The goal of this study was to evaluate the effect of methylphenidate (MPH) and clonidine in comparison with placebo on response inhibition and state regulation in children with Attention Deficit Hyperactivity Disorder (ADHD). The study utilised a double-blind cross-over design in which children were randomly assigned without replacement to placebo, MPH, and clonidine following baseline assessment. The primary dependent measures were derived from children's performance (reaction time and errors) on a GO–NO GO task under three conditions that altered the inter-stimulus interval (ISI) for presented GO–NO GO stimuli: ISI of 1 sec (fast condition), 4 sec (medium condition), and 8 sec (slow condition). Findings indicated no difference in task performance between groups treated for 7 weeks with placebo, MPH, and clonidine. We concluded that the state regulation problem in ADHD is resistant to MPH and clonidine.

Life course and current family factors associated with individual differences in parent–child relationships were investigated in a sample of 467 children from 192 families, including stepfather, single-parent, stepmother, and complex stepfamilies; informants were fathers, mothers, and children. Both positive and negative dimensions of father–child and mother–child relationships were linked to earlier life course experiences of parent and of partner, to current family factors, and to the quality of partner's relationship with the child. The pattern of associations between the adults' life course experiences meant that children were at risk for a “double dose” of less affectionate relationships in families in which parents had experienced early adversities. The significance of biological relatedness, family setting, and child–partner relationships was highlighted.

The current study examined the predictors of parent-child relationship quality and developmental change in a sample of children adopted into the U.K. following severe early privation, and in a comparison sample of nondeprived, within-country adoptees. One hundred and fifty-eight children adopted from Romania and 52 U.K. adoptees were assessed at age 6 years; longitudinal data (age 4 and 6 years) were available on the 110 Romanian adoptees placed into U.K. homes before 24 months of age and all U.K. adoptees. Ratings of parent-child positivity and negativity during a semistructured interaction task were obtained from coders who were blind to the child's background. Results indicated that adoptive parent-child relationship quality was related to duration of deprivation and that cognitive/developmental delay mediated this association. The magnitude of this effect was modest and diminished over time. Longitudinal analyses revealed that positive change in parent-child relationship quality was most marked among children who exhibited cognitive catch-up between assessments. The direction of effects appeared to be primarily child to parent. The findings underscore the need for further research on the long-term impact of early experiences on psychosocial development.

Peer relationships, social skills, self-esteem, parental psychopathology, and family functioning of children with Tourette's disorder and a chronic disease control group of children with diabetes mellitus were compared. Children with Tourette's disorder had poorer peer relationships than their classmates and were more likely to have extreme scores reflecting increased risk for peer relationship problems than children with diabetes mellitus, but did not report self-esteem problems or social skills deficits. Measures of peer relationships were not related to severity or duration of tics. Children with Tourette's disorder and Attention Deficit Hyperactivity Disorder were at increased risk for poor peer relationships. The psychosocial problems of children with Tourette's disorder do not appear to be the generic result of having a chronic disease.

In both theory and research the general issue of the extent to which children's problem behaviour is generalised across situations, and to what extent it is situation specific, has been neglected. In the clinical assessment of disordered children, too, little attention has been paid to the specific situations in which these children display their inappropriate behaviour. In this study the Taxonomy of Problematic Social Situations (TOPS) (Dodge, McClaskey, & Feldman, 1985) was employed. This is a questionnaire in which the child's teacher is asked to rate the likelihood of a child responding in an inappropriate manner in a specific situation. Characteristics of TOPS were investigated both in randomly selected normal school children and in boys with a conduct disorder. Four factors appeared to underlie the TOPS scores from 652 randomly selected boys and girls from grades 1 to 6, these being: teachers' scores for the types of problem situation Being Disadvantaged, Coping with Competition, Social Expectations of Peers, and Teacher Expectations. Because of the high internal consistency of the four factors, TOPS was abbreviated to a TOPS-Short Form (18 instead of 44 items). The four-factor model was cross-validated by means of a second sample of 326 boys and girls. A model with only one general problem behaviour factor did not fit the data of both samples. When the four specific factors were added a satisfactory fit resulted. Moreover, it was found that in the first sample 52% of the variance was explained by the general factor, whereas 18% of the variance was explained by the four specific factors together. Thus, the extent to which problem behaviour is situation specific should not be disregarded. In all four types of problem situation, boys showed more inappropriate behaviour than girls. With increasing age, children were rated as being more competent in dealing with the problem situation Being Disadvantaged. Teachers rated the four types of problem situation as more problematic for boys with a conduct disorder (N = 42) than for normal control boys (N = 67). Conduct disordered boys also differed individually in the number of situational types that were problematic for them. With respect to clinical implications, the identification of the particular social context in which a conduct disordered child displays his or her inappropriate behaviour may help refine treatment goals: more adequate social functioning should be aimed at specifically in those situations that are problematic.

A twin study design was used to examine to what extent genetic and environmental factors mediate the association between life events and depressive symptoms. Questionnaire measures (maternally rated) of depressive symptoms and life events were obtained for a systematically ascertained sample of 270 twin pairs aged 8 to 17 years. Bivariate genetic model fitting showed that depressive symptoms and some life events (total events, negative impact) share a common genetic influence. The covariation of independent life events and depressive symptoms was explained by a shared environmental influence common to both. At least part of the association between life events and depressive symptoms is mediated by familial factors that include both genes and shared environment.

We examined the applicability of attribution theory to mothers' perceptions and reactions to their child's problem behavior. Participants were 149 Latina mothers of children with developmental disabilities who were interviewed regarding specific incidents in which their child exhibited a behavior problem. The findings indicate that most mothers viewed their child as not being responsible for the behavior problem. Furthermore, as predicted by attribution theory, mothers who ascribed relatively high responsibility to the child were significantly more likely to report negative emotions (anger and frustration) and aggressive/harsh behavioral reactions than mothers who ascribed low responsibility. Also, mothers were more likely to ascribe high responsibility to the child when the problem was characterized as a behavioral excess than as a behavioral deficit. The results provide support for the applicability of an attributional framework and may have important implications for helping parents in addressing the problem behaviors of their children with developmental disabilities.

The study aimed to investigate a group of children with severe learning disabilities, challenging daytime behaviour, and severe sleep problems to see if successful behavioural treatment of the children's sleep problems resulted in reduced daytime challenging behaviour as reported by mothers and teachers.

A randomised controlled trial of behavioural interventions for the children's sleep problems was conducted (N=30). The intervention group received an individually tailored behavioural programme and were supported by telephone calls from the therapist. Baseline assessments of the children's behaviour were made using the Aberrant Behavior Checklist and were repeated 1 month and 3 months after the start of intervention.

There were no behavioural changes that were specific to children in the treatment group. However, improvements in some behaviours were seen in both the intervention and the control group at the 1-month and 3-month assessments and there was agreement between mothers' and teachers' reports for many of these changes.

The results suggest that nonspecific effects of participating in the study (including an increased sleep duration, which was seen in both groups), rather than resolution of sleep problem per se, may have a beneficial effect on child behaviour and these factors need to be identified for therapeutic use.

Children are both the direct and indirect targets during wars. They are directly affected by violence aimed at them and their families; they are indirectly affected by the distress caused to their families; they may be internally displaced or find themselves crossing borders as asylum seekers. Their experiences during and immediately after war militate against their developing in a safe, secure, and predictable environment. Their human rights are compromised and their mental health put at risk.

Whether in the country at and after war, or in the country that offers refuge, children's mental health needs have to be properly assessed and met. In many cases, children may only require a sense of safety and support via their family and school. In other cases, they require more complicated psychosocial interventions that address the various stress reactions they manifest.

This paper addresses these issues against the context of a major community-based programme in Mostar in Bosnia during the recent civil war there. It argues that we have reasonably good screening measures to identify children at high risk of developing mental health problems. It presents an hierarchical model of support and intervention whereby psychosocial help is delivered primarily through schools with only a small proportion of more complex needs being met by specially trained mental health professionals. There is a strong need to evaluate various methods of delivering help and to develop new ways of reaching needy children in a nonstigmatising way.

In a test of Patterson's Coercion Theory with young children, 156 children (82 boys and 74 girls) were studied to assess the extent to which parenting and child variables, assessed at 18 months, would predict teacher ratings of externalizing child behaviors at age 5. Child playgroup behavior, parent coercion during home observations, and marital status each emerged as predictors, whereas child temperament, attachment classification, and gender did not. At age 5, the correlates of externalizing behaviors differed for boys and girls. Boys rated higher on externalizing behaviors by the teachers presented many problems in the home and school, whereas externalizing girls did not. In fact, girls rated higher on externalizing behaviors performed better on an intelligence test, yet the girls perceived themselves as less competent.

This paper argues for the scientific utility of the concept “intelligence”. In the first section three common arguments against the validity of general intelligence are discussed and dismissed. The second section presents the evidence in favour of the proposition that individual differences in IQ may be based on differences in speed of information processing. However, the third section shows that executive functions, particularly inhibitory processes, represent a more likely basis for the development of intelligence. The theory of the minimal cognitive architecture underlying intelligence and development (Anderson, 1992a) shows how speed and executive functioning might represent two dimensions to g—one an individual differences (within age) dimension based on speed and the other a developmental dimension based on changing executive functioning. In the fourth section this theory is used to generate new insights on the nature of intellectual disability and specific cognitive deficits and to make practical suggestions for educational intervention for low-IQ children.

In this review we explore the clinical and scientific status of categorical models of childhood disorder. Three themes are developed. First, the practical origins of standardised category-based diagnostic schemes are examined along with their contemporary philosophical and psychological significance. Next, the impact that these systems have had on the science of child psychopathology is explored. We look at their link to the medical model and the assumption that childhood disorders are categorical, endogenous, and dysfunctional in nature. We argue that these assumptions underpin the dominant paradigm in child psychopathology and so constrain empirical study and theory development. In the final section, the different ways in which researchers have responded to this link and its impact on science are presented. We present the sort of scientific realism associated with Meehl (1995) as the most appropriate basis for a philosophically respectable child psychopathology. Following this approach means unpacking the paradigmatic assumptions, including the assumption of the categorical structure of disorder, into hypotheses that are then put to empirical test. The sorts of data that would allow us to test the categorical hypothesis are identified. We conclude by discussing the results from three recent studies using behaviour genetic analysis of twin data that, in fact, lead us toward a rejection of this hypothesis. The implications for diagnostic and clinical practice of such a rejection are discussed.

This study examined the prevalence and risk of psychiatric disturbances and suicidal behaviours among the peers of suicide attempters and completers. The subjects were selected from high schools with and without history of student suicides in the past 3 years. The psychiatric disturbances (as measured by the YSR and CBCL), suicidal behaviours, drug use, and a wide range of potential risk factors were measured. About a quarter of the peers of suicide completers and attempters were probable psychiatric cases and 15–21% of them reported suicidal acts. The increased risk of psychiatric disturbances and suicidal behaviours were still evident after controlling for age, sex, and potential risk factors. The presence of psychiatric disturbances could not wholly account for the increased odds of suicidal behaviours. Peers of suicide attempters carried a higher risk than peers of suicide completers. The close friends of suicide completers were particularly at risk of internalising problems, whereas the close friends of suicide attempters were at high risk of externalising problems. The peers of suicide completers and attempters represent a high-risk group for psychiatric disturbances and suicidal behaviours. The specific association of different types of psychiatric disturbances in the peers of suicide completers and attempters suggested that different risk mechanisms might be in operation within these peer groups.

The personality profiles for youths with Prader-Willi, fragile-X, or Williams syndrome were compared to three matched groups attending regular schools. Using the California Child Q-Set (CCQ), both of the parents of the 39 children with Prader-Willi syndrome, 32 boys with fragile-X syndrome, 28 children with Williams syndrome, and children in the comparison groups provided independent personality descriptions in terms of the Big Five personality factors of Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Openness, along with Motor Activity and Irritability. Specific personality phenotypes for each of the three syndrome groups were found to be differentially related to parental behaviours (i.e. control and anger) and family contexts (i.e. experienced family stress, marital conflict, and parental consistency).

Recent epidemiological studies suggest that both social anxiety and attention deficit hyperactivity disorder (ADHD) in childhood might predict levels of delinquent behavior in adolescence. The current study prospectively examines the influence of social phobia and ADHD symptom scale scores on the correlation in conduct disorder symptom scale scores over time. An epidemiologically selected sample of 776 young people living in Upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews. Correlations among conduct disorder scales over time were examined as a function of social phobia and ADHD ratings. Individuals with low scores on social phobia scales or high scores on ADHD scales exhibited the highest correlation in conduct disorder symptom scales over time. There was also a suggestion that low scores on social phobia scales predicted later risk for conduct disorder. Low scores on social phobia symptom scales or high scores on ADHD scales predict stronger across-time correlations in conduct disorder symptom scales. Various cognitive or biological factors might account for these moderating effects on conduct problems.

A group of 4–7-year-old war orphans were examined for the first time while living in an institution (the Solomuna Orphanage) during a protracted war between Eritrea and Ethiopia. At that time, they were compared to a group of refugee children living in a nearby camp with one or both parents. The orphans exhibited significantly more behavioral symptoms than the refugee children, but performed the cognitive tests at a more advanced level. Five years later, the orphans were re-examined; and they were compared to unaccompanied 9–12-year-children living in one of two residential settings that differed qualitatively in their social climate, principles of child care, and patterns of staff–child interactions. Although the severity of their behavioral symptoms had diminished, the orphans still exhibited many symptoms of emotional distress. On the other hand, they performed the cognitive measures as well as, or better than, unaccompanied children who had been protected from the terrors of war. The cross-sectional comparisons indicated that a residential setting that respects the individuality of children and promotes their close personal ties with at least one staff member can ameliorate many of the more serious psychological sequelae of having lost both parents and being exposed to the physical dangers of the war. The implications for war orphans in other Third World countries are discussed.

Infant attachment and mother–child interaction were evaluated for 65 primiparous women and their singleton infants conceived through in vitro fertilisation (IVF) and a control group of 61 women and their infants conceived naturally. The sample was enrolled during pregnancy as part of a longitudinal study. At 12 months postpartum, security of infant attachment was assessed using the Strange Situation procedure, and mother–child interaction was assessed in a free play context using the Emotional Availability Scales. IVF children demonstrated predominantly secure attachment relationships with their mothers (64.6% IVF, 55.9% controls), and there were no significant between-group differences in the proportion of IVF compared to control group children classified in any of the secure or insecure attachment groups. Furthermore, there were no significant group differences on maternal (sensitivity, structuring, hostility) or child (responsivity, involving) dimensions of interaction during play. The majority of IVF mothers (86%) were sensitive and their infants responsive (91%). Contrary to expectation, mother's ratings of greater anticipated infant difficultness assessed during pregnancy and higher ratings of infant temperament and behaviour difficulty assessed at 4 and 12 months postpartum were associated with secure attachment relationships and more optimal mother–child interaction in both the IVF and control groups.

This study addressed three questions: (1) Do adolescents undergoing plastic surgery have a realistic view of their body? (2) How urgent is the psychosocial need of adolescents to undergo plastic surgery? (3) Which relations exist between bodily attitudes and psychosocial functioning and personality? From 1995 to 1997, 184 plastic surgical patients aged 12 to 22, and a comparison group of 684 adolescents and young adults from the general population aged 12 to 22 years, and their parents, were interviewed and completed questionnaires and standardised rating scales. Adolescents accepted for plastic surgery had realistic appearance attitudes and were psychologically healthy overall. Patients were equally satisfied with their overall appearance as the comparison group, but more dissatisfied with the specific body parts concerned for operation, especially when undergoing corrective operations. Patients had measurable appearance-related psychosocial problems. Patient boys reported less self-confidence on social areas than all other groups. There were very few patient-comparison group differences in correlations between bodily and psychosocial variables, indicating that bodily attitudes and satisfaction are not differentially related to psychosocial functioning and self-perception in patients than in peers. We concluded that adolescents accepted for plastic surgery have considerable appearance-related psychosocial problems, patients in the corrective group reporting more so than in the reconstructive group. Plastic surgeons may assume that these adolescents in general have a realistic attitude towards their appearance, are psychologically healthy, and are mainly dissatisfied about the body parts concerned for operation, corrective patients more so than reconstructive patients. Introverted patients may need more attention from plastic surgeons during the psychosocial assessment.

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.

This paper reviews research in pediatric psychopharmacology over the past decade. The authors first discuss social, economic, and other influences on pediatric psychopharmacology research and prescribing patterns including changing models of childhood psychopathology, increased government funding, and changes in industry regulations. Definitions are offered for current research terminology including efficacy, effectiveness, and adverse events. Design trends and new approaches to outcome measurement are also presented. New data from the last 10 years of research is reviewed for each major class of psychotropic agents. Criteria for inclusion in the review are presented and include aspects of study design (placebo-controlled, large sample size), source of funding (government funded vs. industry), and vision (creative applications). Data for short-term efficacy, long-term efficacy, effectiveness, and safety and adverse events are discussed for each class of medication, although for many, there remains little empirical data. Findings for stimulants, selective serotonin reuptake inhibitors, neuroleptics, alpha-adrenergic agonists, mood stabilizers, buproprion, secretin, naltrexone, immune therapies, and natural supplements are all presented. Finally, the authors offer some speculations regarding the future of pediatric psychopharmacology research.