Oppositional Defiant Disorder (ODD) is among the most prevalent disorders in preschoolers. It has been linked to temperament, since characteristics such as elevated surgency and negative affect, as well as low levels of effortful control, contribute to the development of this disorder. Evidence also indicates that parental psychopathology can accentuate temperamental traits. Our aim was to assess whether the levels of psychopathology of mothers and fathers acts as a moderator of the relationship between temperament and ODD symptoms in preschoolers, both cross-sectionally at ages 3, 4 and 5, and longitudinally between ages 3 and 5. The sample included 550 children evaluated at ages 3, 4 and 5 through questionnaires and a semi-structured diagnostic interview with parents. Parents also answered a questionnaire about their own psychopathology. The results indicated that negative affect and effortful control are associated with higher levels of ODD symptoms in preschoolers. At child age 5, higher levels of paternal depression and anxiety increased the effect of low effortful control on ODD. High levels of negative affect and low levels of effortful control at age 3 were statistical predictors of ODD levels at age 5, and this relationship was also moderated by paternal anxiety and depression. The results have important clinical implications for the proper orientation of interventions, suggesting that interventions should integrate the paternal caregiver in the treatment.
Enlace al artículo en Journal of Child and Family Studies

Objective: Oppositional defiant disorder (ODD) is a common disorder in preschool children. Evidence indicates that maternal and paternal psychopathology, particularly aggressive behavior and anxious and depressed symptoms, contributes to the development of this disorder. The latest research also suggests that ODD symptoms may exacerbate the mental health problems of parents. Our aim was to establish the existence of a reciprocal association between paternal and maternal psychopathology (aggression, depression, and anxiety) and child ODD at ages 3 and 8, using a longitudinal design in a community sample of preschoolers. Method: The sample included 331 children evaluated at ages 3 and 8 through questionnaires and a semistructured diagnostic interview with parents. Parents also informed about their own psychopathology. Results: At 3 years of age, higher levels of ODD symptoms in girls were concurrently associated with maternal anxious and depressed symptoms and paternal aggressive behavior, and higher levels of ODD symptoms in boys were concurrently associated with maternal aggressive behavior. Longitudinally, for boys, higher levels of maternal anxious and depressed symptoms at child age 3 predicted increases in ODD symptoms from 3 to 8 years of age. In addition, higher levels of ODD symptoms in boys aged 3–8 years predicted increases in fathers’anxious and depressive symptoms. Conclusion: Children with ODD should be evaluated and treated promptly, but efforts should be extended to their parents. Mothers’ and fathers’ mental health must be explored because the psychopathologies of children and parents reciprocally affect each other.
Enlace al artículo en Journal of Clinical Psychology

This work examines the moderator effect of sex and age on the relationship between different types of exposure to intimate partner violence (IPV) and child psychopathology and functional impairment. One hundred and sixty-six Spanish children aged 4 to 17 years exposed to intimate partner violence were assessed using a diagnostic interview and other instruments for the measurement of psychopathology and functional impairment. Participants were classified in three groups according to the degree of exposure: witness (N=77), involved (N=63) and victim (N=26). According to mothers self-reports and mother-child combined information, boy victims of IPV showed more mood disorders than involved or witness boys. There were no other moderator effects of either sex or age. The effect of exposure to intimate partner violence among children was not dependent, in general, on the childs sex or age, and this this has important implications for the assessment, treatment and prevention of childrens exposure to IPV.
Enlace al artículo en Journal of Family Violence

There are discrepancies about whether children who witness and suffer domestic violence (DV) have similar outcomes in terms of psychopathology. This work examines the relationship between different types of exposure to DV and child psychopathology and functional impairment. One hundred and forty-four Spanish children aged from 4 to 17 years and exposed to DV were evaluated using a diagnostic interview and other instruments of psychopathology and functional impairment. The participants were classified in three groups according to the degree of exposure: witness (n = 72), involved (n = 52), and victim (n = 20). According to mothers self-reports and mother–child combined information, DV equally affects psychopathology and functional impairment regardless of the degree of the exposure. Childrens self-reports showed a linear trend to present greater psychopathology as a victim than as a witness. The differential effect of exposure to DV measured in this study depended on the informant, which underlines the importance of obtaining information from the children exposed to violence at home.
Enlace en Journal of Interpersonal Violence

The present study investigates reciprocal associations between positive parenting, parental monitoring, CU traits, and ODD in children assessed at age 3 and again at age 6. Data were collected from a sample of preschoolers (N = 419; 51.58% female) through diagnostic interviews and questionnaires answered by parents and teachers. Structural equation modeling revealed a bidirectional relationship between poor monitoring and ODD, with poor monitoring at age 3 predicting ODD at age 6 (β = .11, p < .05), and ODD at age 3 predicting poor monitoring at age 6 (β = .10, p < .05). While poor monitoring at age 3 predicted CU traits at age 6 (β = .11, p < .05), CU traits at age 3 predicted positive parenting (β = .09, p < .05) and ODD (β = .13, p < .05) at age 6. Results have important implications for early targeted parenting interventions for CU traits and ODD.
Enlace al artículo en Child Psychiatry and Human Development

Se presenta una entrevista diagnóstica estructurada para niños y adolescentes de 6 a 17 años que sigue los criterios diagnósticos del DSM-III-R. Es un protocolo totalmente pautado donde las preguntas se han redactado de tal forma que permiten, en la medida de lo posible, que la entrevista fluya de forma semejante a una conversación. La DICA es una entrevista muy completa y de fácil uso. Estas características la convierten en un instrumento idóneo tanto para la investigación como para la práctica diaria.

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. Keywords: Conduct disorder, oppositional defiant disorder, major depression, dysthymic disorder, comorbidity, functional impairment. Abbreviations: MDD/DD: major depression or dysthymia; CD/ODD: conduct or oppositional defiant disorders; SAD: separation anxiety disorder; GAD: generalized anxiety disorder; ADHD: attention deficit hyperactivity disorder.
Artículo disponible en formato PDF con permiso de Association for Child Psychology and Psychiatry.

Executive functioning in 3-year-old preschoolers with attention-deficit hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), comorbid ADHD+ODD, and children without any of these conditions (control group) was examined. A community sample including 622 children was diagnosed using a diagnostic interview following DSM-IV criteria, and assessed using the Behavior Rating Inventory of Executive Function Preschool version (BRIEF-P) and the Kiddie-Conners Continuous Performance Test.
The children diagnosed withADHDshowed the poorest executive function (EF) profile in comparison with controls, and were closely followed up in this respect by the comorbid ADHD+ODD children. The ADHD and comorbid groups presented similar executive difficulties. The ODD group obtained mean scores statistically equal to those of controls in EF. These findings suggest that, in preschoolers, executive functioning deficits assessed with a performance-based measure or with behavioural descriptions are specific to children with ADHD, in comparison with those with ODD. This study contributes knowledge about EFs in two prevalent and comorbid disorders in preschool children, ADHD and ODD, knowledge that can help our understanding of specific deficits and the design of specific early intervention initiatives.
Enlace en Journal of Neuropsychology

Abstract Objective The aim of this study was to clarify the validity of the mixed conduct/depressive disorder in young people to justify its place in ICD-10 by examining a wide range of risk factors, school performance and other contextualvariables. Method Data on risk factors and other school and family variables were compared between 66 referred children with depressive disorders without conduct disorder, 135 with conduct or oppositional defiant disorder without depressive disorders, and 90 with both.Data were obtained through structured diagnostic interviews with parents and children and questionnaires. Results Marked differences emerged between depressive and comorbid groups in rearing style, school and friends. Comorbid conduct-depression and pure conduct disorders share similar contextual factors; the differences are larger in school, where the pure conduct group has more difficulties. Conclusions Based on contextual factors, pure depression is different from conduct- depressive disorder, but pure conduct disorder is similar to the comorbid condition. The results have implications for nosology and treatment of these disorders.

Te objective was to determine the psychometric properties of the Children´s Global Assessment Scale (CGAS), a measure of functional impairment, in Spanish samples. After evaluating 337 pediatric and psychiatric children with a structured diagnostic interview, a score of impairment was assigned. The CGAS is a reliable instrument, in time and inter raters, and valid, because it differentiates between subjects with and without psychopathology and between subjects with a different number of disorders. The inclusion of independent measures of impairment in diagnostic assessment, in general, and in clinical and epidemiological research, in particular, is recommended.
El objetivo del trabajo ha consistido en estudiar las propiedades psicométricas en muestras españolas de la escala Children´s Global Assessment Scale (CGAS), que valora el grado de deterioro funcional que presenta el niño. Tras evaluar 337 niños y adolescentes que acudían a centros pediátricos o psiquiátricos con una entrevista diagnóstica estructurada, se adjudicaba la puntuación de deterioro. La escala CGAS es un instrumento fiable, en el tiempo y entre evaluadores, y válido, ya que diferencia a grupos de sujetos con y sin psicopatología y a sujetos con diferente número de trastornos. Se recomienda la inclusión de medidas independientes de deterioro funcional en la evaluación psicodiagnóstica, en general, y en la investigación clínica y epidemiológica, en particular.
Enlace al artículo en Revista de Psiquiatria Infanto Juvenil © Copyright 1999

There is increasing interest in describing different variants and subtypes that characterize the heterogeneity of behavior problems with the aim of supporting early detection and prevention, as well as facilitating research into etiological differences. This work examines the course of co-occurrence of callous-unemotional traits (CU), anxiety (ANX) and oppositionality (ODD-s) levels in a longitudinal community sample. A sample of 622 3-year-old preschoolers, followed up until age 7, was assessed annually with dimensional measures of callous-unemotional traits, oppositional defiant disorder and anxiety and related psychological constructs answered by parents, teachers and performed by children. Growth-Mixture-Modeling yielded six trajectories (null 58.9%, ANX increasing 4.9%, CU+ANX+ ODD 2.4%, CU+ ODD-decreasing 8.1%, ODD-increasing 16.4%, and ANX-decreasing 9.2%) that represent the variants previously described with older subjects. The specifier ODD “with limited prosocial emotion” (CU + ODD decreasing and increasing) showed deficits in executive functioning, attention, aggressive behavior and social cognition in comparison with null trajectory. The secondary variant showed a more severe clinical picture and presented more difficulties in executive functioning, worse environmental characteristics, and worse outcomes at age 7. It is possible to identify the heterogeneity of disruptive behavior problems from preschool age. The identification of homogeneous groups in this category of disorders may help to design more suitable treatments with specific components for specific difficulties, and to progress in the etiological research of each class.
Enlace al artículo en Personality and Individual Differences

Background: Data based on general population studies of exposure-to-risk factors are not adequate to describe the mental o health of children living in the most extreme “high-risk” environments. Methods: Data were collected in a longitudinal prospective study of two cohorts of 9 and 13 year-old socially at-risk children. Cluster analysis was used to classify youths based on the reports about potential areas of risk. The psychopathological structure of empirical clusters was compared through cross-sectional and longitudinal epidemiological indexes and through multiple regression and multivariate analysis of variance. Results: Cluster analysis provided 8 binary high-low risk classifications. Exposure to risk was highly prevalent. In preadolescence, broken family, rearing style and contextual profiles were the highest risk factors for psychopathology. In adolescence, they were psychological variables, verbal comprehension, pre-peri-postnatal history, physical health and family characteristics. Cumulative risk followed a linear trend on psychopathology and functional impairment. Conclusions: Extreme socially at-risk populations have specific profiles of risk that can be identified through person-centered approach and may be amenable to selective preventive interventions.
Enlace al artículo en Social Psychiatry and Psychiatric Epidemiology© Copyright 1999 Revista de Psiquiatria Infanto Juvenil.

Aim: To examine use of and unmet need for mental health services in children from a disadvantaged Spanish population and to explore the factors that may longitudinally predict these. Method: Data were collected prospectively on two cohorts of children aged 9 and 13. Results: Highest observed unmet need was 73% for preadolescents and 84% for adolescents and was significantly higher for adolescent girls than boys. Barriers to access services were perceived in 43% of preadolescents and 29% of adolescents. Acceptability barriers were the most frequent. Boys were perceived as more in need of help than girls by the parents of preadolescents and by teachers of adolescents. Adjusted logistic regression models showed that preadolescents with ADHD and adolescents with oppositional defiant disorder, ADHD, depressive and anxiety disorders had a significantly higher probability of seeking help. The number of DSM diagnoses was linearly associated with the use of services. Predictors of service use were: perception of problems and the presence of contextual risks. Unmet need in preadolescents was predicted by not to perceive problems, not having contextual risks and lower impairment, and by lower impairment and female sex in adolescents. Conclusions: Children from high risk populations rarely use mental health services in spite of considerable need. Specific strategies need to be developed to meet that need, especially, for adolescent girls
Enlace al artículo en Epidemiologia e Psichiatria Sociale © .Copyright 1999 Revista de Psiquiatria Infanto Juvenil.

There is a need to know whether callous-unemotional (CU) traits identify a more severe group of oppositional defiant children (ODD). The aim of this study is to ascertain cross-sectionally and longitudinally the specific contribution of CU levels and the presence of ODD in the psychological state of preschool children from the general population. A total of 622 children were assessed longitudinally at ages 3 and 5 with a semi-structured diagnostic interview and questionnaires filled out by parents and teachers. In multivariate models simultaneously including ODD diagnosis and CU levels, controlling by socioeconomic status, ethnicity, sex, severity of conduct disorder symptoms and other comorbidity, high CU scores were related to higher levels of aggression, withdrawn, externalizing and global symptomatology, functional impairment and higher probability of comorbid disorders and use of services. The contribution of CU traits on children’s psychological state was not moderated by the presence/absence of ODD. Stability for CU traits and number of ODD-symptoms between ages 3 and 5 was statistically significant but moderate-low (intra-class correlation under .40). Assessment and identification of CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems.
Enlace al artículo en PLoS ONE

The present work tests the applicability and validity of the CAFAS, an instrument for assessing functional impairment, in the Spanish population. The sample included 441 psychiatric outpatients from 8 to 17 years old and their parents, and a pediatric group of 74 outpatients. Different instruments for assessing functional impairment, psychopathology, and other related variables were used. Interrater reliability ranged from moderate to very good. Weak-to-moderate agreement between CAFAS scores based on information from parents and children was obtained. Correlations with other measures of impairment and functioning were moderate. CAFAS scores differentiated significantly between children with and without psychopathology. These results permit the use of the instrument for studies on psychopathology and functional impairment, and for planning intervention and mental health services.
Enlace al artículo en Wiley InterScience

The study identifies the variables that predict the perception of need for psychiatric help and use of mental health services in children and adolescents from 7 to 17 years old attending psychiatric and paediatric outpatient consultation. The perception of problems and consultation depend on the degree of functional impairment, parents perception of the existence of problems, the age of the child, temperamental trails, parental rearing style and severe stressful life-events. The variables that permit realization of the existence of problems but do not lead to consultation are primarily developmental difficulties. Families consult with professionals, despite not perceiving the presence of psychiatric problems, when children have difficulties in their behavioural style. The presence of psychopathology is not enough to explain the perception of the need for help by the subject or the fact of attending consultation. Resultant indicators may be useful for planning mental health services.
El estudio identifica las variables que pueden predecir la percepción de necesidad de ayuda psicológica y el uso de los servicios de salud mental en jóvenes de 7 a 17 años que acudían a consultas ambulatorias psiquiátricas y pediátricas. La percepción de la existencia de problemas y la consulta por ellos depende de que los padres perciban de la incapacidad funcional que producen., la edad del niño, su temperamento, los acontecimientos estresantes que ha sufrido, y del estilo educativo de los padres. Las dificultades evolutivas se perciben como problemas pero no conducen a consulta. LAs familias consultan con los profesionales, a pesar que no perciban la existencia de problemas cuando los niños presentan dificultades menores en su comportamiento. La presencia de psicopatología no es suficiente para explicar la percepción de la necesidad de ayuda o de acudir a consulta. Los indicadores hallados pueden ser útiles para planificar los servicios de salud mental.
Enlace al artículo. © Copyright 2002 Psicothema

The goal of this study was to investigate the variables that best predict functional impairment in children and adolescents. 208 psychiatric and 129 pediatric children 7 to 17 years old 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, that included all the significant variables in partial models, revealed the following predictors of impairment: receiving review lessons, chronic disease or handicap, the presence of other 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.
Enlace al artículo. © Copyright 2000 Cambridge University Press

Abstract
. Objective: Previous studies on developmental trajectories have used ad hoc definitions of oppositional defiant behaviors (ODB), which makes it difficult to compare results. This article defines developmental trajectories of ODB from ages 3–5 based on five different standard measurements derived from three separate instruments. Method: A sample of 622 three-year-old preschoolers, followed up at ages 4, 5, and 6, was assessed with the five measures of oppositionality answered by parents and teachers. Growth-Mixture-Modeling (GMM) estimated separate developmental trajectories for each ODB measure for ages 3 to 5. Results: The number of classes-trajectories obtained in each GMM depended on the ODB measure, but two clear patterns emerged: four trajectories (persistent low, decreasers, increasers/high increasers, persistent moderate/persistent high) or three trajectories (persistent low, decreasers, increasers/high increasers). Persistent high trajectories accounted for 4.4%–9.5% of the children. The trajectories emerging from the different ODB measures at ages 3 to 5 discriminated disruptive disorders, comorbidity, use of services, and impairment at age 6, and globally showed a similar pattern, summarizing longitudinal information on oppositionality in preschool children in a similar way. Conclusions: Trajectories resulting from standard scales of the questionnaires have predictive validity for identifying relevant clinical outcomes, but are measure-specific. The results contribute to knowledge about the development of ODB in preschool children.
Enlace al artículo en PloS One

Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semistructured interview and questionnaires on psychopathology, temperament and executive functioning completed by parents and teachers. Results: Using categorical and dimensional symptoms of ODD it was possible to confirm, cross-informant and cross-method, distinct dimensions for defining the structure of ODD: one made up of irritable and headstrong and the other of negative affect, oppositional behaviour and antagonistic behaviour. Specific associations with DSM-IV disorders were found, and irritable was associated with anxiety disorders, whereas headstrong was associated with disruptive disorders, including aggressive and non-aggressive CD symptoms. Also, negative affect was associated with anxiety disorders and non-aggressive CD symptoms, oppositional behaviour with disruptive disorders and aggressive CD symptoms, and antagonistic behaviours with disruptive disorders and, in boys, with mood disorders. The dimensions correlated with specific scales of psychopathology, temperament and executive functioning. Conclusions: Oppositional defiant disorder is a heterogeneous disorder from preschool age. Different dimensions, with moderate to acceptable reliability and convergent and discriminant validity with other psychological constructs, can be identified early in life. Keywords: Comorbidity, dimensions, headstrong, irritability, negative affect, oppositional defiant disorder, preschool.
Enlace al artículo en Journal of Child Psychology and Psychiatry

We provide the first validation data on the Strengths and Difficulties Questionnaire (SDQ3–4), a brief screening tool for behavioral and emotional problems, in preschool children. Parents of a community sample of 1341 Spanish 3-year-olds and teachers of a sample of 622 children responded to the SDQ3–4 and different measures of psychopathology. Confirmatory factor analysis yielded adequate fit of the model to the original structure. Internal consistency (omega coefficient) for total scores was .87 for parents and .91 for teachers. Convergent validity of SDQ3–4-parents' reports with Achenbach's taxonomy and diagnostic interview was good, but low for SDQ3–4-teachers' reports. The SDQ3–4 showed predictive accuracy for discriminating use of mental health services and functional impairment. This is the first work presenting empirical evidence of the reliability and validity of the parents' and teachers' SDQ3–4 for preschoolers. The SDQ3–4 presents acceptable psychometric properties for use in the identification of preschool children who might have behavioral or emotional problems.
Enlace al artículo en Comprehensive Psychiatry

Abstract This study traces the developmental course of irritability symptoms in oppositional defiant disorder (ODD) from ages 3–5 and examines the psychopathological outcomes of the different trajectories at age 6. Method. A sample of 622 3-year old preschoolers (311 were boys), followed up until age 6, was assessed yearly with a semi-structured diagnostic interview with parents and at age 6 with questionnaires answered by parents, teachers and children. Results. Growth-Mixture-Modeling yielded five trajectories of irritability levels for the whole sample (high-persistent 3.5%, decreasing 3.8 %, increasing 2.6 %, low persistent 44.1 % and null 46.0 %). Among the children who presented with ODD during preschool age, three trajectories of irritability symptoms resulted (high-persistent 31.9 %, decreasing 34.9 % and increasing 33.2 %). Null, low-persistent and decreasing irritability courses in the sample as awhole gave very similar discriminative capacity for children’s psychopathological state at age 6, while the increasing and high-persistent categories involved poorer clinical outcomes than the null course. For ODD children, the high-persistent and increasing trajectories of irritability predicted disruptive behavior disorders, comorbidity, high level of functional impairment, internalizing and externalizing problems and low anger control at age 6. Conclusions. Irritability identifies a subset of ODD children at high risk of poorer longitudinal psychopathological and functional outcomes. It might be clinically relevant to identify this subset of ODD children with a high number of irritability symptoms throughout development with a view to preventing comorbid and future adverse longitudinal outcomes.
Enlace al artículo en Journal of Abnormal Child Psychology

Objective: We provide validation data on the Behavior Rating Inventory of Executive Functioning–Preschool version (BRIEF-P) in preschool children. Method: Teachers of a community sample of six hundred and twenty 3-year-olds, who were followed up at age 4, responded to the BRIEF-P, and parents and children answered different psychological measures. Results:
Confirmatory factor analysis achieved adequate fit of the original structure (five-first-order-factor plus three-second-order-factor model) after excluding four items. The derived dimensions obtained satisfactory internal consistency, moderate convergent validity with psychopathology and temperament, and good ability to discriminate between children with ADHD. BRIEF-P scales were not associated with a performance-based measure of attention. The teachers BRIEF-P adds significant clinical information for the diagnosis of ADHD (Δ R.from 5.3 to 15.3) when used with other instruments for the assessment of psychopathology, functional impairment, or performance-based attention. Conclusion: The BRIEF-P may be useful in the identification of preschool children, specifically those with ADHD, who might have a dysfunction in executive functioning.
Enlace al artículo en Journal of Attention Disorders

This paper reports rates of psychopathology in a population of 9- and 13-yr olds from a Spanish slum. Two cohorts of all the children born in 1989 and in 1993 and registered in the census of a municipality in 2001 were assessed over a 3-yr . period with structured diagnostic interviews and functional measures. In the first year of the study 79 (53.7%) children of the adolescent 13-yr-old population and 72 (59.5%) of the pre-adolescent 9-yr-old population participated. Between 30% and 60% of preadolescents and between 30% and 50% of adolescents presented some mental disorder. Anxiety and disruptive behavior disorders were the most frequent disorders in both cohorts. For both genders, the highest risk for any psychopathology was at 10 yr. We found that, psychopathology and functional impairment decreased with age, and that the psychopathology of children in a peripheral slum of a big city is 3 times higher than the median of the general population. This information should be useful for administrators providing services for children from the most disadvantaged segment of the population.
Web Tables
Enlace al artículo en Social Science & Medicine

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 1420 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 defant 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 sufered. The implications of these findings for nosology and prevention are discussed.
Enlace al artículo. © .Copyright 2001 Cambridge University Press.

Green environments are associated with improved child brain development and mental health. We study cross-sectionally the association of the availability of greenspace at home and school with obsessive-compulsive behaviors (OCB) in primary schoolchildren. Greenspace and tree cover surrounding home and school of 378 children aged 9-10 in Barcelona (Spain) were characterized using satellite-based indices [Normalized Difference Vegetation Index (NDVI), Modified Soil Adjusted Vegetation Index (MSAVI), Vegetation Continuous Field (VCF)] across buffers of 100m, 300m, and 500m, and distance to the nearest green space. OCB was assessed with the Spence Children's Anxiety Scale-Parent version. Linear and mixed effects models showed that greenspace at school, but not at home, was significantly related to a reduction in OCB across buffers, with benefits for girls and also children with graduate parents. Higher greenspace around the school might be associated with less obsessive-compulsive behavior in primary schoolchildren, especially in girls and those with higher socioeconomic status.
Enlace al artículo.

ABSTRACT: Objective: To obtain joint hypermobility classes in children from the general population and to study their characteristics in relation to anxiety measures. Methods: A total of 336 nine-year-old children from the general population were clinically assessed through 9 items of hypermobility, and their parents reported about the severity of anxiety symptoms. Latent class analysis was estimated to group the children according to the presence of hypermobility symptoms, and the obtained classes were related to anxiety. Results: A 2-class solution, labeled as high hypermobility and low hypermobility, best fitted the data. Children in the high hypermobility group scored higher in separation anxiety, social phobia, physical injury fears, and total anxiety than did those in the low group. When applying the threshold reference scores to the total anxiety score, 7.4% of children in the high hypermobility group versus 6% in the low group were reported to experience clinical elevations on total anxiety. Conclusion: High symptoms of hypermobility are associated with higher scores in anxiety symptoms in children from the general population. Children with frequent symptoms of hypermobility may benefit from screening for anxiety symptoms because a subset of them are experiencing clinical elevations and may need comprehensive physical and psychological treatment.
Enlace al artículo en Journal of Developmental and Behavioral Pediatrics.

Objective To examine the one-year first-incidence and prevalence of oppositional defiant disorder (ODD), the outcomes on psychopathology and functioning by age of onset and the risk factors of onset of ODD from ages 3 to 9 in children from the Spanish general population.
Design Longitudinal with 7 follow-ups and double cohort (ODD and non-ODD children). Setting General population of preschool and elementary school children in Barcelona (Spain).
Participants On a first phase the parent-rated Strengths and Difficulties Questionnaire conduct problems scale plus oppositional defiant disorder DSM-IV symptoms were used to screen for behavioral problems. The second phase sample size contained 622 cases at age 3 and at age 9 418 remained in the study.
Results The probability of the onset of ODD showed increasing values at ages 4 (R =2.7%) and 5 years (R=4.4%). These values decreased until age 7 (R=1.9%) and increased again until age 9 (R=3.6%). Up to 9 years old the cumulative risk of new cases of ODD was 21.9%. Early onset was associated with a higher risk of depression comorbidity and later onset with higher functional impairment and symptomatology. Subthreshold ODD, high scores in irritability and headstrong dimensions, ADHD and other comorbidity, negative affectivity until age 7, difficulties in inhibit and emotional control, punitive parenting and maternal internalizing problems were risk factors of a first episode of ODD during this seven-year period. Conclusions The risk of new cases of ODD in the general population at preschool age and during childhood is high. Preschool age is a target period for preventive interventions. Identified risk factors are objectives for targeted and indicated interventions.
Enlace al artículo en BMJ Open

Background: There is debate about whether the difficulties that children with different degrees of oppositionality (ODD) and callous–unemotional traits (CU) have in processing emotions are global or specific. The aim of this study is to identify difficulties in recognizing emotion (happiness, anger, sadness and fear) through a go/no-go task in children with different levels of ODD and CU traits. Method: A total of 320 8-year-old children were assessed through questionnaires filled out by teachers about oppositional defiant symptoms and CU traits and were then distributed into four groups: LowCU–HighODD, HighCU–LowODD, HighCU–HighODD and a comparison group (LowCU–LowODD).
Results: The analyses of variance comparing the 4 groups showed that the two groups with high ODD were less accurate than the control group in recognizing the emotion when the stimuli expressed happiness, fear or neutral emotion. The HighCU–HighODD group differed in the quality of the response (correct/wrong responses) but not in the reaction time in relation to the comparison group. The LowCU–HighODD group was faster to respond to emotions than the comparison group. Implications: The results show that the deficit in emotion processing is not restricted to specific distressing emotions such as fear or sadness, but they point to a global impairment in emotion processing in children scoring high in the constructs studied. The results also suggest that the difficulties that children with combined CU traits and oppositional conduct problems have in processing emotions are more of an emotional rather than an attentional nature.
Enlace al artículo en Comprehensive Psychiatry

Abstract: Spanish children were locked down for 72 days due to COVID-19, causing severe disruption to their normal life. The threat posed by COVID-19 continues and clinicians, administrators, and families need to know the life conditions associated with more psychological problems to modify them and minimize their effect on mental health. The goal was to study the life conditions of adolescents during lockdown and their association with psychological problems. A total of 226 parents of 117 girls and 109 boys (mean age: 13.9; Standard deviation: 0.28) from the community that were participants in a longitudinal study answered an online questionnaire about life conditions during lockdown and the Strengths and Difficulties Questionnaire (SDQ). Stepwise regression analyses controlling by previous reports of SDQ were performed. Conduct, peer, prosocial, and total problems scores increased after lockdown. After adjusting for previous measures of psychopathology, worse adolescents’ mental health during COVID-19 lockdown was associated with unhealthy activities, worsening of the relationships with others, and dysfunctional parenting style. It seems important to mitigate psychological stress in a situation of isolation due to a state of emergency by keeping the adolescent active and maintaining their daily habits and routines in a non-conflictive atmosphere and give support to parents.
Enlace al artículo en IJERPH.

Purpose The goal is to examine the prevalence, comorbidity and impairment of DSM-IV disorders in 3-year-old children from the Spanish general population. Method A sample of 1,341 3-year-old preschoolers were randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semi-structured interview and functional impairment measures. Results Prevalence of any diagnosis was 29.9 %, the most prevalent disorders being primary insomnia (11.7 %) and oppositional defiant disorder (ODD) (6.9 %). There were no sex differences in the prevalence. One-third of the families had sought professional help for the childs symptoms, and 9.4% received treatment (4.4 % psychological and 2.1 % pharmacological). After controlling for other comorbidities, ADHD was significantly associated with ODD, CD, insomnia and social phobia; ODD was
. associated with CD, separation anxiety, specific phobia and major depression. Diagnostic categories were associated with impairment, family burden, seeking professional help and receiving treatment. A diagnosis was more frequent in children of low socioeconomic status, born outside Spain, from one-parent families, with younger parents and with parents of lower educational level. Conclusions: Psychopathology, comorbidity and associated factors are very frequent from age three, suggesting a need for efforts of detection, prevention and treatment in the different societies.
Enlace al artículo en Social Psychiatry and Psychiatric Epidemiology

El artículo examina el acuerdo diagnóstico entre 145 niños pacientes psicológicos externos y sus padres al responder a la Diagnostic Interview for Children and Adolescents-Revised (DICA-R) adaptada al castellano. Los resultados indican que existe acuerdo, en general bajo, entre ambas fuentes respecto a la mayoría de las categorías diagnósticas. El grado de acuerdo aumentó con la edad. Niños y adolescentes informaron de más síntomas que sus padres. Las áreas donde se encontraron mayores diferencias entre las fuentes fueron los trastornos por conductas perturbadoras y trastornos por ansiedad, y también en depresión mayor para los adolescentes. Para la evaluación de la psicopatología de niños y adolescentes es necesaria la información ambos.
Enlace al artículo © .Copyright 1995 Rev. Psiquiatría Fac. Med. Barna ,22,6,153-163

El artículo examina la fiabilidad test-retest de la adaptación española de la Diagnostic Interview for Children and adolescents-Revised (DICA-R) en una muestra de 110 niños y adolescentes pacientes psiquiátricos externos. Niños y padres fueron entrevistados con la DICA-R en dos ocasiones separadas por un intervalo medio de 11 días. Los resultados del estudio indican que hay estabilidad en la evaluación de los trastornos con la DICA-R, como lo demuestra la ausencia de diferencias significativas entre el test y el retest y el rango de la mayoría de los valores kappa que oscilaron entre buenos y excelentes. Los más estables informando sobre los trastornos fueron los padres y los menos fiables fueron los adolescentes. Los trastornos mostraron cierta atenuación en el retest, aunque las diferencias no fueron significativas. La fiabilidad de los respondientes individuales dependió del tipo de trastorno y de la edad. La entrevista fue más fiable en las categoría más generales que en los trastornos específicos.
Enlace al artículo © Copyright 1997 Psicothema

The purpose of this study was to test the factor structure of the Inventory of Callous-Unemotional Traits (ICU; Frick, 2004) and to study the relation between the derived dimensions and external variables in a community sample of preschool children. A total of 622 children 3 and 4 years of age were assessed with a semistructured diagnostic interview, the ICU, and other questionnaires on psychopathology, temperament, and executive functioning, completed by parents and teachers. Confirmatory factor analysis derived from teachers ICU responses yielded three dimensions: Callousness, Uncaring, and Unemotional. Callousness and Uncaring subscale scores correlated with the specific scales related to aggressive behavior, temperament, executive functioning, and conduct problems. The ICU scale scores discriminated cross-sectionally oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses, aggressive and nonaggressive symptoms of CD, use of services, and ODD=CD-related family burden. Longitudinally, Callousness subscale score at age 3 predicted ODD or CD diagnosis at age 4. Unemotional was not associated with aggressive measures, but it was linked to anxiety disorders cross-sectionally and longitudinally. Callous-Unemotional traits contributed significantly to predicting disruptive behavior disorders controlling for sex, temperament, and executive functioning (predictive accuracy between 3 and 5%). The ICU is a promising questionnaire for identifying early Callous and Uncaring traits in preschool years that may help in the identification of a subset of preschool children who might have severe behavioral problems.
Enlace al artículo en Journal of Clinical Child and Adolescent Psychology

Abstract: Objective: To explore whether the symptoms and diagnosis of Oppositional Defiant Disorder (ODD), as defined in the DSM-IV, are equally impairing for girls and boys from the general population in the early school years. Method: A sample of 852 three to seven-year-old schoolchil-dren were screened out for a double-phase design. A total of 251 families were assessed with a diagnostic interview and with measures of functional impairment. Results: ODD symptoms and diagnosis were equally prevalent in boys and girls, but three- to five-year-old girls had a higher prevalence of subthreshold ODD. There were no significant differences between boys and girls in the impact on use of services, treatment received and family burden associated with ODD symptoms and diagnosis. Although diagnosis of ODD was not associated with higher functional impairment by sex, in-dividual symptoms and subthreshold diagnosis were more impairing for boys than for girls. Conclusion: Oppositionality may be measuring differ-ent things for boys and girls, and this possibility must be taken into ac-count with a view to the correct identification of this problem in each sex.
Enlace al artículo en Anales de Psicología

There is a need for reliable and well-validated diagnostic measures for studying psychopathology in preschool . and young children. The goal is to study the psychometric properties of the Diagnostic Interview for Children . and Adolescents for Parents of Preschool and Young Children (DICA-PPYC) in the general population. A sample of 852 Spanish school children, aged 3 to 7 years, were randomly selected and screened for a double phase design. A total of 251 families were interviewed with the DICA-PPYC and 244 participated in a test–retest design. Different measures of psychopathology and functional impairment were also administered. Test–retest agreement with a mean interval of 8.8 days ranged from excellent to slight (kappa from 1 to 0.39) for DSM-IV-TR and from good to fair (kappa from 0.77 to 0.49) for Research Diagnostic Criteria-Preschool Age diagnoses. Attenuation between test and retest was not significant for the prevalence of diagnoses, although it was significant for the number of externalising and total symptoms in the interview. The diagnoses converged moderately with the CBCL and Dominic scores. The presence of diagnoses in the DICA-PPYC significantly differentiated preschoolers and young children who had used mental health services, were more impaired, and presented more severe psychopathology measured by dimensional scales. The DICA-PPYC is a reliable and valid semi-structured interview schedule for preschool and young children, and can serve to advance the knowledge and mental health care of this population.
Enlace al artículo en Psychiatry Research

Examined the diagnostic agreement between clinicians and the Diagnostic Interview for Children and Adolescents (DICA). 137 children and adolescent outpatients (aged 6-17 yrs) and their parents were diagnosed independently following Mental Disorders-III-Revised (DSM-III-R) criteria by clinicians and by a revised version of the DICA (DICA--R). The diagnostic concordance between clinicians and DICA--R ranged from low to moderate in the majority of the categories. The only exception was Conduct Disorder. Differences depending on the informant and the quality of the information (cognitive vs observable) were observed. Combining the information from the child/adolescent and their parents ameliorated the concordance. The reasons for the scanty agreement found could be due to the fact that clinicians and structured interviews differ in what they evaluate (conditions on which they focus), how they evaluate (strictness in the criteria application, use of different informants, and different information), and when they evaluate (present condition vs Iifespan).
Enlace al artículo © Copyright 1997 Cambridge University Press

Abstract. Measurement invariance (metric/scalar) of oppositional defiant disorder (ODD) dimensions (negative affect, oppositional behavior, and antagonistic behavior) across sex and informants is tested. Parents and teachers of 622 preschool children from the general population answered a dimensional measure of ODD. ODD dimensions function similarly in boys and girls. Some differences were found by informant, indicating that the equivalence of the ratings of parents and teachers is not complete and that given the same underlying level of the latent trait, some parents item scores were higher than those of teachers. Metric invariance was complete but scalar invariance was not attained. The results contribute evidence on the conceptualization of ODD as a source-specific disorder. The simultaneous use of ODD dimensions reported by parents and teachers must be considered in the context of a lack of complete measurement invariance, which implies that comparisons of observed means from parents and teachers are not readily interpretable.
Enlace en European Journal of Psychological Assessment

Irritability is a transdiagnostic symptom in oppositional defiant disorder, depression, and anxiety, all highly comorbid disorders but with unknown simultaneous evolution. The aim was to obtain the developmental trajectories of simultaneous irritability and oppositional, depression, and anxiety problems from preschool age to early adolescence. A sample of 493 community children was followed up annually from ages 3–11 years and assessed using categorical and dimensional measures answered by parents and teachers. Latent Class Growth Analysis for four parallel processes was used to identify distinct groups of individual trajectories for irritability and oppositional, depression, and anxiety problems. Outcomes at ages 11 and 12 were compared among trajectoriesusing regression models and multiple comparisons. A 3-class model showed the highest entropy (0.961) and adequate posterior probabilities of class membership (≥0.969). Class 1 (n = 331, 67.1%) was made up of children with stable low scores in all the variables; class 2 (n = 55, 11.2%) of children with high depression, anxiety, and irritability and above the mean stable profiles for oppositional problems; and class 3 (n = 107, 21.7%) of children with medium-high increasing irritability and oppositional problems and on the mean depression and anxiety. The classes with symptomatology and irritability (2 and 3) clearly differed from class 1 (low) at baseline and in outcomes. The course of irritability and oppositional, depression, and anxiety problems from ages 3–11 years differed qualitatively and quantitatively across subgroups of children. The 3 classes identified may help to guide clinicians’ decision-making regarding treating irritability and its comorbid disorders.
Enlace al Articulo en Behavior Research and Therapy Transdiagnostic trajectories of irritability and oppositional, depression and anxiety problems from preschool to early adolescence - ScienceDirect

This study ascertains how the proposed subtypes and specifiers of oppositional defiant disorder (ODD) based on irritability and prosocial emotions co-develop and describes the clinical characteristics of the resultant classes. A sample of 488 community children was followed up from ages 3 to 12 years and assessed with categorical and dimensional measures answered by parents and teachers. Latent class growth analysis for three parallel processes [defiant/headstrong, irritability, and limited prosocial emotions (LPE)] identified a 4-class model with adequate entropy (.912) and posterior probabilities of class membership (≥ .921). Class 1 (n = 38, 7.9%) was made up of children with defiant/headstrong with chronic irritability and LPE. Class 2 (n = 128, 26.3%) was comprised of children with defiant/headstrong with chronic irritability and typical prosocial emotions. Class 3 (n = 101, 20.7%) clustered children with LPE without defiant/headstrong and without irritability. Class 4 (n = 220, 45.1%) included children with the lowest scores in all the processes. The classes were distinguishable and showed different clinical characteristics through development. These findings support the validity of ICD-11 ODD subtypes based on chronic irritability and may help to guide clinicians’ decision-making regarding treating oppositionality in children.
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Little is known about the coexistence of oppositionality and obsessive-compulsive problems (OCP) in community children and how it affects their development until adolescence to prevent possible dysfunctions. The co-development of oppositional defiant dimensions and OCP is studied in 563 children (49.7% female) from ages 6 to 13 years, assessed yearly with measures answered by parents and teachers. A 4-class model based on Latent Class Growth Analysis for three parallel processes (irritability, defiant, and OCP) was selected, which showed adequate fitting indexes. Class 1 (n=349, 62.0%) children scored low on all the measures. Class 2 (n=53, 9.4%) contained children with high OCP and low irritability and defiant. Class 3 (n=108, 19.2%) clustered children with high irritability and defiant and low OCP. Class 4 (n=53, 9.4%) clustered comorbid irritability, defiant, and OCP characteristics. The classes showed different clinical characteristics through development. The developmental co-occurrence of irritability and defiant plus obsessive-compulsive behaviors is frequent and adds severity through development regarding comorbidity, peer problems, executive functioning difficulties, and daily functioning. The identification of different classes when combining oppositional problems and OCP may be informative to prevent developmental dysfunctions and to promote good adjustment through development.
Enlace al Articulo.

Although irritability, headstrong/defiant behavior, and callous-unemotional traits (CU traits) often co-occur, the prospec¬tive associations between them are not well known. A general population sample of 622 children was followed up yearly from ages 3 to 12 years and assessed using dimensional measures of irritability, headstrong/defiant, and CU traits with teacher provided information. A random intercept cross-lagged panel model, accounting for all unmeasured time-invariant confounding using the children as their own controls, revealed cross-lagged reciprocal associations between increased headstrong/defiant and increased CU traits at all ages and a unidirectional association from headstrong/defiant to irritabil¬ity. The findings are consistent with headstrong/defiant behavior and CU traits mutually influencing each other over time and headstrong/defiant behavior enhancing irritability. School-based intervention and prevention programs should take these findings into consideration. They also suggest that irritability acts as a distinct developmental dimension of head¬strong/defiant and callous-unemotional behaviors and needs to be addressed independently.
Enlace al Articulo.

The objective was to obtain developmental trajectories combining callous-unemotional traits and the number of stressful life-events between ages 3 and 9 years and to ascertain their association with the polymorphism rs53576 at the Oxytocin Receptor gene (OXTR). A total of 377 children were assessed yearly from ages 3 to 9 years. Latent class growth analysis for parallel processes was used to identify distinct trajectories for callous-unemotional traits (assessed using the Inventory of Callous-Unemotional Traits, ICU) and number of stressful life-events, and then the influence of being an A allele carrier on class membership was included with OXTR genotypes as a binary time-invariant predictor, following a 3-step approach. A 3-class model showed the highest entropy (.859) and adequate posterior probabilities of class membership (≥ .884). Class 1 (n = 226, 59.9%) included children with low and stable ICU scores and low and descending stressful life-events; class 2 (n = 127, 33.7%) included children with high and ascending ICU scores and low and slightly descending stressful life-events; and class 3 (n = 24, 6.4%) included children with persistently high profiles both for ICU scores and stressful life-events. Carrying an A allele (genotypes GA/AA) increased the odds of pertaining to class 3 (high and persistent ICU scores and stressful life-events) as opposed to class 2 (OR = 4.27, p = .034) or class 1 (OR = 3.81, p = .042). The results suggest the importance of considering callous-unemotional traits and stressful life-events in conjunction. In addition, the genetic variability of OXTR (rs53576) may help to understand individual differences in early development.
Enlace al artículo en Journal of Abnormal Child Psychology

Irritability and parenting are potential targets for transdiagnostic studies to identify the common and core dysfunctional characteristics underlying several diagnostic pictures with the goal of addressing these issues in treatment. Our objective was to investigate the different paths from temperament to child psychopathology (affective, anxiety, and oppositional problems) through irritability and parenting using a prospective design from ages 3 to 7. A sample of 614 3-year-old preschoolers was followed at ages 4, 6, and 7. Parents answered questionnaires about temperament (age 3), irritability (age 4), parenting practices (age 6), and psychopathology (age 7). Statistical analyses were carried out through structural equation modeling (SEM) to test the mediation effect of irritability and parenting practices from temperament (negative affectivity and effortful control) through to affective, anxious, and oppositional problems. The proposed model fit the data well. SEM showed a) an indirect effect from temperament to affective problems, via irritability and positive parenting; b) a direct effect from negative affectivity to anxiety, plus an indirect effect from both temperament dimensions, via irritability and autonomy parenting practices; and c) an indirect effect from temperament to oppositional problems, via irritability and punitive parenting. Irritability and parenting are transdiagnostic mediational variables that should be focused on in intervention programs for affective, anxiety, and oppositional problems.
Enlace al artículo en Aggressive Behavior

Background: The Affective Reactivity Index (ARI) is a brief instrument originally designed as a self- and parent report. However, the view of teachers, who can observe social situations that may give rise to irritability, is relevant. The goal is to provide the measurement qualities of the ARI score as reported by teachers.. Method: Children formed part of a longitudinal study on behavior problems in Barcelona (Spain) and they were assessed when they were 7 (N=471) and 11 years old (N=454) with questionnaires about psychopathology, anger and aggressive behavior, and a diagnostic interview answered by the parents, youths and teachers. Confirmatory factor analysis, measurement invariance, reliability and validity were studied for the ARI answered by teachers..
Results: The 6-item, 1-factor model fitted well. Almost full metric invariance and partial scalar invariance was obtained across sex and over age. The ARI scores largely converged with other teacher-reported measures of anger and irritability, and with other measures of psychopathology, aggressive behavior, and callous-unemotional traits at a medium level. The associations with parent's measures were medium to low, and very low for child self-reported measures. The ARI scores significantly differentiated children with and without psychopathology and functional impairment, both cross-sectionally and longitudinally..
Limitations: Only one child self-report measure of irritability included. Limited internal consistency of some scale scores. Findings are mostly generalizable to Spanish children..
Conclusions: ARI could be a suitable instrument for measuring irritability as reported by teachers. The teacher's view can be useful when planning treatment by helping to identify treatment targets.
Enlace al artículo en Journal of Affective Disorders

El objetivo de este estudio fue analizar el malestar asociado a la psicopatología en niños y adolescentes. La muestra incluyó 330 sujetos entre 8 y 17 años que atendían a consulta externa en servicios de salud mental de la red pública de Barcelona (España), que fueron valorados a través de entrevista diagnóstica estructurada. Una parte significativa de los niños que solicitaron tratamiento sufrían malestar asociado a los síntomas psicológicos interiorizados y exteriori­zados. El malestar psicológico fue más frecuente en las chicas y entre los adolescentes y también fue más informado por los propios niños y adolescentes que por sus padres. El malestar fue un predictor de la percepción de necesidad de ayuda psicológica y se relacionó significativamente con los diagnósticos, condiciones subumbral y deterioro funcio­nal. Los síntomas individuales de depresión, distimia, ansiedad generalizada y trastorno negativista desafiante fueron los que más estrechamente se asociaron con el malestar psicológico. Dada la importancia del estrés subjetivo y del deterioro funcional para la identificación y definición de la psicopatología y para la planificación de las intervencio­nes, la evaluación diagnóstica debería incluir cuestiones referidas al malestar.
Enlace al artículo en Escritos de Psicología

This is a study of comorbid anxiety disorders and how they affect the clinical picture of comorbid cases. The sample consisted of 576 Spanish children aged 8 to 17 years receiving psychiatric outpatient consultation that were evaluated using a semi-structured diagnostic interview for both parents and children. A specific association of homotypic comorbidity among anxiety disorders that was independent of the presence of other disorders was found. There was heterotypic comorbidity between anxiety and depressive disorders, ADHD, anorexia and tic disorders. Relationships between non-anxiety disorders were, in general, independent of anxiety, but anxiety moderated the relationship between ADHD-Conduct disorder and Conduct disorder-enuresis. Comorbid anxiety increased difficulties in social interaction, was related with higher global impairment and had an impact on consultation and medication. Anxiety disorder comorbidity should be well recognized in order not to disregard the treatment of all present disorders.
Enlace al artículo en Journal of Psychopathology and Behavioral

This work addresses methodological and conceptual issues related to the translation of the DSM-IV diagnoses from verbal language into formal language through computerized algorithms, with the aim of guaranteeing its quality. A great number of biases can affect this process, so the main difficulties connected with each phase are outlined, proposals to standardize the process are advances, and practical solutions to avoid errors in the formal diagnostic definitions are presented. The steps followed are: (a) classification of the disorders in seven different groups depending on the diagnostic structure they have in the taxonomy; .(b) the creation of macros in SPSS and SAS languages that express formally the structures/groups identified; .(c) elaboration of 162 macro calls, specifiying formally all the particular diagnostic conditions for each DSM-IV disorder; and .(d) checking the correct functioning of the formal definitions proposed in a test data file (that has also been created in this work). .Moreover, because the standadization of the process that creates the diagnoses in programming language requires the homogenization of the variable names and the codification formats, we have produced a proposal compatible with the verbal language for identifying, through letters and numbers, all the DSM-IV criteria. The main contribution of this work consists of facilitating computerized and universal algorithms for obtaining automatically any DSM-IV diagnosis in three categories (present, absent, and not evaluable due to the lack of information) starting from a vector that includes all the criteria for that disorder. This study will also contribute to endowing the classification system most used inpsychopathology (DSM-IV) with greater methodological rigour.
Enlace al artículo en International Journal of Methods in Psychiatric Research

Reinforcement Sensitivity Theory has been applied to childhood psychopathology and the development of different types of personality in recent years. Few studies have reported evidence of the reliability/validity of specific measures based on this theory. The aim of this study was to assess the psychometric properties of the measures obtained through the Spanish version of the Sensitivity to Punishment and Sensitivity to Reward Questionnaire for Children (SPSRQ-C) in a community sample of N=478 children aged 6. Confirmatory Factor Analysis showed that the three-factor model was the best solution with indexes of moderate to good fit. Resulting factors were F1 sensitivity-to-punishment, F2 impulsivity/fun-seeking and drive and F3 reward-responsivity. High correlations were achieved between empirical SPSRQ-C factors and external measures: a) F1 largely correlated with anxiety–depression and internalizing problems, shyness and negative affectivity; b) F2 was strongly related to externalizing problems (attention-aggressive), activity level and surgency; and c) F3 achieved the highest correlations with externalizing problems. These results highlight the validity of the SPSRQ-C measures to be usedwith young children from the general population. Availability of accurate measures of response to punishment and reward is especially valuable in educational and therapeutic plans that include discipline and incentives as contingencies.
Enlace al artículo en Personality and Individual Differences

Abstract Objective To study socio-demographic and functional features related with non-collaboration in a longitudinal design of mental health within a high-risk population of individuals 9 and 13 years old. Method Regression analyses were used to assess factors affecting the decision to decline participation, and what characteristics both of children and families increase the probability of dropping out once the study had already started. Results Refusal of participation at the outset is more probable for lower socioeconomic groups, unemployed families (or with Social Security benefits), minority cultures and children having low school performance. The risk of participants dropping out is higher for adolescents, those who need help at school, are unhealthy, have more life-events, receive professional help for mental problems or have had more psychopathology in previous assessments. Lengthy interviews or evaluations without the return of reports to families are also predictive of drop out. Conclusions This study has practical implications for reducing the lack of collaboration in the prospective studies that assess mental health in children and adolescents. Improvement in the estimation of epidemiological indices requires the planning of special measures for research projects carried out on populations with fewer resources so as to recruit individuals with lower SES, adolescents, individuals with pathologies (physical or psychological) and those with lower levels of school achievement.
Enlace al artículo en Social Psychiatry & Psychiatric Epidemiology

Examines some of the characteristics of the informants as well as some of the attributes of the Diagnostic Interview for Children and Adolescents--Revised (DICA--R) interview that could influence the test-retest reliability in a sample of 109 psychiatric outpatients aged 7-17 years. Of those characteristics evaluated in the children, a high level of psychological impairment proved to be significant when it came to predicting the lowest test-retest reliability of the answers; none of the subject-related characteristics were significant in the adolescent patient model. The attributes of the questions that proved to be significant when explaining the lower reliability obtained for the individual question in the children's model were the length of the questions (longest questions), the content (internalising), the presence of time concepts, comparison with the peer group, and the need to exercise judgement; in the adolescents' model, the significant attributes were found to be the internalising content, the presence of time concepts, evaluation concerning the mpairment caused by the disorder, and the need to exercise judgement.
Enlace al artículo © Copyright 1998 Cambridge University Press

Objective To analyze information on attention deficit hyperactivity disorder (ADHD)–oppositional defiant disorder (ODD) and its consequences, provided separately or in combination by children and their parents in a longitudinal prospective study of 9–15 year-old children from the general population. Method Cross-sectional and longitudinal epidemiological indexes were compared for single and multiple reports. We evaluated which informant is required for the identification of each DSM-IV criterion. Logistic regressions determined which features were related with the reporting of the ‘‘absence of symptom s. Results Both informants were required in order to obtain complete psychopathological profiles. Single reports provide infra-estimated prevalences (between 8.8 and 22.9% of ADHD and between 1.7 and 7.6% of ODD), risks (around 3% for ADHD and 2% for ODD) and comorbidities. Psychological and functional measures analyzed in the study were relatively similar for cases presenting ADHD/ODD diagnosis, regardless of the diagnostic algorithm (based on single or combined reports); however, these clinical profiles were different to those obtained for non diagnosed children. The main predictors of not reporting the presence of psychopathology were: large families (OR between 2 and 2.5), children that are conflictive at school (OR ranging between 1.3 and 4.3) or those with poor mental health (OR between 1.1 and 1.6). Conclusions These results may provide guidance for obtaining accurate diagnostic information, properly identifying children with mental health needs and planning the required preventive and corrective measures.
Enlace al artículo en European Child & Adolescent Psychiatry

Abstract. Objective: To compare the predictive validity of different diagnostic classifications for disruptive behavioral disorder (DBD) in youths aged 9 to 15 years of age: the DSM-IV categorical diagnosis, the number of DSM-IV DBD symptoms and Achenbachs taxonomy (Child Behaviors Checklist scores for social problems, rule-breaking behaviors, aggressive behaviors, and attention problems). The incremental validity, after including clinical structured interviews with parents and children into models that contained CBCL scores, is reported. Method: Longitudinal study in a Spanish high-risk population, comparing each classification in 1 and 2-year follow-ups. Both predictors and criteria pertain to measures of the same class of behaviors: clinical information regarding impairment at school and community. Results: Predictive accuracy was dependent on the specific outcomes and the childrens age. The CBCL scores obtained the best predictive results. Dimensional approaches (the number of DSM-IV DBD symptoms and CBCL) obtained higher R2 values than categorical DSM-IV diagnosis. Assessment based on clinical interviews with family significantly increased the predictive validity of Achenbachs taxonomy. Conclusions: These results provide guidance for detecting early disruptive behaviors and planning measures for the prevention of subsequent antisocial conduct. This work may provide direction to future validation studies of classifications and diagnostic systems for behavioral adjustment in youths.
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Objectives. To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in  preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the  independent variable and the parenting style and the children’s executive functioning (EF) as the mediating factors. Method. The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. Results. Structural Equation Modeling showed that the associations between SES, EF, parenting style and ODD levels differed by children’s gender: a) for girls, the association of low SES and high ODD scores was partially mediated by difficulties in EF inhibition, and parenting practices defined by corporal punishment and inconsistent discipline obtained a quasi-significant indirect effect into the association between SES and ODD; b) for boys, SES and EF (inhibition and emotional control) had a direct effect on ODD with no mediation. Conclusion. SES seems a good indicator to identify children at high-risk for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control.
Enlace al artículo en Frontiers in Psychology

El Achenbach System of Empirically Based Assessment (ASEBA) es un ejemplo de los esfuerzos realizados para converger los métodos de evaluación categoriales y dimensionales. El Child Behavior Checklist (CBCL) y el Youth Self-Report (YSR) han incluido en su última edición las Escalas DSM, construidas de modo racional a partir de los ítems que forman parte de estos inventarios. Objetivo: Analizar las propiedades psicométricas de las Escalas DSM de los cuestionarios CBCL y YSR. Método: Se evaluó una muestra clínica de 420 niños y adolescentes (8-17 años) con los cuestionarios CBCL y YSR, con una entrevista diagnóstica estructurada y con medidas de deterioro funcional para estudiar la fiabilidad y validez de las Escalas DSM. Resultados: La consistencia interna osciló entre moderada y buena en todas las escalas, excepto en la Escala DSM-Pr.Ansiedad. El acuerdo entre padres e hijos fluctuó entre valores moderados y bajos. Los coeficientes Kappa mostraron una concordancia moderada en los diferentes síntomas. Las Escalas DSM presentaron un aceptable  poder diagnóstico sobre los trastornos DSM-IV y una relación significativa con medidas de deterioro funcional. Conclusión: Las Escalas DSM son una aproximación útil desde el modelo dimensional a los trastornos DSM-IV en población clínica española.
Enlace al artículo en Spanish Journal of Psychology

Background: The school-age versions of the ASEBA (Achenbach System of Empirically Based Assessment) incorporate the DSM-Oriented scales. These scales make it possible to quantify and normalize problems defined in the DSM. The objective was to study the incremental validity of the DSM-Oriented scales of the ASEBA inventories, the Child Behavior Checklist - CBCL, completed by parents of children aged 6-18 years, and the Youth Self-Report -YSR, a self-report for children/adolescents aged 11-18, over: (a) scores on the Syndromes Scales for making DSM-IV diagnoses; and (b) diagnoses obtained with structured interviews for the assessment of functioning. Method: A clinical sample of 420 children and adolescents (8-17 years) was assessed with the CBCL, and 108 adolescents were assessed with the CBCL and YSR questionnaires. All underwent a diagnostic interview, and interviewers completed a measure of global functional impairment. Results: The DSM-Oriented scales showed significant incremental validity in conjunction with the Empirical Syndrome scales for discriminating DSM-IV diagnoses, and considerable incremental validity in conjunction with the diagnoses obtained through the diagnostic interview for predicting the level of functional impairment. Conclusion: DSM-Oriented scales should be considered simultaneously with the Syndrome Scales of the ASEBA taxonomy, as they provide useful additional information in the clinical process.
Enlace al artículo en Psicothema

Background and objectives: The aim of the study is to identify factors related to comorbid oppositional defiant disorder (ODD) and anxiety disorders (ADs). Design: A sample of 622 children was assessed longitudinally at 3 and 5 years of age. Methods: At baseline, there were 310 boys (49.8%), most participants were of Caucasian–white ethnicity (89.1%) and attended to public school (64.0%), and families’ socioeconomic status was 64.3% medium-high, 14.1% medium and 20.5% medium-low. Children diagnosed with ODD and/or AD were selected: n = 103 at 3 years of age (44 ODD, 42 AD and 17 ODD + AD) and n = 106 at 5 years of age (31 ODD, 60 AD and 15 ODD + AD). Results: High levels of the child’s negative affectivity and the mother’s aggressive behavior (versus AD), and high scores in the father’s psychopathology measurements (versus ODD) were related to the
. presence of comorbid ODD + AD at 3 years of age. High scores in approach-positive anticipation, fears (only in boys, in girls the reverse effect occurred) compared to ODD and AD independently and aggressive behavior (versus AD), and low scores for smiling and laughter (versus ODD only and AD only) were predictive of comorbidity at the 5 years of age. Conclusions: Temperament traits may be a common factor in explaining longitudinal ODD + AD comorbidity.
Enlace al artículo en Anxiety, Stress and Coping

Background: The aim was to study the comorbidity of oppositional defiant disorder (ODD) and anxiety disorders (AD) among preschool children of the general population, and to assess the contribution of comorbidity to the childs functional impairment. Method: 622 children were assessed at the ages of 3 and 5, through a diagnostic interview. They were clustered into three diagnostic groups: only ODD, only AD and comorbid ODD+AD. Results: At age 3, ODD was associated with specific phobia, OR = 4.7, 95% CI [1.4, 14.1], and at age 5, with any anxiety disorder, OR=3.9; 95% CI [1.8, 8.4]. ODD at age 3 was predictive of separation anxiety at age 5, OR=4.1; 95% CI [1.2, 14.3]. Comorbid ODD+AD cases showed a higher risk of functional impairment at school and in behavior toward others. Sex and socioeconomic status were not related to the diagnostic group. Conclusions: ODD+AD comorbidity can be identified in preschool children. Early identification of this association is needed to adequately treat the affected children.
Enlace al artículo en Psicothema

.The current study examined the independent effects of mothers' childhood abuse (CA) and intimate partner violence (IPV) on psychopathology and functional impairment in children;
. and the potential moderating and mediating role of individual and family factors in these relationships. Additionally, this study explored the potential cumulative effects of both maternal CA and IPV on children's outcomes. Method: The sample included 547 Spanish children and adolescents aged between 8 and 17 years, and their parents, who had accessed mental health services. The assessment was based on structured interviews with the children and their parents. Statistical analyses were carried out through hierarchical multiple, negative-binomial and logistic regressions, and Structural Equation Models. Results: Children whose mothers experienced CA and those whose mothers suffered physical IPV showed increased DSM-IV disruptive disorders and externalizing behavior problems, respectively. Children who directly observed physical IPV and also suffered physical punishment by parents showed increased internalizing problems. IPV had effects, either direct or indirect by physical punishment, on children's externalizing problems. Cumulative effect analyses indicated that theprevalence of disruptive disorders was highest in children whose mothers had suffered both CA and IPV. Conclusion: Spanish children whose mothers have suffered CA, IPV or both, are at high risk of serious conduct problems, whereas children exposed to IPV and who were also physically abused are at greater risk of internalizing problems. Physical punishment of children contributes in part to explainexternalizing problems of IPV-exposed children. These findings indicate potential targets of assessment and intervention for families seeking help in mental health services.
Enlace al artículo en Child Abuse and Neglect

This study examined the mediator role of mothers mental health in the relationship among maternal childhood abuse, intimate partner violence and offsprings psychopathology, and explored whether mediational pathways were moderated by childrens sex. Participants were 327 Spanish outpatient children, 8-17 years-old, and their mothers. Mothers global psychological distress and depressive symptoms mediated the associations between mothers violence history and childrens externalizingproblems. However, only depressive symptoms fully mediated these relationships. Childrens sex did not have a moderating role in adjusted paths. Mothers depressive symptoms are an importantmechanism by which maternal violence experiences could affect externalizing problems in Spanish children.
Enlace al artículo en Violence Against Women

The aim of the study was to examine whether maternal depression, mothers and fathers parenting, child physical punishment and negative life events (NLE) mediate the effect of maternal childhood abuse (CA), intimate partner violence (IPV) and cumulative violence (both CA and IPV) on Spanish childrens and adolescents psychopathology. Furthermore, multiple mediator models examine whether IPV mediates the effect of CA on the contextual and family factors mentioned above. Three hundred and eighteen Spanish outpatients aged 7 to 18 and their parents were assessed using a structured interview and other instruments for measuring the study variables. Structural equation models (SEMs) showed multiple pathways explaining psychopathological problems among offspring of mothers who suffered CA, IPV and both of these violent experiences. In particular, mothers depression mediated the link between maternal CA, IPV, cumulative violence and childrens externalizing, and total behavior problems. Child NLE was an important pathway between maternal CA and total behavior problems, as well as between cumulative violence and both externalizing and total problems. IPV contributed to explaining the link between maternal CA and contextual and family factors, such as child physical punishment and NLE, which were in turn, associated with childrens behavior problems. Findings show the complex interconnections between different types of violence and their harmful effects on the mental health of women and their offspring, as well as the need to extend our knowledge on this subject.
Enlace al artículo en Journal of Interpersonal Violence

Applied receiver operating characteristic (ROC) curve analysis to results obtained with the Child Behavior Checklist (CBCL). Human Ss: 144 male and female Spanish school-age children and adolescents (aged 6-17 yrs) (psychopathology) (psychiatric patients). 52 normal male and female Spanish school-age children and adolescents (aged 6-17 yrs) (pediatric patients). CBCL scores were analyzed using 3 classification criteria (external validators): (1) patient population (pediatric vs psychiatric), (2) results obtained with the Diagnostic Interview Schedule for Children and Adolescents--Revised (W. Reich et al, 1991), and (3) clinical diagnosis using the Mental Disorders-III-Revised (DSM-III-R) Checklist (L. Ezpeleta, 1994). The optimal cut-off on the CBCL as a screening test was determined.
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Abstract
Introduction.
School victimization by peers is an important social problem with serious short- and long-term consequences poorly studied at preschool ages, which can lead to school bullying without timely intervention. Longitudinal data was used to determine the prevalence of warning signs of preschool peer victimization and its individual and family risk factors.
Methods
Data was obtained from 577 community preschoolers. School victimization was measured using the Strengths and Difficulties Questionnaire (SDQ) administered to parents and teachers of children at ages 4 and 5. Risk factors for the child (demographics, conduct and emotional problems, aggressiveness) and the family (maternal problems during pregnancy and early development, parenting styles, adaptive functioning and parents’ problems) were previously recorded at 3 years old.
Results
Combined information from parents and teachers showed that 4.2% of preschoolers presented warning signs of victimization at ages 4 and 5. Low socioeconomic status, poor emotional control, early problems making friends and low level of parenting education in social norms at age 3 predicted later victimization at ages 4 and 5 (AUC = .78).
Conclusion
Peer victimization affects a considerable percentage of preschoolers. Early detection may help to reduce the risk of escalation.
Enlace al artículo en PloS One

The aim of this study is to examine whether children and adolescents exposed to interparental physical and environmental violence have specific needs when seeking public mental health services compared to non-exposed outpatients. The witnessing of intimate partner violence (IPV), psychopathology, functional impairment, and several individual and family variables were assessed in 520 children aged 8 to 17 years. Results showed that living with violent parents at home increased the child's risk of posttraumatic stress disorder, dysthymia, self-harming behavior, and functional impairment. Exposed children's mothers we're more likely to overprotect their sons, punish their daughters and report greater psychopathology, whereas fathers who engaged in marital violence displayed greater emotional distress and were more likely to punish and reject their children. The child's sex moderated the IPV effects on parenting, parental discipline, child's life events and health appraisal. Given the specific clinical profile of exposed children, mental health services should develop schedules to detect, assess, and treat these cases.
Enlace al artículo en Children and Youth Services Review

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Se sintetizan las áreas principales de evaluación psicológica en niños y adolescentes expuestos a violencia doméstica. Las características de la situación vivida (violencia doméstica), los efectos de la misma sobre la salud mental y el funcionamiento cotidiano de los niños y adolescentes y las variables mediadoras de carácter individual, familiar y social son objeto de atención en el proceso de evaluación. Se remarca la importancia de considerar a los niños expuestos a violencia doméstica en el proceso de evaluación y de intervención psicológica. Se proponen diferentes instrumentos apropiados para evaluar cada una de las variables intervinientes.
The main psychological assessment areas in children and adolescents exposed to domestic violence are synthesized. Violence characteristics, their effects on children and adolescents mental health and daily functioning as well as individual, familiar and social me-diator variables are focused in the assessment process. The idea of considering children exposed to domestic violence in theassessment-intervention process is highlighted. Several instruments appropriated to assess each of the participant variables.
Enlace al artículo en Papeles del Psicólogo

The aim of the study is to estimate the prevalence of feeding problems during the preschool period and to explore the associations of feeding related behaviors with parenting practices. Participants were a large community sample of N = 622 children longitudinally assessed yearly at ages 3, 4 and 5 years-old through diagnostic interview and questionnaires reported by parents. The prevalence of children who met DSM-IV criteria for feeding disorder during the follow-up was 1.6%, the amount of children who presented feeding disorder symptoms was 33.3%, those with clinical impairment due to these symptoms were 25.7% and 11.6% reported seek for professional help related to feeding problems. Logistic regressions adjusted to children’s sex and other DSM-IV diagnoses different to feeding disorder showed that the dimensions of parenting more strongly related to feeding related behaviors and impairment due to feeding problems were poor monitoring, inconsistence practices, corporal punishment, low norms and low autonomy. Although the prevalence of preschool children who met DSM-IV criteria for feeding disorder was relatively low, the presence of feeding related behaviors (symptoms, impairment and consultation) was common during this developmental period. Parenting practices are associated to the presence of these behaviors, and so they must be considered into the prevention and intervention programs
Enlaceal artículo en la Revista Microsoft Word - 2015, vol12(2).docx (uned.es).

El artículo examina la fiabilidad entre entrevistadores de la Diagnostic Interview for Children and Adolescents-Revised (DICA-R). El estudio se llevó a cabo con un total de 45 entrevistas, en las cuales participaron un examinador y un observador. Se describe de manera exhaustiva el procedimiento de entrenamiento. Los resultados muestran que la DICA-R es un instrumento objetivo que puede ser utilizado por personas legas si se les proporciona un entrenamiento adecuado. Se pone énfasis en la necesidad de que los diseños para estudiar la fiabilidad entre examinadores sean estrictos.
Enlace al artículo © Copyright 1996 Psicothema

This paper examines the convergent validity of the Diagnostic Interview for Children and Adolescents – Revised (DICA-R), using the Child Behavior Checklist of T.M. Achenbach as a criterion. The ability of the instrument to detect subjects with psychopathology in the general population is also studied. The study was made through 196 interviews with psychiatric patients and 130 interviews with subjects from schools and paediatric services. The results obtained with the DICA-R are comparable with those obtained from another instruments that are widely accepted and considered as valid, The interview is a valid instrument for use in epidemiological research, as it can distinguish correctly between controls and cases.
Enlace al artículo © Copyright 1997 Psychology in Spain

Early detection of mental health problems is important. The implication of primary care professionals and the adequacy of instruments could be of great help. Objective: To study the validity of a brief questionnaire based on psychosocial functioning to detect mental health problems in a high-risk general population. Study group: 151 children and adolescents were assessed as part of a longitudinal 3 year follow-up study of two cohorts born in 1989 and 1993, respectively. Method: semi-structured diagnostic interviews were used to evaluate their psychopathological condition, to test for functional impairment, and to determine whether it would be appropriate for them to be referred to Mental Health Services. Parents also answered a Brief Mental Health Screening Questionnaire (BMHSQ) containing questions about main psychosocial functioning areas. Logistic and multiple regressions were applied to study the predictive power of the questionnaire. Results: The BMHSQ showed good clinical screening properties and was useful in determining who should be addressed to a specialized psychopathological service. Conclusion: General practitioners could play an essential role in detecting and referring such disorders if provided with the proper tools. The use of brief questionnaires on functioning and outcomes in pediatric practice could improve comprehensive health care for children and adolescents. Rapid detection of mental health problems in a primary care setting is possible, as is better use and planning of health services.
Enlace al artículo en Journal of Adolescent Medicine and Health

This article reports on the diagnostic validity of the Dominic Interactive Assessment (DIA) in a sample of Spanish children exposed to intimate partner violence (IPV). The study participants included 55 children aged between 6 and 11 years whose mothers visited an IPV counselling centre. Psychopathology and functional impairment were used as the main criteria for assessing DIAs predictive and discriminative accuracy as well as incremental validity. The results indicate that DIA permits to obtain useful information from children. This information improves the prediction and validity of the process of clinical assessment of children exposed to IPV. Childrens self-reports could prove effective in identifying cases in this high-risk population when developmentally adequate instruments and functional criteria are used.
Enlace al artículo en Psicothema

El trabajo que presentamos ofrece los primeros resultados correspondientes a la adaptación y validación en población española del Child Behavior Checklist 2/3 siguiendo estrictamente la metodología propuesta por los autores de la prueba (Achenbach, Edelbrock y Howell, 1987). Los datos corresponden a la aplicación del cuestionario en una muestra aleatoria de población normal. Se informa del resultado del análisis de ítems, las diferencias entre sexo y la estructura factorial de la prueba en nuestro país. A falta de la aplicación en muestra clínica, los resultados se asemejan a los obtenidos con el instrumento original.

The goal of the study was to examine the affective-cognitive components of Theory of Mind (ToM), in a community sample of 538 preschoolers, and more specifically in a subsample of 40 children diagnosed with Oppositional Defiant Disorder (ODD). The relationship between affective and cognitive ToM and some ODD clinical characteristics was examined. Children were assessed with structured diagnostic interviews and dimensional measures of psychopathology, impairment and unemotional traits. A measure based on eye-gaze was used to assess ToM. Mixed analysis of variance compared the mean cognitive versus affective scale scores and the between-subjects factor ODD. The association between ToM-scores and clinical measures was assessed through correlation models.  Execution and reaction time to emotional and cognitive components of ToM tasks are different at age 5 in normally developing children. Oppositional Defiant children had slower response time when performing the affective mentalizing condition than children without the disorder. The correlation matrix between ToM-scores and clinical measures showed specific associations depending on the impaired ToM aspect and the psychological domain. Results may have clinical implications for the prevention and management of ODD.
Enlace al artículo en Psychiatry Research

Parenting practices should be assessed and taken into account at an early age, since it is well documented that they are strongly related to childrens development. This study provides data on the psychometric properties of a Spanish version of the Alabama Parenting Questionnaire for Preschool children (APQ-Pr). A community sample of 622 (310 boys and 312 girls) 3 year-old children and their parents, participated in the study. Data were obtained from parents reports and correspond to a semi-structured diagnostic interview and self-report questionnaires evaluating parenting and childrens psychological states. Confirmatory factor analysis supported a three-factor solution: positive parenting, inconsistent parenting and punitive parenting. These scales scores showed moderate to good internal consistence (omega values ranged from .54 to .86). Inconsistent parenting scores achieved the strongest associations with external measures of psychopathology, especially for externalizing and conduct problems, as well as for functional impairment, the poorest associations being for the positive parenting scores. Results support the validity of the Spanish APQ-Pr, which is potentially a useful measure for the study of parenting practices regarding preschool children and their relation to conduct problems.
Enlace al artículo en Journal of Child and Family Studies

The aim was to test the internal structure of scores on the short and very short forms of the Childrens Behavior Questionnaire (CBQ) scale and to study the relationship between the dimensions derived and external variables previously related to extreme temperament in a Spanish community sample. The sample comprised of 622 three-year-old children participating in a longitudinal study. Data were obtained from parents and teachers through a semi-structured diagnostic interview and questionnaires evaluating childrens characteristics and psychological states. Results showed a three-factor structure and moderate reliability of the scale scores for both the short and very short forms. Associations were found between the Surgency/Extraversion dimension and attention-deficit/hyperactivity disorder and externalizing problems, between Negative Affect and internalizing and emotional problems, and between Effortful Control and attention, externalizing, and social problems and other executive function measures. Salient temperamental characteristics predicted psychopathological disorders and impairment at ages 3 and 4. The short forms of the CBQ provide reliable and valid scores for assessing temperamental characteristics in the preschool years.
Enlace al artículo en Assessment

This study provides data on the usefulness of the Spanish version of the Social and Communication Disorders Checklist (SCDC; Skuse et al., 1997), in terms of the validity and reliability of derived scores. Data were obtained from parents interviews and parents and teachers questionnaires that measured different psychological variables from a community sample of 579 (291 boys and 288 girls), 5-year-old children. These children were tested to assess their intellectual capacity. Confirmatory factor analyses yield a one-dimensional structure invariant across sex within each informant (parents or teachers), with negligible latent mean differences between boys and girls for both informants (parents-teachers). The internal consistency was satisfactory (alpha values ≥ .85 for teacher version and ≥ .75 for parent version). SCDC scores correlated with specific scales related to developmental problems, aggressive behavior, executive functioning, and uncaring behavior towards others. SCDC scores were unrelated to intelligence quotient, whereas SCDC scores were associated with the presence of disruptive disorders, measured with diagnostic interview. Results provide evidence on reliability and validity of SCDC scores, which is potentially a useful measure for the study of social cognition and its relationship with preschool adjustment.
Enlace al artículo en European Journal of Psychological Assessment

This paper studies the discriminative capacity of CBCL/1½-5 (Manual for the ASEBA Preschool-Age Forms & Profiles, University of Vermont, Research Center for Children, Youth, & Families, Burlington, 2000) DSM5 scales attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety and depressive problems for detecting the presence of DSM5 (DSM5 diagnostic and statistical manual of mental disorders, APA, Arlington, 2013) disorders, ADHD, ODD, Anxiety and Mood disorders, assessed through diagnostic interview, in children aged 3–5. Additionally, we compare the clinical utility of the CBCL/1½-5-DSM5 scales with respect to analogous CBCL/1½-5 syndrome scales. A large community sample of 616 preschool children was longitudinally assessed for the stated age group. Statistical analysis was based on ROC procedures and binary logistic regressions. ADHD and ODD CBCL/1½-5-DSM5 scales achieved good discriminative ability to identify ADHD and ODD interview’s diagnoses, at any age. CBCL/1½-5-DSM5 Anxiety scale discriminative capacity was fair for unspecific anxiety disorders in all age groups. CBCL/1½-5-DSM5 depressive problems’ scale showed the poorest discriminative capacity for mood disorders (including depressive episode with insufficient symptoms), oscillating into the poor-tofair range. As a whole, DSM5-oriented scales generally did not provide evidence better for discriminative capacity than syndrome scales in identifying DSM5 diagnoses. CBCL/1½-5-DSM5 scales discriminate externalizing disorders better than internalizing disorders for ages 3–5. Scores on the ADHD and ODD CBCL/1½-5-DSM5 scales can be used to screen for DSM5 ADHD and ODD disorders in general populations of preschool children.
Enlace en European Child & Adolescent Psychiatry

Exposure to greenspace has been associated with mental health benefits in children; however, the available evidence for such an association with anxiety is still scarce. This longitudinal study aimed to evaluate that association on a community cohort of 539 children, from Barcelona province, followed from 3 to 11 years. Long-term exposure to greenspace was characterized at both residential address and school as (i) surrounding greenspace based on satellite-derived indexes (normalized difference vegetation index (NDVI) and Vegetation Continuous Field (VCF) across different buffers and (ii) distance to the nearest green space. We characterized anxiety using the Child Behavior Checklist and the Spence Children's Anxiety Scale, and cross-sectionally and longitudinally analyzed the associations between the greenspace exposure and the anxiety, using linear mixed models. Higher greenspace surrounding home and school were associated with lower levels of anxiety. Our findings suggest that increasing exposure to greenspace, specially at schools, could be included in preventive policies to promote mental health in children.
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Background: Hostile Attributional Bias (HAB) has been related to conduct problems. The common and unique associations between the different dimensions of Oppositional Defi ant Disorder (ODD) symptoms, specifi ccomponents of HAB, sex and types of aggression (overt and relational) in a community sample of 491 7-year-old children are investigated. Method: Teachers rated the children’s ODD symptoms and aggression and the children self-reported about HAB. Multiple linear regressions showed that ODD dimensions were directly associated with both types of aggression. Results: Boys were more overtly aggressive and girls more relational. Emotional distress was directly associated with relational aggression. The relational component of HAB uniquely moderated the infl uence of the oppositional dimension on relational aggressive behaviour. Conclusions: The assessment of social cognition variables is necessary to approach specifi c interventions in the presence of ODD symptoms, as this may help to identify a subset of children prone to aggressive reactions.
Enlace al artículo en Psicothema

Aim: To study the prevalence of subthreshold Oppositional Defiant Disorder (ST ODD) - less than 4 symptoms, but nonetheless an impairing form of Oppositional Defiant Disorder (ODD) - its coexistence with other homotypic externalizing and heterotypical internalizing problems in children and associated impairment, as well as the long-term effect of this condition. Methods: A population-based sample of 622 preschoolers (50.0% boys) was followed up from preschool to preadolescence. Parents were interviewed when the children were 3, 6 and 9 years old with the Diagnostic Interview for Preschoolers/Children and Adolescents versions following DSM-5 and the children’s functioning was assessed by trained clinicians. Results: ST ODD diagnosis is highly prevalent (19.4%-25.5%), highly comorbid [homo- (10.9%-18.4%) and heterotypical (5.8%-23.7%)], resulting in functional impairment across child development in a similar way for both genders. ST is also a risk factor condition that predicts the presence of psychological problems and impairment in childhood and preadolescence from preschool age. Conclusion: A broader clinical assessment and intervention similar to that provided to full syndrome cases is needed for children presenting subthreshold forms of ODD.
Enlace al artículo en European Child and Adolescent Psychiatry

This longitudinal study aims to define the developmental trajectories of social cognition (SC) in a community sample (N = 378) assessed from preschool (3 years old) to preadolescence (12 years old). Parents and teachers reported on a SC measure at ages 5, 10, and 12. We tested the existence of different trajectories and whether they discriminated outcomes in early adolescence. The data were collected from different sources, the children, the parents, and teachers, by means of different methods. Using Growth Mixture Modeling (GMM), we identified three distinct social cognition trajectories: persistently mild difficulties reported by parents and teachers (7.9% of the children), stable low problems reported by parents and increased difficulties reported by teachers (10.5% of the sample), and stable low problems reported by both informants for most of the participants (81.5%). Comparison of the psychological outcomes between classes using regression models showed that the two trajectories including children with any level of problems differ from the normative one as regards their association with psychological problems, daily functioning, and variables such as aggressive behavior and callousness. The two non-normative trajectories also differ from each other in terms of the personal characteristics of the adolescents included in them. Adolescents in the increasing problematic class in the school have a tougher and more problematic style of social relating, while children with persistent and non-context-dependent difficulties are more anxious. These results might help to better detect and design specific interventions for children with deficits in SC that might respond to different personal characteristics leading to different outcomes.
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This work tackles the measurement invariance of the social cognition construct when different observers, age and participant’s age are considered. This is a prior question that needs to be answered before attributing discrepancies in information coming from diverse sources just to the varying behavior occurring across setting, and mainly interpret the discrepancies as indicative of cross-contextual variability. The article also studies the link between discrepancies and source-specific information and the validity of that information to predict several outcomes. The measurement invariance across sex, time and informant of a social cognition measure applied to children’s parents and teachers was longitudinally tested in a Spanish general population sample, at ages 5 (N = 581) and 10 (N = 438). Full or partial metric and scalar equivalence were found across sex and over time within informants. Partial scalar invariance was not obtained across informants. Latent class analysis identified 2 classes of difficulties in social cognition for both informants at both ages: low social cognition and high social cognition. Comparison of classes resulting predicting outcomes yielded differential predictions due not only to varying context but also to a different concept of social cognition across informants. In general, significant differences between raters were informant dependent. We conclude that it is important to consider both teachers’ and parents’ observations to fully understand the construct of social cognition.
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We provide the first validation data on the Spanish version of the Brief Problem Monitor-Parent form (BPM-P), a recently developed abbreviated version of the 120-item Child Behavior Checklist for Ages 6 to 18 (CBCL/6–18) in young schoolchildren. Parents of a community sample of 521 children aged 6–8 answered the CBCL/6–18 yearly, and the 19 BPM-P items were examined; parents also provided different measures of psychopathology. Confirmatory factor analysis of the expected 3-factor model (attention, externalizing, and internalizing) showed adequate fit (root mean square error of approximation, RMSEA _ .057), and measurement invariance across sex and age was observed. Internal consistency for the derived scores was satisfactory (_ _ .83). Concurrent validity with the equivalent scale scores of the original full CBCL/6–18 (r _ .84) and convergent validity with parents’ ratings of the Strengths and Difficulties Questionnaire scores (r _ .52) were good. BPM-P scores at age 7 showed good predictive accuracy for discriminating the use of mental health services (OR _ 1.12), functional impairment (B _ _1.25), and the presence of the corresponding disorders diagnosed with an independent clinical interview, both cross-sectionally at age 7 and longitudinally at age 8 (OR _ 1.24). The BPM-P provides reliable and valid scores as a very brief follow-up and screening tool for assessing behavioral and emotional problems in young schoolchildren.
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Objectives: The aim of this study was to evaluate the psychometric properties of the Spanish version of the short Egna Minnen Beträffande Uppfostran–Adolescent version (S-EMBU-A) in a clinical context. Methods: The S-EMBU-A is a 22-item self-report questionnaire, based on the original 64-item EMBU-A, that assesses perceived parental rearing style in adolescents, comprising 3 subscales (Rejection, Emotional Warmth, and Overprotection). The questionnaire was administered to a clinical sample of 281 Spanish psychiatric outpatients aged 13 to 18 years. Confirmatory factor analysis was performed, analyzing the adolescents' reports about their parents' rearing style. Results: Confirmatory factor analysis yielded an acceptable fit to data of the 3-factor model (comparative fit index = 0.90; root mean squared error of approximation = 0.054) and parameters were equivalent for the ratings assigned to fathers and mothers. Satisfactory internal consistency reliability was obtained for the 3 scales (Cronbach α ≥ .74). The influence of gender (of adolescents and parents) and age on scale scores was inappreciable. High scores for Rejection and low scores for Emotional Warmth were related to bad relationships with parents, absence of family support, presence of rejection, harsh discipline, and lack of parental supervision. Conclusions: The Spanish version of S-EMBU-A can be used with psychometric guarantees to identify rearing style in psychiatric outpatients, because evidence of quality in clinical setting matches that obtained in community samples.
Enlace en Comprehensive Psychiatry

Background: We provide the first validation data of the Spanish version of the Egna Minnen Beträffande Uppfostran—Child Version (EMBU-C) in a clinical context. The EMBU-C is a 41-item self-report questionnaire that assesses perceived parental rearing style in children, comprising 4 subscales (rejection, emotional warmth, control attempts/overprotection, and favoring subjects). Methods: The test was administered to a clinical sample of 174 Spanish psychiatric outpatients aged 8 to 12. Confirmatory factor analyses were performed, analyzing the children's reports about their parents' rearing style. Results: The results were almost equivalent for father's and mother's ratings. Confirmatory factor analysis yielded an acceptable fit to data of the 3-factor model when removing the items of the favoring subjects scale (root mean squared error of approximation b0.07). Satisfactory internal consistency reliability was obtained for 2 of the 3 scales, rejection and emotional warmth (Cronbach α N.73), whereas control attempts scale showed lower values, as in previous studies. The influence of sex (of children and parents) on scale scores was inappreciable and children tended to perceive their parents as progressively less warm as they grew older. As predicted, the scores for rejection and emotional warmth were related to bad relationships with parents, absence of family support, harsh discipline, and lack of parental supervision. Conclusions: The Spanish version of EMBU-C can be used with psychometric guarantees to identify rearing style in psychiatric outpatients because evidences of quality in this setting match those obtained in community samples.
Enlace al artículo en Comprehensive Psychiatry

Previous studies have shown that there are several significant early-life risk factors associated with childhood overweight. However, research has mainly focused on school-aged children. The aim of this study is to identify risk factors in early life for overweight in a community sample of Spanish preschoolers. A sample of 622 three-year-olds was monitored until the age of 5, and their height and weight were registered annually. Overweight status was defined by World Health Organization standards. A large set of risk factors including sociodemographic variables, family structure, pregnancy, birth, postnatal period, school and neighborhood were measured through semi-structured interviews. Stepwise logistic regressions created predictive models with the best predictors of overweight for each age group. This is the first longitudinal study to examine a large set of risk factors among Spanish preschoolers. Several potential early risk factors in preschool children were associated with later overweight: high birth weight, ethnicity, excess screen time, low attention span, maternal smoking during pregnancy, inconsistent discipline, fewer rules, corporal punishment and parents psychopathology. Among them, the most powerful factor was high birth-weight (odds ratio=1.89 at age 3, 1.87 at age 4, and 2.35 at age 5), underlining the importance of weight monitoring from postpartum and routine screening for overweight in children who have high birth weight. With the increasing prevalence of overweight in children at early ages, understanding the determinants for overweight risk becomes crucial for public health professionals and policy-makers in order to implement effective prevention and intervention programs.
Enlace al Artículo en Acción Psicológica

Objective To examine cross-sectional and longitudinal associations between behavioral problems and weight status, considering body mass index (BMI) z-scores and overweight status, in a community sample of preschoolers. Methods The Strengths and Difficulties Questionnaire and the Diagnostic Interview for Children and Adolescents were administered to 611 parents. Adjusted general linear models and binary logistic regressions were used. Results Children who were overweight and had a higher BMI were at increased risk of peer problems and attention-deficit/hyperactivity disorder (ADHD) symptoms. Prospective analyses showed that a higher BMI at the age of 3 years was predictive of peer problems at ages 4 and 5 years and hyperactivity and ADHD symptoms at the age of 4 years. Conclusion This is the first study using a diagnostic- based instrument that shows a relationship between weight status and ADHD symptoms in preschoolers. Overweight children might benefit from screening for behavioral disorders and peer relationship problems.
Enlace al artículo en Journal of Pediatric Psychology

Callous Unemotional (CU) traits are associated with different environmental risk factors, such as negative stressful life events (SLE). The most common studied SLE associated with CU trait has been childhood maltreatment, but less is known about how other SLE impact the development of CU traits. Therefore, this work examines risk factors, personal factors (executive functioning), and mental health outcomes associated with the trajectories of Callous Unemotional (CU) traits and Stressful Life Events (SLE) in a community sample of children. A cohort of 377 preschoolers were followed up between ages 3 and 10. Several risk factors and outcomes for three trajectory groups (high CU/SLE; high CU/low SLE; and the reference group with low CU/SLE) were analyzed by using multiple post-hoc comparisons. We hypothesized that children with high CU/SLE would face more contextual risk factors, more executive functioning difficulties and more mental health problems than children with high CU/low SLE or the reference group. At the age of 3, children who showed high CU/SLE faced more early contextual adversity, including socioeconomic difficulties and maternal antisocial behavior than the other groups of children. At the age of 10, children with high CU/SLE presented more peer problems and higher psychopathology symptoms than the reference group, but no differences on mental health outcomes in comparison to the high CU/low SLE group. These results have potential implications for clinical practice and studies attempting to identify different CU subtypes in children.
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This longitudinal study aims to provide meaningful cut-off scores for total score of the teacher-rated Inventory of Callous Unemotional Traits (ICU) from the preschool age until early adolescence, separately by age and sex. The ICU cut-off scores were determined by using low/high trajectories of oppositional defiant problems and conduct problems in a Spanish community sample of 620 children that were followed up between the ages of 3 and 13. Receiver operating characteristic (ROC) curves with the two trajectories as criteria and ICU total score at each age as a predictor were estimated by sex separately, and the area under the ROC curve (AUC) was obtained. Average ICU cut-off scores of 26 for boys and 22 for girls were found to be of moderate utility for the prediction of high trajectories of each of oppositional defiant problems and conduct problems. They identified cases with an average sensitivity of 66% and specificity of 70% for boys; and an average sensitivity of 69% and specificity of 72% for girls. The obtained cut-off scores might help clinical practitioners in their decision-making process when identifying low and high-risk groups of children.
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Background and Objectives: From a gene-by-environment perspective, parenting in interaction with the polymorphism in the Monoamine oxidase A (MAOA) gene (MAOA-uVNTR) might also be associated with increased callous-unemotional traits (CU) in preschoolers. MAOA-uVNTR results in differential enzyme activity, so that high-activity alleles (MAOA-H) are linked to reduced dopamine, serotonin, and norepinephrine availability in comparison to low-activity allele (MAOA-L). As MAOA-uVNTR has been previously described to moderate the relationship between childhood parental maltreatment and aggressive and antisocial behavior, it may also play a role in CU traits etiology.Methods: Data was collected through questionnaires answered by parents and teachers. MAOA-uVNTR was genotyped in 368 Caucasian children from a community sample (51.9% male). Multiple linear regression analyses were conducted to analyze the interaction effect of MAOA genotypes and both positive parenting and punitive parenting practices on CU traits at two different periods (3 and 5 years old) and separately by sex. Results: No significant interactions were found for boys. Among girls, a significant interaction effect was found for MAOA-LL carriers, who showed higher CU traits at age 5 when exposed to higher punitive or positive parenting at age 3. Conclusions: Our study provides the first evidence for significant MAOA × early parenting effects on CU traits in preschoolers, specifically among female MAOA-LL carriers. This suggests that the MAOA-LL genotype for girls is associated with higher sensitivity to both positive and punitive parenting in girls, so that MAOA-LL emerges as a genotype that confers higher vulnerability to parental influences.
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The aim of this study is to obtain dimensions from a categorical diagnostic interview. 512 children aged 8 to 17 attending public centers for childrens mental health and presenting some form of psychological disorder were interviewed with the Diagnostic Interview for Children and Adolescents (DICA-IV). Analysis of the principal components indicate that a two-dimensional model (externalizing-internalizing) satisfactorily explain the data collected from the children and their parents. The data from the adolescents are better represented by a three-dimensional model (attention problems- internalizing-antisocial behavior). The factor scales show good internal consistency and significantly relate to other criteria of psychopathology and incapacity (concurrent validity). These results show that it is possible to use DICA-IV to obtain categorical and dimensional indicators simultaneously. The latter are particularly sensitive for measuring changes over the course of disorders. Análisis dimensional de una entrevista diagnóstica categorial: la DICA-IV.El objetivo de este estudio es obtener dimensiones a partir de una entrevista diagnóstica categorial. Se entrevistó con la Entrevista Diagnóstica para Niños y Adolescentes a 512 participantes de entre 8 y 17 años de centros de asistencia primaria pediátrica o psiquiátrica que presentaban algún tipo de psicopatología. El análisis de componentes principales indica que un modelo bidimensional (exteriorizado-interiorizado) explica los datos recogidos de los niños y sus padres. Los datos de los adolescentes quedan mejor representados por un modelo de tres dimensiones(problemas de atención-interiorizados-comportamiento antisocial). Las escalas factoriales muestran una buena consistencia interna y se relacionan de forma significativa con otros criterios de psicopatología e incapacidad (validez concurrente). Los resultados indican que es posible obtener simultáneamente indicadores categoriales y dimensionales de esta entrevista. Estos últimos pueden ser especialmente útiles para medir cambios en el curso de los trastornos.
Enlace al artículo © Copyright 2006 Psicothema.

Studied risk factors for anxiety disorders among school-aged children and adolescents. Human Ss: 197 normal male and female Spanish school-aged children and adolescents (aged 6-17 yrs). Data on sociodemographic variables, psychiatric symptoms, family history, and diagnosis of anxiety disorder were obtained by questionnaire and interview. The results were evaluated according to age, sex, race, SES, diagnosis, separation anxiety, avoidance anxiety, excessive anxiety, phobias, obsessive disorder, compulsive disorder, obsessive-compulsive disorder, posttraumatic stress disorder, temperament, general activity level, meal regularity, maternal depression, paternal phobic disorder, maternal psychosis, parental emotional heat, and presence of medical problems during pregnancy, postpartum and early infancy and evidence of developmental delay. Tests used: The SCL-90-R, the Dimensions of Temperament Survey--Revised (M. Windle and R. M. Lerner, 1986), The Diagnostic Interview for Children and Adolescent---Revised (W. Reich et al, 1991), and the Perception of Parental Educational Style Inventory (C. Perris et al, 1980). Logistic regression and other statistical tests were used.
Enlace al artículo © Copyright 1998 Editores de 'Ansiedad y Estrés'. Reproducido con permiso.

The objective was to analyze the sex differences in symptoms, comorbidity and functional impairment in outpatient children with Oppositional Defiant Disorder (ODD). A sample of 343 children aged 8 to 17 diagnosed with ODD were assessed with a semi-structured diagnostic interview and dimensional measures of psychopathology and functional impairment. Boys with ODD more frequently displayed the symptoms “deliberately annoys” and “blames others”, presented comorbid ADHD, and had greater functional impairment in the school and community contexts; girls presented higher comorbidity with internalizing symptomatology (anxiety, depression and somatic complaints). Given that some clinical differences are apparent in ODD between boys and girls, it is necessary to consider the sex of the patient in order to identify and treat this disorder efficiently and effectively in boys and in girls.
Enlace al artículo en Psicothema

Background: Oppositional defi ant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents psychopathology and ODD in preschoolers. Method: A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on childrens psychopathology through a diagnostic interview, and on their own psychological state and parenting style through questionnaires. Results: At ages 3 and 5, corporal punishment mediated the relationships between mothers anxiety-depression and ODD (in girls), between mothers aggressive behavior and ODD (in boys), and between parents rule-breaking and ODD both in boys and girls. For both sexes, there was a direct association between mothers aggressive behavior score and ODD. The association between fathers psychopathology and ODD was not mediated by the fathers parenting practices. Fathers anxiety-depression and aggressive behavior scores were directly associated with ODD. Conclusions: Parents psychopathology must be explored and, in families where such psychopathology is a relevant variable, parenting practices must be addressed with a view to the prevention and treatment of childrens ODD in the preschool years.
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Maternal internalizing symptoms have been linked with child internalizing symptoms, but paternal internalizing difficulties have received little attention. Our aims were to prospectively analyze the simultaneous effect of maternal and paternal internalizing symptoms on child internalizing difficulties, examining gender differences, and to verify the mediating effect of parenting practices and child irritability. The sample included 470 families assessed at child ages 3, 6, 8 and 11. Multi-group Structural Equation Modeling was performed with Mplus8.2. Complete equivalence was found between boys and girls for all paths. Irritability at age 8 fully mediated the relationship between maternal internalizing symptoms at age 3 and child internalizing symptoms at age 11. Paternal internalizing symptoms at age 3 were not associated with any of the variables under study. Maternal internalizing symptoms and child irritability are targets for intervention in order to prevent child internalizing difficulties.
Enlace al artículo en British Journal of Developmental Psychology

Objectives: The current study examined the independent effects of mothers childhood abuse (CA) and intimate partner violence (IPV) on psychopathology and functional impairment in children; and the potential moderating and mediating role of individual and family factors in these relationships. Additionally, this study explored the potential cumulative effects of both maternal CA and IPV on childrens outcomes. Method: The sample included 547 Spanish children and adolescents aged between 8 and 17 years, and their parents, who had accessed mental health services. The assessment was based on structured interviews with the children and their parents. Statistical analyses were carried out through hierarchical multiple, negative-binomial and logistic regressions, and Structural Equation Models. Results: Children whose mothers experienced CA and those whose mothers suffered physical IPV showed increased DSM-IV disruptive disorders and externalizing behavior problems, respectively. Children who directly observed physical IPV and also suffered physical punishment by parents showed increased internalizing problems. IPV had effects, either direct or indirect by physical punishment, on childrens externalizing problems. Cumulative effect analyses indicated that the prevalence of disruptive disorders was highest in children whose mothers had suffered both CA and IPV. Conclusion: Spanish children whose mothers have suffered CA, IPV or both, are at high risk of serious conduct problems, whereas children exposed to IPV and who were also physically abused are at greater risk of internalizing problems. Physical punishment of children contributes in part to explain externalizing problems of IPV-exposed children. These findings indicate potential targets of assessment and intervention for families seeking help in mental health services.
. Keywords: Maternal Childhood Abuse, Intimate Partner Violence, Physical Punishment of Children, Child and Adolescent Psychopathology.
Enlace al artículo en Child Abuse & Neglect

Psychological maltreatment (PM) is an extremely heterogeneous phenomenon that includes several subtypes. The aim of this work is to explore whether the accumulation of different subtypes of PM has a greater impact on the childs psychopathology and functional impairment. One hundred and sixty-eight children and adolescents aged between 4 and 17 whose mothers had been exposed to intimate partner violence (IPV) participated. Psychopathology was assessed through a rating scale and a diagnostic interview. Polynomial contrasts by means of Generalized Estimated Equations explored linear and quadratic trends. The greater the number of PM subtypes suffered by children, the greater the adverse effects in psychopathology and functioning. When a child suffers four PM subtypes, the number of DSM disorders is, on average, twice as high compared with children who are suffering only one PM subtype. Linear trends were mainly found in internalizing problems. The importance of accurately assessing characteristics and severity of PM, and design efficient programs of prevention and treatment, is highlighted.
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This study examined the prevalence, degree of association and differential effect, by sex and age, of conduct disorder symptoms on psychopathology and functioning. Participants included 680 Spanish children and adolescents between 8 and 17 years and their parents, attending to psychiatric outpatient consultation. Data were obtained through structured diagnostic interviews, and other measures of psychopathological outcomes and functional impairment. In general, the prevalence of antisocial behavior did not differ significantly by sex or age. Results indicated a higher frequency for 13–17 year olds, and a greater number of symptoms in boys. Moreover, some symptoms of conduct disorder showed developmental variations. Sex and age differentially affected the expression of some conduct disorder symptoms and their associations with functional impairment and severity of psychopathology. Knowing the different expression of each symptom could help to identify these problems in clinical children and adolescents, contributing to an early detection of population at the highest risk of serious psychopathology and worse prognosis.
Enlace al artículo en Child Psychiatry and Human Development

The aim was to examine the potential mediating role of fathers and mothers parenting styles in the association between parental psychopathology and antisocial behavior in children, and whether this pathway was moderated by childs sex. Participants included both parents and 338 Spanish outpatient children between 8 and 17 years (56.5% boys). Parenting style had a mediating effect on the studied relationships. Maternal psychopathology was positively associated with antisocial behavior in children, either directly or partially by parenting style, while paternal psychopathology was positively associated with offspring antisocial behavior only through the mediator role of parenting style. Childs sex did not moderate these relationships. Parenting style could be a target for prevention and intervention of antisocial behavior in the offspring of parents with mental health problems.
Enlace al artículo en Child Psychiatry & Human Development

Background: Four explanations for the concurrent and prospective associations between temperament and psychopathology in children have been suggested: predisposition, complication/scar, common cause/continuity, and pathoplasty/exacerbation. Because the confounding effects of common causes have not been ruled out in prior work, the support for the various explanations is uncertain. Methods: Screen-stratified community samples of 4-year olds in Trondheim, Norway (n = 1,042), and 3-year olds in Barcelona, Spain (n = 622), were assessed biennially for symptoms of attention-deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct (CD), anxiety, and depressive disorders through interviewer-based psychiatric interviews across four waves of data collection. The parents completed child temperament ratings. The data were analyzed with random and fixed effects regression adjusted for all time-invariant unmeasured confounders (e.g., genetics, common methods bias, item overlap). Results: In both Norway and Spain and across ages, negative affect predisposed children to symptoms of all disorders except CD, low effortful control predisposed children to ADHD and ODD-symptoms, and surgency predisposed children to increased ADHD-symptoms. Complication effects were observed in the Spanish children for ADHD-symptoms, which increased surgency and diminished effortful control, and for ODD-symptoms, which decreased surgency. The common cause and pathoplasty/exacerbation explanations were not supported. Conclusions: The present results are consistent with the view that temperament plays a causal role in the development of symptoms of psychiatric disorders in children. Because temperament is malleable, interventions targeting the affective, attentional, and behavioral regulatory components of temperament may reduce psychopathology in children. Keywords: ADHD; anxiety; conduct disorder; complication; continuity; depression; effortful control; exacerbation; fixed effects; longitudinal; negative affectivity; oppositional defiant disorder; pathoplasty; predisposition; prospective; psychiatric symptoms; random effects; scar; surgency; temperament.
Enlace al artículo en Journal of Child Psychology and Psychiatry

Oppositional defiant problems (ODP) and obsessive-compulsive problems (OCP) may co-occur in children, though the way they interact is not known. The aim of the study was to examine longitudinal associations between executive functions at age 3 and ODP, ODP dimensions, and OCP at age 6. The sample consisted of 622 preschoolers (50% were boys) from the general population. Executive functions were assessed by teachers using the Behavior Rating Inventory of Executive Functioning – Preschool version questionnaire when children were 3 years old, and ODP and OCP were informed by parents and teachers at the age of 6 years. Multiple linear regression analyses indicated that higher Inhibit and Emotional Control and lower Shift deficits were associated with higher ODP reported by teachers, while higher Shift but lower Inhibit deficits were related to higher OCP. Moreover, ODP and OCP shared difficulties on the Flexibility Index, which means that the capacity to modulate emotions and behavior according to contextual and environmental demands is compromised in both disorders. The findings inform etiology and prevention, pointing out not only the executive function specificities related to each problem, but also common cognitive challenges related to Flexibility. Young children could benefit from training and programs designed to improve executive function processes at an early age to prevent later behavioral difficulties.
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