RESUMO
PURPOSE: We investigated whether chronic traffic-generated air pollution containing fine and ultrafine particulate matter is associated with reduced neurobehavioral performance and behavioral dysfunction in urban Ecuadorian schoolchildren. Also, we examined the effect of child hemoglobin and sociodemographic risk factors on these neurocognitive outcomes. METHODS: A convenience sample of healthy children aged 8-14 years attending public schools were recruited in Quito, Ecuador. Child residential proximity to the nearest heavily trafficked road was used as a proxy for traffic-related pollutant exposure. These included high exposure (<100 m), medium exposure (100-199 m) and low exposure (≥ 200 m) from the nearest heavily trafficked road. The Behavioral Assessment and Research System (BARS), a computerized test battery assessing attention, memory, learning and motor function was used to evaluate child neurobehavioral performance. The Child Behavior Checklist (CBCL/6-18) was used to assess child behavioral dysfunction as reported by mothers. The data were analyzed using multiple linear regression. RESULTS: Children with the highest residential exposure to traffic pollutants (< 100 m) had significantly longer latencies as measured by match to sample (b = 410.27; p = 0.01) and continuous performance (b = 37.90; p = 0.02) compared to those living ≥ 200 m away. A similar but non-significant association was observed for reaction time latency. Children living within 100 m of heavy traffic also demonstrated higher scores across all CBCL subscales although only the relationship with thought problems (p = 0.05) was statistically significant in the adjusted model. CONCLUSION: The study findings suggest that children living within 100 m of heavy traffic appear to experience subtle neurobehavioral deficits that may result from fine and ultrafine particulate matter exposure.
Assuntos
Comportamento do Adolescente/efeitos dos fármacos , Desenvolvimento do Adolescente/efeitos dos fármacos , Transtornos do Comportamento Infantil/induzido quimicamente , Comportamento Infantil/efeitos dos fármacos , Desenvolvimento Infantil/efeitos dos fármacos , Exposição Ambiental/efeitos adversos , Sistema Nervoso/efeitos dos fármacos , Material Particulado/efeitos adversos , Poluição Relacionada com o Tráfego/efeitos adversos , Saúde da População Urbana , Emissões de Veículos , Adolescente , Fatores Etários , Atenção/efeitos dos fármacos , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Estudos Transversais , Equador , Feminino , Humanos , Masculino , Memória/efeitos dos fármacos , Atividade Motora/efeitos dos fármacos , Sistema Nervoso/crescimento & desenvolvimento , Características de Residência , Medição de Risco , Fatores de RiscoRESUMO
OBJECTIVE: The aims of this study were (1) to assess obsessive-compulsive symptoms (OCS) dimensionally in a school-aged community sample and to correlate them with clinical and demographical variables; (2) to determine a subgroup with significant OCS ("at-risk for OCD") using the Child Behavior Checklist (CBCL-OCS) and (3) to compare it with the rest of the sample; (4) To review the CBCL-OCS subscale properties as a screening tool for pediatric OCD. METHODS: Data from the Brazilian High Risk Cohort were analyzed. The presence and severity of OCS were assessed through the CBCL-OCS subscale. DSM-IV psychiatric diagnoses were obtained by the Developmental and Well-Being Assessment. Behavioral problems were assessed using the Strengths and Difficulties Questionnaire, the Youth Strengths Inventory, and the CBCL internalizing and externalizing behavior subscales. RESULTS: A total of 2512 (mean age: 8.86 ± 1.84 years; 55.0% male) children were included. Moderate correlations were found between OCS severity and functional impairment (r = 0.36, p < 0.001). Children with higher levels of OCS had higher rates of psychiatric comorbidity and behavioral problems (p < 0.001). A score of 5 or higher in the CBCL-OCS scale determined an "at-risk for OCD" subgroup, comprising 9.7% of the sample (n = 244), with behavioral patterns and psychiatric comorbidities (e.g., tics [odds ratios, OR = 6.41, p < 0.001]), anxiety disorders grouped [OR = 3.68, p < 0.001] and depressive disorders [OR = 3.0, p < 0.001] very similar to those described in OCD. Sensitivity, specificity, positive predictive value, and negative predictive value of the CBCL-OCS for OCD diagnosis were, respectively, 48%, 91.5%; 15.1%, and 98.2%. CONCLUSIONS: The dimensional approach suggests that the presence of OCS in children is associated with higher rates of comorbidity, behavioral problems, and impairment. The "at-risk for OCD" group defined by the CBCL revealed a group of patients phenotypically similar to full blown OCD.
Assuntos
Lista de Checagem/estatística & dados numéricos , Transtornos do Comportamento Infantil/fisiopatologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Comportamento Problema/psicologia , Transtornos de Ansiedade/diagnóstico , Brasil , Criança , Transtornos do Comportamento Infantil/epidemiologia , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricosAssuntos
Humanos , Masculino , Feminino , Criança , Psiquiatria Infantil , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/fisiopatologia , Transtorno da Personalidade Antissocial , Epidemiologia Descritiva , Estudos Retrospectivos , UruguaiRESUMO
This study evaluated the associations among symptoms of attention-deficit/hyperactivity disorder (ADHD) and of oppositional defiant disorder (ODD) in children and adolescents' performance in household tasks and assistance provided by caregivers. Parents of children from 6 to 14 years old with ADHD (n = 67) were interviewed with the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES) instrument. Significant correlations were found between symptoms of ODD and assistance in self-care tasks (r = -0.31; p = 0.01); symptoms of hyperactivity correlated with assistance in self-care (r = -0.30, p = 0.01); and family-care (r = -0.25, p = 0.04) tasks. Age was directly associated with the number of tasks performed by children and inversely related to the assistance provided by caregivers. A greater number of ODD symptoms resulted in more household assistance from caregivers. Characteristics of ODD symptoms, such as disobedience and hostility in the face of authority, may limit these children in accessing household tasks by their own initiative, requiring assistance from caregivers.
Assuntos
Atividades Cotidianas/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos do Comportamento Infantil/psicologia , Análise e Desempenho de Tarefas , Adolescente , Adulto , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Brasil , Cuidadores , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Cuidado da Criança , Estudos Transversais , Feminino , Zeladoria , Humanos , Testes de Inteligência , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
ABSTRACT This study evaluated the associations among symptoms of attention-deficit/hyperactivity disorder (ADHD) and of oppositional defiant disorder (ODD) in children and adolescents’ performance in household tasks and assistance provided by caregivers. Parents of children from 6 to 14 years old with ADHD (n = 67) were interviewed with the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES) instrument. Significant correlations were found between symptoms of ODD and assistance in self-care tasks (r = −0.31; p = 0.01); symptoms of hyperactivity correlated with assistance in self-care (r = −0.30, p = 0.01); and family-care (r = −0.25, p = 0.04) tasks. Age was directly associated with the number of tasks performed by children and inversely related to the assistance provided by caregivers. A greater number of ODD symptoms resulted in more household assistance from caregivers. Characteristics of ODD symptoms, such as disobedience and hostility in the face of authority, may limit these children in accessing household tasks by their own initiative, requiring assistance from caregivers.
RESUMO Este estudo avaliou transversalmente a correlação entre sintomas de transtorno de déficit de atenção e hiperatividade (TDAH) e de oposição com desempenho de crianças e adolescentes nas tarefas domésticas e assistência disponibilizada pelos cuidadores. Pais de crianças e adolescentes com TDAH (n = 67), de 6 a 14 anos, foram entrevistados com o children helping out: responsibilities, expectations and supports (CHORES). Foram encontradas correlações significativas entre sintomas de oposição e assistência em cuidado próprio (r = -0,31; p = 0,01) e de hiperatividade com assistência em cuidado próprio (r = -0,30, p = 0,01) e em cuidado familiar (r = -0,25, p = 0,04). Idade está diretamente correlacionada ao número de tarefas desempenhadas pela criança e inversamente associada à assistência disponibilizada pelos cuidadores. Maior número de sintomas de oposição resultou em maior assistência disponibilizada. Características dos sintomas de oposição, como a desobediência e hostilidade frente às autoridades, são limitantes para que essas crianças acessem as tarefas por iniciativa própria, demandando maior assistência dos cuidadores.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Análise e Desempenho de Tarefas , Atividades Cotidianas/psicologia , Transtornos do Comportamento Infantil/psicologia , Relações Pais-Filho , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Fatores Socioeconômicos , Brasil , Transtornos do Comportamento Infantil/fisiopatologia , Cuidado da Criança , Estudos Transversais , Inquéritos e Questionários , Fatores Etários , Cuidadores , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Zeladoria , Testes de InteligênciaRESUMO
Abstract Objective: To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health. Sources: A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child. Summary of the findings: With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a ‘school readiness’ checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential. Conclusions: The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.
Resumo Objetivo: Revisar a epidemiologia e atualizar os conhecimentos científicos sobre os problemas do desenvolvimento e do comportamento na infância e das recomendações do papel do pediatra na identificação e conduta frente aos transtornos da saúde mental infantil. Fontes de dados: Pesquisamos a literatura relevante nas bases de dados PubMed e Scopus e em publicações do National Scientific Council on the Developing Child. Síntese dos dados: Com o declínio na incidência de doenças transmissíveis em crianças, problemas do desenvolvimento, comportamento e regulação emocional fazem cada vez mais parte do trabalho do pediatra, mas muitos ainda não estão treinados e se sentem desconfortáveis com essa extensão do seu papel. Os instrumentos de triagem do desenvolvimento e comportamento foram revisados e uma lista de verificação da “prontidão escolar” foi apresentada, juntamente com orientações sobre como o pediatra pode incorporar a vigilância da saúde mental em sua de rotina de atendimento, consciente da necessidade da aquisição das habilidades sociais, emocionais e cognitivas para que a criança possa desenvolver toda sua potencialidade. Conclusões: O papel do pediatra no futuro irá abranger tanto a saúde física quanto a mental e reconhecer que o desenvolvimento social, a resiliência e o amadurecimento emocional são tão importantes quanto o crescimento físico e as habilidades neuromotoras no curso da vida de uma criança.
Assuntos
Humanos , Criança , Papel do Médico , Transtornos do Comportamento Infantil/diagnóstico , Deficiências do Desenvolvimento/diagnóstico , Transtornos Motores/diagnóstico , Transtornos Mentais/diagnóstico , Brasil , Transtornos do Comportamento Infantil/fisiopatologia , Desenvolvimento Infantil/fisiologia , Deficiências do Desenvolvimento/fisiopatologia , Programas de Rastreamento/métodos , Saúde Mental , Transtornos Motores/fisiopatologia , Transtornos Mentais/fisiopatologia , Destreza Motora/fisiologiaRESUMO
OBJECTIVE: To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health. SOURCES: A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child. SUMMARY OF THE FINDINGS: With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a 'school readiness' checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential. CONCLUSIONS: The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.
Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Deficiências do Desenvolvimento/diagnóstico , Transtornos Mentais/diagnóstico , Transtornos Motores/diagnóstico , Papel do Médico , Brasil , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Desenvolvimento Infantil/fisiologia , Deficiências do Desenvolvimento/fisiopatologia , Humanos , Programas de Rastreamento/métodos , Transtornos Mentais/fisiopatologia , Saúde Mental , Transtornos Motores/fisiopatologia , Destreza Motora/fisiologiaRESUMO
Objective: Fluid intelligence and the behavioral problems of attention-deficit/hyperactivity disorder (ADHD) are related to academic performance, but how this association occurs is unclear. This study aimed to assess mediation and moderation models that test possible pathways of influence between these factors. Methods: Sixty-two children with ADHD and 33 age-matched, typically developing students were evaluated with Raven's Colored Progressive Matrices and the spelling and arithmetic subtests of the Brazilian School Achievement Test. Dimensional ADHD symptomatology was reported by parents. Results: Our findings suggest that fluid intelligence has a significant impact on academic tests through inattention. The inattentive dimension was the principal behavioral source of influence, also accounting for the association of hyperactive-impulsive manifestations with school achievement. This cognitive-to-behavioral influence path seems to be independent of diagnosis related group, and gender, but lower socioeconomic status might increase its strength. Conclusion: Fluid intelligence is a relevant factor in the influence of ADHD behavioral symptoms on academic performance, but its impact is indirect. Therefore, early identification of both fluid intelligence and inattentive symptoms is of the utmost importance to prevent impaired academic performance and future difficulties in functioning. .
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos do Comportamento Infantil/fisiopatologia , Cognição/fisiologia , Inteligência/fisiologia , Modelos Psicológicos , Estudantes/psicologia , Comportamento/fisiologia , Brasil , Transtornos Cognitivos/fisiopatologia , Testes de Inteligência , Fatores SocioeconômicosRESUMO
The amygdala is related with the recognition of the emotional meaning of stimuli, long-term memory, the orientation of social stimuli and the perception of gaze orientation. It plays a fundamental role in the recognition of faces, especially those expressing fear, and makes it possible to comprehend different emotional states, which will facilitate an appropriate social cognition. Dysfunctions of the amygdala have been associated to a number of different neurodevelopmental disorders as well as neurocognitive and behavioural disorders in specific neurogenetic entities. A number of studies focused on the amygdalic complex have allowed researchers to understand many pathophysiological aspects and to formulate new hypotheses regarding their origins. Given that the disorders or conditions in which the role of the amygdala has been evoked are becoming increasingly more extensive, this article refers the reader to those that have aroused the most interest in recent years. Thus, they can be divided into two groups: developmental and behavioural disorders (autism, anxiety disorders, bipolar disorder, alexithymia and anorexia nervosa) and specific neurogenetic entities (fragile X, Rett, Prader-Willi and Williams syndromes), in which structural or dysfunctional alterations have been observed that may be related with their neurocognitive and behavioural symptoms. It is important to remember that the amygdala is a highly connected structure that forms truly functional networks and has been associated to different disorders with varied explanations and includes several different pathophysiological phenomena. Its role must not, therefore, be simplified in a reductionistic manner, but also placed upon a hierarchy of dysfunctions in other areas that interact with it.
TITLE: La amigdala y su relacion con el autismo, los trastornos conductuales y otros trastornos del neurodesarrollo.La amigdala esta relacionada con el reconocimiento del significado afectivo del estimulo, la memoria a largo plazo, la orientacion del estimulo social y la percepcion de orientacion de la mirada. Desempeña un papel fundamental en el reconocimiento de caras, en especial la de temor, y permite la comprension de diversos estados emocionales, los cuales facilitaran una adecuada cognicion social. Disfunciones de la amigdala se han relacionado con diversos trastornos del neurodesarrollo y con alteraciones neurocognitivas y conductuales en entidades neurogeneticas especificas. Multiples estudios focalizados en el complejo amigdalino han permitido comprender muchos aspectos fisiopatologicos y formular nuevas hipotesis en relacion con su genesis. Dado que los trastornos o entidades en que se ha evocado el papel de la amigdala son cada vez mas extensos, este articulo remite a aquellos que han despertado mayor interes en los ultimos años, dividiendolos en dos grupos: trastornos del desarrollo y conductuales (autismo, trastornos de ansiedad, trastorno bipolar, alexitimia y anorexia nerviosa), y entidades neurogeneticas especificas (sindromes del cromosoma X fragil, Rett, Prader-Willi y Williams), en las cuales se han comprobado alteraciones estructurales o disfunciones que pueden relacionarse con la sintomatologia neurocognitiva y conductual de estas. Es importante recordar que la amigdala es una estructura altamente conectada que conforma verdaderas redes funcionales, se ha asociado a diversos trastornos cuya explicacion es variada e incluye diversos fenomenos fisiopatologicos, por lo que no debe simplificarse de una forma reduccionista su papel, sino tambien jerarquizar disfunciones de otras areas que interactuan con ella.
Assuntos
Tonsila do Cerebelo/fisiopatologia , Doenças Genéticas Inatas/fisiopatologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Sintomas Afetivos/fisiopatologia , Tonsila do Cerebelo/patologia , Anorexia Nervosa/genética , Anorexia Nervosa/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Apetite/fisiologia , Transtorno do Espectro Autista/fisiopatologia , Transtorno Bipolar/fisiopatologia , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Pré-Escolar , Empatia/fisiologia , Medo/fisiologia , Feminino , Síndrome do Cromossomo X Frágil/genética , Síndrome do Cromossomo X Frágil/fisiopatologia , Doenças Genéticas Inatas/genética , Humanos , Lactente , Masculino , Fenótipo , Transtornos Fóbicos/fisiopatologia , Síndrome de Prader-Willi/genética , Síndrome de Prader-Willi/fisiopatologia , Síndrome de Rett/genética , Síndrome de Rett/fisiopatologia , Síndrome de Williams/genética , Síndrome de Williams/fisiopatologiaRESUMO
OBJECTIVE: Fluid intelligence and the behavioral problems of attention-deficit/hyperactivity disorder (ADHD) are related to academic performance, but how this association occurs is unclear. This study aimed to assess mediation and moderation models that test possible pathways of influence between these factors. METHODS: Sixty-two children with ADHD and 33 age-matched, typically developing students were evaluated with Raven's Colored Progressive Matrices and the spelling and arithmetic subtests of the Brazilian School Achievement Test. Dimensional ADHD symptomatology was reported by parents. RESULTS: Our findings suggest that fluid intelligence has a significant impact on academic tests through inattention. The inattentive dimension was the principal behavioral source of influence, also accounting for the association of hyperactive-impulsive manifestations with school achievement. This cognitive-to-behavioral influence path seems to be independent of diagnosis related group, and gender, but lower socioeconomic status might increase its strength. CONCLUSION: Fluid intelligence is a relevant factor in the influence of ADHD behavioral symptoms on academic performance, but its impact is indirect. Therefore, early identification of both fluid intelligence and inattentive symptoms is of the utmost importance to prevent impaired academic performance and future difficulties in functioning.