Childhood chronic condition and subsequent self-reported internalizing and externalizing problems in adolescence: a birth cohort study

Chronic conditions are common in childhood. We investigated the associations of childhood chronic conditions reported by parents with subsequent self-reported internalizing and externalizing problems in adolescence. A sample of 6290 children (3142 boys and 3148 girls) with data on chronic condition reported by parents both at 7 and at 16 years of age was obtained from the Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort (n = 9432) from an unselected, regionally defined population. Internalizing and externalizing problems were measured at 8 years of age with Rutter Children's Behavioral Questionnaire by teachers and at 16 years of age with Youth Self-Report by adolescents. When studying the effects of history of chronic conditions on these problems at 16 years of age, childhood internalizing and externalizing problems and social relations were adjusted. A history of chronic condition predicted subsequent somatic complaints among all adolescents. Early-onset chronic conditions were related to subsequent externalizing (OR 1.35; 1.02-1.79) and attention problems (OR 1.33; 1.01-1.75) and later onset of chronic conditions with internalizing (OR 1.49; 1.22-1.82) and thought problems (OR 1.50; 1.18-1.92). The effect was specific for sex and the type of chronic condition.

CONCLUSION

Childhood chronic conditions predicted internalizing and externalizing problems in adolescence. To prevent poor mental health trajectories, children with chronic conditions during their growth to adolescence need early support and long-term monitoring.

WHAT IS KNOWN

• Childhood adversities increase the risk of mental disorders. • Internalizing and externalizing problems have been suggested for measuring childhood and adolescent psychopathologies.

WHAT IS NEW

• Having a chronic condition (CC) before the age of 7 or later but before the age of 16 had different outcomes in adolescence. The early onset predicted externalizing problems, whereas the late onset predicted internalizing problems and thought problems in adolescence. The risk of somatic complaints was increased regardless of CC onset time. These findings can reflect more restricted ability to mental processing in the younger children.

Teachers' assessments of children's mental problems with respect to adolescents' subsequent self-reported mental health

PURPOSE

To investigate whether teachers' assessments of children are predictive of subsequent self-reported mental problems in adolescence and how these problems are concurrently linked with adolescents' overall life satisfaction.

METHOD

The study subjects originated from the prospective population-based Northern Finland Birth Cohort 1986 (N = 9,432). At age 8 years first-grade students' emotional and behavioral problems were assessed by their teachers with Rutter Children's Behavioural Questionnaires for teachers (RB2). At the age of 16 years, adolescents responded to the eight Youth Self-report (YSR) subscales and the one-item overall life satisfaction scale. Multivariate logistic regression was used to study the longitudinal relationship between RB2 and YSR.

RESULTS

Children who had emotional problems according to their teachers (RB2) were more prone to withdrawal and social problems in adolescence (YSR). Behavioral problems in childhood (RB2) were predictive of attention problems, and delinquent and aggressive behavior (YSR), while hyperactivity (RB2) was only predictive of attention problems and delinquent behavior (YSR). Additionally, each YSR subscale was strongly and linearly associated with concurrent self-reported life satisfaction in adolescence.

CONCLUSIONS

Teachers' assessments of children were predictive of self-reported mental problems in adolescence, which, in turn, were strongly associated with concurrent self-reported life satisfaction. In order to support favorable growth of children to well-adjusted adolescents and to intervene as early as possible in the event of adverse progression, both teachers' assessments of children and adolescent's self-rated overall life satisfaction should be acknowledged.