Psychological development--predictions from infancy

Going beyond the mean in examining relationships of adolescent non-cognitive skills with health-related quality of life and biomarkers in later-life

Several studies have established associations between early-life non-cognitive skills and later-life health and health behaviours. However, no study addresses the more important policy concern about how this relationship varies along the health distribution. We use unconditional quantile regression to analyse the effects of adolescent non-cognitive skills across the distributions of the health-related quality of life at age 50 and biomarkers at age 45 years. We examine the effects of measures of conscientiousness, agreeableness and neuroticism recorded at age 16 for 3585 individuals from the National Child Development Study. Adolescent conscientiousness is positively associated with ability to cope with stress and negatively associated with risk of cardiovascular disease in middle-age. Adolescent agreeableness is associated with higher health-related quality of life and lower physiological 'wear and tear', but negatively associated with ability to cope with stress in middle-age. Adolescent neuroticism is associated with lower health-related quality of life, higher physiological 'wear and tear', and a higher risk of cardiovascular disease in middle-age. All of these associations are stronger at the lower end of the health distribution except for the cardiovascular risk biomarkers. These associations are robust to correcting for attrition using inverse probability weighting and consistent with causal bounds assuming proportional selection on observables and unobservables. They suggest policies that improve non-cognitive skills in adolescence could offer most long-term health benefit to those with the poorest health.

Age as an Ambiguous Variable in Developmental Research: Some Epidemiological Considerations from Developmental Psychopathology

Intra-individual change in behaviour with age constitutes the essential element in developmental research but, unless age is broken down into its component parts, age is devoid of meaning. The issues involved are discussed from the perspective of epidemiology as applied to developmental psychopathology. Methodological concerns are discussed with respect to continuities and discontinuities in development (with special reference to the cumulative emergence of skills and variable consistency over the life span), secular trends, and the distinction between individual and groupaggregated age trends. The different components of chronological age are considered in terms of cognitive level, different types of biological maturity, and the duration of type of life experiences. The same components are discussed with respect to the issues involved in the study of differential effects of experiences according to their timing in the developmental sequence, and maturational delay.

Temperament: then and now

One of many publications emanating from the New York Longitudinal Study (NYLS), the prospective study of Stella Chess, Alexander Thomas, and Mahin Hassibi of six cases of depression during childhood and adolescence, which appeared in the Journal of Nervous and Mental Disease in 1983, provides an opportunity to reflect on the climate in which the NYLS was conceived and conducted. Its methodology is reviewed, and principle findings are summarized. In the more than 50 years since the inception of the NYLS, the attention of temperament investigators has shifted from a focus on definition and measurement to the examination of relations between temperament and psychopathology, including the exploration of the neurocircuitry underlying different dimensions of temperament and their contributions to the etiology, pathogenesis, and treatment of axis I disorders in developing children.

Temperament: concepts, issues and problems

There are marked individual differences in children's temperamental styles-- differences thought to be constitutionally determined in part. The importance of temperamental features is evident in their links with various forms of psychopathology and in their effects on the manner in which other people respond to the child. For these and other reasons it has rightly come to be accepted that greater attention needs to be paid to temperamental issues in consideration of the processes of development, children's responses to stress situations, and the genesis of emotional, behavioural and learning disorders. However, major conceptual, methodological and theoretical problems remain. Problems of measurement are considered in terms of the relativity of measures, whether or not to take social context into account, the functional equivalence of measures at different ages, the circumstances to use in assessing temperament, the choice of measuring instrument and the categorization of temperamental features. The issues involved in the meaning of temperamental differences are discussed with respect to consistency, developmental change, genetic influences, brain damage and mental retardation, sex differences and the mechanisms by which temperamental variables exert their effects.

On the continuity, change and clinical value of infant temperament in a prospective epidemiological study

The temperament of 1855 children born in Helsinki during 1975-76 was recorded at the age of 6-8 months by parental questionnaires. In 1980-81 the continuity of temperamental dimensions was studied in a group of these children by using a temperament questionnaire for 3--7-year-old children. In addition, the clinical usefulness of infant temperament was assessed by analysing the infant temperamental dimensions used was almost negligible, because less than 10% of the total variance of each dimension could be explained by the corresponding dimensions at the infant age. The clinical usefulness of infant temperament questionnaires in prospective epidemiological studies was supported by the observation that children with later paediatric problems (behavioural problems, colic spasms, accidents) had had significantly different temperamental styles at the infant age from those without problems. The results support the importance of negative mood and high intensity of infant's behavioural style as risk factors for later paediatric problems.

Children of alcoholic parents: health, growth, mental development and psychopathology until school age. Results from a prospective longitudinal study of children from the general population

Of 640 women who paid their first visit to the two maternal welfare centres in a new Stockholm suburb during one prospective year, 532 (85%) were interviewed with regard to 41 stress factors forming a "life stress score" (LSS). The interviews were supplemented with data from hospital, social welfare and police records concerning the expectant mother and the father. The 532 mothers were divided into three groups according to the degree of psychosocial stress (group 1 (n = 194) without psychosocial stress; group 2 (n = 171) with severe psychosocial stress; and group 3 (n = 167) in an intermediate group). In group 2, there were 23 mothers and 51 fathers in 64 families known to suffer from alcoholism/heavy drinking at the time of the first interview and these comprised our study group. The pregnancies and deliveries in the families were investigated with prospective methods. There were 497 liveborn children of whom 54 were born into families known for alcoholism/heavy drinking. The physical health and development of the children was followed by prospective data from the child welfare centers. Data concerning psychological development and psychiatric health of the child were obtained by interviewing the mother and evaluating the child during visits at home at one and four years of age. At one year of age, 452 of the children (226 boys, 226 girls) and at four to five years of age, 412 of the children (202 boys, 210 girls), were evaluated using the Griffiths' Development Scales. Findings from these evaluations form the basis for comparison of development of children from alcoholic/heavy drinking parents with all other children. For 388 children, data were available from all examinations up to the end of the fourth year, including 38 children (12 boys, 26 girls) in the study group and 350 other children (183 boys, 167 girls). The present findings indicate that children of alcoholic parents in the general population who were followed from pregnancy up to the end of their fourth year have a higher risk of pre- and postnatal death, and have poorer mental development and more symptoms of a psychopathological child psychiatric nature (DSM-III) than other children. Differences related to physical development during infant years disappeared during the observation time. With regard to mental development over a longer period, it appears that factors related to the parent's addictions and the child's sex (i.e. male child) are more important than pediatric risk factors in the form of a score of reduced optimality.

Comorbidity: a critical issue in attention deficit disorder

In this report, we examine the interrelationships between attention deficit disorder (ADD), learning disabilities (LD), and conduct and oppositional disorders (COD). We indicate that it is reasonable to consider ADD as a distinct entity, frequently co-occurring with LD on the one hand, and COD on the other. The first section reviews the interrelationships between ADD and LD. Here we focus on definitional issues, trace the historical antecedents of ADD and LD, examine the prevalence of ADD and LD, and review studies designed to differentiate cognitive from attentional mechanisms in children with ADD, LD, or both. In the next section, we review the evidence linking ADD with COD, a distinction blurred in earlier investigations by problems with referral bias. More recent studies suggest that the antecedents, clinical characteristics, and prognosis may differ in children with ADD alone compared to those with ADD in association with COD.

Psychomotor and mental development during infancy. Relation to psychosocial conditions and health. Part IV of a longitudinal study of children in a new Stockholm suburb

This article presents the fourth substudy in a Swedish research project of a birth cohort of children in a newly-built Stockholm suburb. The aims are to follow and to describe their mental development by prospective methods. Here we present the results of the one-year follow-up. The children's mental development, measured with the Griffiths' Development Scales, and their behaviour in the test situation and during the home visit are described. These results are related to various psychosocial background factors (such as the parents' ages, number of siblings, form of custody), home environment factors (the parents' mental disease, addictions and criminality) and the children's physical health and development. Children with deviant behaviour during the home visits are described separately. Of 640 women who paid their first visit to the maternal welfare centers in a new Stockholm suburb during one prospective year, 532 (85%) were interviewed with regard to 41 stress factors forming a "Life stress score" (LSS). The interviews were supplemented with data from hospital, social welfare and police records concerning the expectant mother and the father. The 532 mothers were divided into three groups according to the degree of psychosocial stress (194 without psychosocial stress, 171 with severe psychosocial stress and 167 in an intermediate group). The pregnancies and deliveries of all mothers were evaluated. The physical health and development (using information from the child welfare clinics) and the mental health and development (using information from home visits and testings) were studied during infancy in 452 children (226 boys and 226 girls)--i.e. 77% of all children born in the suburb during the year. The children were tested with the Griffiths' Development Scales and their behaviour during the test was observed on home visits by the same psychologist (L.N.) at the age of 10 months (79 boys, 73 girls) or 14 months (92 boys, 107 girls), or about the age of 18 months (55 boys, 46 girls). The test results are mainly reported by descriptive methods. In summary, the results of the evaluation of the children's mental health during the first year of life, generally showed average developmental quotients. However, 20% of the children had values below the average. Thirty-two per cent of the children with low test results (less than -1 standard deviation on the total test) came from homes with serious psychosocial stress and 29% from homes with a mild degree of psychosocial stress. Of the nine children who had generally very low scores in the Griffiths' evaluation, seven came from homes with psychosocial stress.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of thyroid hormone level on temperament in infants with congenital hypothyroidism detected by screening of neonates

To determine the effect of congenital hypothyroidism and its treatment on infant behavior, we assessed temperament in 50 six-month-old infants with congenital hypothyroidism detected by means of screening of neonates. Intelligence and temperament were also evaluated at 12, 18, 24, and 36 months. More of these children were classified as "difficult" than children in the nonhypothyroid standardization sample. Temperamental difficulty was associated with increased nervous system sensitivity, reflecting more intense responses and a lower threshold of response to external stimulation. Greater temperamental difficulty was found to persist until at least age 2 years of age and to be associated with higher circulating triiodothyronine and thyroxine levels between 1 and 3 months of age. Our results suggest that behavioral features should be considered, as well as circulating hormone levels, in determining the proper dose of thyroid hormone replacement in infants with congenital hypothyroidism.

Parent's perceived responsibility for children's problems

Beliefs about parents' influence on their children's behaviour have developed over the last 300 years. During this century multiple socio-economic, ideological and technological changes have combined to leave expert and lay person alike in a sea of confusion and ambiguity about optimal parent-child relationships. While fashions in child rearing change, the mother is usually accorded responsibility for the child's behaviour and social skills. In this study parents attending a multidisciplinary pediatric clinic were asked their opinion of the source of their child's emotional or behavioural problem. Describing confusion and conflicting advice, most parents had concluded that the problem had multiple roots. Between male and female parents, however, a marked difference was evident in the attribution of responsibility to themselves or their spouses and in their formulation of the nature of parental deficiencies.

Culture and temperament: influences on infant temperament in three East African societies

In this study, 178 infants from three East African societies differing on a number of environmental dimensions were examined to determine if aspects of their developmental environment influenced temperament characteristics. Data strongly suggest that cultural child-rearing patterns, degree of modernization, maternal orientation, ecological setting, and specific early life events contribute to temperament.

Human behavioral development and genetics

Behavioral development during childhood is examined in relation to recent concepts and data from evolutionary theory and developmental genetics. The epigenetic framework of Waddington is proposed as a powerful tool for analyzing the progressions in behavior, particularly for recognizing that development involves coordinated pathways of change over time. Many of these pathways appear to depend upon the activity of timed gene-action systems that switch off and on according to a predetermined plan. Behavioral development thus gives expression to the dynamics of preprogrammed change; and in this perspective, behavioral discontinuities may be as strongly rooted in the epigenetic ground plan as the continuities are. The present paper aims to pull together some common themes from different areas that bear on the central issues of behavioral development--the neural foundations, the time course followed, the interplay of maturation and experience, the extent of preorganization furnished by the genetic program, and the adaptive significance of such behaviors in an evolutionary perspective. The final section touches on some hypotheses drawn from developmental neurobiology and developmental genetics that may enrich the analyses of human behavioral development.

[Problems in prevention of mental disorders in preschool children]

In primary prevention, we meet many methodological difficulties: the promotion of mental health requires the transmission of specialized knowledge: this is in fact very difficult to realise. Validation of such programs is impossible. Moreover, primary prevention remains generally unspecific, often helpless--as in the case of psychosis. Problems of prediction are so important that we are not even able to predict--and then to prevent--the development of depression, one of the most common forms of psychiatric disturbance. Early diagnosis (secondary prevention) is also still inadequate: in most cases, we do not know how symptoms detected in early childhood will develop. In view of the poor state of etiopathogenic theories, 2 concepts are being used preferentially in prevention: high risk groups, and the notion of crisis. Large segments of population can be evaluated from these points of view and provided with preventive interventions. Prevention programs can address themselves to either the child himself, his family, or his larger environment. Most successful prevention programs organised by psychiatrists have addressed themselves to the early mother-child interaction. This is one of the most valuable targets for high risk or crisis interventions. Now that various preventive programs have been active for years, one can start evaluating the first results of primary prevention: while difficulties are enormous, one should not regress to comfortable isolationism of clinical work only. On the other hand, utopian dreams of eradication of psychic troubles through environmental manipulation are not valid any longer.

Child Status and Demographic Variables as Related to Maternal Child-Rearing Attitudes

Data from 322 infants and their mothers indicated highly consistent relationships from birth to 12 mo. for both maternal control and hostility. Both maternal control and hostility at 12 mo. were associated with lower occupational status of father, lower IQ of mother, and father's being older. Variables assessing the infant's status at birth and at 12 mo. were generally unrelated to maternal child-rearing attitudes at 12 mo. The results fail to support positions emphasizing the determination of maternal attitudes as a response to characteristics of the child, at least during the baby's first year.