2005 Joint Annual Meeting of the American Academy of Child & Adolescent Psychiatry and the Canadian Academy of Child & Adolescent Psychiatry Toronto, Canada . October 18-23 , 2005
2005 Joint Annual Meeting
of the
American Academy of Child & Adolescent Psychiatry
and the
Canadian Academy of Child & Adolescent Psychiatry
Toronto, Canada . October 18-23 , 2005
1 A Anxiety Disorders from Preschool to Early Adulthood
Adrian Angold
Objective changes in rates of common
anxiety disorders from
pre-adolescence to young
adulthood
components of puberty most
strongly associated with
specific anxiety disorders
1 A Anxiety Disorders from Preschool to Early Adulthood
Methods Great Smoky Mountains study
1,420 community-representative
sample
children aged 9, 11 or 13 at study
entry
received multiple intensive
parent-and child-reported
psychiatric assessment (Child
and Adolescent Psychiatric
Assessment-CAPA) from 9 to 19
1 A Anxiety Disorders from Preschool to Early Adulthood
Results very different patterns of
development change for different
anxiety disorders
in social phobia in adolescent
girls was associated with
testosterone and estradiol while
in GAD was associated with
LH and FSH
The dramatic age-dependent fall off in
rates separation anxiety was not
associated with any pubertal factors
No significant effect of age on the rates
of specific phobia
1 A Anxiety Disorders from Preschool to Early Adulthood
Conclusion : Sex differences in “ adjustment ”
at puberty depend on
sex – differentiated, behaviour
type-specific patterns of interaction
between specific components of
puberty, genetic effects and
environmental components
1 B Specific Childhood Anxiety Disorders aspredictors of Adolescent Psychopathology
Antje Bittner
Objective implications of specific
childhood disorders (before
age 13 years) for adolescent
disorders (age 13-19)
Methods Great Smoky Mountains
study
1 B Specific Childhood Anxiety Disorders aspredictors of Adolescent Psychopathology
Results In girls
Childhood SAD was associated with subsequent specific phobia.
OAD was related to adolescent OAD, panic attacks and CD.
GAD in childhood was significant associated with subsequent
SAD, depression, CD and SUD.
1 B Specific Childhood Anxiety Disorders aspredictors of Adolescent Psychopathology
Results In boys
Homotypic continuity was seen for SAD and social phobia.
Childhood OAD was associated with adolescent depression. Social phobia predicted later
SAD, panic attacks and ADHD.
1 B Specific Childhood Anxiety Disorders aspredictors of Adolescent Psychopathology
Conclusion Anxiety disorders in childhood-especially OAD and socialphobia – seem to be strongpredictors of psychiatric disordersin adolescence
Deletion of OAD and revision ofGAD for children may lead tounderestimation of the impact ofchildhood anxiety disorders
1 C Anxiety Disorders in Preschool children Helen L. Egger
Objective To describe the prevalence of
specific DSM-IV anxiety disorders
and the associations with age,
gender,other psychiatric disorders,
impairment, and mental health
service use in preschool
children
1 C Anxiety Disorders in Preschool children
Methods 1,073 parents of children age 2-5attending a large paediatric clinicwere screened
193 parents of high scorers age(top 30%) and 114 randomly selectedparents of non-high scorers wereinterviewed with the Preschool AgePsychiatric Assessment (PAPA), astructured parent psychiatric interview for assessing psychiatric symptomsand disorders in preschool children
Data is weighted back to the screeningpopulation
1 C Anxiety Disorders in Preschool children
Results The overall prevalence of anxiety
disorders was 9.5% , with no
significant gender differences.
Older children were more likely to meet
criteria for any anxiety disorder and
PTSD.
Preschoolers with an anxiety disorder
were more likely to have another
anxiety disorder, other psychiatric
disorders and be impaired.
1 C Anxiety Disorders in Preschool children
Conclusion Anxiety disorders are common inpreschool children, exhibit substantialhomotypic and heterotypic comorbidity,and show differences in the rates ofhomotypic and heterotypic comorbidityamong the specific anxiety disorders.
Preschoolers with anxiety disordersare impaired but few are referredfor mental health evaluations.
1 D Pediatric Anxiety and Neural CircuitryDysfunction : A Neuroscience Perspective
Daniel S. Pine
Objective To review four studies that examinethe associations among attention,developmental psychopathology andemotion, focusing on the amygdalaand its role in threat processing
1 D Pediatric Anxiety and Neural CircuitryDysfunction : A Neuroscience Perspective
Daniel S. Pine
Methods Two studies examine relationships
in children and adolescents among
anxiety disorders, major depression, and
performance on attention bias tasks.
Two studies use fMRI to examine
the relationships among attention,
amygdala activation and
development.
1 D Pediatric Anxiety and Neural CircuitryDysfunction : A Neuroscience Perspective
Results The two behavioural studies document abnormal
attention bias in paediatric anxiety disorders.
1 D Pediatric Anxiety and Neural CircuitryDysfunction : A Neuroscience Perspective
Results In the fMRI study, greater amygdalaand ventral PFC activation is foundin adolescents with anxiety disorders,relative to psychiatrically healthyadolescents .endogenous attention control during face - emotion viewing, greater activation
in patients is found both in the amygdala and ventral PFC.
exogenous attention control during face-emotion viewing greater amygdalaactivation is found in patients for the subliminal presentation of angry faces.
1 D Pediatric Anxiety and Neural CircuitryDysfunction : A Neuroscience Perspective
Conclusion Attention abnormalities occur in
paediatric anxiety disorders and may relate to perturbed
functioning in the amygdala and ventral PFC
14 A Psychiatric Sequelae of Institutional Care : A randomized controlled Trial in Romania
Charles H. Zeanah
Objective to evaluate foster care as an alternative to institutionalized carefor orphaned children
Methods 136 institutionalized Romanianchildren ages 5-31 months randomlyassigned either to continuedinstitionalized care or foster care
An additional group of 72 children that
had never been institutionalized were recruited for comparison
14 A Psychiatric Sequelae of Institutional Care : A randomized controlled Trial in Romania
Results Both institutionalized and foster care
groups displayed higher levels of
psychopathology than children never
institutionalized.
Preliminary results supported lower
of emotional disorders for children
in the foster care group as compared
to the institutionalized groups.
No difference were observed between
foster care and institutionalized groups
on behavioural disorders.
14 A Psychiatric Sequelae of Institutional Care : A randomized controlled Trial in Romania
Conclusion Preliminary data support foster care
as an effective alternative to
institutionalized care.
14 B The epidemiology of Trauma and Post-Traumatic Stress in children
William E. Copeland
Objective to examine the prevalence of
potentially traumatic life events and
post-traumatic stress in an epidemiologic
sample of rural children and
adolescents
14 B The epidemiology of Trauma and Post-Traumatic Stress in children
Mehtods 1,420 children assessed at multiple
time points from 9 to 16
CAPA used to collect information
about potentially traumatic events,
PTSD symptomatology and other
psychiatric disorders
14 B The epidemiology of Trauma and Post-Traumatic Stress in children
Results 70% of children reported exposureto a potentially traumatic event byAge 16
Although few children met full DSM-IVcriteria for PTSD, up to 25% ofchildren exposed to an event displayedsome post-traumatic stress symptomatology
14 B The epidemiology of Trauma and Post-Traumatic Stress in children
Results Symptoms were highest for children
exposed directly to violence, or
indirectly through witnessing or
learning about violence perpetrated to a peer or loved one
Children exposed to trauma were
two to three times as likely to
display other DSM-IV disorders as
children without trauma
14 B The epidemiology of Trauma and Post-Traumatic Stress in children
Conclusion Exposure to trauma in childhood
is both common and deleterious.
While some children display PTSD
symptomotology, many more
display other behavioural and
emotional problems.
14 C The epidemiology of stressful life eventsand preschool mental health
Helen L. Egger
Objective to estimate the prevalence of
potentially stressful life events in
preschool children
to determine risk factors associated with trauma
exposure
14 C The epidemiology of stressful life eventsand preschool mental health
Methods A cohort of 307 parents of preschool children (Age 2-5) were interviewed with PAPA to assess psychiatric functioning
The PAPA includes a life event
module assessing how low
magnitude stressful events such as
birth of a sibling and high
magnitude events such as physical or sexual abuse
14 C The epidemiology of stressful life eventsAnd preschool mental health
Results Over half of the children were exposed
to some potentially stressful event in
the past three months
Poverty and frequent relocation
were strongly related to stress
exposure
High magnilude events were
significantly related to the meeting
the criteria for an anxiety disorder
14 C The epidemiology of stressful life eventsand preschool mental health
Conclusion Potentially traumatic life events are
relatively common in the lives of
preschool children and are associated
with greater risk for psychiatric
disorders and impairment.
14 D Maltreatment and Resilience : Evidence fromA longitudinal study
Elizabeth Jane Costello
Objective to answer 2 questions
1) Does childhood maltreatment
predict adolescent problems in the
general population ?
2) What predicts adolescent resilience
to childhood maltreatment ?
Methods Great Smoky Mountains study
CAPA was used to assess maltreatment
(i.e physical abuse, sexual abuse or
neglect) psychiatric functioning and
relevant risk factors
14 D Maltreatment and Resilience : Evidence fromA longitudinal study
Results Maltreated children displayed higher
rates of both psychiatric disorder and
other signs of doing poorly.
Resilience to physical or sexual
abuse was predicted by adequate
supervision by parents and low
level of exposure to traumatic events.
14 D Maltreatment and Resilience : Evidence from A longitudinal study
Results For neglect, decreased exposure to
common stressors predicted better
functioning
Family structure, gender and race
were not related to resilience