title: Self-directedness and cooperativeness, psychosocial dysfunction and suffering in ESSENCE.
abstract: BACKGROUND
  The acronym ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) highlights that children seeking clinical treatment are often multiply impaired, thus requiring treatment from several specialties. The aim was to map and relate, on a population level, ESSENCE to two salient predictors of health and adaptation to adversities, namely, Self-Directedness and Cooperativeness and also to dysfunction and suffering.
  
  
  METHODS
  Participants were twins (N = 1892) aged 9 or 12 whose parents were interviewed with the Autism-Tics, ADHD and other Comorbidities inventory (A-TAC), and the Junior Temperament and Character Inventory (J-TCI). The A-TAC was first used to discern four ESSENCE-related screening diagnoses: autism spectrum disorders, attention deficit hyperactivity disorder, learning disabilities, and developmental coordination disorder; second, to quantify dysfunction and suffering in important social areas.
  
  
  RESULTS
  ESSENCE symptoms were continuously and categorically associated with deficiency in Self-Directedness and Cooperativeness and higher ratings of dysfunction and suffering. The impact of ESSENCE symptoms on these measures of mental health was found in a milder form in about 16% of all children and in a severe form in about 2%.
  
  
  CONCLUSIONS
  Therapeutic interventions focusing on Self-Directedness and Cooperativeness might provide a novel method for child psychiatry in its approach to ESSENCE.
authors.affiliation: Centre for Ethics, Law and Mental Health CELAM, University of Gothenburg, Wallinsgatan 8, Mölndal, 431 41 Gothenburg, Sweden. danilo.garcia@neuro.gu.se
authors.forename: Danilo
authors.initials: D
authors.lastname: Garcia
authors.forename: Henrik
authors.initials: H
authors.lastname: Anckarsäter
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lundström
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology