Dépouillements

Editorial: Early detection of mental health and neurodevelopmental disorders: the ethical challenges of a field in its infancy / Sally OZONOFF in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.933-935 Titre : Editorial: Early detection of mental health and neurodevelopmental disorders: the ethical challenges of a field in its infancy Type de document : Texte imprimé et/ou numérique Auteurs : Sally OZONOFF, Auteur Article en page(s) : p.933-935 Langues : Anglais (eng) Mots-clés : Early detection  ethical issues  assessment  neurodevelopmental disorders  incorrect identification Index. décimale : PER Périodiques Résumé : The signs of many mental health and neurodevelopmental conditions first appear in childhood and diagnosis can reliably be made by school age for most. Such conditions can be chronically disabling and confer significant long-term impairment. Determining early risk signs and first emerging symptoms of disorder is imperative to enhance early detection and to identify targets and ideal time points for prevention and intervention efforts. This Special Issue of JCPP focuses on the prospect of earlier identification of conditions that are traditionally diagnosed later in childhood. Ten invited empirical articles cover topics related to the science of early detection. Several are focused on prediction of later diagnosis, of functional impairment, and of future service utilization, while others cover instrument development and topics related to screening. The papers span the conditions of ADHD, ASD, dyslexia, mood dysregulation, disruptive behavior disorders, and anxiety disorders. This Editorial provides an overview of the invited contributions and the perspectives they provide on the ethical challenges and choices of a field still in its infancy. En ligne : http://dx.doi.org/10.1111/jcpp.12452 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Editorial: Early detection of mental health and neurodevelopmental disorders: the ethical challenges of a field in its infancy [Texte imprimé et/ou numérique] / Sally OZONOFF, Auteur . - p.933-935. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.933-935 Mots-clés : Early detection  ethical issues  assessment  neurodevelopmental disorders  incorrect identification Index. décimale : PER Périodiques Résumé : The signs of many mental health and neurodevelopmental conditions first appear in childhood and diagnosis can reliably be made by school age for most. Such conditions can be chronically disabling and confer significant long-term impairment. Determining early risk signs and first emerging symptoms of disorder is imperative to enhance early detection and to identify targets and ideal time points for prevention and intervention efforts. This Special Issue of JCPP focuses on the prospect of earlier identification of conditions that are traditionally diagnosed later in childhood. Ten invited empirical articles cover topics related to the science of early detection. Several are focused on prediction of later diagnosis, of functional impairment, and of future service utilization, while others cover instrument development and topics related to screening. The papers span the conditions of ADHD, ASD, dyslexia, mood dysregulation, disruptive behavior disorders, and anxiety disorders. This Editorial provides an overview of the invited contributions and the perspectives they provide on the ethical challenges and choices of a field still in its infancy. En ligne : http://dx.doi.org/10.1111/jcpp.12452 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Thresholds and accuracy in screening tools for early detection of psychopathology / R. Christopher SHELDRICK in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.936-948 Titre : Thresholds and accuracy in screening tools for early detection of psychopathology Type de document : Texte imprimé et/ou numérique Auteurs : R. Christopher SHELDRICK, Auteur ; James C. BENNEYAN, Auteur ; Ivy Giserman KISS, Auteur ; Margaret J. BRIGGS-GOWAN, Auteur ; William COPELAND, Auteur ; Alice S. CARTER, Auteur Article en page(s) : p.936-948 Langues : Anglais (eng) Mots-clés : Assessment  screening  psychopathology  developmental psychopathology  methodology Index. décimale : PER Périodiques Résumé : Background The accuracy of any screening instrument designed to detect psychopathology among children is ideally assessed through rigorous comparison to ‘gold standard’ tests and interviews. Such comparisons typically yield estimates of what we refer to as ‘standard indices of diagnostic accuracy’, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value. However, whereas these statistics were originally designed to detect binary signals (e.g., diagnosis present or absent), screening questionnaires commonly used in psychology, psychiatry, and pediatrics typically result in ordinal scores. Thus, a threshold or ‘cut score’ must be applied to these ordinal scores before accuracy can be evaluated using such standard indices. To better understand the tradeoffs inherent in choosing a particular threshold, we discuss the concept of ‘threshold probability’. In contrast to PPV, which reflects the probability that a child whose score falls at or above the screening threshold has the condition of interest, threshold probability refers specifically to the likelihood that a child whose score is equal to a particular screening threshold has the condition of interest. Method The diagnostic accuracy and threshold probability of two well-validated behavioral assessment instruments, the Child Behavior Checklist Total Problem Scale and the Strengths and Difficulties Questionnaire total scale were examined in relation to a structured psychiatric interview in three de-identified datasets. Results Although both screening measures were effective in identifying groups of children at elevated risk for psychopathology in all samples (odds ratios ranged from 5.2 to 9.7), children who scored at or near the clinical thresholds that optimized sensitivity and specificity were unlikely to meet criteria for psychopathology on gold standard interviews. Conclusions Our results are consistent with the view that screening instruments should be interpreted probabilistically, with attention to where along the continuum of positive scores an individual falls. En ligne : http://dx.doi.org/10.1111/jcpp.12442 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Thresholds and accuracy in screening tools for early detection of psychopathology [Texte imprimé et/ou numérique] / R. Christopher SHELDRICK, Auteur ; James C. BENNEYAN, Auteur ; Ivy Giserman KISS, Auteur ; Margaret J. BRIGGS-GOWAN, Auteur ; William COPELAND, Auteur ; Alice S. CARTER, Auteur . - p.936-948. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.936-948 Mots-clés : Assessment  screening  psychopathology  developmental psychopathology  methodology Index. décimale : PER Périodiques Résumé : Background The accuracy of any screening instrument designed to detect psychopathology among children is ideally assessed through rigorous comparison to ‘gold standard’ tests and interviews. Such comparisons typically yield estimates of what we refer to as ‘standard indices of diagnostic accuracy’, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value. However, whereas these statistics were originally designed to detect binary signals (e.g., diagnosis present or absent), screening questionnaires commonly used in psychology, psychiatry, and pediatrics typically result in ordinal scores. Thus, a threshold or ‘cut score’ must be applied to these ordinal scores before accuracy can be evaluated using such standard indices. To better understand the tradeoffs inherent in choosing a particular threshold, we discuss the concept of ‘threshold probability’. In contrast to PPV, which reflects the probability that a child whose score falls at or above the screening threshold has the condition of interest, threshold probability refers specifically to the likelihood that a child whose score is equal to a particular screening threshold has the condition of interest. Method The diagnostic accuracy and threshold probability of two well-validated behavioral assessment instruments, the Child Behavior Checklist Total Problem Scale and the Strengths and Difficulties Questionnaire total scale were examined in relation to a structured psychiatric interview in three de-identified datasets. Results Although both screening measures were effective in identifying groups of children at elevated risk for psychopathology in all samples (odds ratios ranged from 5.2 to 9.7), children who scored at or near the clinical thresholds that optimized sensitivity and specificity were unlikely to meet criteria for psychopathology on gold standard interviews. Conclusions Our results are consistent with the view that screening instruments should be interpreted probabilistically, with attention to where along the continuum of positive scores an individual falls. En ligne : http://dx.doi.org/10.1111/jcpp.12442 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Early identification of ADHD risk via infant temperament and emotion regulation: a pilot study / Elinor L. SULLIVAN in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.949-957 Titre : Early identification of ADHD risk via infant temperament and emotion regulation: a pilot study Type de document : Texte imprimé et/ou numérique Auteurs : Elinor L. SULLIVAN, Auteur ; Kathleen F. HOLTON, Auteur ; Elizabeth K. NOUSEN, Auteur ; Ashley N. BARLING, Auteur ; Ceri A. SULLIVAN, Auteur ; Cathi B. PROPPER, Auteur ; Joel T. NIGG, Auteur Article en page(s) : p.949-957 Langues : Anglais (eng) Mots-clés : ADHD risk  markers  early identification  maternal precursors  emotional dysregulation  infant temperament Index. décimale : PER Périodiques Résumé : Background Attention deficit hyperactivity disorder (ADHD) is theorized to have temperamental precursors early in life. These are difficult to identify because many core features of ADHD, such as breakdowns in executive function and self-control, involve psychological and neural systems that are too immature to reliably show dysfunction in early life. ADHD also involves emotional dysregulation, and these temperamental features appear earlier as well. Here, we report a first attempt to utilize indices of emotional regulation to identify ADHD-related liability in infancy. Methods Fifty women were recruited in the 2nd trimester of pregnancy, with overselection for high parental ADHD symptoms. Measures of maternal body mass index, nutrition, substance use, stress, and mood were examined during pregnancy as potential confounds. Offspring were evaluated at 6 months of age using LABTAB procedures designed to elicit fear, anger, and regulatory behavior. Mothers completed the Infant Behavior Questionnaire about their child's temperament. Results After control for associated covariates, including maternal depression and prenatal stress, family history of ADHD was associated with measures of anger/irritability, including infant negative vocalizations during the arm restraint task (p = .004), and maternal ratings of infant distress to limitations (p = .036). In the regulation domain, familial ADHD was associated with less parent-oriented attention seeking during the still face procedure (p < .001), but this was not echoed in the maternal ratings of recovery from distress. Conclusions Affective response at 6 months of age may identify infants with familial history of ADHD, providing an early indicator of ADHD liability. These preliminary results provide a foundation for further studies and will be amplified by enlarging this cohort and following participants longitudinally to evaluate ADHD outcomes. En ligne : http://dx.doi.org/10.1111/jcpp.12426 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Early identification of ADHD risk via infant temperament and emotion regulation: a pilot study [Texte imprimé et/ou numérique] / Elinor L. SULLIVAN, Auteur ; Kathleen F. HOLTON, Auteur ; Elizabeth K. NOUSEN, Auteur ; Ashley N. BARLING, Auteur ; Ceri A. SULLIVAN, Auteur ; Cathi B. PROPPER, Auteur ; Joel T. NIGG, Auteur . - p.949-957. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.949-957 Mots-clés : ADHD risk  markers  early identification  maternal precursors  emotional dysregulation  infant temperament Index. décimale : PER Périodiques Résumé : Background Attention deficit hyperactivity disorder (ADHD) is theorized to have temperamental precursors early in life. These are difficult to identify because many core features of ADHD, such as breakdowns in executive function and self-control, involve psychological and neural systems that are too immature to reliably show dysfunction in early life. ADHD also involves emotional dysregulation, and these temperamental features appear earlier as well. Here, we report a first attempt to utilize indices of emotional regulation to identify ADHD-related liability in infancy. Methods Fifty women were recruited in the 2nd trimester of pregnancy, with overselection for high parental ADHD symptoms. Measures of maternal body mass index, nutrition, substance use, stress, and mood were examined during pregnancy as potential confounds. Offspring were evaluated at 6 months of age using LABTAB procedures designed to elicit fear, anger, and regulatory behavior. Mothers completed the Infant Behavior Questionnaire about their child's temperament. Results After control for associated covariates, including maternal depression and prenatal stress, family history of ADHD was associated with measures of anger/irritability, including infant negative vocalizations during the arm restraint task (p = .004), and maternal ratings of infant distress to limitations (p = .036). In the regulation domain, familial ADHD was associated with less parent-oriented attention seeking during the still face procedure (p < .001), but this was not echoed in the maternal ratings of recovery from distress. Conclusions Affective response at 6 months of age may identify infants with familial history of ADHD, providing an early indicator of ADHD liability. These preliminary results provide a foundation for further studies and will be amplified by enlarging this cohort and following participants longitudinally to evaluate ADHD outcomes. En ligne : http://dx.doi.org/10.1111/jcpp.12426 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Latent profile analysis of neuropsychological measures to determine preschoolers' risk for ADHD / Khushmand RAJENDRAN in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.958-965 Titre : Latent profile analysis of neuropsychological measures to determine preschoolers' risk for ADHD Type de document : Texte imprimé et/ou numérique Auteurs : Khushmand RAJENDRAN, Auteur ; Sarah O'NEILL, Auteur ; David J. MARKS, Auteur ; Jeffrey M. HALPERIN, Auteur Article en page(s) : p.958-965 Langues : Anglais (eng) Mots-clés : Latent profile analysis  preschool  ADHD  neuropsychology Index. décimale : PER Périodiques Résumé : Background Hyperactive/Inattentive preschool children show clear evidence of neuropsychological dysfunction. We examined whether patterns and severity of test scores could reliably identify subgroups of preschoolers with differential risk for ADHD during school-age. Method Typically developing (TD: n = 76) and Hyperactive/Inattentive (HI: n = 138) 3–4 year olds were assessed annually for 6 years (T1–T6). Latent profile analysis (LPA) was used to form subgroups among the HI group based on objective/neuropsychological measures (NEPSY, Actigraph and Continuous Performance Test). Logistic regression assessed the predictive validity of empirically formed subgroups at risk for ADHD diagnosis relative to the TD group and to each other from T2 to T6. Results Latent profile analysis yielded two subgroups of HI preschoolers: (a) selectively weak Attention/Executive functions, and (b) pervasive neuropsychological dysfunction across all measures. Both subgroups were more likely to have ADHD at all follow-up time-points relative to the TD group (OR range: 11.29–86.32), but there were no significant differences between the LPA-formed subgroups of HI children at any time-point. Conclusions Objective/neuropsychological measures distinguish HI preschoolers from their TD peers, but patterns and severity of neuropsychological dysfunction do not predict risk for ADHD during school-age. We hypothesize that trajectories in at-risk children are influenced by subsequent environmental and neurodevelopmental factors, raising the possibility that they are amenable to early intervention. En ligne : http://dx.doi.org/10.1111/jcpp.12434 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Latent profile analysis of neuropsychological measures to determine preschoolers' risk for ADHD [Texte imprimé et/ou numérique] / Khushmand RAJENDRAN, Auteur ; Sarah O'NEILL, Auteur ; David J. MARKS, Auteur ; Jeffrey M. HALPERIN, Auteur . - p.958-965. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.958-965 Mots-clés : Latent profile analysis  preschool  ADHD  neuropsychology Index. décimale : PER Périodiques Résumé : Background Hyperactive/Inattentive preschool children show clear evidence of neuropsychological dysfunction. We examined whether patterns and severity of test scores could reliably identify subgroups of preschoolers with differential risk for ADHD during school-age. Method Typically developing (TD: n = 76) and Hyperactive/Inattentive (HI: n = 138) 3–4 year olds were assessed annually for 6 years (T1–T6). Latent profile analysis (LPA) was used to form subgroups among the HI group based on objective/neuropsychological measures (NEPSY, Actigraph and Continuous Performance Test). Logistic regression assessed the predictive validity of empirically formed subgroups at risk for ADHD diagnosis relative to the TD group and to each other from T2 to T6. Results Latent profile analysis yielded two subgroups of HI preschoolers: (a) selectively weak Attention/Executive functions, and (b) pervasive neuropsychological dysfunction across all measures. Both subgroups were more likely to have ADHD at all follow-up time-points relative to the TD group (OR range: 11.29–86.32), but there were no significant differences between the LPA-formed subgroups of HI children at any time-point. Conclusions Objective/neuropsychological measures distinguish HI preschoolers from their TD peers, but patterns and severity of neuropsychological dysfunction do not predict risk for ADHD during school-age. We hypothesize that trajectories in at-risk children are influenced by subsequent environmental and neurodevelopmental factors, raising the possibility that they are amenable to early intervention. En ligne : http://dx.doi.org/10.1111/jcpp.12434 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Preschool hyperactivity is associated with long-term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood / Maria CHOROZOGLOU in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.966-975 Titre : Preschool hyperactivity is associated with long-term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood Type de document : Texte imprimé et/ou numérique Auteurs : Maria CHOROZOGLOU, Auteur ; Elizabeth SMITH, Auteur ; Johanna KOERTING, Auteur ; Margaret J. THOMPSON, Auteur ; Kapil SAYAL, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur Article en page(s) : p.966-975 Langues : Anglais (eng) Mots-clés : Hyperactivity  ADHD  conduct disorder  longitudinal  preschool children  health economics evaluation Index. décimale : PER Périodiques Résumé : Background Preschool hyperactivity is an early risk factor for adult mental health problems and criminality. Little is known about; (a) the patterns of long-term service costs associated with this behavioural marker in the general population and (b) the specific factors predicting hyperactivity-related costs. We undertook a prospective study investigating associations between preschool hyperactivity and average individual annual service costs up to late adolescent and young adulthood. Methods One-hundred and seventy individuals rated as hyperactive by their parents and 88 nonhyperactive controls were identified from a community sample of 4,215 three years olds. Baseline information about behaviour/emotional problems and background characteristics were collected. At follow-up (when individuals were aged between 14 and 25 years) information was obtained on service use, and associated costs since the age of three. Based on this information we calculated the average cost per annum incurred by each individual. Results Compared to controls, preschoolers with hyperactivity had 17.6 times higher average costs per annum across domains (apart from nonmental health costs). These were £562 for each hyperactive individual compared with £30 for controls. Average annual costs decreased as a function of age, with higher costs incurred at younger ages. The effects of hyperactivity remained significant when other baseline factors were added to the model. Effects were fully mediated by later psychiatric morbidity. When the hyperactive group were examined separately, costs were consistently predicted by male gender and, for some cost codes, by conduct problems. Conclusions Preventative approaches targeting early hyperactivity may be of value. Services should be targeted towards high-risk individuals with careful consideration given to the cost-to-benefit trade-off of early intervention strategies. En ligne : http://dx.doi.org/10.1111/jcpp.12437 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Preschool hyperactivity is associated with long-term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood [Texte imprimé et/ou numérique] / Maria CHOROZOGLOU, Auteur ; Elizabeth SMITH, Auteur ; Johanna KOERTING, Auteur ; Margaret J. THOMPSON, Auteur ; Kapil SAYAL, Auteur ; Edmund J. S. SONUGA-BARKE, Auteur . - p.966-975. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.966-975 Mots-clés : Hyperactivity  ADHD  conduct disorder  longitudinal  preschool children  health economics evaluation Index. décimale : PER Périodiques Résumé : Background Preschool hyperactivity is an early risk factor for adult mental health problems and criminality. Little is known about; (a) the patterns of long-term service costs associated with this behavioural marker in the general population and (b) the specific factors predicting hyperactivity-related costs. We undertook a prospective study investigating associations between preschool hyperactivity and average individual annual service costs up to late adolescent and young adulthood. Methods One-hundred and seventy individuals rated as hyperactive by their parents and 88 nonhyperactive controls were identified from a community sample of 4,215 three years olds. Baseline information about behaviour/emotional problems and background characteristics were collected. At follow-up (when individuals were aged between 14 and 25 years) information was obtained on service use, and associated costs since the age of three. Based on this information we calculated the average cost per annum incurred by each individual. Results Compared to controls, preschoolers with hyperactivity had 17.6 times higher average costs per annum across domains (apart from nonmental health costs). These were £562 for each hyperactive individual compared with £30 for controls. Average annual costs decreased as a function of age, with higher costs incurred at younger ages. The effects of hyperactivity remained significant when other baseline factors were added to the model. Effects were fully mediated by later psychiatric morbidity. When the hyperactive group were examined separately, costs were consistently predicted by male gender and, for some cost codes, by conduct problems. Conclusions Preventative approaches targeting early hyperactivity may be of value. Services should be targeted towards high-risk individuals with careful consideration given to the cost-to-benefit trade-off of early intervention strategies. En ligne : http://dx.doi.org/10.1111/jcpp.12437 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Developmental dyslexia: predicting individual risk / Paul A. THOMPSON in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.976-987 Titre : Developmental dyslexia: predicting individual risk Type de document : Texte imprimé et/ou numérique Auteurs : Paul A. THOMPSON, Auteur ; Charles HULME, Auteur ; Hannah M. NASH, Auteur ; Debbie GOOCH, Auteur ; Emma HAYIOU-THOMAS, Auteur ; Margaret J. SNOWLING, Auteur Article en page(s) : p.976-987 Langues : Anglais (eng) Mots-clés : Familial (family) risk  dyslexia  reading disability  language skills  executive motor  early identification Index. décimale : PER Périodiques Résumé : Background Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known. Methods The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6 months (T1) at approximately annual intervals on tasks tapping cognitive, language, and executive-motor skills. The children were recruited to three groups: children at family risk of dyslexia, children with concerns regarding speech, and language development at 3;06 years and controls considered to be typically developing. At 8 years, children were classified as ‘dyslexic’ or not. Logistic regression models were used to predict the individual risk of dyslexia and to investigate how risk factors accumulate to predict poor literacy outcomes. Results Family-risk status was a stronger predictor of dyslexia at 8 years than low language in preschool. Additional predictors in the preschool years include letter knowledge, phonological awareness, rapid automatized naming, and executive skills. At the time of school entry, language skills become significant predictors, and motor skills add a small but significant increase to the prediction probability. We present classification accuracy using different probability cutoffs for logistic regression models and ROC curves to highlight the accumulation of risk factors at the individual level. Conclusions Dyslexia is the outcome of multiple risk factors and children with language difficulties at school entry are at high risk. Family history of dyslexia is a predictor of literacy outcome from the preschool years. However, screening does not reach an acceptable clinical level until close to school entry when letter knowledge, phonological awareness, and RAN, rather than family risk, together provide good sensitivity and specificity as a screening battery. En ligne : http://dx.doi.org/10.1111/jcpp.12412 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Developmental dyslexia: predicting individual risk [Texte imprimé et/ou numérique] / Paul A. THOMPSON, Auteur ; Charles HULME, Auteur ; Hannah M. NASH, Auteur ; Debbie GOOCH, Auteur ; Emma HAYIOU-THOMAS, Auteur ; Margaret J. SNOWLING, Auteur . - p.976-987. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.976-987 Mots-clés : Familial (family) risk  dyslexia  reading disability  language skills  executive motor  early identification Index. décimale : PER Périodiques Résumé : Background Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known. Methods The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6 months (T1) at approximately annual intervals on tasks tapping cognitive, language, and executive-motor skills. The children were recruited to three groups: children at family risk of dyslexia, children with concerns regarding speech, and language development at 3;06 years and controls considered to be typically developing. At 8 years, children were classified as ‘dyslexic’ or not. Logistic regression models were used to predict the individual risk of dyslexia and to investigate how risk factors accumulate to predict poor literacy outcomes. Results Family-risk status was a stronger predictor of dyslexia at 8 years than low language in preschool. Additional predictors in the preschool years include letter knowledge, phonological awareness, rapid automatized naming, and executive skills. At the time of school entry, language skills become significant predictors, and motor skills add a small but significant increase to the prediction probability. We present classification accuracy using different probability cutoffs for logistic regression models and ROC curves to highlight the accumulation of risk factors at the individual level. Conclusions Dyslexia is the outcome of multiple risk factors and children with language difficulties at school entry are at high risk. Family history of dyslexia is a predictor of literacy outcome from the preschool years. However, screening does not reach an acceptable clinical level until close to school entry when letter knowledge, phonological awareness, and RAN, rather than family risk, together provide good sensitivity and specificity as a screening battery. En ligne : http://dx.doi.org/10.1111/jcpp.12412 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Diagnostic stability in young children at risk for autism spectrum disorder: a baby siblings research consortium study / Sally OZONOFF in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.988-998 Titre : Diagnostic stability in young children at risk for autism spectrum disorder: a baby siblings research consortium study Type de document : Texte imprimé et/ou numérique Auteurs : Sally OZONOFF, Auteur ; Gregory S. YOUNG, Auteur ; Rebecca J. LANDA, Auteur ; Jessica BRIAN, Auteur ; Susan E. BRYSON, Auteur ; Tony CHARMAN, Auteur ; Katarzyna CHAWARSKA, Auteur ; Suzanne L. MACARI, Auteur ; Daniel MESSINGER, Auteur ; Wendy L. STONE, Auteur ; Lonnie ZWAIGENBAUM, Auteur ; Ana-Maria IOSIF, Auteur Article en page(s) : p.988-998 Langues : Anglais (eng) Mots-clés : Preschool children  autism spectrum disorders  diagnosis Index. décimale : PER Périodiques Résumé : Background The diagnosis of autism spectrum disorder (ASD) made before age 3 has been found to be remarkably stable in clinic- and community-ascertained samples. The stability of an ASD diagnosis in prospectively ascertained samples of infants at risk for ASD due to familial factors has not yet been studied, however. The American Academy of Pediatrics recommends intensive surveillance and screening for this high-risk group, which may afford earlier identification. Therefore, it is critical to understand the stability of an ASD diagnosis made before age 3 in young children at familial risk. Methods Data were pooled across seven sites of the Baby Siblings Research Consortium. Evaluations of 418 later-born siblings of children with ASD were conducted at 18, 24, and 36 months of age and a clinical diagnosis of ASD or Not ASD was made at each age. Results The stability of an ASD diagnosis at 18 months was 93% and at 24 months was 82%. There were relatively few children diagnosed with ASD at 18 or 24 months whose diagnosis was not confirmed at 36 months. There were, however, many children with ASD outcomes at 36 months who had not yet been diagnosed at 18 months (63%) or 24 months (41%). Conclusions The stability of an ASD diagnosis in this familial-risk sample was high at both 18 and 24 months of age and comparable with previous data from clinic- and community-ascertained samples. However, almost half of the children with ASD outcomes were not identified as being on the spectrum at 24 months and did not receive an ASD diagnosis until 36 months. Thus, longitudinal follow-up is critical for children with early signs of social-communication difficulties, even if they do not meet diagnostic criteria at initial assessment. A public health implication of these data is that screening for ASD may need to be repeated multiple times in the first years of life. These data also suggest that there is a period of early development in which ASD features unfold and emerge but have not yet reached levels supportive of a diagnosis. En ligne : http://dx.doi.org/10.1111/jcpp.12421 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Diagnostic stability in young children at risk for autism spectrum disorder: a baby siblings research consortium study [Texte imprimé et/ou numérique] / Sally OZONOFF, Auteur ; Gregory S. YOUNG, Auteur ; Rebecca J. LANDA, Auteur ; Jessica BRIAN, Auteur ; Susan E. BRYSON, Auteur ; Tony CHARMAN, Auteur ; Katarzyna CHAWARSKA, Auteur ; Suzanne L. MACARI, Auteur ; Daniel MESSINGER, Auteur ; Wendy L. STONE, Auteur ; Lonnie ZWAIGENBAUM, Auteur ; Ana-Maria IOSIF, Auteur . - p.988-998. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.988-998 Mots-clés : Preschool children  autism spectrum disorders  diagnosis Index. décimale : PER Périodiques Résumé : Background The diagnosis of autism spectrum disorder (ASD) made before age 3 has been found to be remarkably stable in clinic- and community-ascertained samples. The stability of an ASD diagnosis in prospectively ascertained samples of infants at risk for ASD due to familial factors has not yet been studied, however. The American Academy of Pediatrics recommends intensive surveillance and screening for this high-risk group, which may afford earlier identification. Therefore, it is critical to understand the stability of an ASD diagnosis made before age 3 in young children at familial risk. Methods Data were pooled across seven sites of the Baby Siblings Research Consortium. Evaluations of 418 later-born siblings of children with ASD were conducted at 18, 24, and 36 months of age and a clinical diagnosis of ASD or Not ASD was made at each age. Results The stability of an ASD diagnosis at 18 months was 93% and at 24 months was 82%. There were relatively few children diagnosed with ASD at 18 or 24 months whose diagnosis was not confirmed at 36 months. There were, however, many children with ASD outcomes at 36 months who had not yet been diagnosed at 18 months (63%) or 24 months (41%). Conclusions The stability of an ASD diagnosis in this familial-risk sample was high at both 18 and 24 months of age and comparable with previous data from clinic- and community-ascertained samples. However, almost half of the children with ASD outcomes were not identified as being on the spectrum at 24 months and did not receive an ASD diagnosis until 36 months. Thus, longitudinal follow-up is critical for children with early signs of social-communication difficulties, even if they do not meet diagnostic criteria at initial assessment. A public health implication of these data is that screening for ASD may need to be repeated multiple times in the first years of life. These data also suggest that there is a period of early development in which ASD features unfold and emerge but have not yet reached levels supportive of a diagnosis. En ligne : http://dx.doi.org/10.1111/jcpp.12421 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Preschool irritability predicts child psychopathology, functional impairment, and service use at age nine / Lea R. DOUGHERTY in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.999-1007 Titre : Preschool irritability predicts child psychopathology, functional impairment, and service use at age nine Type de document : Texte imprimé et/ou numérique Auteurs : Lea R. DOUGHERTY, Auteur ; Victoria C. SMITH, Auteur ; Sara J. BUFFERD, Auteur ; Ellen KESSEL, Auteur ; Gabrielle A. CARLSON, Auteur ; Daniel N. KLEIN, Auteur Article en page(s) : p.999-1007 Langues : Anglais (eng) Mots-clés : Preschool  irritability  longitudinal  mood dysregulation Index. décimale : PER Périodiques Résumé : Background Little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of preschool chronic irritability with psychiatric disorders, functional impairment, and service use at age nine in a large community sample. Methods Four hundred and forty-six children were assessed at age three and again at age nine. Child psychopathology and functional impairment were assessed at age three with the Preschool Age Psychiatric Assessment (PAPA) with parents and at age nine with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with parents and children. Items from the PAPA were used to create a dimensional measure of chronic irritability at age three. At age nine, mothers, fathers, and youth completed the Child Depression Inventory (CDI) and the Screen for Anxiety Related Disorders (SCARED). Results Chronic irritability at age three predicted any current and lifetime anxiety disorders at age nine, current and lifetime generalized anxiety disorder, and current separation anxiety, after controlling for baseline anxiety disorders. In addition, preschool irritability predicted increases in anxiety and disruptive behavior disorder symptoms on the K-SADS, and maternal and paternal reports of depressive and anxiety symptoms on the CDI and SCARED. Lastly, preschool irritability predicted greater functional impairment and outpatient treatment use, even after controlling for all psychiatric disorders at baseline. Conclusions Findings underscore the central role of irritability in developmental psychopathology and support the importance of early detection and interventions targeting preschool irritability. En ligne : http://dx.doi.org/10.1111/jcpp.12403 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Preschool irritability predicts child psychopathology, functional impairment, and service use at age nine [Texte imprimé et/ou numérique] / Lea R. DOUGHERTY, Auteur ; Victoria C. SMITH, Auteur ; Sara J. BUFFERD, Auteur ; Ellen KESSEL, Auteur ; Gabrielle A. CARLSON, Auteur ; Daniel N. KLEIN, Auteur . - p.999-1007. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.999-1007 Mots-clés : Preschool  irritability  longitudinal  mood dysregulation Index. décimale : PER Périodiques Résumé : Background Little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of preschool chronic irritability with psychiatric disorders, functional impairment, and service use at age nine in a large community sample. Methods Four hundred and forty-six children were assessed at age three and again at age nine. Child psychopathology and functional impairment were assessed at age three with the Preschool Age Psychiatric Assessment (PAPA) with parents and at age nine with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with parents and children. Items from the PAPA were used to create a dimensional measure of chronic irritability at age three. At age nine, mothers, fathers, and youth completed the Child Depression Inventory (CDI) and the Screen for Anxiety Related Disorders (SCARED). Results Chronic irritability at age three predicted any current and lifetime anxiety disorders at age nine, current and lifetime generalized anxiety disorder, and current separation anxiety, after controlling for baseline anxiety disorders. In addition, preschool irritability predicted increases in anxiety and disruptive behavior disorder symptoms on the K-SADS, and maternal and paternal reports of depressive and anxiety symptoms on the CDI and SCARED. Lastly, preschool irritability predicted greater functional impairment and outpatient treatment use, even after controlling for all psychiatric disorders at baseline. Conclusions Findings underscore the central role of irritability in developmental psychopathology and support the importance of early detection and interventions targeting preschool irritability. En ligne : http://dx.doi.org/10.1111/jcpp.12403 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

Contextual variation in young children's observed disruptive behavior on the DB-DOS: implications for early identification / Amélie PETITCLERC in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1008-1016 Titre : Contextual variation in young children's observed disruptive behavior on the DB-DOS: implications for early identification Type de document : Texte imprimé et/ou numérique Auteurs : Amélie PETITCLERC, Auteur ; Margaret J. BRIGGS-GOWAN, Auteur ; Ryne ESTABROOK, Auteur ; James L. BURNS, Auteur ; Erica L. ANDERSON, Auteur ; Kimberly J. MCCARTHY, Auteur ; Lauren S. WAKSCHLAG, Auteur Article en page(s) : p.1008-1016 Langues : Anglais (eng) Mots-clés : Behavioral observation  DB-DOS  developmentally sensitive assessment  context sensitivity  disruptive behavior  ODD  ADHD  functional impairment  sex differences  preschoolers  early childhood Index. décimale : PER Périodiques Résumé : Background Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Methods Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment (PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale (FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Results Observed disruptive behavior on the DB-DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. Conclusions The DB-DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research. En ligne : http://dx.doi.org/10.1111/jcpp.12430 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Contextual variation in young children's observed disruptive behavior on the DB-DOS: implications for early identification [Texte imprimé et/ou numérique] / Amélie PETITCLERC, Auteur ; Margaret J. BRIGGS-GOWAN, Auteur ; Ryne ESTABROOK, Auteur ; James L. BURNS, Auteur ; Erica L. ANDERSON, Auteur ; Kimberly J. MCCARTHY, Auteur ; Lauren S. WAKSCHLAG, Auteur . - p.1008-1016. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1008-1016 Mots-clés : Behavioral observation  DB-DOS  developmentally sensitive assessment  context sensitivity  disruptive behavior  ODD  ADHD  functional impairment  sex differences  preschoolers  early childhood Index. décimale : PER Périodiques Résumé : Background Contextual variation in child disruptive behavior is well documented but remains poorly understood. We first examine how variation in observed disruptive behavior across interactional contexts is associated with maternal reports of contextual variation in oppositional-defiant behavior and functional impairment. Second, we test whether child inhibitory control explains the magnitude of contextual variation in observed disruptive behavior. Methods Participants are 497 young children (mean age = 4 years, 11 months) from a subsample of the MAPS, a sociodemographically diverse pediatric sample, enriched for risk of disruptive behavior. Observed anger modulation and behavioral regulation problems were coded on the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) during interactions with parent and examiner. Oppositional-defiant behavior, and impairment in relationships, with parents and nonparental adults, were measured with the Preschool Age Psychiatric Assessment (PAPA) interview with the mother. Functional impairment in the home and out-and-about was assessed with the Family Life Impairment Scale (FLIS), and expulsion from child care/school was measured with the baseline survey and FLIS. Results Observed disruptive behavior on the DB-DOS Parent Context was associated with oppositional-defiant behavior with parents, and with impairment at home and out-and-about. Observed disruptive behavior with the Examiner was associated with oppositional-defiant behavior with both parents and nonparental adults, impairment in relationships with nonparental adults, and child care/school expulsion. Differences in observed disruptive behavior in the Parent versus Examiner Contexts was related to the differences in maternal reports of oppositional-defiant behavior with parents versus nonparental adults. Children with larger decreases in disruptive behavior from Parent to Examiner Context had better inhibitory control and fewer attention-deficit/hyperactivity disorder symptoms. Conclusions The DB-DOS showed clinical utility in a community sample for identifying contextual variation that maps onto reported oppositional-defiant behavior and functioning across contexts. Elucidating the implications of contextual variation for early identification and targeted prevention is an important area for future research. En ligne : http://dx.doi.org/10.1111/jcpp.12430 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

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)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1017-1025 Titre : Development of a novel observational measure for anxiety in young children: The Anxiety Dimensional Observation Scale Type de document : Texte imprimé et/ou numérique Auteurs : Nicholas D. MIAN, Auteur ; Alice S. CARTER, Auteur ; Daniel S. PINE, Auteur ; Lauren S. WAKSCHLAG, Auteur ; Margaret J. BRIGGS-GOWAN, Auteur Article en page(s) : p.1017-1025 Langues : Anglais (eng) Mots-clés : Anxiety  fear  preschool  observation  attention bias  assessment Index. décimale : PER Périodiques Résumé : Background Identifying anxiety disorders in preschool-age children represents an important clinical challenge. Observation is essential to clinical assessment and can help differentiate normative variation from clinically significant anxiety. Yet, most anxiety assessment methods for young children rely on parent-reports. The goal of this article is to present and preliminarily test the reliability and validity of a novel observational paradigm for assessing a range of fearful and anxious behaviors in young children, the Anxiety Dimensional Observation Schedule (Anx-DOS). Methods A diverse sample of 403 children, aged 3 to 6 years, and their mothers was studied. Reliability and validity in relation to parent reports (Preschool Age Psychiatric Assessment) and known risk factors, including indicators of behavioral inhibition (latency to touch novel objects) and attention bias to threat (in the dot-probe task) were investigated. Results The Anx-DOS demonstrated good inter-rater reliability and internal consistency. Evidence for convergent validity was demonstrated relative to mother-reported separation anxiety, social anxiety, phobic avoidance, trauma symptoms, and past service use. Finally, fearfulness was associated with observed latency and attention bias toward threat. Conclusions Findings support the Anx-DOS as a method for capturing early manifestations of fearfulness and anxiety in young children. Multimethod assessments incorporating standardized methods for assessing discrete, observable manifestations of anxiety may be beneficial for early identification and clinical intervention efforts. En ligne : http://dx.doi.org/10.1111/jcpp.12407 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] Development of a novel observational measure for anxiety in young children: The Anxiety Dimensional Observation Scale [Texte imprimé et/ou numérique] / Nicholas D. MIAN, Auteur ; Alice S. CARTER, Auteur ; Daniel S. PINE, Auteur ; Lauren S. WAKSCHLAG, Auteur ; Margaret J. BRIGGS-GOWAN, Auteur . - p.1017-1025. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1017-1025 Mots-clés : Anxiety  fear  preschool  observation  attention bias  assessment Index. décimale : PER Périodiques Résumé : Background Identifying anxiety disorders in preschool-age children represents an important clinical challenge. Observation is essential to clinical assessment and can help differentiate normative variation from clinically significant anxiety. Yet, most anxiety assessment methods for young children rely on parent-reports. The goal of this article is to present and preliminarily test the reliability and validity of a novel observational paradigm for assessing a range of fearful and anxious behaviors in young children, the Anxiety Dimensional Observation Schedule (Anx-DOS). Methods A diverse sample of 403 children, aged 3 to 6 years, and their mothers was studied. Reliability and validity in relation to parent reports (Preschool Age Psychiatric Assessment) and known risk factors, including indicators of behavioral inhibition (latency to touch novel objects) and attention bias to threat (in the dot-probe task) were investigated. Results The Anx-DOS demonstrated good inter-rater reliability and internal consistency. Evidence for convergent validity was demonstrated relative to mother-reported separation anxiety, social anxiety, phobic avoidance, trauma symptoms, and past service use. Finally, fearfulness was associated with observed latency and attention bias toward threat. Conclusions Findings support the Anx-DOS as a method for capturing early manifestations of fearfulness and anxiety in young children. Multimethod assessments incorporating standardized methods for assessing discrete, observable manifestations of anxiety may be beneficial for early identification and clinical intervention efforts. En ligne : http://dx.doi.org/10.1111/jcpp.12407 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267

The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children / Cathrine MIHALOPOULOS in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1026-1033 Titre : The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children Type de document : Texte imprimé et/ou numérique Auteurs : Cathrine MIHALOPOULOS, Auteur ; Theo VOS, Auteur ; Ronald M. RAPEE, Auteur ; Jane PIRKIS, Auteur ; Mary Lou CHATTERTON, Auteur ; Yu-Chen LEE, Auteur ; Rob CARTER, Auteur Article en page(s) : p.1026-1033 Langues : Anglais (eng) Mots-clés : Economic evaluation  anxiety disorders  children  prevention Index. décimale : PER Périodiques Résumé : Background Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. Method A cost-utility economic framework, using Disability-Adjusted-Life-Years (DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio (ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. Results The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. Conclusions Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken. En ligne : http://dx.doi.org/10.1111/jcpp.12438 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 [article] The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children [Texte imprimé et/ou numérique] / Cathrine MIHALOPOULOS, Auteur ; Theo VOS, Auteur ; Ronald M. RAPEE, Auteur ; Jane PIRKIS, Auteur ; Mary Lou CHATTERTON, Auteur ; Yu-Chen LEE, Auteur ; Rob CARTER, Auteur . - p.1026-1033. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1026-1033 Mots-clés : Economic evaluation  anxiety disorders  children  prevention Index. décimale : PER Périodiques Résumé : Background Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. Method A cost-utility economic framework, using Disability-Adjusted-Life-Years (DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio (ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. Results The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. Conclusions Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken. En ligne : http://dx.doi.org/10.1111/jcpp.12438 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267