This is an extra large issue containing 20 articles and a lot of interesting information. The increasing number of high quality articles that are submitted to The Journal of Child Psychology and Psychiatry has resulted in a long line of accepted articles waiting to be published. To bring back the interval between acceptance of an article and the actual appearance in print to the 6 months that we have always aimed for, we have decided to publish a number of bumper issues, beginning with this one. Possibly because of the increasing demands of academic institutions on researchers to publish, there has been a steady rise in submitted articles over the last few years. Editors can deal with such increases in a number of ways including increasing the rejection rate, increasing the number of journal pages, increasing the number of issues per year, and reducing the length of articles. Each decision has to be weighed against the aims of The Journal to publish high quality articles that are interesting for both researchers and clinicians for a reasonable price and to serve as an outlet for the best researchers and clinicians in the field of child psychology and psychiatry. Because the increase in submitted papers is not incidental but seems to reflect a structural change, and because we do not want to increase our rejection rate further, we have decided, as from January this year, to put a limit to the number of words for each article, namely 6000. This number of words is thought to be sufficient for most regular articles. Of course, it remains possible for the editor to occasionally decide to accept articles that contain more words. This, however, will be the exception rather than the rule.
In the annotation in the present issue, Asarnow, Tompson and McGrath review the clinical and treatment literature on childhood schizophrenia. Although many clinicians tend to have little or no lifetime experience with childhood-onset schizophrenia, the literature provides evidence that this syndrome can be reliably diagnosed and that it is predictive of schizophrenia or schizophrenia spectrum disorders in adulthood. This annotation shows that advances have been made in knowledge regarding pharmacological treatment strategies and practice parameters have been developed to guide clinical care.
For clinicians as well as for researchers it is important to know what the prognosis of childhood conditions is. Long term follow-ups of children with psychiatric disorders are both valuable and rare. The follow-up of hyperactive children into young-adulthood by Barkley, Fischer, Smallish and Fletcher showed that, at least in clinically referred children, hyperactivity contributes to a substantially greater risk for young adult antisocial activity and drug use. These risks are directly related to the severity of the childhood disorder and to its persistence into young adulthood. Also, for autistic individuals, the adult outcome is poor. Howlin, Goode, Hutton and Rutter followed-up 68 individuals with autism and a performance IQ of 50 or above across a mean interval of 22 years. Most autistic individuals in their adulthood remained very dependent on their families or other support services. Of course, it would be highly relevant to know whether increased availability and quality of mental health services and educational facilities improve these disappointingly poor long-term outcomes of hyperactive and autistic children across the last decades. Smith and Farrington, in this issue, studied a particular type of continuity of child and adolescent psychopathology, namely the continuity in antisocial behaviors and parenting across three generations. The authors concluded that the between-generations continuity of antisocial behaviours was only partly mediated by parenting. As often with results from aetiologic research, the implications are especially relevant for prevention and less so for the treatment of those who currently come under clinical attention. It is therefore relevant to realise that many children are resilient to extended antisocial commitments and behaviours. Avenues to promote such resilience may include improving problem-solving and parenting skills among couples at risk for conflicted and authoritarian parenting.
Two articles pertain to methodological issues: disagreement between parent and adolescent self-reports, and the use of retrospective reports. It is well known that different informants tend to disagree about the presence of behavioural and emotional problems. Less is known about agreement and disagreement between informants about functional impairment. The study by Kramer and colleagues looked at disagreement between parent and adolescent reports of functional impairment. The authors found that parents and adolescents are more likely to agree about the public consequences of poor functioning than they are to agree about specific problems adolescents have in their roles in the home, school or community. When using retrospective reports, the question that arises is that of the validity of such reports. It is therefore interesting that Hardt and Rutter refine the preconceived and often heard notion that such reports are less valid. The authors systematically reviewed the evidence for the validity of adult retrospective reports of adverse childhood experiences. They come to the conclusion that, if well performed, retrospective reports can have some validity. Non-reports of childhood adversities such as sexual or physical abuse, neglect or family discord are definitively common, while false positive reports are probably quite rare.
Four interesting articles have to do with children who show attention problems and hyperactivity. Sonuga-Barke, de Houwer, de Ruiter, Ajzenstzen and Holland tested the delay-aversion paradigm in their study of the selective attention of children with AD/HD to briefly exposed delay-related cues. The results supported theories that highlight the motivational significance of delay in AD/HD. Van Goozen, Cohen-Kettenis, Snoek, Matthys, Swaab-Barneveld and van Engeland tested the hypothesis that oppositional-defiant disorder children with or without AD/HD have problems in executive functioning. Their results did not support this hypothesis. The results rather emphasised that these children have problems in regulating their behaviour under motivational inhibitory conditions. The third study, by Mehta, Goodyer and Sahakian, is a double blind, placebo-controlled study of the cognitive effects of methylphenidate in boys with AD/HD. The results showed that methylphenidate may selectively improve cognitive difficulties and clinical symptoms. In another study, de Groot, de Sonneville, Stins and Boomsma determined the genetic and environmental contributions to neuropsychological test performance in a sample of twins from the general population. A remarkable finding was that the heritability of neuropsychological test measures that could be considered to be more direct measures of attention was much smaller than the heritability of the attention scale of the Teacher's Report Form.
Language development is a topic that appears in nearly every issue of this Journal. This time three articles refer to language. Viding, Spinath, Price, Bishop, Dale and Plomin studied the role of genetic and environmental factors in the aetiology of language impairment in 4-year-old twins who were selected from a representative community sample. The findings showed that language impairment is heritable, with greater heritability for more severe language impairment. Laws and Gunn studied language and memory progress in individuals with Down syndrome across a 5-year period. Although receptive vocabularies of children with Down syndrome continued to grow into young adulthood, the acquisition of grammar comprehension slowed markedly with chronological age and phonological memory actually declined from the age of 14 years. Hatcher, Hulme and Snowling evaluated the effectiveness of programmes for the teaching of reading to 4-year-old children. This study answers an important theoretical question about reading and phonological awareness in the context of teachers working with whole classes of 4.5-year-olds at school entry. It was found that training in phonological awareness did not boost the reading skills of normally developing children but it did have a beneficial effect on children identified as being at risk of reading failure. The implications are that it is possible to identify at risk children and to help them to acquire literacy. Theoretically, the study also provides further evidence for the importance of phonemic skills, rather than rhyme skills at the early stage of learning to read.
Is depression of the mother prenatally or during the first year of the infant's life related to failure to thrive? Drewett, Blair, Emmett, Emond and the ALSPAC study team studying a whole population birth cohort in Bristol concluded that this was not the case. Using the Edinburgh Postnatal Depression Scale they did not find an association between this scale completed by mothers in pregnancy and the postnatal period and weight measurements of the infant when the infant was born at term. When the infant was born preterm depression was more common in the mothers and failure to thrive was more common in infants. However, there was no association between the two. These results show that although both conditions are common and important in their own right, post-natal depression and failure to thrive are independent problems.
Another environmental influence that is suggestive of posing an increased risk for maladjustment in young children is group day-care. Conflicting research findings make it difficult for clinicians to advise on the most appropriate form of care for young children. The findings from Borge, Rutter, Côté and Tremblay's study of 2- and 3-year-olds in Canada involved three important implications for how such decision-making on care needs to be approached. First, they found major differences between families who chose to use group day care facilities and those who did not: accordingly clinicians need to consider whether any apparent effects of early experiences derive from the experiences as such or of the characteristics of the families who select such experiences. Second, although for most children the rates of physical aggression in the two groups did not differ, in families at high-risk the rate of aggression was higher in those receiving family care. The implication is that the meaning for the child of care at home is likely to vary according to the qualities of the family. Third, there is the implication (still requiring adequate testing) that, in some high-risk circumstances, good quality care outside the home may be protective.
Two articles are related to the role of parents. The study by Marmorstein and Iacono extends our knowledge of the complex relationship between parental psychopathology, family relationships, and child psychopathology. The findings of this study indicate that clinicians working with both depressed and conduct-disordered youth should be aware of the increased risk for depression in the mothers and antisocial behaviors in the fathers of these families. In addition, the frequently noted association between child psychopathology and mother-child conflict appears to be related to the presence of maternal depression; for this reason, considering parental psychopathology is crucial when attempting to understand the families of youth with psychopathology. Wilson and Donenberg investigated the relationship between the quality of parent-teen communication about sex and sexual risk taking. The authors found that how parents talk to their adolescents about sex is more important in terms of reducing risky sexual behaviour than how frequently they bring up such topics.
A well-known epidemiological finding is that only a minority of children and adolescents in the general population with a psychiatric disorder actually receive professional help for their problems. Understanding which factors play a role in the help-seeking process may lead to an improvement in the provision of health care to those children and adolescents who need it the most. Sears studied the role of demographic characteristics, use of informal helpers and markers of emotional and behavioural maladjustment of a community sample of adolescents in various stages of the help-seeking process. Because many of the factors that influence the probability of receiving help may also affect the effectiveness of interventions, it is important that clinicians evaluate the characteristics and circumstances of adolescents who present for assistance in addition to their emotional and behavioural problems. Another study using a community sample of adolescents is the one by Vermeiren, Bogaerts, Ruchkin, Deboutte and Schwab-Stone who showed that subtypes of self-esteem and self-concept were differentially associated with offending. Both low family acceptance and low academic competence predicted property and violent offending, while high peer popularity predicted mainly violent offending.
An interesting question is whether the siblings of individuals with Asperger syndrome demonstrate similar difficulties in social relationships as their brother or sister, albeit to a lesser extent. Dorris, Espie, Knott and Salt studied theory of mind abilities in siblings of children with Asperger syndrome relative to a matched control group. The finding that a proportion of the siblings of children with Asperger syndrome may also have subtle difficulties in social cognition raises the question whether intervention should be family based. The notion of having a double handicap in both genetic liability towards impairment in social cognition, and the longitudinal impact of having family members, whose interactions may not be optimally attuned towards developing social skills, raises interesting questions. These include the optimal form and timing of interventions, and clinicians’ awareness of a potential continuum of vulnerability in family groups.