Maternal depression and trajectories of child internalizing and externalizing problems: the roles of child decision making and working memory

Low neurocognitive performance and problematic contexts: interaction influences in predicting adolescent externalizing behaviors within a community sample

Research has identified neurocognitive and contextual risk factors of externalizing behaviors. However, fewer studies have examined the interaction among neurocognitive and other risk factors in predicting externalizing behaviors. The goal of the current study was to examine the relation between neurocognitive and contextual factors in predicting externalizing behaviors in a community sample of adolescents. Participants were 84 adolescents, aged 11-17 (M = 13.39, SD = 1.82), recruited as part of a larger study. Separate moderated multiple regression models were utilized in which neurocognitive variables (intellectual functioning, short-term memory/attention, disinhibition) were added as predictors and contextual variables (family dysfunction and parental depression, anxiety, and stress) were added as moderators in step 1, and their interaction was added in step 2. Externalizing behaviors served as criterion variables (hyperactivity/impulsivity and oppositional defiant disorder symptom severity, reactive and proactive aggression). Overall, results suggest that higher levels of problematic contextual factors exacerbate the significant negative associations among neurocognitive functioning and externalizing behaviors. Importantly, this pattern was shown across neurocognitive domains and contextual factors. Findings suggest that contextual factors should be targeted for the treatment or prevention of youth externalizing behaviors, particularly for adolescents with neurocognitive vulnerabilities.

Examining Conduct Problems in a Community Sample during Middle Childhood: The Role of Frontal EEG Asymmetry, Temperament, and Working Memory

Previous literature shows that aspects of temperament, executive functioning, and EEG frontal asymmetry are related to externalizing behaviors in children. We examined whether frontal EEG asymmetry measured at age 6 would moderate the impact of negative affectivity, attentional control, and working memory at age 6 on conduct problems at age 9. Behavioral tasks were given to assess children's attentional control and working memory. Parents completed questionnaires about their children's negative affectivity and conduct problems. Results showed that greater negative affectivity reported at age 6 predicted for more conduct problems reported at age 9, regardless of EEG frontal asymmetry. Lower levels of attentional control and working memory at age 6 predicted for more conduct problems reported at age 9 when children also exhibited greater left EEG frontal asymmetry, which has been linked to approach motivation. These findings illustrate the importance of assessing multiple intrinsic factors, both independent and interactive, that contribute to children's conduct problems.

The relationship between mental health and risky decision-making in children and adolescents: a scoping review

BACKGROUND

Evidence from studies on adult participants and clinical samples of children suggest an association between risky decision-making and mental health problems. However, the extent and nature of this association in the general youth population remains unknown. Therefore, this scoping review explores the current evidence on the relationship between mental health (internalising and externalising symptoms) and risky decision-making in the general youth population.

METHODS

A three-step search strategy was followed and applied to four databases. Selection criteria included participants < 18 years representative of the general population, and information on both risky decision-making (assessed using gambling tasks) and internalising /externalising symptoms. Data were extracted and synthesised for study and participant characteristics, aspects and measures for the main variables, and key findings.

RESULTS

Following screening, twenty-one studies were retrieved. Non-significant associations were more frequent than significant associations for both internalising and externalising symptoms, particularly for social difficulties and broad externalising symptoms. Among the significant associations, hyperactivity/inattention and conduct problems appeared to be positively associated with risk-taking and negatively associated with quality of decision-making. However, patterns were less clear for links between risky decision-making and internalising symptoms, especially between risk-taking and anxiety symptoms.

CONCLUSIONS

The present review suggests predominantly a lack of relationship between risky decision-making and mental health problems, and outlines several possible reasons for it. However, when specificity is considered carefully there seems to be a link between risk-taking and specific externalising problems. Future research should employ study designs aimed at disentangling the direction of this relationship and identifying specific aspects of mental health and risky decision-making that could be eventually addressed by tailored interventions.

Measurement bias in caregiver-report of early childhood behavior problems across demographic factors in an ECHO-wide diverse sample

Background

Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5-5 functions equivalently at the item level across diverse samples is unknown.

Methods

Item-level data of CBCL/1.5-5 from a large sample of young children (N = 9087) were drawn from 26 cohorts in the Environmental influences on Child Health Outcomes program. Factor analyses and the alignment method were applied to examine measurement invariance (MI) and differential item functioning (DIF) across child (age, sex, bilingual status, and neurodevelopmental disorders), and caregiver (sex, education level, household income level, depression, and language version administered) characteristics. Child race was examined in sensitivity analyses.

Results

Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and Total Problems. The robust item sets, excluding the high DIF items, showed good reliability and high correlation with the original Internalizing and Total Problems scales, with lower reliability for Externalizing. Language version of CBCL administration, education level and sex of the caregiver respondent showed the most significant impact on MI, followed by child age. Sensitivity analyses revealed that child race has a unique impact on DIF over and above socioeconomic status.

Conclusions

The CBCL/1.5-5, a caregiver-report measure of early childhood behavior problems, showed bias across demographic groups. Robust item sets with less DIF can measure Internalizing and Total Problems equally as well as the full item sets, with slightly lower reliability for Externalizing, and can be crosswalked to the metric of the full item set, enabling calculation of normed T scores based on more robust item sets.

Reciprocal associations between affective decision-making and mental health in adolescence

Poor affective decision-making has been shown to associate cross-sectionally with poor mental health in clinical populations. However, evidence from general population samples is scarce. Moreover, whether decision-making is prospectively linked to mental health in youth in the general population and whether such associations are reciprocal have yet to be examined. The present study examined bidirectional associations between various aspects of affective decision-making and emotional and behavioural problems at ages 11 and 14 years in 13,366 members of the Millennium Cohort Study. Decision-making (delay aversion, deliberation time, quality of decision-making, risk adjustment, risk-taking) and emotional (emotional symptoms, peer problems) and behavioural (conduct problems, hyperactivity/inattention) problems were measured using the Cambridge Gambling Task and the Strengths and Difficulties Questionnaire, respectively. Results of cross-lagged panel models adjusted for confounding revealed a negative reciprocal association between hyperactivity and quality of decision-making but also positive reciprocal associations between conduct problems and delay aversion, and between peer problems and deliberation time. Emotional problems and peer problems predicted a decrease in risk-taking, conduct problems predicted an increase in risk-taking, and hyperactivity predicted an increase in delay aversion and deliberation time. Furthermore, hyperactivity and conduct problems predicted less risk adjustment, and risk adjustment predicted fewer peer problems. The results suggest that behavioural problems are prospectively linked to greater risk-taking and lower risk adjustment in adolescence. Moreover, adolescents with behavioural problems tend to make poorer decisions and be more delay-averse, but also poorer quality of decision-making and increased delay aversion are associated with more behavioural problems over time.

Developmental inflection point for the effect of maternal childhood adversity on children's mental health from childhood to adolescence: Time-varying effect of gender differences

Childhood adversities have a well-established dose-response relationship with later mental health. However, less attention has been given to intergenerational influences. Further, it is unknown how intergenerational influences intersect with children's developmental stages and gender. The current study examined whether a developmental inflection point exists when the intergenerational influences of childhood adversities gain salience and explored differences by children's gender. Data were from the Young Women and Child Development Study (n = 361). Time-varying effect models (TVEMs) and moderation TVEMs by child's gender were evaluated. Our findings reveal that ages 5-8, the period of transition into primary schools, may represent a developmental inflection point when the intergenerational influences of maternal childhood adversity start emerging substantially. The results from gender interaction TVEMs reveal that maternal childhood adversity was a statistically significant predictor of internalizing problems until age 11, regardless of child's gender, and remained statistically significant for girls' internalizing problems until age 16.7. For externalizing problems, maternal childhood adversity was a statistically significant predictor until age 13, regardless of gender.

Child internalizing and externalizing behaviors: Interplay between maternal depressive symptoms and child inhibitory control

Maternal depression is a risk factor for child internalizing and externalizing behaviors. Aiming to investigate the moderating role of child inhibitory control on this relationship, we invited a sub-sample of dyads from the Norwegian Mother, Father, and Child Cohort study (MoBa) for a lab-based assessment (N = 92, M age = 68 months, Range = 59-80, 50% girls). Maternal depression was assessed using the Beck Depression Inventory (BDI-II), while child behaviors were measured using the Child Behavior Check List, and inhibitory control using a child friendly version of the Flanker-task. As expected, higher levels of concurrent maternal depressive symptoms predicted higher levels of child internalizing and externalizing behaviors. Importantly, and in line with our predictions, child inhibitory control moderated the association. Lower levels of inhibitory control predicted a stronger association between concurrent maternal depressive symptoms and child behavioral outcomes. The results support prior research suggesting that concurrent maternal depression poses a risk for child development, and highlight that children with lower levels of inhibitory control are more vulnerable to negative environmental influences. These findings contribute to our understanding of the complexity of parental mental health issues on child development and suggest avenues for personalized treatment programs for families and children at risk.

Executive Function in Kindergarten and the Development of Behavior Competence: Moderating Role of Positive Parenting Practices

The present study used data from the Early Childhood Longitudinal Study-Kindergarten Cohort of 2011 (N = 15,827; 51.1% male; 48.4% White, 13.5% Black/African-American, 24.3% Hispanic/Latino, 7.5% Asian, and 6.3% other ethnicity) to examine the unique contribution of specific executive function processes (working memory and cognitive flexibility) at kindergarten entry on externalizing and internalizing behavior problems in spring of kindergarten, after controlling for fall behavior problems and demographic covariates. Due to the transition to elementary school being a critical identification and prevention period, we also focused on examining the moderating role of specific positive parenting practices (i.e., cognitive stimulation, warmth, and behavior management) on associations between child executive function processes and behavioral functioning. Results indicated working memory was negatively associated with parent-reported externalizing and teacher-rated internalizing behavior problems. Further, the association between working memory and parent-rated externalizing problems was moderated by cognitive stimulation, whereas the association between parent-rated internalizing problems was moderated by behavior management. Cognitive flexibility did not have any significant associations. We discuss implications for research and practice on how parenting practices may be leveraged to improve child outcomes.

Sensory-Processing Sensitivity and Pathways to Depression and Aggression: The Mediating Role of Trait Emotional Intelligence and Decision-Making Style-A Pilot Study

While the link between sensory-processing sensitivity (SPS) and internalizing symptoms has been well-established, a link to externalizing problems is still to be explored. This study aimed to further examine the relation between SPS and behavioral problems by testing the potential mediating roles of trait emotional intelligence (TEI) and decision-making styles. Pathway analyses were conducted on data from 268 community sample participants (M_age = 25.81, SD = 2.41, 61.2% females). Results indicated gender differences in the pathway level outcomes of SPS, as well as potential partial mediators in men and women. SPS both directly and via the mediating effects of the well-being factor (TEI) and avoidant decision-making influenced depression, regardless of gender. Direct effects on aggression were, however, obtained only in the male sample. Indirect effects of SPS on aggression were found in spontaneous decision-making for men and in the self-control and sociability factors of TEI for women. Directions for future research were discussed.

Air pollution and trajectories of adolescent conduct problems: the roles of ethnicity and racism; evidence from the DASH longitudinal study

PURPOSE

No known UK empirical research has investigated prospective associations between ambient air pollutants and conduct problems in adolescence. Ethnic minority children are disproportionately exposed to structural factors that could moderate any observed relationships. This prospective study examined whether exposure to PM2.5 and NO2 concentrations is associated with conduct problems in adolescence, and whether racism or ethnicity moderate such associations.

METHODS

Longitudinal associations between annual mean estimated PM2.5 and NO2 concentrations at the residential address and trajectories of conduct problems, and the potential influence of racism and ethnicity were examined school-based sample of 4775 participants (2002-2003 to 2005-2006) in London, using growth curve models.

RESULTS

Overall, in the fully adjusted model, exposure to lower concentrations of PM2.5 and NO2 was associated with a decrease in conduct problems during adolescence, while exposure to higher concentrations was associated with a flattened trajectory of conduct symptoms. Racism amplified the effect of PM2.5 (β = 0.05 (95% CI 0.01 to 0.10, p < 0.01)) on adolescent trajectories of conduct problems over time. At higher concentrations of PM2.5, there was a divergence of trajectories of adolescent conduct problems between ethnic minority groups, with White British and Black Caribbean adolescents experiencing an increase in conduct problems over time.

CONCLUSION

These findings suggest that the intersections between air pollution, ethnicity, and racism are important influences on the development of conduct problems in adolescence.

Exposure to maternal depressive symptoms and growth in adolescent substance use: The mediating role of delay discounting

Maternal depression is associated with instability within the family environment and increases in offspring substance use across adolescence. Rates of delay discounting, or the tendency to select smaller rewards that are immediately available relative to larger, but delayed rewards, are also associated with steeper increases in substance use among youth. Moreover, recent research suggests that early unstable environments may reinforce youths' propensity towards opportunistic decision making and delay discounting specifically. The current prospective, longitudinal study examined links between maternal depressive symptoms, adolescent delay discounting, and subsequent substance use. Participants included 247 adolescents and their mothers who were assessed annually over a 6-year period (from ages 13 to 19 years). Results supported a small but significant mediation effect. Specifically, maternal depressive symptoms predicted increases in adolescent delay discounting, which, in turn, predicted steeper increases in adolescent substance use over time. Thus, youth decision making may represent a mechanism linking maternal depression and adolescent risk behaviors. Findings indicate the potential for interventions targeting parental psychopathology to prevent subsequent adolescent substance use.

The Relationship Between Maternal Depression, Externalizing and Internalizing Problems in Children, and Caregiving Burden in Urban Low-Income Ethnic and Racial Minority Families

A strong relationship exists between maternal depression and externalizing and internalizing problems in children, and caregiving burden might mediate this relationship. Yet, caregiving burden has rarely been tested as a mechanism underlying the relationship between maternal depression and child emotional and behavioral outcomes. Caregiving burden might be especially high in ethnic and racial minority mother-child dyads in low-income settings where there are more stressors in the environment and rates of maternal depression are elevated. A path analysis with 132 low-income urban mothers who mostly identified as racial and ethnic minorities confirmed our hypothesis that maternal depression has a direct effect on child externalizing and internalizing problems, and also an indirect effect through caregiving burden. We discuss implications of the findings with respect to research, practice, and policy with low-income, ethnic and racial minority families whose mothers have depression and care for children who exhibit externalizing and internalizing problems.

Disentangling the effects of intergenerational transmission of depression from adolescence to adulthood: the protective role of self-esteem

This study aimed to disentangle time-stable and time-varying effects of maternal and paternal depression on trajectories of adolescent depression from ages 13 to 23 and examined whether self-esteem moderates the examined associations. Sex differences in the direct effects of parental depression and its interacted effects with self-esteem were further explored. Data were collected from a sample of 2502 adolescents and their parents participating in a panel study spanning from the year 2000 to 2009 in northern Taiwan. Multilevel modeling was conducted to disentangle the time-stable and time-varying effects of parental depression on adolescent depression. The moderating role of self-esteem and the potential sex differences in the transmission process were tested by adding two- and three-way interactions among parental depression, self-esteem, and sex of adolescents in the models. As predicted, significant time-stable intergenerational transmission of depression was found, indicating that adolescents of parents with higher levels of depression were at increased risks for depression. Self-esteem was further found to buffer the negative effects of maternal depression on development of depression in offspring. No sex-specific intergenerational transmission of depression was observed. In sum, both maternal and paternal depression contributed to elevated levels of adolescent depression. The effects of maternal depression, however, may not be uniform, but depend on levels of self-esteem. Intervention and prevention strategies that enhance self-esteem may help participants withstand the negative effects of maternal depression.

Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder: findings from the ALSPAC cohort

BACKGROUND

Two longitudinal studies have shown that depressive symptoms in women with eating disorders might improve in the antenatal and early postnatal periods. No study has followed up women beyond 8 months postnatal.

AIMS

To investigate long-term trajectories of depressive symptoms in mothers with lifetime self-reported eating disorders.

METHOD

Using data from the Avon Longitudinal Study of Parents and Children and multilevel growth curves we modelled trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with lifetime self-reported anorexia nervosa, bulimia nervosa or both anorexia and bulimia nervosa. As sensitivity analyses we also investigated these trajectories using quintiles of a continuous measure of body image in pregnancy.

RESULTS

Of the 9276 women in our main sample, 126 (1.4%) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6%) of bulimia nervosa and 60 (0.6%) of both anorexia and bulimia nervosa. Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95% CI 1.36-2.83; bulimia nervosa: 2.28, 95% CI: 1.61-2.94, both anorexia and bulimia nervosa: 2.86, 95% CI 1.81-3.90). We also observed a dose-response association between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms, even after adjusting for lifetime eating disorders which also remained independently associated with greater depressive symptoms.

CONCLUSIONS

Women with eating disorders experience persistently greater depressive symptoms across the life-course. More training for practitioners and midwives on how to recognise eating disorders in pregnancy could help to identify depressive symptoms and reduce the long-term burden of disease resulting from this comorbidity.

The role of intelligence in decision-making in early adolescence

This study investigated the role of intelligence and its development across childhood in decision‐making in adolescence (age 11 years). The sample was 12,514 children from the UK's Millennium Cohort Study, followed at ages 3, 5, 7, and 11 years. Decision‐making (risk‐taking, quality of decision‐making, risk adjustment, deliberation time, and delay aversion) was measured with the Cambridge Gambling Task. Even after adjustment for confounding, intelligence was positively associated with risk adjustment and quality of decision‐making in both boys and girls. Furthermore, in girls risk adjustment was related positively to IQ gains. Our findings suggest that there are important, substantively, associations between intelligence and adapting behaviour to risk at the cusp of adolescence, the period when the response to risk can shape life trajectories.