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Walter Matthys - One of the best experts on this subject based on the ideXlab platform.
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empathy and prosocial Behavior in response to sadness and distress in 6 to 7 year olds diagnosed with Disruptive Behavior Disorder and attention deficit hyperactivity Disorder
European Child & Adolescent Psychiatry, 2015Co-Authors: Peter Deschamps, Dennis J L G Schutter, J L Kenemans, Walter MatthysAbstract:Empathy has been associated with decreased antisocial and increased prosocial Behavior. This study examined empathy and prosocial Behavior in response to sadness and distress in Disruptive Behavior Disorder (DBD) and attention-deficit hyperactivity Disorder (ADHD). Six- and 7-year-old children with DBD (with and without ADHD) (n = 67) and with ADHD only (n = 27) were compared to typically developing children (TD) (n = 37). Parents and teachers rated affective empathy in response to sadness and distress on the Griffith Empathy Measure. Children reported affective empathic ability in response to sad story vignettes. Empathy-induced prosocial Behavior in response to sadness and distress was assessed with a computer task, the Interpersonal Response Task (IRT). Compared to TD, children with DBD (with and without ADHD) and those with ADHD only were rated as less empathic by their teachers, but not by their parents. No differences between groups were observed in children who reported affect correspondence. Children with DBD (with and without ADHD) showed less prosocial Behavior in response to sadness and distress compared to TD. Children with ADHD only did not differ from TD. An additional analysis comparing all children with a diagnosis to the TD group revealed that the difference in prosocial Behavior remained after controlling for ADHD symptoms, but not after controlling for DBD symptoms. These findings of impaired empathy-induced prosocial Behavior in response to sadness and distress in young children with DBD suggest that interventions to ameliorate peer relationships may benefit from targeting on increasing prosocial Behavior in these children.
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facial mimicry in 6 7 year old children with Disruptive Behavior Disorder and adhd
PLOS ONE, 2014Co-Authors: Peter Deschamps, Nicolette M Munsters, Leon Kenemans, Dennis J L G Schutter, Walter MatthysAbstract:Background: Impairments in facial mimicry are considered a proxy for deficits in affective empathy and have been demonstrated in 10 year old children and in adolescents with Disruptive Behavior Disorder (DBD). However, it is not known whether these impairments are already present at an earlier age. Emotional deficits have also been shown in children with attention-deficit/hyperactivity Disorder (ADHD). Aims: To examine facial mimicry in younger, 6-7 year old children with DBD and with ADHD. Methods: Electromyographic (EMG) activity in response to emotional facial expressions was recorded in 47 children with DBD, 18 children with ADHD and 35 healthy developing children. Results: All groups displayed significant facial mimicry to the emotional expressions of other children. No group differences between children with DBD, children with ADHD and healthy developing children were found. In addition, no differences in facial mimicry were found between the clinical group (i.e., all children with a diagnosis) and the typically developing group in an analysis with ADHD symptoms as a covariate, and no differences were found between the clinical children and the typically developing children with DBD symptoms as a covariate. Conclusion: Facial mimicry in children with DBD and ADHD throughout the first primary school years was unimpaired, in line with studies on empathy using other paradigms.
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clinical usefulness of the kiddie Disruptive Behavior Disorder schedule in the diagnosis of dbd and adhd in preschool children
Journal of Abnormal Child Psychology, 2013Co-Authors: Tessa L Bunte, Kim Schoemaker, David J Hessen, Peter G M Van Der Heijden, Walter MatthysAbstract:The aim of the present study was to investigate the clinical usefulness of a semi-structured diagnostic parent interview, i.e., the Kiddie-Disruptive Behavior Disorder Schedule (K-DBDS), in preschool children. For Oppositional Defiant Disorder (ODD), to define symptoms two coding methods were compared, i.e., one based on the threshold “often” and the other based on the frequency of Behaviors in combination with the presence of clinical concern. For Attention-Deficit/Hyperactivity Disorder (ADHD), to define symptoms, two coding methods were compared, i.e., one with and one without consideration of pervasiveness across contexts. Participants were referred preschool children with externalizing Behavioral problems (N = 193; 83% male) and typically developing (TD) children (N = 58; 71% male). The referred children were given a diagnosis of either ODD/CD (N = 39), or ADHD (N = 58) or comorbid ODD/CD+ADHD (N = 57) or no diagnosis (N = 39) based on best-estimate diagnosis. Receiver Operating Characteristic curve analyses showed that a cutoff score of four ODD symptoms using “often” as the threshold for frequency of Behaviors led to a sensitivity of 87% and a specificity of 93%; the coding method which included the frequency of Behaviors yielded a sensitivity of 56% and a specificity of 100%. For ADHD, a clinical cutoff score of five symptoms without the pervasiveness criterion yielded a sensitivity of 83% and a specificity of 98%; when the pervasiveness criterion was included sensitivity was 77% and specificity 98%. In the clinical assessment of ODD and ADHD in preschool children, the K-DBDS may be used with ODD symptom definition based on the threshold “often” and ADHD pervasiveness across contexts not included.
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Risky Decision Making in Substance Dependent Adolescents with a Disruptive Behavior Disorder
Journal of Abnormal Child Psychology, 2011Co-Authors: Dennis J L G Schutter, John E Lochman, Irene Bokhoven, Louk J. M. J. Vanderschuren, Walter MatthysAbstract:Of all psychiatric Disorders, the Disruptive Behavior Disorders (DBDs) are the most likely to predispose to substance dependence (SD). One possible underlying mechanism for this increased vulnerability is risky decision making. The aim of this study was to examine decision making in DBD adolescents with and without SD. Twenty-five DBD adolescents (19 males) with SD (DBD+SD), 28 DBD adolescents (23 males) without SD (DBD-SD) and 99 healthy controls (72 males) were included in the study. DBD adolescents with co-morbid attention deficit/ hyperactivity Disorder (ADHD) were excluded. Risky decision making was investigated by assessing the number of disadvantageous choices in the Iowa gambling task. DBD+SD made significantly more risky choices than healthy controls and DBD-SD. Healthy controls and DBD-SD did not differ on risky decision making. These results suggest that risky decision making is a vulnerability factor for the development of SD in a subgroup of adolescents with DBD without ADHD.
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preventive effects of treatment of Disruptive Behavior Disorder in middle childhood on substance use and delinquent Behavior
Journal of the American Academy of Child and Adolescent Psychiatry, 2007Co-Authors: Marjo J S Zonnevyllebender, Walter Matthys, Nicolle M H Van De Wiel, John E LochmanAbstract:ABSTRACT Objective Disruptive Behavior Disorder (DBD) is a well-known risk factor for substance abuse and delinquent Behavior in adolescence. Therefore, the long-term preventive effects of treatment of DBD in middle childhood on beginning substance use and delinquency in early adolescence were investigated. Method Children with DBD (8-13 years old) had been randomly assigned to manualized Behavior therapy (Utrecht Coping Power Program; UCPP) or to care as usual (CU) in the Netherlands. Five years (2003-2005) after the start of treatment (1996-1999), substance use and delinquency were monitored in 61 of the initial 77 adolescents and compared with a matched healthy control group by means of self-report questionnaires. One-factor analyses of variance and Pearson's χ 2 analyses were performed. Results Differences in substance use were revealed in favor of the UCPP, with more adolescents in the CU group smoking cigarettes in the last month (UCPP 17%, CU 42%; χ 2 = 4.7; p 2 = 4.0; p Conclusions Manualized Behavior therapy for DBD in middle childhood seems to be more powerful than CU in reducing substance use in early adolescence. Both treatment conditions show a beneficial long-term preventive effect on delinquency.
John E Lochman - One of the best experts on this subject based on the ideXlab platform.
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evaluation of improvement in externalizing Behaviors and callous unemotional traits in children with Disruptive Behavior Disorder a 1 year follow up clinic based study
Administration and Policy in Mental Health, 2017Co-Authors: Pietro Muratori, Azzurra Manfredi, Annarita Milone, Gabriele Masi, Laura Ruglioni, Lisa Polidori, Furio Lambruschi, John E LochmanAbstract:Multi-component interventions based on cognitive Behavioral principles and practices have been found effective in reducing Behavioral problems in children with Disruptive Behavior Disorders (oppositional defiant Disorder and conduct Disorder). However, it is still unclear if these interventions can affect children's callous-unemotional traits, which are predictive of subsequent antisocial Behavior. Furthermore, it could be important to identify empirically supported treatment protocols for specific Disorders addressed by child mental health services. The present study aimed to test the following two hypotheses: first, the Coping Power (CP) treatment program is able to reduce externalizing Behaviors in children with Disruptive Behavior Disorders treated in a mental health care unit; second, the CP program can reduce children's callous unemotional traits. The sample included 98 Italian children, 33 treated with the CP program; 37 with a less focused multi-component intervention, and 28 with child psychotherapy. The results showed that the CP program was more effective than the other two treatments in reducing aggressive Behaviors. Furthermore, only the CP program was associated with a decrease in children's callous unemotional traits. The CP program was also associated with lower rate of referrals to mental health services at one-year follow-up. These findings support the importance of disseminating manualized and focused intervention programs in mental health services.
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which dimension of parenting predicts the change of callous unemotional traits in children with Disruptive Behavior Disorder
Comprehensive Psychiatry, 2016Co-Authors: Pietro Muratori, John E Lochman, Annarita Milone, Annalaura Nocentini, Simone Pisano, Elisa Lai, Elisabetta Righini, Gabriele MasiAbstract:Knowledge regarding anesthetic practice variations in the use of general anesthesia (GA) vs neuraxial anesthesia (NA) as primary anesthetics for a primary total hip arthroplasty (THA) is limited. A total of 107,490 cases were identified in the National Anesthesia Clinical Outcomes Registry, in which 31.7% and 68.3% were performed with NA and GA, respectively. Resident presence, board-certification status, comorbidities, and case duration were associated with the implementation of NA vs GA. Neuraxial anesthesia was associated with decreased rates of extended recovery room stay, inadequate pain control, and postoperative nausea/vomiting. Anesthetic technique differences were associated with patient and provider characteristics. Our results can help improve quality measures and identify areas that need improvement in cost reduction and efficiency within this specific surgical patient population. Language: en
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callous unemotional traits in children with Disruptive Behavior Disorder predictors of developmental trajectories and adolescent outcomes
Psychiatry Research-neuroimaging, 2016Co-Authors: Pietro Muratori, John E Lochman, Azzurra Manfredi, Annarita Milone, Annalaura Nocentini, Simone Pisano, Gabriele MasiAbstract:The present study investigated trajectories of Callous Unemotional (CU) traits in youth with Disruptive Behavior Disorder diagnosis followed-up from childhood to adolescence, to explore possible predictors of these trajectories, and to individuate adolescent clinical outcomes. A sample of 59 Italian referred children with Disruptive Behavior Disorder (53 boys and 6 girls, 21 with Conduct Disorder) was followed up from childhood to adolescence. CU traits were assessed with CU-scale of the Antisocial Process Screening Device-parent report. Latent growth curve models showed that CU traits are likely to decrease linearly from 9 to 15 years old, with a deceleration in adolescence (from 12 to 15). There was substantial individual variability in the rate of change of CU traits over time: patients with a minor decrease of CU symptoms during childhood were at increased risk for severe Behavioral problems and substance use into adolescence. Although lower level of socio-economic status and lower level of parenting involvement were associated to elevated levels of CU traits at baseline evaluation, none of the considered clinical and environmental factors predicted the levels of CU traits. The current longitudinal research suggests that adolescent outcomes of Disruptive Behavior Disorder be influenced by CU traits trajectories during childhood.
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maternal depression and parenting practices predict treatment outcome in italian children with Disruptive Behavior Disorder
Journal of Child and Family Studies, 2015Co-Authors: Pietro Muratori, Azzurra Manfredi, Annarita Milone, Annalaura Nocentini, Gabriele Masi, Laura Ruglioni, Lisa Polidori, Furio Lambruschi, John E LochmanAbstract:Childhood aggression has been conceptualized as a risk marker on the developmental trajectories leading to a variety of negative adolescent outcomes such as delinquency, substance use and poor school adjustment. The contextual social–cognitive model emphasizes parenting processes in the development and escalation of aggressive Behavioral problems. Many multi-component treatment models have been found to be efficacious in reducing children’s aggressive Behaviors. However a major goal in clinical research is to discover predictors of negative treatment outcome. It has been hypothesized that the change in inconsistent or harsh maternal discipline, and the level of maternal depression, may affect the efficacy of a multi-component treatment on child aggressive Behavior. The aim of the study is to test this hypothesis in 62 Italian children (mean age 9.6) with Disruptive Behavior Disorders, treated with Coping Power Program. We used the residualized change in a two-wave model to measure the change in aggressive Behavior, as an outcome variable; and the change in parenting practices and the level of maternal depression at the beginning of the treatment were the independent variables. Our results show that a decrease in inconsistent discipline, but not in harsh discipline, was associated with a better treatment outcome in children. Furthermore, a higher level of maternal depression predicted a worse treatment outcome in children. According to our findings, change in parenting skill is a key mechanism for promoting a positive treatment outcome. The implications of these findings for the implementation of strategies aimed at preventing aggressive Behavior and promoting better treatment outcome after multi-component intervention are discussed.
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Risky Decision Making in Substance Dependent Adolescents with a Disruptive Behavior Disorder
Journal of Abnormal Child Psychology, 2011Co-Authors: Dennis J L G Schutter, John E Lochman, Irene Bokhoven, Louk J. M. J. Vanderschuren, Walter MatthysAbstract:Of all psychiatric Disorders, the Disruptive Behavior Disorders (DBDs) are the most likely to predispose to substance dependence (SD). One possible underlying mechanism for this increased vulnerability is risky decision making. The aim of this study was to examine decision making in DBD adolescents with and without SD. Twenty-five DBD adolescents (19 males) with SD (DBD+SD), 28 DBD adolescents (23 males) without SD (DBD-SD) and 99 healthy controls (72 males) were included in the study. DBD adolescents with co-morbid attention deficit/ hyperactivity Disorder (ADHD) were excluded. Risky decision making was investigated by assessing the number of disadvantageous choices in the Iowa gambling task. DBD+SD made significantly more risky choices than healthy controls and DBD-SD. Healthy controls and DBD-SD did not differ on risky decision making. These results suggest that risky decision making is a vulnerability factor for the development of SD in a subgroup of adolescents with DBD without ADHD.
Pietro Muratori - One of the best experts on this subject based on the ideXlab platform.
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emotional processing deficits in italian children with Disruptive Behavior Disorder the role of callous unemotional traits
Behaviour Research and Therapy, 2019Co-Authors: Lucia Billeci, Pietro Muratori, Annarita Milone, Annalaura Nocentini, Sara Calderoni, Natasha Chericoni, Valentina Levantini, Marina Papini, Laura Ruglioni, Mark R DaddsAbstract:Abstract Research suggests that callous unemotional (CU) traits are associated with poor emotion recognition due to impairments in attention to relevant emotional cues. To further investigate the mechanisms that underlie CU traits, this study focused on the relationship between levels of CU and children's attention to, and recognition of, facial emotions. Participants were 7- to 10-year-old Italian boys, 35 with a diagnosis of Disruptive Behavior Disorder (age: M = 8.93, SD = 1.35), and 23 healthy male controls (age: M = 8.86, SD = 1.35). Children viewed standardized emotional faces (happiness, sadness, fear, disgust, anger, and neutral) while eye-tracking technology was used to evaluate scan paths for each area of interest (eyes, face, mouth), and for each emotion. CU traits were assessed using parent and teacher ratings on the Antisocial Process Screening Device. In the whole sample, elevated levels of CU traits were associated with a lower ability to recognize sadness, a lower number of fixations, and a lower average length of each fixation, specifically to the eye area of sad faces. In children with Disruptive Behavior Disorder diagnoses, high levels of CU traits were associated with lower duration of fixations to the eye-region on the eye area of sad faces, which in turns predicted lower levels of sadness recognition. The findings confirm that poor emotion recognition is associated with impairments in attention to critical information about other people's emotions. The clinical implications are discussed.
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trajectories of callous unemotional traits from childhood to adolescence in referred youth with a Disruptive Behavior Disorder who received intensive multimodal therapy in childhood
Neuropsychiatric Disease and Treatment, 2018Co-Authors: Gabriele Masi, Azzurra Manfredi, Annarita Milone, Annalaura Nocentini, Simone Pisano, Laura Ruglioni, Lisa Polidori, Paola Brovedani, Gioia Maccaferri, Pietro MuratoriAbstract:Purpose Our aims were to explore the developmental trajectories of callous-unemotional (CU) traits using a growth curve analysis in Italian children with Disruptive Behavior Disorders treated with a multimodal intervention, and to test both predictors and distal outcomes of CU traits trajectories. Patients and method One hundred and sixty-eight children were enrolled, of whom 24 were lost in the follow-up and 144 were followed up from ages 8-9 to 14-15 years with four assessment points. Patients included 128 males (88.9%) with a mean age of 8.7 years, 96 with oppositional defiant Disorder (66.7%) and 48 with conduct Disorder (CD) (33.3%). The developmental trajectories of CU traits were assessed with the Inventory of Callous-Unemotional Traits (ICU). Results Our findings revealed that CU features were likely to fit a quadratic model from childhood to adolescence. The CU traits tended to decrease during childhood, with stabilization in adolescence and a significant variability in the growth curves. Pretreatment CD and higher levels of externalizing Behavioral problems were associated with higher level of CU traits at baseline, whereas positive parenting was associated with lower levels. No significant effects were found for all the other predictors (socioeconomic status, negative parenting, combined pharmacotherapy). Regarding outcomes into adolescence, both higher levels of CU traits at the baseline and a lower decrease of CU traits across time points predicted a higher risk of CD diagnosis, and higher rate of referrals to mental health services and of substance use. Furthermore, pretreatment CD and negative parenting predicted a higher risk of substance use into adolescence. Conclusion Our findings suggest that a close monitoring of CU traits in referred children with Disruptive Behavior Disorders may help to detect the patients at higher risk of poor outcome.
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moral disengagement and callous unemotional traits configurations in adolescents with Disruptive Behavior Disorder a person oriented approach
Psychiatry Research-neuroimaging, 2017Co-Authors: Marinella Paciello, Gabriele Masi, Annarita Milone, Maria Grazia Clemente, Pietro MuratoriAbstract:Abstract The interplay between Callous Unemotional Traits (CU) and Moral Disengagement (MD) was examined in a sample of 90 adolescents with Disruptive Behavior Disorders. Using a person-centered approach, three CU and MD configurations were identified, attesting the strong relationship between these two moral dimensions. However, for some adolescents, CU and MD do not ‘move together’. Practical implications are discussed in terms of assessment and intervention.
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paternal psychopathological risk and psychological functioning in children with eating Disorders and Disruptive Behavior Disorder
Psychiatry Research-neuroimaging, 2017Co-Authors: Luca Cerniglia, Pietro Muratori, Annarita Milone, Valentina Levantini, Laura Ruglioni, Marinella Paciello, Silvia Cimino, Renata TambelliAbstract:Abstract Several studies demonstrated that maternal psychopathological risk is related to child’s maladjustment, but until recently research has relatively neglected fathers. Disruptive Behavior Disorder (DBD) and Eating Disorders (ED) have a large prevalence during childhood but a few studies have focused on their association with paternal psychopathological risk. One-hundred and thirty-nine children and their fathers were recruited from pediatric hospitals and outpatient clinics and paired with a healthy control group (CG). Fathers were administered the SCL-90/R and the CBCL 6–18 to assess: 1) psychopathological risk of fathers of children with DBD, ED and CG; 2) significant differences between ED and DBD fathers’ psychopathological profiles; and 3) associations between specific fathers’ psychopathological symptoms and children’s emotional-Behavioral problems. Fathers of children with ED showed a higher psychopathological risk than fathers of DBD offspring. Children with DBD showed higher externalizing symptoms. Paternal hostility was associated with internalizing problems in children with DBD. Paternal hostility showed a non-significant but clinically interesting association with internalizing problems in DBD children; interpersonal sensitivity was associated with internalizing problems in ED children. This study can constitute a contribution to a better understanding of the clinical characteristics of fathers of children with DBD and ED.
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evaluation of improvement in externalizing Behaviors and callous unemotional traits in children with Disruptive Behavior Disorder a 1 year follow up clinic based study
Administration and Policy in Mental Health, 2017Co-Authors: Pietro Muratori, Azzurra Manfredi, Annarita Milone, Gabriele Masi, Laura Ruglioni, Lisa Polidori, Furio Lambruschi, John E LochmanAbstract:Multi-component interventions based on cognitive Behavioral principles and practices have been found effective in reducing Behavioral problems in children with Disruptive Behavior Disorders (oppositional defiant Disorder and conduct Disorder). However, it is still unclear if these interventions can affect children's callous-unemotional traits, which are predictive of subsequent antisocial Behavior. Furthermore, it could be important to identify empirically supported treatment protocols for specific Disorders addressed by child mental health services. The present study aimed to test the following two hypotheses: first, the Coping Power (CP) treatment program is able to reduce externalizing Behaviors in children with Disruptive Behavior Disorders treated in a mental health care unit; second, the CP program can reduce children's callous unemotional traits. The sample included 98 Italian children, 33 treated with the CP program; 37 with a less focused multi-component intervention, and 28 with child psychotherapy. The results showed that the CP program was more effective than the other two treatments in reducing aggressive Behaviors. Furthermore, only the CP program was associated with a decrease in children's callous unemotional traits. The CP program was also associated with lower rate of referrals to mental health services at one-year follow-up. These findings support the importance of disseminating manualized and focused intervention programs in mental health services.
Gabriele Masi - One of the best experts on this subject based on the ideXlab platform.
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trajectories of callous unemotional traits from childhood to adolescence in referred youth with a Disruptive Behavior Disorder who received intensive multimodal therapy in childhood
Neuropsychiatric Disease and Treatment, 2018Co-Authors: Gabriele Masi, Azzurra Manfredi, Annarita Milone, Annalaura Nocentini, Simone Pisano, Laura Ruglioni, Lisa Polidori, Paola Brovedani, Gioia Maccaferri, Pietro MuratoriAbstract:Purpose Our aims were to explore the developmental trajectories of callous-unemotional (CU) traits using a growth curve analysis in Italian children with Disruptive Behavior Disorders treated with a multimodal intervention, and to test both predictors and distal outcomes of CU traits trajectories. Patients and method One hundred and sixty-eight children were enrolled, of whom 24 were lost in the follow-up and 144 were followed up from ages 8-9 to 14-15 years with four assessment points. Patients included 128 males (88.9%) with a mean age of 8.7 years, 96 with oppositional defiant Disorder (66.7%) and 48 with conduct Disorder (CD) (33.3%). The developmental trajectories of CU traits were assessed with the Inventory of Callous-Unemotional Traits (ICU). Results Our findings revealed that CU features were likely to fit a quadratic model from childhood to adolescence. The CU traits tended to decrease during childhood, with stabilization in adolescence and a significant variability in the growth curves. Pretreatment CD and higher levels of externalizing Behavioral problems were associated with higher level of CU traits at baseline, whereas positive parenting was associated with lower levels. No significant effects were found for all the other predictors (socioeconomic status, negative parenting, combined pharmacotherapy). Regarding outcomes into adolescence, both higher levels of CU traits at the baseline and a lower decrease of CU traits across time points predicted a higher risk of CD diagnosis, and higher rate of referrals to mental health services and of substance use. Furthermore, pretreatment CD and negative parenting predicted a higher risk of substance use into adolescence. Conclusion Our findings suggest that a close monitoring of CU traits in referred children with Disruptive Behavior Disorders may help to detect the patients at higher risk of poor outcome.
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moral disengagement and callous unemotional traits configurations in adolescents with Disruptive Behavior Disorder a person oriented approach
Psychiatry Research-neuroimaging, 2017Co-Authors: Marinella Paciello, Gabriele Masi, Annarita Milone, Maria Grazia Clemente, Pietro MuratoriAbstract:Abstract The interplay between Callous Unemotional Traits (CU) and Moral Disengagement (MD) was examined in a sample of 90 adolescents with Disruptive Behavior Disorders. Using a person-centered approach, three CU and MD configurations were identified, attesting the strong relationship between these two moral dimensions. However, for some adolescents, CU and MD do not ‘move together’. Practical implications are discussed in terms of assessment and intervention.
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evaluation of improvement in externalizing Behaviors and callous unemotional traits in children with Disruptive Behavior Disorder a 1 year follow up clinic based study
Administration and Policy in Mental Health, 2017Co-Authors: Pietro Muratori, Azzurra Manfredi, Annarita Milone, Gabriele Masi, Laura Ruglioni, Lisa Polidori, Furio Lambruschi, John E LochmanAbstract:Multi-component interventions based on cognitive Behavioral principles and practices have been found effective in reducing Behavioral problems in children with Disruptive Behavior Disorders (oppositional defiant Disorder and conduct Disorder). However, it is still unclear if these interventions can affect children's callous-unemotional traits, which are predictive of subsequent antisocial Behavior. Furthermore, it could be important to identify empirically supported treatment protocols for specific Disorders addressed by child mental health services. The present study aimed to test the following two hypotheses: first, the Coping Power (CP) treatment program is able to reduce externalizing Behaviors in children with Disruptive Behavior Disorders treated in a mental health care unit; second, the CP program can reduce children's callous unemotional traits. The sample included 98 Italian children, 33 treated with the CP program; 37 with a less focused multi-component intervention, and 28 with child psychotherapy. The results showed that the CP program was more effective than the other two treatments in reducing aggressive Behaviors. Furthermore, only the CP program was associated with a decrease in children's callous unemotional traits. The CP program was also associated with lower rate of referrals to mental health services at one-year follow-up. These findings support the importance of disseminating manualized and focused intervention programs in mental health services.
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which dimension of parenting predicts the change of callous unemotional traits in children with Disruptive Behavior Disorder
Comprehensive Psychiatry, 2016Co-Authors: Pietro Muratori, John E Lochman, Annarita Milone, Annalaura Nocentini, Simone Pisano, Elisa Lai, Elisabetta Righini, Gabriele MasiAbstract:Knowledge regarding anesthetic practice variations in the use of general anesthesia (GA) vs neuraxial anesthesia (NA) as primary anesthetics for a primary total hip arthroplasty (THA) is limited. A total of 107,490 cases were identified in the National Anesthesia Clinical Outcomes Registry, in which 31.7% and 68.3% were performed with NA and GA, respectively. Resident presence, board-certification status, comorbidities, and case duration were associated with the implementation of NA vs GA. Neuraxial anesthesia was associated with decreased rates of extended recovery room stay, inadequate pain control, and postoperative nausea/vomiting. Anesthetic technique differences were associated with patient and provider characteristics. Our results can help improve quality measures and identify areas that need improvement in cost reduction and efficiency within this specific surgical patient population. Language: en
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callous unemotional traits in children with Disruptive Behavior Disorder predictors of developmental trajectories and adolescent outcomes
Psychiatry Research-neuroimaging, 2016Co-Authors: Pietro Muratori, John E Lochman, Azzurra Manfredi, Annarita Milone, Annalaura Nocentini, Simone Pisano, Gabriele MasiAbstract:The present study investigated trajectories of Callous Unemotional (CU) traits in youth with Disruptive Behavior Disorder diagnosis followed-up from childhood to adolescence, to explore possible predictors of these trajectories, and to individuate adolescent clinical outcomes. A sample of 59 Italian referred children with Disruptive Behavior Disorder (53 boys and 6 girls, 21 with Conduct Disorder) was followed up from childhood to adolescence. CU traits were assessed with CU-scale of the Antisocial Process Screening Device-parent report. Latent growth curve models showed that CU traits are likely to decrease linearly from 9 to 15 years old, with a deceleration in adolescence (from 12 to 15). There was substantial individual variability in the rate of change of CU traits over time: patients with a minor decrease of CU symptoms during childhood were at increased risk for severe Behavioral problems and substance use into adolescence. Although lower level of socio-economic status and lower level of parenting involvement were associated to elevated levels of CU traits at baseline evaluation, none of the considered clinical and environmental factors predicted the levels of CU traits. The current longitudinal research suggests that adolescent outcomes of Disruptive Behavior Disorder be influenced by CU traits trajectories during childhood.
Annarita Milone - One of the best experts on this subject based on the ideXlab platform.
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emotional processing deficits in italian children with Disruptive Behavior Disorder the role of callous unemotional traits
Behaviour Research and Therapy, 2019Co-Authors: Lucia Billeci, Pietro Muratori, Annarita Milone, Annalaura Nocentini, Sara Calderoni, Natasha Chericoni, Valentina Levantini, Marina Papini, Laura Ruglioni, Mark R DaddsAbstract:Abstract Research suggests that callous unemotional (CU) traits are associated with poor emotion recognition due to impairments in attention to relevant emotional cues. To further investigate the mechanisms that underlie CU traits, this study focused on the relationship between levels of CU and children's attention to, and recognition of, facial emotions. Participants were 7- to 10-year-old Italian boys, 35 with a diagnosis of Disruptive Behavior Disorder (age: M = 8.93, SD = 1.35), and 23 healthy male controls (age: M = 8.86, SD = 1.35). Children viewed standardized emotional faces (happiness, sadness, fear, disgust, anger, and neutral) while eye-tracking technology was used to evaluate scan paths for each area of interest (eyes, face, mouth), and for each emotion. CU traits were assessed using parent and teacher ratings on the Antisocial Process Screening Device. In the whole sample, elevated levels of CU traits were associated with a lower ability to recognize sadness, a lower number of fixations, and a lower average length of each fixation, specifically to the eye area of sad faces. In children with Disruptive Behavior Disorder diagnoses, high levels of CU traits were associated with lower duration of fixations to the eye-region on the eye area of sad faces, which in turns predicted lower levels of sadness recognition. The findings confirm that poor emotion recognition is associated with impairments in attention to critical information about other people's emotions. The clinical implications are discussed.
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trajectories of callous unemotional traits from childhood to adolescence in referred youth with a Disruptive Behavior Disorder who received intensive multimodal therapy in childhood
Neuropsychiatric Disease and Treatment, 2018Co-Authors: Gabriele Masi, Azzurra Manfredi, Annarita Milone, Annalaura Nocentini, Simone Pisano, Laura Ruglioni, Lisa Polidori, Paola Brovedani, Gioia Maccaferri, Pietro MuratoriAbstract:Purpose Our aims were to explore the developmental trajectories of callous-unemotional (CU) traits using a growth curve analysis in Italian children with Disruptive Behavior Disorders treated with a multimodal intervention, and to test both predictors and distal outcomes of CU traits trajectories. Patients and method One hundred and sixty-eight children were enrolled, of whom 24 were lost in the follow-up and 144 were followed up from ages 8-9 to 14-15 years with four assessment points. Patients included 128 males (88.9%) with a mean age of 8.7 years, 96 with oppositional defiant Disorder (66.7%) and 48 with conduct Disorder (CD) (33.3%). The developmental trajectories of CU traits were assessed with the Inventory of Callous-Unemotional Traits (ICU). Results Our findings revealed that CU features were likely to fit a quadratic model from childhood to adolescence. The CU traits tended to decrease during childhood, with stabilization in adolescence and a significant variability in the growth curves. Pretreatment CD and higher levels of externalizing Behavioral problems were associated with higher level of CU traits at baseline, whereas positive parenting was associated with lower levels. No significant effects were found for all the other predictors (socioeconomic status, negative parenting, combined pharmacotherapy). Regarding outcomes into adolescence, both higher levels of CU traits at the baseline and a lower decrease of CU traits across time points predicted a higher risk of CD diagnosis, and higher rate of referrals to mental health services and of substance use. Furthermore, pretreatment CD and negative parenting predicted a higher risk of substance use into adolescence. Conclusion Our findings suggest that a close monitoring of CU traits in referred children with Disruptive Behavior Disorders may help to detect the patients at higher risk of poor outcome.
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moral disengagement and callous unemotional traits configurations in adolescents with Disruptive Behavior Disorder a person oriented approach
Psychiatry Research-neuroimaging, 2017Co-Authors: Marinella Paciello, Gabriele Masi, Annarita Milone, Maria Grazia Clemente, Pietro MuratoriAbstract:Abstract The interplay between Callous Unemotional Traits (CU) and Moral Disengagement (MD) was examined in a sample of 90 adolescents with Disruptive Behavior Disorders. Using a person-centered approach, three CU and MD configurations were identified, attesting the strong relationship between these two moral dimensions. However, for some adolescents, CU and MD do not ‘move together’. Practical implications are discussed in terms of assessment and intervention.
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paternal psychopathological risk and psychological functioning in children with eating Disorders and Disruptive Behavior Disorder
Psychiatry Research-neuroimaging, 2017Co-Authors: Luca Cerniglia, Pietro Muratori, Annarita Milone, Valentina Levantini, Laura Ruglioni, Marinella Paciello, Silvia Cimino, Renata TambelliAbstract:Abstract Several studies demonstrated that maternal psychopathological risk is related to child’s maladjustment, but until recently research has relatively neglected fathers. Disruptive Behavior Disorder (DBD) and Eating Disorders (ED) have a large prevalence during childhood but a few studies have focused on their association with paternal psychopathological risk. One-hundred and thirty-nine children and their fathers were recruited from pediatric hospitals and outpatient clinics and paired with a healthy control group (CG). Fathers were administered the SCL-90/R and the CBCL 6–18 to assess: 1) psychopathological risk of fathers of children with DBD, ED and CG; 2) significant differences between ED and DBD fathers’ psychopathological profiles; and 3) associations between specific fathers’ psychopathological symptoms and children’s emotional-Behavioral problems. Fathers of children with ED showed a higher psychopathological risk than fathers of DBD offspring. Children with DBD showed higher externalizing symptoms. Paternal hostility was associated with internalizing problems in children with DBD. Paternal hostility showed a non-significant but clinically interesting association with internalizing problems in DBD children; interpersonal sensitivity was associated with internalizing problems in ED children. This study can constitute a contribution to a better understanding of the clinical characteristics of fathers of children with DBD and ED.
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evaluation of improvement in externalizing Behaviors and callous unemotional traits in children with Disruptive Behavior Disorder a 1 year follow up clinic based study
Administration and Policy in Mental Health, 2017Co-Authors: Pietro Muratori, Azzurra Manfredi, Annarita Milone, Gabriele Masi, Laura Ruglioni, Lisa Polidori, Furio Lambruschi, John E LochmanAbstract:Multi-component interventions based on cognitive Behavioral principles and practices have been found effective in reducing Behavioral problems in children with Disruptive Behavior Disorders (oppositional defiant Disorder and conduct Disorder). However, it is still unclear if these interventions can affect children's callous-unemotional traits, which are predictive of subsequent antisocial Behavior. Furthermore, it could be important to identify empirically supported treatment protocols for specific Disorders addressed by child mental health services. The present study aimed to test the following two hypotheses: first, the Coping Power (CP) treatment program is able to reduce externalizing Behaviors in children with Disruptive Behavior Disorders treated in a mental health care unit; second, the CP program can reduce children's callous unemotional traits. The sample included 98 Italian children, 33 treated with the CP program; 37 with a less focused multi-component intervention, and 28 with child psychotherapy. The results showed that the CP program was more effective than the other two treatments in reducing aggressive Behaviors. Furthermore, only the CP program was associated with a decrease in children's callous unemotional traits. The CP program was also associated with lower rate of referrals to mental health services at one-year follow-up. These findings support the importance of disseminating manualized and focused intervention programs in mental health services.