Altered amygdala and hippocampus function in adolescents with hypercortisolemia: A functional magnetic resonance imaging study of Cushing syndrome / Françoise S. MAHEU in Development and Psychopathology, 20-4 (Fall 2008)  

Public ISBD [article]  inDevelopment and Psychopathology > 20-4 (Fall 2008) . - p.1177-1189 Titre : Altered amygdala and hippocampus function in adolescents with hypercortisolemia: A functional magnetic resonance imaging study of Cushing syndrome Type de document : texte imprimé Auteurs : Françoise S. MAHEU, Auteur ; Daniel S. PINE, Auteur ; Monique ERNST, Auteur ; Luigi MAZZONE, Auteur ; Deborah P. MERKE, Auteur ; Margaret F. KEIL, Auteur ; Constantine A. STRATAKIS, Auteur Année de publication : 2008 Article en page(s) : p.1177-1189 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Chronic elevations of endogenous cortisol levels have been shown to alter medial temporal cortical structures and to be accompanied by declarative memory impairments and depressive symptoms in human adults. These effects of elevated endogenous levels of cortisol have not been directly studied in adolescents. Because adolescents with Cushing syndrome show endogenous elevations in cortisol, they represent a unique natural model to study the effects of prolonged hypercortisolemia on brain function, and memory and affective processes during this developmental stage. Using functional magnetic resonance imaging (fMRI), we compared 12 adolescents with Cushing syndrome with 22 healthy control adolescents on amygdala and anterior hippocampus activation during an emotional faces encoding task. None of these adolescents manifested depressive symptoms. Encoding success was assessed using a memory recognition test performed after the scan. The fMRI analyses followed an event-related design and were conducted using the SPM99 platform. Compared to healthy adolescents, patients with Cushing syndrome showed greater left amygdala and right anterior hippocampus activation during successful face encoding. Memory performance for faces recognition did not differ between groups. This first study of cerebral function in adolescents with chronic endogeneous hypercortisolemia due to Cushing syndrome demonstrates the presence of functional alterations in amygdala and hippocampus, which are not associated with affective or memory impairments. Such findings need to be followed by work examining the role of age and related brain maturational stage on these effects, as well as the identification of possible protective factors conferring resilience to affective and cognitive consequences in this disease and/or during this stage of cerebral development. En ligne : http://dx.doi.org/10.1017/s0954579408000564 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=602 [article] Altered amygdala and hippocampus function in adolescents with hypercortisolemia: A functional magnetic resonance imaging study of Cushing syndrome [texte imprimé] / Françoise S. MAHEU, Auteur ; Daniel S. PINE, Auteur ; Monique ERNST, Auteur ; Luigi MAZZONE, Auteur ; Deborah P. MERKE, Auteur ; Margaret F. KEIL, Auteur ; Constantine A. STRATAKIS, Auteur . - 2008 . - p.1177-1189. Langues : Anglais (eng) in Development and Psychopathology > 20-4 (Fall 2008) . - p.1177-1189 Index. décimale : PER Périodiques Résumé : Chronic elevations of endogenous cortisol levels have been shown to alter medial temporal cortical structures and to be accompanied by declarative memory impairments and depressive symptoms in human adults. These effects of elevated endogenous levels of cortisol have not been directly studied in adolescents. Because adolescents with Cushing syndrome show endogenous elevations in cortisol, they represent a unique natural model to study the effects of prolonged hypercortisolemia on brain function, and memory and affective processes during this developmental stage. Using functional magnetic resonance imaging (fMRI), we compared 12 adolescents with Cushing syndrome with 22 healthy control adolescents on amygdala and anterior hippocampus activation during an emotional faces encoding task. None of these adolescents manifested depressive symptoms. Encoding success was assessed using a memory recognition test performed after the scan. The fMRI analyses followed an event-related design and were conducted using the SPM99 platform. Compared to healthy adolescents, patients with Cushing syndrome showed greater left amygdala and right anterior hippocampus activation during successful face encoding. Memory performance for faces recognition did not differ between groups. This first study of cerebral function in adolescents with chronic endogeneous hypercortisolemia due to Cushing syndrome demonstrates the presence of functional alterations in amygdala and hippocampus, which are not associated with affective or memory impairments. Such findings need to be followed by work examining the role of age and related brain maturational stage on these effects, as well as the identification of possible protective factors conferring resilience to affective and cognitive consequences in this disease and/or during this stage of cerebral development. En ligne : http://dx.doi.org/10.1017/s0954579408000564 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=602

An fMRI examination of developmental differences in the neural correlates of uncertainty and decision-making / Amy L. KRAIN in Journal of Child Psychology and Psychiatry, 47-10 (October 2006)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 47-10 (October 2006) . - p.1023–1030 Titre : An fMRI examination of developmental differences in the neural correlates of uncertainty and decision-making Type de document : texte imprimé Auteurs : Amy L. KRAIN, Auteur ; Daniel S. PINE, Auteur ; Sara HEFTON, Auteur ; Monique ERNST, Auteur ; Rachel G. KLEIN, Auteur ; Michael P. MILHAM, Auteur ; Francisco Xavier CASTELLANOS, Auteur Année de publication : 2007 Article en page(s) : p.1023–1030 Langues : Anglais (eng) Mots-clés : Adolescence anxiety brain-imaging development Index. décimale : PER Périodiques Résumé : Background: Maturation of prefrontal circuits during adolescence contributes to the development of cognitive processes such as decision-making. Recent theories suggest that these neural changes also play a role in the shift from generalized anxiety disorder (GAD) to depression that often occurs during this developmental period. Cognitive models of the development of GAD highlight the role of intolerance of uncertainty (IU), which can be characterized behaviorally by impairments in decision-making. The present study examines potential developmental differences in frontal regions associated with uncertain decision-making, and tests the impact of IU on these circuits. Methods: Twelve healthy adults (ages 19–36) and 12 healthy adolescents (ages 13–17) completed a decision-making task with conditions of varied uncertainty while fMRI scans were acquired. They also completed measures of worry and IU, and a questionnaire about their levels of anxiety and certainty during the task. Results: Combined group analyses demonstrated significant linear effects of uncertainty on activity within anterior cingulate cortex (ACC). Region of interest (ROI)-based analysis found a significant interaction of group and IU ratings in ACC. Increased IU was associated with robust linear increases in ACC activity only in adolescents. An ROI analysis of feedback-related processing found that adolescents demonstrated greater activation during incorrect trials relative to correct trials, while the adults showed no difference in neural activity associated with incorrect and correct feedback. Conclusions: This decision-making task was shown to be effective at eliciting uncertainty-related ACC activity in adults and adolescents. Further, IU impacts ACC activity in adolescents during uncertain decision-making, providing preliminary support for a developmental model of GAD. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2006.01677.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=792 [article] An fMRI examination of developmental differences in the neural correlates of uncertainty and decision-making [texte imprimé] / Amy L. KRAIN, Auteur ; Daniel S. PINE, Auteur ; Sara HEFTON, Auteur ; Monique ERNST, Auteur ; Rachel G. KLEIN, Auteur ; Michael P. MILHAM, Auteur ; Francisco Xavier CASTELLANOS, Auteur . - 2007 . - p.1023–1030. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 47-10 (October 2006) . - p.1023–1030 Mots-clés : Adolescence anxiety brain-imaging development Index. décimale : PER Périodiques Résumé : Background: Maturation of prefrontal circuits during adolescence contributes to the development of cognitive processes such as decision-making. Recent theories suggest that these neural changes also play a role in the shift from generalized anxiety disorder (GAD) to depression that often occurs during this developmental period. Cognitive models of the development of GAD highlight the role of intolerance of uncertainty (IU), which can be characterized behaviorally by impairments in decision-making. The present study examines potential developmental differences in frontal regions associated with uncertain decision-making, and tests the impact of IU on these circuits. Methods: Twelve healthy adults (ages 19–36) and 12 healthy adolescents (ages 13–17) completed a decision-making task with conditions of varied uncertainty while fMRI scans were acquired. They also completed measures of worry and IU, and a questionnaire about their levels of anxiety and certainty during the task. Results: Combined group analyses demonstrated significant linear effects of uncertainty on activity within anterior cingulate cortex (ACC). Region of interest (ROI)-based analysis found a significant interaction of group and IU ratings in ACC. Increased IU was associated with robust linear increases in ACC activity only in adolescents. An ROI analysis of feedback-related processing found that adolescents demonstrated greater activation during incorrect trials relative to correct trials, while the adults showed no difference in neural activity associated with incorrect and correct feedback. Conclusions: This decision-making task was shown to be effective at eliciting uncertainty-related ACC activity in adults and adolescents. Further, IU impacts ACC activity in adolescents during uncertain decision-making, providing preliminary support for a developmental model of GAD. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2006.01677.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=792

Anxiety symptoms and children's eye gaze during fear learning / Kalina J. MICHALSKA in Journal of Child Psychology and Psychiatry, 58-11 (November 2017)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 58-11 (November 2017) . - p.1276-1286 Titre : Anxiety symptoms and children's eye gaze during fear learning Type de document : texte imprimé Auteurs : Kalina J. MICHALSKA, Auteur ; Laura MACHLIN, Auteur ; Elizabeth MORONEY, Auteur ; Daniel S. LOWET, Auteur ; John M. HETTEMA, Auteur ; Roxann ROBERSON-NAY, Auteur ; Bruno B. AVERBECK, Auteur ; Melissa A. BROTMAN, Auteur ; Eric E. NELSON, Auteur ; Ellen LEIBENLUFT, Auteur ; Daniel S. PINE, Auteur Article en page(s) : p.1276-1286 Langues : Anglais (eng) Mots-clés : Eye gaze  face processing  anxiety  conditioning  psychophysiology Index. décimale : PER Périodiques Résumé : Background The eye region of the face is particularly relevant for decoding threat-related signals, such as fear. However, it is unclear if gaze patterns to the eyes can be influenced by fear learning. Previous studies examining gaze patterns in adults find an association between anxiety and eye gaze avoidance, although no studies to date examine how associations between anxiety symptoms and eye-viewing patterns manifest in children. The current study examined the effects of learning and trait anxiety on eye gaze using a face-based fear conditioning task developed for use in children. Methods Participants were 82 youth from a general population sample of twins (aged 9–13 years), exhibiting a range of anxiety symptoms. Participants underwent a fear conditioning paradigm where the conditioned stimuli (CS+) were two neutral faces, one of which was randomly selected to be paired with an aversive scream. Eye tracking, physiological, and subjective data were acquired. Children and parents reported their child's anxiety using the Screen for Child Anxiety Related Emotional Disorders. Results Conditioning influenced eye gaze patterns in that children looked longer and more frequently to the eye region of the CS+ than CS− face; this effect was present only during fear acquisition, not at baseline or extinction. Furthermore, consistent with past work in adults, anxiety symptoms were associated with eye gaze avoidance. Finally, gaze duration to the eye region mediated the effect of anxious traits on self-reported fear during acquisition. Conclusions Anxiety symptoms in children relate to face-viewing strategies deployed in the context of a fear learning experiment. This relationship may inform attempts to understand the relationship between pediatric anxiety symptoms and learning. En ligne : http://dx.doi.org/10.1111/jcpp.12749 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=326 [article] Anxiety symptoms and children's eye gaze during fear learning [texte imprimé] / Kalina J. MICHALSKA, Auteur ; Laura MACHLIN, Auteur ; Elizabeth MORONEY, Auteur ; Daniel S. LOWET, Auteur ; John M. HETTEMA, Auteur ; Roxann ROBERSON-NAY, Auteur ; Bruno B. AVERBECK, Auteur ; Melissa A. BROTMAN, Auteur ; Eric E. NELSON, Auteur ; Ellen LEIBENLUFT, Auteur ; Daniel S. PINE, Auteur . - p.1276-1286. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 58-11 (November 2017) . - p.1276-1286 Mots-clés : Eye gaze  face processing  anxiety  conditioning  psychophysiology Index. décimale : PER Périodiques Résumé : Background The eye region of the face is particularly relevant for decoding threat-related signals, such as fear. However, it is unclear if gaze patterns to the eyes can be influenced by fear learning. Previous studies examining gaze patterns in adults find an association between anxiety and eye gaze avoidance, although no studies to date examine how associations between anxiety symptoms and eye-viewing patterns manifest in children. The current study examined the effects of learning and trait anxiety on eye gaze using a face-based fear conditioning task developed for use in children. Methods Participants were 82 youth from a general population sample of twins (aged 9–13 years), exhibiting a range of anxiety symptoms. Participants underwent a fear conditioning paradigm where the conditioned stimuli (CS+) were two neutral faces, one of which was randomly selected to be paired with an aversive scream. Eye tracking, physiological, and subjective data were acquired. Children and parents reported their child's anxiety using the Screen for Child Anxiety Related Emotional Disorders. Results Conditioning influenced eye gaze patterns in that children looked longer and more frequently to the eye region of the CS+ than CS− face; this effect was present only during fear acquisition, not at baseline or extinction. Furthermore, consistent with past work in adults, anxiety symptoms were associated with eye gaze avoidance. Finally, gaze duration to the eye region mediated the effect of anxious traits on self-reported fear during acquisition. Conclusions Anxiety symptoms in children relate to face-viewing strategies deployed in the context of a fear learning experiment. This relationship may inform attempts to understand the relationship between pediatric anxiety symptoms and learning. En ligne : http://dx.doi.org/10.1111/jcpp.12749 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=326

Assessing gene–environment interactions on anxiety symptom subtypes across childhood and adolescence / Jennifer Y.F. LAU in Development and Psychopathology, 19-4 (Fall 2007)  

Public ISBD [article]  inDevelopment and Psychopathology > 19-4 (Fall 2007) . - p.1129-1146 Titre : Assessing gene–environment interactions on anxiety symptom subtypes across childhood and adolescence Type de document : texte imprimé Auteurs : Jennifer Y.F. LAU, Auteur ; Daniel S. PINE, Auteur ; Thalia C. ELEY, Auteur ; Alice M. GREGORY, Auteur ; Michelle A. GOLDWIN, Auteur Année de publication : 2007 Article en page(s) : p.1129-1146 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Consistent evidence shows both genetic and stress-related risks on child and adolescent anxiety, yet few studies have considered the degree to which genetic effects are moderated by stress (gene–environment interaction). We used longitudinal data from both a child and adolescent sample of twins to examine three novel issues on the presence of gene–environment interaction on anxiety symptoms. First, we assessed moderation of genetic risks on anxiety symptoms by negative life events in each age group. Second, by distinguishing between “stable” and “age-specific” genetic factors, we explored the continuity of gene–environment interaction across time and/or its emergence at specific ages. Third, we compared the presence of gene–environment interaction across different symptom types (general, panic, social, and separation). Genetic effects on separation anxiety symptoms in childhood (mean age = 8 years, 6 months) and panic anxiety symptoms in adolescence (mean age = 15 years) increased across independent negative life events. Shared environmental effects on separation anxiety symptoms and nonshared environmental effects on general anxiety symptoms in adolescence were also moderated by negative life events. We interpret these preliminary findings tentatively in the context of gene–environment interaction on anxiety in general, and on early separation and later panic anxiety in particular. En ligne : http://dx.doi.org/10.1017/s0954579407000582 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=182 [article] Assessing gene–environment interactions on anxiety symptom subtypes across childhood and adolescence [texte imprimé] / Jennifer Y.F. LAU, Auteur ; Daniel S. PINE, Auteur ; Thalia C. ELEY, Auteur ; Alice M. GREGORY, Auteur ; Michelle A. GOLDWIN, Auteur . - 2007 . - p.1129-1146. Langues : Anglais (eng) in Development and Psychopathology > 19-4 (Fall 2007) . - p.1129-1146 Index. décimale : PER Périodiques Résumé : Consistent evidence shows both genetic and stress-related risks on child and adolescent anxiety, yet few studies have considered the degree to which genetic effects are moderated by stress (gene–environment interaction). We used longitudinal data from both a child and adolescent sample of twins to examine three novel issues on the presence of gene–environment interaction on anxiety symptoms. First, we assessed moderation of genetic risks on anxiety symptoms by negative life events in each age group. Second, by distinguishing between “stable” and “age-specific” genetic factors, we explored the continuity of gene–environment interaction across time and/or its emergence at specific ages. Third, we compared the presence of gene–environment interaction across different symptom types (general, panic, social, and separation). Genetic effects on separation anxiety symptoms in childhood (mean age = 8 years, 6 months) and panic anxiety symptoms in adolescence (mean age = 15 years) increased across independent negative life events. Shared environmental effects on separation anxiety symptoms and nonshared environmental effects on general anxiety symptoms in adolescence were also moderated by negative life events. We interpret these preliminary findings tentatively in the context of gene–environment interaction on anxiety in general, and on early separation and later panic anxiety in particular. En ligne : http://dx.doi.org/10.1017/s0954579407000582 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=182

Association between irritability and bias in attention orienting to threat in children and adolescents / Giovanni A. SALUM in Journal of Child Psychology and Psychiatry, 58-5 (May 2017)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 58-5 (May 2017) . - p.595-602 Titre : Association between irritability and bias in attention orienting to threat in children and adolescents Type de document : texte imprimé Auteurs : Giovanni A. SALUM, Auteur ; Karin MOGG, Auteur ; Brendan P. BRADLEY, Auteur ; Argyris STRINGARIS, Auteur ; Ary GADELHA, Auteur ; Pedro M. PAN, Auteur ; Luis Augusto ROHDE, Auteur ; Guilherme V. POLANCZYK, Auteur ; Gisele G. MANFRO, Auteur ; Daniel S. PINE, Auteur ; Ellen LEIBENLUFT, Auteur Article en page(s) : p.595-602 Langues : Anglais (eng) Mots-clés : Irritability  anger  attention  bias  cognition  emotion Index. décimale : PER Périodiques Résumé : Background Irritability, a frequent complaint in children with psychiatric disorders, reflects increased predisposition to anger. Preliminary work in pediatric clinical samples links irritability to attention bias to threat, and the current study examines this association in a large population-based sample. Methods We studied 1,872 children (ages 6–14) using the Development and Well-Being Assessment (DAWBA), Childhood Behavior Checklist (CBCL), and dot-probe tasks. Irritability was defined using CBCL items that assessed temper tantrums and hot temper. The dot-probe task assessed attention biases for threat-related (angry face) stimuli. Multiple regression analysis was used to assess specificity of associations to irritability when adjusting for demographic variables and co-occurring psychiatric traits. Propensity score matching analysis was used to increase causal inference when matching for demographic variables and co-occurring psychiatric traits. Results Irritability was associated with increased attention bias toward threat-related cues. Multiple regression analysis suggests associations between irritability and threat bias are independent from demographic variables, anxiety, and externalizing traits (attention-deficit/hyperactivity, conduct, and headstrong/hurtful), but not from broad internalizing symptoms. Propensity score matching analysis indicated that this association was found for irritable versus nonirritable groups matched on demographic and co-occurring traits including internalizing symptoms. Conclusions Irritability in children is associated with biased attention toward threatening information. This finding, if replicated, warrants further investigation to examine the extent to which it contributes to chronic irritability and to explore possible treatment implications. En ligne : http://dx.doi.org/10.1111/jcpp.12659 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=306 [article] Association between irritability and bias in attention orienting to threat in children and adolescents [texte imprimé] / Giovanni A. SALUM, Auteur ; Karin MOGG, Auteur ; Brendan P. BRADLEY, Auteur ; Argyris STRINGARIS, Auteur ; Ary GADELHA, Auteur ; Pedro M. PAN, Auteur ; Luis Augusto ROHDE, Auteur ; Guilherme V. POLANCZYK, Auteur ; Gisele G. MANFRO, Auteur ; Daniel S. PINE, Auteur ; Ellen LEIBENLUFT, Auteur . - p.595-602. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 58-5 (May 2017) . - p.595-602 Mots-clés : Irritability  anger  attention  bias  cognition  emotion Index. décimale : PER Périodiques Résumé : Background Irritability, a frequent complaint in children with psychiatric disorders, reflects increased predisposition to anger. Preliminary work in pediatric clinical samples links irritability to attention bias to threat, and the current study examines this association in a large population-based sample. Methods We studied 1,872 children (ages 6–14) using the Development and Well-Being Assessment (DAWBA), Childhood Behavior Checklist (CBCL), and dot-probe tasks. Irritability was defined using CBCL items that assessed temper tantrums and hot temper. The dot-probe task assessed attention biases for threat-related (angry face) stimuli. Multiple regression analysis was used to assess specificity of associations to irritability when adjusting for demographic variables and co-occurring psychiatric traits. Propensity score matching analysis was used to increase causal inference when matching for demographic variables and co-occurring psychiatric traits. Results Irritability was associated with increased attention bias toward threat-related cues. Multiple regression analysis suggests associations between irritability and threat bias are independent from demographic variables, anxiety, and externalizing traits (attention-deficit/hyperactivity, conduct, and headstrong/hurtful), but not from broad internalizing symptoms. Propensity score matching analysis indicated that this association was found for irritable versus nonirritable groups matched on demographic and co-occurring traits including internalizing symptoms. Conclusions Irritability in children is associated with biased attention toward threatening information. This finding, if replicated, warrants further investigation to examine the extent to which it contributes to chronic irritability and to explore possible treatment implications. En ligne : http://dx.doi.org/10.1111/jcpp.12659 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=306

Attention bias and anxiety in young children exposed to family violence / Margaret J. BRIGGS-GOWAN in Journal of Child Psychology and Psychiatry, 56-11 (November 2015)  

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Attention bias in the developmental unfolding of post-traumatic stress symptoms in young children at risk / Margaret J. BRIGGS-GOWAN in Journal of Child Psychology and Psychiatry, 57-9 (September 2016)  

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Attention bias modification for youth with social anxiety disorder / Lee PERGAMIN-HIGHT in Journal of Child Psychology and Psychiatry, 57-11 (November 2016)  

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Attention to novelty in behaviorally inhibited adolescents moderates risk for anxiety / Bethany C. REEB-SUTHERLAND in Journal of Child Psychology and Psychiatry, 50-11 (November 2009)  

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Childhood abuse and reduced cortical thickness in brain regions involved in emotional processing / Andrea L. GOLD in Journal of Child Psychology and Psychiatry, 57-10 (October 2016)  

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Commentary: Diagnosis and classification: There must be something left about which to argue – reflections on Rutter (2011) / Daniel S. PINE in Journal of Child Psychology and Psychiatry, 52-6 (June 2011)  

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Commentary: To intervene or not? Appreciating or treating individual differences in childhood temperament – remarks on Rapee (2013) / Nathan A. FOX in Journal of Child Psychology and Psychiatry, 54-7 (July 2013)  

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Cross-sectional and longitudinal abnormalities in brain structure in children with severe mood dysregulation or bipolar disorder / Nancy E. ADLEMAN in Journal of Child Psychology and Psychiatry, 53-11 (November 2012)  

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Development of inhibitory control during childhood and its relations to early temperament and later social anxiety: unique insights provided by latent growth modeling and signal detection theory / Sonya V. TROLLER-RENFREE in Journal of Child Psychology and Psychiatry, 60-6 (June 2019)  

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Development of a novel observational measure for anxiety in young children: The Anxiety Dimensional Observation Scale / Nicholas D. MIAN in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

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