Anelli Xavier Announces Recent Case Results from Albany, New York

Anelli Xavier, DWI Defense Firm, announces three recent DWI case results from Albany. "Although the results of actual cases are displayed, Anelli Xavier cannot represent such results to be indicative of those that may be obtained in any particular case."

Albany, NY (PRWEB) November 30, 2012

New York Law Firm Anelli Xavier, announces recent favorable outcomes for Albany clients charged with Driving While Intoxicated (DWI).

In one recent case, People vs. J.B. (Town of Halfmoon Court, Case #11-0328), the client was charged with three felony counts of DWI, including one count of Aggravated Driving While Intoxicated. Client was alleged to have a BAC of a .19, more than twice the legal limit. Moreover, this client had been convicted of a DWI within the previous 10 years, increasing the current charge to a felony, which is punishable up to four years in state prison. After extensive negotiations with the DA's office and pretrial hearings, the firm was unable to come up with a resolution that was acceptable to the client. Since the client was an Army veteran who served in Iraq, he could not plead to a felony and continue on the career path that he had chosen. Following negotiations, the trial team successfully argued that the client was not in fact driving at the time that the prosecution alleged. After a four-day trial, the jury found the client not guilty of all charges. This result allowed him to avoid any criminal conviction, incarceration, or probation.

In another case, People vs. D.B. (Town of Rotterdam Court, Case #12-0404), the client was charged with one count of misdemeanor DWI, having refused to supply a breath sample when arrested. He was alleged to have hit a telephone pole and then driven away with damage to the front of his truck. The offer extended by the DA?s office was to plead guilty to the crime as charged. The prosecutor stated that the client did not deserve a reduction as he had previously been convicted of two drinking and driving offenses and then during this incident was involved in an accident and refused taking a breathalyzer. The firm suggested that the client undergo treatment, given his obvious issues with alcohol and driving, and that if he was able to successfully participate in real treatment, that he be offered a reduction to a DWAI. The prosecutor appreciated the fact that we were taking the issue seriously and seeking ways to correct the behavior and gave the firm the offer of a DWAI based on participation in sanctioned treatment.

In a third case, People vs. M.D. (Albany City Court, Case #12-0054), the client was charged with a DWI and failure to stop at a stop sign. The prosecutor could not offer a reduction to our client based on the county policy of not reducing charges of anyone alleged to have refused the breath test. However, the client was adamant that he was not guilty of DWI and insisted that he would not plead guilty to anything other than Driving while Ability Impaired (DWAI), a traffic infraction. A member of the trial team handled a probable cause hearing, where the team was able to elicit valuable testimony that was favorable to our client. The attorney was then able to use this testimony at the subsequent trial of our client. At the trial, the client was found not guilty of DWI, a misdemeanor. He was convicted of DWAI and failing to stop at a stop sign, both traffic infractions. This allowed the client to maintain a clean criminal history and avoid having to install an Ignition Interlock Device on any vehicle that he owned or operated.

?I am encouraged by the level lawyering being done firm wide and particularly by the Albany team. These results, as well as the others obtained by our firm, show that our ongoing commitment to be New York?s State?s best DWI firm is coming to fruition.? ? states Tom Anelli, Founder/Senior Partner, Anelli Xavier.

If you are charged with a DWI in New York State, Anelli Xavier provides free DWI case evaluations. Please check out our recent Anelli Xavier reviews. "Although the results of actual cases are displayed, Anelli Xavier cannot represent such results to be indicative of those that may be obtained in any particular case."


------

About Anelli Xavier


Anelli Xavier is New York?s DWI focused law firm, made up of a team of lawyers with backgrounds in criminal litigation whose sole focus is DWI defense. The firm?s goal is to be the most powerful team of DWI defense lawyers in New York State. Learn more today by visiting the DWI attorney Albany website.

Sean Kelsey
Anelli Xavier
1-877-394-3476
Email Information

Source: http://news.yahoo.com/anelli-xavier-announces-recent-case-results-albany-york-132053479.html

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NKorea preps rocket launch that would irk China

WASHINGTON (AP) ? Satellite photos indicate North Korea has moved two sections of a long-range rocket in preparation for a launch that would alarm both its adversaries and lone ally China.

But North Korea has yet to announce its plans, leaving some uncertainty whether and when it will proceed with a launch that would be sure to draw international condemnation.

The U.S.-Korea Institute at Johns Hopkins School of Advanced International Studies said Thursday the recent activity at the Sohae site on North Korea's northwest coast suggests it could be ready to launch a three-stage rocket by the end of the first week in December.

A commercial satellite photo taken Monday shows two long trailers, likely used to carry the first two stages of a rocket, according to an analysis written for 38 North, the institute's website. The trailers are parked near the main missile assembly building, where it says rocket stages would be checked before moving to the launch pad for takeoff about a half-mile away.

In April, North Korea fired a rocket from the same site in a failed attempt to launch a satellite into space, drawing U.N. censure as that technology can be easily converted into use for missiles. The launch dashed prospects for a resumption of international aid-for-disarmament talks.

South Korean officials confirmed Thursday there are signs of preparations at the rocket site. A launch in the next few weeks would be seen in Seoul as timed for South Korea's Dec. 19 presidential election.

Victor Cha, a former White House director of Asia policy, said Pyongyang has a track record of reacting to elections in both the U.S. and South Korea in provocative ways, most recently when President Barack Obama took office in 2009. North conducted a rocket and nuclear test within four months.

Another motivating factor for the North could be that South Korea recently won U.S. approval to expand its ballistic-missile range, and this week, was readying its own satellite launch. However, it scrapped those launch plans Thursday, citing technical problems.

North Korea conducted nuclear tests in 2006 and 2009, and Washington says Pyongyang uses long-range rocket launches to develop missiles that could target the United States, although it is not yet believed to have miniaturized a nuclear device to mount on a missile.

A rocket launch would not only dismay the U.S. and its allies, but the North's chief ally and source of economic support, China, which is midway through a leadership transition.

"If North Korea does carry out a launch, Beijing will not be happy," said Evans Revere, a former senior U.S. State Department official and expert on East Asia. "It flies in the face of China's request for North Korea to reduce tensions in the region and not escalate them."

Past launches have happened in spring or summer when weather conditions are better, but according to the analysis on the institute's website 38 North, there are several telltale signs that one is being readied now.

As well as the trailers, the images show empty tanks in four locations suggest fueling preparations. There's work under way at an instrumentation site that would monitor a launch. Also, temporary structures for keeping the snow off cars have been erected near a building used to house visiting VIPs.

But any launch could still be weeks away. The analysis notes that North Korea has yet to provide notification for international flight and shipping of splashdown zones for the used rocket stages, as it did before the April launch. Nor has it filed a plan for a frequency for a signal that would be emitted by a satellite.

David Wright, a physicist with the Union of Concerned Scientists, said the launch preparation so soon after the April failure "calls into question whether the North could have analyzed and fixed whatever went wrong." North Korea has yet to successfully test a rocket with a range of more than 800 miles.

Another failure would embarrass young North Korean leader Kim Jong Un, not yet a year in the job after the death of longtime ruler Kim Jong Il, his father.

___

Associated Press writers Foster Klug and Sam Kim in Seoul, Seoul Korea, contributed to this report.

____

Online: http://38north.org/

Source: http://news.yahoo.com/nkorea-preps-rocket-launch-irk-china-203845245.html

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Preventing 'C'yber Pearl Harbor'

ScienceDaily (Nov. 30, 2012) ? Cyber attacks that have long caused major work disruption and theft of private information are becoming more sophisticated with prolonged attacks perpetrated by organized groups. In September 2012, Bank of America, Citibank, the New York Stock Exchange, and other financial institutions were targets of attacks for more than five weeks. Defense Secretary Leon E. Panetta warned that the United States was facing the possibility of a "cyber-Pearl Harbor" and was increasingly vulnerable to foreign computer hackers who could disrupt the government, utility, transportation, and financial networks.

Key to protecting online operations is a high degree of "cyber security awareness," according to human factors/ergonomics researchers Varun Dutt, Young-Suk Ahn, and Cleotilde Gonzalez. In their Human Factors article, "Cyber Situation Awareness: Modeling Detection of Cyber Attacks With Instance-Based Learning Theory," they developed a computer model that presented 500 simulated cyber attack scenarios to gauge simulated network security analysts' ability to detect attacks characterized as either "impatient" (the threat occurs early in the attack) or "patient" (the threat comes later in the attack and is not detected promptly). Their model was able to predict the detection rates of security analysts by varying the analysts' degree of experience and risk tolerance as well as an attacker's strategy (impatient or patient attack).

The authors found that experienced, risk-averse analysts were less accurate at detecting threats in patient than in impatient attacks. "In a patient attack, when the attacker waits until the end to generate threats, the experiences in the analyst's memory that indicate an attack" are not as readily retrieved, says Dutt, which "makes it difficult to correctly detect patient attacks."

"Application of our results include the design of training tools that increase competency and the development of decision-support tools that improve defenders' on-the-job performance in detecting cyber attacks." The authors suggest that employers evaluate an analysts' risk tolerance before employment and/or manipulate tolerance levels during training to better identify threats.

As cyber warfare strategies and tactics evolve, the authors plan to further investigate the trend of drawn-out attacks and new intrusion detection software.

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Story Source:

The above story is reprinted from materials provided by Human Factors and Ergonomics Society, via EurekAlert!, a service of AAAS.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. V. Dutt, Y.-S. Ahn, C. Gonzalez. Cyber Situation Awareness: Modeling Detection of Cyber Attacks With Instance-Based Learning Theory. Human Factors: The Journal of the Human Factors and Ergonomics Society, 2012; DOI: 10.1177/0018720812464045

Note: If no author is given, the source is cited instead.

Disclaimer: Views expressed in this article do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/mq61JPdemRM/121130222253.htm

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Patent Law Jobs by Patently-O: Patent Attorney - Large Corporation ...

FLSmidth FLSmidth, a multinational company in the engineering and manufacturing industries seeks, due to continued growth and expansion, an experienced Patent Attorney to work in our Global IPR Portfolio Management department, based in Salt Lake City, Utah, U.S.A.

Responsibilities:
? Negotiate and administer IP agreements including confidentiality agreements, joint development agreements, licensing agreements and consultancy agreements
? Manage litigation matters involving Company?s intellectual property rights
? Advising on the infringement and enforcement of patent and trademark rights, including working with outside counsel to defend or enforce company patents and trademarks worldwide;
? Working closely with Research & Development Department and inventors on patentability of new inventions and on surveillance of competitor patent activities;
? Advise management and Patent Committee on various IPR legal matters, including chances of success of obtaining patents;
? Prepare, file, and prosecute patent applications before the United States Patent and Trademark Office (USPTO);
? managing overseas agents on applications for foreign patent and trademark applications; training and educating company employees on intellectual property issues

Qualifications:
? Juris Doctor
? Licensed to practice law in the State of Utah (or have the ability to obtain such license) and before the USPTO
? At least 5 years experience of legal experience
? Great communication skills both verbal and written.
? Fluent in English.
? Ability to work independently and as part of a team with rapidly changing deadlines and priorities
? The position involves domestic and international travel.
Competitive salary and excellent benefits offered.

Contact:
Please apply at: https://flsmidth.iapplicants.com/application.php.

Additional Info:
Employer Type: Large Corporation
Job Location: Salt Lake City, Utah

Source: http://www.patentlyo.com/jobs/2012/11/patent-attorney-large-corporation-salt-lake-city-utah.html

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Panel to eye links between cycling body, Armstrong

FILE - This May 21, 2006, file photo shows Lance Armstrong showing his Tufts University cycling jersey while he delivered the commencement address at Tufts University 150th commencement in Somerville, Mass. Tufts University has rescinded Armstrong's honorary degree. A university spokeswoman says the school's trustees voted unanimously at their meeting this month to rescind the doctor of humane letters bestowed upon Armstrong in 2006. (AP Photo/Chitose Suzuki, File)

FILE - This May 21, 2006, file photo shows Lance Armstrong showing his Tufts University cycling jersey while he delivered the commencement address at Tufts University 150th commencement in Somerville, Mass. Tufts University has rescinded Armstrong's honorary degree. A university spokeswoman says the school's trustees voted unanimously at their meeting this month to rescind the doctor of humane letters bestowed upon Armstrong in 2006. (AP Photo/Chitose Suzuki, File)

(AP) ? An independent panel will examine possible links between cycling's governing body and the Lance Armstrong doping case.

The three-member panel will meet in London from April 9-26, with a June 1 deadline to deliver its report.

The group consists of retired British judge Philip Otton, Australian lawyer Malcolm Holmes and former Paralympics star Tanni Grey-Thompson. They were appointed by John Coates, president of the Court of Arbitration for Sport.

"The appointment of these three eminent figures demonstrates clearly that the UCI wants to get to the bottom of the Lance Armstrong affair and put cycling back on the right track," Pat McQuaid, president of the International Cycling Union, said in a statement Friday. "We will listen to and act on the commission's recommendations."

Otton's sports legal cases include a Premier League relegation dispute involve Carlos Tevez, and Chelsea's tactics in trying to lure Ashley Cole from Arsenal. Grey-Thompson, a 10-time Paralympic gold medalist in wheelchair racing, is now a lawmaker in the upper chamber of Britain's Parliament.

The cycling body said the three will have access to "all relevant documents in the control or possession of the UCI," including bank and telephone records and laboratory test results.

The announcement came two days before a group of the UCI's and Armstrong's fiercest critics, including three-time Tour de France winner Greg LeMond, meets in London to press for changes in how cycling is run.

The UCI asked Coates last month to help create a panel to investigate suspicions raised by the U.S. Anti-Doping Agency's damning report into widespread doping by Armstrong's teams during his record seven Tour wins from 1999-2005. Armstrong was stripped of seven Tour de France titles and banned for life.

The panel's work could be key in determining whether the governing body can rebuild its damaged credibility. The commission will scrutinize McQuaid, who was elected as UCI president weeks after Armstrong first retired in 2005, and his predecessor, Hein Verbruggen, in their relations with Armstrong.

The governing body denies claims made by former Armstrong teammates to USADA that it covered up suspicious samples from Armstrong in exchange for payments totaling $125,000, or that the American rider enjoyed special protection.

"The commission's report and recommendations are critical to restoring confidence in the sport of cycling and in the UCI as its governing body," McQuaid said. "We will cooperate fully with the commission and provide them with whatever they need to conduct their inquiry and we urge all other interested stakeholders to do the same."

The UCI pledged to fund the commission's work and will be legally represented at the London hearings. It did not specify if sessions will be public.

McQuaid said the cost of the commission will be a "significant burden" on his organization.

"However, it is clear that only such a decisive and transparent examination of the past will answer our critics by thoroughly examining our assertion that the UCI's anti-doping procedures are and have been among the most innovative and stringent in sport," he said.

The panel will examine whether the UCI's doping rules were "inadequate or were not enforced with sufficient rigor"; if the UCI had "any reliable evidence or information" that Armstrong was doping; and if it "adequately cooperated with, assisted in and reacted to the USADA" investigation.

A potential conflict of interest between the UCI's role promoting the sport and its duty to police doping will also be examined.

Following the USADA report, LeMond denounced McQuaid and Verbruggen as "the corrupt part of the sport" and called on them to leave the UCI.

LeMond, now the only American winner of cycling's biggest prize, will be joined in London by journalists Paul Kimmage and David Walsh and Australian anti-doping scientist Michael Ashenden, who helped the UCI develop its biological passport anti-doping project.

Under the "Change Cycling Now" banner, the group will meet over two days.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/347875155d53465d95cec892aeb06419/Article_2012-11-30-CYC-UCI-Armstrong-Probe/id-12a7559fd58246408addf5284120723c

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Video games to be showcased in prestigious Museum of Modern Art ...

This might help settle the debate on whether video games should be considered art: An initial batch of 14 video games is zapping its way into the Museum of Modern Art (MoMA).

?

Paola Antonelli, senior curator of the MoMA's Department of Architecture and Design, said the 14 are part of an initial wish list of about 40 games to be acquired soon.

?

"We are very proud to announce that MoMA has acquired a selection of 14 video games, the seedbed for an initial wish list of about 40 to be acquired in the near future, as well as for a new category of artworks in MoMA?s collection that we hope will grow in the future," she said.

?

She said this acquisition will allow MoMA to study, preserve, and exhibit video games as part of its Architecture and Design collection.

?

The initial group, to be installed in the Museum?s Philip Johnson Galleries in March 2013, includes:

?

  • Pac-Man (1980)
  • Tetris (1984)
  • Another World (1991)
  • Myst (1993)
  • SimCity 2000 (1994)
  • vib-ribbon (1999)
  • The Sims (2000)
  • Katamari Damacy (2004)
  • EVE Online (2003)
  • Dwarf Fortress (2006)
  • Portal (2007)
  • flOw (2006)
  • Passage (2008)
  • Canabalt (2009)

?

Other games the MoMA is planning to acquire soon include:

?

  • Spacewar! (1962)
  • games for the Magnavox Odyssey console (1972)
  • Pong (1972)
  • Snake (originally designed in the 1970s; Nokia phone version dates from 1997)
  • Space Invaders (1978)
  • Asteroids (1979)
  • Zork (1979)
  • Tempest (1981)
  • Donkey Kong (1981)
  • Yars? Revenge (1982)
  • M.U.L.E. (1983)
  • Core War (1984)
  • Marble Madness (1984)
  • Super Mario Bros. (1985)
  • The Legend of Zelda (1986)
  • NetHack (1987)
  • Street Fighter II (1991)
  • Chrono Trigger (1995)
  • Super Mario 64 (1996)
  • Grim Fandango (1998)
  • Animal Crossing (2001)
  • Minecraft (2011)

?

Are video games art?

?

Antonelli said video games are not only "art" but are also design, adding MoMA selected the for its collection as "outstanding examples of interaction design."

?

She said that in the past year and a half, MoMA had sought the advice of scholars, digital conservation and legal experts, historians, and critics in forming the wish list.

?

"Our criteria, therefore, emphasize not only the visual quality and aesthetic experience of each game, but also the many other aspects?from the elegance of the code to the design of the player?s behavior?that pertain to interaction design," she said.

?

Design criteria

?

Antonelli said the central interaction design traits that the museum privileged are:

?

  • Behavior: scenarios, rules, stimuli, incentives, and narratives
  • Aesthetics
  • Space
  • Time

?

Acquisition procedure

?

MoMA?s acquisition process includes:

  • obtaining copies of the games? original software format (cartridges or discs) and hardware (consoles or computers) whenever possible.
  • acquiring the source code in the language in which it was written, so as to be able to translate it in the future.
  • requesting corroborating technical documentation, and possibly an annotated report of the code by the original designer or programmer.
  • working out the complex rights situation.

?

Antonelli said MoMA?s general counsel is in deep negotiations with the publishers.

?

"Of course, what we acquire depends on each game, how it is best represented, and how it will be shown in the galleries. If the duration of the game is short enough, the game itself could be made playable in its entirety," she said.

?

If the game is too complex or too time-consuming to be experienced as an interactive display in the galleries, MoMA will create a video akin to a demo, in which the concept and characters of the game are laid out. ? TJD, GMA News

Source: http://www.gmanetwork.com/news/story/284514/scitech/gaming/video-games-to-be-showcased-in-prestigious-museum-of-modern-art

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U.S. bans BP from new government contracts after oil spill deal

WASHINGTON (Reuters) - The U.S. government banned BP Plc on Wednesday from new federal contracts over its "lack of business integrity" in the 2010 Deepwater Horizon oil spill, possibly imperiling the company's role as a top U.S. offshore oil and gas producer and the No. 1 military fuel supplier.

The suspension, announced by the Environmental Protection Agency, comes on the heels of BP's November 15 agreement with the U.S. government to plead guilty to criminal misconduct in the Gulf of Mexico disaster, the worst offshore oil spill in U.S. history. The British energy giant agreed to pay $4.5 billion in penalties, including a record $1.256 billion criminal fine.

BP and its affiliates are barred from new federal contracts until they demonstrate they can meet federal business standards, the EPA said. The suspension is "standard practice" and BP's existing U.S. government contracts are not affected, it said.

The EPA acted hours before a government auction of offshore tracts in the Gulf of Mexico, a region where BP is the largest investor and lease-holder of deep-water tracts and hopes for further growth. BP is also the top fuel supplier to the U.S. military, the largest single buyer of oil in the world.

Suspension of contracts could give the government leverage to pressure BP to settle federal and state civil litigation that could top $20 billion if a court finds BP was grossly negligent in the Deepwater Horizon disaster.

An EPA official said government-wide suspensions generally do not exceed 18 months, but can continue longer if there are ongoing legal cases.

In a statement, BP said it has been in "regular dialogue" with the EPA, and that the agency has informed BP that it is preparing an agreement that "would effectively resolve and lift this temporary suspension." The EPA has notified BP that the draft agreement will be available soon, BP said.

U.S. operations accounted for more than 30 percent of BP's pre-tax profits in the third quarter, and the United States accounts for about a fifth of BP's global oil production.

The U.S. military has been a reliable customer of BP's jet fuel and other refined products. As recently as September, BP affiliates won two military fuel contracts worth as much as $1.37 billion, according to a website that tracks U.S. military contracts.

The EPA's action is a sign that all federal contractors will be held to high standards, said Scott Amey, general counsel for the Project on Government Oversight, a private watchdog group.

"BP had years to improve its business ethics and is paying the price for its inaction," Amey said.

On November 15, BP Finance Director Brian Gilvary told investors on a conference call that any blanket ban could force the company to rethink its entire U.S. business.

The Justice Department says it intends to prove in a court case set to get underway in February 2013 that BP was grossly negligent under the Clean Water Act, a claim the company has adamantly denied.

"The critical question is whether this a shot across BP's bows to get settlement, or a more sustained stance, in which case the importance of the context is underlined" by Gilvary's comments, said Peter Hutton, an analyst with RBC Capital Markets.

The EPA's suspension will not impair BP's ability to produce oil and gas from existing U.S. assets, said Pavel Molchanov, an analyst with Raymond James & Associates Inc in Houston.

"BP's supply contract of fuels to the Pentagon might be at risk, but of course BP could supply other customers if this supply contract is not renewed," Molchanov said in a research note.

BP and the U.S. government likely worked out a deal on the timing of the suspension before BP agreed to sign off on the November 15 criminal plea deal, said Samuel Buell, a Duke University Law School professor and former federal prosecutor.

"It's just inconceivable to me that BP's lawyers ... would have entered into that agreement last week without the issue of a suspension or debarment having been addressed," Buell said.

BP did not participate in Wednesday's federal auction of 20 million acres (8 million hectares) of drilling tracts in the Gulf of Mexico, one of BP's biggest oil production regions globally.

One long-time critic of BP applauded the decision.

"After pleading guilty to such reckless behavior that killed men and constituted a crime against the environment, suspending BP's access to contracts with our government is the right thing to do," U.S. Rep. Edward Markey, a Democrat from Massachusetts, said in a statement.

BP's U.S.-traded shares closed flat, while London-traded shares were down less than 1 percent at 427 pence.

(Additional reporting by Andrew Callus in London, Ayesha Rascoe in Washington, Joshua Schneyer in New York and Kristen Hays in Houston; Writing by Chris Baltimore; Editing by John Wallace, Grant McCool, Andrew Hay and Marguerita Choy)

Source: http://news.yahoo.com/epa-temporarily-suspends-bp-u-federal-government-contracts-135930995--finance.html

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Family-Environmental Factors Associated with Attention Deficit Hyperactivity Disorder in Chinese Children: A Case-Control Study

BackgroundAttention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders, affecting an estimated 5 to 12% of school-aged children worldwide. From 15 to 19 million Chinese children suffer from ADHD. The aim of this study was to investigate the association between family-environmental factors and ADHD in a sample of Chinese children.MethodsA pair-matched, case-control study was conducted with 161 ADHD children and 161 non-ADHD children of matching age and sex, all from 5?18 years of age. The ADHD subjects and the normal controls were all evaluated via structured diagnostic interviews. We examined the association between family-environmental factors and ADHD using the conditional multiple logistic regression with backward stepwise selection to predict the associated factors of ADHD.ResultsHaving experienced emotional abuse and being a single child were both significant factors associated with children diagnosed with ADHD. ADHD subjects were more likely to have suffered from emotional abuse (OR?=?11.09, 95% CI?=?2.15?57.29, P?=?0.004) and have been a single child in the family (OR?=?6.32, 95% CI?=?2.09?19.14, P?=?0.001) when compared to normal controls. The results were not modified by other confounding factors.ConclusionOur findings provide evidence that family-environmental factors are associated with ADHD among children in China. These findings, if confirmed by future research, may help to decrease ADHD by increasing the awareness of the effects of childhood emotional abuse.

Xianming du Prel Carroll1, Honggang Yi2, Yuezhu Liang3, Ke Pang4, Sandra Leeper-Woodford5, Patrizia Riccardi6, Xianhong Liang4*

1 Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China, 2 Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China, 3 Beijing Children and Adolescents Mental Health Center, Beijing An Ding Hospital, Capital Medical University, Beijing, China, 4 Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China, 5 Division of Basic Medical Sciences, Mercer University School of Medicine, Macon, Georgia, United States of America, 6 Department of Psychiatry, Mercer University School of Medicine, Macon, Georgia, United States of America

Background

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders, affecting an estimated 5 to 12% of school-aged children worldwide. From 15 to 19 million Chinese children suffer from ADHD. The aim of this study was to investigate the association between family-environmental factors and ADHD in a sample of Chinese children.

Methods

A pair-matched, case-control study was conducted with 161 ADHD children and 161 non-ADHD children of matching age and sex, all from 5?18 years of age. The ADHD subjects and the normal controls were all evaluated via structured diagnostic interviews. We examined the association between family-environmental factors and ADHD using the conditional multiple logistic regression with backward stepwise selection to predict the associated factors of ADHD.

Results

Having experienced emotional abuse and being a single child were both significant factors associated with children diagnosed with ADHD. ADHD subjects were more likely to have suffered from emotional abuse (OR = 11.09, 95% CI = 2.15?57.29, P = 0.004) and have been a single child in the family (OR = 6.32, 95% CI = 2.09?19.14, P = 0.001) when compared to normal controls. The results were not modified by other confounding factors.

Conclusion

Our findings provide evidence that family-environmental factors are associated with ADHD among children in China. These findings, if confirmed by future research, may help to decrease ADHD by increasing the awareness of the effects of childhood emotional abuse.

Citation: du Prel Carroll X, Yi H, Liang Y, Pang K, Leeper-Woodford S, et al. (2012) Family-Environmental Factors Associated with Attention Deficit Hyperactivity Disorder in Chinese Children: A Case-Control Study. PLoS ONE 7(11): e50543. doi:10.1371/journal.pone.0050543

Editor: Ehsan U. Syed, Pennsylvania State University, United States of America

Received: April 15, 2012; Accepted: October 24, 2012; Published: November 28, 2012

Copyright: ? 2012 du Prel Carroll et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This research was funded by a grant support from Mercer University Seed Grant (2009?2010, account #2-26724, IRB#H0907165-01). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

* E-mail: hh_liang@hotmail.com

Introduction?Top

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders occurring during childhood and adolescence, affecting an estimated 5 to 12% of school-aged children worldwide [1]?[3]. Children with ADHD may suffer from cognitive and social deficits, in addition to displaying behavioral problems that result in disturbances in peer and family relationships, as well as poor academic achievement [4], [5]. Compared with the current data supporting the roles of genetic and biological factors in the etiology of ADHD, research on environmental, social and interpersonal aspects is less robust [6], [7].

Family structure, such as being a single child in a family with either two biological parents or with a single parent/step-parent, may play a role in child psychiatric disorders since these factors affect material resources and emotional strain in families [8], [9]. In a review of the family factors associated with ADHD, Johnston and Mash highlighted disturbances in family functioning, conflicted parent?child relationships, as well as increased parenting stress and psychopathology as common co-occurring factors [10], [11]. Previous investigations [12] have also found that child abuse and parental psychiatric disorders are associated with higher rates of ADHD with comorbid disruptive behavior disorder. While uncovering susceptibility genes for ADHD may help us understand the emergence of ADHD symptoms, researchers have speculated that unique environmental factors may play a larger role in determining outcomes for children, even if they are not a primary cause of the core symptoms [11], [13]. Understanding the risk and protective factors within the environment, such as the influence of the family, school and community, as well as their interactions with child characteristics, can extend the findings of genetic work in tracing the variability in development of children with ADHD.

A 3 year panel study in Taiwan [14] investigated adolescent mental disorder and showed that the most prevalent psychiatric condition among 7th and 8th graders was ADHD (weighted prevalence 7.5% and 6.1%). A recent survey [15] in China showed that a total of 15 to 19 million Chinese children suffer from ADHD, therefore indicating that ADHD has become a serious public health problem in China. As in many other countries today, youth in China are also facing greater familial-socio environmental stress than their predecessors. Owing to the rigid educational system and high parental expectation on academic achievement, the competition in joint entrance examinations for junior/senior high schools and universities is very keen [16]. These family-environmental changes and their impact on adolescent psychopathology deserve an adequate inquiry. However, studies on the relationship between ADHD and the family environment, with respect to how demographic variables interact with family factors, are lacking. The aim of this study is to investigate the relationship between family-environmental factors and ADHD in a sample of Chinese children. Our hypothesis is that these factors are related to the ADHD children and their family environment when compared to normal controls.

Methods?Top

Study Subjects

This study was designed as a pair matching case-control study and conducted from July 2009 to May 2010. ADHD subjects were recruited from the Beijing Children and Adolescents Mental Health Center at Beijing An Ding Hospital of Capital Medical University in Beijing, China. All ADHD (ICD-10 codes F90, 208?210) subjects were children of Chinese Han nationality and between 5 to 18 years old at the time of the investigation. All ADHD participants were evaluated by child psychiatrists and fully met DSM-IV-TR criteria for ADHD (any subtype) [17]. The DSM-IV-TR diagnostic criteria were previously translated into Chinese, and the reliability for the ADHD diagnosis was previously assessed [15], [18]?[20]. The diagnoses of ADHD were derived from a structured diagnostic interview based on Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-E) [21], which was modified to assess DSM-IV-TR criteria and incorporate parents? and teachers? reports of behavioral symptoms, clinical observation of behavior, the Aberrant Behavior Checklist [22], and tests of attention such as the Conners Continuous Performance Test [23]. One on one interviews of the ADHD participants, at least one of their parents/primary caregivers, and their teachers were conducted by trained researchers who are child/adolescent psychiatrists or psychologists in the outpatient department of the Beijing Children and Adolescents Mental Health Center. These diagnoses were then independently reassessed by two senior psychiatrists, who systematically reviewed all of the interview records. In the reassessment, the principle of rate-down was employed, and any information that was dubious or uncertain was discarded. Psychiatric diagnoses generated from this reassessment were jointly discussed, and a consensus diagnosis was taken as final. Exclusion criteria of the ADHD subjects included the presence of any other psychiatric illness such as depression, autism, Asperger syndrome, other pervasive developmental disorders (ICD-10 codes F84.0?F84.9, 308.0), and mental retardation (ICD-10 codes F70?F79, 312?315) [20].

Normal controls were children between 5 to 18 years old randomly selected from local elementary and middle/high schools during the same study period and from the same district in Beijing as the ADHD subjects. Using the pair-matched test design, each ADHD subject and normal control had the same sex and the same age (difference between birthdays within 6 months). The same exclusion criteria applied to the ADHD subjects was applied to the normal controls.

The study was approved by the institutional review boards of An Ding Hospital of Capital Medical University and Mercer University, and complied with all applicable requirements of the United States. Written informed consent was obtained from each of the parents after the purpose and procedure of the study was explained. Parents and teachers of the ADHD subjects completed the questionnaire with a participation rate of 97.5%, and parents and teachers of the normal controls completed the questionnaire with a participation rate of 100%.

Measures

Matched factors.

To address important confounding factors, such as the male sex and younger ages being associated with an increased prevalence of ADHD [24], [25], we designed pair-matches on age and sex for the control vs. ADHD subjects in this study. Therefore the control subjects were exposed to associated factors at the same sex and age as the ADHD subjects.

Biological factors.

The variable of maternal stress during pregnancy was provided by the biological mothers of both the ADHD and normal subjects. The mothers were asked whether or not they had experienced any of 10 major life stress events selected from a broader list of life stress events [26], [27]: pregnancy problems, death of a close friend or relative, separation or divorce, marital problems, problems with children, job loss (involuntary), partner?s job loss (involuntary), monetary problems, residential relocation, or any other stressful events. If the answer they provided was one or more positive response to the 10 major events during their pregnancy, the coding would be a ?yes?, otherwise ?no?. Pregnancy-induced hypertension (PIH) information was also provided by the affected mothers of the study subjects. We analyzed continuous potential factors, such as maternal age at the child?s birth, according to biological rationales (median split) as categorical variables: ?26 years, and >26 years of age. The data of our study sample showed that none of the mothers smoked or drank during pregnancy, so the variables of maternal smoking and maternal drinking were not considered for further analysis.

Family-environmental factors.

In the questionnaire, the parents were required to provide information about familial factors present during the child?s lifetime. Maternal and paternal education was assigned as being either compulsory education (?9 years), high school education (9?12 years), or some college or advanced training (?12 years) [20]. The number of siblings was asked to determine whether or not the child was a single child [28]. Family structure was divided into 2 categories [29]: the child having an intact family with both biological parents, and the child having other family structures (which included single-parent and 2-parent families, in which one or both parents were step-parents). Since literature suggests that family conflicts are connected with children functioning [30], [31], the parents informed in a yes/no format in regards to the occurrence of conflicts between adult family members/relatives. Emotional abuse was defined by two questions from the Conflict Tactics Scale (CTS) [32]. The questions, which were asked to the ADHD subjects, were as follows: 1) ?How often did a parent, stepparent, or adult living in your home swear at you, insult you, or put you down?? 2) ?How often did a parent, stepparent, or adult living in your home act in a way that made you afraid that you might be physically hurt?? Responses of ?often? or ?very often? to either item defined emotional abuse during childhood.

Lifestyle factors.

Altogether, seven lifestyle variables were included in this study. Parents were asked about their children?s exposure to domestic tobacco smoke and domestic alcohol consumption. Study factors were defined as binary variables - that is, domestic tobacco smoke (yes/no) and domestic alcohol consumption (yes/no) [33], [34]. Based on questions included on the 2009 US middle school Youth Risk Behavior Survey (YRBS) [35], parents and teachers were asked to report physical activity of the study subjects (?During the past 7 days, on how many days was the child physically active for a total of at least 60 minutes per day??). The answers were divided into the following: physical inactive, outdoor activity ?3 days in 1 week; physical active, outdoor activity >3 days in 1 week. Parents also reported on the number of hours that their child viewed television and accessed the internet. The American Academy of Pediatrics recommends that children ?2 years of age limit their time with entertainment media to ?1 to 2 hours of programming daily [36], [37]. The measure of interest was >2 hours of television viewing (including videos) and internet accessing daily. The behavioral factor for accidental injury was defined as a binary variable (yes/no), and a nutritional factor was also included in the questionnaire and defined as daily dietary supplement intake (yes/no).

Statistical Analyses

Statistical analyses were performed by SAS, version 9.2 (SAS Institute Inc., Cary, NC, USA). To assess the impact of the associated factors on the dependent variable-ADHD, we performed multivariate logistic regression analysis with all factors simultaneously included in the same model to adjust each other. The following independent variables were included in the model: age, sex, biological factors, family-environmental factors, and lifestyle factors. Finally, we performed a conditional logistic regression analysis with backward stepwise procedures based on the maximum partial likelihood estimates to construct a final best fit logistic regression model to identify the predictors of risk for ADHD among all factors. This specifies the significance level at p 0.05 for entering an explanatory variable into the model in the backward stepwise method. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for differing levels of exposure. All statistical tests were considered to be significant at an alpha level of 0.05 on a two-tailed test.

Results?Top

The analysis included 161 ADHD cases and 161 non-ADHD control subjects matched by age and sex. There were 113 boys and 48 girls included in the case group and control group of this study. There was no statistical age difference between the two groups (mean age of 12.89?2.96 in the case group and mean age of 12.91?2.81 in the control group).

Demographic and Distribution of Biological Factors, Family-environmental Factors, and Lifestyle Factors

General information in demographic and distribution of biological factors is shown in Table 1. We found that ADHD subjects were significantly associated with maternal stress during pregnancy (OR = 3.67, 95% CI = 1.49?9.04, p = 0.005).

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Table 1. Demographic and Distribution of Biological Factors of ADHD: Comparisons of ADHD Cases and Non-ADHD Control subjects.

doi:10.1371/journal.pone.0050543.t001

ORs for ADHD cases and controls by family-environmental factors are presented in Table 2. ADHD subjects were significantly associated with single-child (OR = 4.00, 95% CI = 2.27?7.044, p<.0001), family conflicts (OR = 3.09, 95% CI = 1.57?6.10, p = 0.001), presence of emotional abuse (OR = 10.50, 95% CI = 3.77?29.28, p<.0001), and paternal education (OR = 2.07, 95% CI = 1.07?4.01, p = 0.017) when the 9?12 years education group was compared with the ?12 years education group.

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Table 2. Distribution of Family-Environmental Factors of ADHD: Comparisons of ADHD Cases and Non-ADHD Control Subjects.

doi:10.1371/journal.pone.0050543.t002

In Table 3, we observed a significant association between ADHD subjects and being physically inactive (OR = 1.68, 95% CI = 1.05?2.68, p = 0.03).

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Table 3. Distribution of Lifestyle Factors of ADHD: Comparisons of ADHD Cases and Non-ADHD Control Subjects.

doi:10.1371/journal.pone.0050543.t003

The remaining variables in our analysis were not associated with ADHD status (Table 1, 2, 3).

Stepwise Logistic Regression Models Predicting the Strongest Association between All Factors and ADHD

To eliminate multivariable interaction and multicollinearity, we performed a backward stepwise logistic regression based on the maximum partial likelihood estimates. In the final best-fit model, the associations between ADHD and maternal stress during pregnancy, maternal age at childbirth, paternal education, family conflicts, and physical activity which were once significant (Table 1, 2, 3) had changed to not significant and were removed from the final model.

In contrast, the ORs (Table 4) for the association between emotional abuse and ADHD (OR = 11.09, 95% CI = 2.15?57.29, P = 0.004), and the association between being a single child and ADHD (OR = 6.32, 95% CI = 2.09?19.14, P = 0.001), were largely unchanged from estimates obtained in the original model used in Table 2. Therefore these two variables were kept in the final best fit model.

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Table 4. Associated Factors Identified in Backward Stepwise Logistic Regression Model.

doi:10.1371/journal.pone.0050543.t004

Discussion?Top

In this study, we examined the effects of family-environmental factors in pair-matched ADHD cases and normal controls in a population of Chinese children, 5 to18 years of age. The results show that having suffered emotional abuse and being a single child were likely to have strong associations with ADHD. The ADHD subjects were 11 times more likely to suffer from emotional abuse as compared to the normal controls.

Emotional Abuse

Recently, family-environmental factors such as abnormal intra-familial relationships, lack of emotional warmth towards the child, child maltreatment (physical/emotional), frequent arguments and fights between adults in the family, ambiguous communication patterns, parental separation/divorce and isolated family units, showed a trend towards an increasing risk for having a child with ADHD-related disorders, as reported previously in numerous studies. Poor parenting and conditions such as negative, inconsistent and detached parenting have been repeatedly reported as a risk factor for ADHD children [11], [38]. Pires et al. described that negative family relationships are associated with symptoms of ADHD, and children who suffered verbal abuse from their mother had prevalence 3.7 times higher than the ones not exposed to this situation in the last year [39]. Bandou et al. suggested that child abuse and maternal psychiatric disorders are significant risk factors in influencing the development of comorbid disruptive behavior disorders in offspring [12]. Also, Ouyang et al. indicated a significant association between inattentive ADHD symptoms and each type of child maltreatment [40]. Consistent with previous investigations, our present data confirms the findings of an association between ADHD and emotional abuse in Chinese children. We also found that the association is not influenced by other confounding factors.

There is a growing body of literature that supports the claim that psychological mistreatment is just as damaging as physical or sexual abuse, and child neglect [41]?[43]. Association between ADHD and child mistreatment has been reported for a variety of reasons [40]. The most important reason is that the behavior patterns found in children with ADHD disorders places those affected children at risk for parental mistreatment [40]. Extensive research on the parent-child interaction of children with ADHD reported a more stressful and conflicted family in those environments [10], [44]?[48]. Especially, child-rearing in Chinese societies is influenced by the Confucian ideology, which places emphasis on social norms and interpersonal harmony. Academic achievement is emphasized and dependence is encouraged. Due to the competition in joint entrance examinations for junior/senior high schools and universities being extremely strong, Chinese children are given more homework and spend more time receiving after-school tutoring [14], [16], [49]?[51]. As such, clinicians providing services to individuals with ADHD should be aware of the implications of co-occurring mistreatment and the associated risks.

Single Child

Since the 1970s, China has had a one-child policy and family planning program. Today the total fertility rate is 1.6, which releases 24% more resources for the family and national investments [52]?[54]. China is becoming a small-family culture. A study showed that 73 to 75% of respondents in the wealthy Jiangsu province were satisfied with their one child regardless of sex, whereas in the poorer Anhui province, 58% were satisfied with an only boy, while only 31% were satisfied with an only girl [55]. Besides the sex ratio, old-age dependency may become a Chinese problem in the future due to the 4 (grandparents): 2 (parents): 1(child) phenomenon. In addition, another consequence of the one-child policy has been to create a spoiled ?little prince? or ?little princess? in some Chinese families. Information about the relationship between the single child status and the ADHD disorder in the Chinese population is lacking. This study revealed that having a single child in a family was associated with the risk of ADHD diagnosis. The association was not influenced by other confounding factors. The reason may be due to the single child receiving more parental concern, so they are more likely to be brought to medical professionals for assessment and diagnosis. Since we cannot explain clearly the mechanism that underlies the correlation between single child status and ADHD, further investigation for the causal relationship is needed.

Other Family-environmental Factors

Previous studies have found that family-environmental factor such as family conflicts [56], [57] are associated with ADHD diagnosis. In contrast to these findings, the absence of statistically significant associations between the above factor and ADHD was unexpected in our study. The reason may be that the interactions between the related independent variables such as family conflicts and emotional abuse (correlation: r = 0.29, p<.0001), and family conflicts and family structure (correlation: r = 0.39, p<.0001) could influence family conflicts in the final best fit model. Previous works also found higher paternal education was associated with decreased risk for ADHD [24]. In our study, there is no relationship between paternal education and ADHD.

Previous reports have indicated that the biological factor of maternal stress during pregnancy is associated with ADHD [26], [27], [58]. In our study, there is no relationship between the above factor and ADHD. The reason might be recall bias, as the mothers who experienced life stress events during pregnancy may underreport it, which limits the statistical power in detecting a significant difference.

Previous studies also found that physical inactivity is associated with increased ADHD diagnosis in children [59]. We have not found the relationship between physical activity and ADHD in our study.

Further investigations are needed before definitive conclusions can be made about the possible effects of these potential factors on ADHD.

Limitations

Several limitations should be considered in interpreting the results of this study. First, case-control studies offer only hints about causal models leading to the development of ADHD. The use of terms such as ?prediction? and ?risk? are not meant to imply causal or temporal relationships. Second, retrospective self-reporting of prenatal complications or family environment and lifestyle factors may be susceptible to recall bias. Observational measures of parent-child interactions may be necessary to understand moment-to-moment relationships between parent and child behavior patterns. Other variables such as in utero tobacco and alcohol exposure may be also susceptible to recall bias. Third, this study lacks of a comparison of the differences between ADHD subgroups. Future research may focus the relationship between family-environmental factors and ADHD subgroups, especially on the difference between subgroups. Fourth, all of our subjects were Chinese Han; the cohort was not a random sample of the Chinese population so potential selection biases cannot be fully ruled out. In addition, children living in foster families were not included, so the results of this study may not generalize to children with different socioeconomic or ethnic backgrounds. Future studies may be proposed to address these limitations.

Conclusions

This hospital-based case-control study identified that emotional abuse and single child status are associated with ADHD children in China. The families and health care providers of children with ADHD should be aware of the implications of existing emotional abuse and the associated risks to these children. Appropriate parenting skills, such as proper supervision and prevention by increasing knowledge, need to be addressed for parents of children with ADHD, particular of single child families. Further investigations based on prospective, longitudinal birth cohorts are needed to explain the causal relationships between family-environmental factors and ADHD. Future studies may help to form the basis for successful intervention to prevent ADHD through reduction of family risk factors.

Acknowledgments?Top

We appreciate Dr. Shiji Zhang, Child Psychiatrist and Dr. Fan D. Chen, Epidemiologist, who closely cooperated with this project.

Author Contributions?Top

Conceived and designed the experiments: XdPC XHL. Performed the experiments: XdPC XHL. Analyzed the data: HGY. Contributed reagents/materials/analysis tools: KP YZL. Wrote the paper: XdPC XHL. Revised the manuscript critically for important intellectual content: SLW PR.

References?Top

  1. Freitag CM, H?nig S, Schneider A, Seitz C, Palmason H, et al. (2012) Biological and psychosocial environmental risk factors influence symptom severity and psychiatric comorbidity in children with ADHD. J Neural Transm 119: 81?94. Find this article online
  2. Biederman J, Faraone SV (2005) Attention-deficit hyperactivity disorder. Lancet 366: 237?248. Find this article online
  3. Zimmerman ML (2003) Attention-deficit hyperactivity disorder. Nurs Clin North Am 38: 55?66. Find this article online
  4. Biederman J (1998) Attention-deficit/hyperactivity disorder: a life-span perspective. J Clin Psychiatry 59 Suppl 7: 4?16. Find this article online
  5. Stevenson J, Asherson P, Hay D, Levy F, Swanson J, Thapar A, et al. (2005) Characterizing the ADHD phenotype for genetic studies. Dev Sci 8: 115?121. Find this article online
  6. Pheula GF, Rohde LA, Schmitz M (2011) Are family variables associated with ADHD, inattentive type? A case-control study in schools. Eur Child Adolesc Psychiatry 20: 137?45. Find this article online
  7. Froehlich TE, Anixt JS, Loe IM, Chirdkiatgumchai V, Kuan L, et al. (2011) Update on environmental risk factors for attention-deficit/hyperactivity disorder. Curr Psychiatry Rep 13: 333?44. Find this article online
  8. Vollebergh VAM, ten Have M, Dekovic M, Oosterwegel A, Pels T, et al. (2005) Mental health in immigrant children in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 40: 489?496. Find this article online
  9. Rydell AM (2010) Family factors and children?s disruptive behavior: an investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD. Soc Psychiatry Psychiatr Epidemiol 45: 233?44. Find this article online
  10. Johnston C, Mash EJ (2001) Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child Fam Psychol Rev 4: 183?207. Find this article online
  11. Deault LC (2010) A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry Hum Dev 41: 168?92. Find this article online
  12. Bandou N, Koike K, Matuura H (2010) Predictive familial risk factors and pharmacological responses in ADHD with comorbid disruptive behavior disorders. Pediatr Int 52: 415?9. Find this article online
  13. Barkley RA (2005) ADHD and the nature of self-control. Guilford Press, New York.
  14. Gau SS, Chong MY, Chen TH, Cheng AT (2005) A 3-year panel study of mental disorders among adolescents in Taiwan. Am J Psychiatry 162: 1344?50. Find this article online
  15. Shan H (2007) ADHD Affects over 15 Million Chinese Children. China.org.cn http://www.china.org.cn/english/China/21?9830.htm.
  16. Gau SF, Soong WT (1995) Sleep problems of junior high school students in Taipei. Sleep18: 667?73. Find this article online
  17. APA (2000) Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
  18. Su L, Wan G, Yang Z, Yu S, Li X (2001) The study of diagnostic criteria for attention deficit hyperactivity disorder. Chin J Nerv Ment Dis 27: 199?201. Find this article online
  19. Chen YZ, Wen FQ, Zhou KY, Yang CH, Zhang W, et al. (2010) Clinical features of various subtypes of attention deficit hyperactivety disorders in children. Chin J Contemp Pediatr 12: 704?708. Find this article online
  20. Wang HL, Chen XT, Yang B, Ma FL, Wang S, et al. (2008) Case-control study of blood lead levels and attention deficit hyperactivity disorder in Chinese children. Environ Health Perspect 116: 1401?6. Find this article online
  21. Ambrosini PJ (2000) Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry 39: 49?58. Find this article online
  22. Aman MG, Singh NN (1986) Aberrant Behavior Checklist: Manual. New York: Slosson Educational Publications.
  23. Homack S, Riccio CA (2006) Conners? Continuous Performance Test (2nd ed. CCPT-II). J Atten Disord 9: 556?558. Find this article online
  24. Biederman J, Mick E, Faraone SV, Braaten E, Doyle A, et al. (2002) Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic. Am J Psychiatry 159: 36?42. Find this article online
  25. Visser SN, Lesesne CA, Perou R (2007) National estimates and factors associated with medication treatment for childhood attention-deficit/hyperactivity disorder. Pediatrics 119: 99?106. Find this article online
  26. Tennant C, Andrews G (1976) A scale to measure the stress of life events. Aust. N. Z. J. Psychiatry 10: 27?32. Find this article online
  27. Ronald A, Pennell CE, Whitehouse AJO (2010) Prenatal maternal stress associated with ADHD and autistic traits in early childhood. Front Psychol 1: 1?8. Find this article online
  28. Du Prel X, Kr?mer U, Behrendt H, Johannes Ring, Hanna Oppermann, et al. (2006) Preschool children?s health and its association with parental education and individual living conditions in East and West Germany. BMC Public Health 6: 312. Find this article online
  29. Rydell AM (2010) Family factors and children?s disruptive behaviour: an investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD. Soc Psychiat Epidemiol 45: 233?244. Find this article online
  30. Counts CA, Nigg JT, Stawicki JA, Rappley MD, von Eye A (2005) Family adversity in DSM-IV ADHD combined and inattentive subtypes and associated disruptive behaviour problems. J Am Acad Child Adolesc Psychiatry 44: 690?698. Find this article online
  31. Cunningham CE, Boyle MH (2002) Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family, parenting and behavioural correlates. J Abnorm Child Psychol 30: 555?569. Find this article online
  32. Dube SR, Felitti VJ, Dong M, Chapman DP, Giles WH, et al. (2003) Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics 111: 564?72. Find this article online
  33. Du Prel X, Kr?mer U, Ranft U (2006) Time trends in exposure to environmental tobacco smoke and parental educational level for 6-year-old children in Germany. Journal of Public Health 14: 309?315. Find this article online
  34. Torvik FA, Rognmo K, Ask H, R?ysamb E, Tambs K (2011) Parental alcohol use and adolescent school adjustment in the general population: Results from the HUNT study. BMC Public Health 11: 706. Find this article online
  35. Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, et al. (2010) Youth risk behavior surveillance - United States, 2009. MMWR Surveill Summ 59: 1?142. Find this article online
  36. American Academy of Pediatrics (1999) Committee on Public Education (1999) Media education. Pediatrics 104: 341?343. Find this article online
  37. Mistry KB, Minkovitz CS, Strobino DM, Borzekowski DL (2007) Children?s Television Exposure and Behavioral and Social Outcomes at 5.5 Years: Does Timing of Exposure Matter? Pediatrics 120: 762?769. Find this article online
  38. Pfiffner LJ, McBurnett K, Rathouz PJ, Judice S (2005) Family correlates of oppositional and conduct disorders in children with attention deficit/hyperactivity disorder. J Abnorm Child Psychol 33: 551?63. Find this article online
  39. Pires TD, Silva CM, Assis SG (2012) Family environment and attention-deficit hyperactivity disorder. Rev Saude Publica pii: S0034-89102012005000043.
  40. Ouyang L, Fang X, Mercy J, Perou R, Grosse SD (2008) Attention-deficit/hyperactivity disorder symptoms and child maltreatment: a population-based study. J Pediatr 153: 851?6. Find this article online
  41. Edwards VJ, Holden GW, Felitti VJ, Anda RF (2003) Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. Am J Psychiatry 160: 1453?1460. Find this article online
  42. Sesar K, Zivci?-Be?irevi? I, Sesar D (2008) Multi-type maltreatment in childhood and psychological adjustment in adolescence: questionnaire study among adolescents in Western Herzegovina Canton. Croat Med J 49: 243?256. Find this article online
  43. Higgins DJ, McCabe MP (2000) Relationships between different types of maltreatment during childhood and adjustment in adulthood. Child Maltreat 5: 261?272. Find this article online
  44. Egeland B, Sroufe LA, Erickson M (1983) The developmental consequence of different patterns of maltreatment. Child Abuse Negl 7: 459?69. Find this article online
  45. Ford JD, Racusin R, Ellis CG, Daviss WB, Reiser J, et al. (2000) Child maltreatment, other trauma exposure, and posttraumatic symptomatology among children with oppositional defiant and attention deficit hyperactivity disorders. Child Maltreat 5: 205?17. Find this article online
  46. Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M (1993) Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry 50: 565?76. Find this article online
  47. Barkley RA, Fischer M, Smallish L, Fletcher K (2006) Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry 45: 192?202. Find this article online
  48. De Sanctis VA, Trampush JW, Harty SC, Marks DJ, Newcorn JH, et al. (2008) Childhood maltreatment and conduct disorder: independent predictors of adolescent substance use disorders in youth with attention deficit/hyperactivity disorder. J Clin Child Adolesc Psychol 37: 785?93. Find this article online
  49. Lam AK, Ho TP (2010) Early adolescent outcome of attention-deficit hyperactivity disorder in a Chinese population: 5-year follow-up study. Hong Kong Med J 16: 257?64. Find this article online
  50. Sun H (2003) Physical and Mental health of contemporary Chinese children. Journal of Family and Economic Issues 24: 355?364. Find this article online
  51. Gomez R, Vance A (2008) Parent ratings of ADHD symptoms: differential symptom functioning across Malaysian Malay and Chinese children. J Abnorm Child Psychol 36: 955?67. Find this article online
  52. Potts M (2006) China?s one child policy. BMJ 333: 361?2. Find this article online
  53. Hesketh T, Lu L, Xing ZW (2005) The effect of China?s one-child family policy after 25 years. N Engl J Med 353: 1171?6. Find this article online
  54. Wang C (2011) History of the Chinese Family Planning program: 1970?2010. Contraception Dec 14.
  55. Hardee K, Xie Z, Gu B (2004) Family planning and women?s lives in rural China. Int Fam Plan Perspect 30: 68?76. Find this article online
  56. Talge NM, Neal C, Glover V (2007) Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry 48: 245?61. Find this article online
  57. Biederman J, Milberger S, Faraone SV, Kiely K, Guite J, et al. (1995) Family-environment risk factors for attention-deficit hyperactivity disorder. A test of Rutter?s indicators of adversity. Arch Gen Psychiatry 52: 464?70. Find this article online
  58. Li J, Olsen J, Vestergaard M, Obel C (2010) Attention-deficit/hyperactivity disorder in the offspring following prenatal maternal bereavement: a nationwide follow-up study in Denmark. Eur Child Adolesc Psychiatry 19: 747?53. Find this article online
  59. Grigsby-Toussaint DS, Chi SH, Fiese BH (2011) Where they live, how they play: Neighborhood greenness and outdoor physical activity among preschoolers. Int J Health Geogr 10: 66. Find this article online

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