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Waaktaar T.,Center for Child and Adolescent Mental Health | Torgersen S.,University of Oslo
Behavior Genetics | Year: 2012

The aim of this multi-informant twin study was to determine the relative role of genetic and environmental factors in explaining variation in trait resilience in adolescents. Participants were consenting families (N = 2,638 twins in 1,394 families), from seven national cohorts (age 12-18 years, both sexes) of monozygotic and dizygotic twins reared together. Questionnaire data on the adolescents' Ego-resilience (ER89) was collected from mothers, fathers and twins, and analysed by means of multivariate genetic modelling. Variance in trait resilience was best represented in an ADE common pathways model with sex limitation. Variance in the latent psychometric resilience factor was largely explained by additive genetic factors (77% in boys, 70% in girls), with the remaining variance (23 and 30%) attributable to non-shared environmental factors. Additive genetic sources explained more than 50% of the informant specific variation in mothers and fathers scores. In twins, additive and non-additive genetic factors together explained 40% and non-shared environmental factor the remaining 60% of variation. In the mothers' scores, the additive genetic effect was larger for boys than for girls. The non-additive genetic factor found in the twins' self ratings was larger in boys than in girls. The remaining sex differences in the specific factors were small. Trait resilience is largely genetically determined. Estimates based on several informants rather than single informants approaches are recommended. © The Author(s) 2011.


Oerbeck B.,University of Oslo | Stein M.B.,University of California at San Diego | Pripp A.H.,University of Oslo | Kristensen H.,Center for Child and Adolescent Mental Health
European Child and Adolescent Psychiatry | Year: 2015

Cognitive behavioral therapy (CBT) is generally considered the recommended approach for selective mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study. In the present report we provide outcome data 1 year after having completed the 6-month course of CBT for 24 children with SM, aged 3-9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, four were in remission, and 12 children were without diagnosis. Younger children improved more, as 78 % of the children aged 3-5 years did not have SM, compared with 33 % of children aged 6-9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention. © The Author(s) 2014.


Kaale A.,University of Oslo | Kaale A.,Center for Child and Adolescent Mental Health | Smith L.,Center for Child and Adolescent Mental Health | Sponheim E.,University of Oslo
Journal of Child Psychology and Psychiatry and Allied Disciplines | Year: 2012

Background: Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parent-mediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools. Aim: Assess the effects of a preschool-based JA-intervention. Methods: 61 children (48 males) with autistic disorder (29-60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and video taped preschool teacher-child and mother-child play at baseline and post-intervention. Clinical trials registration:: NCT00378157. Results: Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers. Conclusions: This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention. © 2011 Association for Child and Adolescent Mental Health.


Waaktaar T.,University of Oslo | Torgersen S.,Center for Child and Adolescent Mental Health | Torgersen S.,University of Oslo
American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics | Year: 2012

Loneliness is prevalent in adolescence, despite the widespread expectation directed to young people to start building close relationships beyond the nuclear family. The aim of the present study was to explore the causal genetic and environmental structure behind variability in adolescents' perceived loneliness. Seven national cohorts (ages 12-18 years) of Norwegian twins reared together (1,394 twin pairs) participated. Perceived loneliness was measured with five items from the UCLA Loneliness Scale. Data were collected from mothers, fathers, and twins' self ratings by means of a posted questionnaire. Biometric analyses were applied, testing the causal architecture of loneliness within a psychometric model with one common latent factor in addition to specific genetic and environmental sources influencing the scores of each informant. The results showed a heritability (h2) of 75% on the latent perceived loneliness factor, and nonshared environmental effects (e2) explaining the remaining 25% of the latent factor variance. There were also significant rater-specific genetic and nonshared environmental effects. No shared environmental effects were found in the model, and there were no sex differences in the estimates. This study showed that variation in perceived loneliness in adolescents is highly genetic. Additional genetic and nonshared environmental etiological sources are to some extent represented in the scores of the specific rater. © 2012 Wiley Periodicals, Inc.


Kaale A.,University of Oslo | Fagerland M.W.,University of Oslo | Martinsen E.W.,University of Oslo | Smith L.,Center for Child and Adolescent Mental Health
Journal of the American Academy of Child and Adolescent Psychiatry | Year: 2014

Objective This study reports 12-month follow-up data from a randomized controlled trial of preschool-based social communication treatment for young children with autism. Method A total of 61 children (48 males) with autism, 29 to 60 months of age, had earlier been randomized either to 8 weeks of preschool-based social communication treatment in addition to standard preschool program (n = 34) or to standard preschool program only (n = 27). Significant short-term effects on targeted social communication skills have previously been published. Long-term gains in social communication, language and global social functioning and communication were assessed from video-taped preschool teacher-child and mother-child interactions, Early Social Communication Scales, Reynell Developmental Language Scale, and Social Communication Questionnaire. Results Compared with those in the control group, the treated children achieved significantly larger improvements in joint attention and joint engagement from baseline to 12-month follow-up. However, no effects were detected on language and global ratings of social functioning and communication. The treatment effect on child initiation of joint attention increased with increasing level of sociability at baseline, whereas nonverbal IQ and expressive language had no moderating effect. Conclusions This study is the first to show that, similar to specialist-delivered treatment, preschool-based treatment may produce small but possibly clinically important long-term changes in social communication in young children with autism. The treatment did not affect language and global ratings of social functioning and communication. More studies are needed to better understand whether treatment effects may be improved by increasing the intensity and duration of the treatment. Clinical trial registration information - Joint Attention Intervention and Young Children With Autism; http://clinicaltrials. gov/; NCT00378157. © 2014 American Academy of Child and Adolescent Psychiatry.


Heiervang E.,Center for Child and Adolescent Mental Health | Goodman R.,King's College London
Social Psychiatry and Psychiatric Epidemiology | Year: 2011

Background: Web-based surveys may have advantages related to the speed and cost of data collection as well as data quality. However, they may be biased by low and selective participation. We predicted that such biases would distort point-estimates such as average symptom level or prevalence but not patterns of associations with putative risk-factors. Methods: A structured psychiatric interview was administered to parents in two successive surveys of child mental health. In 2003, parents were interviewed face-to-face, whereas in 2006 they completed the interview online. In both surveys, interviews were preceded by paper questionnaires covering child and family characteristics. Results: The rate of parents logging onto the web site was comparable to the response rate for face-to-face interviews, but the rate of full response (completing all sections of the interview) was much lower for web-based interviews. Full response was less frequent for non-traditional families, immigrant parents, and less educated parents. Participation bias affected point estimates of psychopathology but had little effect on associations with putative risk factors. The time and cost of full web-based interviews was only a quarter of that for face-to-face interviews. Conclusions: Web-based surveys may be performed faster and at lower cost than more traditional approaches with personal interviews. Selective participation seems a particular threat to point estimates of psychopathology, while patterns of associations are more robust. © 2009 Springer-Verlag.


Skirbekk B.,Center for Child and Adolescent Mental Health | Hansen B.H.,Center for Child and Adolescent Mental Health | Hansen B.H.,Akershus University Hospital | Oerbeck B.,Center for Child and Adolescent Mental Health | And 2 more authors.
Journal of Abnormal Child Psychology | Year: 2011

The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7-13 years were assigned to four groups, i.e., referred children with comorbid AnxDs and ADHD (n=25), ADHD (n=39), AnxDs (n=41), and nonreferred controls (n=36). Furthermore we explored the association between SCT and several neurocognitive measures (reaction time, verbal memory, and spatial memory). Diagnoses were established using Kiddie-SADS P/L. SCT was assessed using a 17-item mother-reported questionnaire. SCT correlated significantly with inattentiveness, regardless of the subtype of ADHD. Furthermore, we found significant differences in the levels of SCT among the four groups, with the highest SCT scores observed in the comorbid group. SCT correlated with variability in spatial memory; in contrast, there was no correlation between SCT and reaction time. © 2011 Springer Science+Business Media, LLC.


Posserud M.,Center for Child and Adolescent Mental Health | Lundervold A.J.,University of Bergen | Lie S.A.,Center for Child and Adolescent Mental Health | Gillberg C.,Gothenburg University
Social Psychiatry and Psychiatric Epidemiology | Year: 2010

Background A large part of the variability in rates of autism spectrum disorders (ASD) across studies is nonaetiologic,and can be explained by differences in diagnostic criteria, case-finding method, and other issues of study design. Aim To investigate the effects on ASD prevalence of two methodological issues; non-response bias and case ascertainment.We compared the findings of using a semi-structured parent interview versus in-depth clinical assessment, including an ASD specific interview. We further explored whether including information on non-responders affected the ASD prevalence estimate. Method A total population of 7- to 9-year olds (N = 9,430) was screened for ASD with the autism spectrum screening questionnaire (ASSQ) in the Bergen Child Study (BCS). Children scoring above the 98th percentile on parent and/or teacher ASSQ were invited to participate in the second and subsequently in the third phase of the BCS where they were assessed for ASD using the Development and Well-Being Assessment (DAWBA), and the Diagnostic Interview for Social and Communication disorders (DISCO), respectively. Results Clinical assessment using DISCO confirmed all DAWBA ASD cases, but also diagnosed additional cases. DISCO-generated minimum prevalence for ASD was 0.21%, whereas estimated prevalence was 0.72%, increasing to 0.87% when adjusting for non-responders. The DAWBA estimate for the same population was 0.44%. Conclusion Large variances in prevalence rates across studies can be explained by methodological differences. Both information about assessment method and nonresponse are crucial when interpreting prevalence rates of ASD. © Springer-Verlag 2009.


Eide K.,Center for Child and Adolescent Mental Health | Eide K.,Telemark University College | Hjern A.,Karolinska Institutet
Acta Paediatrica, International Journal of Paediatrics | Year: 2013

The numbers of refugee adolescents that arrive in Europe without their families has increased in recent years, particularly in Sweden. Research has demonstrated that these children have high rates of mental health problems, particularly depression and post-traumatic stress disorder, during the first years after resettlement. Despite this, there are also indications that many of these unaccompanied children are resourceful and arrive with a clear vision of a positive future in the new country. Follow-up studies in the United States and Norway have indicated fairly good social outcomes in the long term. Conclusion The education and care that unaccompanied minors receive during the first years after resettlement, together with their own drive to create a positive future, are key factors in their mental health and long-term adjustment. © 2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.


Gere M.K.,Center for Child and Adolescent Mental Health | Villabo M.A.,Center for Child and Adolescent Mental Health | Torgersen S.,Center for Child and Adolescent Mental Health | Kendall P.C.,Temple University
Journal of Anxiety Disorders | Year: 2012

The relationship between overprotective parenting and child anxiety has been examined repeatedly because theories emphasize its role in the maintenance of child anxiety. No study has yet tested whether this relationship is unique to child anxiety, by controlling for commonly co-occurring behavior problems within the same children. The current study examined 190 children (age 7-13, 89 boys) referred to mental health clinics and their parents. Results revealed that significant correlations between overprotective parenting and child anxiety symptoms disappear after controlling for co-occurring child behavior symptoms. It appears that overprotection is not uniquely related to child anxiety. Furthermore, overprotective parenting was significantly and uniquely related to child behavior symptoms. Researchers and practitioners need to consider co-occurring child behavior problems when working with the parents of anxious children. © 2012 Elsevier Ltd.

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