Objective The importance of dimensional approaches is widely recognized, but an empirical base for clinical application is lacking. This is particularly true for irritability, a dimensional phenotype that cuts across many areas of psychopathology and manifests early in life. We examine longitudinal, dimensional patterns of irritability and their clinical import in early childhood. Method Irritability was assessed longitudinally over an average of 16 months in a clinically enriched diverse community sample of preschoolers (N=497; M=4.2 years; SD=0.8). Using the Temper Loss scale of the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) as a developmentally sensitive indicator of early childhood irritability, we examined its convergent/divergent, clinical and incremental predictive validity, and modeled its linear and nonlinear associations with clinical risk. Results The Temper Loss scale demonstrated convergent and divergent validity to child and maternal factors. In multivariate analyses, Temper Loss predicted mood (separation anxiety disorder [SAD], generalized anxiety disorder [GAD], and depression/dysthymia) and disruptive (oppositional defiant disorder [ODD], attention-deficit/hyperactivity disorder [ADHD], and conduct disorder [CD]) symptoms. Preschoolers with even mildly elevated Temper Loss scale scores showed substantially increased risk of symptoms and disorders. For ODD, GAD, SAD, and depression, increases in Temper Loss scale scores at the higher end of the dimension had a greater impact on symptoms relative to increases at the lower end. Temper Loss scale scores also showed incremental validity over DSM-IV disorders in predicting subsequent impairment. Finally, accounting for the substantial heterogeneity in longitudinal patterns of Temper Loss significantly improved prediction of mood and disruptive symptoms. Conclusion Dimensional, longitudinal characterization of irritability informs clinical prediction. A vital next step will be empirically generating parameters for incorporation of dimensional information into clinical decision-making with reasonable certainty.

Genetic factors underlie PA frequency and stability during early childhood; they are also responsible for initial status and growth rate in PA. The contribution of shared environment is modest, and perhaps limited, as it appears only at 50 months. Future research should investigate the complex nature of these dynamic genetic factors through genetic-environment correlation (r GE) and interaction (G×E) analyses.

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Introduction Callous-unemotional (CU) traits in the presence of conduct problems are associated with increased risk of severe antisocial behavior. Developmentally sensitive methods of assessing CU traits have recently been generated, but their construct validity in relation to neurocognitive underpinnings of CU has not been demonstrated. The current study sought to investigate whether the fear-specific emotion recognition deficits associated with CU traits in older individuals are developmentally expressed in young children as low concern for others and punishment insensitivity. Methods A sub-sample of 337 preschoolers (mean age 4.8 years [SD=.8]) who completed neurocognitive tasks was taken from a larger project of preschool psychopathology. Children completed an emotional recognition task in which they were asked to identify the emotional face from the neutral faces in an array. CU traits were assessed using the Low Concern (LC) and Punishment Insensitivity (PI) subscales of the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB), which were specifically designed to differentiate the normative misbehavior of early childhood from atypical patterns. Results High LC, but not PI, scores were associated with a fear-specific deficit in emotion recognition. Girls were more accurate than boys in identifying emotional expressions but no significant interaction between LC or PI and sex was observed. Conclusions Fear recognition deficits associated with CU traits in older individuals were observed in preschoolers with developmentally-defined patterns of low concern for others. Confirming that the link between CU-related impairments in empathy and distinct neurocognitive deficits is present in very young children suggests that developmentally-specified measurement can detect the substrates of these severe behavioral patterns beginning much earlier than prior work. Exploring the development of CU traits and disruptive behavior disorders at very early ages may provide insights critical to early intervention and prevention of severe antisocial behavior.

Objective:To review preventive studies of disruptive behaviour disorders (DBDs) in light of recent empirical knowledge on their development. Method:We draw on the results of longitudinal studies of children starting in infancy to examine the onset, development, and risk factors for DBD symptoms. We review randomized controlled trials of preventive interventions provided to families before the child is aged 3 years, with reported outcome measures of DBD symptoms at follow-up. Results:Children who present high levels of DBD symptoms start to do so in the first 2 years of life and have risk factors that can be identified in the mother during pregnancy or even earlier, and shortly after the child's birth. Most preventive experiments have started relatively late after birth and have targeted parenting, with weak effects on children's DBDs. Preventive experiments that have provided intensive intervention to at-risk mothers starting during pregnancy have shown important effects in reducing key risk factors and some of the most severe consequences of DBDs. However, even those experiments have not succeeded in preventing childhood DBDs in the home and school contexts. Conclusions:We suggest adopting a sequential, multitarget, intergenerational, experimental approach both to increase our knowledge about causal mechanisms and to increase our effectiveness in curbing DBDs and their serious lifelong consequences.Can J Psychiatry. 2009;54(4):222-231. Clinical Implications· Potentially alterable risk factors for child DBDs are identifiable in the mothers before, during, or shortly after pregnancy. · Serious consequences of DBDs can be prevented when interventions start during pregnancy and target multiple risk factors. Limitations· More experimental preventive interventions are needed during pregnancy and early childhood to understand causal mechanisms and effective interventions. · Experiments need to focus on the interplay between genes and environment, especially environmental effects on gene expression.

Rather than decreasing recidivism, juvenile court intervention increased both violent and nonviolent future crimes. Along with previous studies, this study highlights a pressing need for more research and knowledge transfer about effective interventions to reduce recidivism among youths who commit crime.

This study used a British cohort (n = ∼13,000) to investigate the association between child care during infancy and later cognition while controlling for social selection and missing data. It was found that attending child care (informal or center based) at 9 months was positively associated with cognitive outcomes at age 3 years, but only for children of mothers with low education. These effects did not persist to ages 5 or 7 years. Early center-based care was associated with better cognitive outcomes than informal care at ages 3 and 5 years, but not at 7 years. Effect sizes were larger among children whose mother had low education. Propensity score matching and multiple imputation revealed significant findings undetected using regression and complete-case approaches.