Rutter's Child and Adolescent Psychiatry (eBook)
John Wiley & Sons (Verlag)
978-1-118-38193-9 (ISBN)
Rutter's Child and Adolescent Psychiatry is the leading textbook in its field.
Both interdisciplinary and international, it provides a coherent appraisal of the current state of the field to help researchers, trainees and practicing clinicians in their daily work. Integrating science and clinical practice, it is a comprehensive reference for all aspects of child and adolescent psychiatry.
New to this full color edition are expanded coverage on classification, including the newly revised Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and new chapters on systems neuroscience, relationship-based treatments, resilience, global psychiatry, and infant mental health.
From an international team of expert editors and contributors, this sixth edition is essential reading for all professionals working and learning in the fields of child and adolescent mental health and developmental psychopathology as well as for clinicians working in primary care and pediatric settings.
Michael Rutter has contributed a number of new chapters and a Foreword for this edition: 'I greatly welcome this new edition as providing both a continuity with the past and a substantial new look.'
-Professor Sir Michael Rutter, extract from Foreword.
Reviews of previous editions:
'This book is by far the best textbook of Child & Adolescent Psychiatry written to date.'
-Dr Judith Rapoport, NIH
'The editors and the authors are to be congratulated for providing us with such a high standard for a textbook on modern child psychiatry. I strongly recommend this book to every child psychiatrist who wants a reliable, up-to-date, comprehensive, informative and very useful textbook. To my mind this is the best book of its kind available today.'
-Journal of Child Psychology and Psychiatry
Anita Thapar, Cardiff University, Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre in Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Heath Park, Cardiff, UK
Daniel S. Pine, Chief, Section on Development and Affective Neuroscience, NIMH Intramural Research Program, Bethesda, MD, USA
James F. Leckman, Neison Harris Professor in the Child Study Center and Professor of Pediatrics and of Psychiatry; Director, Research at Child Study Center, Yale School of Medicine, New Haven, CT, USA
Stephen Scott, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College, London, UK
Margaret J. Snowling, St John's College and University, Oxford, UK
Eric Taylor, Emeritus Professor of Child and Adolescent Psychiatry, King's College London institute of Psychiatry, UK
Rutter's Child and Adolescent Psychiatry is the leading textbook in its field. Both interdisciplinary and international, it provides a coherent appraisal of the current state of the field to help researchers, trainees and practicing clinicians in their daily work. Integrating science and clinical practice, it is a comprehensive reference for all aspects of child and adolescent psychiatry. New to this full color edition are expanded coverage on classification, including the newly revised Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and new chapters on systems neuroscience, relationship-based treatments, resilience, global psychiatry, and infant mental health. From an international team of expert editors and contributors, this sixth edition is essential reading for all professionals working and learning in the fields of child and adolescent mental health and developmental psychopathology as well as for clinicians working in primary care and pediatric settings. Michael Rutter has contributed a number of new chapters and a Foreword for this edition: "e;I greatly welcome this new edition as providing both a continuity with the past and a substantial new look."e; Professor Sir Michael Rutter, extract from Foreword. Reviews of previous editions: "e;This book is by far the best textbook of Child & Adolescent Psychiatry written to date."e; Dr Judith Rapoport, NIH "e;The editors and the authors are to be congratulated for providing us with such a high standard for a textbook on modern child psychiatry. I strongly recommend this book to every child psychiatrist who wants a reliable, up-to-date, comprehensive, informative and very useful textbook. To my mind this is the best book of its kind available today."e; Journal of Child Psychology and Psychiatry
Anita Thapar, Cardiff University, Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre in Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Heath Park, Cardiff, UK Daniel S. Pine, Chief, Section on Development and Affective Neuroscience, NIMH Intramural Research Program, Bethesda, MD, USA James F. Leckman, Neison Harris Professor in the Child Study Center and Professor of Pediatrics and of Psychiatry; Director, Research at Child Study Center, Yale School of Medicine, New Haven, CT, USA Stephen Scott, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College, London, UK Margaret J. Snowling, St John's College and University, Oxford, UK Eric Taylor, Emeritus Professor of Child and Adolescent Psychiatry, King's College London institute of Psychiatry, UK
Cover 1
Title Page 5
Copyright 6
Contents?????????????????????????????? 7
List of contributors?????????????????????????????????????????????????????? 11
Foreword?????????????????????????????? 17
Preface???????????????????????????? 19
Part I Conceptual issues and research approaches?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 21
A Developmental psychopathology 23
Chapter 1 Development and psychopathology: a life course perspective?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 25
Introduction?????????????????????????????????????? 25
Methodological considerations???????????????????????????????????????????????????????????????????????? 26
Research designs?????????????????????????????????????????????? 26
Retrospective and prospective measures?????????????????????????????????????????????????????????????????????????????????????????? 26
Statistical methods for longitudinal research???????????????????????????????????????????????????????????????????????????????????????????????????????? 27
Childhood-adulthood continuities?????????????????????????????????????????????????????????????????????????????? 27
Antisocial behavior???????????????????????????????????????????????????? 27
Depression?????????????????????????????????? 28
Anxiety disorders???????????????????????????????????????????????? 29
Neurodevelopmental disorders?????????????????????????????????????????????????????????????????????? 30
Heterotypic transitions and psychopathological progressions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 30
Long-term effects of early experience???????????????????????????????????????????????????????????????????????????????????????? 32
Conclusions???????????????????????????????????? 33
References?????????????????????????????????? 33
Chapter 2 Diagnosis, diagnostic formulations, and classification?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 37
Introduction?????????????????????????????????????? 37
Definition?????????????????????????????????? 37
Clinical and research classifications???????????????????????????????????????????????????????????????????????????????????????? 38
Biomarkers and neural signatures?????????????????????????????????????????????????????????????????????????????? 38
Dimensions and categories???????????????????????????????????????????????????????????????? 39
The supposed separateness of syndromes?????????????????????????????????????????????????????????????????????????????????????????? 40
Validation of diagnostic categories???????????????????????????????????????????????????????????????????????????????????? 40
Age trends and sex differences?????????????????????????????????????????????????????????????????????????? 40
Familiality and genetics?????????????????????????????????????????????????????????????? 40
Psychosocial correlates???????????????????????????????????????????????????????????? 41
Long-term course?????????????????????????????????????????????? 42
Drug response???????????????????????????????????????? 42
Cognitive impairments and developmental delay???????????????????????????????????????????????????????????????????????????????????????????????????????? 43
Biology???????????????????????????? 43
Validating criteria???????????????????????????????????????????????????? 44
"Lumping" or "splitting"?????????????????????????????????????????????????????????????? 45
Threshold for diagnosis???????????????????????????????????????????????????????????? 46
Separate classifications in different countries???????????????????????????????????????????????????????????????????????????????????????????????????????????? 46
Staging or severity of disorders?????????????????????????????????????????????????????????????????????????????? 46
DSM-5 and ICD-11?????????????????????????????????????????????? 47
References?????????????????????????????????? 47
Chapter 3 Neurodevelopmental disorders?????????????????????????????????????????????????????????????????????????????????????????? 51
The classification of neurodevelopmental disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 51
Concepts of maturational lag and of plateaus in developmental progress?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 52
Concept of comorbidity and patterns of co-occurrence within the group of neurodevelopmental disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 53
The co-occurrence of different neurodevelopmental disorders due to shared risks and biological characteristics?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 55
Genetics?????????????????????????????? 55
Environmental influences?????????????????????????????????????????????????????????????? 55
Shared biological and neural characteristics?????????????????????????????????????????????????????????????????????????????????????????????????????? 56
Sex differences???????????????????????????????????????????? 56
Does neurodevelopmental impairment have the same meaning in all disorders??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 57
Clinical value of neurodevelopmental impairment concepts?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 58
Acknowledgments???????????????????????????????????????????? 58
References?????????????????????????????????? 58
Chapter 4 Conceptual issues and empirical challenges in the disruptive behavior disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 61
The scope of this chapter???????????????????????????????????????????????????????????????? 61
What is the phenotype??????????????????????????????????????????????????????????? 61
The starting point: well-replicated findings?????????????????????????????????????????????????????????????????????????????????????????????????????? 62
What do we need to explain????????????????????????????????????????????????????????????????????? 62
Unraveling risks for disruptive behavior problems???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 63
Anger-proneness in interaction with adverse parenting-a high reactive pathway???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 63
Lack of responsiveness to others' distress-a low reactive pathway???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 65
Adaptations to threat over development-from high reactivity to low reactivity???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 66
Peer influences???????????????????????????????????????????? 66
Sex differences???????????????????????????????????????????? 67
"Comorbidity"???????????????????????????????????????? 67
Adolescent onset of disruptive and antisocial behaviors???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 68
Conclusions???????????????????????????????????? 69
References?????????????????????????????????? 69
Chapter 5 Emotion, emotion regulation and emotional disorders: conceptual issues for clinicians and neuroscientists???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 73
Terms and definitions???????????????????????????????????????????????????????? 73
An imaginary experiment???????????????????????????????????????????????????????????? 73
The clinician's approach: description and first-person account?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 73
A neuroscientist's approach: distinguishing emotions from feelings?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 73
More from the neuroscientist: context, and interpretation versus reward and punishment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 74
More than one way of defining emotions?????????????????????????????????????????????????????????????????????????????????????????? 74
Basic emotions?????????????????????????????????????????? 74
The debate about basic emotions???????????????????????????????????????????????????????????????????????????? 74
Basic emotions and the brain?????????????????????????????????????????????????????????????????????? 75
Emotion regulation?????????????????????????????????????????????????? 75
Distinctions between emotion and emotion regulation???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 76
Heterogeneity of emotion regulation???????????????????????????????????????????????????????????????????????????????????? 76
Different forms of emotional regulation???????????????????????????????????????????????????????????????????????????????????????????? 76
The brain in emotion regulation: the generator-regulator model?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 77
The brain in emotion regulation: recognizing complexity???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 77
The brain in emotion regulation: the importance of learning and timing?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 78
Emotion and development???????????????????????????????????????????????????????????? 78
Emotion and development: challenges to its study?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 78
Emotions and their differentiation in early life?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 78
Development and emotion regulation: some examples???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 78
Developmental transitions and emotions?????????????????????????????????????????????????????????????????????????????????????????? 79
Impulsivity and emotions during adolescence???????????????????????????????????????????????????????????????????????????????????????????????????? 79
Transitions in emotional disorders?????????????????????????????????????????????????????????????????????????????????? 79
Disorders of emotion and emotion regulation: boundaries to normality, relation to basic science, and other challenges???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 80
Boundaries to normality???????????????????????????????????????????????????????????? 80
Overlap between basic science and clinical concepts???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 80
One symptom, many disorders???????????????????????????????????????????????????????????????????? 80
Overlap between emotional and disruptive disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 81
The specificity of emotional disorders?????????????????????????????????????????????????????????????????????????????????????????? 81
Understudied emotional symptoms???????????????????????????????????????????????????????????????????????????? 81
Emotions and treatment?????????????????????????????????????????????????????????? 81
Boundaries of treatments and underlying mechanisms?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 82
Emotion and treatment effects???????????????????????????????????????????????????????????????????????? 82
Conclusion and outlook?????????????????????????????????????????????????????????? 82
References?????????????????????????????????? 82
Chapter 6 Attachment: normal development, individual differences, and associations with experience?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 85
Historical context of the development of attachment theory?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 85
Reaction to psychoanalytic theory???????????????????????????????????????????????????????????????????????????????? 85
Effects of deprivation?????????????????????????????????????????????????????????? 85
Ethology and evolutionary theory?????????????????????????????????????????????????????????????????????????????? 86
Ainsworth as methodologist?????????????????????????????????????????????????????????????????? 86
Infant attachment quality???????????????????????????????????????????????????????????????? 87
Measurement: the strange situation?????????????????????????????????????????????????????????????????????????????????? 87
Stability???????????????????????????????? 88
Cross-cultural?????????????????????????????????????????? 88
Alternative approaches to measurement???????????????????????????????????????????????????????????????????????????????????????? 88
Individual differences?????????????????????????????????????????????????????????? 88
Parental behavior???????????????????????????????????????????????? 88
Attachment state of mind?????????????????????????????????????????????????????????????? 89
Parent challenges???????????????????????????????????????????????? 90
Psychopathology???????????????????????????????????????????? 90
Trauma exposure and domestic violence???????????????????????????????????????????????????????????????????????????????????????? 90
Challenging environmental conditions?????????????????????????????????????????????????????????????????????????????????????? 90
Other factors: child care and child temperament???????????????????????????????????????????????????????????????????????????????????????????????????????????? 90
Links between infant attachment and later outcomes?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 91
Social relationships in childhood???????????????????????????????????????????????????????????????????????????????? 91
Internalizing behavior?????????????????????????????????????????????????????????? 91
Externalizing behavior?????????????????????????????????????????????????????????? 91
Dissociation?????????????????????????????????????? 92
Assessments of attachment beyond infancy?????????????????????????????????????????????????????????????????????????????????????????????? 92
Preschool???????????????????????????????? 92
Move to the level of representation???????????????????????????????????????????????????????????????????????????????????? 92
Story stems and narratives?????????????????????????????????????????????????????????????????? 92
Child attachment interview?????????????????????????????????????????????????????????????????? 92
Adult attachment interview?????????????????????????????????????????????????????????????????? 92
Self-report assessments???????????????????????????????????????????????????????????? 93
Attachment and neurobiology???????????????????????????????????????????????????????????????????? 93
Avoidance in the strange situation?????????????????????????????????????????????????????????????????????????????????? 93
Avoidance in the adult attachment interview???????????????????????????????????????????????????????????????????????????????????????????????????? 93
Cortisol reactivity in the strange situation?????????????????????????????????????????????????????????????????????????????????????????????????????? 93
Attachment among fathers?????????????????????????????????????????????????????????????? 93
Attachment among atypical populations???????????????????????????????????????????????????????????????????????????????????????? 94
Attachment among children in foster care?????????????????????????????????????????????????????????????????????????????????????????????? 94
Attachment in kibbutz???????????????????????????????????????????????????????? 94
Attachment and interventions?????????????????????????????????????????????????????????????????????? 94
Infants and toddlers?????????????????????????????????????????????????????? 94
Attachment and biobehavioral catch-up???????????????????????????????????????????????????????????????????????????????????????? 94
Circle of Security?????????????????????????????????????????????????? 94
Child-parent psychotherapy?????????????????????????????????????????????????????????????????? 94
Preschoolers?????????????????????????????????????? 95
Children and adolescents?????????????????????????????????????????????????????????????? 95
Future directions???????????????????????????????????????????????? 95
Clinical implications???????????????????????????????????????????????????????? 95
Cross-cutting research?????????????????????????????????????????????????????????? 95
Studying extreme conditions???????????????????????????????????????????????????????????????????? 95
Conclusions???????????????????????????????????? 95
References?????????????????????????????????? 95
Chapter 7 Infant/early years mental health?????????????????????????????????????????????????????????????????????????????????????????????????? 99
Introduction?????????????????????????????????????? 99
The concepts of infancy and infant mental health?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 99
Pregnancy and family perspectives???????????????????????????????????????????????????????????????????????????????? 99
Aspects of infant's social and emotional development?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 99
Cultural influences in infant mental heath?????????????????????????????????????????????????????????????????????????????????????????????????? 100
Risk and protective factors???????????????????????????????????????????????????????????????????? 100
Risk factors?????????????????????????????????????? 100
Protective factors and infant resilience?????????????????????????????????????????????????????????????????????????????????????????????? 101
Special features in assessing infants???????????????????????????????????????????????????????????????????????????????????????? 101
Guidelines for assessment???????????????????????????????????????????????????????????????? 101
Assessment of the infant's mental state???????????????????????????????????????????????????????????????????????????????????????????? 101
Infant and toddler observation methods?????????????????????????????????????????????????????????????????????????????????????????? 101
Assessment of the parent-infant relationship?????????????????????????????????????????????????????????????????????????????????????????????????????? 103
Assessment of triadic interaction and coparenting???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 104
Integrating the information from the assessment???????????????????????????????????????????????????????????????????????????????????????????????????????????? 104
Common problems versus pathways to psychopathology?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 105
What is a problem, a symptom, or a disorder??????????????????????????????????????????????????????????????????????????????????????????????????????? 105
Problems with sleeping, feeding, and eating???????????????????????????????????????????????????????????????????????????????????????????????????? 105
Problems in emotion regulation and early mood disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 106
Problems with behavior regulation and aggression?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 106
Problems related to adverse experiences and effects of severe trauma?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 106
Disorders in development and communicating?????????????????????????????????????????????????????????????????????????????????????????????????? 107
Special features of interventions in infancy?????????????????????????????????????????????????????????????????????????????????????????????????????? 107
Goals for treatment???????????????????????????????????????????????????? 107
Preventive parent-infant programs???????????????????????????????????????????????????????????????????????????????? 107
Parent-infant therapies???????????????????????????????????????????????????????????? 107
Family and group interventions?????????????????????????????????????????????????????????????????????????? 109
Multicomponent interventions for high-risk groups???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 109
Conclusion?????????????????????????????????? 109
References?????????????????????????????????? 109
Chapter 8 Temperament: individual differences in reactivity and regulation as antecedent to personality???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 113
Introduction?????????????????????????????????????? 113
Definitions and conceptual distinctions between temperament and personality???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 113
Approaches to the study of temperament?????????????????????????????????????????????????????????????????????????????????????????? 114
Alexander Thomas and Stella Chess???????????????????????????????????????????????????????????????????????????????? 114
Mary Rothbart???????????????????????????????????????? 114
Jerome Kagan?????????????????????????????????????? 114
Assessment of temperament???????????????????????????????????????????????????????????????? 115
Genetic origins of temperament?????????????????????????????????????????????????????????????????????????? 116
The temperament of behavioral inhibition?????????????????????????????????????????????????????????????????????????????????????????????? 117
Temperament and adjustment?????????????????????????????????????????????????????????????????? 118
Behavioral inhibition: temperament or psychopathology??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 119
Future directions in temperament research???????????????????????????????????????????????????????????????????????????????????????????????? 120
Temperamental exuberance?????????????????????????????????????????????????????????????? 120
Final comments?????????????????????????????????????????? 121
References?????????????????????????????????? 121
B Neurobiology 125
Chapter 9 Neurobiological perspectives on developmental psychopathology???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 127
Introduction?????????????????????????????????????? 127
Key issues in developmental neurobiology?????????????????????????????????????????????????????????????????????????????????????????????? 127
Deterministic versus probabilistic epigenesis???????????????????????????????????????????????????????????????????????????????????????????????????????? 127
Mosaic versus regulatory development?????????????????????????????????????????????????????????????????????????????????????? 128
Static versus dynamic mapping???????????????????????????????????????????????????????????????????????? 128
Plasticity, epigenetics, and fate maps?????????????????????????????????????????????????????????????????????????????????????????? 128
The role of time in brain development???????????????????????????????????????????????????????????????????????????????????????? 129
Human structural brain development?????????????????????????????????????????????????????????????????????????????????? 129
Key features of postnatal development???????????????????????????????????????????????????????????????????????????????????????? 131
Oscillating rhythms???????????????????????????????????????????????????? 132
Resting activity and network connectivity???????????????????????????????????????????????????????????????????????????????????????????????? 133
Determinants of cortical specialization???????????????????????????????????????????????????????????????????????????????????????????? 133
Human functional brain development?????????????????????????????????????????????????????????????????????????????????? 134
Atypical human neurodevelopment???????????????????????????????????????????????????????????????????????????? 134
Risk?????????????????????? 135
Resilience?????????????????????????????????? 136
Future directions???????????????????????????????????????????????? 136
Definitions???????????????????????????????????? 136
Acknowledgements?????????????????????????????????????????????? 137
References?????????????????????????????????? 137
Chapter 10 Systems neuroscience???????????????????????????????????????????????????????????????????????????? 139
Introduction?????????????????????????????????????? 139
Child psychiatry and systems neuroscience???????????????????????????????????????????????????????????????????????????????????????????????? 140
Cognitive control???????????????????????????????????????????????? 140
Defining specific behaviors???????????????????????????????????????????????????????????????????? 140
Linking the behavior to clinical questions?????????????????????????????????????????????????????????????????????????????????????????????????? 141
Examining the neural circuitry supporting the behavior?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 141
Extending the current literature?????????????????????????????????????????????????????????????????????????????? 142
Fear?????????????????????? 142
Defining specific behaviors???????????????????????????????????????????????????????????????????? 142
Behavior, clinical questions, and neural circuitry?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 144
Extending the current literature?????????????????????????????????????????????????????????????????????????????? 144
Attachment and affiliation?????????????????????????????????????????????????????????????????? 145
Defining specific behaviors???????????????????????????????????????????????????????????????????? 145
Linking the behavior to clinical questions?????????????????????????????????????????????????????????????????????????????????????????????????? 146
Examining the neural circuitry supporting the behavior?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 146
Extending the current literature?????????????????????????????????????????????????????????????????????????????? 147
Brain development???????????????????????????????????????????????? 148
Defining a specific behavior in a clinical context?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 148
Examining the neural circuitry supporting the behavior?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 148
Extending the current literature?????????????????????????????????????????????????????????????????????????????? 149
Conclusion?????????????????????????????????? 149
References?????????????????????????????????? 149
Chapter 11 Neuroimaging in child psychiatry???????????????????????????????????????????????????????????????????????????????????????????????????? 152
Introduction?????????????????????????????????????? 152
Overview of neuroimaging techniques???????????????????????????????????????????????????????????????????????????????????? 153
Magnetic resonance imaging (MRI)?????????????????????????????????????????????????????????????????????????????? 153
Structural MRI?????????????????????????????????????????? 153
Functional MRI?????????????????????????????????????????? 153
Structural and functional connectivity?????????????????????????????????????????????????????????????????????????????????????????? 155
Diffusion tensor imaging?????????????????????????????????????????????????????????????? 155
Functional connectivity???????????????????????????????????????????????????????????? 155
Electrophysiology???????????????????????????????????????????????? 155
Electroencephalography?????????????????????????????????????????????????????????? 155
Magnetic resonance spectroscopy???????????????????????????????????????????????????????????????????????????? 157
Magnetoencephalography?????????????????????????????????????????????????????????? 157
Positron emission tomography?????????????????????????????????????????????????????????????????????? 157
Functional near infrared spectroscopy???????????????????????????????????????????????????????????????????????????????????????? 157
Imaging genomics?????????????????????????????????????????????? 158
Analysis and interpretation of imaging data???????????????????????????????????????????????????????????????????????????????????????????????????? 158
Study level design considerations???????????????????????????????????????????????????????????????????????????????? 159
Within-subjects designs???????????????????????????????????????????????????????????? 159
Between-subjects designs?????????????????????????????????????????????????????????????? 159
Cross-sectional versus longitudinal studies???????????????????????????????????????????????????????????????????????????????????????????????????? 159
Test-retest reliability???????????????????????????????????????????????????????????? 159
Experiment level design considerations?????????????????????????????????????????????????????????????????????????????????????????? 159
Block designs???????????????????????????????????????? 159
Event-related designs???????????????????????????????????????????????????????? 159
Motion and motion artifacts???????????????????????????????????????????????????????????????????? 160
Normalization and group comparisons???????????????????????????????????????????????????????????????????????????????????? 160
Difference maps???????????????????????????????????????????? 160
Conclusions???????????????????????????????????? 161
References?????????????????????????????????? 161
C Epidemiology, interventions and services 163
Chapter 12 Using natural experiments and animal models to study causal hypotheses in relation to child mental health problems???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 165
Introduction?????????????????????????????????????? 165
Why natural experiments are useful?????????????????????????????????????????????????????????????????????????????????? 166
Natural experiment designs used to test causal hypotheses on environmental risks and that control for genetic contribution?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 166
Twin designs?????????????????????????????????????? 166
Discordant MZ twin pairs and MZ twin pair differences???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 167
Discordant DZ and sibling pairs???????????????????????????????????????????????????????????????????????????? 168
Children of twins designs and its extensions?????????????????????????????????????????????????????????????????????????????????????????????????????? 168
Adoption studies?????????????????????????????????????????????? 169
Assisted reproductive technologies?????????????????????????????????????????????????????????????????????????????????? 169
Maternal versus paternal exposure during pregnancy?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 170
Migration???????????????????????????????? 170
Natural experiment designs that aim to remove or reduce selection or allocation bias in defined populations???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 170
Universal introduction of risk?????????????????????????????????????????????????????????????????????????? 170
Universal removal of risk???????????????????????????????????????????????????????????????? 171
Interrupted time series???????????????????????????????????????????????????????????? 171
Using changes in policy as natural experiments?????????????????????????????????????????????????????????????????????????????????????????????????????????? 171
China's one child policy?????????????????????????????????????????????????????????????? 171
Change in legislation on sale of alcohol in Sweden?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 172
Radical changes in environment?????????????????????????????????????????????????????????????????????????? 172
Adoption following profound institutional deprivation???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 172
Regression discontinuity?????????????????????????????????????????????????????????????? 172
Using instrumental variables?????????????????????????????????????????????????????????????????????? 173
Mendelian randomization???????????????????????????????????????????????????????????? 173
Statistical methods to reduce selection biases and confounders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 173
Experimental manipulation in humans???????????????????????????????????????????????????????????????????????????????????? 174
Animal models to test environmental influences?????????????????????????????????????????????????????????????????????????????????????????????????????????? 174
Animal models to study the causal effects of genetic risks?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 176
Rett syndrome???????????????????????????????????????? 176
Fragile X???????????????????????????????? 177
Tuberous sclerosis (TS)???????????????????????????????????????????????????????????? 177
Behavior-based animal models to study causal risks in relation to multifactorial psychiatric disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 177
A wide variety of animal species can inform causal research in psychopathology?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 177
Conclusions???????????????????????????????????? 178
References?????????????????????????????????? 178
Chapter 13 Using epidemiology to plan, organize, and evaluate services for children and adolescents with mental health problems???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 183
Introduction?????????????????????????????????????? 183
Why bother????????????????????????????????????? 183
Overview of key methodological issues???????????????????????????????????????????????????????????????????????????????????????? 184
Who was surveyed????????????????????????????????????????????????? 184
Whose views were considered??????????????????????????????????????????????????????????????????????? 185
How was categorization made??????????????????????????????????????????????????????????????????????? 186
Interpreting epidemiological data???????????????????????????????????????????????????????????????????????????????? 186
What is need????????????????????????????????????????? 186
What can epidemiology tell us about levels of need????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 186
What can epidemiology tell us about planning to meet need??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 187
Service use now???????????????????????????????????????????? 187
What factors predict access??????????????????????????????????????????????????????????????????????? 187
Using epidemiology to determine organization?????????????????????????????????????????????????????????????????????????????????????????????????????? 191
Using epidemiology to determine funding arrangements?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 191
Using epidemiological data to understand outcomes of treatment for teams and services???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 192
Conclusion and further directions???????????????????????????????????????????????????????????????????????????????? 193
Acknowledgments???????????????????????????????????????????? 193
References?????????????????????????????????? 193
Chapter 14 Evaluating interventions???????????????????????????????????????????????????????????????????????????????????? 197
Introduction?????????????????????????????????????? 197
The fundamental principles?????????????????????????????????????????????????????????????????? 197
The control/comparison groups???????????????????????????????????????????????????????????????????????? 197
Measuring the effect of T versus C?????????????????????????????????????????????????????????????????????????????????? 197
Randomization???????????????????????????????????????? 198
"Blinding"?????????????????????????????????? 198
Analysis by intention to treat?????????????????????????????????????????????????????????????????????????? 198
Ethical issues/clinical equipoise???????????????????????????????????????????????????????????????????????????????? 198
Basic principles of the randomized clinical trial???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 198
Alternatives to RCTS????????????????????????????????????????????????????????? 198
The pre-post design???????????????????????????????????????????????????? 198
Cross-over designs?????????????????????????????????????????????????? 199
Natural experiments, observational studies, quasi-experimental designs?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 199
Effect sizes. Not P-values?????????????????????????????????????????????????????????????????? 199
Exploratory activities, pilot studies, and RCTS???????????????????????????????????????????????????????????????????????????????????????????????????????????? 200
Formulating the hypothesis?????????????????????????????????????????????????????????????????? 201
Efficacy versus effectiveness???????????????????????????????????????????????????????????????????????? 201
Population and sampling:?????????????????????????????????????????????????????????????? 201
Multisite RCTs?????????????????????????????????????????? 201
Individual versus cluster randomized studies?????????????????????????????????????????????????????????????????????????????????????????????????????? 201
Designing the RCT???????????????????????????????????????????????? 202
Choice of control group???????????????????????????????????????????????????????????? 202
Randomization???????????????????????????????????????? 202
Choice of outcome measure(s)?????????????????????????????????????????????????????????????????????? 203
Power and precision???????????????????????????????????????????????????? 204
RCT execution/fidelity?????????????????????????????????????????????????????????? 204
Primary analysis and presentation of results?????????????????????????????????????????????????????????????????????????????????????????????????????? 205
Moving the frontiers: exploration of RCT data???????????????????????????????????????????????????????????????????????????????????????????????????????? 205
Completing the cycle: meta-analysis???????????????????????????????????????????????????????????????????????????????????? 206
Discussion?????????????????????????????????? 207
References?????????????????????????????????? 207
Chapter 15 What clinicians need to know about statistical issues and methods?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 208
Common misunderstandings, study design, multiple testing, meta-analysis and the natural history of "findings"???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 208
Confounding, selection and randomization?????????????????????????????????????????????????????????????????????????????????????????????? 210
Adjustment for measured confounders: regression and the generalized linear model?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 210
Mechanisms and statistical interactions and effects scales?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 211
Longitudinal data analysis?????????????????????????????????????????????????????????????????? 212
Measurement error, latent variables and growth models???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 213
Structural equation modelling???????????????????????????????????????????????????????????????????????? 213
SEM with continuous and discrete variables and interactions: trajectory models?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 215
Causal analysis???????????????????????????????????????????? 215
Propensity score approach???????????????????????????????????????????????????????????????? 216
Instrumental variables?????????????????????????????????????????????????????????? 217
Mediation???????????????????????????????? 217
Missing data?????????????????????????????????????? 217
Screening, diagnosis and misclassification?????????????????????????????????????????????????????????????????????????????????????????????????? 218
Reporting results???????????????????????????????????????????????? 218
Conclusions???????????????????????????????????? 218
References?????????????????????????????????? 219
Chapter 16 Global psychiatry?????????????????????????????????????????????????????????????????????? 221
Introduction?????????????????????????????????????? 221
Historical context of global health???????????????????????????????????????????????????????????????????????????????????? 221
Mental health in the context of global health???????????????????????????????????????????????????????????????????????????????????????????????????????? 222
Child mental health in the context of global mental health?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 222
The economic case for early investments in global child mental health???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 222
Context heterogeneity???????????????????????????????????????????????????????? 223
Poverty???????????????????????????? 224
Malnutrition?????????????????????????????????????? 224
Intellectual disability???????????????????????????????????????????????????????????? 224
Orphans and vulnerable children???????????????????????????????????????????????????????????????????????????? 224
War and terrorism???????????????????????????????????????????????? 224
Methods in global child and adolescent psychiatric epidemiology???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 225
Challenges and opportunities?????????????????????????????????????????????????????????????????????? 228
Research?????????????????????????????? 228
Services?????????????????????????????? 230
Training?????????????????????????????? 231
Future perspectives???????????????????????????????????????????????????? 232
References?????????????????????????????????? 232
Chapter 17 Prevention of mental disorders and promotion of competence???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 235
Epidemiology and the rationale for preventive interventions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 235
The role of developmental theory in the prevention of MEBDs???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 235
The role of protective factors?????????????????????????????????????????????????????????????????????????? 236
Developmental neuroscience and genetics???????????????????????????????????????????????????????????????????????????????????????????? 236
Promotion of competence???????????????????????????????????????????????????????????? 236
Defining prevention???????????????????????????????????????????????????? 236
Levels of prevention?????????????????????????????????????????????????????? 236
Empirical advances in prevention research with children and families?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 237
Conduct problems and aggression???????????????????????????????????????????????????????????????????????????? 238
Depression?????????????????????????????????? 238
Anxiety???????????????????????????? 238
Early substance use???????????????????????????????????????????????????? 239
Promotion of social and emotional competence?????????????????????????????????????????????????????????????????????????????????????????????????????? 239
Event-triggered prevention: the prevention of trauma?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 239
Birth to five: early prevention???????????????????????????????????????????????????????????????????????????? 240
Prevention in lower and lower-middle income countries???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 240
Key issues in current prevention research???????????????????????????????????????????????????????????????????????????????????????????????? 240
Limited longitudinal studies?????????????????????????????????????????????????????????????????????? 240
The need for independent replication studies?????????????????????????????????????????????????????????????????????????????????????????????????????? 240
Limited study of factors that moderate effects?????????????????????????????????????????????????????????????????????????????????????????????????????????? 240
Consistent standards for evidence and research reporting?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 241
Need for improved standards concerning intervention replications and cultural adaptations???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 241
Metrics for reporting and levels of prevention?????????????????????????????????????????????????????????????????????????????????????????????????????????? 241
Dissemination, implementation and sustainability Type 2 questions??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
Adopting public health impact-oriented models???????????????????????????????????????????????????????????????????????????????????????????????????????? 242
Conclusion?????????????????????????????????? 242
References?????????????????????????????????? 243
Chapter 18 Health economics???????????????????????????????????????????????????????????????????? 247
Introduction?????????????????????????????????????? 247
Costs in childhood?????????????????????????????????????????????????? 248
Costs continuing into adulthood???????????????????????????????????????????????????????????????????????????? 249
Evidence from the Inner London Longitudinal Study???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 249
Evidence from a British birth cohort study?????????????????????????????????????????????????????????????????????????????????????????????????? 250
Evidence from a 20-year follow-up of boys resident in the London Borough of Newham?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 250
Evidence of early prevention and intervention programs for young people???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 251
Impact of child maltreatment?????????????????????????????????????????????????????????????????????? 251
Cost-offset considerations?????????????????????????????????????????????????????????????????? 251
Randomized controlled trial???????????????????????????????????????????????????????????????????? 252
Quasi-experimental study design???????????????????????????????????????????????????????????????????????????? 252
Simulation modeling???????????????????????????????????????????????????? 252
Exploring cost-effectiveness?????????????????????????????????????????????????????????????????????? 252
Question and perspective?????????????????????????????????????????????????????????????? 252
Cost measurement?????????????????????????????????????????????? 253
Effectiveness measurement???????????????????????????????????????????????????????????????? 253
Making trade-offs???????????????????????????????????????????????? 254
Utility measurement???????????????????????????????????????????????????? 255
Benefit measurement???????????????????????????????????????????????????? 255
Conclusion?????????????????????????????????? 256
References?????????????????????????????????? 257
Chapter 19 Legal issues in the care and treatment of children with mental health problems???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 259
The universality of human rights?????????????????????????????????????????????????????????????????????????????? 259
The different roles of the mental health professional???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 260
Intervening against the parents???????????????????????????????????????????????????????????????????????????? 260
Intervening against the child???????????????????????????????????????????????????????????????????????? 263
The child's right to consent to treatment???????????????????????????????????????????????????????????????????????????????????????????????? 263
Overriding the child's refusal to consent to treatment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 264
Using mental health law???????????????????????????????????????????????????????????? 266
Expert witnesses?????????????????????????????????????????????? 267
Conclusion?????????????????????????????????? 268
References?????????????????????????????????? 268
Chapter 20 Children's testimony: a scientific framework for evaluating the reliability of children's statements???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 270
Outline of present case involving allegations of sexual abuse 1???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 271
Research findings/major principles?????????????????????????????????????????????????????????????????????????????????? 272
Preschoolers' reports are often very accurate.?????????????????????????????????????????????????????????????????????????????????????????????????????????? 272
Biased interviewers can taint the child's report, rendering it unreliable???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 272
Biased interviewers use suggestive interviewing techniques?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 273
Specific questions?????????????????????????????????????????????????? 273
Repeated specific questions within interviews???????????????????????????????????????????????????????????????????????????????????????????????????????? 273
Repeated suggestive interviews?????????????????????????????????????????????????????????????????????????? 273
Stereotype induction?????????????????????????????????????????????????????? 273
Peer contamination (cowitness contamination)?????????????????????????????????????????????????????????????????????????????????????????????????????? 273
Nonverbal props???????????????????????????????????????????? 273
The first interview with a child provides the most reliable testimony???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 274
Suggestive interviewing techniques can result in false beliefs that are longlasting???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 274
Children's false reports can seem credible?????????????????????????????????????????????????????????????????????????????????????????????????? 274
Electronic recordings of the full interview must be obtained in order to determine the degree of bias and suggestiveness of the interview???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 274
Scientific analysis of the facts of the case?????????????????????????????????????????????????????????????????????????????????????????????????????? 275
Sources of information about the children's reports???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 275
The role of bias in the evolution of children's initial disclosures???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 275
Mother?????????????????????????? 275
SG (The school's crisis counselor)?????????????????????????????????????????????????????????????????????????????????? 275
Suggestive techniques on September 28???????????????????????????????????????????????????????????????????????????????????????? 275
November 2005 interviews?????????????????????????????????????????????????????????????? 276
Evidence of peer contamination?????????????????????????????????????????????????????????????????????????? 276
Reports of hitting and of scatological behavior???????????????????????????????????????????????????????????????????????????????????????????????????????????? 276
Dr. Sy Interviews Sophia on July 19, 2006, 10 months after her last contact with her father???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 277
Dr. Sy's recording and reporting techniques???????????????????????????????????????????????????????????????????????????????????????????????????? 277
Dr. Sy violated important interview guidelines?????????????????????????????????????????????????????????????????????????????????????????????????????????? 277
The experts vouched for the truth of Sophia's reports???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 278
Beyond issues of sexual abuse???????????????????????????????????????????????????????????????????????? 279
References?????????????????????????????????? 279
Chapter 21 Residential and foster care?????????????????????????????????????????????????????????????????????????????????????????? 281
Introduction?????????????????????????????????????? 281
Residential care?????????????????????????????????????????????? 281
The nature of residential care?????????????????????????????????????????????????????????????????????????? 281
Development of children raised in institutional care?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 282
Physical growth???????????????????????????????????????????? 282
Hormonal (HPA axis) development???????????????????????????????????????????????????????????????????????????? 282
Cognitive development???????????????????????????????????????????????????????? 282
Attachment security???????????????????????????????????????????????????? 283
Resilience of attachment security in the face of structural neglect???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 283
Indiscriminate friendliness???????????????????????????????????????????????????????????????????? 283
Psychopathology???????????????????????????????????????????? 284
Benefits and harms of residential care?????????????????????????????????????????????????????????????????????????????????????????? 284
Can institutional care be as good as family care????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 284
Harmful effects of deviant groups???????????????????????????????????????????????????????????????????????????????? 284
Abuse and violence in residential care?????????????????????????????????????????????????????????????????????????????????????????? 284
Violence against residential group care workers???????????????????????????????????????????????????????????????????????????????????????????????????????????? 285
Effects of removal from orphanages to adoptive or foster care???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 285
Summary of the effects of residential care?????????????????????????????????????????????????????????????????????????????????????????????????? 285
Foster care???????????????????????????????????? 286
Prevalence and nature of foster care?????????????????????????????????????????????????????????????????????????????????????? 286
Development of children in foster care?????????????????????????????????????????????????????????????????????????????????????????? 286
Hormonal (HPA axis) development???????????????????????????????????????????????????????????????????????????? 286
Attachment patterns???????????????????????????????????????????????????? 286
Psychopathology???????????????????????????????????????????? 286
Factors influencing successful foster placement???????????????????????????????????????????????????????????????????????????????????????????????????????????? 286
Assessment?????????????????????????????????? 287
Introduction?????????????????????????????????????? 287
Taking the history?????????????????????????????????????????????????? 287
Examination and investigations?????????????????????????????????????????????????????????????????????????? 287
Formulation and treatment planning?????????????????????????????????????????????????????????????????????????????????? 288
Intervention?????????????????????????????????????? 288
Individual-level work???????????????????????????????????????????????????????? 288
General principles?????????????????????????????????????????????????? 288
Managing contact with birth parents???????????????????????????????????????????????????????????????????????????????????? 288
Interventions to improve residential care???????????????????????????????????????????????????????????????????????????????????????????????? 289
Improving cognitive development???????????????????????????????????????????????????????????????????????????? 289
Improving social development?????????????????????????????????????????????????????????????????????? 289
Interventions to improve foster care?????????????????????????????????????????????????????????????????????????????????????? 289
Interventions for infants and young children?????????????????????????????????????????????????????????????????????????????????????????????????????? 289
Interventions for older children?????????????????????????????????????????????????????????????????????????????? 289
Conclusions???????????????????????????????????? 289
Acknowledgments???????????????????????????????????????????? 290
References?????????????????????????????????? 290
Chapter 22 Adoption???????????????????????????????????????????????????? 293
Contemporary trends in adoptive family formation?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 293
Decreases in domestic and intercountry adoption???????????????????????????????????????????????????????????????????????????????????????????????????????????? 293
Alternatives for individuals and families who want to adopt???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 294
Open adoption???????????????????????????????????????? 294
Foster care to adoption???????????????????????????????????????????????????????????? 294
Kinship care?????????????????????????????????????? 294
Transracial adoption?????????????????????????????????????????????????????? 294
Assistive reproductive technologies (ART): in vitro fertilization, intracytoplasmic sperm injection, donor insemination???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 295
Gay and lesbian adoption?????????????????????????????????????????????????????????????? 295
Opening the birth records: search for birth parents (including ART donors)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 296
Outcomes of adoption?????????????????????????????????????????????????????? 297
Outcomes of domestic adoption???????????????????????????????????????????????????????????????????????? 297
Outcomes of intercountry adoption???????????????????????????????????????????????????????????????????????????????? 297
Selection, preparation, and assessment?????????????????????????????????????????????????????????????????????????????????????????? 298
Postadoption services???????????????????????????????????????????????????????? 298
Conclusions and future directions???????????????????????????????????????????????????????????????????????????????? 299
References?????????????????????????????????? 300
Part II Influences on psychopathology???????????????????????????????????????????????????????????????????????????????????????? 305
Chapter 23 Biology of environmental effects???????????????????????????????????????????????????????????????????????????????????????????????????? 307
Introduction?????????????????????????????????????? 307
Prenatal experiences?????????????????????????????????????????????????????? 307
Maternal drinking of alcohol during pregnancy???????????????????????????????????????????????????????????????????????????????????????????????????????? 307
Exposure to mother's smoking during pregnancy???????????????????????????????????????????????????????????????????????????????????????????????????????? 308
Prenatal exposure to cocaine?????????????????????????????????????????????????????????????????????? 308
Prenatal exposure to depression/anxiety and antidepressant medication???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 309
Maternal depression and antidepressants compared?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 309
Prenatal effects of subnutrition/famine???????????????????????????????????????????????????????????????????????????????????????????? 310
Prenatal exposure to testosterone???????????????????????????????????????????????????????????????????????????????? 310
Biological effects of prenatal stress???????????????????????????????????????????????????????????????????????????????????????? 310
Postnatal maltreatment?????????????????????????????????????????????????????????? 311
Telomere length???????????????????????????????????????????? 312
Inflammation?????????????????????????????????????? 312
Institutional deprivation???????????????????????????????????????????????????????????????? 313
Social disadvantage???????????????????????????????????????????????????? 313
Enrichment and deprivation studies?????????????????????????????????????????????????????????????????????????????????? 314
Experience-expectant effects?????????????????????????????????????????????????????????????????????? 315
Vision?????????????????????????? 315
Pollutants?????????????????????????????????? 315
Lead?????????????????????? 315
Traumatic brain injury?????????????????????????????????????????????????????????? 316
Biological effects of different therapeutic interventions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 316
Gene-environment interaction (G x E)?????????????????????????????????????????????????????????????????????????????????????? 316
Overall conclusions???????????????????????????????????????????????????? 317
References?????????????????????????????????? 318
Chapter 24 Genetics???????????????????????????????????????????????????? 323
Introduction?????????????????????????????????????? 323
DNA, genes and chromosomes?????????????????????????????????????????????????????????????????? 323
DNA???????????????????? 323
Genes???????????????????????? 323
Chromosomes???????????????????????????????????? 323
Genetic variation and its detection???????????????????????????????????????????????????????????????????????????????????? 325
Genetic variation???????????????????????????????????????????????? 325
Detecting variation???????????????????????????????????????????????????? 325
Relating Genes to Behaviors???????????????????????????????????????????????????????????????????? 327
Genetic epidemiology?????????????????????????????????????????????????????? 327
Family studies?????????????????????????????????????????? 327
Twin designs?????????????????????????????????????? 328
Adoption studies?????????????????????????????????????????????? 329
Approaches to gene discovery?????????????????????????????????????????????????????????????????????? 329
Parametric linkage analysis???????????????????????????????????????????????????????????????????? 329
Common variant / candidate gene studies???????????????????????????????????????????????????????????????????????????????????????????? 329
Genome-wide association studies???????????????????????????????????????????????????????????????????????????? 330
Cytogenetics?????????????????????????????????????? 330
Copy number variation analysis?????????????????????????????????????????????????????????????????????????? 330
Next-generation sequencing?????????????????????????????????????????????????????????????????? 331
Gene x environment interplay?????????????????????????????????????????????????????????????????????? 331
Gene-environment correlation?????????????????????????????????????????????????????????????????????? 331
Gene-environment interaction?????????????????????????????????????????????????????????????????????? 331
Pharmacogenetic/ pharmacogenomics???????????????????????????????????????????????????????????????????????????????? 332
Intermediate phenotypes???????????????????????????????????????????????????????????? 332
Genetic testing???????????????????????????????????????????? 333
Summary: recent findings and changing conceptions???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 334
References?????????????????????????????????? 334
Chapter 25 Epigenetics and the developmental origins of vulnerability for mental disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 337
Parental influences???????????????????????????????????????????????????? 337
Epigenetics???????????????????????????????????? 338
Chromatin modifications???????????????????????????????????????????????????????????? 338
DNA methylation???????????????????????????????????????????? 339
DNA methylation in development?????????????????????????????????????????????????????????????????????????? 340
Maternal regulation of stress reactivity in the offspring???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 341
The human early environment and DNA methylation???????????????????????????????????????????????????????????????????????????????????????????????????????????? 343
Tissue specificity: DNA methylation in blood and brain?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 344
The molecular definition of gene x environment interaction?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 345
Methodological considerations in studies of epigenetics???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 346
Summary and concluding remarks?????????????????????????????????????????????????????????????????????????? 346
References?????????????????????????????????? 347
Chapter 26 Psychosocial adversity???????????????????????????????????????????????????????????????????????????????? 350
Introduction?????????????????????????????????????? 350
Conceptual issues in the effects of psychosocial adversity on children?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 350
Transactional processes between individuals and their environments?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 350
Moderation processes in the effects of environmental adversity?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 350
Mediation: from distal to proximal risks?????????????????????????????????????????????????????????????????????????????????????????????? 350
Developmental timing?????????????????????????????????????????????????????? 351
Empirical findings on distal risk factors???????????????????????????????????????????????????????????????????????????????????????????????? 351
Neighborhood influences???????????????????????????????????????????????????????????? 351
Exposure to war???????????????????????????????????????????? 351
Socioeconomic status?????????????????????????????????????????????????????? 352
Effects of poverty on children mediated by parenting?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 352
Cumulative risk???????????????????????????????????????????? 352
Cumulative social disadvantage and parenting?????????????????????????????????????????????????????????????????????????????????????????????????????? 352
Distal risks in low- and middle-income countries?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 352
Empirical findings on proximal risk factors: development in the context of close relationships?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 353
Parental responsivity???????????????????????????????????????????????????????? 353
Parenting dimensions?????????????????????????????????????????????????????? 353
Harshness???????????????????????????????? 353
Warmth?????????????????????????? 353
Monitoring?????????????????????????????????? 353
Parenting for cognitive development???????????????????????????????????????????????????????????????????????????????????? 354
Differential parenting?????????????????????????????????????????????????????????? 354
The childhoods of parents???????????????????????????????????????????????????????????????? 354
Loss of a parent?????????????????????????????????????????????? 354
Siblings?????????????????????????????? 354
The family environment?????????????????????????????????????????????????????????? 354
Peers???????????????????????? 355
Marital conflict?????????????????????????????????????????????? 355
Separation and divorce?????????????????????????????????????????????????????????? 356
Childcare influences?????????????????????????????????????????????????????? 356
Chronic versus acute psychosocial adversity???????????????????????????????????????????????????????????????????????????????????????????????????? 356
Summary of findings related to psychosocial adversity causing child psychopathology???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 356
Directions for future research?????????????????????????????????????????????????????????????????????????? 357
References?????????????????????????????????? 357
Chapter 27 Resilience: concepts, findings, and clinical implications?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 361
Testing for environmental mediation of risks?????????????????????????????????????????????????????????????????????????????????????????????????????? 362
Types of features associated with resilience?????????????????????????????????????????????????????????????????????????????????????????????????????? 363
Features that are neutral or risky in the absence of a risk experience?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 363
Mental features???????????????????????????????????????????? 363
Turning points in life after childhood?????????????????????????????????????????????????????????????????????????????????????????? 364
Enhancement of successful coping with stress/challenge?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 365
Gene-environment interactions (G x E)???????????????????????????????????????????????????????????????????????????????????????? 365
Supportive family warmth and cohesion???????????????????????????????????????????????????????????????????????????????????????? 366
Overview of resilience features???????????????????????????????????????????????????????????????????????????? 367
Clinical implications???????????????????????????????????????????????????????? 367
Prevention?????????????????????????????????? 367
Treatment???????????????????????????????? 368
Conclusions???????????????????????????????????? 368
References?????????????????????????????????? 368
Chapter 28 Impact of parental psychiatric disorder and physical illness???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 372
Intergenerational transmission of psychiatric disorder: a conceptual and theoretical overview???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 372
Intergenerational transmission of psychopathology: one size does not fit all?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 374
The mechanics of mechanism: mediators versus moderators in clinical research?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 374
Parental psychiatric disorders?????????????????????????????????????????????????????????????????????????? 375
Depression?????????????????????????????????? 375
Anxiety???????????????????????????? 376
Eating disorders?????????????????????????????????????????????? 376
Alcohol and substance misuse?????????????????????????????????????????????????????????????????????? 376
Schizophrenia and other psychoses???????????????????????????????????????????????????????????????????????????????? 377
Psychiatric disorders in fathers?????????????????????????????????????????????????????????????????????????????? 377
Parental physical disorders???????????????????????????????????????????????????????????????????? 377
Clinical implications???????????????????????????????????????????????????????? 378
Parental psychiatric disorders?????????????????????????????????????????????????????????????????????????? 378
Common psychiatric disorders in parents???????????????????????????????????????????????????????????????????????????????????????????? 379
Psychotic disorder?????????????????????????????????????????????????? 380
Substance misuse?????????????????????????????????????????????? 380
Parental physical disorders???????????????????????????????????????????????????????????????????? 380
Young carers and parental psychiatric and physical illness?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 380
Concluding comments in relation to both parental physical and psychiatric disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 381
Summary???????????????????????????? 381
References?????????????????????????????????? 381
Chapter 29 Child maltreatment???????????????????????????????????????????????????????????????????????? 384
Safeguarding children: a pressing global challenge?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 384
Definitions: maltreatment types???????????????????????????????????????????????????????????????????????????? 385
Epidemiology?????????????????????????????????????? 385
Factors associated with occurrence of maltreatment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 386
Child's individual risk factors for victimization???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 386
Parents' or carers' individual risk factors for perpetration?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 386
Family risk factors???????????????????????????????????????????????????? 386
Community risk factors?????????????????????????????????????????????????????????? 386
Consequences of maltreatment?????????????????????????????????????????????????????????????????????? 387
Recognizing child maltreatment?????????????????????????????????????????????????????????????????????????? 388
Responding to child maltreatment?????????????????????????????????????????????????????????????????????????????? 390
Interventions???????????????????????????????????????? 391
Prevention of recurrence of child maltreatment?????????????????????????????????????????????????????????????????????????????????????????????????????????? 391
Prevention and treatment of impairment?????????????????????????????????????????????????????????????????????????????????????????? 391
Prevention of maltreatment occurrence???????????????????????????????????????????????????????????????????????????????????????? 392
Universal interventions???????????????????????????????????????????????????????????? 392
Targeted interventions?????????????????????????????????????????????????????????? 392
Future directions???????????????????????????????????????????????? 392
References?????????????????????????????????? 393
Chapter 30 Child sexual abuse???????????????????????????????????????????????????????????????????????? 396
Introduction?????????????????????????????????????? 396
Definitions???????????????????????????????????? 396
Cultural aspects?????????????????????????????????????????????? 397
Legal considerations?????????????????????????????????????????????????????? 397
Demographics?????????????????????????????????????? 397
The victims???????????????????????????????????? 397
Age of victims?????????????????????????????????????????? 397
Gender of victims???????????????????????????????????????????????? 397
Disability?????????????????????????????????? 397
Abusers???????????????????????????? 397
Adults?????????????????????????? 397
Children and adolescents?????????????????????????????????????????????????????????????? 398
Abuser-child relationship???????????????????????????????????????????????????????????????? 398
The nature and circumstances of the abuse???????????????????????????????????????????????????????????????????????????????????????????????? 398
Frequency and duration of abuse for an individual child???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 398
Contact abuse???????????????????????????????????????? 398
Noncontact abuse?????????????????????????????????????????????? 398
The use of the internet and mobile phone technology???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 398
Organized abuse???????????????????????????????????????????? 398
Commercial sexual exploitation of children?????????????????????????????????????????????????????????????????????????????????????????????????? 399
Abuse by clergy, media personnel, and in institutions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 399
Epidemiology?????????????????????????????????????? 399
Prevalence?????????????????????????????????? 399
Fluctuations in rates of reported cases???????????????????????????????????????????????????????????????????????????????????????????? 399
Country, ethnicity, culture, socioeconomic, and family status???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 400
Risk and maintaining factors for child sexual abuse???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 400
Maintaining factors???????????????????????????????????????????????????? 400
Effects of child sexual abuse???????????????????????????????????????????????????????????????????????? 401
Effects in childhood and adolescence?????????????????????????????????????????????????????????????????????????????????????? 401
Factors and postulated explanations for variability???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 401
Protective factors?????????????????????????????????????????????????? 401
Effects in adulthood?????????????????????????????????????????????????????? 401
Mental health???????????????????????????????????????? 401
Physical health???????????????????????????????????????????? 402
Neurobiological effects???????????????????????????????????????????????????????????? 402
Suspicion, recognition, investigation, validation, and protection???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 402
Principles?????????????????????????????????? 402
Suspicion, recognition, and disclosure?????????????????????????????????????????????????????????????????????????????????????????? 402
The investigation, protection, and formal interview???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 403
Validation?????????????????????????????????? 403
The nature of protection?????????????????????????????????????????????????????????????? 403
Legal proceedings???????????????????????????????????????????????? 404
Therapeutic work?????????????????????????????????????????????? 404
Fulfilment of children's therapeutic needs?????????????????????????????????????????????????????????????????????????????????????????????????? 404
Group therapy???????????????????????????????????????? 404
Individual therapy?????????????????????????????????????????????????? 404
Therapeutic work with caregivers and family???????????????????????????????????????????????????????????????????????????????????????????????????? 405
Non-abusing caregivers?????????????????????????????????????????????????????????? 405
Siblings and the family???????????????????????????????????????????????????????????? 405
Work with abusers???????????????????????????????????????????????? 405
Child and adolescent abusers?????????????????????????????????????????????????????????????????????? 405
Adult abusers???????????????????????????????????????? 405
Conclusions???????????????????????????????????? 405
References?????????????????????????????????? 405
Chapter 31 Brain disorders and psychopathology?????????????????????????????????????????????????????????????????????????????????????????????????????????? 409
Brain damage????????????????????????????????????????? 409
Birth damage?????????????????????????????????????? 410
Brain dysfunction increases the risk of child psychiatric disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 410
At risk for which psychiatric disorders??????????????????????????????????????????????????????????????????????????????????????????????? 411
How do neurological and non neurological risk factors interact????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 411
What are the mediating links????????????????????????????????????????????????????????????????????????? 413
The psychiatric consequences of specific brain disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 414
Epilepsy?????????????????????????????? 414
Cerebral palsy?????????????????????????????????????????? 417
Childhood dementias and other conditions involving the loss of skills???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 417
Treatment of psychiatric problems in children with brain disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 419
References?????????????????????????????????? 420
Part III Approaching the clinical encounter???????????????????????????????????????????????????????????????????????????????????????????????????? 423
A The clinical assessment 425
Chapter 32 Clinical assessment and diagnostic formulation???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 427
Introduction?????????????????????????????????????? 427
Initial questions regarding referral?????????????????????????????????????????????????????????????????????????????????????? 427
Observations of the family?????????????????????????????????????????????????????????????????? 429
Attitudes to referral, disorder and treatment???????????????????????????????????????????????????????????????????????????????????????????????????????? 429
Patterns of interaction???????????????????????????????????????????????????????????? 429
Basic elements in the diagnostic clinical assessment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 430
Interview with the child?????????????????????????????????????????????????????????????? 430
Parental interview?????????????????????????????????????????????????? 430
School reports and direct contact with teachers???????????????????????????????????????????????????????????????????????????????????????????????????????????? 431
Psychological testing and medical assessment?????????????????????????????????????????????????????????????????????????????????????????????????????? 432
Standardization of clinical assessment?????????????????????????????????????????????????????????????????????????????????????????? 432
Presence/absence of clinically significant psychopathology?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 432
Assessment of psychosocial impairment and safety?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 433
Duration and timing of disorder???????????????????????????????????????????????????????????????????????????? 433
Diagnostic formulation: integration and synthesis???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 434
Psychoeducation???????????????????????????????????????????? 434
Treatment planning?????????????????????????????????????????????????? 435
Safety?????????????????????????? 435
Build on strengths, foster resilience, and keep development "on track"?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 435
Team building with the child and the parents?????????????????????????????????????????????????????????????????????????????????????????????????????? 436
Interface with school personnel, pediatricians, and other practitioners???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 436
Cultural appropriateness?????????????????????????????????????????????????????????????? 436
Standards for Practice?????????????????????????????????????????????????????????? 436
Approaches to assessment and treatment planning across the globe?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 436
Conclusions???????????????????????????????????? 437
References?????????????????????????????????? 437
Chapter 33 Use of structured interviews, rating scales, and observational methods in clinical settings?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 439
Introduction?????????????????????????????????????? 439
Selecting measures?????????????????????????????????????????????????? 440
Purpose???????????????????????????? 440
Psychometrics???????????????????????????????????????? 440
Practical considerations?????????????????????????????????????????????????????????????? 440
Interviews?????????????????????????????????? 440
Scales?????????????????????????? 441
Comprehensive and broad-based scales?????????????????????????????????????????????????????????????????????????????????????? 441
Anxiety and depression (also see Chapters 60 and 63)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 441
Anxiety???????????????????????????? 441
Depression?????????????????????????????????? 447
Disorders of attention, impulsivity, hyperactivity and disruptive behavior (also see Chapters 55 and 65)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 448
Scales for other specific disorders???????????????????????????????????????????????????????????????????????????????????? 448
Impairment and functioning?????????????????????????????????????????????????????????????????? 451
Observations?????????????????????????????????????? 451
Implementing standardized assessments in clinical settings?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 452
Conclusion?????????????????????????????????? 452
References?????????????????????????????????? 452
Chapter 34 Psychological assessment in the clinical context???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 456
Introduction?????????????????????????????????????? 456
Psychological assessment within the broader context???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 456
Informal and semi-formal clinical assessments???????????????????????????????????????????????????????????????????????????????????????????????????????? 456
Pre-assessment assessments?????????????????????????????????????????????????????????????????? 456
Clinic-based assessments?????????????????????????????????????????????????????????????? 457
Interviewing children and young people and parents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 457
Non-clinic-based assessment???????????????????????????????????????????????????????????????????? 458
Formal psychometric assessment?????????????????????????????????????????????????????????????????????????? 458
Intelligence testing?????????????????????????????????????????????????????? 458
Standardized assessments?????????????????????????????????????????????????????????????? 459
What makes a "good" test????????????????????????????????????????????????????????????????? 459
Tests of general intelligence???????????????????????????????????????????????????????????????????????? 460
Assessments for infants and toddlers?????????????????????????????????????????????????????????????????????????????????????? 460
Tests of other abilities?????????????????????????????????????????????????????????????? 462
Assessment of executive functioning, attention, and memory?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 462
Achievement tests???????????????????????????????????????????????? 462
Special considerations?????????????????????????????????????????????????????????? 462
Low IQ?????????????????????????? 462
Testing hearing and/or language impaired children???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 463
Rare disorders?????????????????????????????????????????? 463
Different cultures and communities?????????????????????????????????????????????????????????????????????????????????? 463
Interpreting and reporting test scores in "atypical" children???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 463
Unstandardized assessments?????????????????????????????????????????????????????????????????? 464
Considerations in the testing environment???????????????????????????????????????????????????????????????????????????????????????????????? 464
What to report and how?????????????????????????????????????????????????????????? 464
Professional issues for psychologists???????????????????????????????????????????????????????????????????????????????????????? 465
Using psychological assessments to inform intervention?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 465
Assessing behavioral functions?????????????????????????????????????????????????????????????????????????? 465
The value of single case research???????????????????????????????????????????????????????????????????????????????? 466
Conclusions???????????????????????????????????? 466
References?????????????????????????????????? 467
Chapter 35 Physical examination and medical investigation???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 469
Introduction?????????????????????????????????????? 469
The medical history???????????????????????????????????????????????????? 470
The physical examination?????????????????????????????????????????????????????????????? 472
Laboratory investigation?????????????????????????????????????????????????????????????? 474
An example: the evaluation of psychosis???????????????????????????????????????????????????????????????????????????????????????????? 477
Summary???????????????????????????? 478
References?????????????????????????????????? 478
B Considering and selecting available treatments 481
Chapter 36 Psychological interventions: overview and critical issues for the field?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 483
Studying the effects of youth psychotherapy: methods and findings???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 483
Meta-analytic findings?????????????????????????????????????????????????????????? 483
Identifying "evidence-based psychotherapies"?????????????????????????????????????????????????????????????????????????????????????????????????????? 484
The evidence-based psychotherapies: "well-established" and "probably efficacious"???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 484
Autism?????????????????????????? 484
Eating disorders?????????????????????????????????????????????? 486
Anxiety disorders???????????????????????????????????????????????? 486
Depression?????????????????????????????????? 486
Attention deficit/hyperactivity disorder?????????????????????????????????????????????????????????????????????????????????????????????? 486
Conduct-related problems and disorders?????????????????????????????????????????????????????????????????????????????????????????? 487
Adolescent substance abuse?????????????????????????????????????????????????????????????????? 487
Investigating the strength, causes, and conditions of effective treatment???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 487
Mediators and mechanisms of change?????????????????????????????????????????????????????????????????????????????????? 487
Moderators of treatment outcome???????????????????????????????????????????????????????????????????????????? 487
Mediators of evidence-based psychotherapies???????????????????????????????????????????????????????????????????????????????????????????????????? 487
Negative cognitions???????????????????????????????????????????????????? 487
Parenting practices???????????????????????????????????????????????????? 488
Discussion?????????????????????????????????? 488
Moderators of evidence-based psychotherapies?????????????????????????????????????????????????????????????????????????????????????????????????????? 489
Youth characteristics???????????????????????????????????????????????????????? 489
Caregiver and family characteristics?????????????????????????????????????????????????????????????????????????????????????? 489
Method factors?????????????????????????????????????????? 490
Therapist adherence and competence?????????????????????????????????????????????????????????????????????????????????? 490
Adapting and testing psychotherapies for diverse populations?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 491
Ethnic minority populations???????????????????????????????????????????????????????????????????? 491
Lower and middle-income countries and war-exposed youths?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 491
Youth offenders in the juvenile and criminal justice system???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 492
Youths cared for in child protection programs???????????????????????????????????????????????????????????????????????????????????????????????????????? 492
Putting science into practice: EBPs and the clinical practice of youth mental health care???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 492
Dissemination and implementation of evidence-based practices?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 493
Goodness-of-fit issues in the design of evidence-based practices?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 493
Context of EBP development and testing versus conditions of everyday practice???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 493
(Un)Representiveness of most research on evidence-based youth psychotherapies???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 493
Do EBPs actually produce better outcomes than usual clinical care??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 494
Strategies for strengthening youth psychotherapies and intervention science???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 494
Making intervention research look more like practice?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 494
Tapping the heuristic potential of usual care???????????????????????????????????????????????????????????????????????????????????????????????????????? 494
Taking risks and learning from both failure and harm?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 495
Restructuring evidence-based psychotherapies to fit clinical practice needs???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 496
Improving care through monitoring and feedback?????????????????????????????????????????????????????????????????????????????????????????????????????????? 497
Enriching our understanding of what makes treatments work???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 497
Building efficient and accessible delivery methods and models???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 497
Summary and concluding comment?????????????????????????????????????????????????????????????????????????? 498
References?????????????????????????????????? 498
Chapter 37 Parenting programs???????????????????????????????????????????????????????????????????????? 503
Introduction?????????????????????????????????????? 503
Styles of parenting addressed by parenting programs???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 503
Dimensions of parenting addressed in interventions derived from social learning theory?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 503
Dimensions of parenting addressed in interventions derived from attachment theory???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 504
Biological effects of parenting???????????????????????????????????????????????????????????????????????????? 504
Child characteristics that may affect susceptibility to the effects of parenting?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 505
Inherited characteristics and behavioral phenotypes???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 505
Specific genotypes?????????????????????????????????????????????????? 505
Programs for children with conduct problems???????????????????????????????????????????????????????????????????????????????????????????????????? 505
Effectiveness???????????????????????????????????????? 505
Outcomes?????????????????????????????? 505
Comparison with nonbehavioral programs?????????????????????????????????????????????????????????????????????????????????????????? 507
Programs for infants?????????????????????????????????????????????????????? 507
Effectiveness???????????????????????????????????????? 508
Father involvement in parenting programs?????????????????????????????????????????????????????????????????????????????????????????????? 508
Application of programs to specific populations???????????????????????????????????????????????????????????????????????????????????????????????????????????? 508
Programs for particular child issues and contexts???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 509
Depression, anxiety, and other emotional problems???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 509
ADHD?????????????????????? 509
Callous unemotional traits?????????????????????????????????????????????????????????????????? 509
Programs for particular parent issues and contexts?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 509
Specific parental issues and contexts???????????????????????????????????????????????????????????????????????????????????????? 509
Transportability of parenting programs to different cultures and countries?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 509
What makes parenting programs work????????????????????????????????????????????????????????????????????????????????????? 510
Predictors and moderators of outcome?????????????????????????????????????????????????????????????????????????????????????? 510
Child age and gender?????????????????????????????????????????????????????? 510
Child psychopathology???????????????????????????????????????????????????????? 510
Family factors?????????????????????????????????????????? 510
Mediators of change???????????????????????????????????????????????????? 510
Implementation and dissemination?????????????????????????????????????????????????????????????????????????????? 511
Implementation?????????????????????????????????????????? 511
Therapist effects???????????????????????????????????????????????? 511
Dissemination???????????????????????????????????????? 511
Prevention?????????????????????????????????? 511
Conclusions???????????????????????????????????? 512
References?????????????????????????????????? 512
Chapter 38 Cognitive-behavioral therapy, behavioral therapy, and related treatments in children???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 516
Understanding cognitive-behavioral therapy (CBT)?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 516
Empirically-supported CBTs and BTs for youth?????????????????????????????????????????????????????????????????????????????????????????????????????? 517
Treatment modalities?????????????????????????????????????????????????????? 517
Anxiety disorders???????????????????????????????????????????????? 517
Obsessive compulsive disorder???????????????????????????????????????????????????????????????????????? 517
Post traumatic stress disorder?????????????????????????????????????????????????????????????????????????? 517
Depressive disorders?????????????????????????????????????????????????????? 518
Bipolar disorder?????????????????????????????????????????????? 518
Disruptive behavior disorders???????????????????????????????????????????????????????????????????????? 518
Eating disorders?????????????????????????????????????????????? 519
Attention deficit/hyperactivity disorder?????????????????????????????????????????????????????????????????????????????????????????????? 519
Common treatment components???????????????????????????????????????????????????????????????????? 519
Psychoeducation???????????????????????????????????????????? 519
Relaxation?????????????????????????????????? 520
Problem-solving???????????????????????????????????????????? 520
Homework?????????????????????????????? 520
Work with parents???????????????????????????????????????????????? 521
Social skills training?????????????????????????????????????????????????????????? 521
Contingency management?????????????????????????????????????????????????????????? 521
Modeling and role play?????????????????????????????????????????????????????????? 521
Cognitive restructuring???????????????????????????????????????????????????????????? 522
Flexible adaptations of CBT???????????????????????????????????????????????????????????????????? 522
"Flexibility within fidelity"???????????????????????????????????????????????????????????????????????? 522
Modular treatments?????????????????????????????????????????????????? 522
Obstacles to treatment?????????????????????????????????????????????????????????? 523
Internet provided CBT???????????????????????????????????????????????????????? 523
Developmental considerations?????????????????????????????????????????????????????????????????????? 523
CBT and BT for intellectual disabilities?????????????????????????????????????????????????????????????????????????????????????????????? 523
Criticisms of CBT???????????????????????????????????????????????? 524
CBT related therapies???????????????????????????????????????????????????????? 524
Mindfulness-based cognitive therapy (MBCT)?????????????????????????????????????????????????????????????????????????????????????????????????? 524
Acceptance and commitment therapy (ACT)???????????????????????????????????????????????????????????????????????????????????????????? 524
Dialectical behavior therapy?????????????????????????????????????????????????????????????????????? 524
Future directions???????????????????????????????????????????????? 525
Acknowledgment?????????????????????????????????????????? 525
References?????????????????????????????????? 525
Chapter 39 Family interventions???????????????????????????????????????????????????????????????????????????? 530
Family interventions in the broader context of other psychological treatments???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 530
The role of the family therapist in the multidisciplinary team?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 530
Theoretical considerations informing work with families???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 531
The family context of individual problems and the broader social environment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 531
The family as a system?????????????????????????????????????????????????????????? 531
The role of the family in the development and maintenance of psychopathology?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 531
Impact of individual problems on family life?????????????????????????????????????????????????????????????????????????????????????????????????????? 532
The family life cycle???????????????????????????????????????????????????????? 532
A conceptual framework for working with families?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 532
Creating a safe context for working together toward change?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 532
Frameworks for change???????????????????????????????????????????????????????? 533
Maintenance framework???????????????????????????????????????????????????????? 533
Influencing framework???????????????????????????????????????????????????????? 533
Frameworks focusing on changes in belief and meaning?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 534
Practical issues and techniques of family interventions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 534
Whom to see and when?????????????????????????????????????????????????????? 534
The context of family sessions?????????????????????????????????????????????????????????????????????????? 535
Specific interview and intervention techniques?????????????????????????????????????????????????????????????????????????????????????????????????????????? 535
Genograms, family drawings, and other techniques?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 535
Contraindications for family interventions and/or indications to proceed with special care?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 536
Criticism, family conflict, hostility, and violence???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 536
Abuse and neglect???????????????????????????????????????????????? 536
Disorganized and poorly functioning families?????????????????????????????????????????????????????????????????????????????????????????????????????? 536
Research evidence informing family therapy practice???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 536
Implications for clinical practice?????????????????????????????????????????????????????????????????????????????????? 537
Conclusions???????????????????????????????????? 538
References?????????????????????????????????? 538
Chapter 40 Relationship-based treatments?????????????????????????????????????????????????????????????????????????????????????????????? 541
Introduction?????????????????????????????????????? 541
Treatments targeted at early relationships?????????????????????????????????????????????????????????????????????????????????????????????????? 541
Context of parental risk?????????????????????????????????????????????????????????????? 541
Parent-mediated video-aided interventions???????????????????????????????????????????????????????????????????????????????????????????????? 541
Psychotherapeutic interventions???????????????????????????????????????????????????????????????????????????? 542
Group support and counselling???????????????????????????????????????????????????????????????????????? 542
Context of child developmental risk or disability???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 542
Summary???????????????????????????? 543
Therapist-patient relationship as a mode of treatment???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 543
Therapeutic alliance?????????????????????????????????????????????????????? 543
Alliance, treatment fidelity, and adherence???????????????????????????????????????????????????????????????????????????????????????????????????? 544
Attachment-based therapy?????????????????????????????????????????????????????????????? 544
Motivational interviewing???????????????????????????????????????????????????????????????? 545
Psychotherapeutic treatments for children and adolescents???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 545
Mentalization based treatment???????????????????????????????????????????????????????????????????????? 545
Short term psychodynamic psychotherapy (STPP)???????????????????????????????????????????????????????????????????????????????????????????????????????? 546
Interpersonal psychotherapy???????????????????????????????????????????????????????????????????? 547
Cognitive analytic therapy?????????????????????????????????????????????????????????????????? 548
Summary???????????????????????????? 548
Implementation science?????????????????????????????????????????????????????????? 548
Treatment selection???????????????????????????????????????????????????? 549
Global health???????????????????????????????????????? 549
References?????????????????????????????????? 549
Chapter 41 Educational interventions for children's learning difficulties???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 553
Conceptual and methodological issues?????????????????????????????????????????????????????????????????????????????????????? 553
Dyslexia and decoding impairments???????????????????????????????????????????????????????????????????????????????? 553
Nature and causes of dyslexia and decoding impairments?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 553
Interventions targeting phonology???????????????????????????????????????????????????????????????????????????????? 554
Meta-analyses of outcome studies?????????????????????????????????????????????????????????????????????????????? 554
Moderators of outcome???????????????????????????????????????????????????????? 554
Interventions targeting reading fluency???????????????????????????????????????????????????????????????????????????????????????????? 555
Meta-analyses of outcome studies?????????????????????????????????????????????????????????????????????????????? 555
Recent studies targeting phonology and decoding???????????????????????????????????????????????????????????????????????????????????????????????????????????? 555
Summary: interventions for decoding and reading fluency problems?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 555
Reading comprehension impairment?????????????????????????????????????????????????????????????????????????????? 556
Nature and causes of reading comprehension impairment???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 556
Interventions targeting reading comprehension impairment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 556
Meta-analyses of outcome studies?????????????????????????????????????????????????????????????????????????????? 556
Moderators of outcome???????????????????????????????????????????????????????? 556
Recent studies targeting reading comprehension impairments?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 556
Summary: interventions for reading comprehension impairment???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 557
Specific language impairment?????????????????????????????????????????????????????????????????????? 557
Nature and causes of specific language impairment???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 557
Interventions targeting specific language impairment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 558
Meta-analyses of outcome studies?????????????????????????????????????????????????????????????????????????????? 558
Recent studies targeting language comprehension???????????????????????????????????????????????????????????????????????????????????????????????????????????? 558
Summary: interventions for oral language impairments in children?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 559
Mathematics disorder?????????????????????????????????????????????????????? 559
Nature and causes of mathematics disorder (see Chapter 53)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 559
Interventions targeting mathematics abilities???????????????????????????????????????????????????????????????????????????????????????????????????????? 559
Meta-analyses of treatment studies?????????????????????????????????????????????????????????????????????????????????? 559
Recent studies targeting mathematical abilities???????????????????????????????????????????????????????????????????????????????????????????????????????????? 559
Summary of interventions for mathematical abilities???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 560
The effectiveness of educational interventions for children with general learning difficulties?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 560
Summary???????????????????????????? 561
The effectiveness of interventions targeting general cognitive functions?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 561
Conclusions and future directions for clinical practice and research?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 562
References?????????????????????????????????? 562
Chapter 42 School-based mental health interventions???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 565
Introduction?????????????????????????????????????? 565
Global school mental health???????????????????????????????????????????????????????????????????? 565
Addressing mental health problems at schools?????????????????????????????????????????????????????????????????????????????????????????????????????? 565
Strengths and weaknesses of school-based interventions?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 566
Identifying risk and disorder???????????????????????????????????????????????????????????????????????? 566
Methods of delivering interventions at school???????????????????????????????????????????????????????????????????????????????????????????????????????? 566
Staff delivering interventions?????????????????????????????????????????????????????????????????????????? 567
Types of intervention???????????????????????????????????????????????????????? 567
Programs developed for delivery at school???????????????????????????????????????????????????????????????????????????????????????????????? 567
Programs targeting overall mental well-being?????????????????????????????????????????????????????????????????????????????????????????????????????? 567
Problem behaviors and conduct disorder?????????????????????????????????????????????????????????????????????????????????????????? 567
Attention hyperactivity disorder (ADHD)???????????????????????????????????????????????????????????????????????????????????????????? 568
Substance use disorders???????????????????????????????????????????????????????????? 568
Universal preventive programs: alcohol?????????????????????????????????????????????????????????????????????????????????????????? 569
Universal preventive programs: nicotine???????????????????????????????????????????????????????????????????????????????????????????? 569
Targeted programs???????????????????????????????????????????????? 569
Use of computers?????????????????????????????????????????????? 569
Depression and anxiety?????????????????????????????????????????????????????????? 569
Posttraumatic stress disorder???????????????????????????????????????????????????????????????????????? 573
Eating disorders?????????????????????????????????????????????? 573
Autistic spectrum disorders (ASD)???????????????????????????????????????????????????????????????????????????????? 573
Suicide prevention and postvention?????????????????????????????????????????????????????????????????????????????????? 573
School absenteeism?????????????????????????????????????????????????? 574
Bullying?????????????????????????????? 574
School-based mental health in practice?????????????????????????????????????????????????????????????????????????????????????????? 574
Conclusions???????????????????????????????????? 575
REFERENCES?????????????????????????????????? 575
Chapter 43 Pharmacological, medically-led and related treatments?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 579
Introduction and regulation of psychoactive drugs???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 579
Discovery???????????????????????????????? 579
Judging clinical trials???????????????????????????????????????????????????????????? 579
Recommendations, guidelines, and protocols?????????????????????????????????????????????????????????????????????????????????????????????????? 579
Licensing, international differences, and off-label use???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 580
International differences and secular trends?????????????????????????????????????????????????????????????????????????????????????????????????????? 581
Place of medication in therapeutic planning???????????????????????????????????????????????????????????????????????????????????????????????????? 581
Targets for medication?????????????????????????????????????????????????????????? 581
Pharmacological versus psychological interventions?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 581
Pretreatment assessment???????????????????????????????????????????????????????????? 582
Explanation and advice?????????????????????????????????????????????????????????? 582
Consent???????????????????????????? 582
Compliance?????????????????????????????????? 583
Involvement of multidisciplinary team: knowledge and attitudes, communication???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 584
Prescribing: evidence and practice?????????????????????????????????????????????????????????????????????????????????? 584
Developmental changes in pharmacokinetics???????????????????????????????????????????????????????????????????????????????????????????????? 584
Prescribing errors and avoiding errors?????????????????????????????????????????????????????????????????????????????????????????? 584
Stimulants and other antihyperkinetic agents?????????????????????????????????????????????????????????????????????????????????????????????????????? 584
Antipsychotics?????????????????????????????????????????? 585
Antidepressants???????????????????????????????????????????? 587
Tricyclics?????????????????????????????????? 587
Selective serotonin reuptake inhibitors (SSRIs)???????????????????????????????????????????????????????????????????????????????????????????????????????????? 587
Newer antidepressants???????????????????????????????????????????????????????? 587
Monoamine oxidase inhibitors (MAOIs)?????????????????????????????????????????????????????????????????????????????????????? 587
Drugs used for stabilizing mood???????????????????????????????????????????????????????????????????????????? 588
Other drugs???????????????????????????????????? 588
Dietary interventions???????????????????????????????????????????????????????? 588
Elimination diets???????????????????????????????????????????????? 588
Elimination of individually identified food substances?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 589
Dietary supplements???????????????????????????????????????????????????? 589
Neurotherapies?????????????????????????????????????????? 589
Combinations of treatment???????????????????????????????????????????????????????????????? 590
Research and future developments?????????????????????????????????????????????????????????????????????????????? 590
References?????????????????????????????????? 590
C Contexts of the clinical encounter and specific clinical situations 593
Chapter 44 Refugee, asylum-seeking and internally displaced children and adolescents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 595
Introduction?????????????????????????????????????? 595
Definition of terms and the global refugee situation?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 596
Prevalence of psychiatric disorder?????????????????????????????????????????????????????????????????????????????????? 596
Risk and resilience in young refugees???????????????????????????????????????????????????????????????????????????????????????? 597
The societal context?????????????????????????????????????????????????????? 597
The community context???????????????????????????????????????????????????????? 598
The family context?????????????????????????????????????????????????? 599
The individual context?????????????????????????????????????????????????????????? 599
Assessment?????????????????????????????????? 599
Interventions???????????????????????????????????????? 600
Trauma-focused interventions?????????????????????????????????????????????????????????????????????? 601
Multimodal interventions?????????????????????????????????????????????????????????????? 601
Course and long-term outcomes for young refugees?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 602
Conclusions???????????????????????????????????? 602
References?????????????????????????????????? 603
Chapter 45 Pediatric consultation and psychiatric aspects of somatic disease?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 606
Introduction?????????????????????????????????????? 606
History???????????????????????????? 606
Consultation service models???????????????????????????????????????????????????????????????????? 606
"Liaison" care?????????????????????????????????????????? 607
Approach to consultation requests???????????????????????????????????????????????????????????????????????????????? 607
The consultation?????????????????????????????????????????????? 607
Interview of child and family???????????????????????????????????????????????????????????????????????? 607
Collateral sources?????????????????????????????????????????????????? 608
Formulation: premorbid medical and psychiatric functioning?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 608
Formulation: conceptions of medical illness across child development?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 608
Formulation: illness-specific medical perspective???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 609
Mental status examination in the hospitalized or medically ill child?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 609
Presenting recommendations to the team?????????????????????????????????????????????????????????????????????????????????????????? 609
Reasons for consultation: primary psychiatric illnesses???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 609
Depression?????????????????????????????????? 609
Anxiety???????????????????????????? 610
Anorexia nervosa?????????????????????????????????????????????? 610
Psychosomatic illness???????????????????????????????????????????????????????? 610
Nonadherence?????????????????????????????????????? 610
Reasons for consultation: emergency consultations???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 611
Suicide attempts?????????????????????????????????????????????? 611
Delirium?????????????????????????????? 611
The challenging family?????????????????????????????????????????????????????????? 611
Child abuse???????????????????????????????????? 611
Reasons for consultation: psychological distress in the medically ill children?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 612
Coping with chronic illness???????????????????????????????????????????????????????????????????? 612
Asthma?????????????????????????? 612
Diabetes?????????????????????????????? 613
Cancer?????????????????????????? 613
Organ transplantation???????????????????????????????????????????????????????? 613
Inflammatory bowel disease?????????????????????????????????????????????????????????????????? 613
Cystic fibrosis???????????????????????????????????????????? 614
Neurologic illness?????????????????????????????????????????????????? 614
Encopresis and soiling/wetting?????????????????????????????????????????????????????????????????????????? 614
Dying in the hospital???????????????????????????????????????????????????????? 615
Conclusion?????????????????????????????????? 616
References?????????????????????????????????? 616
Chapter 46 Mental health and resilience in children and adolescents affected by HIV/AIDS?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 619
The global impact of HIV/AIDS on children and adolescents???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 619
The effects of HIV/AIDS on the social ecology, child development, and mental health???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 619
Brief overview of HIV and child health?????????????????????????????????????????????????????????????????????????????????????????? 621
Modes of HIV transmission in children and adolescents???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 621
HIV and its neurological impact in children and adolescents???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 622
HIV and psychopathology???????????????????????????????????????????????????????????? 622
Mental health and ART adherence???????????????????????????????????????????????????????????????????????????? 623
Mental health treatment for children and adolescents with HIV???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 623
Resilience in children, adolescents, and families affected by HIV/AIDS?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 623
Individual factors promoting resilience???????????????????????????????????????????????????????????????????????????????????????????? 623
Self-esteem and hope for the future???????????????????????????????????????????????????????????????????????????????????? 624
Family-level factors for HIV-affected and HIV-positive children???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 624
Coping in response to parental disease progression?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 624
Access to educational resources???????????????????????????????????????????????????????????????????????????? 624
Social support?????????????????????????????????????????? 624
Peer support?????????????????????????????????????? 625
Disclosure?????????????????????????????????? 625
Implications for intervention research and clinical settings?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 625
Group interventions for children and adolescents living with HIV?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 626
Family-based interventions?????????????????????????????????????????????????????????????????? 626
Economic strengthening interventions?????????????????????????????????????????????????????????????????????????????????????? 626
Community level interventions addressing stigma???????????????????????????????????????????????????????????????????????????????????????????????????????????? 626
Recommendations???????????????????????????????????????????? 627
References?????????????????????????????????? 627
Chapter 47 Children with specific sensory impairments???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 632
Visual impairment???????????????????????????????????????????????? 632
Etiology, identification, and visual management???????????????????????????????????????????????????????????????????????????????????????????????????????????? 632
Early family support and intervention???????????????????????????????????????????????????????????????????????????????????????? 633
Developmental aspects of visual impairment?????????????????????????????????????????????????????????????????????????????????????????????????? 633
Educational attainments???????????????????????????????????????????????????????????? 633
Emotional development and psychological well-being?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 633
Neuropsychological processes?????????????????????????????????????????????????????????????????????? 634
Neuroplasticity and brain organization?????????????????????????????????????????????????????????????????????????????????????????? 634
VI and complexity???????????????????????????????????????????????? 634
Assessment and diagnosis of neurodevelopmental disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 634
Psychological and psychiatric issues?????????????????????????????????????????????????????????????????????????????????????? 634
Hearing impairment?????????????????????????????????????????????????? 635
Etiology, identification, and audiological management???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 635
Early family support and intervention???????????????????????????????????????????????????????????????????????????????????????? 635
Developmental aspects of hearing impairment???????????????????????????????????????????????????????????????????????????????????????????????????? 636
Educational attainments???????????????????????????????????????????????????????????? 636
Emotional development and psychological well-being?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 636
Neuropsychological processes?????????????????????????????????????????????????????????????????????? 637
Neuroplasticity and brain organization?????????????????????????????????????????????????????????????????????????????????????????? 637
Hearing impairment and complexity???????????????????????????????????????????????????????????????????????????????? 637
Assessment and diagnosis of neurodevelopmental disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 637
Psychological and psychiatric issues?????????????????????????????????????????????????????????????????????????????????????? 637
Professional approaches for management and care???????????????????????????????????????????????????????????????????????????????????????????????????????????? 638
Assessment of cognition and language?????????????????????????????????????????????????????????????????????????????????????? 638
Psychological and psychiatric services?????????????????????????????????????????????????????????????????????????????????????????? 639
Global perspective?????????????????????????????????????????????????? 639
Useful websites for further information???????????????????????????????????????????????????????????????????????????????????????????? 639
References?????????????????????????????????? 640
Visual impairment???????????????????????????????????????????????? 640
Hearing impairment?????????????????????????????????????????????????? 641
Chapter 48 Assessment and treatment in nonspecialist community health care settings???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 643
Introduction?????????????????????????????????????? 643
Generalist primary health settings?????????????????????????????????????????????????????????????????????????????????? 643
Core roles of primary health care for child and adolescent mental health?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 644
Child and adolescent mental health problems in nonspecialist primary care settings?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 644
Frequency of contact with primary health care???????????????????????????????????????????????????????????????????????????????????????????????????????? 644
Modes of presentation???????????????????????????????????????????????????????? 644
Other points of contact???????????????????????????????????????????????????????????? 645
Identification of mental health problems in primary care?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 645
Frequency and nature of psychiatric disorder in attenders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 645
Recognizing need and diagnosing disorder?????????????????????????????????????????????????????????????????????????????????????????????? 645
Determinants of parental and youth help-seeking???????????????????????????????????????????????????????????????????????????????????????????????????????????? 646
Determinants of practitioner recognition?????????????????????????????????????????????????????????????????????????????????????????????? 646
Systematic screening or case-finding?????????????????????????????????????????????????????????????????????????????????????? 646
Electronic screening?????????????????????????????????????????????????????? 646
Delivering interventions, partnerships, and coordinated care?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 647
Traditional models of service design and delivery???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 647
Specialist or shifted mental health clinics???????????????????????????????????????????????????????????????????????????????????????????????????? 647
Treatments offered by the primary care team???????????????????????????????????????????????????????????????????????????????????????????????????? 647
Consultation-liaison?????????????????????????????????????????????????????? 647
Newer models of collaborative care?????????????????????????????????????????????????????????????????????????????????? 648
Disorder specific models?????????????????????????????????????????????????????????????? 648
Broad service redesign and delivery models?????????????????????????????????????????????????????????????????????????????????????????????????? 649
Prevention and early intervention???????????????????????????????????????????????????????????????????????????????? 649
Primary prevention?????????????????????????????????????????????????? 649
Early identification of behavioral problems and suicidal risk in adolescents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 650
Building capacity in the front line???????????????????????????????????????????????????????????????????????????????????? 651
Conclusions and further developments?????????????????????????????????????????????????????????????????????????????????????? 651
References?????????????????????????????????? 651
Chapter 49 Forensic psychiatry?????????????????????????????????????????????????????????????????????????? 656
Introduction?????????????????????????????????????? 656
Juvenile justice systems: a global perspective?????????????????????????????????????????????????????????????????????????????????????????????????????????? 656
General principles of juvenile justice?????????????????????????????????????????????????????????????????????????????????????????? 656
Youth justice process???????????????????????????????????????????????????????? 657
Disposal and sentencing???????????????????????????????????????????????????????????? 658
Restorative justice???????????????????????????????????????????????????? 658
A developmental understanding of juvenile delinquency???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 658
The mental health of juvenile offenders???????????????????????????????????????????????????????????????????????????????????????????? 659
Neurodevelopmental disorders?????????????????????????????????????????????????????????????????????? 659
Unmet needs???????????????????????????????????? 660
Forensic psychiatric assessment of juveniles?????????????????????????????????????????????????????????????????????????????????????????????????????? 660
Principles of assessment?????????????????????????????????????????????????????????????? 660
Risk assessment???????????????????????????????????????????? 660
Risk of violence to others?????????????????????????????????????????????????????????????????? 661
Sexually harmful behavior???????????????????????????????????????????????????????????????? 661
Unsafe fire setting and arson???????????????????????????????????????????????????????????????????????? 662
Emotional abuse and stalking?????????????????????????????????????????????????????????????????????? 662
Risk management???????????????????????????????????????????? 662
Interventions???????????????????????????????????????? 662
Principles of intervention?????????????????????????????????????????????????????????????????? 662
Evidence for early interventions?????????????????????????????????????????????????????????????????????????????? 662
Systemic interventions?????????????????????????????????????????????????????????? 663
Psychological and offending behavior programs???????????????????????????????????????????????????????????????????????????????????????????????????????? 663
Medical interventions???????????????????????????????????????????????????????? 663
Unhelpful interventions???????????????????????????????????????????????????????????? 664
Professional considerations???????????????????????????????????????????????????????????????????? 664
Ethical dilemmas facing the forensic psychiatrist???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 664
Conclusions???????????????????????????????????? 664
Acknowledgments???????????????????????????????????????????? 665
References?????????????????????????????????? 665
Chapter 50 Provision of intensive treatment: intensive outreach, day units, and in-patient units?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 668
Introduction?????????????????????????????????????? 668
Community intensive services?????????????????????????????????????????????????????????????????????? 668
Historical development?????????????????????????????????????????????????????????? 668
Overall principles?????????????????????????????????????????????????? 668
Community intensive services based on specific models???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 669
Multisystemic therapy???????????????????????????????????????????????????????? 669
Treatment foster care???????????????????????????????????????????????????????? 669
Case management???????????????????????????????????????????? 670
Intensive home treatment?????????????????????????????????????????????????????????????? 670
Family preservation services?????????????????????????????????????????????????????????????????????? 670
Intensive services based on dialectical behavior therapy?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 671
Day programs (partial hospitalization)?????????????????????????????????????????????????????????????????????????????????????????? 671
What do day programs offer????????????????????????????????????????????????????????????????????? 671
Inpatient services?????????????????????????????????????????????????? 672
Historical background and trends?????????????????????????????????????????????????????????????????????????????? 672
Types of unit???????????????????????????????????????? 672
How are young people admitted to an inpatient unit????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 673
Types of admission?????????????????????????????????????????????????? 673
Reasons for admission and characteristics of who is admitted?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 673
Assessment?????????????????????????????????? 673
Therapeutic function?????????????????????????????????????????????????????? 674
Behavioral management???????????????????????????????????????????????????????? 674
Seclusion???????????????????????????????? 674
Risk management???????????????????????????????????????????? 675
Does inpatient admission work??????????????????????????????????????????????????????????????????????????? 675
Length of stay?????????????????????????????????????????? 675
Readmission???????????????????????????????????? 675
Outcomes and evaluation???????????????????????????????????????????????????????????? 675
Suicide???????????????????????????? 675
Cost/benefits???????????????????????????????????????? 675
Discharge and transition to the community???????????????????????????????????????????????????????????????????????????????????????????????? 676
Summary of some key findings?????????????????????????????????????????????????????????????????????? 676
Final conclusions???????????????????????????????????????????????? 676
References?????????????????????????????????? 676
Part IV Clinical syndromes: neurodevelopmental, emotional, behavioral, somatic/body-brain???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 681
A Neurodevelopmental 683
Chapter 51 Autism spectrum disorder???????????????????????????????????????????????????????????????????????????????????? 685
Overview?????????????????????????????? 685
Clinical characteristics of ASD???????????????????????????????????????????????????????????????????????????? 685
The history of diagnosis and classification???????????????????????????????????????????????????????????????????????????????????????????????????? 686
Epidemiology?????????????????????????????????????? 686
Prevalence rates?????????????????????????????????????????????? 686
Population screening?????????????????????????????????????????????????????? 687
Economic cost???????????????????????????????????????? 688
Cultural factors?????????????????????????????????????????????? 688
Cognitive and emotional processes???????????????????????????????????????????????????????????????????????????????? 688
Longitudinal outcome?????????????????????????????????????????????????????? 689
Diagnostic stability and adult outcome studies?????????????????????????????????????????????????????????????????????????????????????????????????????????? 689
Risk factors and possible aetiologic mechanisms???????????????????????????????????????????????????????????????????????????????????????????????????????????? 689
Genetic studies???????????????????????????????????????????? 689
Environmental risk factors?????????????????????????????????????????????????????????????????? 690
Pre-, peri-, and post natal complications???????????????????????????????????????????????????????????????????????????????????????????????? 690
Environmental chemicals and teratogens, ethnic status and parental age?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 690
Neurotransmitters and neuromodulators???????????????????????????????????????????????????????????????????????????????????????? 691
Neuropathology findings and post mortem studies???????????????????????????????????????????????????????????????????????????????????????????????????????????? 691
Brain imaging???????????????????????????????????????? 691
Assessment?????????????????????????????????? 692
Treatments?????????????????????????????????? 694
Psychosocial and behavioral interventions for the management of core features of ASD?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 694
Other Interventions for the treatment of core features of ASD???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 695
Management of associated and co-occurring conditions?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 695
Identification and treatment of co-occurring behavioral and mental health problems?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 696
Educational issues?????????????????????????????????????????????????? 696
Family support?????????????????????????????????????????? 696
Transition planning???????????????????????????????????????????????????? 697
Future developments and necessary research?????????????????????????????????????????????????????????????????????????????????????????????????? 697
Acknowledgments???????????????????????????????????????????? 697
References?????????????????????????????????? 697
Chapter 52 Disorders of speech, language, and communication???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 703
Introduction?????????????????????????????????????? 703
Distinguishing speech, language, and communication?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 703
General principles of assessment?????????????????????????????????????????????????????????????????????????????? 704
Differential diagnosis of speech disorders?????????????????????????????????????????????????????????????????????????????????????????????????? 705
Speech sound disorder???????????????????????????????????????????????????????? 707
Prevalence, prognosis, causes, and correlates of speech disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 707
Assessment of speech sound disorders?????????????????????????????????????????????????????????????????????????????????????? 707
Childhood onset fluency disorder?????????????????????????????????????????????????????????????????????????????? 707
Prevalence, prognosis, causes, and correlates???????????????????????????????????????????????????????????????????????????????????????????????????????? 707
Assessment and Intervention???????????????????????????????????????????????????????????????????? 708
Voice disorders???????????????????????????????????????????? 708
Prevalence, prognosis, causes, and correlates???????????????????????????????????????????????????????????????????????????????????????????????????????? 708
Assessment and Intervention???????????????????????????????????????????????????????????????????? 708
Language disorder???????????????????????????????????????????????? 708
Diagnostic criteria???????????????????????????????????????????????????? 708
Vocabulary?????????????????????????????????? 709
Grammar and Morphology?????????????????????????????????????????????????????????? 709
Discourse???????????????????????????????? 709
Assessment of language?????????????????????????????????????????????????????????? 709
Preschool assessment?????????????????????????????????????????????????????? 709
School-aged assessment?????????????????????????????????????????????????????????? 709
Differential diagnosis and common comorbidities???????????????????????????????????????????????????????????????????????????????????????????????????????????? 710
Auditory problems???????????????????????????????????????????????? 710
Low nonverbal cognitive ablities?????????????????????????????????????????????????????????????????????????????? 710
Acquired epileptic aphasia (AEA)?????????????????????????????????????????????????????????????????????????????? 710
Specific learning disorders???????????????????????????????????????????????????????????????????? 710
Selective mutism?????????????????????????????????????????????? 711
Psychiatric disorders, including ADHD???????????????????????????????????????????????????????????????????????????????????????? 711
Prevalence?????????????????????????????????? 711
Causal models and risk factors?????????????????????????????????????????????????????????????????????????? 712
Auditory perceptual???????????????????????????????????????????????????? 712
Limited processing capacity???????????????????????????????????????????????????????????????????? 712
Procedural deficit hypothesis???????????????????????????????????????????????????????????????????????? 712
Etiology of language disorders?????????????????????????????????????????????????????????????????????????? 713
Genetic basis of language disorder?????????????????????????????????????????????????????????????????????????????????? 713
Neurobiology?????????????????????????????????????? 713
Environmental factors???????????????????????????????????????????????????????? 713
Distinguishing difference from disorder???????????????????????????????????????????????????????????????????????????????????????????? 714
Longitudinal outcomes???????????????????????????????????????????????????????? 714
Social (pragmatic) communication disorders?????????????????????????????????????????????????????????????????????????????????????????????????? 714
Diagnostic criteria and limitations???????????????????????????????????????????????????????????????????????????????????? 715
Autism spectrum disorder and SPCD???????????????????????????????????????????????????????????????????????????????? 715
Intervention?????????????????????????????????????? 716
General principles of intervention?????????????????????????????????????????????????????????????????????????????????? 716
Speech sound disorders?????????????????????????????????????????????????????????? 716
Language disorders?????????????????????????????????????????????????? 716
Social (pragmatic) communication disorder???????????????????????????????????????????????????????????????????????????????????????????????? 716
Conclusions???????????????????????????????????? 717
Acknowledgments???????????????????????????????????????????? 717
References?????????????????????????????????? 717
Chapter 53 Disorders of reading, mathematical and motor development???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 722
Definitions and diagnosis???????????????????????????????????????????????????????????????? 722
Conceptual issues???????????????????????????????????????????????? 722
Disorders of reading and writing?????????????????????????????????????????????????????????????????????????????? 723
Normal literacy development: a framework?????????????????????????????????????????????????????????????????????????????????????????????? 723
Reading and spelling difficulties???????????????????????????????????????????????????????????????????????????????? 724
Dyslexia?????????????????????????????? 724
Problems of reading comprehension???????????????????????????????????????????????????????????????????????????????? 725
Language learning impairments???????????????????????????????????????????????????????????????????????? 725
Causal models and risk factors?????????????????????????????????????????????????????????????????????????? 725
Phonological deficits in dyslexia???????????????????????????????????????????????????????????????????????????????? 725
Sensory impairments in dyslexia???????????????????????????????????????????????????????????????????????????? 726
Visual deficits???????????????????????????????????????????? 726
Auditory deficits???????????????????????????????????????????????? 726
Language delays and difficulties as precursors of reading difficulties?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 726
Attentional difficulties and reading disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????? 727
Etiology of reading difficulties?????????????????????????????????????????????????????????????????????????????? 727
Genetic basis of dyslexia and related disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????? 727
Brain bases of dyslexia???????????????????????????????????????????????????????????? 727
Social and environmental influences on reading development and disorder???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 728
Home and school background?????????????????????????????????????????????????????????????????? 728
Cross-linguistic manifestations of reading disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 728
Summary???????????????????????????? 728
Problems of numeracy?????????????????????????????????????????????????????? 728
The typical development of number skills and arithmetic???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 728
Definition, classification, and prevalence of mathematical difficulties???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 729
The behavioral profile of children with mathematics disorder?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 729
Cognitive explanations of arithmetic difficulties???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 729
Deficits in number (magnitude) representation???????????????????????????????????????????????????????????????????????????????????????????????????????? 729
Deficits in counting?????????????????????????????????????????????????????? 730
Number fact storage deficits?????????????????????????????????????????????????????????????????????? 730
Working memory deficits???????????????????????????????????????????????????????????? 730
Executive deficits?????????????????????????????????????????????????? 730
Summary???????????????????????????? 730
Etiology of mathematics disorder?????????????????????????????????????????????????????????????????????????????? 731
Genetic effects???????????????????????????????????????????? 731
Brain bases of arithmetic disorders???????????????????????????????????????????????????????????????????????????????????? 731
Developmental coordination disorder (DCD)???????????????????????????????????????????????????????????????????????????????????????????????? 731
Nature, classification, and incidence of DCD?????????????????????????????????????????????????????????????????????????????????????????????????????? 731
Explanations of developmental coordination disorder???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 732
Visual perceptual deficits?????????????????????????????????????????????????????????????????? 732
Balance and postural control?????????????????????????????????????????????????????????????????????? 732
Etiology?????????????????????????????? 732
Longitudinal outcome of learning disorders?????????????????????????????????????????????????????????????????????????????????????????????????? 732
Cognitive and educational outcomes?????????????????????????????????????????????????????????????????????????????????? 732
Psychosocial and mental health outcomes???????????????????????????????????????????????????????????????????????????????????????????? 732
Other learning difficulties???????????????????????????????????????????????????????????????????? 733
Clinical implications???????????????????????????????????????????????????????? 733
Diagnostic assessment???????????????????????????????????????????????????????? 734
Communicating findings?????????????????????????????????????????????????????????? 735
Management of specific learning disorders???????????????????????????????????????????????????????????????????????????????????????????????? 735
Conclusions and future directions???????????????????????????????????????????????????????????????????????????????? 735
References?????????????????????????????????? 735
Chapter 54 Intellectual disability?????????????????????????????????????????????????????????????????????????????????? 739
Terminology and classification?????????????????????????????????????????????????????????????????????????? 739
Epidemiology of intellectual disability???????????????????????????????????????????????????????????????????????????????????????????? 740
Factors influencing the prevalence of intellectual disability???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 740
Severity?????????????????????????????? 740
Sex???????????????????? 740
Socioeconomic factors???????????????????????????????????????????????????????? 740
Ethnicity???????????????????????????????? 741
Higher rates in low- and middle-income countries?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 741
Causes of intellectual disability???????????????????????????????????????????????????????????????????????????????? 741
Genetic factors???????????????????????????????????????????? 741
Other medical disorders associated with ID?????????????????????????????????????????????????????????????????????????????????????????????????? 742
Environmental factors???????????????????????????????????????????????????????? 742
Biology-environmental interplay???????????????????????????????????????????????????????????????????????????? 743
Assessment and diagnosis of intellectual disability???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 743
History???????????????????????????? 743
Psychological assessment?????????????????????????????????????????????????????????????? 744
Physical examination and investigations???????????????????????????????????????????????????????????????????????????????????????????? 744
Longitudinal course of intellectual disability?????????????????????????????????????????????????????????????????????????????????????????????????????????? 744
Behavioral phenotypes???????????????????????????????????????????????????????? 745
Mental disorders in children and adolescents with intellectual disability???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 745
Differences in psychiatric presentation among children with ID?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 745
The syndrome of "behavior that challenges": a distinct condition????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 745
Risk factors for psychiatric disorders in ID?????????????????????????????????????????????????????????????????????????????????????????????????????? 748
Assessment of psychiatric disorders in people with ID???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 748
Assessing behavior in its context???????????????????????????????????????????????????????????????????????????????? 749
Assessment measures for psychiatric symptoms and disorders in ID?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 749
Differential diagnosis?????????????????????????????????????????????????????????? 749
Physical examination and investigations???????????????????????????????????????????????????????????????????????????????????????????? 749
Intervention?????????????????????????????????????? 750
Mental health services for children and adolescents with ID???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 751
Special issues in mental health and ID?????????????????????????????????????????????????????????????????????????????????????????? 751
Children and adolescents with ID and the criminal justice system?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 751
Parents with ID and their parenting???????????????????????????????????????????????????????????????????????????????????? 751
Future developments and necessary research?????????????????????????????????????????????????????????????????????????????????????????????????? 752
Prevention of ID and service development in low- and middle-income countries?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 752
Improved tools for assessing mental disorder in ID and quantifying outcome?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 752
Interventions trialed for children and adolescents with ID?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 752
New technologies and ID???????????????????????????????????????????????????????????? 752
Treating ID: how far away are we????????????????????????????????????????????????????????????????????????????????? 752
References?????????????????????????????????? 752
Chapter 55 ADHD and hyperkinetic disorder???????????????????????????????????????????????????????????????????????????????????????????????? 758
Diagnosis???????????????????????????????? 758
Historical evolution of the concept???????????????????????????????????????????????????????????????????????????????????? 758
Diagnostic schemes?????????????????????????????????????????????????? 758
Dimensions, categories, and subtypes?????????????????????????????????????????????????????????????????????????????????????? 759
Dimensions?????????????????????????????????? 759
Categories and subtypes???????????????????????????????????????????????????????????? 759
Clinical assessment???????????????????????????????????????????????????? 759
Referral to services?????????????????????????????????????????????????????? 760
Problems and pitfalls in diagnosis?????????????????????????????????????????????????????????????????????????????????? 760
Cut-offs?????????????????????????????? 760
Developmental appropriateness???????????????????????????????????????????????????????????????????????? 760
Diagnosis in adult life???????????????????????????????????????????????????????????? 761
Sources of information: conflicts???????????????????????????????????????????????????????????????????????????????? 761
Differential diagnosis?????????????????????????????????????????????????????????? 761
Coexistent disorders?????????????????????????????????????????????????????? 761
Epidemiology?????????????????????????????????????? 762
Prevalence?????????????????????????????????? 762
Risk factors?????????????????????????????????????? 762
Genetic influences?????????????????????????????????????????????????? 762
Environmental influences?????????????????????????????????????????????????????????????? 763
Clinical implications???????????????????????????????????????????????????????? 764
Pathogenesis?????????????????????????????????????? 764
ADHD and brain structure?????????????????????????????????????????????????????????????? 764
ADHD and brain chemistry?????????????????????????????????????????????????????????????? 764
ADHD and brain function???????????????????????????????????????????????????????????? 765
Longitudinal course???????????????????????????????????????????????????? 765
Preschool???????????????????????????????? 765
Middle childhood?????????????????????????????????????????????? 766
Adolescence???????????????????????????????????? 766
Adult life?????????????????????????????????? 766
Heterogeneity???????????????????????????????????????? 766
Treatment???????????????????????????????? 767
Medication?????????????????????????????????? 767
Central nervous stimulants?????????????????????????????????????????????????????????????????? 767
Safety?????????????????????????? 767
Dosage?????????????????????????? 768
Immediate-release versus extended-release treatment???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 769
Atomoxetine???????????????????????????????????? 769
Nonpharmacological therapies?????????????????????????????????????????????????????????????????????? 769
Choice of initial treatment approaches?????????????????????????????????????????????????????????????????????????????????????????? 770
Treatment of refractory cases???????????????????????????????????????????????????????????????????????? 771
Treatment in comorbidity?????????????????????????????????????????????????????????????? 771
Long-term treatment???????????????????????????????????????????????????? 772
References?????????????????????????????????? 772
Chapter 56 Tic disorders?????????????????????????????????????????????????????????????? 777
Introduction?????????????????????????????????????? 777
Phemonenology of tics and diagnosis of tic disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 777
Phenomenology of tics???????????????????????????????????????????????????????? 777
Diagnostic categories???????????????????????????????????????????????????????? 778
Transient tic disorder?????????????????????????????????????????????????????????? 778
Persistent (chronic) motor or vocal tic disorder?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 778
Tourette's syndrome (combined vocal and multiple motor tic disorder)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 778
Epidemiology?????????????????????????????????????? 778
Clinical course???????????????????????????????????????????? 779
Clinical assessment???????????????????????????????????????????????????? 780
Assessment instruments?????????????????????????????????????????????????????????? 780
Comorbid conditions???????????????????????????????????????????????????? 780
Prognosis and quality of life???????????????????????????????????????????????????????????????????????? 781
Risk factors?????????????????????????????????????? 781
Genetic risk factors?????????????????????????????????????????????????????? 781
Perinatal risk factors?????????????????????????????????????????????????????????? 782
Gender-specific endocrine factors???????????????????????????????????????????????????????????????????????????????? 782
Psychosocial stress???????????????????????????????????????????????????? 783
Antecedent infections and immune responses?????????????????????????????????????????????????????????????????????????????????????????????????? 783
Pathophysiology???????????????????????????????????????????? 784
Neural circuits???????????????????????????????????????????? 784
Neuropathology?????????????????????????????????????????? 784
Structural brain imaging?????????????????????????????????????????????????????????????? 785
Functional brain imaging?????????????????????????????????????????????????????????????? 785
Neurophysiology???????????????????????????????????????????? 785
Neurotransmitter systems?????????????????????????????????????????????????????????????? 786
Treatment???????????????????????????????? 786
Educational and supportive interventions?????????????????????????????????????????????????????????????????????????????????????????????? 786
Behavioral, cognitive, and other psychotherapeutic treatments???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 787
Pharmacological treatments?????????????????????????????????????????????????????????????????? 787
Pharmacotherapy of tics???????????????????????????????????????????????????????????? 788
Pharmacotherapy of coexisting ADHD?????????????????????????????????????????????????????????????????????????????????? 788
Pharmacotherapy of coexisting OCD???????????????????????????????????????????????????????????????????????????????? 789
Pharmacotherapy of cooccurring aggressive behavior (rage attacks)???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 789
Future directions???????????????????????????????????????????????? 789
Acknowledgments???????????????????????????????????????????? 789
References?????????????????????????????????? 789
Chapter 57 Schizophrenia and psychosis?????????????????????????????????????????????????????????????????????????????????????????? 794
Introduction?????????????????????????????????????? 794
Clinical features???????????????????????????????????????????????? 794
The clinical phases of schizophrenia?????????????????????????????????????????????????????????????????????????????????????? 795
Premorbid social and developmental impairments?????????????????????????????????????????????????????????????????????????????????????????????????????????? 795
Premorbid psychopathology???????????????????????????????????????????????????????????????? 795
Prodromal symptoms and onset of psychosis???????????????????????????????????????????????????????????????????????????????????????????????? 795
At risk mental states???????????????????????????????????????????????????????? 795
Diagnosis of schizophrenia in childhood and adolescence???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 796
Course and outcome?????????????????????????????????????????????????? 796
Course and prognosis?????????????????????????????????????????????????????? 796
Mortality???????????????????????????????? 796
Epidemiology?????????????????????????????????????? 797
Incidence and prevalence?????????????????????????????????????????????????????????????? 797
Sex differences???????????????????????????????????????????? 797
Genetic risk factors?????????????????????????????????????????????????????? 797
Common variants???????????????????????????????????????????? 797
Rare variants???????????????????????????????????????? 797
Environmental risk factors?????????????????????????????????????????????????????????????????? 798
Advanced paternal age???????????????????????????????????????????????????????? 798
Pregnancy and birth complications???????????????????????????????????????????????????????????????????????????????? 798
Role of infection/inflammation?????????????????????????????????????????????????????????????????????????? 798
Prenatal famine???????????????????????????????????????????? 798
Cannabis and schizophrenia?????????????????????????????????????????????????????????????????? 798
Psychosocial risks?????????????????????????????????????????????????? 799
Migration and social class?????????????????????????????????????????????????????????????????? 799
Childhood abuse and neglect???????????????????????????????????????????????????????????????????? 799
Gene-environment interactions???????????????????????????????????????????????????????????????????????? 799
Neurobiology?????????????????????????????????????? 799
Cross-sectional structural changes?????????????????????????????????????????????????????????????????????????????????? 799
Progressive structural changes?????????????????????????????????????????????????????????????????????????? 800
Functional imaging?????????????????????????????????????????????????? 801
Neuropathology?????????????????????????????????????????? 801
Neurochemistry?????????????????????????????????????????? 801
Neuropsychology of schizophrenia?????????????????????????????????????????????????????????????????????????????? 801
The pattern of cognitive deficits???????????????????????????????????????????????????????????????????????????????? 801
The course of cognitive deficits?????????????????????????????????????????????????????????????????????????????? 802
Assessment?????????????????????????????????? 802
Developmental issues?????????????????????????????????????????????????????? 803
Differential diagnosis?????????????????????????????????????????????????????????? 803
Affective and "atypical" psychoses?????????????????????????????????????????????????????????????????????????????????? 803
Autistic spectrum and developmental language disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 803
Multidimensionally impaired syndrome?????????????????????????????????????????????????????????????????????????????????????? 804
Epilepsy?????????????????????????????? 804
Neurodegenerative disorders???????????????????????????????????????????????????????????????????? 804
Drug psychoses?????????????????????????????????????????? 804
Other investigations?????????????????????????????????????????????????????? 804
Assessment interviews and rating scales???????????????????????????????????????????????????????????????????????????????????????????? 804
Treatment approaches?????????????????????????????????????????????????????? 805
General principles?????????????????????????????????????????????????? 805
Interventions targeting "at risk mental states" (ARMS)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 805
Treatments for schizophrenia and psychosis?????????????????????????????????????????????????????????????????????????????????????????????????? 805
Pharmacological???????????????????????????????????????????? 805
Baseline investigations and monitoring?????????????????????????????????????????????????????????????????????????????????????????? 806
Pharmacological interventions: summary?????????????????????????????????????????????????????????????????????????????????????????? 806
Psychosocial intervention???????????????????????????????????????????????????????????????? 806
Cognitive behavior therapy (CBT)?????????????????????????????????????????????????????????????????????????????? 806
Family intervention???????????????????????????????????????????????????? 806
Psychosocial interventions: summary???????????????????????????????????????????????????????????????????????????????????? 807
Organization of treatment services?????????????????????????????????????????????????????????????????????????????????? 807
Conclusions???????????????????????????????????? 807
References?????????????????????????????????? 807
B Emotional 813
Chapter 58 Disorders of attachment and social engagement related to deprivation???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 815
Definitions???????????????????????????????????? 815
Development of attachment???????????????????????????????????????????????????????????????? 815
Attachment classifications and psychopathology?????????????????????????????????????????????????????????????????????????????????????????????????????????? 816
Historical considerations???????????????????????????????????????????????????????????????? 817
Institutional care and deprivation?????????????????????????????????????????????????????????????????????????????????? 817
Tizard's study?????????????????????????????????????????? 817
Attachment disorders in nosologies?????????????????????????????????????????????????????????????????????????????????? 817
Clinical disorders of attachment: the phenotypes?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 818
Reactive attachment disorder?????????????????????????????????????????????????????????????????????? 818
Disinhibited social engagement disorder/disinhibited attachment disorder?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 818
Middle childhood and adolescence?????????????????????????????????????????????????????????????????????????????? 819
Differential diagnosis?????????????????????????????????????????????????????????? 819
Prevalence?????????????????????????????????? 820
Etiology?????????????????????????????? 820
Course of the disorders???????????????????????????????????????????????????????????? 821
Clinical assessment???????????????????????????????????????????????????? 821
Interviews?????????????????????????????????? 821
Observations?????????????????????????????????????? 821
Interventions???????????????????????????????????????? 821
Conclusions???????????????????????????????????? 822
References?????????????????????????????????? 823
Chapter 59 Post traumatic stress disorder???????????????????????????????????????????????????????????????????????????????????????????????? 826
Characteristics and diagnosis of the condition?????????????????????????????????????????????????????????????????????????????????????????????????????????? 826
Manifestations of stress reactions in children and adolescents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 826
Developmental aspects???????????????????????????????????????????????????????? 827
Cultural issues???????????????????????????????????????????? 827
Impact of disorder on functioning???????????????????????????????????????????????????????????????????????????????? 828
Differential diagnosis?????????????????????????????????????????????????????????? 828
Assessment?????????????????????????????????? 828
Epidemiology?????????????????????????????????????? 829
Longitudinal outcome?????????????????????????????????????????????????????? 829
Risk factors?????????????????????????????????????? 830
Pathological risk processes???????????????????????????????????????????????????????????????????? 831
Physiological processes???????????????????????????????????????????????????????????? 831
Cognitive processes and models?????????????????????????????????????????????????????????????????????????? 832
Treatment???????????????????????????????? 832
Early interventions???????????????????????????????????????????????????? 832
Trauma-focused CBT (TF-CBT) for persistent PTSD???????????????????????????????????????????????????????????????????????????????????????????????????????????? 833
PTSD and single-event traumas???????????????????????????????????????????????????????????????????????? 833
Trauma-focused-CBT with preschool children?????????????????????????????????????????????????????????????????????????????????????????????????? 834
PTSD and child sexual abuse???????????????????????????????????????????????????????????????????? 834
Other approaches to treatment???????????????????????????????????????????????????????????????????????? 835
Eye movement desensitization and reprocessing (EMDR)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 835
Narrative exposure therapy (NET)?????????????????????????????????????????????????????????????????????????????? 835
Structured writing?????????????????????????????????????????????????? 836
Medication?????????????????????????????????? 836
Contingency planning/school-based interventions after mass incidents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 836
Conclusions and recommendations???????????????????????????????????????????????????????????????????????????? 837
References?????????????????????????????????? 837
Chapter 60 Anxiety disorders?????????????????????????????????????????????????????????????????????? 842
Introduction?????????????????????????????????????? 842
Diagnosis???????????????????????????????? 842
Nosology?????????????????????????????? 842
Specific conditions???????????????????????????????????????????????????? 843
Specific phobia???????????????????????????????????????????? 843
Separation anxiety disorder???????????????????????????????????????????????????????????????????? 843
Social anxiety disorder???????????????????????????????????????????????????????????? 843
Generalized anxiety disorder?????????????????????????????????????????????????????????????????????? 843
Panic disorder?????????????????????????????????????????? 843
Agoraphobia???????????????????????????????????? 843
Developmental fluctuations?????????????????????????????????????????????????????????????????? 843
Comorbidity???????????????????????????????????? 844
Assessment?????????????????????????????????? 844
Rating scales???????????????????????????????????????? 844
Diagnostic interviews???????????????????????????????????????????????????????? 844
Epidemiology?????????????????????????????????????? 845
Prevalence?????????????????????????????????? 845
Longitudinal outcome?????????????????????????????????????????????????????? 845
Inhibited temperament and psychopathology???????????????????????????????????????????????????????????????????????????????????????????????? 845
Stability of anxiety disorders?????????????????????????????????????????????????????????????????????????? 845
Risk factors?????????????????????????????????????? 847
Social stress???????????????????????????????????????? 847
Stress reactivity???????????????????????????????????????????????? 848
Medical conditions?????????????????????????????????????????????????? 848
Pathophysiology???????????????????????????????????????????? 849
Genetics?????????????????????????????? 849
Family studies?????????????????????????????????????????? 849
Genetically informative designs???????????????????????????????????????????????????????????????????????????? 849
Molecular genetics?????????????????????????????????????????????????? 849
Psychobiology???????????????????????????????????????? 851
Neural circuitry in animals???????????????????????????????????????????????????????????????????? 851
Neural development and fear???????????????????????????????????????????????????????????????????? 852
Human physiology and neural circuitry???????????????????????????????????????????????????????????????????????????????????????? 852
Human cognition and anxiety???????????????????????????????????????????????????????????????????? 852
Imaging???????????????????????????? 853
Treatment???????????????????????????????? 853
Psychotherapy???????????????????????????????????????? 854
Pharmacotherapy???????????????????????????????????????????? 855
Summary???????????????????????????? 855
References?????????????????????????????????? 856
Chapter 61 Obsessive compulsive disorder?????????????????????????????????????????????????????????????????????????????????????????????? 861
Definition: the concept and current issues?????????????????????????????????????????????????????????????????????????????????????????????????? 861
Epidemiology?????????????????????????????????????? 861
Diagnostic issues???????????????????????????????????????????????? 863
Continuity with normal development?????????????????????????????????????????????????????????????????????????????????? 863
The importance of informant history???????????????????????????????????????????????????????????????????????????????????? 863
Issues with DSM-5 diagnosis???????????????????????????????????????????????????????????????????? 863
Obsessive compulsive spectrum disorders???????????????????????????????????????????????????????????????????????????????????????????? 863
Unique childhood onset subtypes???????????????????????????????????????????????????????????????????????????? 864
Clinical presentation???????????????????????????????????????????????????????? 864
Course and natural history?????????????????????????????????????????????????????????????????? 865
Associated disorders?????????????????????????????????????????????????????? 866
Case illustrations?????????????????????????????????????????????????? 866
Case 1?????????????????????????? 866
Case 2?????????????????????????? 866
The differential diagnosis: distinguishing OCD from other disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 867
Theories of etiology?????????????????????????????????????????????????????? 867
Biological factors?????????????????????????????????????????????????? 867
Genetics?????????????????????????????? 867
Neural basis?????????????????????????????????????? 868
Neurochemistry?????????????????????????????????????????? 869
Treatment approaches?????????????????????????????????????????????????????? 870
Psychological treatment???????????????????????????????????????????????????????????? 870
Pharmacotherapy???????????????????????????????????????????? 870
Combination treatment???????????????????????????????????????????????????????? 872
Augmenting strategies for partial responders?????????????????????????????????????????????????????????????????????????????????????????????????????? 872
Maintenance treatment???????????????????????????????????????????????????????? 872
Immunomodulatory treatments???????????????????????????????????????????????????????????????????? 872
Conclusions???????????????????????????????????? 873
References?????????????????????????????????? 873
Chapter 62 Bipolar disorder in childhood?????????????????????????????????????????????????????????????????????????????????????????????? 878
Introduction?????????????????????????????????????? 878
Characteristics and diagnosis of the condition?????????????????????????????????????????????????????????????????????????????????????????????????????????? 878
Phenomenology???????????????????????????????????????? 878
Distinction between normal and pathological???????????????????????????????????????????????????????????????????????????????????????????????????? 878
Cultural issues???????????????????????????????????????????? 878
Diagnosis in DSM, ICD, elsewhere?????????????????????????????????????????????????????????????????????????????? 878
Impact of the disorder on functioning???????????????????????????????????????????????????????????????????????????????????????? 879
Differential diagnosis?????????????????????????????????????????????????????????? 879
Summary???????????????????????????? 880
Assessment?????????????????????????????????? 880
Core aspects?????????????????????????????????????? 880
Common pitfalls and how to avoid them???????????????????????????????????????????????????????????????????????????????????????? 881
Use of rating scales, diagnostic interviews, and standardized observations?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 881
Coexisting problems: ADHD, anxiety, ODD/CD, and learning disabilities???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 881
Family and school context???????????????????????????????????????????????????????????????? 882
Physical investigations???????????????????????????????????????????????????????????? 882
Summary and conclusions???????????????????????????????????????????????????????????? 882
Epidemiology?????????????????????????????????????? 882
Incidence and prevalence?????????????????????????????????????????????????????????????? 882
Global and time variations?????????????????????????????????????????????????????????????????? 882
Methodological questions?????????????????????????????????????????????????????????????? 882
Public health implications?????????????????????????????????????????????????????????????????? 882
Summary???????????????????????????? 883
Longitudinal outcome?????????????????????????????????????????????????????? 883
Methodological factors?????????????????????????????????????????????????????????? 883
Summary???????????????????????????? 883
Risk factors?????????????????????????????????????? 883
Family studies?????????????????????????????????????????? 883
Twin and adoption studies???????????????????????????????????????????????????????????????? 883
Molecular genetic studies???????????????????????????????????????????????????????????????? 884
Clinical prodromes/risk factors???????????????????????????????????????????????????????????????????????????? 884
Summary and conclusions???????????????????????????????????????????????????????????? 884
Pathophysiology???????????????????????????????????????????? 884
Neural circuitry: computerized behavioral tasks and neuroimaging?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 884
Neurochemistry: magnetic resonance spectroscopy (MRS)???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 885
Diffusion tensor imaging (DTI)?????????????????????????????????????????????????????????????????????????? 885
Summary???????????????????????????? 885
Treatment???????????????????????????????? 885
General approach?????????????????????????????????????????????? 885
Psychopharmacology for pediatric bipolar disorder???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 886
Pharmacotherapy of mania?????????????????????????????????????????????????????????????? 886
Second-generation antipsychotic medications (SGAs)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 887
Lithium???????????????????????????? 887
Antiepileptic drugs (AEDs)?????????????????????????????????????????????????????????????????? 887
Pharmacotherapy of depression in childhood-onset BD???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 888
Pharmacotherapy of ADHD in childhood-onset BD???????????????????????????????????????????????????????????????????????????????????????????????????????? 888
Psychotherapy for pediatric bipolar disorder?????????????????????????????????????????????????????????????????????????????????????????????????????? 888
Summary???????????????????????????? 888
Future developments and necessary research?????????????????????????????????????????????????????????????????????????????????????????????????? 889
Longitudinal studies come of age?????????????????????????????????????????????????????????????????????????????? 889
Novel treatments?????????????????????????????????????????????? 889
References?????????????????????????????????? 889
Chapter 63 Depressive disorders in childhood and adolescence?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 894
Clinical picture?????????????????????????????????????????????? 894
Phenomenology and classification?????????????????????????????????????????????????????????????????????????????? 894
Changes from DSM-IV to DSM-5?????????????????????????????????????????????????????????????????????? 894
Differential diagnosis?????????????????????????????????????????????????????????? 894
Comorbidity???????????????????????????????????? 895
Assessment?????????????????????????????????? 895
Descriptive epidemiology?????????????????????????????????????????????????????????????? 896
Prevalence?????????????????????????????????? 896
Age, gender, and puberty?????????????????????????????????????????????????????????????? 896
Course and outcome?????????????????????????????????????????????????? 896
Episode length and recovery???????????????????????????????????????????????????????????????????? 896
Risk for recurrence???????????????????????????????????????????????????? 896
Bipolar disorder?????????????????????????????????????????????? 896
Suicidal behavior and health risk behaviors???????????????????????????????????????????????????????????????????????????????????????????????????? 896
Models of depression?????????????????????????????????????????????????????? 896
Vulnerability factors for depression?????????????????????????????????????????????????????????????????????????????????????? 896
Genetic???????????????????????????? 896
Cognitive distortion and rumination???????????????????????????????????????????????????????????????????????????????????? 897
Emotion regulation?????????????????????????????????????????????????? 897
Fear and anxiety?????????????????????????????????????????????? 897
Behavioral disorders and irritability???????????????????????????????????????????????????????????????????????????????????????? 897
Sleep???????????????????????? 897
Comorbid medical illness?????????????????????????????????????????????????????????????? 897
Environmental risk factors?????????????????????????????????????????????????????????????????? 897
Parental depression and family discord?????????????????????????????????????????????????????????????????????????????????????????? 897
Child maltreatment?????????????????????????????????????????????????? 898
Peer victimization?????????????????????????????????????????????????? 898
Sexual minority status?????????????????????????????????????????????????????????? 898
Bereavement???????????????????????????????????? 898
Resilience?????????????????????????????????? 898
Neurobiology of depression?????????????????????????????????????????????????????????????????? 898
Hypothalamic pituitary adrenal axis???????????????????????????????????????????????????????????????????????????????????? 898
Inflammation?????????????????????????????????????? 898
Neurocircuitry of depression?????????????????????????????????????????????????????????????????????? 898
Structural studies?????????????????????????????????????????????????? 898
Biased information processing???????????????????????????????????????????????????????????????????????? 898
Peripheral neurocognitive studies???????????????????????????????????????????????????????????????????????????????? 898
fMRI studies?????????????????????????????????????? 898
Positive affect and reward processing???????????????????????????????????????????????????????????????????????????????????????? 899
Treatment???????????????????????????????? 899
Overview?????????????????????????????? 899
Acute treatment???????????????????????????????????????????? 899
CBT???????????????????? 899
IPT???????????????????? 901
Other psychotherapies with at least one RCT???????????????????????????????????????????????????????????????????????????????????????????????????? 901
Medication monotherapy?????????????????????????????????????????????????????????? 901
Bright light?????????????????????????????????????? 902
Combination of medication and CBT???????????????????????????????????????????????????????????????????????????????? 902
Continuation and maintenance?????????????????????????????????????????????????????????????????????? 902
Treatment-resistant depression?????????????????????????????????????????????????????????????????????????? 902
Prevention?????????????????????????????????? 903
Clinical approach to depressed youth?????????????????????????????????????????????????????????????????????????????????????? 903
Initial assessment and management???????????????????????????????????????????????????????????????????????????????? 903
Risk assessment and treatment planning?????????????????????????????????????????????????????????????????????????????????????????? 904
Patient and family education?????????????????????????????????????????????????????????????????????? 904
Family, social, and individual context?????????????????????????????????????????????????????????????????????????????????????????? 904
Initial treatment approach?????????????????????????????????????????????????????????????????? 904
Approach to residual symptoms???????????????????????????????????????????????????????????????????????? 905
Treatment-resistant depression?????????????????????????????????????????????????????????????????????????? 905
Future clinical and research challenges???????????????????????????????????????????????????????????????????????????????????????????? 906
References?????????????????????????????????? 906
Chapter 64 Suicidal behavior and self-harm?????????????????????????????????????????????????????????????????????????????????????????????????? 913
Definitions of terms?????????????????????????????????????????????????????? 913
Population prevalence of suicide, suicidal ideation, and self-harm?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 913
Suicide???????????????????????????? 913
Suicidal ideation and self-harm???????????????????????????????????????????????????????????????????????????? 914
Methods of suicide and self-harm by gender and international differences?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 915
Puberty and self-harm???????????????????????????????????????????????????????? 915
Motives for self-harm???????????????????????????????????????????????????????? 915
Risk factors associated with suicidal phenomena in young people???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 915
Family history and genetic influences on suicidal behavior?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 915
Psychological characteristics???????????????????????????????????????????????????????????????????????? 916
Poor physical health related to psychological problems?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 917
Family factors?????????????????????????????????????????? 917
Peers, including the influence of peer suicidal behaviors and suicide clusters?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 917
Sexual orientation?????????????????????????????????????????????????? 917
Environmental factors???????????????????????????????????????????????????????? 917
School dropout?????????????????????????????????????????? 917
Proximal risk factors/life stressors?????????????????????????????????????????????????????????????????????????????????????? 917
Asylum seeking and cultural factors???????????????????????????????????????????????????????????????????????????????????? 917
Psychiatric disorders associated with self-harm and suicide???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 918
Exposure to suicide and self-harm in the media, the Internet, and music???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 919
Availability of means for self-harm/suicide???????????????????????????????????????????????????????????????????????????????????????????????????? 919
Outcome following self-harm???????????????????????????????????????????????????????????????????? 920
Repetition of self-harm???????????????????????????????????????????????????????????? 920
Suicide following self-harm???????????????????????????????????????????????????????????????????? 920
Psychosocial adjustment???????????????????????????????????????????????????????????? 920
Impact of suicide on peers, school and relatives?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 920
Clinical assessment???????????????????????????????????????????????????? 921
Treatments for adolescents who have self-harmed???????????????????????????????????????????????????????????????????????????????????????????????????????????? 922
Brief psychological therapy???????????????????????????????????????????????????????????????????? 922
Family therapy?????????????????????????????????????????? 922
Group therapy???????????????????????????????????????? 922
Dialectical behavior therapy?????????????????????????????????????????????????????????????????????? 922
Hospitalization???????????????????????????????????????????? 922
Treatments for adolescents with specific psychiatric disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 923
Medication?????????????????????????????????? 923
Cognitive behavior therapy combined with antidepressant???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 923
Multisystemic therapy???????????????????????????????????????????????????????? 923
Issues of access to treatment and engagement in treatment???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 923
Prevention of self-harm and suicide by children and adolescents???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 923
School-based interventions?????????????????????????????????????????????????????????????????? 923
Reducing access to methods of suicide???????????????????????????????????????????????????????????????????????????????????????? 924
Crisis centers and hotlines???????????????????????????????????????????????????????????????????? 924
Internet sources of help?????????????????????????????????????????????????????????????? 924
Conclusions, future clinical and research directions?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 925
Acknowledgment?????????????????????????????????????????? 925
References?????????????????????????????????? 925
C Behavioral 931
Chapter 65 Oppositional and conduct disorders???????????????????????????????????????????????????????????????????????????????????????????????????????? 933
Introduction?????????????????????????????????????? 933
Classification?????????????????????????????????????????? 933
Epidemiology?????????????????????????????????????? 934
Overall prevalence?????????????????????????????????????????????????? 934
Variations in prevalence?????????????????????????????????????????????????????????????? 934
Gender?????????????????????????? 934
Socio economic status (SES) and geographical area???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 935
Worldwide prevalences and minority ethnic groups?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 935
High-risk populations???????????????????????????????????????????????????????? 935
Time periods?????????????????????????????????????? 935
Subtypes according to phenomenology and longitudinal course???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 935
Long-term prognosis???????????????????????????????????????????????????? 936
Service use and cost?????????????????????????????????????????????????????? 937
Etiology?????????????????????????????? 937
Individual-level influences???????????????????????????????????????????????????????????????????? 937
Overall genetic effects???????????????????????????????????????????????????????????? 937
Specific genes?????????????????????????????????????????? 937
Pregnancy and perinatal complications???????????????????????????????????????????????????????????????????????????????????????? 938
Temperament???????????????????????????????????? 938
Brain function?????????????????????????????????????????? 938
Language, IQ, and educational attainment deficits???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 938
Executive dysfunction???????????????????????????????????????????????????????? 938
Autonomic reactivity and the hypothalamus-pituitary-adrenal axis?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 939
Information processing & social cognition????????????????????????????????????????????????????????????????????????????????????????????????
Family-level influences???????????????????????????????????????????????????????????? 939
Child rearing practises???????????????????????????????????????????????????????????? 939
Attachment insecurity???????????????????????????????????????????????????????? 940
Exposure to interparental conflict and violence???????????????????????????????????????????????????????????????????????????????????????????????????????????? 940
Maltreatment?????????????????????????????????????? 940
Influences beyond the family?????????????????????????????????????????????????????????????????????? 941
Overview of peer effects?????????????????????????????????????????????????????????????? 941
Peer rejection?????????????????????????????????????????? 941
Impact of deviant peers on antisocial behavior?????????????????????????????????????????????????????????????????????????????????????????????????????????? 941
School effects?????????????????????????????????????????? 941
Poverty???????????????????????????? 941
Neighborhood influences???????????????????????????????????????????????????????????? 941
Synthesis???????????????????????????????? 942
Assessment, diagnosis, and formulation?????????????????????????????????????????????????????????????????????????????????????????? 942
Assessment?????????????????????????????????? 942
Before the interview?????????????????????????????????????????????????????? 942
History and examination???????????????????????????????????????????????????????????? 942
Investigation???????????????????????????????????????? 943
Differential diagnosis and formulation?????????????????????????????????????????????????????????????????????????????????????????? 943
Differential diagnosis?????????????????????????????????????????????????????????? 943
Multiaxial system???????????????????????????????????????????????? 944
Formulation???????????????????????????????????? 944
Intervention?????????????????????????????????????? 944
Principles?????????????????????????????????? 944
Personalizing the treatment plan?????????????????????????????????????????????????????????????????????????????? 944
Engaging the family???????????????????????????????????????????????????? 944
Choosing which treatment modality to use?????????????????????????????????????????????????????????????????????????????????????????????? 944
Encouraging strengths???????????????????????????????????????????????????????? 944
Treating comorbid conditions?????????????????????????????????????????????????????????????????????? 944
Promoting social and learning skills?????????????????????????????????????????????????????????????????????????????????????? 945
Following guidelines?????????????????????????????????????????????????????? 945
Treating the child in a natural environment???????????????????????????????????????????????????????????????????????????????????????????????????? 945
Family interventions?????????????????????????????????????????????????????? 945
Parent training???????????????????????????????????????????? 945
Family systemic therapies???????????????????????????????????????????????????????????????? 946
Child therapies???????????????????????????????????????????? 946
Interventions in school???????????????????????????????????????????????????????????? 946
Medication?????????????????????????????????? 947
Conclusions???????????????????????????????????? 947
References?????????????????????????????????? 947
Chapter 66 Substance-related and addictive disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 951
Introduction?????????????????????????????????????? 951
Definitions, comparative nosology???????????????????????????????????????????????????????????????????????????????? 952
Epidemiology?????????????????????????????????????? 953
Prevalence of use???????????????????????????????????????????????? 953
Comorbid disorders?????????????????????????????????????????????????? 953
Sex differences???????????????????????????????????????????? 953
Morbidity and mortality???????????????????????????????????????????????????????????? 953
Treatment admissions?????????????????????????????????????????????????????? 954
Shifts in substances used???????????????????????????????????????????????????????????????? 954
Regional and global prevalence variations???????????????????????????????????????????????????????????????????????????????????????????????? 954
Genetic and environmental risk factors?????????????????????????????????????????????????????????????????????????????????????????? 955
Familiality???????????????????????????????????? 955
Environmental context???????????????????????????????????????????????????????? 955
Genetic risk?????????????????????????????????????? 955
Genes and environment: joint effects?????????????????????????????????????????????????????????????????????????????????????? 955
Genetic studies of complex traits???????????????????????????????????????????????????????????????????????????????? 955
Brain function and drug risk-taking???????????????????????????????????????????????????????????????????????????????????? 955
Longitudinal course???????????????????????????????????????????????????? 957
Prevention?????????????????????????????????? 958
Family-based interventions?????????????????????????????????????????????????????????????????? 958
School-based programs???????????????????????????????????????????????????????? 958
Other programs?????????????????????????????????????????? 958
Limits of prevention research???????????????????????????????????????????????????????????????????????? 958
Policy?????????????????????????? 959
Screening, assessment???????????????????????????????????????????????????????? 959
Screening???????????????????????????????? 959
Assessment?????????????????????????????????? 959
First contact???????????????????????????????????????? 959
Assent, consent, and confidentiality?????????????????????????????????????????????????????????????????????????????????????? 960
Who, when???????????????????????????????? 960
Chief complaint???????????????????????????????????????????? 960
History of the problem?????????????????????????????????????????????????????????? 960
Long-term goals???????????????????????????????????????????? 960
Developmental history???????????????????????????????????????????????????????? 960
Family history?????????????????????????????????????????? 961
The youth's history???????????????????????????????????????????????????? 961
Treatment???????????????????????????????? 963
Overview?????????????????????????????? 963
Early intervention?????????????????????????????????????????????????? 963
Venue of treatment?????????????????????????????????????????????????? 963
Psychosocial treatments???????????????????????????????????????????????????????????? 963
Pharmacotherapy???????????????????????????????????????????? 964
Alcohol???????????????????????????? 964
Opioid agonists???????????????????????????????????????????? 965
Opioid antagonists?????????????????????????????????????????????????? 965
Nicotine?????????????????????????????? 965
Blending treatments and treatment matching?????????????????????????????????????????????????????????????????????????????????????????????????? 966
Working with criminal justice and social service agencies???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 966
Relapse prevention?????????????????????????????????????????????????? 966
Treatment of co-morbid mental health disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????? 966
Non-substance "behavioral addictions"???????????????????????????????????????????????????????????????????????????????????????? 966
Future developments and necessary research?????????????????????????????????????????????????????????????????????????????????????????????????? 967
Acknowledgments???????????????????????????????????????????? 967
References?????????????????????????????????? 967
Chapter 67 Disorders of personality???????????????????????????????????????????????????????????????????????????????????? 970
Why is something like the concept of personality disorders needed??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 970
Current conceptualizations of personality disorder and diagnostic and statistical manual (DSM) IV and 5???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 970
Key questions???????????????????????????????????????? 972
How should personality disorder be specified and explained????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 972
Normal personality or personality disorders??????????????????????????????????????????????????????????????????????????????????????????????????????? 972
How do developmental perspectives on personality and its disorders help??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 973
Validation?????????????????????????????????? 974
Stability and associations with episodic disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 974
Differentiation among personality disorders???????????????????????????????????????????????????????????????????????????????????????????????????? 974
Categorical versus dimensional characterizations of personality disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 975
Utility of the personality disorder concept in childhood and adolescence?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 975
Specific personality disorders?????????????????????????????????????????????????????????????????????????? 976
Antisocial personality disorder???????????????????????????????????????????????????????????????????????????? 976
Antisocial personality disorder in adolescence?????????????????????????????????????????????????????????????????????????????????????????????????????????? 976
Borderline personality disorder???????????????????????????????????????????????????????????????????????????? 976
Borderline personality disorder in adolescence?????????????????????????????????????????????????????????????????????????????????????????????????????????? 978
Schizotypal personality disorder?????????????????????????????????????????????????????????????????????????????? 978
Schizoid personality disorder???????????????????????????????????????????????????????????????????????? 978
The application of personality disorders research in clinical practice?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 979
Assessment?????????????????????????????????? 979
Treatment???????????????????????????????? 980
Conclusions???????????????????????????????????? 981
References?????????????????????????????????? 981
Chapter 68 Developmental risk for psychopathy???????????????????????????????????????????????????????????????????????????????????????????????????????? 986
Introduction: characteristics and diagnosis of psychopathy?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 986
The origins of the current description of the psychopathy syndrome?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 986
Chapter overview?????????????????????????????????????????????? 986
Assessment?????????????????????????????????? 986
DSM-5 conduct disorder with limited prosocial emotions?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 987
Co-occurrence with other disorders?????????????????????????????????????????????????????????????????????????????????? 987
Attention deficit hyperactivity disorder (ADHD)???????????????????????????????????????????????????????????????????????????????????????????????????????????? 987
Autism spectrum disorders (ASDs)?????????????????????????????????????????????????????????????????????????????? 987
Anxiety and mood disorders?????????????????????????????????????????????????????????????????? 987
Differential diagnosis?????????????????????????????????????????????????????????? 988
Summary-assessment?????????????????????????????????????????????????? 988
Epidemiology and longitudinal outcomes?????????????????????????????????????????????????????????????????????????????????????????? 988
Prevalence?????????????????????????????????? 988
CU traits in boys and girls???????????????????????????????????????????????????????????????????? 988
Cultural factors?????????????????????????????????????????????? 988
CU traits as a risk indicator for behavioral/psychiatric maladjustment?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 988
Prognostic value into adulthood???????????????????????????????????????????????????????????????????????????? 989
Treatment outcomes?????????????????????????????????????????????????? 989
Summary-epidemiology and longitudinal outcomes?????????????????????????????????????????????????????????????????????????????????????????????????????????? 989
Risk factors?????????????????????????????????????? 989
Genetic factors???????????????????????????????????????????? 989
Pre- and peri-natal factors???????????????????????????????????????????????????????????????????? 990
Sex???????????????????? 990
Hormonal factors?????????????????????????????????????????????? 991
Physiological factors???????????????????????????????????????????????????????? 991
Early temperamental factors???????????????????????????????????????????????????????????????????? 991
Maltreatment?????????????????????????????????????? 991
Parenting???????????????????????????????? 991
Other risk factors?????????????????????????????????????????????????? 992
Summary-risk factors?????????????????????????????????????????????????????? 992
Neurocognitive findings???????????????????????????????????????????????????????????? 992
The amygdala?????????????????????????????????????? 993
The striatum?????????????????????????????????????? 993
The anterior cingulate cortex???????????????????????????????????????????????????????????????????????? 993
The anterior insula???????????????????????????????????????????????????? 993
The prefrontal cortex???????????????????????????????????????????????????????? 993
Summary???????????????????????????? 993
Functional magnetic resonance imaging (fMRI) studies?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 994
Structural magnetic resonance imaging studies???????????????????????????????????????????????????????????????????????????????????????????????????????? 994
Summary-neurocognitive findings???????????????????????????????????????????????????????????????????????????? 995
Treatment implications?????????????????????????????????????????????????????????? 995
Summary-treatment???????????????????????????????????????????????? 996
Future developments and necessary research?????????????????????????????????????????????????????????????????????????????????????????????????? 996
Conclusions???????????????????????????????????? 996
Acknowledgements?????????????????????????????????????????????? 997
References?????????????????????????????????? 997
Suggested further reading/sources of additional information???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1000
D Somatic/body-brain 1001
Chapter 69 Gender dysphoria and paraphilic sexual disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1003
Introduction?????????????????????????????????????? 1003
Gender dysphoria (GD)???????????????????????????????????????????????????????? 1003
Characteristics and diagnosis of the condition?????????????????????????????????????????????????????????????????????????????????????????????????????????? 1003
Phenomenology???????????????????????????????????????? 1003
Normal and pathological behaviors???????????????????????????????????????????????????????????????????????????????? 1003
DSM-5 and the ICD???????????????????????????????????????????????? 1003
Assessment?????????????????????????????????? 1004
Epidemiology?????????????????????????????????????? 1004
Prevalence?????????????????????????????????? 1004
Sex differences in referral rates???????????????????????????????????????????????????????????????????????????????? 1004
Risk factors?????????????????????????????????????? 1004
Molecular and behavior genetics???????????????????????????????????????????????????????????????????????????? 1004
Prenatal sex hormones???????????????????????????????????????????????????????? 1005
Temperament???????????????????????????????????? 1005
Sibling sex ratio and birth order???????????????????????????????????????????????????????????????????????????????? 1005
Psychosocial risk factors???????????????????????????????????????????????????????????????? 1005
Social reinforcement?????????????????????????????????????????????????????? 1005
Cognitive-developmental factors???????????????????????????????????????????????????????????????????????????? 1005
General psychopathology???????????????????????????????????????????????????????????? 1006
Developmental trajectories?????????????????????????????????????????????????????????????????? 1006
Boys?????????????????????? 1006
Girls???????????????????????? 1006
Predictors of long-term gender identity???????????????????????????????????????????????????????????????????????????????????????????? 1006
Ethical considerations?????????????????????????????????????????????????????????? 1006
Treatment???????????????????????????????? 1006
Behavior therapy?????????????????????????????????????????????? 1006
Psychotherapy???????????????????????????????????????? 1007
Parental engagement???????????????????????????????????????????????????? 1007
Supportive or "gender-affirming" treatments???????????????????????????????????????????????????????????????????????????????????????????????????? 1007
Treatment of adolescents?????????????????????????????????????????????????????????????? 1007
Paraphilic sexual disorders???????????????????????????????????????????????????????????????????? 1008
Characteristics and diagnosis of the condition?????????????????????????????????????????????????????????????????????????????????????????????????????????? 1008
Phenomenology???????????????????????????????????????? 1008
DSM-5 and the ICD???????????????????????????????????????????????? 1008
Assessment?????????????????????????????????? 1008
Interviews and questionnaires???????????????????????????????????????????????????????????????????????? 1008
Other information???????????????????????????????????????????????? 1009
Phallometry and viewing time?????????????????????????????????????????????????????????????????????? 1009
Associated psychopathology?????????????????????????????????????????????????????????????????? 1009
Epidemiology?????????????????????????????????????? 1009
Prevalence and incidence?????????????????????????????????????????????????????????????? 1009
Risk factors?????????????????????????????????????? 1010
Conditioning?????????????????????????????????????? 1010
Neurodevelopment?????????????????????????????????????????????? 1010
Cycle of sexual abuse???????????????????????????????????????????????????????? 1011
Developmental trajectories?????????????????????????????????????????????????????????????????? 1011
Treatment???????????????????????????????? 1011
Pharmacological???????????????????????????????????????????? 1011
Psychosocial interventions?????????????????????????????????????????????????????????????????? 1012
Summary and conclusions???????????????????????????????????????????????????????????? 1013
References?????????????????????????????????? 1013
Chapter 70 Sleep interventions: a developmental perspective???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1019
Introduction?????????????????????????????????????? 1019
Basic overview of human sleep architecture across development???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1019
Conceptual models???????????????????????????????????????????????? 1019
Two-process model???????????????????????????????????????????????? 1019
Safety/vigilance/arousal?????????????????????????????????????????????????????????????? 1020
Three-P model???????????????????????????????????????? 1020
Brain development???????????????????????????????????????????????? 1020
Consequences of poor sleep?????????????????????????????????????????????????????????????????? 1020
Sleep is critical for affect regulation???????????????????????????????????????????????????????????????????????????????????????????? 1020
Sleep is important for cognitive functioning?????????????????????????????????????????????????????????????????????????????????????????????????????? 1020
Sleep is important for health and contributes to obesity?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1021
Sleep deprivation is associated with behavioral problems including substance use?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1021
Sleep deprivation contributes to suicidality?????????????????????????????????????????????????????????????????????????????????????????????????????? 1021
Epidemiology?????????????????????????????????????? 1021
Longitudinal outcome and sleep as a risk factor???????????????????????????????????????????????????????????????????????????????????????????????????????????? 1021
Assessment?????????????????????????????????? 1022
Clinical interview?????????????????????????????????????????????????? 1023
Questionnaires?????????????????????????????????????????? 1023
Sleep diary???????????????????????????????????? 1023
Polysomnography (PSG)???????????????????????????????????????????????????????? 1023
Actigraphy?????????????????????????????????? 1024
Classification?????????????????????????????????????????? 1024
Interventions for common sleep disorders of childhood and adolescence???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1024
Problems going to sleep and staying asleep in young children?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1024
Problems going to sleep and staying asleep in older children and adolescents?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1026
Insomnia?????????????????????????????? 1026
"Nights-owls" and delayed sleep phase syndrome (DSPS)???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1026
Daytime sleepiness/difficulty waking up for school?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1027
Parasomnias???????????????????????????????????? 1028
Sleep-disordered breathing?????????????????????????????????????????????????????????????????? 1028
Restless leg syndrome (RLS) and periodic limb movement disorder (PLMD)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1029
Narcolepsy?????????????????????????????????? 1029
Hypersomnia???????????????????????????????????? 1029
Medications???????????????????????????????????? 1029
Technology use?????????????????????????????????????????? 1030
Conclusions and future directions???????????????????????????????????????????????????????????????????????????????? 1031
References?????????????????????????????????? 1031
Chapter 71 Feeding and eating disorders???????????????????????????????????????????????????????????????????????????????????????????? 1036
Introduction?????????????????????????????????????? 1036
Diagnosis and presentation?????????????????????????????????????????????????????????????????? 1036
Pica?????????????????????? 1037
Rumination disorder???????????????????????????????????????????????????? 1037
Avoidant/restrictive food intake disorder???????????????????????????????????????????????????????????????????????????????????????????????? 1038
Anorexia nervosa?????????????????????????????????????????????? 1038
Bulimia nervosa???????????????????????????????????????????? 1039
Binge eating disorder???????????????????????????????????????????????????????? 1039
"Other" feeding and eating disorders and disturbances???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1039
Epidemiology?????????????????????????????????????? 1040
Problems in epidemiological research and implications???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1040
Trends over time?????????????????????????????????????????????? 1040
Current knowledge of incidence and prevalence???????????????????????????????????????????????????????????????????????????????????????????????????????? 1040
Mortality???????????????????????????????? 1040
Economic burden???????????????????????????????????????????? 1041
Risk factors and etiology???????????????????????????????????????????????????????????????? 1041
Biological factors?????????????????????????????????????????????????? 1041
Genetic factors???????????????????????????????????????????? 1041
Neurobiological and neuropsychological factors?????????????????????????????????????????????????????????????????????????????????????????????????????????? 1041
Perinatal factors???????????????????????????????????????????????? 1042
Infection/illness triggers?????????????????????????????????????????????????????????????????? 1042
Puberty???????????????????????????? 1042
Psychological factors???????????????????????????????????????????????????????? 1042
Psychodynamic theories?????????????????????????????????????????????????????????? 1042
Family theories???????????????????????????????????????????? 1042
Temperament???????????????????????????????????? 1043
Attachment and trauma???????????????????????????????????????????????????????? 1043
Early feeding behavior?????????????????????????????????????????????????????????? 1043
Sociocultural factors???????????????????????????????????????????????????????? 1043
Assessment?????????????????????????????????? 1044
Screening and assessment instruments?????????????????????????????????????????????????????????????????????????????????????? 1044
Formulation and treatment planning?????????????????????????????????????????????????????????????????????????????????? 1044
Treatment???????????????????????????????? 1045
Description of core principles and main treatment modalities?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1045
Overview of current evidence base for treatment of feeding and eating disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1047
Limitations in the quality of the evidence base in child and adolescent feeding and eating disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1048
Consent and ethical issues?????????????????????????????????????????????????????????????????? 1048
Outcome???????????????????????????? 1048
Problems in outcome research?????????????????????????????????????????????????????????????????????? 1048
Prognostic factors?????????????????????????????????????????????????? 1049
Recovery and remission?????????????????????????????????????????????????????????? 1049
Migration between diagnoses???????????????????????????????????????????????????????????????????? 1049
Prevention?????????????????????????????????? 1049
Conclusion?????????????????????????????????? 1049
References?????????????????????????????????? 1049
Chapter 72 Somatoform and related disorders???????????????????????????????????????????????????????????????????????????????????????????????????? 1055
Characteristics of the disorders and classification???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1055
The experience of somatic symptoms in children and young people???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1055
The concept of somatization???????????????????????????????????????????????????????????????????? 1055
The current classification of somatoform and related disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1056
The dimensional perspective???????????????????????????????????????????????????????????????????? 1056
Developmental aspects???????????????????????????????????????????????????????? 1056
Clinical presentations, assessment and diagnosis?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1057
Clinical presentations?????????????????????????????????????????????????????????? 1057
Associated impairment???????????????????????????????????????????????????????? 1058
Pathways and engagement in mental health referral???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1058
Diagnosis, differential diagnosis, and psychiatric comorbidity?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1058
Epidemiology?????????????????????????????????????? 1059
Prevalence rates of somatoform and related disorders?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1059
Prevalence rates of dissociative/conversion disorders???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1060
Cultural aspects?????????????????????????????????????????????? 1060
Longitudinal outcome and long-term adjustment???????????????????????????????????????????????????????????????????????????????????????????????????????? 1061
Abdominal pains and other pain syndromes?????????????????????????????????????????????????????????????????????????????????????????????? 1061
Chronic fatigue syndrome?????????????????????????????????????????????????????????????? 1061
Conversion disorder???????????????????????????????????????????????????? 1061
Risk factors?????????????????????????????????????? 1061
Biological factors?????????????????????????????????????????????????? 1062
Psychosocial risk factors???????????????????????????????????????????????????????????????? 1063
Child factors???????????????????????????????????????? 1063
Personality and temperament???????????????????????????????????????????????????????????????????? 1063
Stress reactivity and coping mechanisms???????????????????????????????????????????????????????????????????????????????????????????? 1063
Family factors?????????????????????????????????????????? 1063
Social factors?????????????????????????????????????????? 1064
Pathological risk processes???????????????????????????????????????????????????????????????????? 1064
Assessment. Treatment and treatment setting???????????????????????????????????????????????????????????????????????????????????????????????????? 1064
Assessment using a biopsychosocial framework?????????????????????????????????????????????????????????????????????????????????????????????????????? 1064
Treatment setting???????????????????????????????????????????????? 1067
Specialized mental health treatment???????????????????????????????????????????????????????????????????????????????????? 1067
Treatment of recurrent abdominal pains?????????????????????????????????????????????????????????????????????????????????????????? 1068
Treatment of headaches?????????????????????????????????????????????????????????? 1069
Treatment of juvenile fibromyalgia and other pain syndromes???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 1069
Treatment of chronic fatigue syndrome???????????????????????????????????????????????????????????????????????????????????????? 1069
Treatment of conversion disorder?????????????????????????????????????????????????????????????????????????????? 1069
Medication?????????????????????????????????? 1069
Treatment of psychiatric comorbidity?????????????????????????????????????????????????????????????????????????????????????? 1070
Treatment of severe withdrawal cases?????????????????????????????????????????????????????????????????????????????????????? 1070
Cultural aspects with regard to treatment???????????????????????????????????????????????????????????????????????????????????????????????? 1070
Future developments and necessary research?????????????????????????????????????????????????????????????????????????????????????????????????? 1070
References?????????????????????????????????? 1070
Index???????????????????????? 1075
EULA?????????????????????? 1098
"This new edition retains the place for the Rutter's Child and Adolescent Psychiatry as the best textbook in the field. It is an extremely valuable resource: up-to-date, comprehensive and insightful." (ACAMH, 5 November 2015)
| Erscheint lt. Verlag | 4.6.2015 |
|---|---|
| Sprache | englisch |
| Themenwelt | Geisteswissenschaften ► Psychologie ► Entwicklungspsychologie |
| Medizin / Pharmazie ► Gesundheitsfachberufe | |
| Medizin / Pharmazie ► Medizinische Fachgebiete ► Pädiatrie | |
| Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie | |
| Schlagworte | adolescent mental health • Adolescent Psychiatry • child mental health • Child Psychiatry • Clinicians • Developmental psychopathology • Diagnostic and Statistical Manual of Mental Disorders • DSM-5 • Genetics • global psychiatry • Imaging • Infant mental health • Klinische Psychologie • Medical Science • Medizin • Pädiatrie • Pädiatrie • Pediatrics • Psychiatrie • Psychiatry • Psychologie • Psychology • relationship-based treatments • Researchers • Resilience • systems neuroscience |
| ISBN-10 | 1-118-38193-9 / 1118381939 |
| ISBN-13 | 978-1-118-38193-9 / 9781118381939 |
| Informationen gemäß Produktsicherheitsverordnung (GPSR) | |
| Haben Sie eine Frage zum Produkt? |
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