Characteristics of an infant/preschool psychiatric clinic sample: Implications for clinical assessment and nosology

Luby, Joan L.; Morgan, Kàren

doi:10.1002/(sici)1097-0355(199722)18:2<209::aid-imhj9>3.0.co;2-j

Cited by 32 publications

(13 citation statements)

References 27 publications

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“…Based on estimates of prevalence and reports of referral in clinical settings, depression in preschool children appears to be a clinically under-recognized disorder (4, 12, 13). As preschool depression is not inherently disruptive, and preschoolers are less likely to spontaneously report their internalized distress than older children, these early onset depressive symptoms often go undetected by caregivers.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression

Luby¹,

Gaffrey²,

Tillman³

et al. 2014

AJP

Self Cite

189

132

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Background Preschool-onset depression, a developmentally adapted form of depression arising between the ages of 3–6, has demonstrated numerous features of validity including characteristic alterations in stress reactivity and brain function. Notably, this validated syndrome with multiple clinical markers is characterized by sub-threshold DSM Major Depressive Disorder criteria, raising questions about its clinical significance. To clarify the utility and public health significance of the preschool-onset depression construct, diagnostic outcomes of this group at school age and adolescence were investigated. Methods We investigated the likelihood of meeting full DSM Major Depressive Disorder criteria in later childhood (i.e., ≥ age 6) as a function of preschool depression, other preschool Axis I disorders, maternal depression, parenting non-support and traumatic life events in a longitudinal prospective study of preschool children. Results Preschool-onset depression emerged as a robust predictor of DSM-5 Major Depressive Disorder in later childhood even after accounting for the effect of maternal depression and other risk factors. Preschool-onset conduct disorder also predicted DSM-5 Major Depressive Disorder in later childhood, but this association was partially mediated by maternal non-support, reducing the effect of preschool conduct disorder in predicting DSM depression by 21%. Discussion Study findings provide evidence that this preschool depressive syndrome is a robust risk factor for meeting full DSM criteria for Major Depressive Disorder in later childhood over and above other established risk factors. Preschool conduct disorder also predicted Major Depressive Disorder but was mediated by maternal non-support. Findings suggest that attention to preschool depression and conduct disorder in addition to maternal depression and exposure to trauma should now become an important factor for identification of young children at highest risk for later MDD who should be targeted for early interventions.

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Section: Introductionmentioning

confidence: 99%

Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression

Luby¹,

Gaffrey²,

Tillman³

et al. 2014

AJP

Self Cite

189

132

View full text Add to dashboard Cite

show abstract

“…These problems represent a significant public health concern because they are the most common child mental health referral reason (Keenan & Wakschlag, 2000; Luby & Morgan, 1997; Thomas & Guskin, 2001) and place children at increased risk for developing more severe conduct problems (Moffitt, Caspi, Harrington, & Milne, 2002; Shaw, Gilliom, Ingoldsby, & Nagin, 2003). In addition to the high impairment and poor prognosis, public expenditures are estimated to be $10 thousand more each year for a child with conduct problems (Foster & Jones, 2005), with total lifetime costs exceeding $2 million per individual (Muntz, Hutchings, Edwards, Hounsome, & O'Ceilleachair, 2004).…”

mentioning

confidence: 99%

Home-Based Preventive Parenting Intervention for at-Risk Infants and Their Families: An Open Trial

Bagner

Rodríguez

Blake

et al. 2013

Cognitive and Behavioral Practice

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The purpose of this study was to examine the feasibility, acceptability, and initial outcome of a home-based adaptation of Parent-Child Interaction Therapy for at-risk infants with externalizing behavior problems. Seven 12- to 15-month-old infants and their families were recruited at a large pediatric primary care clinic to participate in a home-based parenting intervention to prevent subsequent externalizing behavior problems. Home-based assessments were conducted at baseline, postintervention, and a 4- to 6-month follow-up. Six of the 7 (86%) families completed the intervention, and all completers reported high satisfaction with the intervention. All of the mothers demonstrated significant improvements and statistically reliable changes in their interactions with their infant, and most reported clinically significant and statistically reliable changes in infant behavior problems. The current study provides preliminary support for the use of this brief, home-based parenting intervention in addressing behavior problems as early as possible to improve access to an intervention for at-risk infants and their families. Successes and challenges with the development and implementation of this intervention are discussed along with directions for future research and clinical practice.

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“…The methodological structure of the P.I.N.T. Clinic was based on the design of an infant and preschool psychiatry clinic at Washington University in St. Louis (Luby & Morgan, 1997), in which the first author had some experience. This approach to early assessment was considered exemplary by the authors because it incorporated several unique aspects of working with young children.…”

Section: Methodsmentioning

confidence: 99%

A Description of Preschool Neuropsychological Assessment in the P.I.N.T. Clinic after the First 5 Years

Heffelfinger

Koop

2009

The Clinical Neuropsychologist

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Assessment of preschool-aged children constitutes a dilemma for many neuropsychologists because of a limited set of standardized measures with normative data as well as inadequate understanding of typical developmental trajectories for neuropsychological functions during the first years of life. However, numerous neurological disorders, medical disorders with central nervous system involvement, and even psychiatric disorders have their onset during this time and subsequently impact cognition by altering functional developmental trajectories. Comprehensive neuropsychological evaluations can help to delineate this alteration in developmental trajectory and assist in determining need for specific interventions services so that they can be implemented early as possible in hopes of reducing developmental cognitive impairments. In this descriptive report, potential preschool neuropsychological evaluation procedures are described and a discussion of appropriate reasons for referral and pertinent testing considerations is presented. Additionally, the Preschool and Infant Neuropsychology (P.I.N.T.) Clinic is presented to describe a methodology for conducting preschool neuropsychological assessment.

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Characteristics of an infant/preschool psychiatric clinic sample: Implications for clinical assessment and nosology

Cited by 32 publications

References 27 publications

Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression

Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression

Home-Based Preventive Parenting Intervention for at-Risk Infants and Their Families: An Open Trial

A Description of Preschool Neuropsychological Assessment in the P.I.N.T. Clinic after the First 5 Years

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