The Development and Well-Being Assessment (DAWBA) is a novel package of questionnaires, interviews, and rating techniques designed to generate ICD-10 and DSM-IV psychiatric diagnoses on 5–16-year-olds. Nonclinical interviewers administer a structured interview to parents about psychiatric symptoms and resultant impact. When definite symptoms are identified by the structured questions, interviewers use open-ended questions and supplementary prompts to get parents to describe the problems in their own words. These descriptions are transcribed verbatim by the interviewers but are not rated by them. A similar interview is administered to 11–16-year-olds. Teachers complete a brief questionnaire covering the main conduct, emotional, and hyperactivity symptoms and any resultant impairment. The different sorts of information are brought together by a computer program that also predicts likely diagnoses. These computer-generated summary sheets and diagnoses form a convenient starting point for experienced clinical raters, who decide whether to accept or overturn the computer diagnosis (or lack of diagnosis) in the light of their review of all the data, including transcripts. In the present study, the DAWBA was administered to community (N = 491) and clinic (N = 39) samples. There was excellent discrimination between community and clinic samples in rates of diagnosed disorder. Within the community sample, subjects with and without diagnosed disorders differed markedly in external characteristics and prognosis. In the clinic sample, there was substantial agreement between DAWBA and case note diagnoses, though the DAWBA diagnosed more comorbid disorders. The use of screening questions and skip rules greatly reduced interview length by allowing many sections to be omitted with very little loss of positive information. Overall, the DAWBA successfully combined the cheapness and simplicity of respondent-based measures with the clinical persuasiveness of investigator-based diagnoses. The DAWBA has considerable potential as an epidemiological measure, and may prove to be of clinical value too.

Previous studies have shown that children and adolescents exposed to traumatic experience in a disaster can suffer from high levels of post-traumatic stress. The present paper is the first a series reporting on the long-term follow-up of a group of young adults who as teenagers had survived a shipping disaster—the sinking of the “Jupiter” in Greek waters—between 5 and 8 years previously. The general methodology of the follow-up study as a whole is described, and the incidence and long-term course of Post-Traumatic Stress Disorder (PTSD). It is the first study of its kind on a relatively large, representative sample of survivors, using a standardised diagnostic interview, and comparing survivors with a community control group. Survivors of the Jupiter disaster (N = 217), and 87 young people as controls, were interviewed using the Clinician Administered PTSD Scale (CAPS). Of the 217 survivors, 111 (51.7%) had developed PTSD at some time during the follow-up period, compared with an incidence in the control group of 3.4% (N = 87). In the large majority of cases of PTSD in the survivors for whom time of onset was recorded, 90% (N = 110), onset was not delayed, being within 6 months of the disaster. About a third of those survivors who developed PTSD (30%, N = 111) recovered within a year of onset, through another third (34%, N = 111) were still suffering from the disorder at the time of follow-up, between 5 and 8 years after the disaster. Issues relating to the generalisability of these findings are discussed.

Individuals with Down syndrome suffer from relatively poor verbal short-term memory. Previous explanations of this deficit have been framed in terms of inefficient or absent rehearsal of verbal material in Down syndrome within the phonological loop component of Baddeley and Hitch's (1974) working memory model. Two experiments are presented which test this explanation by looking for the markers of rehearsal in children with Down syndrome and verbal mental age matched controls. Both experiments confirm that individuals with Down syndrome show poorer verbal short-term memory performance than controls. However, they rule out rehearsal as an explanation of these deficits because the evidence suggests that neither individuals with Down syndrome nor matched controls are engaging in spontaneous subvocal rehearsal. Other explanations of poor verbal short-term memory performance in Down syndrome, in terms of impairments both within and outside of the phonological loop system, are discussed. Practical implications for intervention strategies aimed at improving verbal short-term memory skills in Down syndrome are also outlined.

Expressed Emotion (EE), a measure of the emotional climate of the family, predicts subsequent adjustment of adults with mental disorder (Leff & Vaughn, 1985). Despite the acknowledged importance of the family in childhood disorders, there have been relatively few studies of expressed emotion with adolescents and school-aged children and virtually none focused on preschoolers. The present study utilized the Five Minute Speech Sample (FMSS) to examine how Expressed Emotion relates concurrently and longitudinally to child problem status in a community sample of 112 preschool-aged children. At preschool, the proportion of high EE increased significantly across three child groups: Comparison (8.1%), Borderline Problem (15.8%), and High Problem (41.2%); however, preschool EE was not predictive of subsequent child status at 1st grade. Expanded FMSS codes, tapping positive affect and worry about the child, were also related to child problem group at preschool and were predictive of subsequent child status at 1st grade. Because parents' stress and adjustment were also highly related to child problem group status, we examined whether the FMSS codes were essentially a proxy for these or whether they explained unique variance. In two stepwise regressions on preschool child group status (divided by total problems and by externalizing problems), maternal stress was the only variable to enter. Also, in predicting to 1st grade externalizing child group status, only maternal stress entered. Discussion focused on the extension of the EE construct and other FMSS coding to young children, and the need to recognize that to some extent these variables may reflect maternal stress and adjustment.

A multi-modal abnormality in the integration of parts and whole has been proposed to account for a bias toward local stimuli in individuals with autism (Frith, 1989; Mottron & Belleville, 1993). In the current experiment, we examined the utility of hierarchical models in characterising musical information processing in autistic individuals. Participants were 13 high-functioning individuals with autism and 13 individuals of normal intelligence matched on chronological age, nonverbal IQ, and laterality, and without musical experience. The task consisted of same-different judgements of pairs of melodies. Differential local and global processing was assessed by manipulating the level, local or global, at which modifications occurred. No deficit was found in the two measures of global processing. In contrast, the clinical group performed better than the comparison group in the detection of change in nontransposed, contour-preserved melodies that tap local processing. These findings confirm the existence of a “local bias” in music perception in individuals with autism, but challenge the notion that it is accounted for by a deficit in global music processing. The present study suggests that enhanced processing of elementary physical properties of incoming stimuli, as found previously in the visual modality, may also exist in the auditory modality.

This paper examines the extent to which conduct problems at age 13 are associated with a range of educational, psychosocial, and sexual outcomes at age 18 in a birth cohort of 488 young women. Significant associations were found between early adolescent conduct problems and later risks of educational failure, juvenile crime, substance abuse, mental health problems, and adverse sexual outcomes by late adolescence. These elevated risks were explained, in part, by social, family, and personal disadvantages associated with adjustment at age 13. In addition, there was evidence of a causal chain process in which early adolescent conduct problems were associated with a series of adolescent risk-taking behaviours, including delinquent peer affiliations, early-onset sexual behaviour, substance use, and school problems that were, in turn, associated with increased risks of later adverse outcomes.

Thirteen children and adolescents with diagnoses of Asperger syndrome (AS) were matched with 13 nonautistic control children on chronological age and verbal IQ. They were tested on their ability to recognize simple facial emotions, as well as facial emotions paired with matching, mismatching, or irrelevant verbal labels. There were no differences between the groups at recognizing simple emotions but the Asperger group performed significantly worse than the control group at recognizing emotions when faces were paired with mismatching words (but not with matching or irrelevant words). The results suggest that there are qualitative differences from nonclinical populations in how children with AS process facial expressions. When presented with a more demanding affective processing task, individuals with AS showed a bias towards visual-verbal over visual-affective information (i.e., words over faces). Thus, children with AS may be utilizing compensatory strategies, such as verbal mediation, to process facial expressions of emotion.

Stability and change of attachment was examined longitudinally in a group of 48 children at 14, 24, and 58 months of age. Whereas attachment classifications showed stability between 14 and 24 months, lack of stability was the case between either 14 or 24 months and 58 months. Mothers of children who did not exhibit stability of attachment reported more negative and less positive life events. No correspondence was found between attachment classification at 14 or 24 months and mental representations at 58 months. However there was agreement between representational and behavioral measures of attachment at 58 months, where mental representations of attachment appeared to mirror and complement behavioral classification of the attachment relationship with the mother. Evidence for continuity of attachment from infancy to childhood internal representations was found only in a subgroup of children who showed stability of secure attachment between infancy and 58 months of age. These children exhibited greater Emotional Openness in the SAT at 4.5 years. Findings are discussed in terms of different positions in attachment theory and research regarding the stability and change of attachment relationships.

The goal of this study was to investigate the variables that best predict functional impairment in children and adolescents. Two hundred and eight psychiatric and 129 pediatric children aged 7 to 17 years were assessed with measures of psychopathology, functional impairment, temperament, marital discord, educational style, coping, developmental milestones, stressful life events, medical history, school information, and family history of psychopathology. Multiple regression models adjusted by psychopathology were estimated. The global model, which included all the significant variables in partial models, revealed the following predictors of impairment: receiving review lessons, chronic disease or handicap, the presence of problems the child interpreted as stressful, late onset and long duration of psychopathological problems. These indicators could be useful for the proper identification of children with severe difficulties, in order to provide them with adequate psychological services.

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.

Children and adolescents exposed to trauma can suffer major adverse psychological effects including not only post-traumatic stress but also other psychological disorders. This study investigates the long-term course of general psychopathology following trauma in adolescence using a standardised diagnostic interview and comparisons with a matched control group. Young people (N = 216) who as teenagers had survived a shipping disaster—the sinking of the “Jupiter” in Greek waters—between 5 and 8 years previously and 87 young people as matched controls were interviewed. The survivors showed raised rates of diagnosis in a range of anxiety and affective disorders during the follow-up period. The highest rates were among the survivors who had developed Post-Traumatic Stress Disorder (PTSD), and those survivors who had not were generally similar to the controls. Onset of anxiety and affective disorders varied between being indefinitely close to the disaster to years later. Differences in rates of disorder between the survivor and control groups had lessened by the time of follow-up but were still apparent, due to continuing distress among the survivors still suffering from PTSD, and to a lesser extent among those who had recovered from PTSD. Generalisability of the findings are discussed.

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.

The modulators of maternal separation anxiety were examined in a longitudinal study with 97 mothers of infants from 3 to 9 months of age. The objective of the study was to examine the joint contribution of the mother's attachment concerns as related to her husband together with the perception of the infant's temperament to her concerns over separation from her child. Maternal worries about separation from 3-month-old infants predicted maternal separation anxiety when infants were 9 months old. Mother's attachment to her husband and her perception of her child's temperament further predicted maternal separation anxiety at 9 months over and above the worries at 3 months. Mothers who feared dependent relationships with their husbands experienced high levels of maternal separation anxiety. This tendency was particularly marked when the infant was perceived as adaptable at 3 months. In addition, secure mothers, namely, mothers low in fear of abandonment and in fear of being dependent, increased their maternal separation anxiety as a function of their infant's perceived unadaptability.

Research on theory of mind began in the context of determining whether chimpanzees are aware that individuals experience cognitive and emotional states. More recently, this research has involved various groups of children and various tasks, including the false belief task. Based almost exclusively on that paradigm, investigators have concluded that although “normal” hearing children develop theory of mind by age 5, children who are autistic or deaf do not do so until much later, perhaps not until their teenage years. The present study explored theory of mind by examining stories told by children who are deaf and hearing (age 9–15 years) for statements ascribing behaviour-relevant states of mind to themselves and others. Both groups produced such attributions, although there were reliable differences between them. Results are discussed in terms of the cognitive abilities assumed to underlie false belief and narrative paradigms and the implications of attributing theory of mind solely on the basis of performance on the false belief task.

Deaf children of elementary and secondary school age participated in a study designed to examine their understanding of display rules, the principles governing the expression and concealment of emotion in social situations. The results showed that deaf children's knowledge of display rules, as measured by their reported concealment of emotion, was comparable to that of hearing children of the same age. However, deaf children were less likely to report that they would conceal happiness and anger. They were also less likely to produce reasons for concealing emotion and a smaller proportion of their reasons were prosocial, that is, relating to the feelings of others. The results suggest that the understanding of display rules (which function to protect the feelings of other people) may develop more gradually in deaf children raised in a spoken language environment than it does in hearing children.

Fears and phobias are relatively common in childhood. Both environmental and genetic theories have tried to explain the etiology behind these conditions. However, data supporting the different theories are sparse. To investigate the relative importance of genetic and environmental influences on specific phobias and fears, parental reports of animal, situational, and mutilation fears and phobias were completed for 1106 pairs of 8- to 9-year-old Swedish twins. The prevalence of specific phobias was 7.3% for boys and 10.0% for girls. Genetic, shared environmental, and nonshared environmental effects contributed to individual differences in fears and phobias in young children, but the magnitude of the effects differed between sexes. Shared environmental effects contributed to a general susceptibility for fearfulness. Genetic and nonshared environmental effects, on the other hand, contributed both to the general susceptibility and specific fearfulness, even though these effects primarily were fear specific. These results indicate that both heritable factors as well as environmental factors such as trauma, vicarious learning, and/or negative information are important for differences in fearfulness and phobias—at least in children.

The goal of this study was to examine whether looking away behaviour of ADHD children interferes with their test performance. ADHD and normal children carried out two continuous performance tests (CPTs): one with a regular interstimulus interval (ISI), and the other with an irregular ISI. Children were instructed to push a response button when a target stimulus was presented on the monitor. The children's visual behaviour was recorded and scored offline. A micro-analysis of the visual behaviour indicated that ADHD children timed their looking away behaviour in the regular CPT: i.e. they looked away from the monitor and back in the interval between two succeeding stimuli. As a result they did not miss stimuli. Timing of looking away was less possible in the CPT with the irregular ISI. In this condition, looking away interfered with the ADHD children's task accuracy. In sum, looking away behaviour had a negative effect on the accuracy of test performance of ADHD children when stimuli were unpredictable. Looking away behaviour was not associated with the slower reaction times of the ADHD children. Hence, the often reported slowness of ADHD children is not to be explained by their visual behaviour.

Objective: To evaluate sleep and alertness and to investigate the presence of possible underlying sleep/wake disorders in children with attention-deficit/hyperactivity disorder (ADHD). Method: After 3 nights of adaptation in a room reserved for sleep studies in the department of child psychiatry, children underwent polysomnography (PSG) followed by the Multiple Sleep Latency Test (MSLT) and reaction time tests (RT) during the daytime. Thirty boys diagnosed as having ADHD (DSM-IV), aged between 5 and 10 years, and 22 age- and sex-matched controls participated in the study. All children were medication-free and showed no clinical signs of sleep and alertness problems. Results: No significant differences in sleep variables were found between boys with ADHD and controls. The mean latency period was shorter in children with ADHD. Significant differences were found for MSLT 1, 2 and 3 (p<.05). Mean reaction time was longer in children with ADHD, with significant differences in all tests (p<.05). Number and duration of sleep onsets measured by the MSLT correlated significantly with the hyperactivity-impulsivity and inattentive- passivity indices of the CTRS and CPRS. Conclusion: Children with ADHD were more sleepy during the day, as shown by the MSLT, and they had longer reaction times. These differences are not due to alteration in the quality of nocturnal sleep. The number of daytime sleep onsets and the rapidity of sleep-onsets measured as MSLT were found to be pertinent physiological indices to discriminate between ADHD subtypes. These results suggest that children with ADHD have a deficit in alertness. Whether this deficit is primary or not requires further studies.