Psychometric properties of the Social Behavior Questionnaire (SBQ) in a longitudinal population-based sample

We assessed the psychometric properties of the Social Behavior Questionnaire (SBQ), a 30-item questionnaire evaluating social (e.g., disruptive behaviors, bullying) and emotional problems (e.g., anxiety, depression) among children aged 3.5–12 years. Children ( n = 1,950, 50.21% boys) were drawn from the Quebec Longitudinal Study of Child Development. Mothers reported the frequency with which children presented social and emotional behaviors from 3.5 to 8 years of age, and teachers from 6 to 12 years. We assessed internal structure using Confirmatory Factor Analysis, reliability using Cronbach’s alpha, and convergent and discriminant validity using a multitrait-multimethod (MTMM) approach. The six-factor (emotional distress, withdrawal, impulsive/hyperactive/inattentive, disruptive behaviors, prosocial behaviors, and peer relationships difficulties) structure of the SBQ showed good fit from ages 3.5 to 12 years. Reliability estimates were good to excellent (alphas > .7), and MTMM showed good convergent and discriminant validity. Overall, the SBQ presented good psychometric properties with a large population-based sample aged 3.5–12 years. Further studies should assess its screening potential by investigating its convergent validity with diagnostic information.

Testing Bidirectional, Longitudinal Associations Between Disturbed Sleep and Depressive Symptoms in Children and Adolescents Using Cross-Lagged Models

IMPORTANCE

Understanding the longitudinal, bidirectional associations between disturbed sleep and depression in childhood and adolescence is crucial for the development of prevention and intervention programs.

OBJECTIVE

To test for bidirectional associations and cascade processes between disturbed sleep and depressive symptoms covering both childhood and adolescence and to test for the moderating processes of sex and pubertal status in adolescence.

DESIGN, SETTING, AND PARTICIPANTS

A prospective cohort study using the Québec Longitudinal Study of Child Development (QLSCD; 1997-ongoing). QLSCD's objective is to identify early childhood factors associated with long-term psychosocial and academic adjustment. Data were collected across 8 waves between ages 5 years (2003) and 17 years (2015). Associations were tested through cross-lagged models in childhood (5, 7, and 8 years), and in adolescence (10, 12, 13, 15, and 17 years). Data were analyzed from February to October 2021.

MAIN OUTCOMES AND MEASURES

Primary outcomes were disturbed sleep and depressive symptoms. Disturbed sleep was parent-reported and included sleep duration, time awake in bed, daytime sleepiness, sleep talking, sleepwalking, night terrors, and nightmares. Depressive symptoms were parent-reported in childhood (Child Behavior Checklist and Revised Ontario Child Health Study Scales), and self-reported in adolescence (Mental Health and Social Inadaptation Assessment for Adolescents).

RESULTS

Data on 1689 children (852 female [50.4%]) and 1113 adolescents (595 female [53.5%]) were included in the analyses. In childhood, significant bidirectional associations between depressive symptoms and disturbed sleep at all time points were found, indicating cascade processes (range β = 0.07; 95% CI, 0.02-012 to β = 0.15; 95% CI, 0.10-0.19). In adolescence, significant bidirectional associations from depressive symptoms to disturbed sleep (β = 0.09; 95% CI, 0.04-0.14) and vice versa (β = 0.10; 95% CI, 0.04-0.16) between 10 and 12 years were found. Between 12 and 13 years, depressive symptoms were modestly associated with disturbed sleep (β = 0.05; 95% CI, 0.001-0.10) but the reverse association was not significant. Cross-lagged estimates were nonsignificant after 13 years. The associations did not vary as a function of either sex or puberty-by-sex.

CONCLUSIONS AND RELEVANCE

These findings suggest that disturbed sleep is associated with the consolidation of depressive symptoms starting in childhood, which, in turn, is associated with ongoing sleep problems. It is possible that timely and appropriate interventions for incipient disturbed sleep and depression prevent spiraling effects on both domains.

Developmental trajectories of eating disorder symptoms: A longitudinal study from early adolescence to young adulthood

BACKGROUND

Adolescence is a critical period for the development of eating disorders, but data is lacking on the heterogeneity of their evolution during that time-period. Group-based trajectories can be used to understand how eating disorders emerge and evolve over time. The aim of this study was to identify groups of individuals with distinct levels of eating disorder symptoms between 12 and 20 years and the onset of different types of symptoms. We also studied sex differences in the evolution and course of eating disorder symptoms from early adolescence to adulthood.

METHODS

Using archival data from the QLSCD cohort, trajectories of eating disorder symptomatology were estimated from ages 12 to 20 years using semiparametric models. These trajectories included overall eating disorder symptomatology as measured by the SCOFF (Sick, Control, One Stone, Fat, Food), sex, and symptom-specific trajectories.

RESULTS

Two groups of adolescents following distinct trajectories of eating disorder symptoms were identified. The first trajectory group included 30.9% of youth with sharply rising levels between 12 and 15 years, followed by high levels of symptoms between 15 and 20 years. The second trajectory group included 69.1% of youth with low and stable levels of symptoms between 12 and 20 years. Sex-specific models indicated that the proportion of girls in the high trajectory group was 1.3 times higher than the proportion of boys (42.8% girls vs. 32.3% boys). Trajectories of SCOFF items were similar for loss-of-control eating, feeling overweight, and attributing importance to food. The weight loss item had a different developmental pattern, increasing between 12 and 15 years and then decreasing between 17 and 20 years.

CONCLUSIONS

The largest increase in eating disorder symptoms in adolescence is between the ages of 12 and 15 . Yet, most prevention programs start after 15 years of age. Our findings suggest that, unlike common practices, eating disorder prevention programs should aim to start before puberty.

The Associations Between Child-Care Services During the Preschool Years and High School Graduation: A 20-Year Longitudinal Population-Based Study

OBJECTIVE

Together with family factors, early care and education (ECE) services were shown to improve school readiness in kindergarten. However, it is not clear whether better school readiness at age 6 years translates into higher rates of high school graduation years later. Our objective was therefore to investigate the long-term associations between the use of ECE and high school graduation while considering the sex of the child and the socioeconomic status of the parents as moderators.

METHODS

Participants were children from the Quebec Longitudinal Study on Child Development (QLSCD) born in 1997 to 1998 (N = 2001). Intensity and type of ECE exposure were measured from age 5 months to 5 years. Administrative records were used to determine whether students had obtained a high school diploma by age 20 years. Factors explaining differences in the profiles of ECE users were controlled using propensity score weights.

RESULTS

Twenty-two percent of students did not have a high school diploma by age 20 years. Compared with children never exposed to center-based care, those exposed early (i.e., before toddlerhood) had better odds of graduating from high school (odds ratio = 1.49) after controlling for confounding factors. Late exposure to center-based care was not related to high school graduation rates.

CONCLUSION

Exposure to regulated and center-based ECE on a regular basis from toddlerhood to school entry was associated with higher rates of high school graduation. Regulated center-based ECE at the population level may improve rates of high school graduation.

Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: longitudinal analyses from two 20-year birth cohort studies

BACKGROUND

We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt.

METHODS

Data were from the Québec Longitudinal Study of Child Development (QLSCD, N = 1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5734). Exposures to 32 perinatal adversities (e.g. fetal, obstetric, psychosocial, and parental psychopathology) were modeled using latent class analysis, and associations with a self-reported suicide attempt by age 20 were investigated with logistic regression. We investigated to what extent childhood emotional and behavioral problems, victimization, and cognition explained the associations.

RESULTS

In both cohorts, we identified five profiles: No perinatal risk, Poor fetal growth, Socioeconomic adversity, Delivery complications, Parental mental health problems (ALSPAC only). Compared to children with No perinatal risk, children in the Poor fetal growth (pooled estimate QLSCD-ALSPAC, OR 1.89, 95% CI 1.04-3.44), Socioeconomic adversity (pooled-OR 1.42, 95% CI 1.08-1.85), and Parental mental health problems (OR 1.74, 95% CI 1.27-2.40), but not Delivery complications, profiles were more likely to attempt suicide. The proportion of this effect mediated by the putative mediators was larger for the Socioeconomic adversity profile compared to the others.

CONCLUSIONS

Perinatal adversities associated with suicide attempt cluster in distinct profiles. Suicide prevention may begin early in life and requires a multidisciplinary approach targeting a constellation of factors from different domains (psychiatric, obstetric, socioeconomic), rather than a single factor, to effectively reduce suicide vulnerability. The way these factors cluster together also determined the pathways leading to a suicide attempt, which can guide decision-making on personalized suicide prevention strategies.

Attention deficit hyperactivity disorder symptoms and cannabis use after one year among students of the i-Share cohort

Background

Cannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use.

Methods

Students in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year.

Results

Increase in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year—once a month adjusted odds ratio [OR]: 1.24 (1.15–1.34), more than once a month adjusted OR: 1.43 (1.27–1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year—once a month adjusted OR: 1.15 (0.95–1.39), more than once a month adjusted OR: 1.16 (0.67–2)) but remained in participants who ever used cannabis at inclusion (once a year—once a month adjusted OR: 1.17 (1.06–1.29), more than once a month adjusted OR: 1.35 (1.18–1.55)).

Conclusions

High levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations.

Understanding and attenuating pandemic-related disruptions: a plan to reduce inequalities in child development

The Secretary General of the United Nations described the impact of COVID-19-related school closures as a “generational catastrophe.” What will be the legacy of the 2020–2021 pandemic-related disruptions in 5, 10, 20 years from now, as regards education and well-being of children and youth? Addressing the disproportionate impact on those growing up in socio-economically disadvantaged areas or on those with pre-existing learning challenges is key to sustainable recovery. This commentary builds on the four literature reviews presented in this Special Section on a Pandemic Recovery Plan for Children and proposes strategies to understand and attenuate the impact of pandemic-related lockdown measures. Importantly, we need a monitoring strategy to assess indicators of child development in three areas of functioning: education and learning, health, and well-being (or mental health). Surveillance needs to begin in the critical prenatal period (with prenatal care to expectant parents), and extend to the end of formal high school/college education. Based on child development indicators, a stepped strategy for intervention, ranging from all-encompassing population-based health and education promotion initiatives to targeted prevention programs and targeted remedial/therapeutic interventions, can be offered. As proposed in the UN plan for recovery, ensuring healthy present and future generations involves a concerted and intensive intersectoral effort from the education, health, psychosocial services, and scientific communities.

A three-factor model of common early onset psychiatric disorders: temperament, adversity, and dopamine

Commonly comorbid early onset psychiatric disorders might reflect the varying expression of overlapping risk factors. The mediating processes remain poorly understood, but three factors show some promise: adolescent externalizing traits, early life adversity, and midbrain dopamine autoreceptors. To investigate whether these features acquire greater predictive power when combined, a longitudinal study was conducted in youth who have been followed since birth. Cohort members were invited to participate based on externalizing scores between 11 to 16 years of age. At age 18 (age 18.5 ± 0.6 y.o.), 52 entry criteria meeting volunteers had a 90-min positron emission tomography scan with [¹⁸F]fallypride, completed the Childhood Trauma Questionnaire, and were assessed with the Structured Clinical Interview for DSM-5. The three-factor model identified those with a lifetime history of DSM-5 disorders with an overall accuracy of 90.4% (p = 2.4 × 10^-5) and explained 91.5% of the area under the receiver operating characteristic curve [95% CI: .824, 1.000]. Targeting externalizing disorders specifically did not yield a more powerful model than targeting all disorders (p = 0.54). The model remained significant when including data from participants who developed their first disorders during a three-year follow-up period (p = 3.5 × 10^-5). Together, these results raise the possibility that a combination of temperamental traits, childhood adversity, and poorly regulated dopamine transmission increases risk for diverse, commonly comorbid, early onset psychiatric problems, predicting this susceptibility prospectively.

Emotional and attention-deficit/hyperactivity disorder symptoms of preterm vs. full-term children during COVID-19 pandemic restrictions

BACKGROUND

Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration of children's mental health was observed during COVID-19 pandemic restrictive measures. Our study compared emotional and attention-deficit/hyperactivity disorder (ADHD) symptoms during school closure between preterm and full-term children.

METHODS

Data from two French birth cohorts-ELFE and EPIPAGE-2-were used. In 2011, infants born ≥22 weeks' gestation were recruited. Parents completed the Strengths and Difficulties Questionnaire when the children were 9 years old and experiencing school closure. Multivariate multinomial logistic regression models were used.

RESULTS

Subjects included 4164 full-term and 1119 preterm children. In univariate analyses, compared to full-term children: extremely and very preterm children more frequently had abnormal and borderline ADHD scores (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.50-2.30, OR 1.42, 95% CI 1.08-1.85, respectively) and abnormal emotional scores (OR 1.86, 95% CI 1.43-2.40); moderate to late preterm children more often had abnormal ADHD scores (OR 1.33, 95% CI 1.01-1.78). The associations did not remain when previous symptoms at 5 years old were considered.

CONCLUSIONS

School closure during lockdown did not appear to increase the risk of mental health problems in preterm compared to full-term children.

IMPACT STATEMENT

Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration in children's mental health was observed during COVID-19 pandemic restrictions. However, whether preterm children were a particularly vulnerable subgroup during school closure is unclear. In univariate analyses, extremely and very preterm children more often had abnormal and borderline ADHD symptoms and abnormal emotional symptom scores than full-term children. The associations did not remain significantly associated when previous symptoms were considered. Preterm compared to full-term children more often suffer from ADHD and emotional symptoms, but school closure during lockdown did not appear to increase this risk.

Identifying environmental pathways between irritability during childhood and suicidal ideation and attempt in adolescence: findings from a 20-year population-based study

BACKGROUND

Irritable children are at increased risk of suicidal ideation and suicide attempt, but the underlying environmental mechanisms accounting for these associations are largely unknown. We aimed to investigate the mediating role of peer victimization and harsh parenting in the association between childhood irritability and adolescent suicidal ideation and attempt.

METHOD

N = 1,483 participants from the Québec Longitudinal Study of Child Development followed up from 5 months until 20 years of age (2018) with annual or biannual assessments. Irritability was operationalized using assessments of teacher-reported temper tantrums and reactive aggression. Suicidal ideation and suicide attempt at ages 13, 15, 17, and 20 years were self-reported. Peer victimization (self-reported at age 13) and harsh parenting (mothers reported at age 13) were considered as potential mediators.

RESULTS

We identified four trajectories of teacher-reported irritability symptoms from 6 to 12 years: low (74.8%), rising (12.9%), declining (7.3%), and persistent (4.9%). In adjusted models, children in the persistent and rising trajectories had, respectively, 2.81-fold (CI, 1.27-6.22) and 2.14-fold (CI, 1.20-3.81) increased odds of suicide attempt in adolescence, but not suicidal ideation. We found that a significant proportion of the association between irritability trajectories and suicide attempt was mediated by peer victimization (33% and 35% for rising and persistent, respectively), but there was no mediation via harsh parenting.

CONCLUSIONS

Our findings suggest that peer victimization may be a key mechanism explaining the increased suicide attempt risk of children presenting with persistently high or increasing irritability. Interventions to reduce peer victimization may be helpful to reduce suicide risk among irritable children.

Polygenic scores differentially predict developmental trajectories of subtypes of social withdrawal in childhood

BACKGROUND

Children who consistently withdraw from social situations face increased risk for later socioemotional difficulties. Twin studies indicate that genetic factors substantially account for the persistence of social withdrawal over time. However, the molecular genetic etiology of chronic courses of social wariness and preference for solitude, two dimensions of social withdrawal, remains undocumented. The objectives of the present study were (a) to identify high-risk trajectories for social wariness and preference for solitude in childhood and (b) to examine whether falling on these high-risk trajectories can be predicted by specific polygenic scores for mental health traits and disorders and by a general polygenic predisposition to these traits.

METHODS

Teachers evaluated 971 genotyped children at five occasions (age 6 to 12 years) from two prospective longitudinal studies, the Quebec Newborn Twin Study and the Quebec Longitudinal Study of Child Development. Developmental trajectories for social wariness and preference for solitude were identified. We tested whether polygenic scores for attention deficit hyperactivity disorder, autism spectrum disorder, depression, loneliness, and subjective well-being, as well as a general mental health genetic risk score derived across these traits, were associated with the developmental trajectories.

RESULTS

Polygenic scores differentially predicted social wariness and preference for solitude. Only the loneliness polygenic score significantly predicted the high trajectory for social wariness. By contrast, the general mental health genetic risk score factor was associated with the trajectory depicting high-chronic preference for solitude.

CONCLUSIONS

Distinct associations were uncovered between the polygenic scores, social wariness, and preference for solitude.

Long-term economic and social outcomes of youth suicide attempts

BACKGROUND

Youth who attempt suicide are more at risk for later mental disorders and suicide. However, little is known about their long-term socioeconomic outcomes.

AIMS

We investigated associations between youth suicide attempts and adult economic and social outcomes.

METHOD

Participants were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 2140) and followed up from ages 6 to 37 years. Lifetime suicide attempt was assessed at 15 and 22 years. Economic (employment earnings, retirement savings, welfare support, bankruptcy) and social (romantic partnership, separation/divorce, number of children) outcomes were assessed through data linkage with government tax return records obtained from age 22 to 37 years (2002-2017). Generalised linear models were used to test the association between youth suicide attempt and outcomes adjusting for background characteristics, parental mental disorders and suicide, and youth concurrent mental disorders.

RESULTS

By age 22, 210 youths (9.8%) had attempted suicide. In fully adjusted models, youth who attempted suicide had lower annual earnings (average last 5 years, US$ -4134, 95% CI -7950 to -317), retirement savings (average last 5 years, US$ -1387, 95% CI -2982 to 209), greater risk of receiving welfare support (risk ratio (RR) = 2.05, 95% CI 1.39 to 3.04) and were less likely to be married/cohabiting (RR = 0.82, 95% CI 0.73 to 0.93), compared with those who did not attempt suicide. Over a 40-year working career, the loss of individual earnings attributable to suicide attempts was estimated at US$98 384.

CONCLUSIONS

Youth who attempt suicide are at risk of poor adult socioeconomic outcomes. Findings underscore the importance of psychosocial interventions for young people who have attempted suicide to prevent long-term social and economic disadvantage.

Contribution of birth weight to mental health, cognitive and socioeconomic outcomes: two-sample Mendelian randomisation

BACKGROUND

Low birth weight is associated with adult mental health, cognitive and socioeconomic problems. However, the causal nature of these associations remains difficult to establish owing to confounding.

AIMS

To estimate the contribution of birth weight to adult mental health, cognitive and socioeconomic outcomes using two-sample Mendelian randomisation, an instrumental variable approach strengthening causal inference.

METHOD

We used 48 independent single-nucleotide polymorphisms as genetic instruments for birth weight (genome-wide association studies' total sample: n = 264 498) and considered mental health (attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), schizophrenia, suicide attempt), cognitive (intelligence) and socioeconomic (educational attainment, income, social deprivation) outcomes.

RESULTS

We found evidence for a contribution of birth weight to ADHD (OR for 1 s.d. unit decrease (~464 g) in birth weight, 1.29; 95% CI 1.03-1.62), PTSD (OR = 1.69; 95% CI 1.06-2.71) and suicide attempt (OR = 1.39; 95% CI 1.05-1.84), as well as for intelligence (β = -0.07; 95% CI -0.13 to -0.02) and socioeconomic outcomes, i.e. educational attainment (β = -0.05; 95% CI -0.09 to -0.01), income (β = -0.08; 95% CI -0.15 to -0.02) and social deprivation (β = 0.08; 95% CI 0.03-0.13). However, no evidence was found for a contribution of birth weight to the other examined mental health outcomes. Results were consistent across a wide range of sensitivity analyses.

CONCLUSIONS

These findings support the hypothesis that birth weight could be an important element on the causal pathway to mental health, cognitive and socioeconomic outcomes.

Childcare Attendance and Academic Achievement at Age 16 Years

IMPORTANCE

Low school preparedness is linked to high school dropout, poor employment, and negative outcomes. Childcare attendance may increase school readiness and foster academic achievement.

OBJECTIVE

To explore whether childcare attendance was associated with academic achievement at the end of compulsory schooling (age 16 years in the UK), whether maternal education level was a moderator, and the benefit-cost ratio of childcare regarding productivity returns of academic achievement.

DESIGN, SETTING, AND PARTICIPANTS

In this cohort study, data were included from the Avon Longitudinal Study of Parents and Children (ALSPAC) born from April 1991 to December 1992 and the UK National Pupil Database for examination results. Data on academic achievement at age 16 years were available for 11 843 participants. Data were collected from June 2006 to June 2008, and data were analyzed from September 2019 to May 2020.

EXPOSURES

On average, 3.7%, 5.9%, and 90.4% attended childcare full time, part time, and less than 10 hours per week, respectively. Maternal education was assessed by questionnaire during pregnancy. Analyses included weights for population representativeness and propensity score weights to account for parental selection into childcare.

MAIN OUTCOMES AND MEASURES

Academic achievement was defined as no certificate, Level 1 General Certificate of Secondary Education (GCSE; limited training), or Level 2 GCSE (qualification for academic post-16 education; high school diploma equivalent). Lifetime productivity return estimates were withdrawn from previous economic analysis based on pupil's qualifications.

RESULTS

Of 14 541 children in the ALSPAC study, 8936 children had complete data on childcare attendance, academic achievement, and maternal education levels. Of these, 4499 (50.3%) were male. Attending childcare was associated with higher probabilities of obtaining a Level 1 or 2 GCSE qualification (Level 1: relative risk, 1.41; 95% CI, 1.16-1.73; Level 2: relative risk, 1.62; 95% CI, 1.30-2.01); however, this association was moderated by the child's maternal education level. When children of mothers with low education attended childcare, their probability of no GCSE qualification went from 28.9% (95% CI, 26.8-31.0) to 20.3% (95% CI, 18.0-22.8), whereas children of mothers with higher education had a probability of no qualification of less than 10% regardless of childcare attendance. The benefit-cost ratio for each £1 (US $1.40) invested in full-time childcare attendance for children of mothers with low education was £1.71 (95% CI, 1.03-2.45; US $2.39; 95% CI, 1.44-3.43) for those who reached a Level 2 GCSE qualification.

CONCLUSIONS AND RELEVANCE

Promoting universal childcare with facilitated access for children of lower socioeconomic backgrounds deserves to be considered as a way to reduce the intergenerational transmission of low academic achievement.

Longitudinal associations of cannabis, depression, and anxiety in heterosexual and LGB adolescents

Cannabis use is linked to symptoms of depression and anxiety, particularly among sexual minorities. This study examines the relationships between cannabis, and depression and anxiety symptoms at 13, 15, and 17 years using cross-lagged models in a predominantly White (n = 1,430; 92%) subsample of 1,548 participants from the Quebec Longitudinal study of Child Development. Multigroup analyses were conducted to examine the models according to sexual orientation. Demographic covariates were included as control variables, as well as alcohol, cigarette, and other drug use to examine cannabis specificity. The full sample revealed small bidirectional associations, which remained significant once control variables were included in the model: cannabis at 13 and 15 years predicted anxiety symptoms at 15 and 17 years respectively, and depression symptoms at 15 years predicted cannabis at 17 years. The initial association between cannabis at 13 years and depression symptoms at 15 years was accounted for by other drug use at 13 years. Substantial differences were found between heterosexual participants and sexual minorities: LGB participants presented a substantially larger positive association between depression symptoms at 15 years and cannabis at 17 years, as well as a negative association between anxiety symptoms at 15 years and cannabis at 17 years. Both of these relationships remained significant when accounting for control variables. These results suggest that the relationships between cannabis, and depression and anxiety symptoms are bidirectional across adolescence, albeit small. Sexual minorities present particularly large associations that may represent self-medication efforts for depressive symptoms between 15 and 17 years. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Contributions of childhood peer victimization and/or maltreatment to young adult anxiety, depression, and suicidality: a cross-sectional study

BACKGROUND

Childhood maltreatment and peer victimization are major risk factors for depression and suicidal behavior. Furthermore, childhood maltreatment increases the risk of peer victimization. Our objective was to distinguish between the contributions of parental maltreatment and peer victimization to the development of mental health problems in young adulthood. Specifically, we tested whether peer victimization alone or in combination with parental maltreatment before 18 years old was associated with anxiety, depression, and suicidal thoughts and behaviors at age 21 years.

METHODS

We analyzed data collected from questionnaires administered in the i-Share (Internet-based Students' Health ResearchEnterprise) study in France from February 2013 to September 2019 (N = 2271 participants). We performed multinomial and binary logistic regression analyses to assess the single and combined contributions of childhood peer victimization and parental maltreatment to anxiety, depression, and suicidality in adulthood.

RESULTS

Nearly one third of students (28.8%) reported at least one mental health problem; 29.8% reported peer victimization alone; 7.5% reported parental maltreatment alone; and 10.3% reported both parental maltreatment and victimization. In multivariate models, compared to participants that did not experience maltreatment or peer victimization, those that experienced peer victimization alone were more likely to report anxiety (adjusted odds ratio [aOR]: 1.90; 95% CI: 1.50-2.40), depression (aOR: 1.95; 95% CI: 1.46-2.60), or suicidal ideation, without (aOR: 1.62; 95% CI: 1.26-2.09) or with a suicide attempt (aOR: 2.70; 95% CI: 1.51-4.85). Similar associations were observed for participants that experienced maltreatment alone. Participants that experienced both maltreatment and peer victimization were at increased risk of depression (aOR: 2.63; 95% CI: 1.79-3.86) and suicidal ideation, with (aOR: 9.19; 95% CI: 4.98-16.92) and without a suicide attempt (aOR: 2.64; 95% CI: 1.86-3.76).

CONCLUSIONS

Separate and combined exposures to parental maltreatment and peer victimization in childhood or adolescence were associated with increased risks of anxiety, depression, and suicidal behaviors. Peer victimization appeared to play a specific role in mental health disorders that were not otherwise explained by polyvictimization. Currently, peer victimization is a frequent, but avoidable type of child abuse; therefore, these findings have implications for policies for preventing and dealing with peer victimization.

Sex differences in the association between maternal depression and child and adolescent cognitive development: a systematic review and meta-analysis

BACKGROUND

Maternal depression is negatively associated with cognitive development across childhood and adolescence, with mixed evidence on whether this association differs in boys and girls. Herein, we performed a systematic review and meta-analysis of sex-specific estimates of the association between maternal depression and offspring cognitive outcomes.

METHOD

Seven databases (PubMed, EMBASE, PsycINFO, ERIC, CINAHL, Scopus, ProQuest) were searched for studies examining the longitudinal association between maternal depression and offspring (up to 18 years) cognitive outcomes. Studies were screened and included based on predetermined criteria by two independent reviewers (Cohen's κ = 0.76). We used random-effects models to conduct a meta-analysis and used meta-regression for subgroup analyses. The PROSPERO record for the study is CRD42020161001.

RESULTS

Twelve studies met inclusion criteria. Maternal depression was associated with poorer cognitive outcomes in boys [Hedges' g = -0.36 (95% CI -0.60 to -0.11)], but not in girls [-0.17 (-0.41 to 0.07)]. The association in boys varied as a function of the measure of depression used (b = -0.70, p = 0.005): when maternal depression was assessed via a diagnostic interview, boys [-0.84 (-1.23 to -0.44)] had poorer cognitive outcomes than when a rating scale was used [-0.16 (-0.36 to 0.04)].

CONCLUSIONS

This review and meta-analysis indicates that maternal depression is only significantly associated with cognitive outcomes in boys. Understanding the role of sex differences in the underlying mechanisms of this association can inform the development of targeted interventions to mitigate the negative effects of maternal depression on offspring cognitive outcomes.

Behavior in childhood is associated with romantic partnering patterns in adulthood

BACKGROUND

Most people will partner at some point during their lives. Yet little is known about the association between childhood behavior and patterns of long-term romantic partnering in adulthood.

METHODS

In this population-based cohort study, behavioral ratings were prospectively obtained from teachers when children (n = 2,960) were aged 10-12 years - for inattention, hyperactivity, aggression-opposition, anxiety, and prosociality - and linked to their tax return records from age 18 to 35 years (1998-2015). We used group-based based trajectory modeling to estimate the probability of partnership (marriage/cohabitation) over time and multinomial logistic regression models to examine the association between childhood behavior and trajectory group membership. The child's sex and family socioeconomic background were adjusted for.

RESULTS

Five distinct trajectories of partnering were identified: early-partnered (n = 420, 14.4%), mid-partnered (n = 620, 21.3%), late-partnered (n = 570, 19.2%), early-partnered-separated (n = 460, 15.5%), and delayed-or-unpartnered (n = 890, 30.0%). Participants in the early-partnered-separated and delayed-or-unpartnered trajectories were more likely to have left high school without a diploma and to have lower earnings and higher welfare receipt from age 18 to 35 years. After adjustment for sex and family background, inattention and aggression-opposition were uniquely and additively associated with increased likelihood of following an early-partnered-separated trajectory, while inattention and anxiety were associated with an increased likelihood of following a delayed-or-unpartnered trajectory. Childhood prosocial behaviors were consistently associated with earlier and more sustained patterns of partnership.

CONCLUSIONS

Children with behavioral problems are more likely to separate or to be unpartnered across early adulthood. This may have consequences for their psychological health and wellbeing and that of their families.

A machine learning approach for predicting suicidal thoughts and behaviours among college students

Suicidal thoughts and behaviours are prevalent among college students. Yet little is known about screening tools to identify students at higher risk. We aimed to develop a risk algorithm to identify the main predictors of suicidal thoughts and behaviours among college students within one-year of baseline assessment. We used data collected in 2013–2019 from the French i-Share cohort, a longitudinal population-based study including 5066 volunteer students. To predict suicidal thoughts and behaviours at follow-up, we used random forests models with 70 potential predictors measured at baseline, including sociodemographic and familial characteristics, mental health and substance use. Model performance was measured using the area under the receiver operating curve (AUC), sensitivity, and positive predictive value. At follow-up, 17.4% of girls and 16.8% of boys reported suicidal thoughts and behaviours. The models achieved good predictive performance: AUC, 0.8; sensitivity, 79% for girls, 81% for boys; and positive predictive value, 40% for girls and 36% for boys. Among the 70 potential predictors, four showed the highest predictive power: 12-month suicidal thoughts, trait anxiety, depression symptoms, and self-esteem. We identified a parsimonious set of mental health indicators that accurately predicted one-year suicidal thoughts and behaviours in a community sample of college students.

Pre- and postnatal maternal smoking and offspring smoking trajectories: Evidence from a 20-year birth cohort

Maternal smoking is associated with increased risk of smoking in the offspring. However, it remains unclear whether this association depends on the timing of exposure to maternal smoking. We investigated the association between prenatal and/or postnatal maternal smoking and offspring smoking during adolescence. Participants (N = 1661) were from the Québec Longitudinal Study of Child Development cohort. We identified longitudinal trajectories of maternal smoking from before pregnancy to child age 12 years using group-based trajectory modeling (GBTM). Adolescent (12-19 years) smoking trajectories were also identified using GBTM. Associations between maternal smoking and offspring smoking trajectories were estimated using multinomial logistic regressions. We used propensity score inverse probability weighting (IPW) to account for the differential distribution of maternal and familial characteristics across exposure groups. We identified four distinct groups for maternal smoking: no (66.1%), decreasing (5.6%), increasing (9.5%) and persistent (18.8%) smoking, and three adolescent smoking trajectories: abstinent, early-onset (before age 15) and late-onset (after age 15). In IPW-adjusted models, youth with mothers with decreasing, increasing and persistent smoking had higher risk of being early-onset smokers compared with youth with mothers in the non-smoking group. We also found that only youth whose mothers were persistent smokers had an increased risk of late-onset smoking. Regardless of timing, offspring exposure to maternal smoking is associated with increased risk of smoking during adolescence. More research is needed on how to create effective smoking cessation campaigns that span preconception, prenatal, and postnatal periods to help prevent intergenerational transmission of smoking behaviors.

Promoting better functioning among children exposed to high levels of family adversity: the protective role of childcare attendance

BACKGROUND

Children exposed to early adversity are vulnerable to cognitive impairments and externalizing behaviors. Attending childcare may, however, partly buffer this detrimental effect by providing social and cognitive stimulation in a secure environment. The aims of this study were (a) to determine whether the association between exposure to adversity and later externalizing behaviors is mediated by children's cognitive abilities, and (b) to examine if childcare attendance moderates this mediation-thereby highlighting a protective function of children's childcare attendance.

METHODS

Data come from the Avon Longitudinal Study of Children and Parents (N = 6,149). Exposure to adversity was assessed by maternal reports three times from the second trimester of the mother's pregnancy to the child's fourth year of age. Childcare attendance was assessed on four occasions between eight months and three years of age. Factors explaining differences in childcare attendance were controlled using propensity score weights. Children's cognitive abilities were assessed by the Weschler Intelligence Scale for Children at eight years of age, and externalizing behaviors were reported by mothers using the Development and Well-Being Assessment interview at 10, 13, and 15 years of age.

RESULTS

Notably, lower cognitive abilities partly accounted for the higher levels of externalizing behaviors in adolescents exposed to adversity (B indirect effect = 0.02, 95% CI = 0.007-0.03, p < .01). Importantly, childcare attendance moderated this indirect effect. For children exposed to adversity, being in maternal care was associated with lower cognitive abilities which were related to higher levels of externalizing behaviors. On the contrary, for children exposed to adversity, attending childcare was associated with higher cognitive abilities which were linked to lower levels of externalizing behaviors.

CONCLUSIONS

Easily accessible community childcare may be a relatively low-cost public health strategy to prevent the emergence of externalizing behavioral problems in adolescence through its positive effects on cognitive abilities.

Cohort Profile: Quebec Longitudinal Study of Child Development (QLSCD)

PURPOSE

The Quebec Longitudinal Study of Child Development (QLSCD) was designed to examine the long-term associations of preschool physical, cognitive, social, and emotional development with biopsychosocial development across childhood, adolescence, and young adulthood.

METHODS

QLSCD is an ongoing prospective cohort including 2120 singletons born in 1997/1998 in the Canadian province of Quebec. So far, data have been collected annually or every 2 years from child ages 5 months to 21 years. The cohort currently includes 1245 participants. Data available include a range of environmental (e.g., family characteristics, child behaviour, educational attainment, mental health), biological (e.g., hair cortisol, genetic, epigenetic), and administrative data.

RESULTS

QLSCD has contributed to the understanding of children's psychosocial development, including the development of physical aggression and anxiety. QLSCD articles have advanced scientific knowledge on the influence of early childhood factors on childhood, adolescent, and young adult mental health, including the effect of participation in early childcare on cognitive and behavioural development, the developmental origins of adolescent and young adult mental health problems and suicide risk, and the development of interpersonal difficulties (e.g., peer victimisation) from preschool years to adolescence.

CONCLUSION

QLSCD has given major contributions to our understanding of the link between different aspects of child development and biopsychosocial development during the first two decades of life. Unique features include the presence of environmental, biological, and administrative data, long-term follow-up with frequent data collections, and use of data from multiple informants, including teachers, mothers, fathers, and the children themselves.

Machine Learning Assessment of Early Life Factors Predicting Suicide Attempt in Adolescence or Young Adulthood

IMPORTANCE

Although longitudinal studies have reported associations between early life factors (ie, in-utero/perinatal/infancy) and long-term suicidal behavior, they have concentrated on 1 or few selected factors, and established associations, but did not investigate if early-life factors predict suicidal behavior.

OBJECTIVE

To identify and evaluate the ability of early-life factors to predict suicide attempt in adolescents and young adults from the general population.

DESIGN, SETTING, AND PARTICIPANTS

This prognostic study used data from the Québec Longitudinal Study of Child Development, a population-based longitudinal study from Québec province, Canada. Participants were followed-up from birth to age 20 years. Random forest classification algorithms were developed to predict suicide attempt. To avoid overfitting, prediction performance indices were assessed across 50 randomly split subsamples, and then the mean was calculated. Data were analyzed from November 2019 to June 2020.

EXPOSURES

Factors considered in the analysis included 150 variables, spanning virtually all early life domains, including pregnancy and birth information; child, parents, and neighborhood characteristics; parenting and family functioning; parents' mental health; and child temperament, as assessed by mothers, fathers, and hospital birth records.

MAIN OUTCOMES AND MEASURES

The main outcome was self-reported suicide attempt by age 20 years.

RESULTS

Among 1623 included youths aged 20 years, 845 (52.1%) were female and 778 (47.9%) were male. Models show moderate prediction performance. The areas under the curve for the prediction of suicide attempt were 0.72 (95% CI, 0.71-0.73) for females and 0.62 (95% CI, 0.60-0.62) for males. The models showed low sensitivity (females, 0.50; males, 0.32), moderate positive predictive values (females, 0.60; males, 0.62), and good specificity (females, 0.76; males, 0.82) and negative predicted values (females, 0.75; males, 0.71). The most important factors contributing to the prediction included socioeconomic and demographic characteristics of the family (eg, mother and father education and age, socioeconomic status, neighborhood characteristics), parents' psychological state (specifically parents' antisocial behaviors) and parenting practices. Birth-related variables also contributed to the prediction of suicidal behavior (eg, prematurity). Sex differences were also identified, with family-related socioeconomic and demographic characteristics being the top factors for females and parents' antisocial behavior being the top factor for males.

CONCLUSIONS AND RELEVANCE

These findings suggest that early life factors contributed modestly to the prediction of suicidal behavior in adolescence and young adulthood. Although these factors may inform the understanding of the etiological processes of suicide, their utility in the long-term prediction of suicide attempt was limited.

Developmental profiles of childhood attention-deficit/hyperactivity disorder and irritability: association with adolescent mental health, functional impairment, and suicidal outcomes

BACKGROUND

Irritability is frequently comorbid with ADHD. Although irritability alone has been linked to deleterious mental health and adaptive issues, the joint developmental course of ADHD and irritability symptoms during childhood as well as its association with later mental health and suicidal outcomes is not fully understood. We aimed to describe the developmental trajectories of childhood ADHD and irritability symptoms and to quantify their association with adolescent mental health and suicidal outcomes.

METHODS

The Quebec Longitudinal Study of Child Development (QLSCD) included 1407 participants from the general population followed up from age 5 months to 17 years. We used a multitrajectory approach to identify developmental trajectories of childhood (6-12 years) ADHD and irritability symptoms. Outcome measures were adolescent (13-17 years) mental health (psychiatric symptoms/functional impairment) and suicidal outcomes.

RESULTS

We identified distinct developmental profiles: combined absent or very low ADHD and absent or very low irritability (940 [66.8%]; reference group), moderately high irritability and low ADHD (158 [11.2%]), moderately high ADHD and low irritability (198 [14.1%]), and combined high ADHD and high irritability (111 [7.9%]). Multivariate modeling showed that, compared to children in the reference group, those in the combined high ADHD and high irritability profile showed higher levels of ADHD continuity (d ranges = 0.40-0.50), externalizing (d ranges = 0.25-0.59), internalizing (d ranges = 0.20-0.29), and functional impairments (d ranges = 0.17-0.48) and suicidal behaviors (odds ratio (OR) = 2.12, confidence interval (CI) = 1.47-3.06) in adolescence.

CONCLUSIONS

The presence of persistently high levels of irritability along with ADHD symptoms during childhood significantly predicts adolescent ADHD continuity, externalizing, internalizing, and suicidal outcomes. Systematic consideration of irritability when assessing and treating ADHD may improve long-term mental health outcomes.

Inattention in boys from low-income backgrounds predicts welfare receipt: a 30-year prospective study

BACKGROUND

Childhood disruptive behaviors are highly prevalent and associated with adverse long-term social and economic outcomes. Trajectories of welfare receipt in early adulthood and the association of childhood behaviors with high welfare receipt trajectories have not been examined.

METHODS

Boys (n = 1000) from low socioeconomic backgrounds were assessed by kindergarten teachers for inattention, hyperactivity, aggression, opposition, and prosociality, and prospectively followed up for 30 years. We used group-base trajectory modeling to estimate trajectories of welfare receipt from age 19-36 years using government tax return records, then examined the association between teacher-rated behaviors and trajectory group membership using mixed effects multinomial regression models.

RESULTS

Three trajectories of welfare receipt were identified: low (70.8%), declining (19.9%), and chronic (9.3%). The mean annual personal employment earnings (US$) for the three groups at age 35/36 years was $36 500 (s.d. = $24 000), $15 600 (s.d. = $16 275), and $1700 (s.d. = $4800), respectively. Relative to the low welfare receipt group, a unit increase in inattention (mean = 2.64; s.d. = 2.32, range = 0-8) at age 6 was associated with an increased risk of being in the chronic group (relative risk ratio; RRR = 1.16, 95% CI 1.03-1.31) and in the declining group (RRR = 1.13, 95% CI 1.03-1.23), after adjustment for child IQ and family adversity, and independent of other behaviors. Family adversity was more strongly associated with trajectories of welfare receipt than any behavior.

CONCLUSIONS

Boys from disadvantaged backgrounds exhibiting high inattention in kindergarten are at elevated risk of chronic welfare receipt during adulthood. Screening and support for inattentive behaviors beginning in kindergarten could have long-term social and economic benefits for individuals and society.