Faculty Bibliography

This investigation sought to establish if anger is associated with PTSD among children and adolescents or with trauma exposure in the absence of PTSD. The State-Trait Anger Expression Inventory (STAXI) was administered to youth with PTSD (n=24), traumatized youth without PTSD (n=58), and a non-traumatized control group (n=38). In the absence of potentially confounding major comorbid disorders, the PTSD group had significantly higher scores on the STAXI State, Trait, and Angry Temperament scales. Trauma exposure in the absence of PTSD was not associated with higher anger scores.

Reviews the book, Child and Adolescent Psychiatry, Second Edition. (Blackwell's Neurology and Psychiatry Access Series) by S. B. Sexson (Ed.) (2005). This edited book focuses on its many tables which are organized into four different formats that have already proved useful in other books in the Blackwell Access Series. 'Pearls and Perils' are especially welcome additions topics and very amenable to the table format. 'Monitor and deal with negative reactions to minimize impact on patient care' is one common peril; the authors' wording may be more palatable to the non-psychiatrist than the more commonly seen 'countertransference', which might be too easily dismissed as obscure. This volume seems optimally suited for a paediatrics or family-practice readership; it may find a home with students taking child and adolescent psychiatry electives, or with general psychiatry residents covering their child requirements. Among child and adolescent psychiatrists, it may prove useful as an organizing axis from which to develop lecture materials.

This study examines the relationship between child play-narratives and family drawings by children of violence-exposed mothers with posttraumatic stress disorder (PTSD). The Family Attachment Drawing Task (FAD-T) and MacArthur Story Stem Battery (MSSB) were administered. Of the 23 children (ages 4-7 years), 16 (70%) created drawings that were coded as being representative of insecure attachment. Attachment insecurity and disorganization of child-caregiver attachment on the FAD-T were significantly associated with trauma-related dimensions of the MSSB, but not to other factors. This study suggests that the FAD-T provides access to child mental representations, which may affect intergenerational transmission of violent trauma.

We (Fox et al., 2005) recently described a gene-by- environment interaction involving child temperament and maternal social support, finding heightened behavioral inhibition in children homozygous or heterozygous for the serotonin transporter (5HTTLPR) gene short allele whose mothers reported low social support. Here, we propose a model, Plasticity for Affective Neurocircuitry, that describes the manner in which genetic disposition and environmental circumstances may interact. Children with a persistently fearful temperament (and the 5HTTLPR short allele) are more likely to experience caregiving environments in which threat is highlighted. This in turn will exacerbate an attention bias that alters critical affective neurocircuitry to threat and enhances and maintains anxious behavior in the child.

OBJECTIVE: The Diagnostic and Statistical Manual, Fourth Edition (DSM-IV, 1994) included atypical features as an illness specifier for major depression and dysthymia. We asked whether subsequent literature supported its validity and addressed the relationship between depression with atypical features and melancholia. METHOD: Literature review focusing on studies addressing the validity of atypical depression, supplemented by the authors' previously unpublished data. RESULTS: Most studies support the discriminant validity of depression with atypical features relative to melancholia and depression having neither melancholic nor atypical features. However, studies addressing illness course suggest that criteria for depression with atypical features define a heterogeneous patient population. CONCLUSION: DSM-IV criteria for depression with atypical features define a valid, but heterogeneous disorder. Criteria including age of onset and chronicity may define a more homogeneous group that is distinct from both melancholia and other depressed patients.

Two curricula designed to enhance the early literacy skills of 4-year-old preschool children were evaluated against a third, comparison condition. Thirty-five Head Start preschool classrooms were assigned randomly to incorporate one of two early literacy curricular approaches, Let's Begin with the Letter People (R) or Waterford Early Reading Program (R) Level 1, into their current curriculum, the High/ Scope (R) Educational Approach, or to use the High/Scope method alone. Results indicated that children in the literacy intervention classrooms demonstrated significantly stronger outcomes in the areas of emergent writing, book and print knowledge, and general reading readiness skills. Minority language status also played a significant role in outcome, regardless of intervention condition. Implications for early childhood literacy interventions, especially important for children of low-income families, are discussed.

There are limited data on the neurocognitive correlates of childhood anxiety disorders. The objective of this study was to examine whether visual and verbal memory deficits of nonemotional stimuli are (1) a shared feature of three common childhood anxiety disorders (social phobia, separation anxiety disorder, and generalized anxiety disorder) or whether these deficits are restricted to specific anxiety disorders, and (2) present in offspring who possess at least one of the following established risk factors for anxiety disorders, parental history of panic disorder (PD), or major depressive disorder (MDD). One hundred and sixty offspring, ages 9-20 years, were recruited from parents with lifetime diagnoses of PD, MDD, PD plus MDD, or neither illness. Different clinicians blindly administered semistructured diagnostic interviews to offspring and parents. Verbal and visual memory subtests of the Wide Range Assessment of Memory and Learning were administered to offspring. The results showed that offspring with ongoing social phobia demonstrated reduced visual but not verbal memory scores compared to those without social phobia when controlling for offspring IQ, separation anxiety disorder, and generalized anxiety disorder. No other offspring anxiety disorder predicted memory performance. Neither parental PD nor parental MDD was associated with offspring memory performance. These findings are relevant to understanding the phenomenology of childhood anxiety disorders and may provide insights into the neural circuits underlying these disorders