The claim that early childhood television exposure causes later attention problems (Christakis et al., 2004) remains strongly held by both the popular media and many researchers in the field, despite the fact that re-analyses and meta-analyses have directly challenged this finding (Foster & Watkins, 2010; Kostyrka-Allchorne et al., 2017; Nikkelen et al., 2014). To further examine the validity of the original claim, we subjected the same dataset (the National Longitudinal Survey of Youth) to a “multiverse analysis” (Steegen et al., 2016). Because research requires a series of analytic decisions, some of which are arbitrary, any individual finding may be more or less dependent on the analysis strategy used. Thus, we employed more than 100 analytic models to see how robust the purported effect might be across a variety of analytic decisions. As in Christakis et al. (2004), data were obtained from the National Longitudinal Survey of Youth - 1979. Our variable selection process was based on the one reported in the original study with some additions. All downloaded data, analysis codes, and supplemental figures are available anonymously at goo.gl/93uWt4. One added covariate of particular interest was children’s temperament, because difficult temperament (i.e., short attention span, negative reactivity) has been associated with both attentional flexibility (Smith et al., 1997) and concurrent TV watching (Thompson et al., 2013). We first conducted 4 linear regressions and 36 propensity score analyses, varying analytic parameters including: the cut point for distinguishing “high TV” from “low TV” exposure; age at TV exposure [approximately 1.5 years vs. 3 years]; whether a doubly-robust analysis was used; whether the attention outcome was standardized within sex; and whether estimating the average treatment effect (ATE) or the average treatment effect for the treated (ATT). Only 4 of the 40 analyses was consistent with a causal effect of TV on attention (all four were variants of PSA using the unstandardized attention measure). Figure 1 shows a summary of the analyses using the unstandardized attention measure. Note that effect sizes cluster around zero. In an attempt to replicate the original analytic strategy, we also conducted 42 logistic regressions. The logistic regressions required dichotomizing the attention measure to discriminate problematic from non-problematic behavior. Because there were no a priori reasons to choose a particular cut point, we systematically varied the cut point from 110 to 130. As shown in Figure 2, we found that significant effects only emerge at cut points of 123 and 124, similar to the cut point of 120 chosen by Christakis et al. (2004). Given that only four analytic paths out of 82 showed a significant effect, Christakis et al.’s findings appear extremely model dependent, leading us to conclude that early exposure to TV has no real effect on later attention. Finally, we found that difficult temperament was in fact predictive of hours of TV watching in early childhood, at about the same magnitude as BMI and parent education. This finding is in line with recent investigations of temperament and screen media use (e.g., Thompson et al., 2013).

No description available.

Despite evidence suggesting considerable overlap between the neurobiology underlying sleep regulation and the neurobehavioral systems regulating attention control and emotional arousal, sleep remains an understudied domain in the quest to improve children's regulation of behavior, emotions, and cognition in support of school competence during middle childhood. Using a large, normative sample (n = 1,057) from the National Institutes of Child Health and Human Development's Study of Early Childcare and Youth (NICHD-SECCYD), I tested a conceptual model of sleep, school competence, and children's adjustment to address important gaps in our understanding of the direction of effects and interrelations among sleep problems, attention problems, and academic and social competence across middle childhood. I examined the domains for their combined effects and pathways of influence on children's adjustment (e.g., depressive symptoms and feelings about school) at the end of middle childhood--a period just prior to the impending biological and contextual changes associated with adolescence. Using structural equation modeling and repeated measurement at 54 months-of-age, Grade 1, Grade 3, and Grade 5, findings indicated that maternal-reported sleep problems in preschool directly predicted teacher-reported attention problems when children were in third and fifth grade. Findings lend support for models of sleep and neural development that posit adverse early effects of sleep problems on prefrontal cortex (PFC) maturation that aids in the development of attention control. Maternal-reported sleep problems did not predict standardized assessments of reading and math at any time across the assessment period. In contrast, sleep problems predicted teacher reports of children's ability to effectively cooperate and execute positive response strategies with peers. Effective language and cognitive skills are important and necessary for positive peer interactions and problem solving, and sleep problems have been associated with slower growth in language development and memory processes. Both maternal-reported sleep problems and teacher-reported peer relations uniquely predicted children's self-reported depressive symptoms, perceived competence, and motivation and social support in school at the end of middle childhood. Findings lend support for an emotion information processing model of sleep and competency-based models of depression. Academic achievement and attention problems and attention problems and peer relations were reciprocally related at all assessment periods. In support of the academic underachievement hypothesis, academic achievement consistently exerted stronger effects on attention problems compared to inverse relations. Attention problems and academic achievement had no direct effects on children's depressive symptoms or motivation for school, but exerted indirect effects through their effects on peer relations. Despite expected relations, no domain in the present study predicted children's sleep problems. Even though results are somewhat surprising given theoretical perspectives and limited empirical work investigating associations between sleep problems, attention problems, and academic and social competence, this study was novel in its design for simultaneously evaluating effects of these domains together across time. Findings from the present study may fail to align with prior research because multiple domains were allowed to compete with one another in a single model, and shared rater variance as well as prior and concurrent levels of each domain were controlled across the study period. Alternatively, variables not measured in the present study but associated with children's sleep problems, such as child temperament or parenting practices, may be stronger predictors of children's sleep. In sum, results point to the unique associations between children's sleep problems, attention problems, and academic and social competence across middle childhood, and the importance of considering their combined influence on children's feelings of adjustment as they enter the challenging period of adolescence. / Educational Psychology

This research program represents the first systematic exploration of the subjective experience of alogia, anhedonia, attention problems, avolition, and emotional blunting, and its relation to other objective and subjective factors in schizophrenia. Using a combined rational-empirical approach, a vulnerability-stress-coping model of adjustment to the 5 negative symptoms was developed and tested. Three aspects of appraisal were examined, the primary appraisals of symptom severity and distress, and the secondary appraisal of control. The dimensions of coping with individual symptoms were initially examined using a rational approach, and then empirically using exploratory factor analyses. The Appraisal and Coping with Negative Symptoms Interview Schedule (ACNSIS) was developed for use in Study 1. Both qualitative and quantitative appraisal and coping data were examined for 20 people with negative symptoms. Responses to the ACNSIS demonstrated that appraisals and coping responses varied across participants and individual negative symptoms. Previously employed categorisations of coping behaviour were used to examine and quantify coping. Negative symptom-specific differences were found in awareness of negative symptom presence, degree of agreement with objective ratings, appraisals, reliance on different types of coping, and relations with participant characteristics. Participant coping responses from Study 1 were used to construct the self-report measure used in subsequent studies. Study 2 involved the development, administration, and evaluation of the self-report Appraisal and Coping with Negative Symptoms Questionnaire (ACNSQ). Both an electronic and paper version of the ACNSQ were developed. The ACNSQ was administered to 120 people with schizophrenia or schizoaffective disorder. Participants were required to make severity, distress and control appraisals for each negative symptom they believed they were suffering from. Following symptom appraisals, a number of symptom-specific and general coping items were presented for each negative symptom. In Study 2A, the multidimensionality of coping responses and the nature of empirically derived subscales were explored individually for each negative symptom. Factor analyses of data from 119 participants resulted in 3 underlying coping dimensions for each symptom. These dimensions, which formed the basis of the ACNSQ coping subscales, were labelled as active, emotional, or avoidant forms of coping. Coping subscales were found to be moderately similar across symptoms. The subscales were shown to be internally consistent and largely independent within symptoms. It was found that the degree of reliance on particular coping subscales was negative symptom-specific, although participant coping was related across symptoms. In Study 2B, the nature of negative symptom appraisals and the psychometric properties of the ACNSQ were examined. There was evidence that the nature of appraisals varied according to negative symptom. Retest reliability analyses indicated that overall, ACNSQ appraisals had a low to moderate degree of reliability while coping subscales demonstrated a moderate to high degree of reliability. Differential associations between appraisal and coping and a range of theoretically related variables provided evidence of the construct validity of the ACNSQ. Study 3 used exploratory techniques to conduct cross-sectional tests of a vulnerability-stress-coping model of adjustment to individual negative symptoms based on the data of the 119 participants. Associations between the objective indicator of negative symptom stressor level, and the subjective experience variables of insight, appraisal and coping were examined in relation to adjustment using a multidimensional approach. Two models of the relations between negative symptom predictors and 3 separate domains of adjustment were investigated. Study 3A provided moderate support for a direct effects model for each of the 5 negative symptoms. Objective negative symptom level, insight, primary appraisals and coping subscales all had significant direct effects on one or more domains of adjustment. In general, higher objective negative symptom levels, higher severity and distress appraisals, and greater reliance on avoidant forms of coping were associated with poorer adjustment. The direct effects of active and emotional forms of coping were less consistent and varied across symptoms and adjustment domains. Study 3B extended these findings by providing a limited amount of support for a mediated effects model. Appraisal and coping were found to act as mediators in some of the relations between objective indicators and subjective experience variables for alogia, attention problems and avolition. There was evidence that the impact of insight on coping was partly mediated by control appraisals. Coping partly mediated the relation between stress and adjustment, and appraisal and adjustment. Overall, this series of exploratory studies make a unique contribution to understanding the subjective experience of the negative symptoms of schizophrenia. The proposed vulnerability-stress-coping model demonstrated utility in identifying variables important in the prediction of adjustment to individual negative symptoms, and in delineating the nature of associations between variables. Further research is required to improve the psychometric properties of the ACNSQ. However, it offers promise as an instrument with which to assess negative symptom appraisals and coping responses, in both clinical and research settings. The present findings have important theoretical and clinical implications concerning the role of subjective and objective factors involved in adjustment to the negative symptoms of schizophrenia. This research program provides a valuable foundation for future research to test the vulnerability-stress-coping model in its entirety.

Bakgrund: Fysisk aktivitet har visat sig ha en positiv effekt för både den psykiska och fysiska hälsan. Den kan minska psykiska problem som oro, stress och depression, samt fysiska åkommor som blodtryck, stroke och diabetes. Fysisk aktivitet är numera en allt mer vedertagen metod för att behandla fysiska och psykiska besvär. Individer med ADHD har vanligen problem med hyperaktivitet, impulsivitet, uppmärksamhet, sociala beteenden och kognitiva förmågor.Syfte: Att undersöka den vetenskapliga litteraturen för att få belägg för vilka effekter fysisk aktivitet kan ha för symptom hos individer med ADHD.Metod: I denna systematiska litteraturstudie återfanns via sökningar i databaserna PubMed, The Cochrane Library, Web of Science, Science Direct och PsycINFO artiklar som sedan granskades utifrån en bedömningsmall.Resultat: Fysisk aktivitet upplevdes ha en positiv effekt för hyperaktivitet och uppmärksamhetsproblem samt visade sig minska risken för sociala beteendeproblem hos individer diagnostiserade med ADHD. Vidare påvisades att oavsett regelbundenhet eller omfattning av fysisk aktivitet en positiv effekt för kognitiva förmågor hos individer diagnostiserade med ADHD.Konklusion: Den vetenskapliga litteraturen visar att fysisk aktivitet troligen har en positiv effekt för ett flertal symptom hos individer med ADHD. Dock krävs ytterligare forskning i ämnet. / Background: Physical activity has been shown to have a positive impact for both mental and physical health. It may reduce psychological problems such as anxiety, stress and depression, and physical issues like high blood pressure, stroke and diabetes. Physical activity is now an increasingly accepted method to treat physical and mental disorders. Individuals with ADHD usually have problems with hyperactivity, impulsivity, attention, social behavior and cognitive abilities.Aim: To investigate the scientific literature for evidence about the effect of physical activity on symptoms in individuals with ADHD.Method: In this systematic literature review articles where found through the databases PubMed, The Cochrane Library, Web of Science, Science Direct and PsycINFO witch was later surveyed based on an assessment template.Results: Physical activity was perceived to have a positive effect for hyperactivity and attention problems and appeared to reduce the risk of social behavior problems in individuals diagnosed with ADHD. Furthermore, it was shown that regardless of frequency or extent of physical activity a positive effect was shown on cognitive abilities in individuals diagnosed with ADHD.Conclusion: The scientific literature shows that physical activity is likely to have a positive effect for a variety of symptoms in individuals with ADHD. However, further research on the subject is required.

Background: In many severely mentally disordered children, the clinical presentation is complicated by comorbid affective and behavioral dysregulation. Recently, a highly heritable behavioral phenotype of simultaneous deviance on the anxious/depressed, attention problems, and aggressive behavior syndrome scales has been identified on the Child Behavior Checklist Dysregulation Profile (CBCL-DP). The aim of the present pilot study was to determine an equivalent to the CBCL-DP using the Strengths and Difficulties Questionnaire (SDQ). Sampling and Methods: We applied stepwise linear discriminant analyses and receiver operating characteristic (ROC) analysis to data from 543 consecutively referred children and adolescents, aged 5–17 years. The CBCL and the SDQ were completed by parents as part of the diagnostic routine. ICD-10 discharge diagnoses were established in consensus conferences. Results: A combination of five SDQ items (SDQ-Dysregulation Profile, SDQ-DP) yielded the best discrimination of children with and without CBCL-DP and classified 81.0% of the subjects correctly leading to an area under the curve of 0.93. The content of the five SDQ-DP items mirrors well the mixed behavioral phenotype of anxious-depressive, aggressive and attention problems captured by the CBCL-DP. SDQ-DP status was highly correlated with CBCL-DP status and was best defined by a SDQ-DP score ≧5. Conclusions: The psychometric properties of the SDQ-DP have been robustly tested and validated. Based on these results, clinicians may use the SDQ-DP as a useful and economical screening measure to improve the assessment, prevention, and treatment of severe dysregulation in childhood and adolescence. Future investigations should study the longitudinal stability, heritability, and genetic associations of this behavioral phenotype. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Abstract The primary aim of this study was to survey attention and behavioural problems among Finnish adolescents living in different family environments. The second aim was to study the psychosocial well-being of these adolescents. The third aim was to study the psychiatric comorbidity of ADHD (attention deficit hyperactivity disorder) in association with the family environment. The fourth aim was to study the persistence of ADHD from childhood to adolescence. In the first phase, 15-year-old adolescents and their parents from the Northern Finland 1986 Birth Cohort (N = 9432) completed questionnaires on attention and behavioural problems, family characteristics and the life situation of the adolescents. In the second phase, 457 adolescents aged from 16 to 18 years were drawn from the cohort. After assessment with a clinical semi-structured interview, logistic regression models were used to study ADHD and the persistence of the diagnosis and comorbid psychopathology in association with family characteristics. Girls reported more commonly than boys attention and behavioural problems, while their parents reported more attention problems in their sons than daughters. Living in other than intact families was related to attention and behavioural problems in both genders. Adolescents with ADHD symptoms considered their physical health and psychosocial well-being poor more often than their controls. Psychosocial problems accumulated for those with many ADHD symptoms. Adolescents with ADHD had more commonly than others comorbid behavioural disorder, alcohol abuse and depression. Those with ADHD and comorbidity lived more commonly than others in non-intact families, in low-income families, with mothers who were dissatisfied with life and with parents who showed little interest in their adolescent's activities. Persistence of ADHD into adolescence occurred in about two thirds of cases. Those who persisted with the diagnosis compared to those who remitted it had more dreamy-like inattentive symptoms, and had more often early-onset comorbid depression or oppositional defiant disorder and had more often fathers with attention problems. These results indicate that attention and behavioural problems are common among adolescents in Finland, especially among those living in disrupted families. Being a persistent disorder, ADHD warrants more concern in primary health care and the educational system in order to prevent the concurrent development of other psychiatric and psychosocial problems. In primary health care, family intervention is essential. / Tiivistelmä Tämän tutkimuksen tarkoituksena oli ensiksi selvittää suomalaisten nuorten tarkkaavuuden ja käyttäytymisen ongelmia suhteessa nuoren perherakenteeseen. Toiseksi tutkittiin näiden nuorten psykososiaalista hyvinvointia. Kolmanneksi tavoitteena oli tutkia ADHD:n (tarkkaavuushäiriö) psykiatrisia liitännäissairauksia suhteessa perheympäristöön. Neljäntenä tavoitteena oli tutkia ADHD:n pysyvyyttä lapsuudesta nuoruuteen. Tutkimuksen ensimmäisessä vaiheessa Pohjois-Suomen vuoden 1986 syntymäkohorttiin kuuluvat 15-vuotiaat nuoret (N = 9 432), ja heidän vanhempansa täyttivät kyselylomakkeet. Kysymykset koskivat nuoren tarkkaavuuden ja käyttäytymisen ongelmia, perheympäristöä ja nuoren elämäntilannetta. Toisessa vaiheessa tutkittiin 457 16–18-vuotiasta kohorttiin kuuluvaa nuorta. Nuoret arvioitiin käyttäen puolistrukturoitua kliinistä haastattelua. Logistisia regressiomalleja käytettiin kuvaamaan ADHD-diagnoosia ja sen pysyvyyttä sekä psykiatrisia liitännäissairauksia suhteessa perheympäristöön. Tytöt raportoivat poikia useammin tarkkaavuuden ja käyttäytymisen ongelmista, kun taas vanhemmat raportoivat tarkkaavuuden ongelmia olevan useammin pojilla kuin tytöillä. Perhetaustaltaan muu kuin ydinperhe oli yhteydessä tarkkaavuuden ja käyttäytymisen ongelmiin sekä tytöillä että pojilla. Nuoret, joilla oli ADHD-oireita, pitivät terveyttään ja psykososiaalista hyvinvointiaan huonona useammin kuin nuoret, joilla näitä oireita ei ollut. Psykososiaaliset ongelmat kasaantuivat niillä nuorilla, joilla oli paljon ADHD-oireita. Myös käyttäytymishäiriöistä, alkoholin väärinkäytöstä ja masennuksesta kärsivät muita useammin nuoret, joilla havaittiin ADHD. Nuoret, joilla oli ADHD ja edellä mainittu liitännäissairaus, asuivat muita useammin muussa kuin ydinperheessä, alemman tulotason perheessä, äidin kanssa, joka oli tyytymätön elämäänsä tai vanhempien kanssa, jotka eivät olleet kiinnostuneet nuorensa asioista. ADHD-diagnoosi pysyi nuoruuteen noin kahdella kolmasosalla niistä, joilla se oli lapsuudessa. Niillä nuorilla, joilla diagnoosi pysyi, oli muita useammin unelmoivasta hajamielisyydestä kertovia tarkkaamattomuusoireita, varhain alkanut masennus- tai käyttäytymishäiriö tai isä, jolla oli itsellään ADHD-oireita. Nämä tulokset osoittavat, että tarkkaavuuden ja käyttäytymisen ongelmat ovat yleisiä suomalaisilla nuorilla, ja erityisesti niillä, jotka asuvat muussa kuin ydinperheessä. Koska ADHD on pysyvä häiriö, se tulee ottaa paremmin huomioon perusterveydenhuollossa ja koulumaailmassa, jotta voitaisiin ehkäistä muita psykiatrisia ja psykososiaalisia ongelmia. Perusterveydenhuollossa erityisesti perheinterventiot ovat tärkeitä.

Background: In many severely mentally disordered children, the clinical presentation is complicated by comorbid affective and behavioral dysregulation. Recently, a highly heritable behavioral phenotype of simultaneous deviance on the anxious/depressed, attention problems, and aggressive behavior syndrome scales has been identified on the Child Behavior Checklist Dysregulation Profile (CBCL-DP). The aim of the present pilot study was to determine an equivalent to the CBCL-DP using the Strengths and Difficulties Questionnaire (SDQ). Sampling and Methods: We applied stepwise linear discriminant analyses and receiver operating characteristic (ROC) analysis to data from 543 consecutively referred children and adolescents, aged 5–17 years. The CBCL and the SDQ were completed by parents as part of the diagnostic routine. ICD-10 discharge diagnoses were established in consensus conferences. Results: A combination of five SDQ items (SDQ-Dysregulation Profile, SDQ-DP) yielded the best discrimination of children with and without CBCL-DP and classified 81.0% of the subjects correctly leading to an area under the curve of 0.93. The content of the five SDQ-DP items mirrors well the mixed behavioral phenotype of anxious-depressive, aggressive and attention problems captured by the CBCL-DP. SDQ-DP status was highly correlated with CBCL-DP status and was best defined by a SDQ-DP score ≧5. Conclusions: The psychometric properties of the SDQ-DP have been robustly tested and validated. Based on these results, clinicians may use the SDQ-DP as a useful and economical screening measure to improve the assessment, prevention, and treatment of severe dysregulation in childhood and adolescence. Future investigations should study the longitudinal stability, heritability, and genetic associations of this behavioral phenotype. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.