Maria Nobile

M.D., Ph.D.
IRCCS Eugenio Medea · Child Psychiatry Department
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Topics (5)

Skills (1)

Publications (40) View all

  • Article: The ability of CBCL DSM-oriented scales to predict DSM-IV diagnoses in a referred sample of children and adolescents.
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    ABSTRACT: The majority of studies examining associations between clinical-diagnostic and empirical-quantitative approaches have concentrated only on the target diagnosis without taking into account any possible co-variation of psychopathological traits, which is intrinsic to child psychopathology. The ability of child behaviour checklist (CBCL) DSM-oriented scales (DOSs) to predict target and other DSM diagnoses, taking into consideration the covariation of psychopathological traits, was analysed by logistic regression analysis. Corresponding odds ratio (OR) was used as indicator of the strength of the relationship between the clinical score in DOSs and the presence of DSM-IV diagnoses. Logistic regression allowed us to consider multiple scales simultaneously, thus addressing the problem of co-occurrence of psychopathological traits, and to include gender and age as covariates. The sample consisted of 360 children and adolescents aged 6-16 years, consecutively referred for behavioural and emotional problems. As a whole, the CBCL DOSs seem to be more specific but with a weaker association with DSM-IV diagnoses than syndrome scales, and with some distinctive features: clinical scores in the anxiety DOS suggest a diagnosis of both anxiety and mood disorder; clinical scores in the somatic problems DOS are very strong and specific predictors for diagnosis of separation anxiety disorder; clinical scores in the oppositional defiant problems DOS are not only predictors of the oppositional defiant disorder but are also strong predictors of generalized anxiety disorder; clinical scores in the conduct problems DOS are a specific and strong predictor for oppositional defiant disorder. Results confirm the clinical usefulness of CBCL and suggest using both syndrome and DOS scales for a complete and accurate assessment of children and adolescents.
    European Child & Adolescent Psychiatry 11/2012; · 2.82 Impact Factor
  • Article: COMT Val158Met polymorphism and socioeconomic status interact to predict attention deficit/hyperactivity problems in children aged 10–14
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    ABSTRACT: The functional Val158Met COMT polymorphism appears to affect a host of behaviours mediated by the pre-frontal cortex, and has been found associated to the risk for disruptive behaviours including ADHD. Parental socioeconomic status (SES) has also been reported as a predictor for the same childhood disorders. In a general population sample of 575 Italian pre-adolescents aged 10–14, we examined the association of the functional Val158Met COMT polymorphism and SES—both as linear and interactive effects—with oppositional defiant problems, conduct problems, and attention deficit/hyperactivity problems, as defined by the newly established Child Behaviour Check-List/6-18 DSM oriented scales. Multivariate- and subsequent univariate-analysis of covariance showed a significant association of COMT×SES interaction with CBCL 6/18 DOS attention deficit/hyperactivity problems (p=0.004), and revealed higher scores among those children with Val/Val COMT genotype who belonged to low-SES families. We also found a significant association of SES with attention deficit/hyperactivity problems and conduct problems DOS (p=0.04 and 0.01, respectively). Our data are consistent with a bulk of recent literature suggesting a role of environmental factors in moderating the contribution of specific genetic polymorphisms to human variability in ADHD. While future investigations will refine and better clarify which specific environmental and genetic mechanisms are at work in influencing the individual risk to ADHD in pre-adolescence, these data may contribute to identify/prevent the risk for ADHD problems in childhood. KeywordsCOMT polymorphism-SES-ADHD-CBCL-Gene–environment interaction
    European Child & Adolescent Psychiatry 04/2012; 19(7):549-557. · 2.82 Impact Factor
  • Article: Psychopathology and adversities from early- to late-adolescence: a general population follow-up study with the CBCL DSM-Oriented Scales.
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    ABSTRACT: Aims.Adolescence is a critical transition phase between childhood and adulthood, when the burden of mental disorder may still be prevented. The aim of this study was to evaluate the continuity and discontinuity of behavioural problems in adolescence while taking into account the multiple co-variation of psychopathological traits and the complex role of recent stressful life events (SLEs).Methods.This is a 5-year follow-up investigation of emotional and behavioural problems assessed by the newly developed Child Behavior Checklist (CBCL) DSM-Oriented Scales (DOSs) in 420 general population subjects aged 15-19 years.Results.The DOSs showed good stability, even when multiple co-variation was taken into account. Longitudinal data showed that homotypic evolution of psychopathology was to be expected in the first place. Equifinality and multifinality were also found. Oppositional Defiant Problems emerged to be polyvalent predictors of both internalizing and externalizing problems. Furthermore, Oppositional Defiant Problems predicted more SLEs, which in turn predicted more Depression, Anxiety and Oppositional Defiant Problems. Mediational analyses confirmed the role of SLEs in partially accounting for the continuity of Oppositional Defiant Problems and for the heterotypic progression towards Affective Problems.Conclusions.These data underscore early adolescence behavioural problems as an important focus for primary and secondary intervention.
    Epidemiology and Psychiatric Sciences 04/2012; · 3.16 Impact Factor
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    Article: Pediatric Biobanking: A Pilot Qualitative Survey of Practices, Rules, and Researcher Opinions in Ten European Countries
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    ABSTRACT: on behalf of the Pediatric Biobank ELSI Working Group { Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have con-sidered a variety of the individual issues crucial to pediatric biobanking such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens and data handling, and return of results as faced in 10 European countries. Because of the lack of comparative analyses of these topics, a pilot study was designed. Following a qualitative methodology, a questionnaire draft mostly including open-ended queries was developed, tested, and sent by e-mail to a selected group of researchers dealing with pediatric biobanking (n = 57). Returned questionnaires (n = 31) highlighted that the collection, storage, distribution, and use of biospecimens and data from children were widely practiced in the contacted laboratories. In most cases, pediatric biobanking was subjected to national or local regulations covering 1
    Biopreservation and Biobanking 01/2012; · 1.29 Impact Factor
  • Article: Further evidence of complex motor dysfunction in drug naive children with autism using automatic motion analysis of gait.
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    ABSTRACT: In order to increase the knowledge of locomotor disturbances in children with autism, and of the mechanism underlying them, the objective of this exploratory study was to reliably and quantitatively evaluate linear gait parameters (spatio-temporal and kinematic parameters), upper body kinematic parameters, walk orientation and smoothness using an automatic motion analyser (ELITE systems) in drug naïve children with Autistic Disorder (AD) and healthy controls. The children with AD showed a stiffer gait in which the usual fluidity of walking was lost, trunk postural abnormalities, highly significant difficulties to maintain a straight line and a marked loss of smoothness (increase of jerk index), compared to the healthy controls. As a whole, these data suggest a complex motor dysfunction involving both the cortical and the subcortical area or, maybe, a possible deficit in the integration of sensory-motor information within motor networks (i.e., anomalous connections within the fronto-cerebello-thalamo-frontal network). Although the underlying neural structures involved remain to be better defined, these data may contribute to highlighting the central role of motor impairment in autism and suggest the usefulness of taking into account motor difficulties when developing new diagnostic and rehabilitation programs.
    Autism 05/2011; 15(3):263-83. · 2.27 Impact Factor

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