This issue starts with an overview of what we know from MRI neuroimaging of children and adolescents with psychiatric disorders. As is often the case in child psychopathology, accomplishments in adult psychiatry serve as the model for the study of childhood conditions. Thus Eliez and Reiss, in their clear overview of neuro-imaging studies, emphasise the results pertaining to child/adolescent onset schizophrenia, with its main conclusion that childhood-onset schizophrenia is not distinct from adult-onset schizophrenia from the standpoint of neuroanatomical variation. The use of the new imaging techniques in the search for neurobiological substrates of the more common psychiatric disorders in children and adolescents is still in its infancy. This can be concluded from the fact that only a few studies are available on children with ADHD, autism, or Tourette's disorder, with no neuroimaging studies yet available on childhood conditions such as depression, conduct disorder, anxiety disorders, or pervasive developmental disorders other than autism. A rather crude finding that stands out is the relationship between total brain volume and intelligence. The authors point out that studies that did not take IQ into account erroneously interpreted differences between groups of children to be specific for a certain condition, whereas in fact the differences could have been explained by differences between the groups in IQ. Reading this annotation, one is struck by the many contradictory findings of the neuroimaging studies that are reviewed. These discrepancies may be due to variations in neuro-imaging methodology and variations in the definition and measurement of neuroanatomical regions. Also, the large etiological heterogeneity, as well as the lack of precision with which we can define and measure behavioural phenotypes, will influence the variability in findings. The authors give an example of how one MRI study looked at children with ADHD without comorbid conditions whereas another study looked at children with ADHD of whom the majority had a comorbid diagnosis of conduct disorder or oppositional defiant disorder. It is not surprising, then, that neuroimaging studies on children with very different behavioural phenotypes, despite claiming that they studied the same phenomenon, end up with contradictory results. Instead of treating childhood conditions such as ADHD as diagnostic categories that are either present or absent, it may be advantageous for MRI studies to retain more diagnostic information by studying the covariation between brain morphology and behavioural phenotypes as continuous measures. Now that some experience with neuroimaging of child/adolescent psychiatric disorders is available, it is hoped that studies using larger sample sizes, advanced techniques such as functional MRI, longitudinal designs, and more precise diagnostic assessment techniques, will shed light on the still somewhat inconsistent findings on brain morphology of psychiatric conditions in children and adolescents.

The readers of the Journal may not be aware that the Joint Editors act independently in making decisions on accepting papers for publication. This means that as an Editor I am just as intrigued as any other reader when I see a new issue of the Journal since it is likely that I will have been responsible for selecting only one third of the papers in that issue. In reading the material in this present issue I was struck by the conceptual and methodological links between a sub-set of papers that were concerned with adverse events and circumstances and their long-term sequelae; moreover, that these papers had between them some important implications for clinical practice. The first of these papers is by Dunn et al. and investigates the transmission within families of qualities of relationships. They found that father–child and mother–child relationships in stepfamilies, single-parent, and non-stepfamilies were found to be related to a number of factors. These included the parents' own earlier life course experiences, current family circumstances, and how a partner and child were getting along. The links with life course experiences meant that children were at risk of a “double dose” of less affectionate relationships in families in which parents had experienced early adversities. They found evidence for both selection effects (similarities in the early experience of both partners) and co-parenting effects (effects of one parent's relationship with a child on the other parent) and effects of biological relatedness.

Many children and adolescents do not have the peaceful and carefree youth they are entitled to, because they have been exposed to adverse environmental influences that disturb a normal development. These influences may be caused directly by adults whose task it is to protect these children, but sometimes traumatic experiences, including those caused by natural disasters or war conditions, are beyond the control of parents or other adults. The first three articles of this issue pertain to traumatic events that have a great impact on the child's development. The Practitioner Review in this issue by Perrin, Smith, and Yule provides the most up-to-date summary of the literature on the assessment of Post-traumatic Stress Disorder (PTSD) in young people. Considerable controversy has surrounded PTSD since its inception into the diagnostic nomenclature. The authors make the case that whatever the limits of the diagnostic criteria, children do indeed suffer from post-traumatic stress reactions. The authors draw on their extensive experience working with children exposed to war, natural and man-made disasters, and domestic violence, to give the reader an expert-eye view of the assessment and treatment of childhood PTSD. They make a strong case based on the available literature that cognitive and behavioural approaches hold the most promise as a treatment for childhood PTSD. The reader will find this article useful from both a conceptual and a clinical-practical point of view.

In this, the 11th Annual Research Review, I have been pleased to work with an outstanding group of contributors. As in past issues of the Annual Research Review the aim is to provide our readers with reviews that update both current knowledge and research findings. Authors are asked to be selective, rather than comprehensive, in their coverage as they identify the issues that they feel are particularly important for future research. I am grateful not only to the authors but to the numerous referees who provided critiques of each paper.

In the first paper in this issue David Skuse provides an update on the relevance of behavioural neuroscience to child psychopathology. This paper provides a thoughtful review of the findings of the past decade and outlines possible directions for future research developments; it appears that we are poised for a major explosion of knowledge in this area. In the second paper Robin Chapman provides a very useful review of recent research on language development. This paper provides an update of Dorothy Bishop's earlier review of the topic and illustrates the considerable progress made since the time of that review. In the third paper Eilish Gilvarry summarises recent research on substance abuse in young people. This review covers recent changes in trends and patterns of substance abuse, aspects of risk and comorbidity, and treatment. Brown and colleagues then review recent work on children and adolescents with HIV and AIDS; this global health problem presents unique issues relative both to research and intervention. Danya Glaser then provides an overview of recent work on child abuse and neglect and the brain; the attempt to bring the various perspectives of neuroscience together on this topic is particularly timely and appropriate. Finally, Sparrow and Davis provide an overview of recent advances in the assessment of intelligence. This paper provides a helpful summary of current perspectives on the assessment of intelligence; the review of instruments will be of particular interest to our readers.

For the 12th edition of the Annual Research Review we anticipate coverage of the following topics: intersubjectivity, reading disability, longitudinal approaches to developmental data, mental retardation, conduct disorder, and psychopharmacology.

What makes young people act in antisocial ways? This question is discussed from several different angles in our current issue. Delinquency is not, of course, a new phenomenon: for those interested in reading a chilling account of life in London in the early years of the last century, Cyril Burt's The young delinquent, published in 1925, is worth tracking down. Definitive answers seem as far away as ever, but the idea that delinquency might be influenced to a significant extent by genetic mechanisms is still a controversial one. Taylor et al. conducted a twin study, and found the variance in delinquent behaviour among adolescent boys and girls was associated largely with experiences that were unique to individuals. Family influences accounted for half of the remaining variance in risk less than 20% could be attributed to additive genetic factors. Their findings imply, they suggest, scope for prevention and/or intervention. On a similar topic, Hawker and Boulton ask, why is it that some children are bullied? What effect does bullying have on children's emotional adjustment? They review the history of research on this topic, going back over two decades to the pioneering studies of Dan Olweus. Using meta-analytic techniques, they conclude victims become emotionally distressed and, in particular, depressed. Clinicians should realise that children who present with emotional problems may be the victims of bullying; interventions that target either bullying or emotional distress may reduce the severity of both problems.

There has been a consensus that children “in care” show a much increased frequency of behavioural difficulties but the reasons why this should be so are much less well understood. The study by Roy et al. sheds important new light on this issue. They found that children admitted into residential group homes as babies are much more likely than children admitted into foster care at the same age to show hyperactivity and inattention. Although the study sample was small, the groups were closely comparable in coming from a very high-risk family background. The evidence from both questionnaire and observational measures was consistent in indicating that the difference in the pattern of rearing made a substantial difference to the child's behaviour. The findings are sobering in their implication that the pattern of care provided to protect children at high risk seemed to have acted in a detrimental manner. The study clearly provides food for thought in terms of the need to improve provision for this vulnerable group of children. The findings are also provocative in their implication that hyperactivity/inattention, although strongly influenced by the child's biology, can also be affected by the pattern of rearing. The message is that clinicians should not assume that the causes of this hyperactive behaviour necessarily reside entirely within the child but there is also the need to clarify whether the form of hyperactivity/inattention arising from these experiences is in someway atypical.

The paper by Reynolds and colleagues is an attempt to evaluate the efficacy of emotional disclosure to offset distress in children experiencing negative life events. There is a developing literature on such interventions in adults but, as these authors suggest, little work has yet been done to test the value of such disclosure in children. Using a randomised controlled trial Reynolds et al. were unable to show a specific benefit from the opportunity provided to write about negative events. Rather, there was a general reduction in symptoms from all groups. Although the results suggest that the efficacy of writing about negative events is less marked in 8–13-year-olds than in adults, they also indicate that it is both feasible and potentially valuable to give children opportunities to engage in discussion about sources of stress and their reaction to them.

For some time, the Editors have been considering the wisdom of devoting one issue a year of the Journal to a specific theme, with a call for papers on that theme, in line with the policy of several comparable journals from North America. We have recently decided to go ahead next year with the first such issue, but readers might wonder if we've jumped the gun this month. With just a handful of exceptions, the papers in this issue concern just two main themes. Before considering those, mention should be made of the annotation by Linda Dowdney on the subject of how children respond to the death of a parent. This is a topic of direct clinical importance, and her conclusions are clear. Children who have been bereaved can experience the same range of symptoms characteristic of bereavement reactions among adults, but their usual reaction is a nonspecific emotional or behavioural disturbance. A significant minority becomes so disturbed that professional advice on management would be appropriate, although the evidence points to this rarely being sought or available.

It is nearly 30 years since the publication of the edited book by Rutter and Martin (1972), The child with delayed speech (London: Heinemann), which drew attention to the two-way relationship between language and behaviour. In the book the mechanisms whereby psychiatric disorders can have an involvement with language development were identified. Also, Mike Rutter suggested various ways in which delayed language development could impinge upon other aspects of psychological development. The current issue of the JCPP has a number of papers that examine the relationship between language development and aspects of cognition and behaviour. These include a long-term follow-up for a group of individuals with receptive language disorder who were first studied at about the time that the 1972 book was published.

The Editors of the JCPP have decided to initiate a series of Special Issues on topics for which there is a particularly high level of research activity. Topics have been selected where findings are published in a wide range of journals and where there would be special benefit from publishing a collection of high-quality empirical papers in one issue of the Journal.

The first topic selected is that of Social Cognition and will be edited by Jim Stevenson. The Editors request the submission of empirical and theoretical papers on this topic applied both to normally developing children and to clinical populations. The papers will be subjected to the normal refereeing process and if accepted for publication will appear together in one special issue of the Journal. The usual guidance on manuscript preparation should be followed—see Instructions for Contributors at:

http://www.cup.cam.ac.uk/journals/cpp/cppifc.htm

Manuscripts should be submitted by 31 March 2001 and should be marked “For consideration for Special Issue on Social Cognition”.

Previous research has shown that children receiving substitute parental care tend to have high rates of emotional/behavioural disturbance, but uncertainty remains on the extent to which this derives from genetic risk, adverse experiences before receiving substitute care, or from risks associated with substitute care experiences. In order to examine the effects of institutional rearing (as a specific form of substitute care), two groups of primary school children reared in substitute care from before the age of 12 months were compared: 19 children in residential group (institutional) care and 19 in continuous stable foster family care (matched for age and gender). The two groups were similar in coming from biological families with high rates of psychopathology and social malfunctioning, but differed with respect to pattern of rearing. Both groups were compared with classroom controls, using teacher questionnaires, systematic classroom observations, and standardised cognitive testing. Parental questionnaires were also obtained for the two substitute care groups. As found previously, the combined substitute care groups differed from controls in showing a high level of hyperactivity/inattention. The observational measures showed a similar effect, indicating that the elevated rate was not attributable to rater bias. The teacher questionnaire and observational measures showed, however, that the increased level of hyperactivity/inattention was substantially higher in the institutional group than the foster family group. Parental questionnaire ratings showed the same contrast between the groups, except that the main difference was on unsociability and emotional disturbance rather than hyperactivity/inattention. It is concluded that, against a background of genetic and early environmental risk, institutional rearing predisposes to a pattern of hyperactivity/inattention.

Over the past 10 years, innovations in physics and computer science have promoted magnetic resonance imaging (MRI) as an essential tool for investigating the biological substrates of psychiatric disorders. Requiring no radiation exposure, MRI is now the preferred imaging technique for pediatric populations. However, the rapid technical advances in MRI pulse sequences, data processing, and analysis have made it increasingly complex for clinicians to compare and critically evaluate MRI research studies. This paper selectively reviews MRI research on five psychiatric conditions occurring in childhood or adolescence: ADHD, autism, childhood-onset schizophrenia, Tourette syndrome, and early-onset depression. The selection of papers reviewed was based on four criteria: the originality of the idea underlying the paper, the quality of the sample and methodologies used, the presence of controversial findings in the paper, and whether the paper was a clear illustration of specific methodological strengths or weaknesses. The two goals of this review paper are to update clinicians on morphometric brain imaging in child psychiatry and the methodological issues pertaining to image acquisition and analysis, and to promote critical reading of future MRI studies.

Recent advances are reviewed in understanding the heightened prevalence of psychopathology and maladaptive behavior among children with intellectual disability. Researchers have traditionally emphasized measurement and prevalence issues, using either psychiatric assessments or rating scales to identify the prevalence of various problems in children with intellectual disability. Yet the time is ripe to shift directions, and identify more precisely why children are at increased risk for psychopathology to begin with. Although several “bio- psycho-social” hypotheses are reviewed, a particularly promising line of work links psychopathology to genetic intellectual disability syndromes. Psychiatric vulnerabilities in several syndromes are reviewed, as are the advantages of phenotypic work for understanding psychopathology among children with intellectual disability more generally.

Life course and current family factors associated with individual differences in parent–child relationships were investigated in a sample of 467 children from 192 families, including stepfather, single-parent, stepmother, and complex stepfamilies; informants were fathers, mothers, and children. Both positive and negative dimensions of father–child and mother–child relationships were linked to earlier life course experiences of parent and of partner, to current family factors, and to the quality of partner's relationship with the child. The pattern of associations between the adults' life course experiences meant that children were at risk for a “double dose” of less affectionate relationships in families in which parents had experienced early adversities. The significance of biological relatedness, family setting, and child–partner relationships was highlighted.

Post-traumatic Stress Disorder (PTSD) is a syndrome defined by the intrusive re-experiencing of a trauma, avoidance of traumatic reminders, and persistent physiological arousal. PTSD is associated with high levels of comorbidity and may increase the risk for additional disorders over time. While controversies remain regarding the applicability of the PTSD criteria to very young children, it has proved to be a useful framework for guiding assessment and treatment research with older children and adolescents. This article presents an overview of the literature on the clinical characteristics, assessment, and treatment of PTSD in children and adolescents.

There is an urgent need to pay attention to the mental health of children in developing countries. Professionals confronted with this task face a number of challenges. Services have to be planned in a rational way, keeping in mind the needs of local populations. These needs will often exceed the available resources, and it will be necessary to set priorities. Feasible and cost-effective models of service delivery then have to be developed to meet these needs. This annotation provides a framework within which mental health needs of children can be assessed, priorities established, and services organised. This is illustrated with examples of relevant activities undertaken in low-income developing countries over the last two decades.

We have just emerged from “the Decade of the Brain”, yet in so many ways it was the “Decade of the Genome”. What relevance does the remarkable advance in knowledge in genetics and neuroscience over that period have to our understanding of child psychopathology? When the complexity of the genetic systems involved in behavioural regulation of relatively simple organisms such as the nematode worm Caenorhabditis elegans or the fruitfly Drosophila melanogaster is considered, the possibility of comprehending the links from genes to behaviour in the developing child seems remote. Yet, the principles of investigation in model systems are not so different to those that should apply in humans. This review draws out the parallels, and introduces recent findings from behavioural studies of C. elegans, D. melanogaster, and the laboratory mouse, as well as humans, to illustrate the point.

This paper examines the cognitive and neuropsychological functioning of children who were in utero to age 15 months at the time of the Chornobyl disaster and were evacuated to Kyiv from the 30-kilometer zone surrounding the plant. Specifically, we compared 300 evacuee children at ages 10–12 with 300 non-evacuee Kyiv classmates on objective and subjective measures of attention, memory, and school performance. The evacuee children were not significantly different from their classmates on the objective measures (grades; Symbolic Relations subtest of the Detroit Test; forms 1 and 2 of the Visual Search and Attention Test; Benton Form A; Trails A; Underline the Words Test) or on most of the subjective measures (the attention subscale of the Child Behavior Checklist completed by mothers; the attention items of the Iowa Conners Teacher's Rating Scale; mother and child perceptions of school performance). The one exception was that 31.3% of evacuee mothers compared to 7.4% of classmate mothers indicated that their child had a memory problem. However, this subjective measure of memory problems was not significantly related to neuropsychological or school performance. No significant differences were found in comparisons of evacuees and classmates who were in utero at the time of the explosion, children from Pripyat vs. other villages in the 30-kilometer zone, and children manifesting greater generalized anxiety. For both groups, children with greater Chornobyl-focused anxiety performed significantly worse than children with less Chornobyl-focused anxiety on measures of attention. The results thus fail to confirm two previous reports that relatively more children from areas contaminated by radiation had cognitive deficits compared to controls. Possible reasons for the differences in findings among the studies are discussed.

This paper reviews the treatment of obsessive-compulsive disorder (OCD) in children and adolescents. Focusing on clinical features of the disorder and its treatment particular to pediatric onset, diagnosis, assessment, and behavioral, pharmacological, as well as new investigative treatments are covered. Adaptation of cognitive-behavioral therapy for children and adolescents, use of augmenting agents in drug treatment, and subtyping of OCD cases are developments relevant for current practice.

This paper examines risk factors for the development of Post Traumatic Stress Disorder (PTSD), and its severity and chronicity, in a group of 217 young adults who survived a shipping disaster in adolescence. The survivors were followed up 5 to 8 years after the disaster. Risk factors examined fell into three main categories: pre-disaster child and family vulnerability factors, including childhood psychopathology; objective and subjective disaster-related experiences; and post-disaster factors, including results from screening questionnaires administered 5 months post-disaster, coping mechanisms adopted subsequently, life events, and availability of social supports. Developing PTSD following the disaster was significantly associated with being female, with pre-disaster factors of learning and psychological difficulties in the child and violence in the home, with severity of exposure to the disaster, survivors' subjective appraisal of the experience, adjustment in the early post-disaster period, and life events and social supports subsequently. When all these factors were considered together, measures of the degree of exposure to the disaster and of subjective appraisal of life threat, and ratings of anxiety obtained 5 months post-disaster, best predicted whether survivors developed PTSD. For those survivors who developed PTSD, its duration and severity were best predicted not by objective and subjective disaster-related factors, but by pre-disaster vulnerability factors of social, physical, and psychological difficulties in childhood together with ratings of depression obtained 5 months post-disaster, and whether survivors received post-disaster support at school. The implications of these findings are considered for targeting assessment and intervention efforts at survivors most at risk of developing difficulties in adjustment following similar traumatic experiences.

Recent research with adults by Pennebaker and his colleagues has found that emotional disclosure through writing about stressful events appears to have significant benefits in terms of psychological and physical health outcomes. This report describes a controlled trial of emotional disclosure, adapted for school children, with the major hypothesis that the repeated description of negative events will have beneficial effects on measures of mental health, attendance, and school performance. The sample consisted of children aged 8–13 years from four schools, a primary and a secondary school both from a suburban and an inner-city area. Children were randomly assigned to one of three conditions: writing about negative events, writing about nonemotional events, and a non-writing control group. Children in all groups were seen four times during a single week and were then followed up after 2 months with measures of health and school performance. The intervention was well received by both schools and children, and the scripts written by the emotional and nonemotional writing groups differed in content in the predicted ways. Contrary to expectation, there was little evidence of a specific effect of emotional disclosure, and several possible reasons for this are discussed. Nevertheless, there was a general reduction in symptom measures, indicating that children may have benefited from their involvement in the study. Although there are several possible explanations for our findings, they indicate that it is both feasible and potentially valuable to give children opportunities to engage in discussion about sources of stress and their reactions to them.