Externalizing and Internalizing Problems: Associations with Family Adversity and Young Children's Adrenocortical and Autonomic Functioning

Associations between bed-sharing in infancy and childhood internalizing and externalizing symptoms

Bed-sharing is a controversial but common parenting practice with claimed benefits for emotional and behavioral development. Using data from the UK Millennium Cohort Study (N = 16,599), this prospective study investigated whether bed-sharing at 9 months is associated with childhood internalizing and externalizing symptom trajectories. Children were grouped by their patterns of co-developing internalizing and externalizing symptoms from 3 to 11 years of age using a parallel process latent class growth analysis. There were no associations between bed-sharing at 9 months of age and internalizing and externalizing symptom trajectories across childhood. This finding suggests that bed-sharing at 9 months has no positive or negative influence on the development of internalizing and externalizing symptoms across childhood. Clinicians should inform parents that bed-sharing during the second half of the first year is unlikely to have an impact on the later emotional and behavioral development of the children.

Social inequalities, green and blue spaces and mental health in 6-12 years old children participating in the INMA cohort

Availability of green and blue spaces in the area of residence has been related to various health outcomes during childhood, including mental health. These environmental exposures are not evenly distributed among socioeconomic groups, which may increase social inequalities in mental health. The mechanisms through which natural environments may promote mental health are numerous and diverse. This study aimed to explore 1) the potential associations of socioeconomic variables (SES and maternal education attainment) with mental health scores and residential greenness, blueness and NO2 metrics, and, 2) the association between greenness and blueness metrics and mental health scores of children in the Spanish INfancia y Medio Ambiente (INMA) birth cohort at two different time points. The study samples were composed of 1738 six-to eight-year-olds (49% female) and 1449 ten-to twelve-year-olds (living in Asturias, Gipuzkoa, Sabadell and Valencia, Spain. Individual Normalized Difference Vegetation Index (NDVI) values in 100-, 300- and 500-m buffers and availability of green and blue spaces >5000 m2 in 300-m buffers were calculated using Geographic Information Systems software. Residential NO2 values were estimated using land use regression models. Internalizing, externalizing and total problems scores were obtained with the Strengths and Difficulties Questionnaire (SDQ). Linear and logistic mixed-effects models revealed unequal distribution of environmental exposures by SES and maternal education but did not show statistically significant associations between greenness and blueness metrics and mental health indicators. The protective effect of green and blue spaces on children's mental health could not be confirmed in this study and therefore further research is required.

Autonomic Arousal, Ethical Guilt, and Externalizing Behavior in Childhood: A Clinical Extension and Replication

Lower autonomic arousal is associated with higher externalizing behavior in childhood but the mechanisms explaining this link are still debated. One possibility is that lower autonomic arousal makes it difficult for children to anticipate or express social emotions, such as ethical guilt rooted in concern for others, thereby increasing their likelihood of externalizing behavior. However, evidence for this social-emotional hypothesis has been limited to community samples. The present study included ethnically diverse samples of 150 typically developing children (M_age = 8.01 years; 50% girls) and 62 children referred for clinically elevated externalizing behavior (M_age = 9.16 years; 16% girls; N = 212). Caregivers reported children's externalizing behavior. Children's respiratory sinus arrhythmia (RSA) was measured as an indicator of parasympathetic activity in response to hypothetical vignettes depicting externalizing behavior. Children's ethical guilt was coded from semi-structured interviews following each vignette. Greater RSA increases (indicating a low-arousal, rest-and-digest response) were associated with lower ethical guilt. Lower ethical guilt was associated with higher externalizing behavior. A significant indirect effect showed that RSA increases were associated with higher externalizing behavior through relative lapses in ethical guilt. Results were consistent across and within the community and clinical samples. Theoretical and practical implications for clinically elevated externalizing behavior are discussed.

Externalizing psychopathology from childhood to early adolescence: Psychometric evaluation using latent variable and network modeling

Applying both latent variable and network frameworks, we conducted a comprehensive psychometric evaluation of the diverse array of symptoms from three externalizing dimensions, including attention problems, aggressive behavior, and delinquency/rule-breaking of the Child Behavior Checklist (Achenbach, 1991) across six time points from childhood to early adolescence. We also examined sex differences. Participants (N = 1,339) were drawn from two multisite longitudinal studies: Fast Track and the Child Development Project. Parents reported on externalizing psychopathology in kindergarten and Grades 1, 2, 4, 5, and 7. Using exploratory structural equation modeling, we found almost uniformly excellent fit across time and samples. However, we also observed multiple cross-loadings and heterogeneity in terms of which symptoms cross-loaded across time points. Alternatively, using network modeling, we observed that symptoms of attention problems and aggressive behavior had stronger connections, relative to delinquency/rule-breaking, across time and samples. Significant differences in overall connectivity were found at early (kindergarten vs. Grade 1, Grade 1 vs. Grade 2) and late (Grade 5 vs. Grade 7) time points for the combined sample and only late time points for the male sample. In addition, the items impulsive and lies or cheats consistently displayed the greatest bridge strength, that is, symptom from one dimension that connects to symptoms from another dimension, across time and samples. Our results illustrate how two methods-latent variable and network modeling-provide important and complementary information on multidimensional constructs. Findings also inform understanding of externalizing psychopathology through childhood to early adolescence by identifying key symptoms, critical transition points, and possible transdiagnostic liabilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association Between Measures Derived From Children's Primary Exfoliated Teeth and Psychopathology Symptoms: Results From a Community-Based Study

Mental disorders are among the most disabling health conditions globally. However, there remains a lack of valid, reliable, noninvasive, and inexpensive biomarkers to identify (at an early age) people who are at the greatest risk of experiencing a future mental health condition. Exfoliated primary teeth, when used in combination with established and emerging tools (e.g., family history, imaging, genetics, epigenetics), may provide important additional insights about vulnerability to mental illness. Teeth are especially promising because they develop in parallel with the brain and maintain a permanent record of environmental insults occurring during prenatal and perinatal development. Despite their potential, few empirical studies have investigated features of exfoliated teeth in relation to mental health. Here, we used micro-CT imaging to test the hypothesis that measures derived from exfoliated primary incisors associated with psychopathology symptoms in a community-based sample of children (n = 37). We found that enamel volume (β = −0.77, 95% CI, −1.35 to −0.18, P = 0.01) had large negative associations with internalizing symptoms, and enamel mineral density (β = 0.77, 95% CI, 0.18–1.35, P = 0.01) had large positive associations with internalizing behavioral symptoms, even after stringent control for multiple testing. Pulp volume (β = −0.50, 95% CI, −0.90 to −0.09, P = 0.02) had a moderately-large negative association with externalizing behavioral symptoms, though these associations did not survive multiple testing correction. These results support the ongoing investigation of teeth as potential novel biomarkers of mental health risk.