RESUMO
Evidence points to an independent relationship among childhood maltreatment, impairments in executive functions (EF) and disruptive behavior disorders (DBD). However, it is still not fully understood how these three factors are interrelated. This study evaluated the association between childhood maltreatment and DBD testing the role of EF performance as a mediator or moderator. We studied a probabilistic school-based sample of 2016 children from 6 to 12 years. Mental disorders were assessed using the Development and Well-Being Assessment with parents and children. Children answered questions about exposure to child maltreatment and were evaluated with a set of cognitive tasks addressing inhibitory control, working memory, cognitive flexibility and planning. Childhood maltreatment was strongly associated with DBD (OR = 7.7, CI 95% 4.5-12.9). No association was found between childhood maltreatment and EF performance. Children with DBD showed worse performance in cognitive flexibility, which was not identified as a mediator or moderator of the association between childhood maltreatment and DBD. Results indicate that the association between maltreatment and disruptive behavior occurs regardless of performance in executive function in a community sample. Future studies are essential to confirm these findings and elucidate the cognitive mechanisms involved in this association.
Assuntos
Maus-Tratos Infantis/psicologia , Função Executiva/fisiologia , Comportamento Problema/psicologia , Criança , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Parental warmth (PW) has a strong influence on child development and may precede the onset of psychiatric disorders in children. PW is interconnected with other family processes (e.g., coercive discipline) that may also influence the development of psychiatric disorders in children. We prospectively examined the association between PW and child psychiatric disorders (anxiety, major depression disorder, ADHD, disruptive behavior disorders) over the course of three years among Puerto Rican youth, above and beyond the influence of other family factors. METHODS: Boricua Youth Study participants, Puerto Rican children 5 to 13 years of age at Wave 1 living in the South Bronx (New York) (SB) and San Juan and Canguas (PR) (n = 2,491), were followed for three consecutive years. Youth psychiatric disorders were measured by the Diagnostic Interview Schedule for Children-IV (DISC-IV). Generalized Linear Mixed models tested the association between PW (Wave 1) and psychiatric disorders in the next two years adjusting for demographic characteristics and family processes. RESULTS: Higher levels of PW were related to lower odds of child anxiety and major depressive disorder over time (OR = 0.69[0.60; 0.79]; 0.49[0.41; 0.58], respectively). The strength of the association between PW and ADHD and disruptive behavior disorder declined over time, although it was still significant in the last assessment (OR = 0.44[0.37; 0.52]; 0.46[0.39; 0.54], respectively). PW had a unique influence on psychiatric disorders beyond the influence of other parenting and family processes. Stronger associations were observed among girls for depression and ADHD. CONCLUSIONS: Incorporating PW behaviors such as acceptance, support, and comforting into interventions focused on parenting skills may help prevent child psychiatric disorders.
Assuntos
Comparação Transcultural , Hispânico ou Latino/psicologia , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Poder Familiar/psicologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Etnicidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Estudos Prospectivos , Porto Rico/epidemiologia , Fatores Sexuais , Apoio Social , Estatística como AssuntoRESUMO
Os transtornos disruptivos são os transtornos psiquiátricos mais frequentes na infância e têm grande impacto na adolescência e na vida adulta. Porém, há uma série de empecilhos para seu diagnóstico: a) dificuldade com o diagnóstico diferencial, principalmente em relação a ansiedade, depressão e déficit de atenção/hiperatividade; b) dificuldade em apontar quando o comportamento faz parte do ciclo normal do desenvolvimento infantil; e c) escassez de instrumentos e técnicas padronizadas para esse tipo de atendimento. Portanto, este artigo teórico tem por objetivo refletir sobre os aspectos considerados necessários e importantes para o atendimento psicoterápico nos transtornos disruptivos, sem pretensão de esgotar a discussão. Para tanto, inicialmente serão apresentadas a definição e a caracterização de transtorno da conduta e transtorno desafiador de oposição. A partir desse ponto serão levantadas questões sobre avaliação, passando por entrevista clínica, análise funcional e inventários, e sobre as técnicas de intervenção, discutindo-se aspectos relevantes do treinamento de pais e do treinamento de crianças e adolescentes
The disruptive disorders are the most common psychiatric disorders in childhood and with considerable impact in adolescence and adulthood. However, there are a number of obstacles in making the diagnosis: a) difficulty with the differential diagnosis, especially in relation to anxiety, depression and attention-deficit/hyperactivity disorder, b) to point where performance is part of the normal cycle of child development and, c) shortage instruments and standardized techniques for this type of care. Therefore, this theoretical article aims to reflect on the aspects considered necessary and important for psychotherapy in disruptive disorders, without the pretension of exhausting the discussion. For that, initially, there will be a passage for the definition and characterization of conduct disorder and oppositional defiant disorder. From this point will be raised about assessment, via the clinical interview, functional analysis and inventories, and on intervention techniques, discussing relevant aspects of parental training and training of children and adolescents