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ABSTRACT: BACKGROUND: Several self-report instruments were developed to capture psychotic prodrome, and were claimed to have good predictive validity. The feasibility of screening is questionable considering the heterogeneity of the targeted populations and the negative ramifications of false positive identification. This study developed a questionnaire using data covering a wide range of clinical characteristics. METHODS: One hundred and eleven putative pre-psychotic participants, 129 normal comparison subjects, and 95 non-psychotic psychiatric outpatients completed a 231-item questionnaire comprising a 110-item Wisconsin psychotic prone scale, 74-item schizotypal personality questionnaire, 33-item basic symptoms, and 14-item cognitive symptoms. Items showing the best discriminating power, estimated using chi-square statistics with Bonferroni correction, were extracted to create a brief version. A two-stage cut-off approach emphasizing specific items was applied to maximize sensitivity and specificity. The concurrent validity of the proposed approach was estimated using a ten-fold cross-validation procedure. RESULTS: A 15-item self-report questionnaire was developed. Respondents checking at least eight items, or those checking three to seven items including any of the three referring to feeling stress in crowds, aloofness, and perceptual disturbance, would be considered putatively pre-psychotic with the largest sensitivity+specificity (0.784+0.705=1.489). This cut-off selection was the best estimate by calculating 1000 permutations in the cross-validation procedure. CONCLUSIONS: This investigation proposes a different orientation for applying questionnaires to screen putative pre-psychotic states, with less emphasis on attenuated psychotic symptoms and predictive values. Besides providing a handy tool for increasing awareness and referral, the instructions of such a screening questionnaire should be carefully worded.
Biological Psychiatry 11/2012; · 8.28 Impact Factor
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ABSTRACT: OBJECTIVE: Western literature documents impaired father-child interactions in addition to strong evidence of impaired mother-child interactions in children with attention-deficit/hyperactivity disorder (ADHD). However, the parenting process of fathers and their engagement in the Asian family with children with ADHD remain unexplored. The authors compared fathering and father-child relationships between children with ADHD and those without ADHD and identified the correlates of these paternal measures. METHODS: Fathering and father-child relationships were compared between 296 children with attention-deficit/hyperactivity disorder (ADHD) and 229 children without ADHD in Taiwan. All child participants and their parents received psychiatric interviews for the diagnosis of ADHD and other psychiatric disorders of the children, and their fathers were assessed for ADHD, anxiety and depressive symptoms. Both the fathers and children reported on the father's parenting style, father-child interactions, behavioral problems at home, and perceived family support. RESULTS: The results showed that children with ADHD received less affection/care and more overprotection and authoritarian control from their fathers. They had less active interactions with their fathers, more severe behavioral problems at home; and perceived less family support than children without ADHD. Correlates for impaired father-child interactions included childhood ADHD symptoms, any comorbidity, age at assessment, and the father's neurotic personality and depressive symptoms. In addition, the children reported more negatively on fathering and father-child interactions than the fathers. CONCLUSIONS: Our findings suggest the negative impacts of ADHD on the father's parenting style and father-child interactions. Clinical interventions aimed at improving father-child interactions warrant more attention.
Comprehensive psychiatry 09/2012; · 2.08 Impact Factor
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ABSTRACT: The Autism Spectrum Quotient (AQ) has been widely used for measuring autistic characteristics in parents of children with autism spectrum disorders (ASD). Nonetheless, its psychometric validity is yet to be justified. This study tested the factor structure of the AQ by means of principal component analysis and confirmatory factor analysis using, for the first time, data from 4192 Taiwanese parents (1208 with ASD children and 2984 with typically developing children). Results yielded a 35-item, 5-dimensional factor solution that had favorable psychometric characteristics (RMSEA=.054; NNFI=.962; CFI=.969) than any of the previously-published AQ factor solutions. Subscales of this new AQ-Chinese model were statistically and semantically coherent, namely: Socialness, Mindreading, Patterns, Attention to Details and Attention Switching. The psychometric properties of the AQ-Chinese did not change between clinic-based and community-based data suggesting good fitting for a continuum of autistic expression. Furthermore, the considerable overlap between the AQ-Chinese and the AQ factor structures derived previously using student samples indicated consistency in the manifestation of the autistic profile across different cultures and age groups. Group differences in the AQ-Chinese scores were in line with previous studies, i.e. males generally scored radically higher than females except in Attention to Details. Interestingly, mothers of ASD children reported lower total AQ scores than community mothers yet no significant group difference for the fathers. Important research and clinical implications pertinent to parents with children with ASD and the utility of the AQ were drawn.
Research in developmental disabilities 09/2012; 34(1):294-305. · 4.41 Impact Factor
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ABSTRACT: Previous evidence suggests that language function is modulated by genetic variants on chromosome 7q31-36. However, it is unclear whether this region harbors loci that contribute to speech delay in autism. We previously reported that the WNT2 gene located on 7q31 was associated with the risk of autism. Additionally, two other genes on 7q31-36, FOXP2 and the EN2 genes are also found to play a role in language impairment. Therefore, we hypothesize that the WNT2 gene, FOXP2 gene, and EN2 gene, may act in concert to influence language development in the same population. A total of 373 individuals diagnosed with autistic disorder were recruited in the current study. We selected 6 tag single nucleotide polymorphisms (SNPs) within the WNT2 gene, 3 tag SNPs in the FOXP2, and 3 tag SNPs in the EN2 genes, to study the effect of these genes on language development. Age of first phrase was treated as a quantitative trait. We used general linear model to assess the association between speech delay and these variants. The results show that rs2896218 in the WNT2 gene was moderately significantly associated with age of first phrase (permutation p = 0.0045). A three-locus haplotype in the WNT2 gene was significantly associated with age of first phrase (permutation p = 2 × 10(-4)). Furthermore, we detected an interaction effect on age of first phrase between a SNP rs2228946 in the WNT2 gene and another SNP rs6460013 in the EN2 gene (p = 0.0012). Therefore, the WNT2 gene may play a suggestive role in language development in autistic disorder. Additionally, the WNT2 gene and EN2 gene may act in concert to influence the language development in autism.
Research in developmental disabilities 04/2012; 33(5):1533-40. · 4.41 Impact Factor
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ABSTRACT: Chronotye is associated with age, sex, personality, and parental monitoring during childhood. The evening type is associated with poor school performance, sleep problems, anxious/depressive symptoms, tobacco smoking, caffeine consumption, alcohol drinking, and suicidality in adolescents. The present study tested the relationships between chronotype and a wide range of psychopathology and personality traits among 2919 incoming undergraduate students. Each participant completed a self-administered questionnaire that included demographics, plus the Morningness-Eveningness (M-E) scale, Brief Symptom Rating Scale (BSRS), Tridimensional Personality Questionnaire, and Maudesley Personality Inventory. The t-score distribution of the M-E scale was used to form the morning (t-score >60, n = 419), evening (t-score <40, n = 371), and intermediate (40 ≤ t-score ≤ 60, n = 2129) groups. Multivariable regression was employed for data analysis. For males, the evening type scored higher on all subscales of the BSRS than the morning type, except phobic anxiety. For females, the evening type had higher scores than the other two types on all subscales, except in obsession/compulsion and phobic anxiety, where the evening type only scored higher than the intermediate type. The evening type of both sexes also scored higher than the morning type in novelty seeking, harm avoidance, and neurotic personality characteristics, but lower than the morning type in extraversion and social desirability. In reward dependence, the evening type scored lowest for males, but there was no difference for females. The findings of the evening type being associated with possible psychopathology and certain types of personality have public health implications, that is, chronotype needs to be taken into account in the development of mental health prevention programs and assessment of and intervention for mental problems in young adults.
Chronobiology International 04/2012; 29(4):491-501. · 4.03 Impact Factor
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ABSTRACT: Autism is a complex neurodevelopmental disorder with high heritability. Despite different approaches worldwide to identify susceptibility loci or genes for autism spectrum disorders (ASDs), no consistent result has been reported. CNS patterning genes have been recognized as candidate genes for autism based on neuroimage and neuropathology evidence. This study investigated four candidate genes (WNT2, EN2, SHANK3, and FOXP2) by a tag SNP approach in a family-based association study. The trio samples include 1164 subjects from 393 families, including 393 probands (aged 9.1±4.0years; male, 88.6%) diagnosed with autistic disorder (n=373) or Asperger's disorder (n=20) according to the DSM-IV diagnostic criteria and confirmed by the Chinese ADI-R interview. Three tag SNPs of EN2 (7q36), 6 SNPs of WNT2 (7q31-33), 5 SNPs of SHANK3 (22q13.3), 3 SNPs of FOXP2 (7q31) were genotyped. TDT analysis was done to test the association of each tag SNP and haplotype. There was no association with autism for 17 tag SNPs of WNT2, EN2, SHANK3, and FOXP2 based on SNP analyses. Haplotype analyses did not reveal significant association except for the 6 tag SNPs of WNT2 gene showing a significant association on one haplotype composed of rs2896218 and rs6950765 (G-G) (p=0.0095). Other haplotypes composed of rs2896218 and rs6950765 (G-G) were also significantly associated with autism. The present study indicates that SHANK3 may not be a critical gene for the etiology of ASDs in Han Chinese population. Inconsistent findings in EN2 and FOXP2 in the Han Chinese population need further clarification. A haplotype of WNT2 (rs2896218-rs6950765: G-G) is significantly associated with ASDs in our trios samples, this finding warrants further validation by different sample and confirmation by functional study.
Progress in Neuro-Psychopharmacology and Biological Psychiatry 05/2011; 35(6):1512-7. · 3.25 Impact Factor
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Archiv f ur Psychiatrie und Nervenkrankheiten 03/2011; 262(2):179-80. · 2.75 Impact Factor
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ABSTRACT: to investigate the attentional processes and symptoms of attention-deficit hyperactivity disorder (ADHD) in pediatric patients with epilepsy and IQ greater than 70 in Taiwan.
we assessed 61 children (male, 62.3%; full-scale IQ >70) with epilepsy, ages 6-16 years, and 61 sex-, age-, and parental education-matched typically developing children (controls). All participants completed the intelligence (WISC-III) and attention assessments (Conners' Continuous Performance Test, CPT). The parents reported on the ADHD symptoms of their children.
children with epilepsy had more omission errors and deviant response style (β) and scored lower in the Hit Reaction Time (RT) Block Change, reflecting inattention and slowness. Epileptic children with ADHD symptoms had longer and more variable Hit RT than those without ADHD and controls. Higher full-scale IQ was significantly associated with less change in Hit RT, Hit RT block, standard error, and inter-stimulus intervals. There were no effects from age of onset, duration of having epilepsy, etiology of epilepsy, and brain anomaly on the CPT profiles.
the findings suggest that children with epilepsy, despite not mentally retarded, may have attention deficits. Hence, screening for attention problems among patients with epilepsy regardless of intelligence level and ADHD symptoms is recommended to offset possible learning adversities of this population.
Epilepsy research 01/2011; 93(1):53-65. · 2.48 Impact Factor
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ABSTRACT: This study aimed to investigate the association between attention-deficit hyperactivity disorder (ADHD) symptoms and subtypes, and sleep schedules, daytime inadvertent napping, and sleep problems/disorders in children and adolescents with and without ADHD. The sample included 325 patients with ADHD, aged 10-17 years [male: 81.5%; combined type (ADHD-C): 174; predominantly inattentive type (ADHD-I): 130; predominantly hyperactive-impulsive type (ADHD-HI): 21], and 257 children and adolescents without lifetime ADHD (non-ADHD). We conducted psychiatric interviews with the participants and their mothers before making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD symptoms. Multi-level models were used for data analyses controlling for sex, age, psychiatric comorbidities, and treatment with methylphenidate. The ADHD-C and ADHD-I groups had more daytime inadvertent napping. In general, the three subtypes were associated with increased rates of sleep problems/disorders. Specifically, ADHD-C rather than ADHD-I was associated with circadian rhythm problems, sleep-talking, nightmares (also ADHD-HI), and ADHD-I was associated with hypersomnia. The most-related sleep schedules and problems for inattention and hyperactivity-impulsivity were earlier bedtime, later rise time, longer nocturnal sleep, more frequent daytime napping, insomnia, sleep terrors, sleep-talking, snoring, and bruxism across informants. The findings imply that in addition to the dichotomous approach of ADHD and considering the psychiatric comorbid conditions, ADHD subtypes and symptom dimensions need to be considered in clinical practice and in the research regarding the association between ADHD and sleep problems/disorders.
Journal of Sleep Research 12/2010; 19(4):535-45. · 3.16 Impact Factor
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Chen-Chung Liu,
Meng-Chuan Lai,
Chih-Min Liu, Yen-Nan Chiu,
Ming H Hsieh,
Tzung-Jeng Hwang,
Yi-Ling Chien,
Wei J Chen,
Mau-Sun Hua,
Ping-Chuan Hsiung,
Ya-Chuan Huang,
Hai-Gwo Hwu
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ABSTRACT: To describe the outcomes of subjects with suspected pre-psychotic state in Taiwan.
A prospective clinical observation was performed on subjects recruited by referrals from a community-based population. Three pre-psychotic risk groups were established by means of clinical interviews: an ultra-high risk group (UHR; 59 subjects), an intermediate-risk group (IRG; 46 subjects), and a marginal-risk group (MRG; 48 subjects). Also recruited were 60 subjects with first-episode psychosis (FEP) and 144 normal controls (NC group). All subjects were aged 16 to 32 years.
Of the 59 UHR subjects, 21 (35.6%) converted to FEP, including 15 with schizophrenia (6 had relatively brief positive yet persistent prominent negative symptoms), 2 with schizophreniform disorder, 1 with schizoaffective disorder, 2 with brief psychotic disorder, and 1 with bipolar disorder. The cumulative±SE rate of conversion to psychosis was 21.7%±5.4% at 6 months, 28.2%±6.2% at 12 months, 30.4%±6.4% at 18 months, and 33.3%±6.8% at 24 months. The UHR subjects who converted had a higher rate of initial antipsychotic use than those who did not convert. Only half of the IRG and two-thirds of the MRG subjects received follow-up, and none of them developed FEP.
Our results lent support to both sides of the current debate regarding establishing a new diagnostic category of "psychosis risk syndrome." The divergent trajectories of the UHR subjects deserve more clinical attention, especially with regard to the use of antipsychotics and the presence of a group with prominent negative symptoms.
Biological Psychiatry 11/2010; 126(1-3):65-70. · 8.28 Impact Factor
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ABSTRACT: Early identification of subjects at risk of developing psychosis is the key to early intervention. A prospective study on the psychopathological progress from prodromal state to full-blown psychosis was initiated in Taiwan in 2006. However, the clinical entity of our interests is ill-defined; therefore, recruitment of at risk subjects to participate in studies requires innovation. In November 2006, the study team launched a special clinic for cognitive and perceptual disturbance. In the first year, 142 subjects, mostly aged 16-30 year olds, made an appointment for this special clinic. More than 20 tentative diagnoses were made. Seventy-six subjects with a gradient of clinical severity were eligible for enrollment, and 68 gave informed consent to participate in the research. It seems that setting up a special clinic to provide a service for at risk subjects, combined with certain campaigns, could facilitate their engagement in a longitudinal prospective study for early psychosis.
Journal of the Formosan Medical Association 07/2010; 109(7):543-9. · 1.13 Impact Factor
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ABSTRACT: Using a sample of 268 patients and 137 community-based children with DSM-IV ADHD, and 268 school controls, aged 6-15, this study aimed to compare the emotional/behavioral problems and functional impairment between clinic- and community-based children with ADHD. Children's ADHD-related symptoms, a wide range of emotional/behavioral problems, and functional impairments were assessed by the psychiatric interviews and self-, parent- and teacher-reported questionnaires. Both ADHD groups scored higher in parent- and teacher-reported ADHD-related symptoms, wide-ranging emotional/behavioral problems, and impairments in the school, peer, family, and leisure time domains than school controls. However, clinic-based children with ADHD had more physical/developmental problems, more severe functional impairments and teacher-reported hyperactivity/impulsivity symptoms, and higher family burdens than their community counterparts. Our findings suggest that a higher maternal educational level, parent's perceived child functional impairment, teacher's perceived impaired peer relationship and hyperactivity-impulsivity, and child physical and developmental problems may be related to the psychiatric referrals of children with ADHD.
Journal of Abnormal Child Psychology 05/2010; 38(4):521-32. · 3.09 Impact Factor
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ABSTRACT: The aim of the present study was to examine changes of attention-deficit-hyperactivity disorder (ADHD) symptoms and psychiatric comorbidities at adolescence, and mother-child agreement on reports of ADHD symptoms among children with ADHD as compared to unaffected controls.
The participants included 93 patients (male, 82.8%) aged 11-16, who were clinically diagnosed with ADHD at the mean age of 7.3 +/- 2.8 years, and 93 age-, sex-, and parental education-matched school controls. The participants and their mothers were first interviewed separately for baseline psychopathology at childhood, followed by current psychopathology using the Chinese Kiddie Epidemiologic version of the Schedule for Affective Disorders and Schizophrenia.
At adolescence, 46 patients (49.5%) met full DSM-IV ADHD criteria, 31 (33.3%) had subthreshold ADHD, and 16 (17.2%) had recovered from ADHD. We found a significant progressive decline in the three ADHD core symptoms for the ADHD group: hyperactivity had the greatest effect size, followed by inattention, and then impulsivity. Children with ADHD tended to report less severe ADHD symptoms at childhood and adolescence than their mothers. They were more likely than the controls to have oppositional defiant disorder (odds ratio (OR)=18.0; 95% confidence interval (CI)=8.3-38.9), conduct disorder (OR=23.1, 95%CI =5.3-100.2), mood disorders (OR=3.8, 95%CI = 1.5-9.4), bipolar disorders (Fisher's exact p < 0.001), and sleep disorders (OR=3.1, 95%CI = 1.6-6.0) at adolescence.
The present findings are similar to those of Western studies, regarding the patterns of comorbidity, stability of core symptoms, and mother-child differences on symptom reports.
Australian and New Zealand Journal of Psychiatry 04/2010; 44(4):323-32. · 2.93 Impact Factor
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ABSTRACT: The aims of the present study were to examine the current psychiatric comorbidity among children and adolescents with and without persistent attention-deficit hyperactivity disorder (ADHD) as compared to school controls, and to determine the factors predicting psychiatric comorbidity.
The sample included 296 patients (male, 85.5%), aged 11-17, who were diagnosed with DSM-IV ADHD at the mean age of 6.7 +/- 2.7 years and 185 school controls. The ADHD and other psychiatric diagnoses were made based on clinical assessments and confirmed by psychiatric interviews. The ADHD group was categorized into 186 patients (62.8%) with persistent ADHD and 110 (37.2%) without persistent ADHD.
Compared to the controls, the two ADHD groups were more likely to have oppositional defiant disorder (ODD), conduct disorder (CD), tics, mood disorders, past and regular use of substances, substance use disorders and sleep disorders (odds ratios (ORs) = 1.8-25.3). Patients with persistent ADHD had higher risks for anxiety disorders, particularly specific phobia than the controls. Moreover, patients with persistent ADHD were more likely to have ODD than their partially remitted counterparts. Advanced analyses indicated that more severe baseline ADHD symptoms predicted ODD/CD at adolescence; longer methylphenidate treatment duration was associated with an increased risk for tics and ODD/CD at adolescence; and older age predicted higher risks for mood disorders and substance use disorders.
Reduced ADHD symptoms at adolescence may not lead to decreased risks for psychiatric comorbidity, and identification of severe ADHD symptoms at childhood and age-specific comorbid patterns throughout the developmental stage is important to offset the long-term adverse psychiatric outcomes of ADHD.
Australian and New Zealand Journal of Psychiatry 02/2010; 44(2):135-43. · 2.93 Impact Factor
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ABSTRACT: There have been no published reports regarding the epidemiological and psychiatric features of gender dysphoria in non-clinical young adults. The current study aimed to investigate the demographics, co-occurring psychiatric symptoms, and perceived parenting style and family support in Taiwanese young adults with gender dysphoria. The sample consisted of 5010 university freshmen (male, 51.6%) with a mean age of 19.6 years (SD = 2.7) from a national university in Taiwan. The questionnaires used for this university-based survey included the Adult Self Report Inventory-4 for psychopathology (including gender dysphoria), the Parental Bonding Instrument for parenting style, and the Family APGAR for perceived family support. Results showed that gender dysphoria was more prevalent in females (7.3%) than males (1.9%). Young adults with gender dysphoria were more likely to meet a wide but specific range of co-occurring psychiatric symptoms. The most significantly associated symptoms for males were agoraphobia, hypochondriasis, manic episode, and pathological gambling, and for females dissociative disorder, hypochondriasis, and body dysmorphic disorder. Both males and females with gender dysphoria perceived significantly less support from their families and less affection/care from both parents. Findings suggest that gender dysphoria, associated with a specific range of psychopathology and family/parenting dissatisfaction (with both similar and dissimilar patterns between sexes), is not uncommon in Taiwanese university students, particularly in females. This implies the importance of attention and specific measures to offset psychiatric conditions and to promote mental well-being of this population.
Archives of Sexual Behavior 11/2009; 39(6):1415-28. · 3.53 Impact Factor
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ABSTRACT: Autism is a childhood-onset neurodevelopmental disorder with a strong genetic component in its etiology. Several studies reported that the solute carrier family 25 member A12 (SLC25A12) gene was associated with autism. This study aimed to replicate this finding in a Han Chinese sample from Taiwan using a population-based case-control approach.
We genotyped two single nucleotide polymorphisms (SNPs, rs2056202 and rs2292813) of the SLC25A12 gene that were previously reported to be associated with autism in 465 patients (402 males and 63 females) and 450 control subjects (227 males and 223 females) from Taiwan. Differences in the genotype, allele, and haplotype frequencies between the two groups were compared.
We found no differences in the allele, genotype, or haplotype frequencies of these two SNPs between patients and controls.
Our data do not support that the SLC25A12 gene is associated with autism in our population. The discrepant results of other studies may come from the clinical heterogeneity of patients recruited for studies, or the genetic heterogeneity of autism in different populations.
Progress in Neuro-Psychopharmacology and Biological Psychiatry 11/2009; 34(1):189-92. · 3.25 Impact Factor
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ABSTRACT: To investigate the effects of age, gender, prenatal/perinatal factors, and maternal psychological distress on childhood emotional/behavioral problems, and the gender difference in the patterns of comorbid emotional/behavioral problems.
The sample included 1391 children aged 4-9 in Taipei using a multi-stage sampling method. Their mothers completed questionnaires including demographics, prenatal/perinatal variables, the Child Behavior Checklist, and the Chinese Health Questionnaire. The linear and non-linear mixed model was used for data analysis.
Boys scored higher on externalizing problems, and girls scored higher on internalizing problems. Gender also modified the comorbid patterns of emotional/behavioral problems. Aggressive behaviors decreased, but attention and thought problems increased with age. Prenatal/perinatal exposure to alcohol and coffee, vaginal bleeding, and gestational diabetes, low birthweight, and postnatal incubation and resuscitation, and maternal psychological distress predicted the risk for several childhood emotional/behavioral problems.
Prenatal/perinatal and maternal care, and gender-specific measures are important for prevention of childhood emotional/behavioral problems.
Psychiatry and Clinical Neurosciences 06/2009; 63(4):569-76. · 2.13 Impact Factor
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ABSTRACT: The literature has documented maternal distress and behavioral problems among children with Down syndrome (DS), however, little is known about paternal adjustment and behavioural problems among the siblings of children with DS. Here, we examined parental psychopathology, parenting style and emotional/behavioral problems among children with DS, their siblings, and controls in Taiwan.
We recruited 45 families of children with DS (age, 2-4 years) and 50 families of normally developing children (age, 3-5 years). If there were more than two children in the case family, the sibling whose age was closest to the child with DS was recruited (age, 3-8 years). Both parents completed self-administered measures of their personality characteristics, psychopathology, family functioning, parenting styles, and child behavioral problems, using the Chinese versions of the Maudsley Personality Inventory, Brief Symptom Rating Scale, Family Adaptability and Cohesion Evaluation Scale, Parental Bonding Instrument, and Child Behavioral Checklist, respectively.
Children with DS demonstrated significantly more severe symptoms than normal children of a wide range of behavioral problems such as attention problems, delinquency, social problems, somatic complaints, thought problems, and withdrawal compared with the other two groups, and obtained similar parental treatment, except for paternal overprotection. Their parents suffered from more psychopathology and their mothers were less often employed than their counterparts. The siblings of children with DS obtained less overprotection from their mothers than children with DS and less maternal care and control than normal children. There was no difference in emotional/behavioral problems between the siblings and normal controls.
Our findings suggest that in addition to the physical, educational and psychological needs of children with DS, the psychological care of their mothers, fathers and siblings also needs to be evaluated. Moreover, parenting counseling should focus not only on children with DS, but their siblings as well.
Journal of the Formosan Medical Association 10/2008; 107(9):693-703. · 1.13 Impact Factor
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ABSTRACT: Adolescent eveningness is associated with age, parental monitoring, daytime sleepiness, sleep problems, moodiness, and the use of coffee. This study investigated the association between adolescent morningness-eveningness and psychopathology, substance use, and suicidality in 1332 students ages 12 to 13. Each student-participant completed the Chinese version of the Child Morningness/Eveningness Scale (CMES), the Pubertal Development Scale, and a questionnaire about their sleep schedule, trouble sleeping, habitual substance use, and suicidality. Their mothers completed the Child Behavioral Checklist and Chinese Health Questionnaire. The morning (n = 412), intermediate (n = 740), and evening (n = 180) groups were operationally defined by the CMES t scores. The mixed model was used for data analysis. The evening group had shorter weekday sleep time, longer weekend sleep time, more daytime napping, and greater sleep compensation on weekends and was more likely than the other 2 groups to have behavioral/emotional problems, suicidality, and habitual substance use. Internalizing and externalizing problems partially explained the association between eveningness, substance use, and suicidality. The findings suggest that eveningness may be an indicator for adolescents with behavioral/emotional problems and risky behaviors and suggest an investigation for possible intervention.
Journal of Biological Rhythms 07/2007; 22(3):268-74. · 2.93 Impact Factor
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ABSTRACT: To examine the association between sleep-related problems and symptoms of attention-deficit/hyperactivity disorder (ADHD) in a community sample of young adults in Taiwan.
A college-based cross-sectional survey.
Two thousand two hundred eighty-four first-year college students (aged 18-20) in a university in Taiwan.
Each student completed a questionnaire regarding sleep schedule (self-estimated total sleep duration and sleep need), sleep problems (dyssomnia, parasomnia, and snoring), and the Chinese version of the Adult ADHD Self-Report Scale. Subjects were grouped separately for the inattention and hyperactivity subscales into highly likely ADHD (2.3%, 0.7%), probable ADHD (21.3%, 5.7%), and probably non-ADHD (76.4%, 93.6%) groups according to the scoring scheme of the subscales of the Adult ADHD Self-Report Scale. Results showed that, for both inattention and hyperactivity symptoms, the highly likely ADHD and probable ADHD groups were more likely than the non-ADHD group to have a variety of current and lifetime sleep problems. No significant difference in sleep problems was found between the highly likely ADHD and probable ADHD groups. Inattention, but not hyperactivity, was associated with greater sleep need and greater difference between sleep need and self-estimated nocturnal sleep duration. Hyperactivity, but not inattention, was associated with decreased nocturnal sleep duration.
Consistent with prior findings from children and adolescents, ADHD symptoms in young adults are related to sleep problems. Further studies on adults with ADHD should help to refine our understanding of the causal basis for any implications of this association.
Sleep 03/2007; 30(2):195-201. · 5.05 Impact Factor
