childhood DMDD had elevated rates of anxiety and depression and were more likely to meet criteria for more than one adult disorder relative to comparison subjects with no history of childhood psychiatric disorders (noncases) or individuals meeting criteria for psychiatric disorders other than DMDD in childhood or adolescence (psychiatric comparison subjects). Participants with a history of DMDD were more likely to have adverse health outcomes, be impoverished, have reported police contact, and have low educational attainment as adults compared with either psychiatric or noncase comparison subjects. CONCLUSIONS: The long-term prognosis of children with DMDD is one of pervasive impaired functioning that in many cases is worse than that of other childhood psychiatric disorders.}, Doi = {10.1176/appi.ajp.2014.13091213}, Key = {fds270278} } @article{fds270280, Author = {Shanahan, L and Copeland, WE and Angold, A and Bondy, CL and Costello, EJ}, Title = {Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {53}, Number = {5}, Pages = {550-558}, Year = {2014}, Month = {May}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2013.12.029}, Abstract = {OBJECTIVE: We tested whether sleep problems co-occur with, precede, and/or follow common psychiatric disorders during childhood and adolescence. We also clarified the role of comorbidity and tested for specificity of associations among sleep problems and psychiatric disorders. METHOD: Data came from the Great Smoky Mountains Study, a representative population sample of 1,420 children, assessed 4 to 7 times per person between ages 9 and 16 years for major Diagnostic and Statistical Manual-Fourth Edition (DSM-IV) disorders and sleep problems. Sleep-related symptoms were removed from diagnostic criteria when applicable. RESULTS: Sleep problems during childhood and adolescence were common, with restless sleep and difficulty falling asleep being the most common symptoms. Cross-sectional analyses showed that sleep problems co-occurred with many psychiatric disorders. Longitudinal analyses revealed that sleep problems predicted increases in the prevalence of later generalized anxiety disorder (GAD) and high GAD/depression symptoms, and oppositional defiant disorder (ODD). In turn, GAD and/or depression and ODD predicted increases in sleep problems over time. CONCLUSIONS: Sleep problems both predict and are predicted by a diagnostic cluster that includes ODD, GAD, and depression. Screening children for sleep problems could offer promising opportunities for reducing the burden of mental illness during the early life course.}, Doi = {10.1016/j.jaac.2013.12.029}, Key = {fds270280} } @article{fds270282, Author = {Towe-Goodman, NR and Franz, L and Copeland, W and Angold, A and Egger, H}, Title = {Perceived family impact of preschool anxiety disorders.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {53}, Number = {4}, Pages = {437-446}, Year = {2014}, Month = {April}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2013.12.017}, Abstract = {OBJECTIVE: We examined the perceived impact of child anxiety disorders on family functioning, because such impact is a key predictor of mental health service receipt. In addition, we examined the relative impact of preschool anxiety compared to that of other early childhood disorders, and whether this impact persisted after accounting for the effects of comorbidity, or varied by child age and sex. METHOD: Drawing from a pediatric primary-care clinic and oversampling for children at risk for anxiety, 917 parents of preschoolers (aged 2-5 years) completed a diagnostic interview and reported on child psychiatric symptom impact on family finances, relationships, activities, and well-being. RESULTS: After accounting for comorbid disorders, families of children with anxiety were 3.5 times more likely to report a negative impact of their child's behavior on the family relative to nondisordered children. Generalized and separation anxiety had an impact on family functioning similar to that of attention-deficit/hyperactivity disorder and disruptive disorders. There was a significant family impact for girls with social phobia, whereas there was no impact for boys. CONCLUSIONS: Preschool anxiety has a significant, unique impact on family functioning, particularly parental adjustment, highlighting the family impairment linked with early anxiety, and the need for further research on barriers to care for these disorders.}, Doi = {10.1016/j.jaac.2013.12.017}, Key = {fds270282} } @article{fds270284, Author = {Copeland, WE and Angold, A and Shanahan, L and Costello, EJ}, Title = {Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {53}, Number = {1}, Pages = {21-33}, Year = {2014}, Month = {January}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2013.09.017}, Abstract = {OBJECTIVE: The aims of this study were 2-fold: to provide a brief introduction to the prospective longitudinal Great Smoky Mountains Study and review recent findings; and to use this sample to conduct an epidemiologic analysis of common childhood anxiety disorders. METHOD: The population-based Great Smoky Mountains Study assessed 1,420 participants from 11 counties in the southeastern United States up to 11 times between ages 9 and 26 years with the structured Child and Adolescent Psychiatric Assessment and its upward extension, the Young Adult Psychiatric Assessment. RESULTS: The U-shaped age prevalence curve for any anxiety disorder was the product of high levels of childhood separation anxiety and adult panic, agoraphobia, and generalized anxiety. More than 1 in 5 subjects met criteria for an anxiety disorder by early adulthood. In terms of cumulative comorbidity, there was evidence of overlap between anxiety disorders, but the level of overlap was generally consistent with what is seen among other common childhood disorders. All childhood anxiety disorders were associated with adverse functioning in at least 1 young adult functional domain, with the poorest outcomes for childhood generalized anxiety and DSM-III-R overanxious disorder. CONCLUSION: Clinically significant anxiety is a common mental health problem to have had by adulthood. There was little evidence to support the consolidation of anxiety disorders, and some evidence to justify reintroduction of DSM-III-R overanxious disorder. The transition to young adulthood appears to be a key period for understanding the development of common adult anxiety disorders such as panic and agoraphobia.}, Doi = {10.1016/j.jaac.2013.09.017}, Key = {fds270284} } @article{fds270285, Author = {Franz, L and Angold, A and Copeland, W and Costello, EJ and Towe-Goodman, N and Egger, H}, Title = {Preschool anxiety disorders in pediatric primary care: prevalence and comorbidity.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {52}, Number = {12}, Pages = {1294-1303.e1}, Year = {2013}, Month = {December}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24290462}, Abstract = {OBJECTIVE: We sought to establish prevalence rates and detail patterns of comorbidity for generalized anxiety disorder, separation anxiety disorder, and social phobia in preschool-aged children. METHOD: The Duke Preschool Anxiety Study, a screen-stratified, cross-sectional study, drew from pediatric primary care and oversampled for children at risk for anxiety. A total of 917 parents of preschool children (aged 2-5 years) completed the Preschool Age Psychiatric Assessment. RESULTS: Generalized anxiety disorder, separation anxiety disorder, and social phobia are common in preschool-aged children attending pediatric primary care. Three-fourths of preschoolers with an anxiety disorder only had a single anxiety disorder. Generalized anxiety disorder displayed the greatest degree of comorbidity: with separation anxiety disorder (odds ratio [OR] = 4.1, 95% CI = 2.0-8.5), social phobia (OR = 6.4, 95% CI = 3.1-13.4), disruptive behavior disorders (OR = 5.1, 95% CI = 1.6-15.8), and depression (OR = 3.7, 95% CI = 1.1-12.4). CONCLUSIONS: The weakness of association between generalized anxiety disorder and depression stands in contrast to substantial associations between these 2 disorders reported in older individuals. Attenuated associations in preschool-aged children could translate into clinical opportunities for targeted early interventions, aimed at modifying the developmental trajectory of anxiety disorders.}, Doi = {10.1016/j.jaac.2013.09.008}, Key = {fds270285} } @article{fds270290, Author = {Costello, EJ and Copeland, WE and Shanahan, L and Worthman, CM and Angold, A}, Title = {C-reactive protein and substance use disorders in adolescence and early adulthood: a prospective analysis.}, Journal = {Drug Alcohol Depend}, Volume = {133}, Number = {2}, Pages = {712-717}, Year = {2013}, Month = {December}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24099969}, Abstract = {BACKGROUND: Dysregulated immune function and elevated inflammation markers are seen in adults with chronic diseases, including some psychiatric disorders, but evidence on inflammation in the case of drug abuse is conflicting. OBJECTIVE: To test the concurrent and predictive relations between C-reactive protein (CRP) and use and abuse of alcohol, nicotine and cannabis in a longitudinal, population sample of adolescents and young adults, at the period of highest increase in drug use. METHODS: Data from the prospective population-based Great Smoky Mountains Study (N=1420) were used, covering children in the community assessed at ages 9-16, 19, and 21. Structured interviews were used to assess substance abuse symptoms and DSM-IV substance use disorders. Bloodspots were collected at each assessment and assayed for CRP. RESULTS: CRP levels were higher in the presence of nicotine, alcohol, and cannabis use and nicotine dependence. In prospective analyses, higher CRP levels predicted cannabis use and nicotine dependence, and nicotine use predicted higher CRP levels, once covariates were included in the models. Significant covariates were age, race (American Indian), and obesity. CONCLUSIONS: The inter-relationship of CRP and substance abuse has implications for the later health risks associated with early drug and alcohol use and abuse.}, Doi = {10.1016/j.drugalcdep.2013.08.027}, Key = {fds270290} } @article{fds270292, Author = {Shanahan, L and Copeland, WE and Worthman, CM and Angold, A and Costello, EJ}, Title = {Children with both asthma and depression are at risk for heightened inflammation.}, Journal = {J Pediatr}, Volume = {163}, Number = {5}, Pages = {1443-1447}, Year = {2013}, Month = {November}, ISSN = {0022-3476}, url = {http://dx.doi.org/10.1016/j.jpeds.2013.06.046}, Abstract = {OBJECTIVE: To test whether children and adolescents with co-occurring asthma and depression are at risk for elevated inflammation-concurrently and at the next assessment. STUDY DESIGN: Up to 6 yearly assessments per person from the prospective, population-based Great Smoky Mountains Study (N = 1420) were used, covering children in the community aged 10-16 years old. High-sensitivity C-reactive protein (CRP) was assayed from annual bloodspot collections and provided indicators of elevated inflammation at CRP > 1, CRP > 2, and CRP > 3 mg/L. Depression was assessed with the Child and Adolescent Psychiatric Assessment. Asthma was assessed using a form adapted from the Centers for Disease Control and Prevention National Health Interview Survey. RESULTS: Controlling common covariates of CRP, the co-occurrence of asthma and depression predicted heightened CRP-concurrently and at the next assessment. In turn, elevated CRP was relatively stable from one assessment to the next. CONCLUSIONS: The co-occurrence of asthma and depression in childhood poses a risk for substantially elevated inflammation concurrently and over time, which could contribute to pathophysiological processes involved in the development of additional chronic diseases and also to asthma--related morbidity and mortality.}, Doi = {10.1016/j.jpeds.2013.06.046}, Key = {fds270292} } @article{fds270289, Author = {Wolke, D and Copeland, WE and Angold, A and Costello, EJ}, Title = {Impact of bullying in childhood on adult health, wealth, crime, and social outcomes.}, Journal = {Psychol Sci}, Volume = {24}, Number = {10}, Pages = {1958-1970}, Year = {2013}, Month = {October}, ISSN = {0956-7976}, url = {http://dx.doi.org/10.1177/0956797613481608}, Abstract = {Bullying is a serious problem for schools, parents, and public-policymakers alike. Bullying creates risks of health and social problems in childhood, but it is unclear if such risks extend into adulthood. A large cohort of children was assessed for bullying involvement in childhood and then followed up in young adulthood in an assessment of health, risky or illegal behavior, wealth, and social relationships. Victims of childhood bullying, including those that bullied others (bully-victims), were at increased risk of poor health, wealth, and social-relationship outcomes in adulthood even after we controlled for family hardship and childhood psychiatric disorders. In contrast, pure bullies were not at increased risk of poor outcomes in adulthood once other family and childhood risk factors were taken into account. Being bullied is not a harmless rite of passage but throws a long shadow over affected people's lives. Interventions in childhood are likely to reduce long-term health and social costs.}, Doi = {10.1177/0956797613481608}, Key = {fds270289} } @article{fds270297, Author = {Shanahan, L and Copeland, WE and Worthman, CM and Erkanli, A and Angold, A and Costello, EJ}, Title = {Sex-differentiated changes in C-reactive protein from ages 9 to 21: the contributions of BMI and physical/sexual maturation.}, Journal = {Psychoneuroendocrinology}, Volume = {38}, Number = {10}, Pages = {2209-2217}, Year = {2013}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23711900}, Abstract = {BACKGROUND: Sex differences in levels of C-reactive protein (CRP) are well established in adulthood, but little is known about when and why they emerge. Here, we tested longitudinal models of CRP levels from ages 9 to 21, when marked physical and behavioral changes could contribute to growing sex disparities in CRP. METHODS: Data from the community-based prospective-longitudinal Great Smoky Mountains Study (N=1420) were used. Participants were 9-13 years old at intake and were followed through age 21. High-sensitivity C-reactive protein (CRP) was assayed from up to nine bloodspot collections per person. BMI, physical/sexual maturation, substance use, and control variables were assessed during yearly interviews to age 16, and at ages 19 and 21. RESULTS: Multilevel models revealed that the development of CRP in females was best described by a quadratic trend: after slow increases in CRP until age 15, the rate of increase accelerated thereafter. Changes in CRP in males were best described by a smaller, linear increase. After sex-differentiated associations with BMI, physical/sexual maturation, and substance use variables had been accounted for, increases in CRP after age 15 no longer differed by sex. CONCLUSION: Physical/sexual maturation and behavioral changes during adolescence could initiate life-long sex disparities in CRP.}, Doi = {10.1016/j.psyneuen.2013.04.010}, Key = {fds270297} } @article{fds270294, Author = {Stringaris, A and Maughan, B and Copeland, WS and Costello, EJ and Angold, A}, Title = {Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {52}, Number = {8}, Pages = {831-840}, Year = {2013}, Month = {August}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1016/j.jaac.2013.05.017}, Abstract = {OBJECTIVE: DSM-IV grants episodic irritability an equal status to low mood as a cardinal criterion for the diagnosis of depression in youth, yet not in adults; however, evidence for irritability as a major criterion of depression in youth is lacking. This article examines the prevalence, developmental characteristics, associations with psychopathology, and longitudinal stability of irritable mood in childhood and adolescent depression. METHOD: Data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used. We divided observations on 9- to 16-year-olds who met criteria for a diagnosis of depression into 3 groups: those with depressed mood and no irritability, those with irritability and no depressed mood, and those with both depressed and irritable mood. We compared these groups using robust regression models on adolescent characteristics and early adult (ages 19-21 years) depression outcomes. RESULTS: Depressed mood was the most common cardinal mood in youth meeting criteria for depression (58.7%), followed by the co-occurrence of depressed and irritable mood (35.6%); irritable mood alone was rare (5.7%). Youth with depressed and irritable mood were similar in age and developmental stage to those with depression, but had significantly higher rates of disruptive disorders. The co-occurrence of depressed and irritable mood was associated with higher risk for comorbid conduct disorder in girls (gender-by-group interaction, F1,132 = 4.66, p = .03). CONCLUSIONS: Our study findings do not support the use of irritability as a cardinal mood criterion for depression. However, the occurrence of irritability in youth depression is associated with increased risk of disruptive behaviors, especially in girls.}, Doi = {10.1016/j.jaac.2013.05.017}, Key = {fds270294} } @article{fds270302, Author = {Copeland, WE and Adair, CE and Smetanin, P and Stiff, D and Briante, C and Colman, I and Fergusson, D and Horwood, J and Poulton, R and Costello, EJ and Angold, A}, Title = {Diagnostic transitions from childhood to adolescence to early adulthood.}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {54}, Number = {7}, Pages = {791-799}, Year = {2013}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23451804}, Abstract = {BACKGROUND: Quantifying diagnostic transitions across development is needed to estimate the long-term burden of mental illness. This study estimated patterns of diagnostic transitions from childhood to adolescence and from adolescence to early adulthood. METHODS: Patterns of diagnostic transitions were estimated using data from three prospective, longitudinal studies involving close to 20,000 observations of 3,722 participants followed across multiple developmental periods covering ages 9-30. Common DSM psychiatric disorders were assessed in childhood (ages 9-12; two samples), adolescence (ages 13-18; three samples), and early adulthood (ages 19 to age 32; three samples) with structured psychiatric interviews and questionnaires. RESULTS: Having a disorder at an early period was associated with at least a threefold increase in odds for having a disorder at a later period. Homotypic and heterotypic transitions were observed for every disorder category. The strongest evidence of continuity was seen for behavioral disorders (particularly ADHD) with less evidence for emotional disorders such as depression and anxiety. Limited evidence was found in adjusted models for behavioral disorders predicting later emotional disorders. Adult substance disorders were preceded by behavioral disorders, but not anxiety or depression. CONCLUSIONS: Having a disorder in childhood or adolescence is a potent risk factor for a range of psychiatric problems later in development. These findings provide further support for prevention and early life intervention efforts and suggest that treatment at younger ages, while justified in its own right, may also have potential to reduce the risk for disorders later in development.}, Doi = {10.1111/jcpp.12062}, Key = {fds270302} } @article{fds270296, Author = {Akee, R and Simeonova, E and Copeland, W and Angold, A and Costello, EJ}, Title = {Young Adult Obesity and Household Income: Effects of Unconditional Cash Transfers.}, Journal = {American Economic Journal: Applied Economics}, Volume = {5}, Number = {2}, Pages = {1-28}, Year = {2013}, Month = {April}, ISSN = {1945-7782}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000316732800001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {We investigate the effect of household cash transfers during childhood on young adult body mass indexes (BMI). The effects of extra income differ depending on the household's initial socioeconomic status (SES). Children from the initially poorest households have a larger increase in BMI relative to children from initially wealthier households. Several alternative mechanisms are examined. Initial SES holds up as the most likely channel behind the heterogeneous effects of extra income on young adult BMI. (JEL D14, H23, H75, I12, J13, J15).}, Doi = {10.1257/app.5.2.1}, Key = {fds270296} } @article{fds270298, Author = {Costello, EJ and Eaves, L and Sullivan, P and Kennedy, M and Conway, K and Adkins, DE and Angold, A and Clark, SL and Erkanli, A and McClay, JL and Copeland, W and Maes, HH and Liu, Y and Patkar, AA and Silberg, J and van den Oord, E}, Title = {Genes, environments, and developmental research: methods for a multi-site study of early substance abuse.}, Journal = {Twin Research and Human Genetics : the Official Journal of the International Society for Twin Studies}, Volume = {16}, Number = {2}, Pages = {505-515}, Year = {2013}, Month = {April}, ISSN = {1832-4274}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23461817}, Abstract = {The importance of including developmental and environmental measures in genetic studies of human pathology is widely acknowledged, but few empirical studies have been published. Barriers include the need for longitudinal studies that cover relevant developmental stages and for samples large enough to deal with the challenge of testing gene-environment-development interaction. A solution to some of these problems is to bring together existing data sets that have the necessary characteristics. As part of the National Institute on Drug Abuse-funded Gene-Environment-Development Initiative, our goal is to identify exactly which genes, which environments, and which developmental transitions together predict the development of drug use and misuse. Four data sets were used of which common characteristics include (1) general population samples, including males and females; (2) repeated measures across adolescence and young adulthood; (3) assessment of nicotine, alcohol, and cannabis use and addiction; (4) measures of family and environmental risk; and (5) consent for genotyping DNA from blood or saliva. After quality controls, 2,962 individuals provided over 15,000 total observations. In the first gene-environment analyses, of alcohol misuse and stressful life events, some significant gene-environment and gene-development effects were identified. We conclude that in some circumstances, already collected data sets can be combined for gene-environment and gene-development analyses. This greatly reduces the cost and time needed for this type of research. However, care must be taken to ensure careful matching across studies and variables.}, Doi = {10.1017/thg.2013.6}, Key = {fds270298} } @article{fds270299, Author = {Copeland, WE and Wolke, D and Angold, A and Costello, EJ}, Title = {Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence.}, Journal = {Jama Psychiatry}, Volume = {70}, Number = {4}, Pages = {419-426}, Year = {2013}, Month = {April}, ISSN = {2168-622X}, url = {http://dx.doi.org/10.1001/jamapsychiatry.2013.504}, Abstract = {IMPORTANCE: Both bullies and victims of bullying are at risk for psychiatric problems in childhood, but it is unclear if this elevated risk extends into early adulthood. OBJECTIVE: To test whether bullying and/or being bullied in childhood predicts psychiatric problems and suicidality in young adulthood after accounting for childhood psychiatric problems and family hardships. DESIGN: Prospective, population-based study. SETTING: Community sample from 11 counties in Western North Carolina. PARTICIPANTS: A total of 1420 participants who had being bullied and bullying assessed 4 to 6 times between the ages of 9 and 16 years. Participants were categorized as bullies only, victims only, bullies and victims (hereafter referred to as bullies/victims), or neither. MAIN OUTCOME MEASURE: Psychiatric outcomes, which included depression, anxiety, antisocial personality disorder, substance use disorders, and suicidality (including recurrent thoughts of death, suicidal ideation, or a suicide attempt), were assessed in young adulthood (19, 21, and 24-26 years) by use of structured diagnostic interviews. RESULTS Victims and bullies/victims had elevated rates of young adult psychiatric disorders, but also elevated rates of childhood psychiatric disorders and family hardships. After controlling for childhood psychiatric problems or family hardships, we found that victims continued to have a higher prevalence of agoraphobia (odds ratio [OR], 4.6 [95% CI, 1.7-12.5]; P < .01), generalized anxiety (OR, 2.7 [95% CI, 1.1-6.3]; P < .001), and panic disorder (OR, 3.1 [95% CI, 1.5-6.5]; P < .01) and that bullies/victims were at increased risk of young adult depression (OR, 4.8 [95% CI, 1.2-19.4]; P < .05), panic disorder (OR, 14.5 [95% CI, 5.7-36.6]; P < .001), agoraphobia (females only; OR, 26.7 [95% CI, 4.3-52.5]; P < .001), and suicidality (males only; OR, 18.5 [95% CI, 6.2-55.1]; P < .001). Bullies were at risk for antisocial personality disorder only (OR, 4.1 [95% CI, 1.1-15.8]; P < .04). CONCLUSIONS AND RELEVANCE: The effects of being bullied are direct, pleiotropic, and long-lasting, with the worst effects for those who are both victims and bullies.}, Doi = {10.1001/jamapsychiatry.2013.504}, Key = {fds270299} } @article{fds270303, Author = {Copeland, WE and Angold, A and Costello, EJ and Egger, H}, Title = {Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder.}, Journal = {American Journal of Psychiatry}, Volume = {170}, Number = {2}, Pages = {173-179}, Year = {2013}, Month = {February}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23377638}, Abstract = {OBJECTIVE: No empirical studies on the DSM-5 proposed disruptive mood dysregulation disorder have yet been published. This study estimated prevalence, comorbidity, and correlates of this proposed disorder in the community. METHOD: Prevalence rates were estimated using data from three community studies involving 7,881 observations of 3,258 participants from 2 to 17 years old. Disruptive mood dysregulation disorder was diagnosed using structured psychiatric interviews. RESULTS: Three-month prevalence rates for meeting criteria for disruptive mood dysregulation disorder ranged from 0.8% to 3.3%, with the highest rate in preschoolers. Rates dropped slightly with the strict application of the exclusion criterion, but they were largely unaffected by the application of onset and duration criteria. Disruptive mood dysregulation co-occurred with all common psychiatric disorders. The highest levels of co-occurrence were with depressive disorders (odds ratios between 9.9 and 23.5) and oppositional defiant disorder (odds ratios between 52.9 and 103.0). Disruptive mood dysregulation occurred with another disorder 62%-92% of the time, and it occurred with both an emotional and a behavioral disorder 32%-68% of the time. Affected children displayed elevated rates of social impairments, school suspension, service use, and poverty. CONCLUSIONS: Disruptive mood dysregulation disorder is relatively uncommon after early childhood, frequently co-occurs with other psychiatric disorders, and meets common standards for psychiatric "caseness." This disorder identifies children with severe levels of both emotional and behavioral dysregulation.}, Doi = {10.1176/appi.ajp.2012.12010132}, Key = {fds270303} } @article{fds270283, Author = {Copeland, WE and Shanahan, L and Erkanli, A and Costello, EJ and Angold, A}, Title = {Indirect comorbidity in childhood and adolescence.}, Journal = {Frontiers in Psychiatry}, Volume = {4}, Pages = {144}, Year = {2013}, url = {http://dx.doi.org/10.3389/fpsyt.2013.00144}, Abstract = {OBJECTIVE: Comorbidity between psychiatric disorders is common, but pairwise associations between two disorders may be explained by the presence of other diagnoses that are associated with both disorders or "indirect" comorbidity. MATERIALS AND METHODS: Comorbidities of common childhood psychiatric disorders were tested in three community samples of children ages 6-17 (8931 observations of 2965 subjects). Psychiatric disorder status in all three samples was assessed with the Child and Adolescent Psychiatric Assessment. Indirect comorbidity was defined as A-B associations that decreased from significance to non-significance after adjusting for other disorders. RESULTS: All tested childhood psychiatric disorders were positively associated in bivariate analyses. After adjusting for comorbidities, many associations involving a behavioral disorder and an emotional disorder were attenuated suggesting indirect comorbidity. Generalized anxiety and depressive disorders displayed a very high level of overlap (adjusted OR = 37.9). All analyses were rerun with depressive disorders grouped with generalized anxiety disorder in a single "distress disorders" category. In these revised models, all associations between and emotional disorder and a behavior disorder met our criteria for indirect comorbidity except for the association of oppositional defiant disorder with distress disorders (OR = 11.3). Follow-up analyses suggested that the indirect associations were primarily accounted for by oppositional defiant disorder and the distress disorder category. There was little evidence of either sex differences or differences by developmental period. CONCLUSION: After accounting for the overlap between depressive disorders with generalized anxiety disorder, direct comorbidity between emotional and behavioral disorders was uncommon. When there was evidence of indirect comorbidity, ODD, and distress disorders were the key intermediary diagnoses accounting for the apparent associations.}, Doi = {10.3389/fpsyt.2013.00144}, Key = {fds270283} } @article{fds270426, Author = {Copeland, WE and Shanahan, L and Worthman, C and Angold, A and Costello, EJ}, Title = {Generalized anxiety and C-reactive protein levels: a prospective, longitudinal analysis.}, Journal = {Psychol Med}, Volume = {42}, Number = {12}, Pages = {2641-2650}, Year = {2012}, Month = {December}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22716910}, Abstract = {BACKGROUND: Generalized anxiety disorder (GAD) is highly co-morbid with depression. Depression is associated with elevated levels of the inflammation marker C-reactive protein (CRP), cross-sectionally and over time. To date, no studies have looked at the association between CRP and GAD. METHOD: A total of nine waves of data from the prospective population-based Great Smoky Mountains Study (n=1420) were used, covering children in the community aged 9-16, 19 and 21 years old. Structured interviews were used at each assessment to assess GAD symptoms, diagnosis and cumulative episodes. Blood spots were collected and assayed for high-sensitivity CRP levels. RESULTS: GAD was associated with increased levels of CRP in bivariate cross-sectional analyses. These bivariate associations, however, were attenuated after accounting for demographic, substance-use and health-related covariates. In longitudinal models, there was little evidence that CRP predicted later GAD. Associations from GAD to later CRP were attenuated in models adjusted for health-related coavariates and there was evidence that the GAD-CRP association was mediated by body mass index (BMI) and medication use. CONCLUSIONS: Similar to depression, GAD was associated with elevated levels of CRP, but the effect of GAD on CRP levels was explained by the effect of GAD on health-related behaviors such as BMI and medication use. This study suggests differences in the association between inflammation and depression and GAD.}, Doi = {10.1017/S0033291712000554}, Key = {fds270426} } @article{fds270301, Author = {Wichstrøm, L and Berg-Nielsen, TS and Angold, A}, Title = {About 7% of 4-year-olds in Norway meet criteria for a psychiatric diagnosis}, Journal = {Evidence Based Mental Health}, Volume = {15}, Number = {4}, Pages = {108}, Publisher = {BMJ}, Year = {2012}, Month = {November}, ISSN = {1362-0347}, url = {http://dx.doi.org/10.1136/eb-2012-100907}, Doi = {10.1136/eb-2012-100907}, Key = {fds270301} } @article{fds270425, Author = {Copeland, WE and Angold, A and Shanahan, L and Dreyfuss, J and Dlamini, I and Costello, EJ}, Title = {Predicting persistent alcohol problems: a prospective analysis from the Great Smoky Mountain Study.}, Journal = {Psychol Med}, Volume = {42}, Number = {9}, Pages = {1925-1935}, Year = {2012}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22153225}, Abstract = {BACKGROUND: Rates of alcohol disorders peak in late adolescence and decrease substantially into the mid-20s. Our aim was to identify risk factors that predict alcohol problems that persist into the mid-20s. METHOD: Data are from the prospective, population-based Great Smoky Mountains Study (GSMS; n=1420), which followed children through late adolescence and into young adulthood. Alcohol persisters were defined as subjects with an alcohol disorder (abuse or dependence) in late adolescence (ages 19 and 21 years) that continued to meet criteria for an alcohol disorder at the mid-20s assessment. RESULTS: The 3-month prevalence of having an alcohol disorder (abuse or dependence) decreased markedly from late adolescence into the mid-20s. A third of late adolescents with an alcohol disorder continued to meet criteria for an alcohol disorder in young adulthood (37 of 144 who met criteria in late adolescence). Risk factors for persister status included multiple alcohol abuse criteria during late adolescence but no alcohol dependence criteria. Risk factors for persister status also included associated features of alcohol dependence such as craving alcohol and drinking to unconsciousness. Persister status was also associated with depression, cannabis dependence and illicit substance use, but not with other psychiatric disorders. More than 90% of late adolescents with three or more of the risk factors identified met criteria for a young adult alcohol disorder. CONCLUSIONS: Symptoms of alcohol abuse, not dependence, best predict long-term persistence of alcohol problems. The set of risk factors identified may be a useful screen for selective and indicated prevention efforts.}, Doi = {10.1017/S0033291711002790}, Key = {fds270425} } @article{fds270423, Author = {Wichstrøm, L and Berg-Nielsen, TS and Angold, A and Egger, HL and Solheim, E and Sveen, TH}, Title = {Prevalence of psychiatric disorders in preschoolers.}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {53}, Number = {6}, Pages = {695-705}, Year = {2012}, Month = {June}, ISSN = {0021-9630}, url = {http://dx.doi.org/10.1111/j.1469-7610.2011.02514.x}, Abstract = {BACKGROUND: Many disorders in childhood and adolescence were already present in the preschool years. However, there is little empirical research on the prevalence of psychiatric disorders in young children. A true community study using structured diagnostic tools has yet to be published. METHODS: All children born in 2003 or 2004 in the city of Trondheim, Norway, who attended the regular community health check-up for 4-year-olds (97.2% of eligible children) whose parents consented to take part in the study (N = 2,475, 82.0%) were screened for behavioral and emotional problems with the Strengths and Difficulties Questionnaire (SDQ). A screen-stratified subsample of 1,250 children took part in a furthermore comprehensive study including a structured diagnostic interview (the Preschool Age Psychiatric Assessment, PAPA), which 995 parents (79.6%) completed. RESULTS: The estimated population rate for any psychiatric disorder (excluding encopresis - 6.4%) was 7.1%. The most common disorders were attention deficit hyperactivity disorder (1.9%), oppositional defiant disorder (1.8%), conduct disorder (0.7%), anxiety disorders (1.5%), and depressive disorders (2.0%). Comorbidity among disorders was common. More emotional and behavioral disorders were seen in children whose parents did not live together and in those of low socioeconomic status. Boys more often had attention-deficit/hyperactivity disorder (ADHD) and depressive disorders than girls. CONCLUSIONS: The prevalence of disorders among preschoolers was lower than in previous studies from the USA. Comorbidity was frequent and there was a male preponderance in ADHD and depression at this early age. These results underscore the fact that the most common disorders of childhood can already be diagnosed in preschoolers. However, rates of disorder in Norway may be lower than in the USA.}, Doi = {10.1111/j.1469-7610.2011.02514.x}, Key = {fds270423} } @article{fds270422, Author = {Angold, A and Erkanli, A and Copeland, W and Goodman, R and Fisher, PW and Costello, EJ}, Title = {Psychiatric diagnostic interviews for children and adolescents: a comparative study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {51}, Number = {5}, Pages = {506-517}, Year = {2012}, Month = {May}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22525957}, Abstract = {OBJECTIVE: To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). METHOD: Roughly equal numbers of males and females of white and African American ethnicity, aged 9 to 12 and 13 to 16 years, were recruited from primary care pediatric clinics. Participants (N = 646) were randomly assigned to receive two of the three interviews, in counterbalanced order. Five modules were used: any depressive disorder, anxiety disorders, oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder. At two sessions about 1 week apart, parent and child completed one of two interviews plus five screening questionnaires. RESULTS: When interviewed with the DAWBA, 17.7% of youth had one or more diagnoses, compared with 47.1% (DISC) and 32.4% (CAPA). The excess of DISC diagnoses was accounted for by specific phobias. Agreement between interview pairs was 0.13 to 0.48 for DAWBA-DISC comparisons, 0.21 to 0.61 for DISC-CAPA comparisons, and 0.23 to 0.48 for CAPA-DAWBA comparisons. DAWBA-only cases were associated with higher parent-report questionnaire scores than DISC/DAWBA cases, but equivalent child-report scores. CONCLUSIONS: The DAWBA is shorter and cases were probably more severe, making it a good choice for clinical trials, but the user cannot examine the data in detail. The DISC and CAPA are similar in length and training needs. Either would be a better choice where false-negative results must be avoided, as in case-control genetic studies, or when researchers need to study individual symptoms in detail.}, Doi = {10.1016/j.jaac.2012.02.020}, Key = {fds270422} } @article{fds270424, Author = {Copeland, WE and Shanahan, L and Worthman, C and Angold, A and Costello, EJ}, Title = {Cumulative depression episodes predict later C-reactive protein levels: a prospective analysis.}, Journal = {Biol Psychiatry}, Volume = {71}, Number = {1}, Pages = {15-21}, Year = {2012}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22047718}, Abstract = {BACKGROUND: Depression is associated with elevated levels of the inflammation marker C-reactive protein (CRP); yet, the direction of this association remains unclear. This study tested bi-directional longitudinal associations between CRP and depression in a sample of adolescents and young adults. The study compared the effect of current depression with the effect of cumulative episodes of depression over time. METHODS: Nine waves of data from the prospective population-based Great Smoky Mountains Study (n = 1420) were used, covering children in the community aged 9 to 16, 19, and 21 years old. Structured interviews were used to assess depressive symptoms, depression diagnosis, and cumulative depressive episodes. Bloodspots were collected at each observation and assayed for CRP levels. RESULTS: CRP levels were not associated with later depression status. In contrast, all depression-related variables displayed evidence of association with later CRP levels. The associations with depressive symptoms and diagnostic status were attenuated after controlling for covariates, particularly body mass index, smoking, and medication use. The effect of cumulative depressive episodes, however, continued to be significant after accounting for a range of covariates. Body mass index, smoking behavior, and recent infections may mediate a portion of the effect of cumulative episodes on later CRP, but cumulative depressive episodes continued to predict CRP levels independently. CONCLUSIONS: The occurrence of multiple depressive episodes exerted the greatest effect on later CRP levels. This suggests that risk for the diseases of middle and old age--cardiovascular and metabolic disease--may begin in childhood and depend, in part, on long-term emotional functioning.}, Doi = {10.1016/j.biopsych.2011.09.023}, Key = {fds270424} } @article{fds270420, Author = {Shanahan, L and Copeland, WE and Costello, EJ and Angold, A}, Title = {Child-, adolescent- and young adult-onset depressions: differential risk factors in development?}, Journal = {Psychol Med}, Volume = {41}, Number = {11}, Pages = {2265-2274}, Year = {2011}, Month = {November}, ISSN = {0033-2917}, url = {http://dx.doi.org/10.1017/S0033291711000675}, Abstract = {BACKGROUND: Previous research reported that childhood adversity predicts juvenile- onset but not adult-onset depression, but studies confounded potentially genuine differences in adversity with differences in the recency with which adversity was experienced. The current study paper took into account the recency of risk when testing for differences among child-, adolescent- and young adult-onset depressions. METHOD: Up to nine waves of data were used per subject from two cohorts of the Great Smoky Mountains Study (GSMS; n=1004), covering children in the community aged 9-16, 19 and 21 years. Youth and one of their parents were interviewed using the Child and Adolescent Psychiatric Assessment (CAPA) between ages 9 and 16; these same youth were interviewed using the Young Adult Psychiatric Assessment (YAPA) at ages 19 and 21. The most common psychosocial risk factors for depression were assessed: poverty, life events, parental psychopathology, maltreatment, and family dysfunction. RESULTS: Consistent with previous research, most childhood psychosocial risk factors were more strongly associated with child-onset than with adolescent-/adult-onset depression. When potentially genuine risk differences among the depression-onset groups were disentangled from differences due to the recency of risk, child- and young adult-onset depression were no longer different from one another. Adolescent-onset depression was associated with few psychosocial risk factors. CONCLUSIONS: There were no differences in putative risk factors between child- and young adult-onset depression when the recency of risk was taken into account. Adolescent-onset depression was associated with few psychosocial risk factors. It is possible that some adolescent-onset depression cases differ in terms of risk from child- and young adult-onset depression.}, Doi = {10.1017/S0033291711000675}, Key = {fds270420} } @article{fds270421, Author = {Costello, EJ and Copeland, W and Angold, A}, Title = {Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {52}, Number = {10}, Pages = {1015-1025}, Year = {2011}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21815892}, Abstract = {BACKGROUND: Little is known about changes in the prevalence of psychiatric disorders between childhood and adolescence, and adolescence and adulthood. METHODS: We reviewed papers reporting prevalence rates of psychiatric disorders separately for childhood, adolescence, and early adulthood. Both longitudinal and cross-sectional papers published in the past 15 years were included. RESULTS: About one adolescent in five has a psychiatric disorder. From childhood to adolescence there is an increase in rates of depression, panic disorder, agoraphobia, and substance use disorders (SUD), and a decrease in separation anxiety disorder (SAD) and attention-deficit hyperactivity disorder (ADHD). From adolescence to early adulthood there is a further increase in panic disorder, agoraphobia, and SUD, and a further decrease in SAD and ADHD. Other phobias and disruptive behavior disorders also fall. CONCLUSIONS: Further study of changes in rates of disorder across developmental stages could inform etiological research and guide interventions.}, Doi = {10.1111/j.1469-7610.2011.02446.x}, Key = {fds270421} } @article{fds270418, Author = {Egger, HL and Pine, DS and Nelson, E and Leibenluft, E and Ernst, M and Towbin, KE and Angold, A}, Title = {The NIMH Child Emotional Faces Picture Set (NIMH-ChEFS): a new set of children's facial emotion stimuli.}, Journal = {Int J Methods Psychiatr Res}, Volume = {20}, Number = {3}, Pages = {145-156}, Year = {2011}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22547297}, Abstract = {With the emergence of new technologies, there has been an explosion of basic and clinical research on the affective and cognitive neuroscience of face processing and emotion perception. Adult emotional face stimuli are commonly used in these studies. For developmental research, there is a need for a validated set of child emotional faces. This paper describes the development of the National Institute of Mental Health Child Emotional Faces Picture Set (NIMH-ChEFS), a relatively large stimulus set with high quality, color images of the emotional faces of children. The set includes 482 photographs of fearful, angry, happy, sad and neutral child faces with two gaze conditions: direct and averted gaze. In this paper we describe the development of the NIMH-ChEFS and data on the set's validity based on ratings by 20 healthy adult raters. Agreement between the a priori emotion designation and the raters' labels was high and comparable with values reported for commonly used adult picture sets. Intensity, representativeness, and composite "goodness" ratings are also presented to guide researchers in their choice of specific stimuli for their studies. These data should give researchers confidence in the NIMH-ChEFS's validity for use in affective and social neuroscience research.}, Doi = {10.1002/mpr.343}, Key = {fds270418} } @article{fds270417, Author = {Copeland, WE and Sun, H and Costello, EJ and Angold, A and Heilig, MA and Barr, CS}, Title = {Child μ-opioid receptor gene variant influences parent-child relations.}, Journal = {Neuropsychopharmacology}, Volume = {36}, Number = {6}, Pages = {1165-1170}, Year = {2011}, Month = {May}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21326192}, Abstract = {Variation in the μ-opioid receptor gene has been associated with early social behavior in mice and rhesus macaques. The current study tested whether the functional OPRM1 A118G predicted various indices of social relations in children. The sample included 226 subjects of self-reported European ancestry (44% female; mean age 13.6, SD=2.2) who were part of a larger representative study of children aged 9-17 years in rural North Carolina. Multiple aspects of recent (past 3 months) parent-child relationship were assessed using the Child and Adolescent Psychiatric Assessment. Parent problems were coded based upon a lifetime history of mental health problems, substance abuse, or criminality. Child genotype interacted with parent behavior such that there were no genotype differences for those with low levels of parent problems; however, when a history of parent problems was reported, the G allele carriers had more enjoyment of parent-child interactions (mean ratio (MR)=3.5, 95% CI=1.6, 8.0) and fewer arguments (MR=3.1, 95% CI=1.1, 8.9). These findings suggest a role for the OPRM1 gene in the genetic architecture of social relations in humans. In summary, a variant in the μ-opioid receptor gene (118G) was associated with improved parent-child relations, but only in the context of a significant disruption in parental functioning.}, Doi = {10.1038/npp.2010.251}, Key = {fds270417} } @article{fds270419, Author = {Lau, JY and Britton, JC and Nelson, EE and Angold, A and Ernst, M and Goldwin, M and Grillon, C and Leibenluft, E and Lissek, S and Norcross, M and Shiffrin, N and Pine, DS}, Title = {Distinct neural signatures of threat learning in adolescents and adults.}, Journal = {Proc Natl Acad Sci U S A}, Volume = {108}, Number = {11}, Pages = {4500-4505}, Year = {2011}, Month = {March}, ISSN = {0027-8424}, url = {http://dx.doi.org/10.1073/pnas.1005494108}, Abstract = {Most teenage fears subside with age, a change that may reflect brain maturation in the service of refined fear learning. Whereas adults clearly demarcate safe situations from real dangers, attenuating fear to the former but not the latter, adolescents' immaturity in prefrontal cortex function may limit their ability to form clear-cut threat categories, allowing pervasive fears to manifest. Here we developed a discrimination learning paradigm that assesses the ability to categorize threat from safety cues to test these hypotheses on age differences in neurodevelopment. In experiment 1, we first demonstrated the capacity of this paradigm to generate threat/safety discrimination learning in both adolescents and adults. Next, in experiment 2, we used this paradigm to compare the behavioral and neural correlates of threat/safety discrimination learning in adolescents and adults using functional MRI. This second experiment yielded three sets of findings. First, when labeling threats online, adolescents reported less discrimination between threat and safety cues than adults. Second, adolescents were more likely than adults to engage early-maturing subcortical structures during threat/safety discrimination learning. Third, adults' but not adolescents' engagement of late-maturing prefrontal cortex regions correlated positively with fear ratings during threat/safety discrimination learning. These data are consistent with the role of dorsolateral regions during category learning, particularly when differences between stimuli are subtle [Miller EK, Cohen JD (2001) Annu Rev Neurosci 24:167-202]. These findings suggest that maturational differences in subcortical and prefrontal regions between adolescent and adult brains may relate to age-related differences in threat/safety discrimination.}, Doi = {10.1073/pnas.1005494108}, Key = {fds270419} } @article{fds270416, Author = {Copeland, W and Shanahan, L and Costello, EJ and Angold, A}, Title = {Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {50}, Number = {3}, Pages = {252-261}, Year = {2011}, Month = {March}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21334565}, Abstract = {OBJECTIVE: No longitudinal studies beginning in childhood have estimated the cumulative prevalence of psychiatric illness from childhood into young adulthood. The objective of this study was to estimate the cumulative prevalence of psychiatric disorders by young adulthood and to assess how inclusion of not otherwise specified diagnoses affects cumulative prevalence estimates. METHOD: The prospective, population-based Great Smoky Mountains Study assessed 1,420 participants up to nine times from 9 through 21 years of age from 11 counties in the southeastern United States. Common psychiatric disorders were assessed in childhood and adolescence (ages 9 to 16 years) with the Child and Adolescent Psychiatric Assessment and in young adulthood (ages 19 and 21 years) with the Young Adult Psychiatric Assessment. Cumulative prevalence estimates were derived from multiple imputed datasets. RESULTS: By 21 years of age, 61.1% of participants had met criteria for a well-specified psychiatric disorder. An additional 21.4% had met criteria for a not otherwise specified disorder only, increasing the total cumulative prevalence for any disorder to 82.5%. Male subjects had higher rates of substance and disruptive behavior disorders compared with female subjects; therefore, they were more likely to meet criteria for a well-specified disorder (67.8% vs 56.7%) or any disorder (89.1% vs 77.8%). Children with a not otherwise specified disorder only were at increased risk for a well-specified young adult disorder compared with children with no disorder in childhood. CONCLUSIONS: Only a small percentage of young people meet criteria for a DSM disorder at any given time, but most do by young adulthood. As with other medical illness, psychiatric illness is a nearly universal experience.}, Doi = {10.1016/j.jaac.2010.12.014}, Key = {fds270416} } @article{fds270414, Author = {Rowe, R and Costello, EJ and Angold, A and Copeland, WE and Maughan, B}, Title = {Developmental pathways in oppositional defiant disorder and conduct disorder.}, Journal = {J Abnorm Psychol}, Volume = {119}, Number = {4}, Pages = {726-738}, Year = {2010}, Month = {November}, ISSN = {0021-843X}, url = {http://dx.doi.org/10.1037/a0020798}, Abstract = {The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) specifies a developmental relationship between oppositional defiant disorder (ODD) and conduct disorder (CD). Evidence for this link is mixed, however, and recent studies suggest that different symptom dimensions in ODD may have different outcomes. The authors examined links between ODD, CD, and their young adult outcomes in the Great Smoky Mountains Study (E. J. Costello et al., 1996), a longitudinal data set with over 8,000 observations of 1,420 individuals (56% male) covering ages 9-21 years. ODD was a significant predictor of later CD in boys but not in girls after control for comorbid CD and subthreshold CD symptomatology. Transitions between ODD and CD were less common than anticipated, however, particularly during adolescence. The authors examined characteristics and outcomes of children with pure ODD, pure CD, and combined CD/ODD. Alongside many similarities in childhood and adolescent correlates, key differences were also identified: CD largely predicted behavioral outcomes, whereas ODD showed stronger prediction to emotional disorders in early adult life. Factor analysis identified irritable and headstrong dimensions in ODD symptoms that showed differential prediction to later behavioral and emotional disorders. Overall, the results underscore the utility of retaining separate ODD and CD diagnoses in DSM-V.}, Doi = {10.1037/a0020798}, Key = {fds270414} } @article{fds344703, Author = {Kaplow, JB and Saunders, J and Angold, A and Costello, EJ}, Title = {Psychiatric symptoms in bereaved versus nonbereaved youth and young adults: a longitudinal epidemiological study.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {49}, Number = {11}, Pages = {1145-1154}, Year = {2010}, Month = {November}, url = {http://dx.doi.org/10.1016/j.jaac.2010.08.004}, Abstract = {OBJECTIVE: To examine potential differences in psychiatric symptoms between parent-bereaved youth (N = 172), youth who experienced the death of another relative (N = 815), and nonbereaved youth (N = 235), aged 11 to 21 years, above and beyond antecedent environmental and individual risk factors. METHOD: Sociodemographics, family composition, and family functioning were assessed one interview wave before the death. Child psychiatric symptoms were assessed during the wave in which the death was reported and one wave before and after the death. A year was selected randomly for the nonbereaved group. RESULTS: The early loss of a parent was associated with poverty, previous substance abuse problems, and greater functional impairment before the loss. Both bereaved groups of children were more likely than nonbereaved children to show symptoms of separation anxiety and depression during the wave of the death, controlling for sociodemographic factors and prior psychiatric symptoms. One wave following the loss, bereaved children were more likely than nonbereaved children to exhibit symptoms of conduct disorder and substance abuse and to show greater functional impairment. CONCLUSIONS: The impact of parental death on children must be considered in the context of pre-existing risk factors. Even after controlling for antecedent risk factors, both parent-bereaved children as well as those who lost other relatives were at increased risk for psychological and behavioral health problems.}, Doi = {10.1016/j.jaac.2010.08.004}, Key = {fds344703} } @article{fds270413, Author = {Copeland, W and Shanahan, L and Miller, S and Costello, EJ and Angold, A and Maughan, B}, Title = {Outcomes of early pubertal timing in young women: a prospective population-based study.}, Journal = {American Journal of Psychiatry}, Volume = {167}, Number = {10}, Pages = {1218-1225}, Year = {2010}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20478880}, Abstract = {OBJECTIVE: Early pubertal timing in girls is associated with psychosocial problems throughout adolescence, but it is unclear whether these problems persist into young adulthood. The authors analyzed outcomes in adolescence and young adulthood in girls in a longitudinal study. METHOD: The data for this study were from the prospective population-based Great Smoky Mountains Study (N=1,420), which initially recruited children at ages 9, 11, and 13 and followed them into young adulthood. Pubertal timing was defined on the basis of self-reported Tanner stage and age at menarche. Outcome measures included functioning related to crime, substance use, school/peer problems, family relationships, sexual behavior, and mental health in adolescence (ages 13 to 16) as well as crime, substance use, education/socioeconomic status, sexual behavior, and mental health in young adulthood (ages 19 and 21). RESULTS: In adolescence, early-maturing girls displayed higher levels of self-reported criminality, substance use problems, social isolation, early sexual behavior, and psychiatric problems. By young adulthood, most of these differences had attenuated. Functioning for early maturers improved in some areas; in others, on-time and late maturers had caught up with their early-maturing peers. Nevertheless, early-maturing girls, particularly those with a history of adolescent conduct disorder, were more likely to be depressed in young adulthood compared to their counterparts. Early maturers were also more likely to have had many sexual partners. CONCLUSIONS: The effects of early pubertal timing on adolescent psychosocial problems were wide ranging but diminished by young adulthood for all but a small group.}, Doi = {10.1176/appi.ajp.2010.09081190}, Key = {fds270413} } @article{fds270412, Author = {Copeland, WE and Keeler, G and Angold, A and Costello, EJ}, Title = {Posttraumatic stress without trauma in children.}, Journal = {American Journal of Psychiatry}, Volume = {167}, Number = {9}, Pages = {1059-1065}, Year = {2010}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20551161}, Abstract = {OBJECTIVE: It remains unclear to what degree children show signs of posttraumatic stress disorder (PTSD) after experiencing low-magnitude stressors, or stressors milder than those required for the DSM-IV extreme stressor criterion. METHOD: A representative community sample of 1,420 children, ages 9, 11, and 13 at intake, was followed annually through age 16. Low-magnitude and extreme stressors as well as subsequent posttraumatic stress symptoms were assessed with the Child and Adolescent Psychiatric Assessment. Two measures of posttraumatic stress symptoms were used: having painful recall, hyperarousal, and avoidance symptoms (subclinical PTSD) and having painful recall only. RESULTS: During any 3-month period, low-magnitude stressors occurred four times as often as extreme stressors (24.0% compared with 5.9%). Extreme stressors elicited painful recall in 8.7% of participants and subclinical PTSD in 3.1%, compared with 4.2% and 0.7%, respectively, for low-magnitude stressors. Because of their higher prevalence, however, low-magnitude stressors accounted for two-thirds of cases of painful recall and half of cases of subclinical PTSD. Moreover, exposure to low-magnitude stressors predicted symptoms even among youths with no prior lifetime exposure to an extreme stressor. CONCLUSIONS: Relative to low-magnitude stressors, extreme stressors place children at greater risk for posttraumatic stress symptoms. Nevertheless, a sizable proportion of children manifesting posttraumatic stress symptoms experienced only a low-magnitude stressor.}, Doi = {10.1176/appi.ajp.2010.09020178}, Key = {fds270412} } @article{fds270411, Author = {Sterba, SK and Copeland, W and Egger, HL and Jane Costello and E and Erkanli, A and Angold, A}, Title = {Longitudinal dimensionality of adolescent psychopathology: testing the differentiation hypothesis.}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {51}, Number = {8}, Pages = {871-884}, Year = {2010}, Month = {August}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20345843}, Abstract = {BACKGROUND: The differentiation hypothesis posits that the underlying liability distribution for psychopathology is of low dimensionality in young children, inflating diagnostic comorbidity rates, but increases in dimensionality with age as latent syndromes become less correlated. This hypothesis has not been adequately tested with longitudinal psychiatric symptom data. METHODS: Confirmatory factor analyses of DSM-IV symptoms from seven common Axis I syndromes--major depression, generalized anxiety, separation anxiety, social anxiety, attention deficient hyperactivity, conduct, and oppositional defiant disorders--were conducted longitudinally, from ages 9 to 16, using the general-population Great Smoky Mountains Study sample. RESULTS: An eight-syndrome model fit well at all ages, and in both genders. It included social anxiety, separation anxiety, oppositional defiant, and conduct syndromes, along with a multidimensional attention deficit-hyperactivity syndrome (i.e., inattention, hyperactivity, and impulsivity) and a unidimensional major depression/generalized anxiety syndrome. A high degree of measurement invariance across age was found for all syndromes, except for major depression/generalized anxiety. Major depression and generalized anxiety syndromes slightly diverged at age 14-16, when they also began to explain more symptom variance. Additionally, correlations between some emotional and disruptive syndromes showed slight differentiation. CONCLUSIONS: Marked developmental differentiation of psychopathology, as implied by the orthogenetic principle, is not a prominent cause of preadolescent and adolescent psychiatric comorbidity.}, Doi = {10.1111/j.1469-7610.2010.02234.x}, Key = {fds270411} } @article{fds270410, Author = {Costello, EJ and Erkanli, A and Copeland, W and Angold, A}, Title = {Association of family income supplements in adolescence with development of psychiatric and substance use disorders in adulthood among an American Indian population.}, Journal = {Jama}, Volume = {303}, Number = {19}, Pages = {1954-1960}, Year = {2010}, Month = {May}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20483972}, Abstract = {CONTEXT: In a natural experiment in which some families received income supplements, prevalence of adolescent behavioral symptoms decreased significantly. These adolescents are now young adults. OBJECTIVE: To examine the effects of income supplements in adolescence and adulthood on the prevalence of adult psychiatric disorders. DESIGN: Quasi-experimental, longitudinal. POPULATION AND SETTING: A representative sample of children aged 9, 11, or 13 years in 1993 (349 [25%] of whom are American Indian) were assessed for psychiatric and substance use disorders through age 21 years (1993-2006). Of the 1420 who participated in 1993, 1185 were interviewed as adults. From 1996, when a casino opened on the Indian reservation, every American Indian but no non-Indians received an annual income supplement that increased from $500 to around $9000. MAIN OUTCOME MEASURES: Prevalence of adult psychiatric disorders and substance use disorders based on the Diagnostic and Statistical Manual of Mental Disorders in 3 age cohorts, adjusted for age, sex, length of time in the family home, and number of Indian parents. RESULTS: As adults, significantly fewer Indians than non-Indians had a psychiatric disorder (106 Indians [weighted 30.2%] vs 337 non-Indians [weighted 36.0%]; odds ratio [OR], 0.46; 95% confidence interval [CI], 0.30-0.72; P = .001), particularly alcohol and cannabis abuse, dependence, or both. The youngest age-cohort of Indian youth had the longest exposure to the family income. Interactions between race/ethnicity and age cohort were significant. Planned comparisons showed that fewer of the youngest Indian age-cohort had any psychiatric disorder (31.4%) than the Indian middle cohort (41.7%; OR, 0.43; 95% CI, 0.24-0.78; P = .005) or oldest cohort (41.3%; OR, 0.69; 95% CI, 0.51-0.94; P = .01) or the youngest non-Indian cohort (37.1%; OR, 0.66; 95% CI, 0.48-0.90; P = .008). Study hypotheses were not upheld for nicotine or other drugs, or emotional or behavioral disorders. The income supplement received in adulthood had no impact on adult psychopathology. CONCLUSION: Lower prevalence of psychopathology in American Indian youth following a family income supplement, compared with the nonexposed, non-Indian population, persisted into adulthood.}, Doi = {10.1001/jama.2010.621}, Key = {fds270410} } @article{fds270409, Author = {Costello, EJ and Angold, A}, Title = {Developmental transitions to psychopathology: are there prodromes of substance use disorders?}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {51}, Number = {4}, Pages = {526-532}, Year = {2010}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20132418}, Doi = {10.1111/j.1469-7610.2010.02221.x}, Key = {fds270409} } @article{fds270291, Author = {Akee, RKQ and Copeland, WE and Keeler, G and Angold, A and Costello, EJ}, Title = {Parents' Incomes and Children's Outcomes: A Quasi-Experiment.}, Journal = {American Economic Journal: Applied Economics}, Volume = {2}, Number = {1}, Pages = {86-115}, Year = {2010}, Month = {January}, ISSN = {1945-7782}, url = {http://dx.doi.org/10.1257/app.2.1.86}, Abstract = {We examine the role that an exogenous increase in household income due to a government transfer unrelated to household characteristics plays in children's long run outcomes. Children in affected households have higher levels of education in their young adulthood and a lower incidence of criminality for minor offenses. Effects differ by initial household poverty status. An additional $4000 per year for the poorest households increases educational attainment by one year at age 21 and reduces having ever committed a minor crime by 22% at ages 16-17. Our evidence suggests that improved parental quality is a likely mechanism for the change.}, Doi = {10.1257/app.2.1.86}, Key = {fds270291} } @article{fds270408, Author = {Foster, H and Nagin, DS and Hagan, J and Angold, A and Costello, EJ}, Title = {Specifying criminogenic strains: Stress dynamics and conduct disorder trajectories}, Journal = {Deviant Behavior}, Volume = {31}, Number = {5}, Pages = {440-475}, Publisher = {Informa UK Limited}, Year = {2010}, Month = {January}, ISSN = {0163-9625}, url = {http://dx.doi.org/10.1080/01639620903231340}, Abstract = {This article examines family stress dynamics and conduct disorder trajectories prospectively in the lives of adolescents from the Great Smoky Mountains Study of Youth (n = 1,319). Semi-parametric mixture models are used to identify distinct trajectories of conduct disorder, poverty, and family structure. We specify criminogenic features of dynamic family strains with multivariate models. Results highlight the protective role of family stability over time where having always lived in a single-parent family does not elevate the odds of belonging to the riskier conduct disorder groups. Furthermore, poverty duration is also salient where non-chronic exposure is associated with conduct disorder desistance. © Taylor & Francis Group, LLC.}, Doi = {10.1080/01639620903231340}, Key = {fds270408} } @article{fds270407, Author = {Windle, M and Spear, LP and Fuligni, AJ and Angold, A and Brown, JD and Pine, D and Smith, GT and Giedd, J and Dahl, RE}, Title = {Transitions into underage and problem drinking: Summary of developmental processes and mechanisms: Ages 10-15}, Journal = {Alcohol Research and Health}, Volume = {32}, Number = {1}, Pages = {30-40}, Year = {2009}, Month = {October}, ISSN = {1535-7414}, Abstract = {Adolescents ages 10-15 experience dramatic changes in their biological, cognitive, emotional, and social development as well as in their physical and social environments. These include the physiological and psychological changes associated with puberty; further development of the brain; changes in family, peer, and romantic relationships; and exposure to new societal and cultural influences. During this period, many adolescents also begin to use alcohol. Alcohol use during adolescence has adverse effects on the body and increases the risk of alcohol dependence later in life. To better understand why some children drink whereas others do not, researchers are examining nonspecific and alcoholspecific factors that put adolescents at risk for, or which protect them from, early alcohol use and its associated problems. Nonspecific risk factors include certain temperamental and personality traits, family factors, and nonnormative development. Examples of nonspecific protective factors include certain temperamental characteristics, religiosity, and parenting factors (e.g., parental nurturance and monitoring). Among the most influential alcoholspecific risk and protective factors are a family history of alcoholism and the influences of siblings and peers, all of which shape an adolescent's expectancies about the effects of alcohol, which in turn help determine alcohol use behaviors.}, Key = {fds270407} } @article{fds270270, Author = {Costello, J and Angold, A}, Title = {Measurement and design for life course studies of individual differences and development}, Pages = {27-60}, Publisher = {Oxford University Press}, Year = {2009}, Month = {September}, url = {http://dx.doi.org/10.1093/acprof:oso/9780198528487.003.0002}, Abstract = {This chapter reviews methods for studying individual differences across the life course. It starts from the position that even when a life course study is basically observational or descriptive, there is an underlying concern to understand more about causality. There are two aspects of research methods that have to be considered in designing a life course study: study design and measurement of individuals. Under the first heading the chapter describes observational and quasi-experimental designs for life course research. A section on genetically informative designs describes a range of options for increasing the genetic information that can be obtained from life course research. The section on capturing individual differences discusses continuous versus categorical measurement, the timing of measurements, the range of information that can be collected, and nonintrusive methods for collecting individual life course information. A section on biological information discusses applications of molecular genetics and psychoneuroendocrinology to life course research.}, Doi = {10.1093/acprof:oso/9780198528487.003.0002}, Key = {fds270270} } @article{fds270406, Author = {Copeland, WE and Shanahan, L and Costello, EJ and Angold, A}, Title = {Childhood and adolescent psychiatric disorders as predictors of young adult disorders.}, Journal = {Arch Gen Psychiatry}, Volume = {66}, Number = {7}, Pages = {764-772}, Year = {2009}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19581568}, Abstract = {CONTEXT: Most adults with a psychiatric disorder first met diagnostic criteria during childhood and/or adolescence, yet specific homotypic and heterotypic patterns of prediction have not been firmly established. OBJECTIVE: To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disaggregating similar disorders, and examining childhood and adolescent predictors separately. DESIGN: Eleven waves of data from the prospective population-based Great Smoky Mountains Study (N = 1420) were used. SETTING: The Great Smoky Mountains Study is a longitudinal study of the development of psychiatric disorder and need for mental health services in rural and urban youth. A representative sample of children was recruited from 11 counties in western North Carolina. PARTICIPANTS: Children in the community aged 9 to 16, 19, and 21 years. MAIN OUTCOME MEASURES: Common psychiatric disorders were assessed in childhood (ages 9-12 years) and adolescence (ages 13-16 years) with the Child and Adolescent Psychiatric Assessment and in young adulthood (ages 19 and 21 years) with the Young Adult Psychiatric Assessment. RESULTS: Adolescent depression significantly predicted young adult depression in the bivariate analysis, but this effect was entirely accounted for by comorbidity of adolescent depression with adolescent oppositional defiant disorder, anxiety, and substance disorders in adjusted analyses. Generalized anxiety and depression cross-predicted each other, and oppositional defiant disorder (but not conduct disorder) predicted later anxiety disorders and depression. Evidence of homotypic prediction was supported for substance use disorders, antisocial personality disorder (from conduct disorder), and anxiety disorders, although this effect was primarily accounted for by DSM-III-R overanxious disorder. CONCLUSIONS: Stringent tests of homotypic and heterotypic prediction patterns suggest a more developmentally and diagnostically nuanced picture in comparison with the previous literature. The putative link between adolescent and young adult depression was not supported. Oppositional defiant disorder was singular in being part of the developmental history of a wide range of young adult disorders.}, Doi = {10.1001/archgenpsychiatry.2009.85}, Key = {fds270406} } @article{fds270405, Author = {Copeland, W and Shanahan, L and Costello, EJ and Angold, A}, Title = {Configurations of common childhood psychosocial risk factors.}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {50}, Number = {4}, Pages = {451-459}, Year = {2009}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19220623}, Abstract = {BACKGROUND: Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. METHODS: Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class structure was retested in a representative population sample of 1420 children aged 9 to 13. In each sample, the child and one parent were interviewed with the Child and Adolescent Psychiatric Assessment. Concurrent psychiatric status was used to validate class membership. RESULTS: LCA identified five latent classes in both samples: two low risk classes; two moderate risk classes both involving family poverty configured with various other risk factors; and a high risk class characterized by family relational dysfunction and parental risk characteristics. Of the primary sample, 48.6% were categorized as low risk, 42.8% as moderate risk, and 8.6% as high risk. Moderate risk classes differed in their prediction of disruptive and emotional disorders depending on their specific risk factor configurations. High risk youth had the highest levels of both emotional and disruptive disorders. Combining our latent classes with a cumulative risk approach best accounted for the effects of risk factors on psychopathology in our primary sample. CONCLUSIONS: Particular risk configurations have specific associations with psychiatric disorders. Configurational approaches are an important asset for large-scale epidemiological studies that integrate information about patterns of risk and disorders.}, Doi = {10.1111/j.1469-7610.2008.02005.x}, Key = {fds270405} } @article{fds270402, Author = {Angold, A}, Title = {Childhood psychopathology can be really bad for your health.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {48}, Number = {1}, Pages = {3-4}, Year = {2009}, Month = {January}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/CHI.0b013e3181908c49}, Doi = {10.1097/CHI.0b013e3181908c49}, Key = {fds270402} } @article{fds270403, Author = {Angold, A and Costello, EJ}, Title = {Nosology and measurement in child and adolescent psychiatry.}, Journal = {The Journal of Child Psychology and Psychiatry and Allied Disciplines}, Volume = {50}, Number = {1-2}, Pages = {9-15}, Year = {2009}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19175818}, Abstract = {The last 50 years have witnessed enormous strides in the measurement and classification of child and adolescent psychiatric disorders. Debates about whether we should continue to depend upon a categorical nosology still continue, but we argue that, despite the absence of clear dividing lines between psychiatric disorders and normality and ubiquity of diagnostic comorbidity, the current official approach to nosology has served child and adolescent psychiatric research surprisingly well. In particular we point to the utility of non-developmental diagnostic criteria as tools for discovering developmental effects on psychopathology. We also maintain that the search for sharper boundaries between disorders is fundamentally mistaken. However, official nosologies have tended to privilege information collected in diagnostic interviews and to sideline observational and other methods that cannot easily be made to conform to the format of their criteria. We suggest that it is time to remedy this situation. The ICD-10 and DSM-IV are useless for children under the age of about two, while alternatives, such as the DC:0-3, suffer from a profound lack of empirical support. We suggest a way forward through the integration of methods from temperament and psychopathology research. Finally, we deplore the failure of standardized assessment techniques to have penetrated more deeply into everyday clinical assessment.}, Doi = {10.1111/j.1469-7610.2008.01981.x}, Key = {fds270403} } @article{fds270404, Author = {Brown, RA and Kuzara, J and Copeland, WE and Costello, EJ and Angold, A and Worthman, CM}, Title = {Moving from ethnography to epidemiology: lessons learned in Appalachia.}, Journal = {Ann Hum Biol}, Volume = {36}, Number = {3}, Pages = {248-260}, Year = {2009}, ISSN = {0301-4460}, url = {http://dx.doi.org/10.1080/03014460902832942}, Abstract = {BACKGROUND: Anthropologists are beginning to translate insights from ethnography into tools for population studies that assess the role of culture in human behavior, biology, and health. AIM: We describe several lessons learned in the creation and administration of an ethnographically-based instrument to assess the life course perspectives of Appalachian youth, the Life Trajectory Interview for Youth (LTI-Y). Then, we explore the utility of the LTI-Y in predicting depressive symptoms, controlling for prior depressive symptoms and severe negative life events throughout the life course. SUBJECTS AND METHODS: In a sample of 319 youths (190 White, 129 Cherokee), we tested the association between depressive symptoms and two domains of the LTI-Y - life course barriers and milestones. Longitudinal data on prior depressive symptoms and negative life events were included in the model. RESULTS: The ethnographically-based scales of life course barriers and milestones were associated with unique variance in depressive symptoms, together accounting for 11% of the variance in this outcome. CONCLUSION: When creating ethnographically-based instruments, it is important to strike a balance between detailed, participant-driven procedures and the analytic needs of hypothesis testing. Ethnographically-based instruments have utility for predicting health outcomes in longitudinal studies.}, Doi = {10.1080/03014460902832942}, Key = {fds270404} } @article{fds270400, Author = {Brown, RA and Adler, NE and Worthman, CM and Copeland, WE and Costello, EJ and Angold, A}, Title = {Cultural and community determinants of subjective social status among Cherokee and White youth.}, Journal = {Ethnicity & Health}, Volume = {13}, Number = {4}, Pages = {289-303}, Year = {2008}, Month = {September}, ISSN = {1355-7858}, url = {http://dx.doi.org/10.1080/13557850701837302}, Abstract = {BACKGROUND: . Subjective social status (SSS) is associated with physical and mental health in diverse samples. However, community, cultural, and ethnic influences on SSS are poorly understood, especially among rural and American Indian populations. OBJECTIVE: We aimed to examine similarities and differences in how community poverty, family context, and life course attainment predict SSS among Cherokee and White youth in Appalachia. DESIGN: We assessed culturally and developmentally appropriate aspects of life course attainment among 344 Cherokee and White youth (age 19-24) using the Life Trajectory Interview for Youth (Brown et al. 2006. International Journal of Methods in Psychiatric Research, 15, 192-206). Combined with information regarding community context and family history, these data were used to examine common patterns and ethnic differences in community, family, and cultural influences on SSS. RESULTS: Overall, both Cherokee and White youth rank their families lower in SSS than previously studied US youth. Family poverty during childhood and low parental education negatively influence family SSS, Cherokee youth rank higher on subjective socioeconomic status (SES) than Whites, as do participants in high poverty areas. However, White youth rank higher on peer SSS. Ethnographically generated items perform better than standard demographic markers in predicting SSS. Educational attainment is associated with peer SSS among Cherokee (but not White) youths. CONCLUSIONS: Cultural identity, community context, and local reference groups are crucial determinants of SSS. Both White and Cherokee youth in Appalachia exhibit SSS rankings consistent with socioeconomic and cultural marginalization. On a local scale, however, living in high poverty areas or minority communities may buffer individuals from some negative social comparisons regarding subjectively perceived SES. Meanwhile, social monitoring in small minority communities may constrain optimistic bias in assessments of peer popularity and status. Social ecology, family context, and individual attainment appear to exert distinctive influences on SSS across different cultural and ethnic groups.}, Doi = {10.1080/13557850701837302}, Key = {fds270400} } @article{fds270401, Author = {Willoughby, MT and Angold, A and Egger, HL}, Title = {Parent-reported attention-deficit/hyperactivity disorder symptomatology and sleep problems in a preschool-age pediatric clinic sample.}, Journal = {J Am Acad Child Adolesc Psychiatry}, Volume = {47}, Number = {9}, Pages = {1086-1094}, Year = {2008}, Month = {September}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/CHI.0b013e31817eed1b}, Abstract = {OBJECTIVE: To examine the association between attention-deficit/hyperactivity disorder symptomatology and parent-reported sleep problems among preschoolers ages 2 to 5 years. METHOD: A total of 1,073 parents of preschoolers ages 2 to 5 years attending a large pediatric clinic completed the Child Behavior Checklist 1(1/2)-5 years. A stratified probability sample of 193 parents of high scorers and 114 parents of low scorers were interviewed with the Preschool Age Psychiatric Assessment. Poisson regression was used to test the association between parent-reported sleep problems and attention-deficit/hyperactivity disorder symptomatology, as well as psychiatric and demographic covariates. RESULTS: When considered without reference to other psychiatric disorders, elevated hyperactive-impulsive symptomatology was positively associated with parent reported problems including sleep assistance, parasomnias, and dyssomnias; however, all of these effects were attenuated to nonsignificance once psychiatric comorbidity was controlled. In contrast, elevated inattentive symptomatology (especially at lower levels of hyperactive-impulsive symptoms) was positively associated with daytime sleepiness even after psychiatric comorbidity was controlled. CONCLUSIONS: Neither hyperactive-impulsive nor inattentive attention-deficit/hyperactivity disorder symptomatology was uniquely related to parent-reported problems involving sleep assistance, parasomnias, or dyssomnias. However, inattentive symptomatology was uniquely related to daytime sleepiness above and beyond commonly occurring patterns of psychiatric comorbidity, sleep duration, and demographic factors.}, Doi = {10.1097/CHI.0b013e31817eed1b}, Key = {fds270401} } @article{fds270399, Author = {Windle, M and Spear, LP and Fuligni, AJ and Angold, A and Brown, JD and Pine, D and Smith, GT and Giedd, J and Dahl, RE}, Title = {Transitions into underage and problem drinking: developmental processes and mechanisms between 10 and 15 years of age.}, Journal = {Pediatrics}, Volume = {121 Suppl 4}, Number = {Suppl 4}, Pages = {S273-S289}, Year = {2008}, Month = {April}, ISSN = {0031-4005}, url = {http://dx.doi.org/10.1542/peds.2007-2243C}, Abstract = {Numerous developmental changes occur across levels of personal organization (eg, changes related to puberty, brain and cognitive-affective structures and functions, and family and peer relationships) in the age period of 10 to 15 years. Furthermore, the onset and escalation of alcohol use commonly occur during this period. This article uses both animal and human studies to characterize these multilevel developmental changes. The timing of and variations in developmental changes are related to individual differences in alcohol use. It is proposed that this integrated developmental perspective serve as the foundation for subsequent efforts to prevent and to treat the causes, problems, and consequences of alcohol consumption.}, Doi = {10.1542/peds.2007-2243C}, Key = {fds270399} } @article{fds270398, Author = {Shanahan, L and Copeland, W and Costello, EJ and Angold, A}, Title = {Specificity of putative psychosocial risk factors for psychiatric disorders in children and adolescents.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {49}, Number = {1}, Pages = {34-42}, Year = {2008}, Month = {January}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18181879}, Abstract = {BACKGROUND: Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on risk factor-disorder associations. This study tests the specificity of putative psychosocial risk factors while addressing these criticisms. METHODS: Eight waves of data from the Great Smoky Mountains Study (N = 1,420) were used, covering children in the community age 9-16 years old. Youth and one parent were interviewed up to seven times using the Child and Adolescent Psychiatric Assessment, providing a total of 6,674 pairs of interviews. A wide range of putative neighborhood, school, peer, family, and child risk factors, and common and comorbid youth disorders were assessed. RESULTS: The majority of putative risk factors were specific to one disorder or one disorder domain. A unique or 'signature set' of putative risk factors was identified for each disorder. Several putative risk factors were associated with a disorder in preadolescent males, preadolescent females, adolescent males, or adolescent females only. CONCLUSIONS: Our findings support the need to define risk factors and disorders narrowly, to control comorbidity and other risk factors, and to consider developmental patterns of specificity by sex.}, Doi = {10.1111/j.1469-7610.2007.01822.x}, Key = {fds270398} } @article{fds270397, Author = {Bittner, A and Egger, HL and Erkanli, A and Jane Costello and E and Foley, DL and Angold, A}, Title = {What do childhood anxiety disorders predict?}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {48}, Number = {12}, Pages = {1174-1183}, Year = {2007}, Month = {December}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18093022}, Abstract = {BACKGROUND: Few longitudinal studies of child and adolescent psychopathology have examined the links between specific childhood anxiety disorders and adolescent psychiatric disorder. In this paper we test the predictive specificity of separation anxiety disorder (SAD), overanxious disorder (OAD), generalized anxiety disorder (GAD), and social phobia. METHODS: Data come from the Great Smoky Mountains Study (GSMS). A representative population sample of children--ages 9, 11, and 13 years at intake--was followed to age 19. Diagnoses of both childhood (before age 13 years) and adolescent psychiatric disorders (age 13 to 19 years) were available from 906 participants. RESULTS: Childhood SAD predicted adolescent SAD, whereas OAD was associated with later OAD, panic attacks, depression and conduct disorder (CD). GAD was related only to CD. Social phobia in childhood was associated with adolescent OAD, social phobia, and attention-deficit/hyperactivity disorder (ADHD). CONCLUSIONS: Anxiety disorders in childhood are predictors of a range of psychiatric disorders in adolescence. It appears that children meriting a well-defined diagnosis are missed by the current rules for the diagnosis of GAD. Future studies should examine whether OAD deserves reconsideration as a nosological entity.}, Doi = {10.1111/j.1469-7610.2007.01812.x}, Key = {fds270397} } @article{fds270394, Author = {Copeland, WE and Miller-Johnson, S and Keeler, G and Angold, A and Costello, EJ}, Title = {Childhood psychiatric disorders and young adult crime: a prospective, population-based study.}, Journal = {The American Journal of Psychiatry}, Volume = {164}, Number = {11}, Pages = {1668-1675}, Year = {2007}, Month = {November}, ISSN = {0002-953X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17974931}, Abstract = {OBJECTIVE: While psychopathology is common in criminal populations, knowing more about what kinds of psychiatric disorders precede criminal behavior could be helpful in delineating at-risk children. The authors determined rates of juvenile psychiatric disorders in a sample of young adult offenders and then tested which childhood disorders best predicted young adult criminal status. METHOD: A representative sample of 1,420 children ages 9, 11, and 13 at intake were followed annually through age 16 for psychiatric disorders. Criminal offense status in young adulthood (ages 16 to 21) was ascertained through court records. RESULTS: Thirty-one percent of the sample had one or more adult criminal charges. Overall, 51.4% of male young adult offenders and 43.6% of female offenders had a child psychiatric history. The population-attributable risk of criminality from childhood disorders was 20.6% for young adult female participants and 15.3% for male participants. Childhood psychiatric profiles predicted all levels of criminality. Severe/violent offenses were predicted by comorbid diagnostic groups that included both emotional and behavioral disorders. CONCLUSIONS: The authors found that children with specific patterns of psychopathology with and without conduct disorder were at risk of later criminality. Effective identification and treatment of children with such patterns may reduce later crime.}, Doi = {10.1176/appi.ajp.2007.06122026}, Key = {fds270394} } @article{fds270395, Author = {Sterba, S and Egger, HL and Angold, A}, Title = {Diagnostic specificity and nonspecificity in the dimensions of preschool psychopathology.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {48}, Number = {10}, Pages = {1005-1013}, Year = {2007}, Month = {October}, ISSN = {0021-9630}, url = {http://dx.doi.org/10.1111/j.1469-7610.2007.01770.x}, Abstract = {BACKGROUND: The appropriateness of the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) nosology for classifying preschool mental health disturbances continues to be debated. To inform this debate, we investigate whether preschool psychopathology shows differentiation along diagnostically specific lines when DSM-IV symptoms are aggregated statistically. METHODS: One thousand seventy-three parents of preschoolers aged 2-5 years attending a large pediatric clinic completed the Child Behavior Checklist 1.5-5. A stratified probability sample of 193 parents of high scorers and 114 parents of low scorers were interviewed with the Preschool Age Psychiatric Assessment (PAPA). Confirmatory factor analysis was performed on symptoms from seven DSM disorders. RESULTS: Comparison of competing models supported the differentiation of emotional syndromes into three factors: social phobia (SOC), separation anxiety (SAD), and depression/generalized anxiety (MDD/GAD), and the differentiation of disruptive syndromes into three factors: oppositional defiant/conduct syndrome (ODD/CD), hyperactivity/impulsivity, and inattention. Latent syndrome correlations were moderately high after accounting for symptom overlap and measurement error. CONCLUSIONS: Psychopathology appears to be differentiated among preschoolers much as it is among older children, and adolescents. We conclude that it is as reasonable to apply the DSM-IV nosology to preschoolers as it is to apply it to older individuals.}, Doi = {10.1111/j.1469-7610.2007.01770.x}, Key = {fds270395} } @article{fds270396, Author = {Angold, A and Egger, HL}, Title = {Preschool psychopathology: lessons for the lifespan.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {48}, Number = {10}, Pages = {961-966}, Year = {2007}, Month = {October}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17914996}, Doi = {10.1111/j.1469-7610.2007.01832.x}, Key = {fds270396} } @article{fds270392, Author = {Copeland, WE and Keeler, G and Angold, A and Costello, EJ}, Title = {Traumatic events and posttraumatic stress in childhood.}, Journal = {Archives of General Psychiatry}, Volume = {64}, Number = {5}, Pages = {577-584}, Year = {2007}, Month = {May}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17485609}, Abstract = {CONTEXT: Traumatic events are common and are related to psychiatric impairment in childhood. Little is known about the risk for posttraumatic stress disorder (PTSD) across different types of trauma exposure in children. OBJECTIVE: To examine the developmental epidemiology of potential trauma and posttraumatic stress (PTS) in a longitudinal community sample of children. METHODS: A representative population sample of 1420 children aged 9, 11, and 13 years at intake were followed up annually through 16 years of age. Main Outcome Measure Traumatic events and PTS were assessed from child and parent reports annually to 16 years of age. Risk factors and DSM-IV disorders were also assessed. RESULTS: More than two thirds of children reported at least 1 traumatic event by 16 years of age, with 13.4% of those children developing some PTS symptoms. Few PTS symptoms or psychiatric disorders were observed for individuals experiencing their first event, and any effects were short-lived. Less than 0.5% of children met the criteria for full-blown DSM-IV PTSD. Violent or sexual trauma were associated with the highest rates of symptoms. The PTS symptoms were predicted by previous exposure to multiple traumas, anxiety disorders, and family adversity. Lifetime co-occurrence of other psychiatric disorders with traumatic events and PTS symptoms was high, with the highest rates for anxiety and depressive disorders. CONCLUSIONS: In the general population of children, potentially traumatic events are fairly common and do not often result in PTS symptoms, except after multiple traumas or a history of anxiety. The prognosis after the first lifetime trauma exposure was generally favorable. Apart from PTSD, traumatic events are related to many forms of psychopathology, with the strongest links being with anxiety and depressive disorders.}, Doi = {10.1001/archpsyc.64.5.577}, Key = {fds270392} } @article{fds270393, Author = {Costello, EJ and Sung, M and Worthman, C and Angold, A}, Title = {Pubertal maturation and the development of alcohol use and abuse.}, Journal = {Drug and Alcohol Dependence}, Volume = {88 Suppl 1}, Pages = {S50-S59}, Year = {2007}, Month = {April}, ISSN = {0376-8716}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17275214}, Abstract = {OBJECTIVE: To examine the impact of various aspects of puberty on risk of using alcohol and developing alcohol use disorder (AUD). METHODS: Data come from the Great Smoky Mountains Study, a longitudinal study of a representative sample of 1420 youth aged 9-13 at recruitment. Participants were interviewed annually to age 16. A parent was also interviewed. Information was obtained about use of a range of drugs including alcohol, drug abuse and dependence, other psychiatric disorders, life events, and a wide range of family characteristics. Pubertal hormones were assayed annually from blood samples, and morphological development was assessed using a pictorial measure of Tanner stage. RESULTS: Controlling for age, Tanner stage predicted alcohol use and AUD in both boys (OR 1.58, 95% CI 1.18-2.22) and girls (OR 1.62, 95% CI 1.17-2.23). The effect of morphological development was strongest in those who matured early. Early pubertal maturation predicted alcohol use in both sexes, and AUD in girls. The highest level of excess risk for alcohol use was seen in early maturing youth with conduct disorder and deviant peers. Lax supervision predicted alcohol use in early maturing girls, while poverty and family problems were predictive in early maturing boys. CONCLUSIONS: Among the many biological, morphological, and social markers of increasing maturation, the visible signs of maturity are important triggers of alcohol use and AUD, especially when they occur early and in young people with conduct problems, deviant peers, problem families and inadequate parental supervision.}, Doi = {10.1016/j.drugalcdep.2006.12.009}, Key = {fds270393} } @article{fds270391, Author = {Costello, EJ and Worthman, C and Erkanli, A and Angold, A}, Title = {Prediction from low birth weight to female adolescent depression: a test of competing hypotheses.}, Journal = {Archives of General Psychiatry}, Volume = {64}, Number = {3}, Pages = {338-344}, Year = {2007}, Month = {March}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17339522}, Abstract = {CONTEXT: Low birth weight (LBW) predicts later-onset hypertension and diabetes mellitus. Its role as a predictor of depression is unclear. OBJECTIVES: To examine whether LBW predicts depression in male and female children and adolescents and to compare the following 2 hypotheses: Low birth weight is one among several perinatal, childhood, and adolescent risk factors for depression (biopsychosocial hypothesis). Low birth weight is a marker for poor intrauterine conditions that provoke adjustments in fetal development, with long-term consequences for stress response (fetal programming hypothesis). DESIGN: A representative population-based sample from an 11-county area in western North Carolina was assessed annually for psychiatric disorders between the ages of 9 and 16 years. We tested the prediction from LBW and depression in models that included LBW only, LBW plus other prenatal and perinatal adversities, LBW plus significant perinatal and childhood adversities, and LBW plus significant perinatal and childhood adversities and adolescent correlates. SETTING: Academic research. PARTICIPANTS: There were 1420 participants, of whom 49% were female. Main Outcome Measure Cumulative prevalence of DSM-IV depressive disorder at 1 assessment or more during childhood (age range, 9-12 years) and during adolescence (age range, 13-16 years). RESULTS: The cumulative prevalence of depression among adolescent girls with LBW was 38.1% (95% confidence interval [CI], 16.3%-66.0%) compared with 8.4% (95% CI, 5.2%-13.3%) among adolescent girls with normal birth weight. Rates among children and adolescent boys did not exceed 4.9%. In adolescence, there was a significant interaction between LBW and sex (odds ratio, 0.2 [95% CI, 0.1-0.5]; P<.001). Low birth weight predicted female adolescent depression after controlling for other perinatal, childhood, and adolescent adversities. Girls with LBW and normal birth weight with no adversities had no adolescent depression, but each additional adversity increased the risk of in girls with LBW more than in girls with normal birth weight. Low birth weight did not predict other psychiatric disorders in either sex. CONCLUSIONS: Low birth weight predicts depression in adolescent girls but not boys. Data support fetal programming over the biopsychosocial hypothesis, suggesting vulnerability to adversities in girls with LBW after puberty.}, Doi = {10.1001/archpsyc.64.3.338}, Key = {fds270391} } @article{fds270277, Author = {Phillips, SD and Erkanli, A and Costello, EJ and Angold, A}, Title = {Differences among children whose mothers have been in contact with the criminal justice system}, Journal = {Women & Criminal Justice}, Volume = {17}, Number = {2-3}, Pages = {43-61}, Year = {2007}, url = {http://dx.doi.org/10.1300/J012v17n02_04}, Abstract = {In order to effectively help children whose mothers become involved with the criminal justice system, it is important to understand their differing needs. To that end, the analyses described in this article explore the heterogeneity in parent and family risks among a group of children whose mothers had contact with the criminal justice system. Using data from an epidemiologic study of youth, results showed that the two most prevalent problems in the backgrounds of this group of youth were poverty (61.5%) and maternal mental health problems (54.9%). But, results of cluster analyses suggest this group is actually made up of four meaningfully different subgroups: (1) children with only isolated risks, (2) children with histories of abuse, (3) children who have multiple parents/caregivers with histories of drug abuse and/or mental health problems, and (4) children whose parents have few problems, but who are living in economically deprived, single-parent households. © by The Haworth Press, Inc. All rights reserved.}, Doi = {10.1300/J012v17n02_04}, Key = {fds270277} } @article{fds270388, Author = {Jane Costello and E and Erkanli, A and Angold, A}, Title = {Is there an epidemic of child or adolescent depression?}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {47}, Number = {12}, Pages = {1263-1271}, Year = {2006}, Month = {December}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17176381}, Abstract = {BACKGROUND: Both the professional and the general media have recently published concerns about an 'epidemic' of child and adolescent depression. Reasons for this concern include (1) increases in antidepressant prescriptions, (2) retrospective recall by successive birth cohorts of adults, (3) rising adolescent suicide rates until 1990, and (4) evidence of an increase in emotional problems across three cohorts of British adolescents. METHODS: Epidemiologic studies of children born between 1965 and 1996 were reviewed and a meta-analysis conducted of all studies that used structured diagnostic interviews to make formal diagnoses of depression on representative population samples of participants up to age 18. The effect of year of birth on prevalence was estimated, controlling for age, sex, sample size, taxonomy (e.g., DSM vs. ICD), measurement instrument, and time-frame of the interview (current, 3 months, 6 months, 12 months). RESULTS: Twenty-six studies were identified, generating close to 60,000 observations on children born between 1965 and 1996 who had received at least one structured psychiatric interview capable of making a formal diagnosis of depression. Rates of depression showed no effect of year of birth. There was little effect of taxonomy, measurement instrument, or time-frame of interview. The overall prevalence estimates were: under 13, 2.8% (standard error (SE) .5%); 13-18 5.6% (SE .3%); 13-18 girls: 5.9% (SE .3%); 13-18 boys: 4.6% (SE .3%). CONCLUSIONS: When concurrent assessment rather than retrospective recall is used, there is no evidence for an increased prevalence of child or adolescent depression over the past 30 years. Public perception of an 'epidemic' may arise from heightened awareness of a disorder that was long under-diagnosed by clinicians.}, Doi = {10.1111/j.1469-7610.2006.01682.x}, Key = {fds270388} } @article{fds270389, Author = {Erkanli, A and Sung, M and Costello, EJ and Angold, A}, Title = {Bayesian semi-parametric ROC analysis.}, Journal = {Statistics in Medicine}, Volume = {25}, Number = {22}, Pages = {3905-3928}, Year = {2006}, Month = {November}, ISSN = {0277-6715}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16416403}, Abstract = {This paper describes a semi-parametric Bayesian approach for estimating receiver operating characteristic (ROC) curves based on mixtures of Dirichlet process priors (MDP). We address difficulties in modelling the underlying distribution of screening scores due to non-normality that may lead to incorrect choices of diagnostic cut-offs and unreliable estimates of prevalence of the disease. MDP is a robust tool for modelling non-standard diagnostic distributions associated with imperfect classification of an underlying diseased population, for example, when a diagnostic test is not a gold standard. For posterior computations, we propose an efficient Gibbs sampling framework based on a finite-dimensional approximation to MDP. We show, using both simulated and real data sets, that MDP modelling for ROC curve estimation closely parallels the frequentist kernel density estimation (KDE) approach.}, Doi = {10.1002/sim.2496}, Key = {fds270389} } @article{fds270387, Author = {Brotman, MA and Schmajuk, M and Rich, BA and Dickstein, DP and Guyer, AE and Costello, EJ and Egger, HL and Angold, A and Pine, DS and Leibenluft, E}, Title = {Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children.}, Journal = {Biological Psychiatry}, Volume = {60}, Number = {9}, Pages = {991-997}, Year = {2006}, Month = {November}, ISSN = {0006-3223}, url = {http://dx.doi.org/10.1016/j.biopsych.2006.08.042}, Abstract = {BACKGROUND: Controversy concerning the diagnosis of pediatric bipolar disorder (BD) has focused attention on children with chronic irritability and hyperarousal. This syndrome has been called the "broad BD phenotype" or severe mood dysregulation (SMD). This study examines prevalence, concurrent Axis I diagnoses, and longitudinal outcome of SMD in an epidemiologic sample. METHODS: Data were drawn from the Great Smoky Mountains Study, a longitudinal epidemiological study. Items from the Child and Adolescent Psychiatric Assessment were used to generate SMD criteria. RESULTS: Among 1420 children, the lifetime prevalence of SMD in children ages 9-19 was 3.3%. Most (67.7%) SMD youth had an Axis I diagnosis, most commonly attention-deficit/hyperactivity disorder (26.9%), conduct disorder (25.9%), and/or oppositional defiant disorder (24.5%). In young adulthood (mean age 18.3 +/- 2.1 years), youth who met criteria for SMD in the first wave (mean age 10.6 +/- 1.4 years) were significantly more likely to be diagnosed with a depressive disorder (odds ratio 7.2, confidence interval 1.3-38.8, p = .02) than youth who never met criteria for SMD. CONCLUSIONS: Severe mood dysregulation is relatively common in childhood and predicts risk for early adulthood depressive disorders. Research should continue to explore the course of illness in children with SMD.}, Doi = {10.1016/j.biopsych.2006.08.042}, Key = {fds270387} } @article{fds270386, Author = {Angold, A and Costello, EJ}, Title = {Puberty and depression.}, Journal = {Child and Adolescent Psychiatric Clinics of North America}, Volume = {15}, Number = {4}, Pages = {919-ix}, Year = {2006}, Month = {October}, ISSN = {1056-4993}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16952768}, Abstract = {Unipolar depression only becomes more common in girls than boys after the age of 13, as a result of an increased incidence of depressive episodes in girls at that time. This article reviews evidence that links multiple dimensions of maturation in the hypothalamo-pituitary-gonadal axis with this phenomenon. Effects of developmental status and timing have been implicated, but few studies have deployed either the measurement strategies or the statistical power needed to provide a satisfactory answer to the question regarding which components of puberty are most responsible.}, Doi = {10.1016/j.chc.2006.05.013}, Key = {fds270386} } @article{fds270383, Author = {Foley, DL and Goldston, DB and Costello, EJ and Angold, A}, Title = {Proximal psychiatric risk factors for suicidality in youth: the Great Smoky Mountains Study.}, Journal = {Archives of General Psychiatry}, Volume = {63}, Number = {9}, Pages = {1017-1024}, Year = {2006}, Month = {September}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16953004}, Abstract = {CONTEXT: Psychiatric disorder is a major risk factor for suicidality but has poor positive predictive value. OBJECTIVES: To characterize proximal risks for suicidality associated with anxiety, depressive, disruptive behavior, and substance use disorders, and to test whether there are critical combinations of disorders that discriminate at-risk youth independent of severity of psychopathology. DESIGN: The Great Smoky Mountains Study, a representative sample of children and adolescents aged 9 to 16 years from the southeastern United States. Subjects and their parents were interviewed on multiple occasions from 1993 to 2000 about the subjects' recent psychiatric and suicidal history. SETTING: An epidemiological sample of youth. PARTICIPANTS: The sample included 1420 individual subjects with 6676 records across 8 waves of data collection. MAIN OUTCOME MEASURES: Wanting to die, suicidal ideation, suicide plans, or suicide attempt during the past 3 months. RESULTS: Eleven broad psychiatric profiles discriminated suicidal youth. Risk was greatest in association with current depression plus anxiety (specifically GAD [generalized anxiety disorder]) (odds ratio, 468.53) or depression plus a disruptive disorder (primarily ODD [oppositional-defiant disorder]) (odds ratio, 222.94). Unless comorbid, anxiety and substance use disorders were not proximally associated with suicidality. The severity of symptom-related impairment and, in some cases, total symptom load explained risk associated with all psychiatric profiles except depression plus anxiety, specifically GAD (adjusted odds ratio, 50.16). Severity of impairment and poverty defined by federal guidelines for families were both independent risk factors, irrespective of psychiatric profile. Suicidal youth without diagnosable disorders had subthreshold (mostly disruptive) disorders, disabling relationship difficulties, or psychiatric symptoms without associated impairment. CONCLUSIONS: Severity of symptom-related impairment and total symptom load explained most of the risk for suicidality associated with current psychiatric disorders. Only depression plus GAD discriminated at-risk youth independent of severity of psychopathology.}, Doi = {10.1001/archpsyc.63.9.1017}, Key = {fds270383} } @article{fds270385, Author = {Ezpeleta, L and Domènech, JM and Angold, A}, Title = {A comparison of pure and comorbid CD/ODD and depression.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {47}, Number = {7}, Pages = {704-712}, Year = {2006}, Month = {July}, ISSN = {0021-9630}, url = {http://dx.doi.org/10.1111/j.1469-7610.2005.01558.x}, Abstract = {BACKGROUND: We studied the symptomatology of conduct/oppositional defiant disorder and major depression/dysthymic disorder in 'pure' and comorbid presentations. METHOD: The sample comprised 382 children of 8 to 17 years of age attending for psychiatric outpatient consultation. Ninety-two had depressive disorders without conduct disorders, 165 conduct disorder or oppositional defiant disorder without depressive disorders and 125 had both. RESULTS: In general, there were few differences in the distributions of the symptoms of shared disorders between the pure and the comorbid groups. Comorbidity accentuated depressive and emotional symptoms and functional impairment. After controlling for the presence of other disorders and severity of symptoms, comorbid children were more globally impaired than the pure conduct group and more impaired than the pure depressive group in school, the home, and in relationships with other people. CONCLUSIONS: The clinical presentations of 'pure' and comorbid depressive and conduct disorders are similar. Differences found in phenomenology and in functional impairment between the groups have implications for treatment planning and for nosology.}, Doi = {10.1111/j.1469-7610.2005.01558.x}, Key = {fds270385} } @article{fds270384, Author = {Egger, HL and Erkanli, A and Keeler, G and Potts, E and Walter, BK and Angold, A}, Title = {Test-Retest Reliability of the Preschool Age Psychiatric Assessment (PAPA).}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {5}, Pages = {538-549}, Year = {2006}, Month = {May}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16601400}, Abstract = {OBJECTIVE: To examine the test-retest reliability of a new interviewer-based psychiatric diagnostic measure (the Preschool Age Psychiatric Assessment) for use with parents of preschoolers aged 2 to 5 years. METHOD: A total of 1,073 parents of children attending a large pediatric clinic completed the Child Behavior Checklist 1 1/2-5. For 18 months, 193 parents of high scorers and 114 parents of low scorers were interviewed on two occasions an average of 11 days apart. RESULTS: Estimates of diagnostic reliability were very similar to those obtained from interviews with parents of older children and adults, with kappas ranging from 0.36 to 0.79. Test-retest intraclass correlations for DSM-IV syndrome scale scores ranged from 0.56 to 0.89. There were no significant differences in reliability by age, sex, or race (African American versus non-African American). CONCLUSIONS: The Preschool Age Psychiatric Assessment provides a reasonably reliable standardized measure of DSM-IV psychiatric symptoms and disorders in preschoolers for use in both research and clinical service evaluations of preschoolers as young as 2 years old.}, Doi = {10.1097/01.chi.0000205705.71194.b8}, Key = {fds270384} } @article{fds270379, Author = {Costello, EJ and Foley, DL and Angold, A}, Title = {10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {45}, Number = {1}, Pages = {8-25}, Year = {2006}, Month = {January}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16327577}, Abstract = {OBJECTIVE: To describe the growth of developmental epidemiology in the past decade and to illustrate it with examples of recent studies. METHOD: A review of publications on developmental epidemiology in the past 10 years and a discussion of some key examples. RESULTS: The authors describe how the interaction between developmental psychopathology and psychiatric epidemiology has produced developmental epidemiology, the study of patterns of distribution of psychiatric disorders in time as well as in space. They give two examples of the kinds of questions that developmental epidemiology can help to answer: (1) Is the prevalence of autism increasing? Does the use of vaccines explain the increase? (2) Is there an epidemic of child and adolescent depression? Finally, they describe two areas of science that are beginning to inform developmental epidemiology: molecular genetics and the use of biological measures of stress. CONCLUSIONS: While child and adolescent psychiatric epidemiology continues, as described in the first of these reviews, to address questions of prevalence and burden, it has also expanded into new areas of research in the past decade. In the next decade, longitudinal epidemiological data sets with their rich descriptive data on psychopathology and environmental risk over time and the potential to add biological measures will provide valuable resources for research into gene-environment correlations and interactions.}, Doi = {10.1097/01.chi.0000184929.41423.c0}, Key = {fds270379} } @article{fds270382, Author = {Egger, HL and Kondo, D and Angold, A}, Title = {The epidemiology and diagnostic issues in preschool attention-deficit/ hyperactivity disorder: A review}, Journal = {Infants & Young Children}, Volume = {19}, Number = {2}, Pages = {109-122}, Publisher = {Ovid Technologies (Wolters Kluwer Health)}, Year = {2006}, Month = {January}, ISSN = {0896-3746}, url = {http://dx.doi.org/10.1097/00001163-200604000-00004}, Abstract = {This study aims to review the nosology and epidemiology of attention-deficit/hyperactivity disorder (ADHD) in children aged 2 through 5 years. Studies, primarily in community or pediatric clinic settings, were reviewed. In studies using DSM diagnostic criteria, the prevalence of ADHD in preschool children ranges from 2.0% to 7.9%, with hyperactive-impulsive type and combined type significantly more common than pure inattentive type ADHD. Boys and older preschoolers (4- and 5-year-olds vs 2- and 3-year-olds) are more likely to meet criteria for ADHD. Preschoolers with ADHD are significantly impaired in their relationships with adults and other children, in their functioning at home and outside the home, and in cognitive and academic performance. Preschoolers with ADHD are significantly more likely to meet criteria for other psychiatric disorders and those who do meet criteria for other psychiatric disorders are more severely impaired than preschoolers with ADHD alone. Despite the severity of impairment, only about a quarter of preschoolers with ADHD are referred for mental health evaluation or treatment. Preschool ADHD predicts future ADHD and persistent impairment. Preschoolers with ADHD look like older children with ADHD with similar symptom presentations, associated features, and prognosis. These findings suggest that DSM-IV-TR ADHD is a reliable and valid diagnosis for children aged 2 through 5 years. ©2006Lippincott Williams & Wilkins, Inc.}, Doi = {10.1097/00001163-200604000-00004}, Key = {fds270382} } @article{fds270381, Author = {Egger, HL and Angold, A}, Title = {Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {47}, Number = {3-4}, Pages = {313-337}, Year = {2006}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16492262}, Abstract = {We review recent research on the presentation, nosology and epidemiology of behavioral and emotional psychiatric disorders in preschool children (children ages 2 through 5 years old), focusing on the five most common groups of childhood psychiatric disorders: attention deficit hyperactivity disorders, oppositional defiant and conduct disorders, anxiety disorders, and depressive disorders. We review the various approaches to classifying behavioral and emotional dysregulation in preschoolers and determining the boundaries between normative variation and clinically significant presentations. While highlighting the limitations of the current DSM-IV diagnostic criteria for identifying preschool psychopathology and reviewing alternative diagnostic approaches, we also present evidence supporting the reliability and validity of developmentally appropriate criteria for diagnosing psychiatric disorders in children as young as two years old. Despite the relative lack of research on preschool psychopathology compared with studies of the epidemiology of psychiatric disorders in older children, the current evidence now shows quite convincingly that the rates of the common child psychiatric disorders and the patterns of comorbidity among them in preschoolers are similar to those seen in later childhood. We review the implications of these conclusions for research on the etiology, nosology, and development of early onset of psychiatric disorders, and for targeted treatment, early intervention and prevention with young children.}, Doi = {10.1111/j.1469-7610.2006.01618.x}, Key = {fds270381} } @article{fds270380, Author = {Rowe, R and Maughan, B and Costello, EJ and Angold, A}, Title = {Defining oppositional defiant disorder.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {46}, Number = {12}, Pages = {1309-1316}, Year = {2005}, Month = {December}, ISSN = {0021-9630}, url = {http://dx.doi.org/10.1111/j.1469-7610.2005.01420.x}, Abstract = {BACKGROUND: ICD-10 and DSM-IV include similar criterial symptom lists for conduct disorder (CD) and oppositional defiant disorder (ODD), but while DSM-IV treats each list separately, ICD-10 considers them jointly. One consequence is that ICD-10 identifies a group of children with ODD subtype who do not receive a diagnosis under DSM-IV. METHODS: We examined the characteristics of this group of children using the Great Smoky Mountains Study of children in the community aged 9-16. This study provided child and parent reports of symptoms and psychosocial impairment assessed with standardised diagnostic interviews. RESULTS: Children who received an ICD-10 diagnosis but not a DSM-IV diagnosis showed broadly similar levels of psychiatric comorbidity, delinquent activity and psychosocial impairment to those who met DSM-IV criteria in both cross-sectional and longitudinal analyses. CONCLUSIONS: These results indicate that DSM-IV excludes from diagnosis children who receive an ICD-10 diagnosis of CD (ODD sub-type), and who are substantially disturbed. Methods of redressing this situation are considered.}, Doi = {10.1111/j.1469-7610.2005.01420.x}, Key = {fds270380} } @article{fds270378, Author = {Eaves, L and Erkanli, A and Silberg, J and Angold, A and Maes, HH and Foley, D}, Title = {Application of Bayesian inference using Gibbs sampling to item-response theory modeling of multi-symptom genetic data.}, Journal = {Behavior Genetics}, Volume = {35}, Number = {6}, Pages = {765-780}, Year = {2005}, Month = {November}, ISSN = {0001-8244}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16273316}, Abstract = {Several "genetic" item-response theory (IRT) models are fitted to the responses of 1086 adolescent female twins to the 33 multi-category item Mood and Feeling Questionnaire relating to depressive symptomatology in adolescence. A Markov-chain Monte Carlo (MCMC) algorithm is used within a Bayesian framework for inference using Gibbs sampling, implemented in the program WinBUGS 1.4. The final model incorporated separate genetic and non-shared environmental traits ("A and E") and item-specific genetic effects. Simpler models gave markedly poorer fit to the observations judged by the deviance information criterion (DIC). The common genetic factor showed major loadings on melancholic items, while the environmental factor loaded most highly on items relating to self-deprecation. The MCMC approach provides a convenient and flexible alternative to Maximum Likelihood for estimating the parameters of IRT models for relatively large numbers of items in a genetic context. Additional benefits of the IRT approach are discussed including the estimation of latent trait scores, including genetic factor scores, and their sampling errors.}, Doi = {10.1007/s10519-005-7284-z}, Key = {fds270378} } @article{fds270376, Author = {Costello, EJ and Egger, H and Angold, A}, Title = {10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {44}, Number = {10}, Pages = {972-986}, Year = {2005}, Month = {October}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16175102}, Abstract = {OBJECTIVE: To review recent progress in child and adolescent psychiatric epidemiology in the area of prevalence and burden. METHOD: The literature published in the past decade was reviewed under two headings: methods and findings. RESULTS: Methods for assessing the prevalence and community burden of child and adolescent psychiatric disorders have improved dramatically in the past decade. There are now available a broad range of interviews that generate DSM and ICD diagnoses with good reliability and validity. Clinicians and researchers can choose among interview styles (respondent based, interviewer based, best estimate) and methods of data collection (paper and pencil, computer assisted, interviewer or self-completion) that best meet their needs. Work is also in progress to develop brief screens to identify children in need of more detailed assessment, for use by teachers, pediatricians, and other professionals. The median prevalence estimate of functionally impairing child and adolescent psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease. CONCLUSIONS: There is mounting evidence that many, if not most, lifetime psychiatric disorders will first appear in childhood or adolescence. Methods are now available to monitor youths and to make early intervention feasible.}, Doi = {10.1097/01.chi.0000172552.41596.6f}, Key = {fds270376} } @article{fds270377, Author = {Costello, EJ and Egger, HL and Angold, A}, Title = {The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity.}, Journal = {Child and Adolescent Psychiatric Clinics of North America}, Volume = {14}, Number = {4}, Pages = {631-vii}, Year = {2005}, Month = {October}, ISSN = {1056-4993}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16171696}, Abstract = {This article argues that the quality of diagnostic tools used to measure anxiety disorders in children and adolescents has improved enormously in the past few years. As a result, prevalence estimates are less erratic, understanding of comorbidity is increasing, and the role of impairment as a criterion for "caseness" is considered more carefully. Several of the instruments developed for epidemiologic research are now being used in clinical settings. Further integration of laboratory methods and clinical and epidemiologic ideas will benefit children with anxiety disorders and their families.}, Doi = {10.1016/j.chc.2005.06.003}, Key = {fds270377} } @article{fds270374, Author = {Foley, DL and Rutter, M and Angold, A and Pickles, A and Maes, HM and Silberg, JL and Eaves, LJ}, Title = {Making sense of informant disagreement for overanxious disorder.}, Journal = {Journal of Anxiety Disorders}, Volume = {19}, Number = {2}, Pages = {193-210}, Year = {2005}, url = {http://dx.doi.org/10.1016/j.janxdis.2004.01.006}, Abstract = {A community sample of 2798 8-17-year-old twins and their parents completed a personal interview about the child's current psychiatric history on two occasions separated by an average of 18 months. Parents also completed a personal interview about their own lifetime psychiatric history at entry to the study. Results indicate that informant agreement for overanxious disorder (OAD) was no better than chance, and most cases of OAD were based on only one informant's ratings. Disagreement about level of OAD symptoms or presence of another disorder (mostly phobias or depression) accounted for most cases of informant disagreement: 60% of cases based only on child interview, 67% of cases based only on maternal interview, and 100% of cases based only on paternal interview. OAD diagnosed only by maternal interview was also distinguished by an association with maternal alcoholism and increasingly discrepant parental reports of marital difficulties. Given the substantial overlap in case assignments for DSM-III-R OAD and DSM-IV GAD, these findings may identify sources of informant disagreement that generalize to juvenile GAD.}, Doi = {10.1016/j.janxdis.2004.01.006}, Key = {fds270374} } @article{fds270375, Author = {Eaves, L and Silberg, J and Foley, D and Bulik, C and Maes, H and Erkanli, A and Angold, A and Costello, EJ and Worthman, C}, Title = {Genetic and environmental influences on the relative timing of pubertal change.}, Journal = {Twin Research : the Official Journal of the International Society for Twin Studies}, Volume = {7}, Number = {5}, Pages = {471-481}, Year = {2004}, Month = {October}, ISSN = {1369-0523}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15527663}, Abstract = {A multicategory item-response theory model was developed to characterize developmental changes in three items relating to the assessment of puberty in adolescent twin girls and boys. The model allowed for the fixed effects of age on probability of endorsing the responses and for the random effects of individual differences on the timing of pubertal changes relative to chronological age. In girls, the model was applied three-wave data on twin pairs (N = 414 female monozygotic [MZ] and 197 female dizygotic [DZ] pairs) and female twins from boy-girl pairs (N = 300 twins) from the Virginia Twin Study of Adolescent Behavioral Development. In boys, the data comprised 318 MZ and 185 DZ pairs and 297 male twins from boy-girl pairs. A total of 3172 and 2790 individual twin assessments were available in girls and boys, respectively, spanning ages 8-17 years. The availability of twin data allows the contributions of genes, the shared environment and individual unique environmental experiences to be resolved in the relative timing of pubertal changes. Parameters of the mixed model including fixed effects of age and random effects of genes and environment were estimated by Markov Chain Monte Carlo simulations using the BUGS algorithm for Gibbs sampling. The estimated standard deviation of random differences in the timing of puberty relative to age was 0.96 years in girls and 1.01 years in boys. The estimated intraclass correlations for the relative timing of pubertal changes were 0.99 +/-0.01 in MZ girls, 0.52 +/-0.02 in DZ girls, 0.88 +/-0.04 in MZ boys and 0.44+/-0.02 in DZ boys, indicating a very large contribution of genetic factors to the relative timing of pubertal change in both sexes. Additive genetic factors account for an estimated 96.3+/-3.3% of the total variance in random effects in girls and 88.0+/-3.6% in boys. Shared environmental influences account for 3.6+/-3.4% in girls and 0% in boys. In girls, nonshared environmental effects explain 0.1+/-0.1% of the total residual variance. The comparable figure in boys is 12.0+/-3.6%.}, Doi = {10.1375/1369052042335278}, Key = {fds270375} } @article{fds336041, Author = {Costello, EJ and Erkanli, A and Keeler, G and Angold, A}, Title = {Distant Trauma: A prospective study of the effects of september 11th on young adults in North Carolina}, Journal = {Applied Developmental Science}, Volume = {8}, Number = {4}, Pages = {211-220}, Publisher = {Informa UK Limited}, Year = {2004}, Month = {October}, url = {http://dx.doi.org/10.1207/s1532480xads0804_4}, Abstract = {In 2001, 730 young adults (aged 19–21) were given a detailed assessment as part of an ongoing longitudinal, epidemiological study of the development of psychiatric disorders across childhood and adolescence. Each participant had been interviewed up to 6 times previously, beginning in 1993. Parents were also interviewed until participants reached 16 years old. By chance in 2001, two-thirds (475) of the participants were interviewed before September 11, 2001; and one-third (255) were interviewed afterward. This provided an opportunity (a) to compare current psychopathology in those interviewed before and after September 11th, (b) to test whether September 11th acted as an additional stressor, and (c) to examine the factors from participants’ earlier lives that increased the impact of September 11th. Substance use, and substance abuse disorder (SUD), were significantly more prevalent after September 11th in women. Men interviewed after September 11th were slightly more likely to have 1 or more symptoms of posttraumatic stress disorder, but rates of SUD were significantly lower. No other psychiatric disorders showed an increase after September 11th. All psychiatric disorders were more likely to occur in 2001 in those with a previous history of the same diagnosis but only substance abuse in women showed an interaction with September 11th. Overall prevalence of SUD in men was lower after September 11th in both those with and those without a previous history. Examination of a range of risk factors that might predict psychopathology following a trauma showed effects in those with relatively low levels of previous risk, but not in those at the highest levels of risk. This study of young adults living some 500 miles from the events of September 11, 2001, on whom data were available both before and after that date, suggests that the main effect was on drug abuse and dependence. Drug use and abuse increased in women and decreased in men. This finding is in line with earlier work showing that some forms of psychiatric disorder can decrease during times of civic crisis. September 11th served as an additional stressor for those under low to moderate levels of stress but did not affect those already under high stress.}, Doi = {10.1207/s1532480xads0804_4}, Key = {fds336041} } @article{fds270372, Author = {Sung, M and Erkanli, A and Angold, A and Costello, EJ}, Title = {Effects of age at first substance use and psychiatric comorbidity on the development of substance use disorders.}, Journal = {Drug and Alcohol Dependence}, Volume = {75}, Number = {3}, Pages = {287-299}, Year = {2004}, Month = {September}, ISSN = {0376-8716}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15283950}, Abstract = {In this paper, we examine the effects of age at first substance use, and history of psychiatric disorders, on the development of substance use disorder (SUD) by age 16. We use a prospective, longitudinal design to disaggregate the effects of age at first use and time since first use on the development of adolescent SUD. Second, we test the hypothesis that adolescent SUD is an unlikely progression from early substance use unless children also show other early conduct problems. A population sample of 1,420 children from the Great Smoky Mountains Study (GSMS) was assessed annually between ages 9 and 16. Logistic regression models were applied within the hierarchical Bayesian framework, where the covariate effects were described by time-varying parameters having a first-order auto-regressive prior distribution. Posterior analyses based on a Gibbs sampling approach revealed that, controlling for years of exposure, the risk of transition to SUD increased with age at onset for onsets before age 13, but began to fall for onset at 14. Among users, use alone, without early conduct problems, led to a 11% prevalence of SUD by age 16. Past conduct disorder (CD) had a strong additive effect at ages 13-15, but at age 16, when substance use and abuse became more normative, the excess risk from prior CD decreased. Boys, but not girls, with a history of depression were at increased risk of SUD. Anxiety increased the risk of SUD in girls at age 16, but not before that. Results only partially support the study hypothesis; early use was a major predictor of adolescent SUD even in the absence of CD.}, Doi = {10.1016/j.drugalcdep.2004.03.013}, Key = {fds270372} } @article{fds270373, Author = {Foley, D and Rutter, M and Pickles, A and Angold, A and Maes, H and Silberg, J and Eaves, L}, Title = {Informant disagreement for separation anxiety disorder.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {43}, Number = {4}, Pages = {452-460}, Year = {2004}, Month = {April}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-200404000-00011}, Abstract = {OBJECTIVE: To characterize informant disagreement for separation anxiety disorder (SAD). METHOD: The sample comprised 2,779 8- to 17-year-old twins from a community-based registry. Children and their parents completed a personal interview about the child's psychiatric history. Parents completed a personal interview about their own psychiatric history and a questionnaire about their marital relationship. RESULTS: Informant agreement for SAD ranged between chance and extremely poor. Most cases of SAD were diagnosed by interview with only one informant. SAD diagnosed only by child interview was associated with an increased odds of father-rated oppositional defiant disorder, and vice versa. SAD diagnosed only by parent interview was predicted by the parental informant's history of antisocial personality disorder. SAD diagnosed only by paternal interview was also predicted by mother-rated marital conflict and dissatisfaction. CONCLUSIONS: Parents and children rarely agree about the presence of any level of child separation anxiety. A symptom "or-rule" mostly indexes diagnoses based on interview with only one informant, but the relative validity of such diagnoses remains unclear.}, Doi = {10.1097/00004583-200404000-00011}, Key = {fds270373} } @article{fds270370, Author = {Rowe, R and Maughan, B and Worthman, CM and Costello, EJ and Angold, A}, Title = {Testosterone, antisocial behavior, and social dominance in boys: pubertal development and biosocial interaction.}, Journal = {Biological Psychiatry}, Volume = {55}, Number = {5}, Pages = {546-552}, Year = {2004}, Month = {March}, url = {http://dx.doi.org/10.1016/j.biopsych.2003.10.010}, Abstract = {BACKGROUND: Studies linking testosterone and antisocial behavior in humans have produced mixed results. Adolescence offers a promising period to study this relationship; circulating testosterone increases dramatically in boys during puberty, and antisocial behavior increases during the same period. METHODS: Our analyses were based on boys aged 9-15 years who were interviewed during the first three waves of the Great Smoky Mountains Study. Measures included interview assessment of DSM-IV conduct disorder (CD) symptoms and diagnosis, blood spot measurement of testosterone, Tanner staging of pubertal development, and assessment of leadership behaviors and peer deviance. RESULTS: The adolescent rise in CD was primarily attributable to an increase in nonphysically aggressive behaviors. Increasing levels of circulating testosterone and association with deviant peers contributed to these age trends. There was no evidence that physical aggression was related to high testosterone. Evidence of biosocial interactions was identified; testosterone was related to nonaggressive CD symptoms in boys with deviant peers and to leadership in boys with nondeviant peers. CONCLUSIONS: The results are consistent with the hypothesis that testosterone relates to social dominance, with the assumption that behaviors associated with dominance differ according to social context.}, Doi = {10.1016/j.biopsych.2003.10.010}, Key = {fds270370} } @article{fds270371, Author = {Case, B}, Title = {Effect of poverty on emotional symptoms in children.}, Journal = {Jama}, Volume = {291}, Number = {4}, Pages = {424}, Year = {2004}, Month = {January}, url = {http://dx.doi.org/10.1001/jama.291.4.424-a}, Doi = {10.1001/jama.291.4.424-a}, Key = {fds270371} } @article{fds270367, Author = {Hay, DF and Pawlby, S and Angold, A and Harold, GT and Sharp, D}, Title = {Pathways to violence in the children of mothers who were depressed postpartum.}, Journal = {Developmental Psychology}, Volume = {39}, Number = {6}, Pages = {1083-1094}, Year = {2003}, Month = {November}, url = {http://dx.doi.org/10.1037/0012-1649.39.6.1083}, Abstract = {The impact of postnatal depression on a child's risk for violent behavior was evaluated in an urban British community sample (N=122 families). Mothers were interviewed during pregnancy, at 3 months postpartum, and when the child was 1, 4, and 11 years of age. Mothers, teachers, and children reported on violent symptoms at age 11. Structural equation modeling revealed that the child's violence was predicted by the mother's postnatal depression even when her depression during pregnancy, her later history of depression, and family characteristics were taken into account. Violence was associated with symptoms of attention-deficit/hyperactivity disorder and problems with anger management. Children were most violent if mothers had been depressed at 3 months and at least once thereafter.}, Doi = {10.1037/0012-1649.39.6.1083}, Key = {fds270367} } @article{fds270368, Author = {Costello, EJ and Compton, SN and Keeler, G and Angold, A}, Title = {Relationships between poverty and psychopathology: a natural experiment.}, Journal = {Jama}, Volume = {290}, Number = {15}, Pages = {2023-2029}, Year = {2003}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14559956}, Abstract = {CONTEXT: Social causation (adversity and stress) vs social selection (downward mobility from familial liability to mental illness) are competing theories about the origins of mental illness. OBJECTIVE: To test the role of social selection vs social causation of childhood psychopathology using a natural experiment. DESIGN: Quasi-experimental, longitudinal study. POPULATION AND SETTING: A representative population sample of 1420 rural children aged 9 to 13 years at intake were given annual psychiatric assessments for 8 years (1993-2000). One quarter of the sample were American Indian, and the remaining were predominantly white. Halfway through the study, a casino opening on the Indian reservation gave every American Indian an income supplement that increased annually. This increase moved 14% of study families out of poverty, while 53% remained poor, and 32% were never poor. Incomes of non-Indian families were unaffected. MAIN OUTCOME MEASURES: Levels of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, psychiatric symptoms in the never-poor, persistently poor, and ex-poor children were compared for the 4 years before and after the casino opened. RESULTS: Before the casino opened, the persistently poor and ex-poor children had more psychiatric symptoms (4.38 and 4.28, respectively) than the never-poor children (2.75), but after the opening levels among the ex-poor fell to those of the never-poor children, while levels among those who were persistently poor remained high (odds ratio, 1.50; 95% confidence interval, 1.08-2.09; and odds ratio, 0.91; 95% confidence interval, 0.77-1.07, respectively). The effect was specific to symptoms of conduct and oppositional defiant disorders. Anxiety and depression symptoms were unaffected. Similar results were found in non-Indian children whose families moved out of poverty during the same period. CONCLUSIONS: An income intervention that moved families out of poverty for reasons that cannot be ascribed to family characteristics had a major effect on some types of children's psychiatric disorders, but not on others. Results support a social causation explanation for conduct and oppositional disorder, but not for anxiety or depression.}, Doi = {10.1001/jama.290.15.2023}, Key = {fds270368} } @article{fds270365, Author = {Conners, CK and Epstein, JN and Angold, A and Klaric, J}, Title = {Continuous performance test performance in a normative epidemiological sample.}, Journal = {Journal of Abnormal Child Psychology}, Volume = {31}, Number = {5}, Pages = {555-562}, Year = {2003}, Month = {October}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14561062}, Abstract = {A 14-min continuous performance test (CPT) requiring a high rate of responding was administered to a probability-weighted random sample of 816 9-17-year-old children drawn from a population of 17,117 children in an ongoing epidemiological and longitudinal study in Western North Carolina. Systematic main effects of improved performance with older age were found in this age range for all variables, including reaction time (RT), RT standard error, errors of omission, errors of commission, and signal detection parameters (d' and beta). Significant gender main effects included more impulsive errors, less variability, and faster RT by males, with no interactions between age and gender. There were no main effects of ethnicity or interactions of ethnicity with age and/or gender. Large main effects of interstimulus interval (ISI; 1, 2, or 4-s intervals) and time block were present for most CPT performance measures. The normative data from the CPT should provide a useful framework for interpreting similar data in future studies of child and adolescent psychopathology.}, Doi = {10.1023/a:1025457300409}, Key = {fds270365} } @article{fds270369, Author = {Epstein, JN and Erkanli, A and Conners, CK and Klaric, J and Costello, JE and Angold, A}, Title = {Relations between Continuous Performance Test performance measures and ADHD behaviors.}, Journal = {Journal of Abnormal Child Psychology}, Volume = {31}, Number = {5}, Pages = {543-554}, Year = {2003}, Month = {October}, ISSN = {0091-0627}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14561061}, Abstract = {The Conners' Continuous Performance Test (CPT) is a neuropsychological task that has repeatedly been shown to differentiate ADHD from normal groups. Several variables may be derived from the Conners' CPT including errors of omission and commission, mean hit reaction time(RT), mean hit RT standard error, d', and beta. What each CPT parameter actually assesses has largely been based upon clinical assumptions and the face validity of each measure (e.g., omission errors measure inattention, commission errors measure impulsivity). This study attempts to examine relations between various CPT variables and phenotypic behaviors so as to better understand the various CPT variables. An epidemiological sample of 817 children was administered the Conners' CPT. Diagnostic interviews were conducted with parents to determine ADHD symptom profiles for all children. Children diagnosed with ADHD had more variable RTs, made more errors of commission and omission, and demonstrated poorer perceptual sensitivity than nondiagnosed children. Regarding specific symptoms, generalized estimating equations (GEE) and ANCOVAs were conducted to determine specific relationships between the 18 DSM-IV ADHD symptoms and 6 CPT parameters. CPT performance measures demonstrated significant relationships to ADHD symptoms but did not demonstrate symptom domain specificity according to a priori assumptions. Overall performance on the two signal detection measures, d' and beta, was highly related to all ADHD symptoms across symptom domains. Further, increased variability in RTs over time was related to most ADHD symptoms. Finally, it appears that at least 1 CPT variable, mean hit RT, is minimally related to ADHD symptoms as a whole, but does demonstrate some specificity in its link with symptoms of hyperactivity.}, Doi = {10.1023/a:1025405216339}, Key = {fds270369} } @article{fds270366, Author = {Costello, EJ and Mustillo, S and Erkanli, A and Keeler, G and Angold, A}, Title = {Prevalence and development of psychiatric disorders in childhood and adolescence.}, Journal = {Archives of General Psychiatry}, Volume = {60}, Number = {8}, Pages = {837-844}, Year = {2003}, Month = {August}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12912767}, Abstract = {BACKGROUND: This longitudinal community study assessed the prevalence and development of psychiatric disorders from age 9 through 16 years and examined homotypic and heterotypic continuity. METHODS: A representative population sample of 1420 children aged 9 to 13 years at intake were assessed annually for DSM-IV disorders until age 16 years. RESULTS: Although 3-month prevalence of any disorder averaged 13.3% (95% confidence interval [CI], 11.7%-15.0%), during the study period 36.7% of participants (31% of girls and 42% of boys) had at least 1 psychiatric disorder. Some disorders (social anxiety, panic, depression, and substance abuse) increased in prevalence, whereas others, including separation anxiety disorder and attention-deficit/hyperactivity disorder (ADHD), decreased. Lagged analyses showed that children with a history of psychiatric disorder were 3 times more likely than those with no previous disorder to have a diagnosis at any subsequent wave (odds ratio, 3.7; 95% CI, 2.9-4.9; P<.001). Risk from a previous diagnosis was high among both girls and boys, but it was significantly higher among girls. Continuity of the same disorder (homotypic) was significant for all disorders except specific phobias. Continuity from one diagnosis to another (heterotypic) was significant from depression to anxiety and anxiety to depression, from ADHD to oppositional defiant disorder, and from anxiety and conduct disorder to substance abuse. Almost all the heterotypic continuity was seen in girls. CONCLUSIONS: The risk of having at least 1 psychiatric disorder by age 16 years is much higher than point estimates would suggest. Concurrent comorbidity and homotypic and heterotypic continuity are more marked in girls than in boys.}, Doi = {10.1001/archpsyc.60.8.837}, Key = {fds270366} } @article{fds270363, Author = {Egger, HL and Costello, EJ and Angold, A}, Title = {School refusal and psychiatric disorders: a community study.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {42}, Number = {7}, Pages = {797-807}, Year = {2003}, Month = {July}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12819439}, Abstract = {OBJECTIVE: To examine the association between anxious school refusal and truancy and psychiatric disorders in a community sample of children and adolescents using a descriptive rather than etiological definition of school refusal. METHOD: Data from eight annual waves of structured psychiatric interviews with 9- to 16-year-olds and their parents from the Great Smoky Mountains Study were analyzed. RESULTS: Pure anxious school refusal was associated with depression (odds ratio [OR] = 13, 95% confidence interval [CI] 3.4, 42) and separation anxiety disorder (OR = 8.7, 95% CI 4.1, 19). Pure truancy was associated with oppositional defiant disorder (OR = 2.2, 95% CI 1.2, 4.2), conduct disorder (OR = 7.4, 95% CI 3.9, 14), and depression (OR = 2.6, 95% CI 1.2, 56). Of mixed school refusers (children with both anxious school refusal and truancy), 88.2% had a psychiatric disorder. They had increased rates of both emotional and behavior disorders. Specific fears, sleep difficulties, somatic complaints, difficulties in peer relationships, and adverse psychosocial variables had different associations with the three types of school refusal. CONCLUSIONS: Anxious school refusal and truancy are distinct but not mutually exclusive and are significantly associated with psychopathology, as well as adverse experiences at home and school. Implications of these findings for assessment, identification, and intervention for school refusal are discussed.}, Doi = {10.1097/01.CHI.0000046865.56865.79}, Key = {fds270363} } @article{fds270364, Author = {Wasserman, GA and Jensen, PS and Ko, SJ and Cocozza, J and Trupin, E and Angold, A and Cauffman, E and Grisso, T}, Title = {Mental health assessments in juvenile justice: report on the consensus conference.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {42}, Number = {7}, Pages = {752-761}, Year = {2003}, Month = {July}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/01.CHI.0000046873.56865.4B}, Abstract = {OBJECTIVE: At national, state, and local levels, there is increasing recognition of the importance of identifying and responding to the mental health needs of youths in the juvenile justice system, as policymakers and practitioners struggle to find ways to address causes and correlates of juvenile crime and delinquency. The proposed guidelines for mental health assessment provide explicit information about how, why, and when to obtain mental health information on justice youths at each important juncture in processing. METHOD: A national group of expert researchers and practitioners convened in April 2002. Experts derived six recommendations, following the expert consensus method, for conducting mental health assessments in juvenile justice settings. Experts had broad experience creating collaborations between juvenile justice, mental health, and child welfare systems and understood the policy and health implications of conducting such assessments in juvenile justice settings. RESULTS: Consensus Conference recommendations regarding screening for emergent risk, screening and assessment of mental health service needs, comprehensive mental health assessment components, assessment before community re-entry, need for periodic reassessment, and staff training are presented. CONCLUSION: Deriving specific recommendations that can be implemented systematically is a necessary first step toward policy changes that will optimize the standard of care for this vulnerable population.}, Doi = {10.1097/01.CHI.0000046873.56865.4B}, Key = {fds270364} } @article{fds270362, Author = {Angold, A}, Title = {Adolescent depression, cortisol and DHEA.}, Journal = {Psychological Medicine}, Volume = {33}, Number = {4}, Pages = {573-581}, Year = {2003}, Month = {May}, url = {http://dx.doi.org/10.1017/s003329170300775x}, Doi = {10.1017/s003329170300775x}, Key = {fds270362} } @article{fds270360, Author = {Mustillo, S and Worthman, C and Erkanli, A and Keeler, G and Angold, A and Costello, EJ}, Title = {Obesity and psychiatric disorder: developmental trajectories.}, Journal = {Pediatrics}, Volume = {111}, Number = {4 Pt 1}, Pages = {851-859}, Publisher = {American Academy of Pediatrics (AAP)}, Year = {2003}, Month = {April}, url = {http://dx.doi.org/10.1542/peds.111.4.851}, Abstract = {OBJECTIVES: To identify age-related trajectories of obesity from childhood into adolescence, and to test the association of these trajectories with the development of psychiatric disorders (conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, substance abuse, depression, and anxiety). METHODS: White children (N = 991) 9 to 16 years old from the Great Smoky Mountains Study, a representative sample of rural youth, were evaluated annually over an 8-year period for height, weight, psychiatric disorder, and vulnerabilities for psychiatric disorder. Longitudinal analyses on the repeated measures data were conducted using developmental trajectory models and generalized estimating equation models. RESULTS: Obesity was 3 to 4 times more common than expected from national rates using Centers for Disease Control and Prevention 2000 criteria. Four developmental trajectories of obesity were found: no obesity (73%), chronic obesity (15%), childhood obesity (5%), and adolescent obesity (7%). Only chronic obesity was associated with psychiatric disorder: oppositional defiant disorder in boys and girls and depressive disorders in boys. CONCLUSIONS: In a general population sample studied longitudinally, chronic obesity was associated with psychopathology.}, Doi = {10.1542/peds.111.4.851}, Key = {fds270360} } @article{fds270358, Author = {Silberg, JL and Parr, T and Neale, MC and Rutter, M and Angold, A and Eaves, LJ}, Title = {Maternal smoking during pregnancy and risk to boys' conduct disturbance: an examination of the causal hypothesis.}, Journal = {Biological Psychiatry}, Volume = {53}, Number = {2}, Pages = {130-135}, Year = {2003}, Month = {January}, url = {http://dx.doi.org/10.1016/s0006-3223(02)01477-4}, Abstract = {BACKGROUND: We undertook this study to determine whether the widely replicated link between maternal smoking and conduct disturbance (Cd) is better explained by a model of direct causation or of mother-offspring transmission of a latent Cd variable. METHODS: Family data collected on 538 adolescent twin boys from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) was used to compare two alternative models: 1) a model composed of a latent transmissible factor that influences mother's juvenile conduct symptoms, smoking during pregnancy, and subsequent Cd and smoking in her adolescent boys; and 2) a model specifying a direct causal path from mother's smoking to child Cd. RESULTS: The maternal-offspring transmission model fit the data as well as a model specifying a direct causal path from maternal smoking to child Cd. CONCLUSIONS: Our results suggest that the association between maternal smoking during pregnancy and boys' Cd symptoms may be attributed to the transmission of a latent Cd factor and not to a direct effect of the smoking. Our results challenge previous findings of a direct effect of prenatal smoke exposure on risk to Cd once other etiologic factors are considered.}, Doi = {10.1016/s0006-3223(02)01477-4}, Key = {fds270358} } @article{fds270359, Author = {Farmer, EMZ and Burns, BJ and Phillips, SD and Angold, A and Costello, EJ}, Title = {Pathways into and through mental health services for children and adolescents.}, Journal = {Psychiatric Services (Washington, D.C.)}, Volume = {54}, Number = {1}, Pages = {60-66}, Year = {2003}, Month = {January}, ISSN = {1075-2730}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12509668}, Abstract = {OBJECTIVE: This study examined points of entry into the mental health service system for children and adolescents as well as patterns of movement through five service sectors: specialty mental health services, education, general medicine, juvenile justice, and child welfare. METHODS: The data were from the Great Smoky Mountains Study, a longitudinal epidemiologic study of mental health problems and service use among youths. The sample consisted of 1,420 youths who were nine, 11, or 13 years old at study entry. Each youth and a parent were interviewed at baseline and every year thereafter about the use of services for mental health problems over the three-year study period. RESULTS: Population estimates indicated that 54 percent of youths have used mental health services at some time during their lives. The education sector was the most common point of entry and provider of services across all age groups. The specialty mental health sector was the second most common point of entry for youths up to age 13 years, and juvenile justice was the second most common point of entry for youths between the ages of 14 and 16. Youths who entered the mental health system through the specialty mental health sector were the most likely to subsequently receive services from other sectors, and those who entered through the education sector were the least likely to do so. CONCLUSIONS: The education sector plays a central role as a point of entry into the mental health system. Interagency collaboration among three primary sectors-education, specialty mental health services, and general medicine-is critical to ensuring that youths who are in need of mental health care receive appropriate services.}, Doi = {10.1176/appi.ps.54.1.60}, Key = {fds270359} } @article{fds270361, Author = {Pickles, A and Angold, A}, Title = {Natural categories or fundamental dimensions: on carving nature at the joints and the rearticulation of psychopathology.}, Journal = {Development and Psychopathology}, Volume = {15}, Number = {3}, Pages = {529-551}, Year = {2003}, ISSN = {0954-5794}, url = {http://dx.doi.org/10.1017/s0954579403000282}, Abstract = {The question of whether to view psychopathology as categorical or dimensional continues to provoke debate. We review the many facets of this argument. These include the pragmatics of measurement; the needs of clinical practice; our ability to distinguish categories from dimensions empirically; methods of analysis appropriate to each and how they relate; and the potential theoretical biases associated with each approach. We conclude that much of the debate is misconceived in that we do not observe pathology directly; rather, we observe its properties. The same pathology can have some properties that are most easily understood using a dimensional conceptualization while at the same time having other properties that are best understood categorically. We suggest replacing Meehl's analogy involving qualitatively distinct species with an alternative analogy with the "duality" of light, a phenomenon with both wave- and particle-like properties.}, Doi = {10.1017/s0954579403000282}, Key = {fds270361} } @article{fds270356, Author = {Angold, A and Erkanli, A and Silberg, J and Eaves, L and Costello, EJ}, Title = {Depression scale scores in 8-17-year-olds: effects of age and gender.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {43}, Number = {8}, Pages = {1052-1063}, Year = {2002}, Month = {November}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12455926}, Abstract = {BACKGROUND: The excess of unipolar depression in females emerges in adolescence. However, studies of age effects on depression scale scores have produced divergent estimates of changes from childhood to adolescence. METHOD: We explored possible reasons for this discrepancy in two large, longitudinal samples of twins and singletons aged 8-17. RESULTS: There were no differences between twins and singletons in their scores on the Short Mood and Feelings Questionnaire (SMFQ), a 13-item self-report depression scale. SMFQ scores for boys fell over this age-range, while those for girls fell from age 9 to age 11 and then increased from age 12 to age 17. The mean scores of girls under 12 and those 12 and over differed by only around one-fifth of a standard deviation. However, given the non-normal distribution of the scores, a cut point that selected the upper 6% of scores created the expected female:male ratio of 2:1. CONCLUSIONS: Implications for future research on adolescent depression are discussed.}, Doi = {10.1111/1469-7610.00232}, Key = {fds270356} } @article{fds270357, Author = {Angold, A and Erkanli, A and Farmer, EMZ and Fairbank, JA and Burns, BJ and Keeler, G and Costello, EJ}, Title = {Psychiatric disorder, impairment, and service use in rural African American and white youth.}, Journal = {Archives of General Psychiatry}, Volume = {59}, Number = {10}, Pages = {893-901}, Year = {2002}, Month = {October}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12365876}, Abstract = {BACKGROUND: The Caring for Children in the Community Study examined the prevalence of DSM-IV psychiatric disorders and correlates of mental health service use in rural African American and white youth. METHODS: Four thousand five hundred youth aged 9 to 17 years from 4 North Carolina counties were randomly selected from school databases. Parents completed telephone questionnaires about their children's behavior problems. A second-stage sample of 1302 was identified for recruitment into the interview phase of the study, and 920 (70.7%) of these were successfully interviewed at home using the Child and Adolescent Psychiatric Assessment and related measures of service use. RESULTS: Weighted back to general population estimates, 21.1% of youth had 1 or more DSM-IV psychiatric disorders in the past 3 months. Prevalence was similar in African American (20.5%) and white (21.9%) youth. The only ethnic difference was an excess of depressive disorders in white youth (4.6% vs 1.4%). Thirteen percent of participants (36.0% of those with a diagnosis) received mental health care in the past 3 months. White youth were more likely than African American youth to use specialty mental health services (6.1% vs 3.2%), but services provided by schools showed very little ethnic disparity (8.6% vs 9.2%). The effect of children's symptoms on their parents was the strongest correlate of specialty mental health care. CONCLUSIONS: In this rural sample, African American and white youth were equally likely to have psychiatric disorders, but African Americans were less likely to use specialty mental health services. School services provided care to the largest number of youths of both ethnic groups.}, Doi = {10.1001/archpsyc.59.10.893}, Key = {fds270357} } @article{fds270354, Author = {Costello, EJ and Erkanli, A and Fairbank, JA and Angold, A}, Title = {The prevalence of potentially traumatic events in childhood and adolescence.}, Journal = {Journal of Traumatic Stress}, Volume = {15}, Number = {2}, Pages = {99-112}, Year = {2002}, Month = {April}, ISSN = {0894-9867}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12013070}, Abstract = {This paper examines exposure to potentially traumatic events from middle childhood through adolescence, and vulnerability to such exposure. Analyses are based on the first 4 annual waves of data from a longitudinal general population study of youth in western North Carolina, involving 4,965 interviews with 1,420 children and adolescents and their parents or guardians. Participants reported on DSM extreme stressors ("high magnitude events"), other potentially traumatic events ("low magnitude events"), and background vulnerability factors. In this general population sample, one-quarter experienced at least one high magnitude event by age 16, 6% within the past 3 months. One third experienced a low magnitude event in the past 3 months. The likelihood of such exposure increased with the number of vulnerability factors.}, Doi = {10.1023/A:1014851823163}, Key = {fds270354} } @article{fds270355, Author = {Rowe, R and Maughan, B and Pickles, A and Costello, EJ and Angold, A}, Title = {The relationship between DSM-IV oppositional defiant disorder and conduct disorder: findings from the Great Smoky Mountains Study.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {43}, Number = {3}, Pages = {365-373}, Year = {2002}, Month = {March}, url = {http://dx.doi.org/10.1111/1469-7610.00027}, Abstract = {BACKGROUND: We examine models of the relationship between oppositional defiant disorder (ODD) and conduct disorder (CD) in a community sample. Particular attention is paid to the generalisability of findings based on clinic-referred boys. METHODS: The analyses were based on four waves of data from the Great Smoky Mountains Study covering children in the community aged 9-16 years. Child and parent reports of DSM-IV symptoms, diagnoses, and a range of family and environmental adversities were collected using the Child and Adolescent Psychiatric Assessment. RESULTS: Cross-sectional analyses indicated that CD and ODD largely shared similar correlates, although some aspects of parenting appeared more related to CD than ODD. This pattern was broadly similar in boys and girls. Longitudinal analyses confirmed that ODD was a strong risk factor for CD in boys and there was a suggestion that ODD was a stronger risk factor for CD than for other common disorders. Atypical family structure was an important factor in the transition between ODD and CD in boys. In girls ODD provided no increased risk for later CD but was associated with increased risk for continued ODD, depression, and anxiety. CONCLUSIONS: These results are more consistent with a developmental relationship between ODD and CD in boys than girls.}, Doi = {10.1111/1469-7610.00027}, Key = {fds270355} } @article{fds270352, Author = {Kliewer, W and Murrelle, L and Mejia, R and Torres de G and Y and Angold, A}, Title = {Exposure to violence against a family member and internalizing symptoms in Colombian adolescents: the protective effects of family support.}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {69}, Number = {6}, Pages = {971-982}, Year = {2001}, Month = {December}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/0022-006X.69.6.971}, Abstract = {Associations between exposure to serious violence against a family member and internalizing symptoms, and the protective effects of support from family versus friends, were examined in 5,775 adolescents (50% female; mean age = 15.2 years, SD = 2.0) with data from a national, random household survey of residents in Colombia, South America. After accounting for the effects of age, gender, and family life events other than violence, support from family buffered the relations between exposure to violence and adjustment; this relation was strongest for girls and younger adolescents. Disclosure to friends appeared to be protective for younger adolescents but harmful for older adolescents, and this relation was only observed for hopelessness. Results are discussed in terms of cognitive processing models of adjustment to violence.}, Doi = {10.1037/0022-006X.69.6.971}, Key = {fds270352} } @article{fds270348, Author = {Ezpeleta, L and Keeler, G and Erkanli, A and Costello, EJ and Angold, A}, Title = {Epidemiology of psychiatric disability in childhood and adolescence.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {42}, Number = {7}, Pages = {901-914}, Year = {2001}, Month = {October}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11693585}, Abstract = {The goal of the study was to ascertain the factor structure and prevalence of psychiatric disability in children and adolescents in relation to demographic variables and diagnosis. A representative sample of 1,420 children (9-13 years) from 11 countries in North Carolina was followed for up to 6 years. Children and caretakers were interviewed with the Child and Adolescent Psychiatric Assessment, which generates DSM-IV diagnoses and includes a measure of disability secondary to psychological symptoms. Three broad areas of disability were identified (relating to family, school, and peers). School disabilities were more common in boys than girls. while the reverse was true of family disability. Effects of age were complex, and partially gender-differentiated. Children from minority ethnic groups had a higher overall prevalence of school disabilities, and were more prone than Whites to the disabling effects of disruptive behavior disorders. Anxiety disorders were as likely to result in disability as depressive disorders, and oppositional defiant disorders were more strongly associated with disability in some areas than was conduct disorder. The areas where disability is manifested are different depending on race, gender, age, and the type of disorder suffered. The implications of these findings for nosology and prevention are discussed.}, Doi = {10.1111/1469-7610.00786}, Key = {fds270348} } @article{fds270346, Author = {Costello, EJ and Keeler, GP and Angold, A}, Title = {Poverty, race/ethnicity, and psychiatric disorder: a study of rural children.}, Journal = {American Journal of Public Health}, Volume = {91}, Number = {9}, Pages = {1494-1498}, Year = {2001}, Month = {September}, ISSN = {0090-0036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11527787}, Abstract = {OBJECTIVES: This study examined the effect of poverty on the prevalence of psychiatric disorder in rural Black and White children. METHODS: A representative sample of 541 Black children and 379 White children aged 9 to 17 was drawn from 4 predominantly rural counties. Structured interviews with parents and children collected information on psychiatric disorders, absolute and relative poverty, and risk factors for psychiatric disorder. RESULTS: Three-month prevalence of psychiatric disorder was similar to that found in other community samples (20%). Federal criteria for poverty were met by 18% of the White and 52% of the Black families. Black and White children were exposed to equal numbers of risk factors overall, but the association between poverty and psychopathology was stronger for White children (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1, 4.2) than for Black children (OR = 1.5; 95% CI = 0.9, 2.6). Family history of mental illness, poor parenting, and residential instability mediated this association in both groups. CONCLUSIONS: In this rural sample, poverty was only weakly associated with child psychiatric disorders. Risk factors for both racial/ethnic groups were family mental illness, multiple moves, lack of parental warmth, lax supervision, and harsh punishment.}, Doi = {10.2105/ajph.91.9.1494}, Key = {fds270346} } @article{fds270347, Author = {Sandberg, S and Rutter, M and Pickles, A and McGuinness, D and Angold, A}, Title = {Do high-threat life events really provoke the onset of psychiatric disorder in children?}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {42}, Number = {4}, Pages = {523-532}, Year = {2001}, Month = {May}, ISSN = {0021-9630}, url = {http://dx.doi.org/10.1111/1469-7610.00746}, Abstract = {Studies on adults have suggested important effects of stressful life events in provoking onset of psychiatric disorder. Only a few comparable studies on children exist, and their results are inconsistent in relation to definite timing effects. Meeting some important methodological challenges overlooked in the past research, this study set out to examine whether the onset of psychiatric disorder in children was more likely to occur shortly after a severe event, as compared with other times. The sample consisted of 99 consecutive, newly referred patients, aged 8-16 years, from a child psychiatry service in London. PACE (Psychosocial Assessment of Childhood Experiences), an investigator-based, standardized interview was used to assess the timing and impact of life events over the preceding 18 months. CAPA (Child and Adolescent Psychiatric Assessment), a standardized diagnostic assessment, was used to establish the presence, timing, and consequential impairment of child and adolescent psychiatric symptoms. In a within-subject, over-time design, conditional logistic regression techniques were employed to examine whether risk of onset was greater in the 9 weeks following a high-threat life event than at other times. There was a small but statistically significant association between child-reported events and child-reported onset; the associations with parent-reported onset were inconsistent. Parent-reported events failed to relate to onset by either source. The study offers only quite limited support to the notion of negative life events provoking onset of psychiatric disorder in children and young people. The possible reasons for this are discussed, together with important conceptual and methodological issues to problems of defining onset, and the choice of appropriate designs for data analysis.}, Doi = {10.1111/1469-7610.00746}, Key = {fds270347} } @article{fds270351, Author = {Erkanli, A and Soyer, R and Angold, A}, Title = {Bayesian analyses of longitudinal binary data using Markov regression models of unknown order.}, Journal = {Statistics in Medicine}, Volume = {20}, Number = {5}, Pages = {755-770}, Year = {2001}, Month = {March}, ISSN = {0277-6715}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11241574}, Abstract = {We present non-homogeneous Markov regression models of unknown order as a means to assess the duration of autoregressive dependence in longitudinal binary data. We describe a subject's transition probability evolving over time using logistic regression models for his or her past outcomes and covariates. When the initial values of the binary process are unknown, they are treated as latent variables. The unknown initial values, model parameters, and the order of transitions are then estimated using a Bayesian variable selection approach, via Gibbs sampling. As a comparison with our approach, we also implement the deviance information criterion (DIC) for the determination of the order of transitions. An example addresses the progression of substance use in a community sample of n = 242 American Indian children who were interviewed annually four times. An extension of the Markov model to account for subject-to-subject heterogeneity is also discussed.}, Doi = {10.1002/sim.702}, Key = {fds270351} } @article{fds270350, Author = {Conners, CK and Epstein, JN and March, JS and Angold, A and Wells, KC and Klaric, J and Swanson, JM and Arnold, LE and Abikoff, HB and Elliott, GR and Greenhill, LL and Hechtman, L and Hinshaw, SP and Hoza, B and Jensen, PS and Kraemer, HC and Newcorn, JH and Pelham, WE and Severe, JB and Vitiello, B and Wigal, T}, Title = {Multimodal treatment of ADHD in the MTA: an alternative outcome analysis.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {2}, Pages = {159-167}, Year = {2001}, Month = {February}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11211364}, Abstract = {OBJECTIVE: To conduct a post hoc investigation of the utility of a single composite measure of treatment outcome for the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) at 14 months postbaseline. BACKGROUND: Examination of multiple measures one at a time in the main MTA intent-to-treat outcome analyses failed to detect a statistically significant advantage of combined treatment (Comb) over medication management (MedMgt). A measure that increases power and precision using a single outcome score may be a useful alternative to multiple outcome measures. METHOD: Factor analysis of baseline scores yielded two "source factors" (parent and teacher) and one "instrument factor" (parent-child interactions). A composite score was created from the average of standardized parent and teacher measures. RESULTS: The composite was internally consistent (alpha = .83), reliable (test-retest over 3 months = 0.86), and correlated 0.61 with clinician global judgments. In an intent-to-treat analysis, Comb was statistically significantly better than all other treatments, with effect sizes ranging from small (0.28) versus MedMgt, to moderately large (0.70) versus a community comparison group. CONCLUSIONS: A composite of ADHD variables may be an important tool in future treatment trials with ADHD and may avoid some of the statistical limitations of multiple measures.}, Doi = {10.1097/00004583-200102000-00010}, Key = {fds270350} } @article{fds270349, Author = {Gotlib, D}, Title = {Effectiveness of mental health services.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {1}, Pages = {2-4}, Year = {2001}, Month = {January}, url = {http://dx.doi.org/10.1097/00004583-200101000-00003}, Doi = {10.1097/00004583-200101000-00003}, Key = {fds270349} } @article{fds270353, Author = {Farmer, EMZ and Burns, BJ and Chapman, MV and Phillips, SD and Angold, A and Costello, EJ}, Title = {Use of mental health services by youth in contact with social services}, Journal = {Social Service Review}, Volume = {75}, Number = {4}, Pages = {604-624}, Year = {2001}, Month = {January}, url = {http://dx.doi.org/10.1086/323165}, Abstract = {This article compares mental health service need and use among three groups of children: those with a history of foster care placement, those in contact with departments of social services but never in placement, and those from impoverished families who have not been in contact with social services. Data come from a longitudinal epidemiologic study of mental health problems and service use. All three groups show very high rates of mental health problems, but children in foster are or in contact with social services are significantly more likely than children living in poverty to receive mental health services.}, Doi = {10.1086/323165}, Key = {fds270353} } @article{fds328551, Author = {Angold, A}, Title = {Effectiveness of mental health services}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {40}, Number = {1}, Pages = {3-4}, Publisher = {Elsevier BV}, Year = {2001}, Month = {January}, url = {http://dx.doi.org/10.1097/00004583-200101000-00004}, Doi = {10.1097/00004583-200101000-00004}, Key = {fds328551} } @article{fds270341, Author = {Willoughby, MT and Curran, PJ and Costello, EJ and Angold, A}, Title = {Implications of early versus late onset of attention-deficit/hyperactivity disorder symptoms.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {39}, Number = {12}, Pages = {1512-1519}, Year = {2000}, Month = {December}, ISSN = {0890-8567}, url = {http://dx.doi.org/10.1097/00004583-200012000-00013}, Abstract = {OBJECTIVE: The current diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) require that symptoms emerge prior to age 7 in order for a formal diagnosis to be considered. However, this age-of-onset criterion (AOC) has recently been questioned on both theoretical and empirical grounds. METHOD: Data from 4 annual waves of interviews with 9- to 16-year-olds from the Great Smoky Mountains Study were analyzed. RESULTS: Confirming previous studies, a majority of youths who had enough symptoms to meet criteria for ADHD were reported to have first exhibited these symptoms prior to age 7. Early onset of ADHD symptoms was associated with worse clinical outcomes in youths with the combined subtype of ADHD but not youths with the inattentive subtype. CONCLUSIONS: Findings support the continued inclusion of the AOC for the assessment of the combined but not necessarily the inattentive subtype of ADHD. Too few youths had a late onset of solely hyperactive-impulsive symptoms to evaluate the AOC for that group. However, regardless of the age of onset, youths who had elevated levels of ADHD symptoms were at increased risk for negative outcomes that may necessitate intervention.}, Doi = {10.1097/00004583-200012000-00013}, Key = {fds270341} } @article{fds270340, Author = {Angold, A and Erkanli, A and Egger, HL and Costello, EJ}, Title = {Stimulant treatment for children: a community perspective.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {39}, Number = {8}, Pages = {975-984}, Year = {2000}, Month = {August}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10939226}, Abstract = {OBJECTIVE: To examine the use of prescribed stimulants in relation to research diagnoses of attention-deficit hyperactivity disorder (ADHD) in a community sample of children. METHOD: Data from 4 annual waves of interviews with 9- to 16-year-olds from the Great Smoky Mountains Study were analyzed. RESULTS: Over a 4-year period, almost three quarters of children with an unequivocal diagnosis of ADHD received stimulant medications. However, girls and older children with ADHD were less likely to receive such treatment. Most children with impairing ADHD symptoms not meeting full criteria for DSM-III-R ADHD did not receive stimulant treatment. Stimulant treatment in this group was significantly related to the level of symptoms reported by parents and teachers and was much more common in individuals who met criteria for oppositional defiant disorder. The majority of individuals who received stimulants were never reported by their parents to have any impairing ADHD symptoms. They did have higher levels of nonimpairing parent-reported ADHD symptoms, higher levels of teacher-reported ADHD symptoms, and interviewer-observed ADHD behaviors, but these typically fell far below the threshold for a DSM-III-R diagnosis of ADHD. CONCLUSIONS: In this area of the Great Smoky Mountains, stimulant treatment was being used in ways substantially inconsistent with current diagnostic guidelines.}, Doi = {10.1097/00004583-200008000-00009}, Key = {fds270340} } @article{fds270342, Author = {Angold, A and Costello, EJ and Burns, BJ and Erkanli, A and Farmer, EM}, Title = {Effectiveness of nonresidential specialty mental health services for children and adolescents in the "real world".}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {39}, Number = {2}, Pages = {154-160}, Year = {2000}, Month = {February}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10673824}, Abstract = {OBJECTIVE: Although many studies demonstrate the efficacy of a variety of treatments for child and adolescent psychiatric disorders, studies showing the effectiveness of such treatments in ordinary clinical settings have not been forthcoming. This report presents a study of the effectiveness of outpatient treatment in a community sample of 9- to 16-year-olds. METHOD: Four annual waves of data were collected from a representative sample of 1,422 children and their parents in the southeastern United States. Interviews were conducted with the Child and Adolescent Psychiatric Assessment to determine clinical status and the Child and Adolescent impact Assessment to measure the impact of psychiatric disorder on the lives of the children's families. RESULTS: Treated individuals were more severely disturbed and showed deterioration in their clinical status, even before they received treatment, indicating that comparisons with untreated individuals required controls not only for pretreatment clinical status, but for pretreatment clinical trajectory. A significant dose-response relationship was found between the number of specialty mental health treatment sessions received and improvement in symptoms at follow-up. However, no effect of treatment on secondary psychosocial impairment or parental impact was identified. CONCLUSIONS: Child and adolescent outpatient psychiatric treatment has positive effects on psychiatric symptoms, even when conducted outside the academic units where efficacy research usually takes place. The dose of treatment required to produce such effects (more than 8 sessions) suggests that attempts to limit child psychiatric treatment to very short-term interventions may be counterproductive.}, Doi = {10.1097/00004583-200002000-00013}, Key = {fds270342} } @article{fds270343, Author = {Maughan, B and Pickles, A and Rowe, R and Costello, EJ and Angold, A}, Title = {Developmental Trajectories of Aggressive and Non-Aggressive Conduct Problems}, Journal = {Journal of Quantitative Criminology}, Volume = {16}, Number = {2}, Pages = {199-221}, Year = {2000}, Month = {January}, url = {http://dx.doi.org/10.1023/A:1007516622688}, Abstract = {Modeling the heterogeneous trajectories along which antisocial behavior develops in childhood and adolescence may contribute in important ways to understanding antecedents of offending in adult life. This paper examines the development of aggressive and non-aggressive conduct problems in the Great Smoky Mountains Study of Youth, a longitudinal study in the southeastern United States. Aggressive and non-aggressive conduct problems of clinical severity, police contact and arrest, and family and environmental correlates were assessed in four annual interviews for 789 boys and 630 girls aged 9-13 at first interview. The best fitting latent class model identified three developmental trajectories: stable low problem levels, stable high problem levels, and declining levels of conduct problems, for both aggressive and non-aggressive behaviors. Boys were over-represented in the stable high trajectory class on the aggressive trajectory, but sex differences in non-aggressive trajectories were less marked. The overlap between aggressive and non-aggressive trajectory classes was quite limited. Both classifications showed strong associations with risks of police contact and arrest in early adolescence, and with measures of family adversity. The results are discussed in relation to developmental models of conduct disorder and delinquency.}, Doi = {10.1023/A:1007516622688}, Key = {fds270343} } @article{fds270345, Author = {Angold, A and Costello, EJ}, Title = {The Child and Adolescent Psychiatric Assessment (CAPA).}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {39}, Number = {1}, Pages = {39-48}, Year = {2000}, Month = {January}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10638066}, Abstract = {OBJECTIVE: To describe the Child and Adolescent Psychiatric Assessment (CAPA). The base interview covers the age range from 9 to 17 years. METHOD: The interview glossary that provides detailed operational definitions of symptoms and severity ratings is described, and psychometric data and further developments of the interview are presented. RESULTS: Across 5,962 parent-child interviews, the core sections of the CAPA (psychiatric symptoms, functional impairment, demographics, family structure and functioning) took on average 59 minutes for children and 66 minutes for parents. Test-retest reliability for diagnoses ranged from kappa = 0.55 for conduct disorder (CD) to kappa = 1.0 for substance abuse/dependence. Validity as judged by 10 different criteria was good. Developments of the CAPA include a shorter "gateway" version using core symptoms as screen items, a Spanish version, and versions for twin studies, use with young adults (YAPA), and preschool-age children (PAPA). CONCLUSIONS: There is a place in both research and clinical settings for a rigorously operationalized interview (such as the CAPA) that focuses on ensuring that respondents understand what is being asked and on clearly defining levels of symptom severity and functional impairment.}, Doi = {10.1097/00004583-200001000-00015}, Key = {fds270345} } @article{fds270339, Author = {McDade, TW and Stallings, JF and Angold, A and Costello, EJ and Burleson, M and Cacioppo, JT and Glaser, R and Worthman, CM}, Title = {Epstein-Barr virus antibodies in whole blood spots: a minimally invasive method for assessing an aspect of cell-mediated immunity.}, Journal = {Psychosomatic Medicine}, Volume = {62}, Number = {4}, Pages = {560-567}, Year = {2000}, ISSN = {0033-3174}, url = {http://dx.doi.org/10.1097/00006842-200007000-00015}, Abstract = {OBJECTIVE: Study 1: Introduce and validate a method for measuring EBV p18-VCA antibodies in whole blood spots to provide a minimally invasive marker of cell-mediated immune function. Study 2: Apply this method to a large community-based study of psychopathology in children and adolescents. METHODS: The EBV antibody method was evaluated through analysis of precision, reliability, stability, and comparisons with plasma and indirect immunofluorescence methods. The effects of life events on p18-VCA antibody level were considered in a subsample of 9, 11, and 13 year-old children participating in the Great Smoky Mountains Study in North Carolina. The subsample was stratified by age, sex, and degree of overall life strain. RESULTS: Dried blood spots provided a convenient, sensitive, precise, and reliable method for measuring EBV p18-VCA antibody titer. Life events were positively associated with p18-VCA antibodies in girls but not in boys. CONCLUSIONS: The validity of the blood spot EBV p18-VCA antibody assay, as well as the ease of sample collection, storage, and transportation, may provide an opportunity for psychoneuroimmunology to explore a wider range of stress models in larger, community-based studies.}, Doi = {10.1097/00006842-200007000-00015}, Key = {fds270339} } @article{fds270344, Author = {Costello, EJ and Angold, A}, Title = {Developmental psychopathology and public health: past, present, and future.}, Journal = {Development and Psychopathology}, Volume = {12}, Number = {4}, Pages = {599-618}, Year = {2000}, ISSN = {0954-5794}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11202035}, Abstract = {Children's healthy mental development has never been the focus of long-term, committed public health policy in the way that early physical health and development have been. We discuss four types of societal response to illness-cure, care, control, and prevention--and trace the history of public health in terms of its special responsibility to control and prevent disease. We identify four periods in the history of public health: the Sanitarian era (up to 1850), the Bacterial era (1850-1950), the Behavioral era (1950-present), and the Communitarian era (the next century). Looking at this history from the viewpoint of the developmental psychopathology of the first 2 decades of life, we trace progress in public health responses to children with mental illness, from a philosophy of control by isolation toward one of preventive intervention. We examine primary, or universal, prevention strategies that have been tried, and we suggest some that might be worth reconsidering.}, Doi = {10.1017/s095457940000403x}, Key = {fds270344} } @article{fds270331, Author = {Canino, G and Costello, EJ and Angold, A}, Title = {Assessing Functional Impairment and Social Adaptation for Child Mental Health Services Research: A Review of Measures}, Journal = {Mental Health Services Research}, Volume = {1}, Number = {2}, Pages = {93-108}, Year = {1999}, Month = {December}, ISSN = {1522-3434}, url = {http://dx.doi.org/10.1023/A:1022334303731}, Abstract = {The need for assessing impairment in functioning as an integral part of child mental health services research is discussed. Methodologic difficulties related to problems in case definition, the conceptual definition of impairment and social adaptation, and the assessment of the construct across cultures are also addressed. In addition, a critical review of existing child impairment measures with published psychometric properties is presented. The measures are divided into three types: measures of global impairment, domain-specific measures, and symptom-specific measures. The paper concludes that the choice of the measure to use in health services research needs to be determined according to the main goals of the study, the population in which the instrument is going to be used, and the interviewer's knowledge of the child. Other characteristics of the measures of impairment that the researcher should consider are also discussed.}, Doi = {10.1023/A:1022334303731}, Key = {fds270331} } @article{fds270333, Author = {Angold, A and Costello, EJ and Erkanli, A and Worthman, CM}, Title = {Pubertal changes in hormone levels and depression in girls.}, Journal = {Psychological Medicine}, Volume = {29}, Number = {5}, Pages = {1043-1053}, Year = {1999}, Month = {September}, ISSN = {0033-2917}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10576297}, Abstract = {BACKGROUND: Throughout their reproductive years, women suffer from a higher prevalence of depression than men. Before puberty, however, this is not the case. In an earlier study, we found that reaching Tanner Stage III of puberty was associated with increased levels of depression in girls. This paper examines whether the morphological changes associated with puberty (as measured by Tanner stage) or the hormonal changes underlying them are more strongly associated with increased rates of depression in adolescent girls. METHODS: Data from three annual waves of interviews with 9 to 15-year-olds from the Great Smoky Mountains study were analysed. RESULTS: Models including the effects of testosterone and oestradiol eliminated the apparent effect of Tanner stage. The effect of testosterone was non-linear. FSH and LH had no effects on the probability of being depressed. CONCLUSIONS: These findings argue against theories that explain the emergence of the female excess of depression in adulthood in terms of changes in body morphology and their resultant psychosocial effects on social interactions and self-perception. They suggest that causal explanations of the increase in depression in females need to focus on factors associated with changes in androgen and oestrogen levels rather than the morphological changes of puberty.}, Doi = {10.1017/s0033291799008946}, Key = {fds270333} } @article{fds270338, Author = {Costello, EJ and Erkanli, A and Federman, E and Angold, A}, Title = {Development of psychiatric comorbidity with substance abuse in adolescents: effects of timing and sex.}, Journal = {Journal of Clinical Child Psychology}, Volume = {28}, Number = {3}, Pages = {298-311}, Year = {1999}, Month = {September}, ISSN = {0047-228X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10446679}, Abstract = {Examined the impact of childhood psychiatric disorders on the prevalence and timing of substance use and abuse and tested for sex differences. A representative population sample of 1,420 children, ages 9, 11, and 13 at intake, were interviewed annually. American Indians and youth with behavioral problems were oversampled; data were weighted back to population levels for analysis. By age 16, more than half the sample reported substance use, and 6% had abuse or dependence. Alcohol use began by age 9, and smoking in the 13th year. Mean onset of dependence was 14.8 years, and mean onset of abuse was 15.1 years. Substance use began earlier in boys, but not girls, who later developed abuse or dependence. Disruptive behavior disorders and depression were associated with a higher rate and earlier onset of substance use and abuse in both sexes, but anxiety predicted later onset of smoking. Family drug problems were the strongest correlate of early onset. Despite differences in prevalence of psychopathology, boys and girls showed more similarities than differences in the course of early substance use and abuse, and its associations with psychopathology.}, Doi = {10.1207/S15374424jccp280302}, Key = {fds270338} } @article{fds270337, Author = {Egger, HL and Costello, EJ and Erkanli, A and Angold, A}, Title = {Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {38}, Number = {7}, Pages = {852-860}, Year = {1999}, Month = {July}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10405503}, Abstract = {OBJECTIVE: To examine the associations of somatic complaints with DSM-III-R-defined depression, anxiety disorders, conduct disorder, oppositional defiant disorder, and attention-deficit hyperactivity disorder in a population-based sample of children and adolescents. METHODS: Data from 4 annual waves of interviews with 9- to 16-year-olds from the Great Smoky Mountains Study were analyzed. RESULTS: Overall, somatic complaints were strongly associated with emotional disorders in girls and with disruptive behavior disorders in boys. For girls, stomach aches and headaches together and musculoskeletal pains alone were associated with anxiety disorders. For boys, stomach aches were associated with oppositional defiant disorder and attention-deficit hyperactivity disorder. Musculoskeletal pains were associated with depression in both girls and boys. CONCLUSIONS: There were gender-, illness- and complaint-specific associations between somatic complaints and psychopathology. It appears likely that there are differences in the psychobiological processes underlying these associations in boys and girls. Clinical recommendations include screening children and adolescents with persistent complaints of headaches, stomach aches, or musculoskeletal pains for psychiatric disorders with an awareness that gender may affect the type of psychopathology associated with the somatic complaints.}, Doi = {10.1097/00004583-199907000-00015}, Key = {fds270337} } @article{fds270334, Author = {Costello, EJ and Angold, A and Keeler, GP}, Title = {Adolescent outcomes of childhood disorders: the consequences of severity and impairment.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {38}, Number = {2}, Pages = {121-128}, Year = {1999}, Month = {February}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9951210}, Abstract = {OBJECTIVE: To examine the adolescent consequences of clinical and threshold-level psychiatric disorders, with and without significant functional impairment; to predict serious emotional disturbance (SED: clinical-level diagnosis with impairment); and to examine sex differences in the consequences of emotional and behavioral disorders. METHOD: 300 children aged 7 through 11 years were recruited from urban and suburban offices of a large health maintenance organization (HMO). Child and parent were interviewed at home using the Diagnostic Interview Schedule for Children (DISC), version 1.3. Five to 7 years later, 278 (93%) of the sample were reinterviewed using the DISC-2.1. RESULTS: There was considerable continuity of psychopathology, particularly in children with functional impairment. Behavioral disorders at every level of severity predicted adolescent SED in both sexes. For emotional disorders, girls but not boys with childhood SED had significantly higher levels of adolescent SED. CONCLUSIONS: Childhood disorders falling below the level of severity required to meet criteria for treatment set by many HMOs or insurance companies nevertheless can carry a significantly increased risk for severe pathology years later. Functional impairment played an important role in the adolescent consequences of childhood psychiatric disorder.}, Doi = {10.1097/00004583-199902000-00010}, Key = {fds270334} } @article{fds270335, Author = {Angold, A and Costello, EJ and Farmer, EM and Burns, BJ and Erkanli, A}, Title = {Impaired but undiagnosed.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {38}, Number = {2}, Pages = {129-137}, Year = {1999}, Month = {February}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9951211}, Abstract = {OBJECTIVE: To investigate the prevalence and outcomes of individuals with psychosocial impairment not meeting DSM-III-R criteria for any of 29 well-defined disorders and to suggest operational definitions for not otherwise specified (NOS) diagnoses and V codes. METHODS: Two-stage general population sampling resulted in 1,015 youths aged 9, 11, and 13 years being interviewed in the first wave of the Great Smoky Mountains Study. They were reinterviewed 1 year later using the Child and Adolescent Psychiatric Assessment. RESULTS: The weighted prevalence of sibling relational problems was found to be 1.4%. That of parent-child relational problems was 3.6% and that of relational problems NOS was 0.6%. The overall rate of symptomatic impairment was 9.4%. Across a variety of "caseness measures," those with symptomatic impairment proved to be more disturbed than those without either a diagnosis or impairment, and as disturbed as those with a diagnosis but without impairment. CONCLUSION: Children and adolescents who do not meet DSM-III-R criteria for any well-defined disorder but who have symptoms associated with psychosocial impairment should be regarded as suffering from a psychiatric disorder. It is suggested that researchers adopt this definition for the many NOS diagnoses included in the DSM nosology and implement it in their research diagnostic algorithms.}, Doi = {10.1097/00004583-199902000-00011}, Key = {fds270335} } @article{fds270336, Author = {Farmer, EM and Stangl, DK and Burns, BJ and Costello, EJ and Angold, A}, Title = {Use, persistence, and intensity: patterns of care for children's mental health across one year.}, Journal = {Community Mental Health Journal}, Volume = {35}, Number = {1}, Pages = {31-46}, Year = {1999}, Month = {February}, ISSN = {0010-3853}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10094508}, Abstract = {This paper explores the use, persistence, and intensity of services for children's mental health problems across a variety of service sectors during a one year period. Data come from the Great Smoky Mountains Study. Analyses focus on children's psychiatric symptomatology and impairment, service use, and factors that may influence the relationship between psychiatric problems and service use across a one year period. Findings show that approximately 20% of children used some mental health services from some sector during the year. Child's symptomatology and characteristics of parents were associated with use and persistence of services. Parent's perceptions of impact on the family were associated with service use, persistence, and intensity.}, Doi = {10.1023/a:1018743908617}, Key = {fds270336} } @article{fds270332, Author = {Costello, EJ and Angold, A and March, J and Fairbank, J}, Title = {Life events and post-traumatic stress: the development of a new measure for children and adolescents.}, Journal = {Psychological Medicine}, Volume = {28}, Number = {6}, Pages = {1275-1288}, Year = {1998}, Month = {November}, ISSN = {0033-2917}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9854269}, Abstract = {BACKGROUND: A new interview measure of life events and post-traumatic stress disorder (PTSD) has been developed for children and adolescents aged 9 through 17, for use in both epidemiological and clinical studies. It includes 'high magnitude' events associated with PTSD as well as other 'low magnitude' events. METHOD: The interview is designed as a module of the Child and Adolescent Psychiatric Assessment, an interviewer-based interview conducted with parent and child separately by trained lay interviewers. The module includes: (1) questions about a wide range of events; (2) a screen for key PTSD symptoms (painful recall, avoidance, hypervigilance); and (3) a detailed interview on all PTSD symptoms, including onset, duration, severity and co-morbidity. A test-retest reliability study was conducted with 58 parents and children, who were interviewed twice by different interviewers. RESULTS: Intraclass correlations were 0.72 (child) and 0.83 (parent) for high magnitude events, and 0.62 (child) and 0.58 (parent) for low magnitude events. Kappa coefficients ranged from high for violence and sexual abuse to low for child reports of serious accidents and natural disasters. The reliability of the PTSD screen symptoms was fair to excellent (kappa = 0.40-0.79), and reliability of PTSD symptoms in those who passed the screen was excellent (ICC = 0.94-0.99). Compared with a general population sample (N = 1015), the clinic-referred subjects and their parents were twice as likely to report a traumatic event and, depending on the event, up to 25 times as likely to report symptoms of PTSD. CONCLUSIONS: The results support the reliability and discriminant validity of the measure.}, Doi = {10.1017/s0033291798007569}, Key = {fds270332} } @article{fds270330, Author = {Egger, HL and Angold, A and Costello, EJ}, Title = {Headaches and psychopathology in children and adolescents.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {37}, Number = {9}, Pages = {951-958}, Year = {1998}, Month = {September}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9735614}, Abstract = {OBJECTIVE: To examine the association between chronic headaches and DSM-III-R-defined psychiatric disorders, including depression, anxiety disorders, conduct disorder, oppositional defiant disorder and attention-deficit hyperactivity disorder, in a population-based sample of children and adolescents. METHOD: 1,013 children aged 9 to 15 years in the Great Smoky Mountains Study were evaluated annually over a 3-year period using the Child and Adolescent Psychiatric Assessment, a child and parent diagnostic psychiatric interview. Headaches that lasted at least 1 hour and occurred at least once a week during the 3 months prior to the interview were studied. RESULTS: Girls with depression and anxiety disorders had a significantly greater prevalence of headaches than girls without an internalizing disorder. This association was not found for boys. Conduct disorder was significantly associated with headaches in boys. Each of these associations was constant with age. CONCLUSIONS: This study suggests that a distinct gender difference exists between boys and girls in the associations between headaches and psychopathology. Carroll's theory of dysfunction in central pain regulation as an underlying cause of depression is discussed in relation to the proposed serotonergic dysregulation common to headaches, depression, anxiety, aggression, and pain.}, Doi = {10.1097/00004583-199809000-00015}, Key = {fds270330} } @article{fds270329, Author = {Erkanli, A and Soyer, R and Angold, A}, Title = {Optimal Bayesian two-phase designs}, Journal = {Journal of Statistical Planning and Inference}, Volume = {66}, Number = {1}, Pages = {175-191}, Publisher = {Elsevier BV}, Year = {1998}, Month = {January}, url = {http://dx.doi.org/10.1016/s0378-3758(97)00075-x}, Abstract = {In this paper we present a Bayesian decision theoretic approach to the two-phase design problem. The solution of such sequential decision problems is usually difficult to obtain because of their reliance on preposterior analysis. In overcoming this problem, we adopt the Monte-Carlo-based approach of Müller and Parmigiani (1995) and develop optimal Bayesian designs for two-phase screening tests. A rather attractive feature of the Monte Carlo approach is that it facilitates the preposterior analysis by replacing it with a sequence of scatter plot smoothing/regression techniques and optimization of the corresponding fitted surfaces. The method is illustrated for depression in adolescents using data from past studies. © 1998 Elsevier Science B.V.}, Doi = {10.1016/s0378-3758(97)00075-x}, Key = {fds270329} } @article{fds270326, Author = {Angold, A and Costello, EJ and Worthman, CM}, Title = {Puberty and depression: the roles of age, pubertal status and pubertal timing.}, Journal = {Psychological Medicine}, Volume = {28}, Number = {1}, Pages = {51-61}, Year = {1998}, Month = {January}, ISSN = {0033-2917}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9483683}, Abstract = {BACKGROUND: Previous work has indicated that the 2:1 female:male sex ratio in unipolar depressive disorders does not emerge until some time between ages 10 and 15. METHODS: Data from four annual waves of data collection from the Great Smoky Mountains Study (GSMS) involving children aged nine to 16 were employed. RESULTS: Pubertal status better predicted the emergence of the expected sex ratio than did age. Only after the transition to mid-puberty (Tanner Stage III and above) were girls more likely than boys to be depressed. The timing of this transition had no effect on depression rates. Before Tanner Stage III, boys had higher rates of depression than girls, and the prevalence of depression appeared to fall in boys at an earlier pubertal stage than that at which it began to rise in girls. In addition, recent transition to Tanner Stage III or higher had a transient effect in reducing the prevalence of depression in boys. CONCLUSIONS: The period of emergence of increased risk for depression in adolescent girls appears to be a relatively sharply demarcated developmental transition occurring in mid-puberty. Previously reported effects of the timing of puberty (which have tended to be transient) appeared less important in increase of risk for depression than pubertal status.}, Doi = {10.1017/s003329179700593x}, Key = {fds270326} } @article{fds270328, Author = {Angold, A and Messer, SC and Stangl, D and Farmer, EM and Costello, EJ and Burns, BJ}, Title = {Perceived parental burden and service use for child and adolescent psychiatric disorders.}, Journal = {American Journal of Public Health}, Volume = {88}, Number = {1}, Pages = {75-80}, Year = {1998}, Month = {January}, ISSN = {0090-0036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9584037}, Abstract = {OBJECTIVES: Pediatric chronic physical illness and adult psychiatric disorders are substantial sources of burden for family care-takers, but little attention has been paid to parental burden resulting from children's or adolescents' psychiatric disorders. This paper describes the predictors of perceived parental burden and its impact on the use of specialty mental health and school services. METHODS: A representative general population sample of 1015 9-, 11-, and 13-year-olds and their parents completed structured psychiatric diagnostic interviews and the Child and Adolescent Burden Assessment. RESULTS: Weighted estimates indicated that 10.7% of parents in the general population perceived burden resulting from their children's symptomatology. Significant predictors of perceived burden were levels of child symptomatology and impairment and parental mental health problems. Children's depressive and anxiety disorders were associated with less burden than other diagnoses. The effects of child disorder severity on specialty mental health service use appeared to be mediated by the level of burden induced. CONCLUSIONS: Substantial levels of parental burden resulted from child psychiatric disorders and were a major reason for specialist mental health service use.}, Doi = {10.2105/ajph.88.1.75}, Key = {fds270328} } @article{fds270327, Author = {Costello, EJ and Farmer, EM and Angold, A and Burns, BJ and Erkanli, A}, Title = {Psychiatric disorders among American Indian and white youth in Appalachia: the Great Smoky Mountains Study.}, Journal = {American Journal of Public Health}, Volume = {87}, Number = {5}, Pages = {827-832}, Year = {1997}, Month = {May}, ISSN = {0090-0036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9184514}, Abstract = {OBJECTIVES: This study examined prevalence of psychiatric disorders, social and family risk factors for disorders, and met and unmet needs for mental health care among Appalachian youth. METHODS: All 9-, 11-, and 13-year-old American Indian children in an 11-county area of the southern Appalachians were recruited, together with a representative sample of the surrounding population of White children. RESULTS: Three-month prevalences of psychiatric disorders were similar (American Indian, 16.7%; White, 19.2%). Substance use was more common in American Indian children (9.0% vs 3.8% in White children), as was comorbidity of substance use and psychiatric disorder (2.5% vs 0.9%). American Indian poverty, family adversity (e.g., parental unemployment, welfare dependency), and family deviance (parental violence, substance abuse, and crime) rates were higher, but the rate of family mental illness, excluding substance abuse, was lower. Child psychiatric disorder and mental health service use were associated with family mental illness in both ethnic groups but were associated with poverty and family deviance only in White children. Despite lower financial barriers, American Indian children used fewer mental health services. CONCLUSIONS: This study suggests that poverty and crime play different roles in different communities in the etiology of child psychiatric disorder.}, Doi = {10.2105/ajph.87.5.827}, Key = {fds270327} } @article{fds270325, Author = {Federman, EB and Costello, EJ and Angold, A and Farmer, EM and Erkanli, A}, Title = {Development of substance use and psychiatric comorbidity in an epidemiologic study of white and American Indian young adolescents the Great Smoky Mountains Study.}, Journal = {Drug and Alcohol Dependence}, Volume = {44}, Number = {2-3}, Pages = {69-78}, Year = {1997}, Month = {March}, ISSN = {0376-8716}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9088778}, Abstract = {The progression of substance use and the patterns of comorbidity of substance use and psychiatric disorders are explored prospectively in young adolescents enrolled in the Great Smoky Mountains Study. This study is an epidemiologic study of white and American Indian youths living in rural Southern Appalachia. Results from this study indicate that alcohol use without permission predicts subsequent use of illicit drugs and regular tobacco use. Use of tobacco was not associated with either later alcohol or drug use. Patterns of comorbidity showed strong cross-sectional relationships between substance use and behavioral disorders, but not emotional disorders. Use of alcohol was also associated with psychiatric diagnosis at a later interview. There were some differences between white and American Indian youths in the pattern of comorbidity of tobacco use and psychiatric disorder and the relationship between prior psychiatric disorder and later alcohol use. These findings suggest that alcohol use without permission may be an important marker for youths who are at risk for illicit drug use and/or psychiatric diagnoses.}, Doi = {10.1016/s0376-8716(96)01317-8}, Key = {fds270325} } @article{fds270320, Author = {Messer, SC and Angold, A and Costello, EJ and Burns, BJ}, Title = {The child and adolescent burden assessment (CABA): Measuring the family impact of emotional and behavioral problems}, Journal = {International Journal of Methods in Psychiatric Research}, Volume = {6}, Number = {4}, Pages = {261-284}, Publisher = {WILEY}, Year = {1997}, Month = {January}, ISSN = {1049-8931}, url = {http://dx.doi.org/10.1002/(sici)1234-988x(199612)6:4<261::aid-mpr169>3.3.co;2-}, Abstract = {Background: Though adult psychiatric disorders have been found to be substantial sources of burden for family caretakers, little attention has been paid to the measurement of burden resulting from children's psychiatric disturbance, or to its measurement. The purpose of the present study was to describe the development and characteristics of such a measure, the Child and Adolescent Burden Assessment (CABA). Methods: The psychometric properties of the CABA were examined in both general population and clinical samples. Psychometric properties assessed included factor composition, internal consistency, test-retest reliability, and criterion-related validity. Results: Factor analyses demonstrated a robust general 'burden' construct in both the community and clinical samples. Internal consistency reliability estimates were high (coefficient a> .80). Test-retest stability over a one-week period was adequate (ICC = 0.67) in a small clinical sample. Criterion-related validity was supported in comparisons of mean burden levels between community and clinical samples. Conclusions: The CABA appears to be a promising instrument for the measurement of family burden associated with childhood psychiatric disorders. Psychometrically, the CABA performs adequately. Theoretically, the burden construct may prove useful in models of service use, mental health outcomes, and the progress of family adaptation. © 1996 by John Wiley & Sons, Ltd.}, Doi = {10.1002/(sici)1234-988x(199612)6:4<261::aid-mpr169>3.3.co;2-}, Key = {fds270320} } @article{fds270322, Author = {Angold, A and Jane Costello and E}, Title = {The relative diagnostic utility of child and parent reports of oppositional defiant behaviors}, Journal = {International Journal of Methods in Psychiatric Research}, Volume = {6}, Number = {4}, Pages = {253-259}, Publisher = {WILEY}, Year = {1997}, Month = {January}, ISSN = {1049-8931}, url = {http://dx.doi.org/10.1002/(sici)1234-988x(199612)6:4<253::aid-mpr170>3.3.co;2-}, Abstract = {It has been suggested that parents are better reporters of oppositional defiant behaviors than are children themselves and that this may be a reason to ignore child reports in the assessment of Oppositional Defiant Disorder (ODD). Using data from the Great Smoky Mountains Study, a community study 1,015 of nine-, eleven-, and thirteen-yearold children, we found that, indeed, children on average reported lower frequencies of all oppositional defiant behaviors than their parents reported about them. However, their reports of such behaviors and psychosocial impairment had a substantial effect on the rate of oppositional defiant disorder (ODD). Where child reports were required for the DSM-IV criteria ODD criteria to be met, rates of several 'validity' criteria and measures of outcome one year later were as high as when parent reports alone were sufficient to make the diagnosis. We conclude that child self reports of oppositional defiant symptoms are an important part of the assessment of ODD in both research applications and clinical practice. © 1996 by John Wil'ey & Sons, Ltd.}, Doi = {10.1002/(sici)1234-988x(199612)6:4<253::aid-mpr170>3.3.co;2-}, Key = {fds270322} } @article{fds270323, Author = {Farmer, EMZ and Burns, BJ and Angold, A and Costello, EJ}, Title = {Impact of Children's Mental Health Problems on Families: Relationships with Service Use}, Journal = {Journal of Emotional and Behavioral Disorders}, Volume = {5}, Number = {4}, Pages = {230-238}, Publisher = {SAGE Publications}, Year = {1997}, Month = {January}, url = {http://dx.doi.org/10.1177/106342669700500406}, Abstract = {Impact on the family resulting from children's emotional and behavioral problems, with particular attention to relationships between such family impact and use of mental health services, is explored in this article. Data come from the Great Smoky Mountains Study, an epidemiologic, longitudinal study of children's mental health problems and service use in a rural region of the southeastern United States. Reported measures include the Child and Adolescent Psychiatric Assessment, Child and Adolescent Service Assessment, and Child and Adolescent Impact Assessment. Youths who first used services when they were 10-15 years of age showed significantly higher rates and levels of family impact than similar youths who did not enter services. Such impacts were most notable in the areas of parental well-being (e.g., depression, worries) and parents' sense of competence to handle the child's problems. Youths in this age range who used services but were not new to the system showed somewhat higher rates of family impact than youths who were new to the system, particularly in the area of parental use of mental health services. We discuss these findings in terms of service provision and further research needs.}, Doi = {10.1177/106342669700500406}, Key = {fds270323} } @article{fds270324, Author = {Burns, BJ and Costello, EJ and Erkanli, A and Tweed, DL and Farmer, EMZ and Angold, A}, Title = {Insurance coverage and mental health services use by adolescents with serious emotional disturbance}, Journal = {Journal of Child and Family Studies}, Volume = {6}, Number = {1}, Pages = {89-111}, Year = {1997}, Month = {January}, ISSN = {1062-1024}, url = {http://dx.doi.org/10.1023/A:1025024808146}, Abstract = {This paper examines the relationships between insurance coverage, need, and mental health services in a community-based sample of 1,015youths who were 9, 11, and 13 years old at the beginning of the study. They were followed over a two-year period. A strong measure of need based on a standardized diagnostic interview was available and repeated over three annual waves. Data on service use was collected quarterly across two years. Major findings included: (a) high need (serious emotional disturbance [SED]) was strongly related to use of any mental health services; (b) services use was much more likely to occur with public (Medicaid) insurance coverage than either private or no insurance; (c) considerable unmet need was observed even for youths with SED; (d) school-based mental health services potentially substituted for professional mental health services; and (e) there was little unnecessary use of mental health services in the low need group. The major policy implication of these findings is that the regulation of insurance benefits should be based on level of need, rather than on arbitrary limits which are likely to either reduce the probability of or appropriate amount of care for youths who most need mental health services. © 1997 Human Sciences Press, Inc.}, Doi = {10.1023/A:1025024808146}, Key = {fds270324} } @article{fds270314, Author = {Angold, A and Costello, EJ and Messer, SC}, Title = {Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents}, Journal = {International Journal of Methods in Psychiatric Research}, Volume = {5}, Number = {4}, Pages = {237-249}, Year = {1996}, Month = {December}, ISSN = {1049-8931}, Abstract = {The purpose of the present study was to describe the development and assess the psychometric properties of the Short Mood and Feelings Questionnaire (SMFQ). The SMFQ is a brief, easy-to-administer, self-report measure of childhood and adolescent depression, designed for the rapid evaluation of core depressive symptomatology or for use in epidemiological studies. The SMFQ's content and criterion-related validity were examined in a sample of 173 8-16 year-olds, comprised of both psychiatric and unselected pédiatrie controls. Results revealed substantial correlations between the SMFQ, the Children's Depression Inventory (GDI) and the Diagnostic Interview Schedule for Children (DISC) depression scale. The SMFQ successfully discriminated the clinically-referred psychiatric subjects from the pédiatrie controls. Within the pédiatrie (general population) sample, the SMFQ discriminated DISC-diagnosed children with depressive disorder from non-depressed subjects. Exploratory factor analyses, along with a high internal consistency, suggested that the SMFQ was a unifactorial scale. In sum, the SMFQ appears to be a promising tool for both the swift assessment of core depressive symptomatology and as a screening measure for depression in child psychiatric epidemiological studies. © 1995 by John Wiley & Sons, Ltd.}, Key = {fds270314} } @article{fds270317, Author = {Costello, EJ and Angold, A and Burns, BJ and Stangl, DK and Tweed, DL and Erkanli, A and Worthman, CM}, Title = {The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders.}, Journal = {Archives of General Psychiatry}, Volume = {53}, Number = {12}, Pages = {1129-1136}, Year = {1996}, Month = {December}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8956679}, Abstract = {BACKGROUND: The Great Smoky Mountains Study of youth focuses on the relationship between the development of psychiatric disorder and the need for and use of mental health services. METHODS: A multistage, overlapping cohorts design was used, in which 4500 of the 11758 children aged 9, 11, and 13 years in an 11-county area of the southeastern United States were randomly selected for screening for psychiatric symptoms. Children who scored in the top 25% on the screening questionnaire, together with a 1 in 10 random sample of the rest, were recruited for 4 waves of intensive, annual interviews (n = 1015 at wave 1). In a parallel study, all American Indian children aged 9, 11, and 13 years were recruited (N = 323 at wave 1). RESULTS: The 3-month prevalence (+/-SE) of any DSM-III-R axis I disorder in the main sample, weighted to reflect population prevalence rates, was 20.3% +/- 1.7%. The most common diagnoses were anxiety disorders (5.7% +/- 1.0%), enuresis (5.1% +/- 1.0%), tic disorders (4.2% +/- 0.9%), conduct disorder (3.3% +/- 0.6%), oppositional defiant disorder (2.7% +/- 0.4%), and hyperactivity (1.9% +/- 0.4%). CONCLUSIONS: The prevalence of psychiatric disorder in this rural sample was similar to rates reported in other recent studies. Poverty was the strongest demographic correlate of diagnosis, in both urban and rural children.}, Doi = {10.1001/archpsyc.1996.01830120067012}, Key = {fds270317} } @article{fds270318, Author = {Angold, A and Costello, J and Van Kämmen and W and Stouthamer-Loeber, M}, Title = {Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: factor composition and structure across development}, Journal = {International Journal of Methods in Psychiatric Research}, Volume = {5}, Number = {4}, Pages = {251-262}, Year = {1996}, Month = {December}, ISSN = {1049-8931}, Abstract = {In the present study, the factor composition of a new, brief, easy-to-administer, depression inventory for children and adolescents, the Short Mood and Feelings Questionnaire (SMFQ), was examined. Using longitudinal data from the Pittsburgh Youth Study, confirmatory factor analyses were computed to evaluate the age-invariance of a singlefactor SMFQ structure. Results provided strong support for the unidimensional structure of the SMFQ across grades 1-10 in a large sample of boys. Factor loading correlations across age groups were substantial suggesting developmental continuity in item (symptom) salience for the latent variable of depression. The magnitude of the mean factor loadings increased with age, suggesting that the depression construct was measured with less error as the children matured. In sum, the SMFQ appears to provide a brief and reliable measure of a core depression construct in children and adolescents. © 1995 by John Wiley & Sons, Ltd.}, Key = {fds270318} } @article{fds270319, Author = {Angold, A and Erkanli, A and Costello, EJ and Rutter, M}, Title = {Precision, reliability and accuracy in the dating of symptom onsets in child and adolescent psychopathology.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {37}, Number = {6}, Pages = {657-664}, Year = {1996}, Month = {September}, ISSN = {0021-9630}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8894946}, Abstract = {Dates of onset of psychiatric symptoms are required in determining whether diagnostic criteria are met for a number of disorders and for a variety of research questions. However, little attention has been paid to the precision and reliability of their recall by parents and children. We present data from two studies indicating that when symptoms have lasted longer than around 3 months, the month of onset usually cannot be accurately reported, while with symptoms that have lasted a year or more, the year of onset is usually uncertain. The implications of these findings for diagnosis and research are discussed.}, Doi = {10.1111/j.1469-7610.1996.tb01457.x}, Key = {fds270319} } @article{fds270321, Author = {Angold, A and Costello, EJ}, Title = {Toward establishing an empirical basis for the diagnosis of oppositional defiant disorder.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {35}, Number = {9}, Pages = {1205-1212}, Year = {1996}, Month = {September}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8824064}, Abstract = {OBJECTIVES: (1) To determine the frequency of occurrence of oppositional defiant behaviors in the general population with a view to establishing empirical frequency cutoffs for the evaluation of oppositional defiant disorder (ODD). (2) To examine the effects of changes in the definition of ODD between DSM-III-R and DSM-IV. METHOD: The Great Smoky Mountains Study is a general population study of 9-, 11-, and 13-year-olds. Subjects and their parents were interviewed with the Child and Adolescent Psychiatric Assessment at baseline and again 1 year later. RESULTS: Ninetieth percentile frequency cutoffs for ODD symptoms are given. Although rates of ODD were little different between DSM-III-R and DSM-IV, fewer than half of those who met criteria by one or the other definition met criteria according to both. DSM-IV defined a more disturbed group of children than did DSM-III-R. Requiring only two or three ODD symptoms plus impairment identified children with substantial evidence of disturbance who did not otherwise meet criteria for any diagnosis. CONCLUSIONS: The DSM-IV criteria represent an improvement over DSM-III-R. However, a reduction in the number of ODD symptoms required for diagnosis is indicated. Symptom frequency criteria for ODD symptoms are suggested for clinical use.}, Doi = {10.1097/00004583-199609000-00018}, Key = {fds270321} } @article{fds270315, Author = {Angold, A and Erkanli, A and Loebkr, R and Costello, EJ and Van Kammen, W and Stouthamer-Loeber, M}, Title = {Disappearing Depression in a Population Sample of Boys}, Journal = {Journal of Emotional and Behavioral Disorders}, Volume = {4}, Number = {2}, Pages = {95-104}, Publisher = {SAGE Publications}, Year = {1996}, Month = {January}, url = {http://dx.doi.org/10.1177/106342669600400204}, Abstract = {Although there is evidence that rules of depressive disorders increase during adolescence in girls, the data on the effects of age on depression in boys have been contradictory. In order to shed further light on this issue, the Short Mood and Feelings Questionnaire (SMFQ) was administered to a general population sample of approximately 1,500 boys ages 6 to 15 years, during four annual interviews. Longitudinal analyses revealed a substantial decrease in reported depressive symptoms between the ages of 8 and 11. The implications of these findings for developmental epidemiological research on depression arc discussed.}, Doi = {10.1177/106342669600400204}, Key = {fds270315} } @article{fds270316, Author = {Ascher, BH and Farmer, EMZ and Burns, BJ and Angold, A}, Title = {The Child and Adolescent Services Assessment (CASA): Description and Psychometrics}, Journal = {Journal of Emotional and Behavioral Disorders}, Volume = {4}, Number = {1}, Pages = {12-20}, Publisher = {SAGE Publications}, Year = {1996}, Month = {January}, url = {http://dx.doi.org/10.1177/106342669600400102}, Abstract = {The Child and Adolescent Services Assessment (CASA) is a self- and parent-report instrument designed to assess the use of mental health services by children ages 8 years to 18 years. The CASA includes 31 settings covering inpatiem, outpatient, and informal services provided by a variety of child-serving providers and sectors. This instrument collects information on whether a service was ever used and more detailed information (length of stay/number of visits, focus of treatment) on services used in the recent past. A description of the instrument, information on interviewer training and coding of data, psychometric data on clinical samples, and a case study are presented.}, Doi = {10.1177/106342669600400102}, Key = {fds270316} } @article{fds270432, Author = {Angold, A and Prendergast, M and Cox, A and Harrington, R and Simonoff, E and Rutter, M}, Title = {The Child and Adolescent Psychiatric Assessment (CAPA).}, Journal = {Psychological Medicine}, Volume = {25}, Number = {4}, Pages = {739-753}, Year = {1995}, Month = {July}, url = {http://dx.doi.org/10.1017/s003329170003498x}, Abstract = {Great advances have been made during the last 20 years in the development of structured and semi-structured interviews for use with psychiatric patients. However, in the field of child and adolescent psychiatry there have been weaknesses in the specification and definition of both symptoms and the psychosocial impairments resulting from psychiatric disorder. Furthermore, most of the available interviews for use with children have been tied to a single diagnostic system (DSM-III, DSM-III-R, or ICD-9). This has meant that symptom coverage has been limited and nosological comparisons have been inhibited. The Child and Adolescent Psychiatric Assessment (CAPA) represents an attempt to remedy some of these shortcomings. This paper outlines the principles adopted in the CAPA to improve the standardization, reliability and meaningfulness of symptom and diagnostic ratings. The CAPA is an interviewer-based diagnostic interview with versions for use with children and their parents, focused on symptoms occurring during the preceding 3 month period, adapted for assessments in both clinical and epidemiological research.}, Doi = {10.1017/s003329170003498x}, Key = {fds270432} } @article{fds270433, Author = {Angold, A and Costello, EJ}, Title = {A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C).}, Journal = {Psychological Medicine}, Volume = {25}, Number = {4}, Pages = {755-762}, Year = {1995}, Month = {July}, ISSN = {0033-2917}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7480452}, Abstract = {Seventy-seven 10-18-year-old psychiatric in-patients and out-patients took part in a test-retest study of the Child and Adolescent Psychiatric Assessment (CAPA). They were interviewed on two occasions several days apart. Overall reliability of diagnosis ranged from kappa = 0.55 (conduct disorder) to 1.0 (substance abuse or dependence). In general, reliability for scale scores of psychopathology was somewhat lower in out-patients than in-patients, though the opposite was the case for anxiety disorders and psychosocial incapacity and the reliability of the diagnosis of conduct disorder--the only individual diagnosis sufficiently common to permit this comparison. Unreliability of reports of behavioural problems was found to be related to admitting to being a liar in the first interview. The implications of these results for the use of the CAPA are discussed.}, Doi = {10.1017/s0033291700034991}, Key = {fds270433} } @article{fds270313, Author = {Burns, BJ and Costello, EJ and Angold, A and Tweed, D and Stangl, D and Farmer, EM and Erkanli, A}, Title = {Children's mental health service use across service sectors.}, Journal = {Health Affairs}, Volume = {14}, Number = {3}, Pages = {147-159}, Year = {1995}, ISSN = {0278-2715}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7498888}, Abstract = {This DataWatch explores the roles of human service sectors (mental health, education, health, child welfare, and juvenile justice) in providing mental health services for children. The data are from the first wave of the Great Smoky Mountains Study of Youth, a population-based study of psychopathology and mental health service use among children. The results show somewhat higher rates of mental health service use than has been reported previously, while continuing to show a substantial amount of unmet need, even among children with both a psychiatric diagnosis and functional impairment. The findings point to a significant role for the education sector, suggesting that schools may function as the de facto mental health system for children and adolescents.}, Doi = {10.1377/hlthaff.14.3.147}, Key = {fds270313} } @article{fds270431, Author = {Angold, A and Costello, EJ}, Title = {Developmental epidemiology.}, Journal = {Epidemiologic Reviews}, Volume = {17}, Number = {1}, Pages = {74-82}, Year = {1995}, ISSN = {0193-936X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8521948}, Doi = {10.1093/oxfordjournals.epirev.a036187}, Key = {fds270431} } @article{fds270312, Author = {Farmer, EMZ and Angold, A and Burns, BJ and Costello, EJ}, Title = {Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)}, Journal = {Journal of Child and Family Studies}, Volume = {3}, Number = {3}, Pages = {307-325}, Publisher = {Springer Nature}, Year = {1994}, Month = {September}, ISSN = {1062-1024}, url = {http://dx.doi.org/10.1007/BF02234688}, Abstract = {This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) - a self-report instrument for use with 8- to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use). © 1994 Human Sciences Press, Inc.}, Doi = {10.1007/BF02234688}, Key = {fds270312} } @article{fds270430, Author = {Costello, EJ and Burns, BJ and Angold, A and Leaf, PJ}, Title = {Epidemiology and health care reform.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {33}, Number = {7}, Pages = {1058-1059}, Year = {1994}, Month = {September}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7832878}, Doi = {10.1097/00004583-199409000-00020}, Key = {fds270430} } @article{fds270429, Author = {Angold, A and Costello, EJ}, Title = {Depressive comorbidity in children and adolescents: empirical, theoretical, and methodological issues.}, Journal = {The American Journal of Psychiatry}, Volume = {150}, Number = {12}, Pages = {1779-1791}, Year = {1993}, Month = {December}, ISSN = {0002-953X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8238631}, Abstract = {OBJECTIVE: The purpose of the study was to examine comorbidity in the context of child and adolescent depression. METHOD: The authors reviewed recent epidemiological studies using standardized interviews and DSM-III or DSM-III-R criteria. RESULTS: There was a high rate of comorbidity in children and adolescents with major depressive disorders or dysthymia. Comorbidity with conduct disorder/oppositional defiant disorder ranged from 21% to 83%; comorbidity with anxiety disorder ranged from 30% to 75%; and comorbidity with attention deficit disorder ranged from 0% to 57.1%. Rates of depressive comorbidity found in community studies were similar to the rates found in clinical studies. In almost all cases, the disorders were more common in depressed children than expected by chance, and the rates of other disorders in depressed children were higher than the rates of depression in those with depression. CONCLUSIONS: The mechanisms by which comorbidity occurs are obscure at present. Several possibilities and their implications for nosology, epidemiology, and treatment research are discussed.}, Doi = {10.1176/ajp.150.12.1779}, Key = {fds270429} } @article{fds270311, Author = {Costello, EJ and Burns, BJ and Angold, A and Leaf, PJ}, Title = {How can epidemiology improve mental health services for children and adolescents?}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {32}, Number = {6}, Pages = {1106-1114}, Year = {1993}, Month = {November}, ISSN = {0890-8567}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8282654}, Abstract = {Epidemiology, the study of patterns of disease distribution in time and space, can help to improve mental health services for children and adolescents by increasing understanding of the causes, development, and course of psychiatric disorders. For the purpose of service delivery, epidemiologic research on child psychopathology can provide information on need for services, availability of services, and effectiveness of services. For both scientific and planning purposes, epidemiologic research can inform us about (1) the developmental course of psychiatric disorders during childhood and adolescence, (2) the effect of psychiatric disorder on the course of normal childhood development, and (3) the effect of childhood development on the developmental course of psychiatric disorder. Information about prevalence and incidence is useful for planning primary, secondary, and tertiary prevention and treatment services. The same information is scientifically useful to the extent that it helps to answer questions about causation, course, and outcome. However, one aim of this paper is to show that epidemiology is about a great deal more than rates of disorder.}, Doi = {10.1097/00004583-199311000-00002}, Key = {fds270311} } @article{fds270428, Author = {Angold, A and Pickles, A}, Title = {Seclusion on an adolescent unit.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {34}, Number = {6}, Pages = {975-989}, Year = {1993}, Month = {September}, url = {http://dx.doi.org/10.1111/j.1469-7610.1993.tb01102.x}, Abstract = {We studied the seclusion records of an adolescent unit for a six-year period. Problems in the analysis of typical seclusion data are examined and statistical methods that overcame them are explained. Only a few relationships were found between the seclusion regime and available measures of patient and ward characteristics, though there was great variability in the frequency with which individuals were secluded and the duration of various episodes of seclusion. The average duration of seclusion (31 minutes) was much less than had been reported by other investigators. Furthermore, the durations became shorter over the period of study. The implications of these findings for further research and practice are discussed.}, Doi = {10.1111/j.1469-7610.1993.tb01102.x}, Key = {fds270428} } @article{fds322748, Author = {Costello, EJ and Angold, A}, Title = {Toward a developmental epidemiology of the disruptive behavior disorders}, Journal = {Development and Psychopathology}, Volume = {5}, Number = {1-2}, Pages = {91-101}, Publisher = {Cambridge University Press (CUP)}, Year = {1993}, Month = {January}, url = {http://dx.doi.org/10.1017/S0954579400004284}, Abstract = {Epidemiology, the study of patterns of disease distribution in time and space, offers a powerful set of theories and methods for understanding and preventing illness. The disruptive behavior disorders (DBDs) can be studied from the point of view of whether or not epidemiological methods could help to understand and prevent them. We suggest that the best approach to the DBDs is one that takes into account both the development of the child and the development of the disorder. Developmental epidemiology is the attempt to use recent advances in developmental psychopathology to help answer questions about how developmental processes increase or decrease vulnerability to DBDs, how risk factors change across childhood, and how the development of the disorder is reflected in rates of onset and patterns of symptomatology. Using examples of primary and secondary prevention studies, we discuss the importance of appropriate sampling strategies and a clearly articulated theoretical background, if intervention trials are to achieve their full utility as tests of a developmental theory of the DBDs. © 1993, Cambridge University Press. All rights reserved.}, Doi = {10.1017/S0954579400004284}, Key = {fds322748} } @article{fds270310, Author = {Angold, A and Worthman, CW}, Title = {Puberty onset of gender differences in rates of depression: a developmental, epidemiologic and neuroendocrine perspective.}, Journal = {Journal of Affective Disorders}, Volume = {29}, Number = {2-3}, Pages = {145-158}, Year = {1993}, ISSN = {0165-0327}, url = {http://dx.doi.org/10.1016/0165-0327(93)90029-j}, Abstract = {A dramatic feature of the epidemiology of depression is the appearance of a 2:1 female excess of depression during adolescence. In childhood, rates of depression either do not differ between boys and girls or show a slight excess in boys. In this paper we review a number of lines of evidence that implicate the physical and hormonal developments of puberty in this change. We also argue that the analysis of pubertal change in the etiology of depression must take into account the fact that the causation of depression is almost certainly a complex process. In understanding such a process we suggest that developmental epidemiological studies will be of particular value.}, Doi = {10.1016/0165-0327(93)90029-j}, Key = {fds270310} } @article{fds322749, Author = {Angold, A and Rutter, M}, Title = {Effects of age and pubertal status on depression in a large clinical sample}, Journal = {Development and Psychopathology}, Volume = {4}, Number = {1}, Pages = {5-28}, Publisher = {Cambridge University Press (CUP)}, Year = {1992}, Month = {January}, url = {http://dx.doi.org/10.1017/S0954579400005538}, Abstract = {The rate of depression rises overall between childhood and adolescence, and by early adulthood depression is twice as common in women as in men. However, study results are conflicting as to the relative rates of depression in prepubertal boys and girls, and it is not clear whether the rates in adolescent boys rise, fall, or remain steady. It is also uncertain when in adolescence the female preponderance emerges. A number of studies point to effects of the biological developments of puberty as having an important place in these changes. From a developmental point of view, the fact that the hormonal and physical changes of puberty differ in boys and girls, mean that a “biological explanation” fits in well with the gender differentiation in rates of depression across puberty. In a sample of 3,519 8–16-year-old psychiatric patients, both boys and girls shared increasing levels of depression across this age range, but the rate of increase was faster in girls. There was no difference in the rates of depression between boys and girls before the age of 11, but by the age of 16 girls were twice as likely as boys to have significant depressive symptomatology. When age was controlled for, pubertal status had no effect on depression scores. Thus, these results did not support the idea that the biological changes of puberty are a primary motive force in producing the changes in the sex ratio in depression in adolescence. Therefore, further research on this topic needs not only to address the etiology of depression in young people, but also to search for etiologic factors with differential distributions or effects on boys and girls. © 1992, Cambridge University Press. All rights reserved.}, Doi = {10.1017/S0954579400005538}, Key = {fds322749} } @article{fds270309, Author = {Costello, EJ and Benjamin, R and Angold, A and Silver, D}, Title = {Mood variability in adolescents: a study of depressed, nondepressed and comorbid patients.}, Journal = {Journal of Affective Disorders}, Volume = {23}, Number = {4}, Pages = {199-212}, Year = {1991}, Month = {December}, ISSN = {0165-0327}, url = {http://www.ncbi.nlm.nih.gov/pubmed/1791265}, Abstract = {In a study to examine the variability of mood in psychiatrically disturbed adolescents, 30 inpatients aged 13-17 reported on current depressive symptoms three times a day for seven consecutive days, using a set of visual analog scales (the Adolescent Mood Scale: AMS) to record DSM-IIIR and other depressive symptoms. Ten of the patients had no depressive diagnosis; 11 had both a depressive and an 'externalizing' diagnosis (mainly conduct disorders and substance abuse disorders), and nine had depressive diagnoses but no externalizing disorder. Variability was defined in terms of (1) range of AMS scores; (2) amount of change from one test point to the next; (3) rhythmicity, measured by the autocorrelation function across 21 test points. All three groups had high levels of depressive symptoms throughout the week. On all measures of severity of depression, the depressed girls were more depressed than the depressed boys, irrespective of comorbidity. Measures of variability, however, showed no effect of sex, but comorbid patients were more likely to have a wide range of mood scores, and reported a 45% greater amount of mood change. Only five subjects had a significant lag1 autocorrelation function, and there was no indication of diurnal rhythmicity. Implications for research and diagnosis are discussed.}, Doi = {10.1016/0165-0327(91)90101-w}, Key = {fds270309} } @article{fds270308, Author = {Angold, A and Weissman, MM and John, K and Wickramaratne, P and Prusoff, B}, Title = {The effects of age and sex on depression ratings in children and adolescents.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {30}, Number = {1}, Pages = {67-74}, Year = {1991}, Month = {January}, url = {http://dx.doi.org/10.1097/00004583-199101000-00010}, Abstract = {The self-reports of depressive symptomatology of the 89 children and the parental reports of 62 parents whose children had such symptoms from a sample of 220 children, aged 6 to 23 years, in a family-genetic study of children at high and low risk of depression were examined for the effects of the age and sex of the child. The age of the child at interview proved to have a significant effect upon the dating of the onset of dysphoric episodes and the dating of the worst ever episode of dysphoria. The older girls reported about two more depressive symptoms on average than the younger girls. This finding was obscured unless account was taken of the age at which the subjects were interviewed. However, these effects did not apply to a group of melancholia-related symptoms. There were no consistent effects of age at interview or age at episode on the symptom reports of the boys or in the reports from the parents about both their male and female children.}, Doi = {10.1097/00004583-199101000-00010}, Key = {fds270308} } @article{fds270307, Author = {Angold, A}, Title = {Seclusion.}, Journal = {The British Journal of Psychiatry : the Journal of Mental Science}, Volume = {154}, Number = {APR.}, Pages = {437-444}, Year = {1989}, Month = {April}, url = {http://dx.doi.org/10.1192/bjp.154.4.437}, Abstract = {Seclusion is a commonly used management technique in some areas of psychiatric practice. However, its theoretical and empirical underpinnings are greatly wanting in many respects. This paper reviews the present state of our knowledge and ignorance about seclusion, and suggests some strategies for much-needed research.}, Doi = {10.1192/bjp.154.4.437}, Key = {fds270307} } @article{fds270306, Author = {Costello, EJ and Angold, A}, Title = {Scales to assess child and adolescent depression: checklists, screens, and nets.}, Journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, Volume = {27}, Number = {6}, Pages = {726-737}, Year = {1988}, Month = {November}, url = {http://dx.doi.org/10.1097/00004583-198811000-00011}, Abstract = {Child self-report and parent-report measures of depressive symptoms are useful both for preliminary screening and to monitor change in symptomatology. These two aims, however, demand different psychometric properties. Currently available self- and/or parent-reports of depressive symptoms are reviewed in terms of their content validity and criterion validity. There is wide variability in the symptoms covered by the Children's Depression Inventory (CDI), Center for Epidemiological Studies Depression Scale for Children (CES-DC), Depression Self-Rating Scale (DSRS), Children's Depression Scale (CDS), and Mood and Feelings Questionnaire (MFQ). A review of criterion validity showed that information needed is often unavailable. Suggestions are made for ways to provide information that will enable clinicians and researchers to select measures for their purposes.}, Doi = {10.1097/00004583-198811000-00011}, Key = {fds270306} } @article{fds270427, Author = {Angold, A}, Title = {Childhood and adolescent depression. II: Research in clinical populations.}, Journal = {The British Journal of Psychiatry : the Journal of Mental Science}, Volume = {153}, Number = {OCT.}, Pages = {476-492}, Year = {1988}, Month = {October}, url = {http://dx.doi.org/10.1192/bjp.153.4.476}, Abstract = {The tremendous increase in interest in childhood and adolescent depression that has occurred since the early 1970s has resulted in a large and contradictory literature. Development of the concept of childhood depression, and the many clinical studies of depression and its concomitants, both psychosocial and biological, are critically reviewed. A number of methodological and theoretical problems are discussed.}, Doi = {10.1192/bjp.153.4.476}, Key = {fds270427} } @article{fds270305, Author = {Angold, A}, Title = {Childhood and adolescent depression. I. Epidemiological and aetiological aspects.}, Journal = {The British Journal of Psychiatry : the Journal of Mental Science}, Volume = {152}, Number = {MAY}, Pages = {601-617}, Year = {1988}, Month = {May}, url = {http://dx.doi.org/10.1192/bjp.152.5.601}, Abstract = {Depression in childhood and adolescence has become a topic of considerable research interest in the last decade. A number of studies ranging over the last half-century provide information about the prevalence of depressive symptoms and syndromes in non-referred populations. These studies are critically reviewed in the light of an analysis of the various meanings that the term 'depression' may carry, and a variety of methodological issues. The sparse evidence for the involvement of a number of potential risk factors for depressive disorders is then considered and suggestions for future work in this area are outlined.}, Doi = {10.1192/bjp.152.5.601}, Key = {fds270305} } @article{fds270304, Author = {Angold, A and Weissman, MM and John, K and Merikangas, KR and Prusoff, BA and Wickramaratne, P and Gammon, GD and Warner, V}, Title = {Parent and child reports of depressive symptoms in children at low and high risk of depression.}, Journal = {Journal of Child Psychology and Psychiatry, and Allied Disciplines}, Volume = {28}, Number = {6}, Pages = {901-915}, Year = {1987}, Month = {November}, url = {http://dx.doi.org/10.1111/j.1469-7610.1987.tb00678.x}, Abstract = {The K-SADS-E psychiatric interview was administered to children and parents (N = 220) from families containing proband parents who had previously been depressed or who were normal. Agreement between parents and their children about depressive symptoms in the children was significant but low. Boy's reports agreed more highly with their parents' reports about them than did girls' reports. Overall, the children reported more depressive symptoms than their parents reported about them and the overall pattern suggests that parents are relatively insensitive to their children's depressive symptomatology, but their reports show high specificity. The implications of these findings for research and clinical work are discussed.}, Doi = {10.1111/j.1469-7610.1987.tb00678.x}, Key = {fds270304} } @article{fds270300, Author = {Weissman, MM and John, K and Merikangas, KR and Prusoff, BA and Wickramaratne, P and Gammon, GD and Angold, A and Warner, V}, Title = {Depressed parents and their children. General health, social, and psychiatric problems.}, Journal = {American Journal of Diseases of Children (1960)}, Volume = {140}, Number = {8}, Pages = {801-805}, Year = {1986}, Month = {August}, ISSN = {0002-922X}, url = {http://dx.doi.org/10.1001/archpedi.1986.02140220083038}, Abstract = {Two hundred twenty children (aged 6 to 23 years) from families with either depressed or normal (nonpsychiatrically ill) parents of comparable sociodemographic backgrounds were studied. The children from families in which at least one parent had experienced a major depression were reported to have had more adverse perinatal events; were later in achieving some developmental landmarks; had more convulsions, head injuries, operations, and psychiatric disorders (particularly major depression); and made more suicide attempts. Overall, there were no significant differences in IQ between children in both groups. Mothers in families with a depressed parent reported more medical problems during pregnancy and labor, and the children were reported to have experienced more distress at birth. Since major depression is a highly prevalent disorder in women of childbearing ages, these findings have direct clinical implications for pediatricians. Their specificity for major depression, as contrasted with other psychiatric disorders or chronic illnesses in the parents, requires further study.}, Doi = {10.1001/archpedi.1986.02140220083038}, Key = {fds270300} } @article{fds322750, Author = {Angold, AC and Lieb, J}, Title = {CHILDHOOD DEPRESSION}, Journal = {Lancet (London, England)}, Volume = {323}, Number = {8391}, Pages = {1409}, Publisher = {Elsevier BV}, Year = {1984}, Month = {June}, url = {http://dx.doi.org/10.1016/S0140-6736(84)91902-0}, Doi = {10.1016/S0140-6736(84)91902-0}, Key = {fds322750} } %% Papers Published @article{fds136886, Title = {1)Erkanli A, Soyer R, & Angold A (2001). Bayesian analyses of longitudinal binary data using Markov regression models of unknown order. Statistics in Medicine, 20: 755-770.}, Year = {2001}, Key = {fds136886} } @article{fds136887, Title = {2)Costello EJ, Keeler GP, & Angold A (2001). Poverty, race/ethnicity and psychiatric disorder: A study of rural children. American Journal of Public Health, 91:1494-1498.}, Year = {2001}, Key = {fds136887} } @article{fds136888, Title = {6)Kliewer W, Murrelle L, Mejia R, Torres Y, & Angold A (2001). Exposure to Violence Against a Family Member and Internalizing Symptoms in Colombian Adolescents: The Protective Effects of Family Support. Journal of Consulting & Clinical Psychology, 69:971-982.}, Year = {2001}, Key = {fds136888} } @article{fds136920, Title = {3)Sandberg S, Rutter M, Pickles A, McGuiness D, & Angold A (2001). Do high-threat life events really provoke the onset of psychiatric disorder in children? Journal of Child Psychology and Psychiatry, 42: 523-532.}, Year = {2001}, Key = {fds136920} } @article{fds136921, Title = {4)Ezpeleta L, Keeler GP, Erkanli A, Costello EJ, & Angold A (2001). Epidemiology of psychiatric disability in childhood and adolescence. Journal of Child Psychology and Psychiatry, 42:901-914.}, Year = {2001}, Key = {fds136921} } @article{fds136922, Title = {5)Kaplow JB, Curran PJ, Angold A, & Costello EJ (2001). The prospective relation between dimensions of anxiety and the initiation of adolescent alcohol use. Journal of Clinical Child Psychology, 30: 316-326.}, Year = {2001}, Key = {fds136922} } @article{fds136923, Title = {7)Conners CK, Epstein J, March JS, Angold A, Wells KC, Klaric J, Swanson JM, Arnold LE, Abikoff HB, Elliott GR, Greenhill LL, Hechtman L, Hinshaw SP, Hoza B, Jensen PS, Kraemer HC, Newcorn JH, Pelham WE, Severe JB, Vitiello B, & Wigal T (2001). Multimodal treatment of ADHD in the MTA: An alternative outcome analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 40: 159-167.}, Year = {2001}, Key = {fds136923} } @article{fds136924, Title = {8)Angold A, & Costello EJ (2001). The epidemiology of depression in children and adolescents. In I. Goodyer (Ed.), The Depressed Child and Adolescent: Developmental and Clinical Perspectives, 2nd edition. New York: Cambridge University Press, p.143-178.}, Year = {2001}, Key = {fds136924} } @article{fds136870, Title = {Angold A, Costello EJ, & Erkanli A (1999) Comorbidity. Journal of Child Psychology and Psychiatry, 40 (1): 57-87.}, Year = {1999}, Key = {fds136870} } @article{fds136885, Title = {Angold A, Costello EJ, Farmer EMZ, Burns BJ, & Erkanli A (in press) Impaired but undiagnosed. Journal of the American Academy of Child and Adolescent Psychiatry, Special Section.}, Year = {1999}, Key = {fds136885} } @article{fds136918, Title = {Farmer EMZ, Stangl DK, Burns BJ, Costello EJ, & Angold A (1999) Use, persistence, and intensity: Patterns of care for children's mental health across one year. Community Mental Health Journal, 35: 31- 46.}, Year = {1999}, Key = {fds136918} } @article{fds136919, Title = {Costello EJ & Angold A (in press) Adolescent outcomes of childhood disorders: The consequences of severity and impairment. Journal of the American Academy of Child and Adolescent Psychiatry, Special section.}, Year = {1999}, Key = {fds136919} } @article{fds136869, Title = {Angold A, Messer SC, Stangl D, Farmer EMZ, Costello EJ, & Burns BJ (1998) Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88: 75-80.}, Year = {1998}, Key = {fds136869} } @article{fds136883, Title = {Egger HL, Angold A, & Costello EJ (1998) Headaches and psychopathology in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37: 951-958.}, Year = {1998}, Key = {fds136883} } @article{fds136884, Title = {Angold A, Costello EJ & Worthman CM (1998) Puberty and depression: The roles of age, pubertal status, and pubertal timing. Psychological Medicine, 98: 51-61.}, Year = {1998}, Key = {fds136884} } @article{fds136891, Title = {Angold A, Costello EJ & Worthman CM (1998) Puberty and depression: The roles of age, pubertal status, and pubertal timing. Psychological Medicine, 98: 51-61.}, Year = {1998}, Key = {fds136891} } @article{fds136916, Title = {Costello EJ, Pescosolido BA, Angold A, & Burns BJ (1998) A family network-based model of access to child mental health services. Researcfh in Community Mental Health, 9: 165-190.}, Year = {1998}, Key = {fds136916} } @article{fds136917, Title = {Erkanli A, Soyer R, & Angold A (1998) Optimal Bayesian two-phase designs for prevalence estimaton. Journal of Statistical Planning and Inference, 66:171-191.}, Year = {1998}, Key = {fds136917} } @article{fds136882, Title = {Burns BJ, Costello EJ, Erkanli A, Tweed DL, Farmer EMZ, & Angold A (1997) Insurance coverage and mental health service use by adolescents with Serious Emotional Disturbance (SED). Journal of Child and Family Studies, 25:476-486.}, Year = {1997}, Key = {fds136882} } @article{fds136913, Title = {Farmer EMZ, Burns, BJ, Angold A, & Costello EJ (1997) Impact of children's mental health problems on families: Relationships with service use. Journal of Emotional and Behavioral Disorders, 5 (4): 23}, Year = {1997}, Key = {fds136913} } @article{fds136914, Title = {Costello EJ, Farmer EMZ, Angold A, Burns BJ & Erkanli A (1997) Psychiatric disorders among American Indian and white youth in Appalachia: The Great Smoky Mountains Study. American Journal of Public Health, 87: 827-832.}, Year = {1997}, Key = {fds136914} } @article{fds136915, Title = {Federman EB, Costello EJ, Angold A, Farmer EMZ, & Erkanli A (1997) Development of substance use and psychiatric comorbidity in an epidemiologic study of white and American Indian young adolescents: The Great Smoky Mountains Study. Drug and Alcohol Dependence, 44:79-78.}, Year = {1997}, Key = {fds136915} } @article{fds136878, Title = {Angold A and Costello EJ (in press). Toward establishing an empirical basis for the diagnosis of Oppositional Defiant Disorder. Journal of the Academy of Child and Adolescent Psychiatry.}, Year = {1996}, Key = {fds136878} } @article{fds136879, Title = {Angold A, Worthman CM, Costello EJ, Stangl DK, Messer SC & Tweed DL (submitted). Puberty and depression. Nature Medicine.}, Year = {1996}, Key = {fds136879} } @article{fds136880, Title = {Costello EJ, Angold A, Burns BJ, Erkanli A, Stangl D, & Tweed DL (in press). The Great Smoky Mountains Study of youth: Functional impairment and Severe Emotional Disturbance. Archives of General Psychiatry.}, Year = {1996}, Key = {fds136880} } @article{fds136881, Title = {Angold A, Erkanli A, Costello EJ & Rutter M (in press). Precision, reliability and accuracy in the dating of symptom onsets in child and adolescent psychopathology. Journal of Child Psychology and Psychiatry.}, Year = {1996}, Key = {fds136881} } @article{fds136889, Title = {Angold A, Erkanli A, Loeber R, Costello EJ, Van Kammen W, & Stouthamer-Loeber M (1996) Disappearing depression in a population sample of boys. Journal of Emotional and Behavioral Disorders, 4:95-104.}, Year = {1996}, Key = {fds136889} } @article{fds136901, Title = {Angold A, Costello EJ, Pickles A, Messer SC, Winder F & Silver D (1996). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research.}, Year = {1996}, Key = {fds136901} } @article{fds136902, Title = {Messer SC, Angold A, Loeber R, Costello EJ, van Kammen W & Stouthamer-Loeber M (1996). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: Factor composition and structure across development. International Journal of Methods in Psychiatric Research.}, Year = {1996}, Key = {fds136902} } @article{fds136903, Title = {Angold A and Costello EJ (in press). The relative diagnostic utility of child and parent reports of oppositional defiant behaviors. International Journal of Methods in Psychiatric Research.}, Year = {1996}, Key = {fds136903} } @article{fds136904, Title = {Angold A, Erkanli A, Loeber R, Costello EJ, van Kammen W & Stouthamer-Loeber M (in press). Disappearing depression in a population sample of boys. Journal of Behavioral and Emotional Disorders.}, Year = {1996}, Key = {fds136904} } @article{fds136905, Title = {Angold A, Stangl D, Farmer EMZ, Costello EJ, Burns BJ & Messer SC (in press). Perceived parental burden as a predictor of service use for child and adolescent psychiatric disorders. American Journal of Public Health.}, Year = {1996}, Key = {fds136905} } @article{fds136906, Title = {Burns BJ, Farmer EMZ, Angold A, Costello EJ, Behar L (submitted). A randomized trial of case management for youths with Serious Emotional Disturbance. American Journal of Othopsychiatry.}, Year = {1996}, Key = {fds136906} } @article{fds136907, Title = {Costello EJ, Angold A, Burns BJ, Stangl D, Tweed DL & Erkanli A (in press). The Great Smoky Mountains Study of youth: Goals, design, methods, and the prevalence of DSM-II-R disorders. Archives of General Psychiatry.}, Year = {1996}, Key = {fds136907} } @article{fds136908, Title = {Costello EJ, Farmer EMZ, Angold A, Burns BJ & Erkanli A (submitted). The Great Smoky Mountains Study of youth: Risk for psychiatric disorder in American Indian and white youth. American Journal of Public Health.}, Year = {1996}, Key = {fds136908} } @article{fds136909, Title = {Farmer EMZ, Burns BJ, Morrissey JP, Costello EJ, Angold A & Behar L (in press). Youths with serious emotional disturbance in rural and urban systems of care. American Journal of Orthopsychiatry.}, Year = {1996}, Key = {fds136909} } @article{fds136910, Title = {Messer SC, Angold A, Costello EJ, Burns, BJ, Farmer, EMZ & Patrick, MKS (under review). The Child and Adolescent Burden Assessment (CABA): Measuring the family impact of emotional and behavioral problems. International Journal of Methods in Psychiatric Research.}, Year = {1996}, Key = {fds136910} } @article{fds136911, Title = {Ascher BH, Farme, EMZ, Burn, BJ & Angold A (in press). The Child and Adolescent Services Assessment (CASA): Description and psychometrics. Journal of Emotional and Behavioral Disorders.}, Year = {1996}, Key = {fds136911} } @article{fds136912, Title = {Erkanli A, Sayer R, & Angold A (in press). Optimal Bayesian two-phase designs for prevalence estimation. Journal of Statistical Planning and Inference.}, Year = {1996}, Key = {fds136912} } @article{fds136875, Title = {Angold A, & Costello EJ (1995). Developmental epidemiology. Epidemiological Reviews, 17(1):74-82.}, Year = {1995}, Key = {fds136875} } @article{fds136876, Title = {Angold A, Prendergast M, Cox A, Harrington R, Simonoff E & Rutter M (1995). The Child and Adolescent Psychiatric Assessment (CAPA). Psychological Medicine 25:739-753.}, Year = {1995}, Key = {fds136876} } @article{fds136877, Title = {Costello EJ & Angold A (1995). The epidemiology of childhood anxiety disorders. In JS March (Ed.), Anxiety Disorders in Children and Adolescents, pp. 109 - 124. New York:The Guilford Press.}, Year = {1995}, Key = {fds136877} } @article{fds136890, Title = {Angold A, Costello EJ, Messer SC, Pickles A, Winder F, & Silver D (1995) Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research 5: 237-249.}, Year = {1995}, Key = {fds136890} } @article{fds136897, Title = {Angold A & Costello EJ (1995). A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C). Psychological Medicine 25:755-762.}, Year = {1995}, Key = {fds136897} } @article{fds136898, Title = {Burns BJ, Costello EJ, Angold A, Tweed DL, Stangl D, Farmer EMZ and Erkanli A (1995). Children's mental health service use across service sectors. Health Affairs, 14(3):147-159.}, Year = {1995}, Key = {fds136898} } @article{fds136899, Title = {Costello EJ & Angold A (in press). Developmental psychopathology. In R. Cairns, G. Elder, EJ Costello & A McGuire (Eds.) Developmental Science. Oxford: Oxford University Press.}, Year = {1995}, Key = {fds136899} } @article{fds136900, Title = {Costello EJ & Angold A (1995). Developmental epidemiology. In D Cicchetti and DJ Cohen (Eds.), Developmental Psychopathology - Volume 1: Theory and Methods, pp. 23 - 56. New York: John Wiley & Sons, Inc.� Angold A & Costello EJ (1995). The epidemiology of depression in children and adolescents. In IM Goodyer (Ed.) The Depressed Child and Adolescent: Developmental and Clinical Perspectives, pp. 127 - 147. Cambridge: Cambridge University Press.}, Year = {1995}, Key = {fds136900} } @article{fds136896, Title = {Angold A: Clinical interviewing with children adolescents. In (eds Rutter M, Hersov L, Taylor E), Child and Adolescent Psychiatry - Modern Approaches, pp. 51-63, 1994. Oxford: Blackwell Scientific Publications.}, Year = {1994}, Key = {fds136896} } @article{fds136871, Title = {Angold A, Pickles A: Seclusion on an adolescent unit. Journal of Child Psychology and Psychiatry 34 (6): 975-989, 1993.}, Year = {1993}, Key = {fds136871} } @article{fds136872, Title = {Angold A: Why do we not know the causes of depression in children and adolescents? In (eds Hay D, Angold A), Precursors and Causes in Development and Psychopathology, pp. 265-292, 1993. Chichester: John Wiley.}, Year = {1993}, Key = {fds136872} } @article{fds136873, Title = {Angold A, Hay D: An introduction. In (eds Hay D, Angold A), Precursors and Causes in Development and Psychopathology, pp 1-22, 1993. Chichester: John Wiley.}, Year = {1993}, Key = {fds136873} } @article{fds136874, Title = {Hay D, Angold A (eds), Precursors and Causes in Development and Psychopathology, 1993. Chichester: John Wiley.}, Year = {1993}, Key = {fds136874} } @article{fds136892, Title = {Angold A, Costello EJ: Depressive comorbidity in children and adolescents: Empirical, theoretical, and methodological issues. American Journal of Psychiatry 150 (12): 1779-1791, 1993.}, Year = {1993}, Key = {fds136892} } @article{fds136893, Title = {Angold A, Worthman CW: Puberty onset of gender differences in rates of depression: A developmental, epidemiologic, and neuroendocrine perspective. Journal of Affective Disorders 29: 145-158, 1993.}, Year = {1993}, Key = {fds136893} } @article{fds136894, Title = {Costello EJ, Angold A: Towards a developmental epidemiology of the disruptive behavior disorders. Development and Psychopathology 5: 91-101, 1993.}, Year = {1993}, Key = {fds136894} } @article{fds136895, Title = {Costello EJ, Burns BJ, Angold A, Leaf PJ: How can epidemiology improve mental health services for children and adolescents? Journal of American Academy of Child and Adolescent Psychiatry 32 (6): 1106-1117, 1993.}, Year = {1993}, Key = {fds136895} } %% Chapters in Books @misc{fds363746, Author = {Farmer, EMZ and Stangl, DK and Burns, BJ and Costello, EJ and Angold, A}, Title = {Use, Persistence, and Intensity: Patterns of Care for Children’s Mental Health Across One Year}, Pages = {49-64}, Booktitle = {Effective Interventions for Children in Need}, Year = {2017}, Month = {January}, ISBN = {9780754628255}, url = {http://dx.doi.org/10.4324/9781315256900-15}, Abstract = {This paper explores the use, persistence, and intensity of services for children’s mental health problems across a variety of service sectors during a one year period. Data come from the Great Smoky Mountains Study. Analyses focus on children’s psychiatric symptomatology and impairment, service use, and factors that may influence the relationship between psychiatric problems and service use across a one year period. Findings show that approximately 20% of children used some mental health services from some sector during the year. Child’s symptomatology and characteristics of parents were associated with use and persistence of services. Parent’s perceptions of impact on the family were associated with service use, persistence, and intensity.}, Doi = {10.4324/9781315256900-15}, Key = {fds363746} } @misc{fds322747, Author = {Costello, EJ and Angold, A}, Title = {Developmental Epidemiology}, Volume = {1}, Pages = {41-75}, Booktitle = {Developmental Psychopathology: Second Edition}, Publisher = {JOHN WILEY & SONS INC}, Year = {2015}, Month = {September}, ISBN = {0471237361}, url = {http://dx.doi.org/10.1002/9780470939383.ch3}, Abstract = {This chapter discusses developmental psychopathology from the viewpoint of epidemiology, "the study of health and illness in human populations". After a brief introduction to some of the basic concepts of the epidemiological method, it discusses what modern epidemiology is and does, the questions it addresses, some of the key methods it uses, and how these methods can be applied to the special problems of developmental psychopathology. the chapter then presents a short history of how child psychiatric epidemiology has grown into developmental epidemiology, illustrating how these changes reflect society's changing concerns about the mental health of children. Finally, it describes the ways developmental epidemiology is branching out and taking on the concerns and methods of related areas: life course and intergenerational epidemiology; transnational epidemiology; genetic epidemiology; the study of burden of disease; and the use of epidemiologic designs to test hypotheses about the causes of psychiatric disorders.}, Doi = {10.1002/9780470939383.ch3}, Key = {fds322747} } @misc{fds270271, Author = {Costello, EJ and Egger, HL and Copeland, W and Erkanli, A and Angold, A}, Title = {The developmental epidemiology of anxiety disorders: Phenomenology, prevalence, and comorbidity}, Pages = {56-75}, Booktitle = {Anxiety Disorders in Children and Adolescents, Second edition}, Publisher = {Cambridge University Press}, Year = {2011}, Month = {January}, ISBN = {9780521721486}, url = {http://dx.doi.org/10.1017/CBO9780511994920.004}, Abstract = {In this chapter we review the prevalence and comorbidity of anxiety disorders in general, and where possible the specifics of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), specific phobias, panic, social phobia, and panic disorder. There were too few reports of agoraphobia to make a reliable estimate. We have not included post-traumatic stress disorder (PTSD) and obsessive–compulsive disorder (OCD), because their status as anxiety disorders is a topic still being debated for the revision of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). Most recent studies have omitted overanxious disorder (OAD) after its omission from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994), but we shall have something to say about OAD later on.}, Doi = {10.1017/CBO9780511994920.004}, Key = {fds270271} } @misc{fds270269, Author = {Angold, A and Carol, W and Costello, EJ}, Title = {Puberty and depression}, Pages = {137-164}, Booktitle = {Gender Differences at Puberty}, Publisher = {Cambridge University Press}, Year = {2003}, Month = {January}, ISBN = {052100165x}, url = {http://dx.doi.org/10.1017/CBO9780511489716.009}, Abstract = {In this chapter we will examine evidence concerning the emergence of an excess of unipolar depression in females during adolescence. We will also present new data from the Great Smoky Mountains Study (GSMS) in support of an approach that combines consideration of both the endocrinology of puberty and the effects of stress on depression. The phenomenon to be explained Numerous adult studies from around the world have documented that women have 1.5 to 3 times more current and lifetime unipolar depression than men (Bebbington, et al., 1981; Bland, Newman, and Orn, 1988a; Bland, Newman, and Orn, 1988b; Blazer, et al., 1994; Canino, et al., 1987; Cheng, 1989; Hwu, Yeh, and Chang, 1989; Kessler, et al., 1994; Kessler, et al., 1993; Lee, Han, and Choi, 1987; Weissman, et al., 1993; Weissman, et al., 1996; Weissman and Klerman, 1977; Wells, et al., 1989; Wittchen, et al., 1992). In later life (after age 55), the female excess of depressions probably diminishes; mostly on account of falling rates in women (Bebbington, 1996; Bebbington, et al., 1998; Jorm, 1987). Retrospective data from adults suggested that the female excess did not appear until adolescence (Burke, et al., 1990; Kessler, et al., 1993), and the child and adolescent epidemiological literature agrees that rates of unipolar depression in prepubertal girls are not higher than those in prepubertal boys (Anderson, et al., 1987; Angold, Costello, and Worthman, 1998; Angold, Costello, and Worthman, 1999; Angold and Rutter, 1992; Bird, et al.}, Doi = {10.1017/CBO9780511489716.009}, Key = {fds270269} } | |
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