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Ilic T, Porter MA, Reeve JL. Internalising and Externalising Symptoms and Their Association with the Family Environment in Young Children with Williams Syndrome: A Longitudinal Study. Children (Basel) 2023; 10:1717. [PMID: 37892382 PMCID: PMC10605142 DOI: 10.3390/children10101717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
Williams Syndrome (WS) involves high rates of psychopathology across the lifespan. However, little is known about the early, longitudinal trajectory of internalising/externalising symptoms or the association between these and the family environment in WS. WS (n = 16; aged 2 years, 2 months to 9 years, 5 months) and typically developing or TD (n = 46; aged 2 years, 2 months to 11 years, 1 month) children were assessed on two occasions over 2.5 years utilising parent report questionnaires-the Child Behaviour Checklist and the Family Environment Scale. No statistically significant changes were found in CBCL/psychopathology profiles across timepoints, on average, for either WS or TD children. However, reliable change scores showed WS children had considerable variability in CBCL scores over time. Cross-sectionally, the WS group showed higher scores (reflecting more psychopathology) compared to TD controls at both time points across most CBCL subscales, with elevated overall psychopathology problems identified in 56-68% of WS children (versus 8% in TD controls). Psychopathology was not associated with sex, chronological age, or cognitive ability in WS. Conflict in the family environment was positively associated with higher Attention Problems at Time 1 in the WS group, whilst the TD group showed associations between family conflict and total psychopathology problems at both time points and between family cohesion and total psychopathology problems at Time 2. Family environment did not differ between groups, except for lower engagement in intellectual and cultural activities in WS. Findings highlight variable Internalising and Externalising Problems in young WS children over time, with greater biological than environmental contributions to psychopathology in WS.
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Affiliation(s)
| | - Melanie A. Porter
- School of Psychological Sciences, Macquarie University, Balaclava Road, Marsfield, Sydney, NSW 2109, Australia; (T.I.); (J.L.R.)
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Skelton M, Carr E, Buckman JEJ, Davies MR, Goldsmith KA, Hirsch CR, Peel AJ, Rayner C, Rimes KA, Saunders R, Wingrove J, Breen G, Eley TC. Trajectories of depression and anxiety symptom severity during psychological therapy for common mental health problems. Psychol Med 2023; 53:6183-6193. [PMID: 36510471 PMCID: PMC10520600 DOI: 10.1017/s0033291722003403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/22/2022] [Accepted: 10/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is substantial variation in patient symptoms following psychological therapy for depression and anxiety. However, reliance on endpoint outcomes ignores additional interindividual variation during therapy. Knowing a patient's likely symptom trajectories could guide clinical decisions. We aimed to identify latent classes of patients with similar symptom trajectories over the course of psychological therapy and explore associations between baseline variables and trajectory class. METHODS Patients received high-intensity psychological treatment for common mental health problems at National Health Service Improving Access to Psychological Therapies services in South London (N = 16 258). To identify trajectories, we performed growth mixture modelling of depression and anxiety symptoms over 11 sessions. We then ran multinomial regressions to identify baseline variables associated with trajectory class membership. RESULTS Trajectories of depression and anxiety symptoms were highly similar and best modelled by four classes. Three classes started with moderate-severe symptoms and showed (1) no change, (2) gradual improvement, and (3) fast improvement. A final class (4) showed initially mild symptoms and minimal improvement. Within the moderate-severe baseline symptom classes, patients in the two showing improvement as opposed to no change tended not to be prescribed psychotropic medication or report a disability and were in employment. Patients showing fast improvement additionally reported lower baseline functional impairment on average. CONCLUSIONS Multiple trajectory classes of depression and anxiety symptoms were associated with baseline characteristics. Identifying the most likely trajectory for a patient at the start of treatment could inform decisions about the suitability and continuation of therapy, ultimately improving patient outcomes.
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Affiliation(s)
- Megan Skelton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ewan Carr
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joshua E. J. Buckman
- Research Department of Clinical, Centre for Outcomes Research and Effectiveness (CORE), Educational and Health Psychology, University College London, London, UK
- iCope – Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Molly R. Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Colette R. Hirsch
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Alicia J. Peel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christopher Rayner
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katharine A. Rimes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rob Saunders
- Research Department of Clinical, Centre for Outcomes Research and Effectiveness (CORE), Educational and Health Psychology, University College London, London, UK
| | - Janet Wingrove
- Talking Therapies Southwark, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Thalia C. Eley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Mahmud MN, Othman A, Ilias MI. Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective. Singapore Med J 2023; 64:557-562. [PMID: 34600452 PMCID: PMC10564093 DOI: 10.11622/smedj.2021128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 01/21/2021] [Indexed: 11/18/2022]
Abstract
Introduction The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children. Methods This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test. Results A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems. Conclusion Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.
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Affiliation(s)
- Mohamad Nizam Mahmud
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azizah Othman
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohamad Ikram Ilias
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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Hiller RM, Fraser A, Denne M, Bauer A, Halligan SL. The Development of Young Peoples' Internalising and Externalising Difficulties Over the First Three-Years in the Public Care System. Child Maltreat 2023; 28:141-151. [PMID: 35081783 PMCID: PMC9716486 DOI: 10.1177/10775595211070765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although we know there are high rates of mental health difficulties amongst young people in out-of-home care (i.e. social welfare-involved children), there is limited evidence on the longitudinal development of these problems, particularly from when they enter the care system. Using the routinely collected carer-reported strengths and difficulties questionnaire, we explored internalising (emotional and peer) and externalising (conduct and hyperactivity) difficulties for 672 young people across their first 3 years in the UK care system (2-16 yrs, 51% boys, 76% Caucasian). In all cases stable profiles (resilient or chronic) were most common, while changing profiles (recovery or delayed) were less common. Findings showed that entry into the care system is not enough of an intervention to expect natural recovery from mental health difficulties. Number of placements and being separated from siblings were associated with greater difficulties. Implications for child welfare and mental health systems are discussed.
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Affiliation(s)
- Rachel M Hiller
- Division of Psychology & Language Sciences, University College London, UK
- Anna Freud Centre for Children and Families, UK
- Department of Psychology, University of Bath, UK
| | - Abigail Fraser
- Population and Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Megan Denne
- Department of Psychology, University of Bath, UK
| | | | - Sarah L Halligan
- Department of Psychology, University of Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
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Hutchison SM, Brain U, Grunau RE, Kuzeljevic B, Irvine M, Mâsse LC, Oberlander TF. Associations between maternal depressive symptoms and selective serotonin reuptake inhibitor antidepressant treatment on internalising and anxiety behaviours in children: 12-year longitudinal study. BJPsych Open 2023; 9:e26. [PMID: 36721917 PMCID: PMC9970165 DOI: 10.1192/bjo.2022.623] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure is associated with increased internalising and anxious behaviours in young children; whether this continues into early adolescence is unknown. Also, it is not well established whether it is the in utero exposure to SSRIs or the underlying maternal mood that contributes more to these associations. AIMS To examine associations between maternal depressive symptoms, prenatal SSRI antidepressant treatment and internalising and anxiety behaviours from childhood into pre-adolescence. METHOD From a prospective longitudinal cohort, measures of maternal depressive symptoms and SSRI use and child outcomes (n = 191 births) were obtained from the second trimester to 12 years. Maternal reports of internalising and anxiety behaviours in children were obtained at 3, 6 and 12 years. RESULTS Multilevel mixed-effects models revealed that maternal depressed mood at the third trimester assessment, not prenatal SSRI exposure, was associated with longitudinal patterns of higher levels of internalising and anxiety behaviours across childhood from 3 to 12 years of age. At each age, hierarchical regressions showed that maternal mood at the third trimester, compared with current maternal depression or prenatal SSRI exposure, explained a greater proportion of the variance in internalising and anxiety behaviours. CONCLUSIONS Even with prenatal SSRI treatment, maternal depressed mood during the third trimester still had an enduring effect as it was associated with increased levels of internalising and anxiety behaviours across childhood and into early adolescence. Importantly, we found no evidence of a 'main effect' association between prenatal SSRI exposure and internalising and anxiety behaviours in children.
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Affiliation(s)
- Sarah M Hutchison
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ursula Brain
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Boris Kuzeljevic
- (deceased), Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Mike Irvine
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Tim F Oberlander
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; and School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Wilmot A, Hasking P, Leitão S, Hill E, Boyes M. Understanding Mental Health in Developmental Dyslexia: A Scoping Review. Int J Environ Res Public Health 2023; 20:1653. [PMID: 36674408 PMCID: PMC9864451 DOI: 10.3390/ijerph20021653] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Children with dyslexia are at elevated risk of internalising and externalising mental health concerns. Our aim was to scope the extent and nature of the literature investigating factors which may influence this association. We systematically searched the peer-reviewed and grey literature with no restrictions on the date. We included both qualitative and quantitative studies. Inclusion criteria included: (1) a focus on childhood (≤18 years) reading/learning difficulties; (2) internalising and/or externalising symptoms; and (3) a potentially modifiable third factor (e.g., self-esteem). Ninety-eight studies met the inclusion criteria. We organised the studies according to individual, family, and community-level third factors. Whilst a range of third factors were identified, relatively few researchers tested associations between the third factor and mental health in the context of dyslexia. Furthermore, there was a focus on primary rather than secondary school experience and a reliance, in many cases, on teacher/parent perspectives on children's mental health. Future researchers are encouraged to explore links between socio-emotional skills, coping strategies, school connectedness, and mental health in the context of dyslexia. Research of this nature is important to assist with the identification of children who are more (or less) at risk of mental health concerns and to inform tailored mental health programs for children with dyslexia.
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Affiliation(s)
- Adrienne Wilmot
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Penelope Hasking
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA 6845, Australia
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, WA 6845, Australia
| | - Suze Leitão
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, WA 6845, Australia
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Elizabeth Hill
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, WA 6845, Australia
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, WA 6845, Australia
| | - Mark Boyes
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA 6845, Australia
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, WA 6845, Australia
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Speyer LG, Hall HA, Hang Y, Hughes C, Murray AL. Within-family relations of mental health problems across childhood and adolescence. J Child Psychol Psychiatry 2022; 63:1288-1296. [PMID: 35075634 PMCID: PMC9787478 DOI: 10.1111/jcpp.13572] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND While transactional models suggest that parent and child mental health reciprocally influence one another over development, research has largely focused on parent-to-child effects. Additionally, it is not known whether observed associations hold when appropriate statistical tools are used to operationalise within-family dynamics. METHODS We investigated within-family mental health dynamics using autoregressive latent trajectory models with structured residuals, stratified by child gender. Parental psychological distress was assessed using the Kessler (K6) scale, and children's internalising and externalising problems were assessed using the Strengths and Difficulties Questionnaire. Both measures were administered at the age 3, 5, 7, 11, 14 and 17 waves of the Millennium Cohort Study (N = 10,746, ~50% female). RESULTS Maternal psychological distress was positively associated with subsequent internalising and externalising problems for girls but only with internalising problems for boys. Paternal psychological distress was associated with boys' later internalising and externalising problems during early adolescence. Among boys, internalising problems were associated with later maternal psychological distress, while externalising problems were associated with later paternal psychological distress. Among girls, internalising problems were associated with subsequent paternal psychological distress, while externalising problems were associated with later maternal psychological distress. Finally, maternal and paternal psychological distress showed negative bidirectional associations in early childhood but positive associations in middle childhood and early adolescence. CONCLUSIONS Findings support a transactional model of family mental health, with both child-to-parent and parent-to-child effects playing a role in the development of mental health difficulties. Mental health intervention efforts should, therefore, target the whole family system.
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Affiliation(s)
- Lydia Gabriela Speyer
- Department of PsychologyUniversity of EdinburghEdinburghUK,Department of PsychologyUniversity of CambridgeCambridgeUK
| | | | - Yuzhan Hang
- Department of PsychologyUniversity of EdinburghEdinburghUK
| | - Claire Hughes
- Department of PsychologyUniversity of CambridgeCambridgeUK
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Haywood D, Baughman FD, Mullan BA, Heslop KR. Neurocognitive Artificial Neural Network Models Are Superior to Linear Models at Accounting for Dimensional Psychopathology. Brain Sci 2022; 12:1060. [PMID: 36009123 PMCID: PMC9405994 DOI: 10.3390/brainsci12081060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, there has been debate about the optimal conceptualisation of psychopathology. Structural models of psychopathology have been developed to counter issues, including comorbidity and poor diagnostic stability prevalent within the traditional nosological approach. Regardless of the conceptualisation of psychological dysfunction, deficits in neurocognitive abilities have been claimed to be an aetiological feature of psychopathology. Explorations of the association between neurocognition and psychopathology have typically taken a linear approach, overlooking the potential interactive dynamics of neurocognitive abilities. Previously, we proposed a multidimensional hypothesis, where within-person interactions between neurocognitive domains are fundamental to understanding the role of neurocognition within psychopathology. In this study, we used previously collected psychopathology data for 400 participants on psychopathological symptoms, substance use, and performance on eight neurocognitive tasks and compared the predictive accuracy of linear models to artificial neural network models. The artificial neural network models were significantly more accurate than the traditional linear models at predicting actual (a) lower-level and (b) high-level dimensional psychopathology. These results provide support for the multidimensional hypothesis: that the study of non-linear interactions and compensatory neurocognitive profiles are integral to understanding the functional associations between neurocognition and of psychopathology.
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Affiliation(s)
- Darren Haywood
- St. Vincent’s Hospital Melbourne, Mental Health, Fitzroy, VIC 3065, Australia
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
- EnAble Institute, Curtin University, Bentley, WA 6102, Australia
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Barbara A. Mullan
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
- EnAble Institute, Curtin University, Bentley, WA 6102, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Bentley, WA 6102, Australia
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Gidziela A, Rimfeld K, Malanchini M, Allegrini AG, McMillan A, Selzam S, Ronald A, Viding E, von Stumm S, Eley TC, Plomin R. Using DNA to predict behaviour problems from preschool to adulthood. J Child Psychol Psychiatry 2022; 63:781-792. [PMID: 34488248 DOI: 10.1111/jcpp.13519] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND One goal of the DNA revolution is to predict problems in order to prevent them. We tested here if the prediction of behaviour problems from genome-wide polygenic scores (GPS) can be improved by creating composites across ages and across raters and by using a multi-GPS approach that includes GPS for adult psychiatric disorders as well as for childhood behaviour problems. METHOD Our sample included 3,065 genotyped unrelated individuals from the Twins Early Development Study who were assessed longitudinally for hyperactivity, conduct, emotional problems, and peer problems as rated by parents, teachers, and children themselves. GPS created from 15 genome-wide association studies were used separately and jointly to test the prediction of behaviour problems composites (general behaviour problems, externalising, and internalising) across ages (from age 2 to 21) and across raters in penalised regression models. Based on the regression weights, we created multi-trait GPS reflecting the best prediction of behaviour problems. We compared GPS prediction to twin heritability using the same sample and measures. RESULTS Multi-GPS prediction of behaviour problems increased from <2% of the variance for observed traits to up to 6% for cross-age and cross-rater composites. Twin study estimates of heritability, although to a lesser extent, mirrored patterns of multi-GPS prediction as they increased from <40% to 83%. CONCLUSIONS The ability of GPS to predict behaviour problems can be improved by using multiple GPS, cross-age composites and cross-rater composites, although the effect sizes remain modest, up to 6%. Our approach can be used in any genotyped sample to create multi-trait GPS predictors of behaviour problems that will be more predictive than polygenic scores based on a single age, rater, or GPS.
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Affiliation(s)
- Agnieszka Gidziela
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,School of Biological and Chemical Sciences, Queen Mary University of London, London, UK
| | - Kaili Rimfeld
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Margherita Malanchini
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,School of Biological and Chemical Sciences, Queen Mary University of London, London, UK
| | - Andrea G Allegrini
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Division of Psychology and Language Sciences, University College London, London, UK
| | - Andrew McMillan
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Saskia Selzam
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Angelica Ronald
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Thalia C Eley
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robert Plomin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Sim WH, Jorm AF, Yap MBH. The Role of Parent Engagement in a Web-Based Preventive Parenting Intervention for Child Mental Health in Predicting Parenting, Parent and Child Outcomes. Int J Environ Res Public Health 2022; 19:ijerph19042191. [PMID: 35206394 PMCID: PMC8871768 DOI: 10.3390/ijerph19042191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
Although parents’ engagement in parenting programmes has frequently been posited to influence the efficacy and dissemination of these programmes, its relationship with intervention outcomes in parenting programmes is understudied. This study examined the predictive value of parental engagement on preventive parenting outcomes in a tailored online parenting programme aimed at enhancing parental protective factors and reducing risk factors for child depression and anxiety disorders. The present study also explored the associations between parental engagement and other parent, child and family outcomes. Data were collected from a community sample of 177 parents who received a tailored online parenting programme (‘Parenting Resilient Kids’; PaRK) and their children as part of a randomised controlled trial. Participants completed measures on parenting, child anxiety and depressive symptoms, health-related quality of life and family functioning on three occasions. Multiple regressions showed that parental engagement explained additional variance in preventive parenting (most proximal outcomes) at post-intervention and 12-month follow-up. Indicators of higher levels of parental engagement, operationalised by greater proportions of recommended programme modules and intended goals completed, uniquely predicted higher levels of preventing parenting. Higher levels of parental engagement also predicted higher levels of parental acceptance and parental psychosocial health-related quality of life, lower levels of parental psychological control and lower levels of impairments in child health-related quality of life. However, parental engagement did not explain additional variance in parent or child reported anxiety or depressive symptoms. This study provides support for the role of parental engagement in facilitating parenting changes in parenting-focused interventions.
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Affiliation(s)
- Wan Hua Sim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia;
| | - Anthony F. Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3000, Australia;
| | - Marie B. H. Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia;
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3000, Australia;
- Correspondence:
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Hoy N, Lynch S, Waszczuk M, Reppermund S, Mewton L. Investigating the molecular genetic, genomic, brain structural, and brain functional correlates of latent transdiagnostic dimensions of psychopathology across the lifespan: Protocol for a systematic review and meta-analysis of cross-sectional and longitudinal studies in the general population. Front Psychiatry 2022; 13:1036794. [PMID: 36405912 PMCID: PMC9669375 DOI: 10.3389/fpsyt.2022.1036794] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Research using latent variable modelling has identified a superordinate general dimension of psychopathology, as well as several specific/lower-order transdiagnostic dimensions (e.g., internalising and externalising) within the meta-structure of psychiatric symptoms. These models can facilitate discovery in genetic and neuroscientific research by providing empirically derived psychiatric phenotypes, offering greater validity and reliability than traditional diagnostic categories. The prospective review outlined in this protocol aims to integrate and assess evidence from research investigating the biological correlates of general psychopathology and specific/lower-order transdiagnostic symptom dimensions. Cross-sectional and longitudinal studies investigating general population samples of any age group or developmental period will be included to capture evidence from across the lifespan. METHODS AND ANALYSIS MEDLINE, Embase, and PsycINFO databases will be systematically searched for relevant literature. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria were designed to capture psychiatric genetic (i.e., molecular genetic and genomic) and neuroimaging (i.e., brain structural and brain functional) studies investigating latent transdiagnostic dimension(s) or structural model(s) of psychopathology across any age group. Studies which include or exclude participants based on clinical symptoms, disorders, or relevant risk factors (e.g., history of abuse, neglect, and trauma) will be excluded. Biometric genetic research (e.g., twin and family studies), candidate gene studies, neurophysiology studies, and other non-imaging based neuroscientific studies (e.g., post-mortem studies) will be excluded. Study quality and risk of bias will be assessed using the Joanna Briggs Checklist for Analytical Cross-Sectional Studies, the Joanna Briggs Checklist for Cohort Studies, and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system. Meta-analysis will be conducted if sufficient data is available. DISCUSSION This protocol outlines the first systematic review to examine evidence from studies investigating the latent structure and underlying biology of psychopathology and to characterise these relationships developmentally across the lifespan. The prospective review will cover a broad range of statistical techniques and models used to investigate latent transdiagnostic dimensions of psychopathology, as well as a numerous genetic and neuroscientific methods. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier[CRD42021262717].
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Affiliation(s)
- Nicholas Hoy
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Samantha Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Monika Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.,Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
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Abstract
Anxiety disorders are among the most common psychiatric disorders worldwide. They often onset early in life, with symptoms and consequences that can persist for decades. This makes anxiety disorders some of the most debilitating and costly disorders of our time. Although much is known about the synaptic and circuit mechanisms of fear and anxiety, research on the underlying genetics has lagged behind that of other psychiatric disorders. However, alongside the formation of the Psychiatric Genomic Consortium Anxiety workgroup, progress is rapidly advancing, offering opportunities for future research.Here we review current knowledge about the genetics of anxiety across the lifespan from genetically informative designs (i.e. twin studies and molecular genetics). We include studies of specific anxiety disorders (e.g. panic disorder, generalised anxiety disorder) as well as those using dimensional measures of trait anxiety. We particularly address findings from large-scale genome-wide association studies and show how such discoveries may provide opportunities for translation into improved or new therapeutics for affected individuals. Finally, we describe how discoveries in anxiety genetics open the door to numerous new research possibilities, such as the investigation of specific gene-environment interactions and the disentangling of causal associations with related traits and disorders.We discuss how the field of anxiety genetics is expected to move forward. In addition to the obvious need for larger sample sizes in genome-wide studies, we highlight the need for studies among young people, focusing on specific underlying dimensional traits or components of anxiety.
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Affiliation(s)
- Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Rosa Cheesman
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Eshim S Jami
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Daniel F Levey
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut
| | - Kirstin L Purves
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Heike Weber
- Department of Psychology, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
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Terhaag S, Fitzsimons E, Daraganova G, Patalay P. Sex, ethnic and socioeconomic inequalities and trajectories in child and adolescent mental health in Australia and the UK: findings from national prospective longitudinal studies. J Child Psychol Psychiatry 2021; 62:1255-1267. [PMID: 33948953 DOI: 10.1111/jcpp.13410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study investigates the sex, ethnic and socioeconomic inequalities in emotional difficulties over childhood and adolescence using longitudinal cohort studies in the UK and Australia. Estimating cross-national differences contributes to understanding of the consistency of inequalities in mental health across contexts. METHODS Data from 19,748 participants in two contemporary representative samples in Australia (Growing Up in Australia: The Longitudinal Study of Australian Children, n = 4,975) and UK (Millennium Cohort Study, n = 14,773) were used. Emotional difficulties were assessed using the parent-reported Strengths and Difficulties Questionnaire at ages 4/5, 6/7, 11/12 and 14/15 years and the self-reported Short Moods and Feelings Questionnaire at age 14/15. Latent Growth Curve Modelling was used to examine mental health over time. RESULTS There were significant increases in emotional difficulties in both countries over time. Emotional difficulties were higher in Australian children at all ages. The gender gap in self-reported depressive symptoms at age 14/15 was larger in the UK (8% of UK and 13% of Australian boys were above the depression cut-off, compared with 23% of girls). Ethnic minority children had higher emotional difficulties at age 4/5 years in both countries, but over time this difference was no longer observed in Australia. In the UK, this reversed whereby at ages 11/12 and 14/15 ethnic minority children had lower symptoms than their White majority peers. Socioeconomic differences were more marked based on parent education and employment status in Australia and by parent income in the UK. UK children, children from White majority ethnicity and girls evidenced steeper worsening of symptoms from age 4/5 to 14/15 years. CONCLUSIONS Even in two fairly similar countries (i.e. English-speaking, high-income, industrialised), the observed patterns of inequalities in mental health symptoms based on sociodemographics are not the same. Understanding country and context-specific drivers of different inequalities provides important insights to help reduce disparities in child and adolescent mental health.
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Affiliation(s)
- Sonia Terhaag
- Australian Institute of Family Studies, Department of Social Services, Australian Government, Melbourne, Victoria, Australia
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, UCL Institute of Social Research, University College London, London, UK
| | - Galina Daraganova
- Australian Institute of Family Studies, Department of Social Services, Australian Government, Melbourne, Victoria, Australia
| | - Praveetha Patalay
- Centre for Longitudinal Studies, UCL Institute of Social Research, University College London, London, UK.,MRC Unit for Lifelong Health and Ageing, University College London, London, UK
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14
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Donati G, Meaburn E, Dumontheil I. Internalising and externalising in early adolescence predict later executive function, not the other way around: a cross-lagged panel analysis. Cogn Emot 2021; 35:986-998. [PMID: 33900139 PMCID: PMC8372297 DOI: 10.1080/02699931.2021.1918644] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 11/12/2022]
Abstract
Developmental changes in the brain networks involved in emotion regulation are thought to contribute to vulnerability to mental health problems during adolescence. Executive control is often viewed as allowing top-down regulation of emotional responses. However, while associations between executive control and mental health are commonly observed in both clinical and non-clinical populations, the direction of these associations remains unclear. Low, or immature, cognitive control could limit emotion regulation. Reversely, high emotionality could impede cognitive functioning. The scarcity of longitudinal studies testing for bi-directional effects, particularly in adolescence, has made it difficult to draw conclusions. This study analysed data from 1,445 participants of a longitudinal cohort in a cross-lagged panel design to understand bi-directional longitudinal associations between executive function and emotional behaviours across adolescence. Executive function was assessed using experimental working memory and inhibitory control tasks, emotional behaviours through parental report of internalising and externalising behaviours. Cross-sectional associations were replicated. Controlling for cross-sectional associations, early executive functions were not found to predict later emotional behaviours. Instead, early emotional behaviours predicted later executive function, with the strongest link observed between early externalising and later working memory. These results suggest that emotional well-being may affect the maturation of executive function during adolescence.
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Affiliation(s)
- Georgina Donati
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, UK
- Child and Adolescent Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Emma Meaburn
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Iroise Dumontheil
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, UK
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15
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Haywood D, Baughman FD, Mullan BA, Heslop KR. One p-Factor for All? Exploring the Applicability of Structural Models of Psychopathology within Subgroups of a Population. Int J Environ Res Public Health 2021; 18:7108. [PMID: 34281043 PMCID: PMC8297009 DOI: 10.3390/ijerph18137108] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 12/17/2022]
Abstract
Structural models of psychopathology have emerged as an alternative to traditional categorical approaches. The bifactor model, which incorporates a general p-factor, has become the preferred structure. The p-factor is claimed to represent a substantive construct or property of the system; however, recent evidence suggests that it may be without substantive meaning. If a universal substantive p, and associated specific factors, is to be developed they not only must be applicable and consistent between populations but also must be applicable and consistent within subgroups of a population. This consistency needs to include not only factor loadings but also factor correlates. We used a simulated data approach to explore the applicability and consistency of four popular models of psychopathology to a range of heterogeneous subgroups and examined the consistency of their neurocognitive correlates. We found that only eight out of sixty-three subgroups fitted any of the models with all significant loadings, no negative loadings, no non-positive-definite identification issues, and no negative variance. All eight of these subgroups fit the correlated factors model, none fit the original bifactor model, four subgroups fit the revised bifactor model, and one subgroup fit the single-factor model. Correlates of the factors also varied substantially between the subgroups fitted to the same model. We discuss the implications of the findings, including the implications for the development of universal substantive factors of psychopathology.
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Affiliation(s)
- Darren Haywood
- Discipline of Psychology, School of Population Health, Curtin University, GPO BOX U1987, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, GPO BOX U1987, Perth 6845, Australia
- WA Cancer Prevention Research Unit, School of Population Health, Curtin University, GPO BOX U1987, Perth 6845, Australia
| | - Frank D. Baughman
- Discipline of Psychology, School of Population Health, Curtin University, GPO BOX U1987, Perth 6845, Australia; (F.D.B.); (B.A.M.)
| | - Barbara A. Mullan
- Discipline of Psychology, School of Population Health, Curtin University, GPO BOX U1987, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, GPO BOX U1987, Perth 6845, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, GPO BOX U1987, Perth 6845, Australia;
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16
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Ozsivadjian A, Hollocks MJ, Magiati I, Happé F, Baird G, Absoud M. Is cognitive inflexibility a missing link? The role of cognitive inflexibility, alexithymia and intolerance of uncertainty in externalising and internalising behaviours in young people with autism spectrum disorder. J Child Psychol Psychiatry 2021; 62:715-724. [PMID: 32827150 DOI: 10.1111/jcpp.13295] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Internalising (anxiety and low mood) and externalising (aggressive or outburst behaviours, and irritability) difficulties are very common in autism spectrum disorder (ASD) across the life span, relatively stable over time and often associated with poorer quality of life. Understanding the cognitive mechanisms underlying internalising and externalising difficulties in ASD is essential for developing targeted supports and interventions. In the present study, we investigated established and less-researched cognitive factors hypothesised to contribute to internalising and/or externalising difficulties in ASD, namely cognitive inflexibility (CI), intolerance of uncertainty (IU) and alexithymia. Based on previous models and clinical experience, we hypothesised that IU would lead to internalising symptoms, with alexithymia contributing to this pathway, and that CI would have a direct effect on externalising behaviours and may indirectly contribute to internalising symptoms via increasing IU. METHODS Our sample consisted of 95 5- to 18-year-olds presenting to a specialist neurodevelopmental clinic and receiving a diagnosis of ASD. Parents/caregivers completed questionnaires assessing ASD symptomatology, internalising and externalising difficulties, CI, IU and alexithymia. Structural equation modelling was used to examine the hypothesised pathways and relationships between the main variables of interest. RESULTS Cognitive Inflexibility played a significant direct role in the pathway from ASD symptoms to externalising symptoms in ASD, and indirect role via IU in the pathway to internalising problems. Relationships between alexithymia and both internalising and externalising symptoms were weaker, with alexithymia predicting internalising difficulties via IU only. CONCLUSIONS The finding of a direct pathway from CI to externalising behaviours is novel, as is the indirect role of CI in internalising symptomatology. Of the three cognitive mechanisms examined, only CI significantly predicted externalising symptoms. Possible implications for interventions and supports targeting these cognitive processes in ASD are discussed.
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Affiliation(s)
- Ann Ozsivadjian
- Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Matthew J Hollocks
- Department of Child & Adolescent Psychiatry, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Iliana Magiati
- School of Psychological Science, University of Western Australia (UWA), Crawley, WA, Australia
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Gillian Baird
- Newcomen Centre, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Michael Absoud
- Newcomen Centre, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.,Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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17
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Parker SE, Collett BR, Werler MM. Maternal acetaminophen use during pregnancy and childhood behavioural problems: Discrepancies between mother- and teacher-reported outcomes. Paediatr Perinat Epidemiol 2020; 34:299-308. [PMID: 31693212 PMCID: PMC7192789 DOI: 10.1111/ppe.12601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/29/2019] [Accepted: 09/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Maternal acetaminophen use during pregnancy is common and has been associated with childhood behavioural problems among offspring, specifically hyperactivity and conduct problems. OBJECTIVE Assessments of child behaviour in many previous studies have relied on maternal or parent report. Acknowledging that results of behavioural assessments vary between informants, we examined the association between maternal acetaminophen use during pregnancy and behaviour problems in childhood based on mother- and teacher-report. METHODS A longitudinal study of 560 mother-child pairs with data on illnesses and medication use during pregnancy and neurodevelopmental assessments during childhood was conducted. Acetaminophen use during pregnancy was captured using a standardised maternal interview, completed 1 year after delivery on average. Measures of childhood (6-12 years of age) behaviour were obtained via mother- and teacher-report, using the Child Behaviour Checklist and Teacher Report Form. Linear and log-binomial models were used to calculate adjusted mean differences (MD) and risk ratios (RR), respectively and 95% confidence intervals (CI) for internalising, externalising, and total behaviour problems comparing acetaminophen users to non-users. Stabilized inverse probability weights were used to account for loss to follow-up, and adjustments for indication were made. RESULTS Approximately 60% (n = 354) of women reported use of acetaminophen during pregnancy. Acetaminophen use during pregnancy was associated with an increase in total behaviour problem score and risk of clinical behaviour problems according to mother report (MD 2.2, 95% CI 0.3, 4.1 and RR 1.93, 95% CI 0.99, 3.76) but not according to teacher report. Weighting to account for participation did not alter results, while adjustment for indications of acetaminophen use greatly attenuated the associations with mother-reported total behaviour problem score and risk of clinical behaviour problems (MD 0.1, 95% CI -2.1, 2.3 and RR 1.31, 95% CI 0.67, 2.58). CONCLUSIONS Acetaminophen use during pregnancy was weakly associated with mother-reported behaviour problems and not associated with teacher-reported problems.
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Affiliation(s)
- Samantha E. Parker
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Brent R. Collett
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Martha M. Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
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18
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Abstract
Behavioural problems in children are a relatively common occurrence but are a concern for parents. Such problems are often a reflection of the child's social stressors, environment and developmental state. Although a majority of behavioural problems are temporary, some may persist or are symptomatic of neurodevelopmental disorders or an underlying medical condition. Initial management of behaviour problems often involves helping parents to learn effective behaviour strategies to promote desirable behaviours in their children. This article highlights a general approach to evaluating and treating behavioural problems in children in the primary care setting. Sleep problems, eating disorders, and other emotional and developmental disorders, such as autism spectrum disorder and attention deficit hyperactivity disorder, are not within the scope of this article.
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Affiliation(s)
- Dypti Lulla
- SingHealth Polyclinics - Marine Parade, Singapore
| | | | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore.,Family Medicine Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore
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19
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Newton NC, Stapinski L, Teesson M, Slade T, Champion KE, Barrett EL, Birrell L, Kelly E, Mather M, Conrod PJ. Evaluating the differential effectiveness of social influence and personality-targeted alcohol prevention on mental health outcomes among high-risk youth: A novel cluster randomised controlled factorial design trial. Aust N Z J Psychiatry 2020; 54:259-271. [PMID: 31561712 DOI: 10.1177/0004867419877948] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study examined the secondary mental health outcomes of two contrasting alcohol prevention approaches, whereby one intervention targets common underlying personality risk for alcohol use and mental health problems (Preventure) and the other targets alcohol- and drug-related behaviours and cognitions (Climate Schools). METHODS A 2 × 2 cluster randomised controlled factorial design trial was conducted in 26 Australian schools randomised to the following 4 conditions: Climate Schools (n = 6), Preventure (n = 7), combined Climate Schools and Preventure (CAP; n = 6) or treatment as usual (TAU; n = 7). Participants completed questionnaires at baseline, 6, 12, 24 and 36 months post-baseline including the Brief Symptom Inventory anxiety and depression scales and hyperactivity and conduct scales of the Strengths and Difficulties Questionnaire. Analyses focused on students who were at high-risk based on personality traits (n = 947; Mage = 13.3). The effectiveness of each approach in reducing symptoms of internalising and externalising problems was assessed using multi-level mixed effects analysis. RESULTS Main effects for each intervention relative to not receiving that intervention revealed significant main effects of Preventure in reducing anxiety symptoms (d = -0.27, 95% confidence interval [CI] = [-0.53, -0.01], p < 0.05) and a marginal effect in reducing depressive symptoms (d = -0.24, 95% CI = [-0.49, 0.01], p = 0.06) over 3 years. Interaction effects revealed that when delivered alone, Preventure significantly reduced conduct problems (d = -0.45, 95% CI = [-0.78, -0.11], p < 0.05) and hyperactivity symptoms (d = -0.38, 95% CI = [-0.70,-0.07], p < 0.05) compared to TAU. CONCLUSION This study is the first to report the effectiveness of personality-targeted alcohol prevention in reducing internalising and externalising symptoms relative to an active control, providing evidence in favour of its specificity in preventing concurrent substance use and mental health problems among high-risk youth.
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Affiliation(s)
- Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Marius Mather
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Patricia J Conrod
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.,Institute of Psychiatry, Kings College London, London, UK
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20
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Bailey T, Totsika V, Hastings RP, Hatton C, Emerson E. Developmental trajectories of behaviour problems and prosocial behaviours of children with intellectual disabilities in a population-based cohort. J Child Psychol Psychiatry 2019; 60:1210-1218. [PMID: 31225660 DOI: 10.1111/jcpp.13080] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND The study examined developmental trajectories of prosocial behaviours, internalising and externalising behaviour problems in children with intellectual disabilities (ID) between pre-school and middle childhood. METHOD Growth models examined the best-fitting trajectories for internalising and externalising behaviour problems, as well as prosocial behaviours, in 555 children with ID between the ages of three and 11 years from the UK Millennium Cohort Study. Models were also fitted to examine the association of child outcomes with time-varying maternal psychological distress and life satisfaction. Finally, models were extended to compare trajectories with typically developing children. RESULTS Externalising behaviour problems and prosocial behaviours generally improved, whereas internalising problems did not change systematically over time. A cubic trend indicated a slowing down of improvement between ages 5 and 7 for prosocial behaviours and externalising problems. Maternal psychological distress positively co-varied with internalising and externalising behaviour problems over time. Life satisfaction was not related to changes in child behaviours over time. Compared to behavioural trajectories in typical development, intercepts were worse and trajectories also differed in the ID group. CONCLUSIONS Over an 8-year period, externalising behaviour problems and prosocial behaviours of children with ID tended to improve. These behavioural improvements slowed between five and seven years, possibly coinciding with school-related environmental changes. Children with ID significantly differ from children with typical development in both the initial level of difficulties (exhibiting higher externalising and internalising behaviours, and lower prosocial behaviours) and subsequent development as they age, showing comparatively lower decreases in both externalising and internalising behaviours, and lower increases in prosocial behaviours. Findings also highlight the significant role of maternal mental health problems in the trajectory of child behaviour problems.
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Affiliation(s)
- Tom Bailey
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Division of Psychiatry, University College London, London, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Chris Hatton
- Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Eric Emerson
- Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.,Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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21
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Hughes K, Bullock A, Coplan RJ. A person-centred analysis of teacher-child relationships in early childhood. Br J Educ Psychol 2013; 84:253-67. [PMID: 24116925 DOI: 10.1111/bjep.12029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 08/15/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previously, the nature of teacher-child relationships (TCRs) has been explored through dimensions of close, conflicted, and dependent. However, this variable-centred approach is limited, as many relationships can be characterized by more than one characteristic or trait. A person-centred approach would allow for a greater understanding of the types of relationships that are formed and improved interpretation of the students' socio-emotional outcomes associated with that relationship. AIMS The primary goal of this study was to examine the socio-emotional functioning of young children who formed distinct types of TCRs. SAMPLE Participants were n = 202 kindergarten children (98 girls, 104 boys, Mage = 64.12 months, SD = 4.86). METHOD Multi-source assessment was employed with data collected from parent ratings, teacher reports, child interviews, and naturalistic observations in the classroom. Using quartile cut-offs, we identified children who formed conflicted, dependent, and 'combined' (conflicted and dependent) TCRs. RESULTS Results indicated distinct patterns of socio-emotional functioning for each TCR group. For example, whereas children in conflicted TCRs evidenced greater externalizing difficulties, children with dependent TCRs had greater internalizing difficulties. Children who evidenced high levels of both conflicted and dependent TCRs displayed the most pervasive socio-emotional difficulties. CONCLUSIONS Children who form TCRs characterized by high levels of both conflict and dependency displayed the most pervasive adjustment difficulties. Further investigation is needed to improve our understanding of this group and to assess the plausibility of early intervention strategies.
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Affiliation(s)
- Kathleen Hughes
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
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Betancourt TS, Salhi C, Buka S, Leaning J, Dunn G, Earls F. Connectedness, social support and internalising emotional and behavioural problems in adolescents displaced by the Chechen conflict. Disasters 2012; 36:635-55. [PMID: 22443099 PMCID: PMC3735440 DOI: 10.1111/j.1467-7717.2012.01280.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The study investigated factors associated with internalising emotional and behavioural problems among adolescents displaced during the most recent Chechen conflict. A cross-sectional survey (N=183) examined relationships between social support and connectedness with family, peers and community in relation to internalising problems. Levels of internalising were higher in displaced Chechen youth compared to published norms among non-referred youth in the United States and among Russian children not affected by conflict. Girls demonstrated higher problem scores compared to boys. Significant inverse correlations were observed between family, peer and community connectedness and internalising problems. In multivariate analyses, family connectedness was indicated as a significant predictor of internalising problems, independent of age, gender, housing status and other forms of support evaluated. Sub-analyses by gender indicated stronger protective relationships between family connectedness and internalising problems in boys. Results indicate that family connectedness is an important protective factor requiring further exploration by gender in war-affected adolescents.
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Affiliation(s)
- Theresa S Betancourt
- Department of Global Health and Population, François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, 651 Huntington Avenue, FXB Building 7th Floor, Room 709D, Boston, MA 02115, United States.
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