Fire interest, fire setting and psychopathology in Australian children: a normative study

OBJECTIVE: Child and adolescent fire setting is associated with a broad pattern of antisocial behaviour and is associated with huge costs to the Australian community. Assessment and treatment options have principally been tested in clinically referred or incarcerated children and adolescents. Little information is available about fire setting in normal populations and thus opportunities for screening and early intervention are not well developed. METHOD: In this study, a large sample of 4- to 9-year-old children were assessed using a seven-item fire interest history screen with other measures of antisocial behaviour, children's mental health, parenting style and quality and parenting stress. These were followed-up with parent and teacher report measures and a diagnostic interview at 12 months. RESULTS: The fire history screening tool demonstrated utility in screening for early signs of fire setting. Prevalences of fire interest, and match- and fire-play were low overall but consistently higher for boys than for girls across ages. As expected, fire setting was associated with parental stress and a range of antisocial behaviours including conduct problems, hyperactivity, cruelty to animals and thrill-seeking temperament. In girls, it was also associated with anxiety/depression problems. CONCLUSIONS: Fire behaviours in children are related to broader psychopathology and family stress, and can be effectively identified in young children using a brief screening measure.     

Temperamental predictors of externalizing problems among boys and girls: a longitudinal study in a high-risk sample from ages 3 months to 15 years

In a high-risk community sample, we examined the role of regulative temperament and emotionality as well as the extent of gender specificity in the development of externalizing problems. 151 boys and 157 girls born at differing degrees of obstetric and psychosocial risk were followed from birth into adolescence. In infancy and childhood, NYLS-derived temperamental characteristics were assessed by a highly structured parent interview and standardized behavioral observations. At age 15 years, externalizing problems were measured by the Child Behavior Checklist. As revealed by multiple linear regression and logistic regression, low regulative abilities predicted adolescent behavioral and attentional problems over and above obstetric and psychosocial risks. Gender specificity was found in the strength of the association rather than in the kind with a stronger long-term prediction from infant and toddler temperament in girls. Compared to regulative abilities, temperament factors describing aspects of mood and fear/withdrawal versus approach tendencies played a minor role in the development of externalizing problems. Findings are discussed in terms of gender-specific risk factors and possible differential developmental trajectories to subtypes of disruptive behavior.     

Early risk factors for adolescent antisocial behaviour: an Australian longitudinal study

OBJECTIVE: This investigation utilizes data from an Australian longitudinal study to identify early risk factors for adolescent antisocial behaviour. METHOD: Analyses are based on data from the Mater University Study of Pregnancy, an on-going longitudinal investigation of women's and children's health and development involving over 8000 participants. Five types of risk factors (child characteristics, perinatal factors, maternal/familial characteristics, maternal pre- and post-natal substance use and parenting practices) were included in analyses and were based on maternal reports, child assessments and medical records. Adolescent antisocial behaviour was measured when children were 14 years old, using the delinquency subscale of the Child Behaviour Checklist. RESULTS: Based on a series of logistic regression models, significant risk factors for adolescent antisocial behaviour included children's prior problem behaviour (i.e. aggression and attention/restlessness problems at age 5 years) and marital instability, which doubled or tripled the odds of antisocial behaviour. Perinatal factors, maternal substance use, and parenting practices were relatively poor predictors of antisocial behaviour. CONCLUSIONS: Few studies have assessed early predictors of antisocial behaviour in Australia and the current results can be used to inform prevention programs that target risk factors likely to lead to problem outcomes for Australian youth.     

Behavioural and emotional problems in children with intellectual disability attending special schools in Cape Town, South Africa

A sample of 355 children with intellectual disability (ID) attending special schools in Cape Town, South Africa, were assessed on the Developmental Behavioural Checklist – Teacher Version (DBC‐T). A prevalence rate of 31% for psychopathology was found. Boys manifested more behaviour problems than girls, especially in relation to disruptive, self‐absorbed and antisocial behaviours. Children with severe and profound levels of ID showed more behavioural difficulties than those in the mild and moderate categories. Specific behaviour problems were self‐absorbed and autistic behaviours in children with profound ID, communication problems and anxiety in those with severe ID and antisocial behaviour in children with mild ID. Epilepsy, but not cerebral palsy was associated with higher total behaviour scores. Ambulant children were more disruptive and antisocial, while non‐ambulant children were more anxious. Non‐verbal children had higher scores on all of the subscales except for disruptive behaviour.     

Differential susceptibility to environmental influences: the role of early temperament and parenting in the development of externalizing problems

Objective

A difficult or undercontrolled temperament, as well as harsh parental discipline or a lack of warmth, has long been regarded as risk factors for the development of externalizing problems. In addition, it has been suggested that children with difficult temperament are especially susceptible to rearing influences. We investigated the impact of early temperament and parenting and their interactions on externalizing behavior at school age.

Methods

Participants were 148 boys and 160 girls from a prospective longitudinal study on a high-risk sample. At ages 3 months and 2 years, temperament was assessed by a highly structured parent interview and standardized behavioral observations. Maternal parenting was assessed by videotaped behavioral observation and a parent questionnaire. Externalizing problems at age 8 years were measured by the Child Behavior Checklist.

Results

Using hierarchical linear regression analyses, we found that externalizing problems were predicted by psychosocial adversity and poor self-control, whereas no main effect for restrictive parenting or maternal empathy was found. Fearful-inhibited boys were positively affected by empathic and sensitive parenting, whereas girls who were low in self-control and/or fearful developed less externalizing problems with restrictive parenting.

Conclusion

Our results partly support the differential susceptibility hypothesis. In addition, they point toward gender-specific pathways in the development of externalizing problems.     

Decreased cortisol levels in adolescent girls with conduct disorder

BACKGROUND: Female adolescent antisocial behavior is increasing, but little is known about the neuroendocrinologic aspects of this disorder. On the basis of reports of decreased cortisol levels in antisocial males, we investigated morning plasma cortisol levels in adolescent girls with conduct disorder (CD). METHODS: Three plasma samples for cortisol levels were taken every 20 minutes between 8 and 9 AM in 47 adolescent girls with CD (mean +/- SD age, 16.5 +/- 0.9 years) and 37 normal control girls (mean age, 16.0 +/- 0.8 years). All blood was drawn within 72 hours after the onset of menstrual flow. RESULTS: Girls with CD had significantly lower cortisol levels than girls in the normal control group at all 3 sampling times. This finding was not due to procedural factors, demographic characteristics, or the use of medications. The girls with CD who had no other psychiatric problems had lower cortisol levels than girls with other disorders or those in the normal control group. In the multiple regression analysis, having CD predicted 10% of the variance in cortisol levels. CONCLUSIONS: Morning plasma cortisol levels were significantly diminished in adolescent girls with CD. Decreased cortisol levels appear to be most strongly associated with antisocial girls who do not have other psychiatric disorders.     

Pubertal timing,sexual behaviour and self-reported depression in middle adolescence

The associations between pubertal timing, sexual activity and self-reported depression were analysed in a population sample of 17,082 girls and 15,922 boys aged 14-16 as a par of a classroom survey. Pubertal timing was assessed by age at onset of menstruation (menarche) or ejaculations (oigarche). Sexual experiences elicited included kissing, light petting, heavy petting and intercourse. Self-reported depression was measured by the 13-item Beck Depression Inventory. Among girls, self-reported depression was associated with early puberty and intimate sexual relationship. Among boys depression was associated with very early and late puberty and experience of intercourse. Early puberty is a risk factor for self-reported depression. Intimate sexual relationships in middle adolescent are likely to indicate problems in adolescent development rather than successful adolescent passage.     

Malnutrition at age 3 years and externalizing behavior problems at ages 8, 11, and 17 years

OBJECTIVE: Poor nutrition is thought to predispose to externalizing behavior problems, but to date there appear to have been no prospective longitudinal studies testing this hypothesis. This study assessed whether 1) poor nutrition at age 3 years predisposes to antisocial behavior at ages 8, 11, and 17 years, 2) such relationships are independent of psychosocial adversity, and 3) IQ mediates the relationship between nutrition and externalizing behavior problems. METHOD: The participants were drawn from a birth cohort (N=1,795) in whom signs of malnutrition were assessed at age 3 years, cognitive measures were assessed at ages 3 and 11 years, and antisocial, aggressive, and hyperactive behavior was assessed at ages 8, 11, and 17 years. RESULTS: In relation to comparison subjects (N=1,206), the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. The results were independent of psychosocial adversity and were not moderated by gender. There was a dose-response relationship between degree of malnutrition and degree of externalizing behavior at ages 8 and 17. Low IQ mediated the link between malnutrition and externalizing behavior at ages 8 and 11. CONCLUSIONS: These results indicate that malnutrition predisposes to neurocognitive deficits, which in turn predispose to persistent externalizing behavior problems throughout childhood and adolescence. The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior.     

A Biopsychosocial Approach to Risk and Resilience on Behavior in Children Followed from Birth to Age 12

An increasing prevalence of mental health problems calls for more knowledge into factors associated with resilience. The present study used multiple statistical methodologies to examine a biopsychosocial model of risk and resilience on preadolescence behavior. Data from 889 children and mothers from a birth cohort were used. An adversity score was created by combining maternal symptoms of depression, psychosocial risk and children’s experiences of life events. The proposed resilience factors investigated were candidate genetic polymorphisms, child temperament, social functioning, and maternal sense of coherence. The l/l genotype of the serotonin transporter linked polymorphic region was associated with lower internalizing scores, but not mainly related to the level of adversity. An easy temperament was associated with resilience for children exposed to high adversity. Social functioning was found to be promotive independent of the risk level. The results support a multiple-level model of resilience indicating effects, though small, of both biological and psychosocial factors.     

Adolescent stress and future smoking behaviour: a prospective investigation

OBJECTIVE: Adolescent stress has been retrospectively associated with various measures of smoking behaviour in school-aged samples. The present study sought to extend this to a prospective investigation in order to examine the possibly formative influences of stress on the onset of smoking in adolescents. METHOD: A 12-month follow-up study related sources and degree of adolescent stress measured at study commencement with the onset of smoking behaviour 12 months later in a large cohort of adolescents attending Australian secondary schools. RESULTS: Adolescent stress was only weakly related to smoking onset in adolescent males and even this could possibly be explained by other factors. In adolescent girls, however, prospective associations were stronger and more broadly represented across the various domains of adolescent stress, suggesting that stress may exert a formative influence on smoking onset for girls. CONCLUSION: Management strategies for adolescent stress may be an affective target for smoking prevention programs among adolescent girls.     

Psychotic‐spectrum symptoms,cumulative adversity exposure and substance use among high‐risk girls

Aim

Psychotic‐spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high‐risk girls’ mental health, we assessed: (1) psychotic‐spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C‐TALE) and adversity‐indicators (symptoms, maladaptive coping, stressor‐reactivity); and SAU risk‐factors; and (3) relationships among psychotic‐spectrum symptoms, adversity‐indicators and SAU risk‐factors.

Methods

We administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls.

Results

Girls’ psychotic‐spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU‐independent), interpersonal sensitivity, schizoid traits and paranoia (over‐interpretation, anger over‐reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C‐TALE‐types) were common. Mean loss (4) and trauma (8) onset‐age occurred before SAU‐onset (12). Significant positive correlations were found among psychotic‐spectrum symptoms, stressor‐reactivity, C‐TALE, adversity‐indicators; and number of SAU‐types; and a negative correlation occurred between psychotic‐spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU‐types, stressor‐reactivity and adversity‐related numbing individually had the largest associations with total psychotic‐spectrum symptoms (b = 2.6‐4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide) in response to adversity, amplifying potential health‐disparities. No racial/ethnic differences emerged on psychotic‐spectrum symptoms.

Conclusions

This symptom constellation during adolescence likely interferes with social and academic functioning. Whether representing a prodromal phase, trauma‐response or cross‐diagnostic psychopathology, accurate early detection and appropriate treatment of psychotic‐spectrum symptoms are warranted to improve functional outcomes in vulnerable populations.     

Increased height and bulk in antisocial personality disorder and its subtypes

Research suggests that those with antisocial tendencies are larger than controls, but studies have not assessed this association in antisocial personality disorder (APD) or its hypothesized sub-types (i.e. adolescence-limited, late-onset). Height, weight, body mass index, bulk, and psychosocial adversity were assessed in 44 controls, nine adolescent-limited antisocials, 21 APDs, and 13 late-onset antisocials from the community. Adult antisocial individuals, regardless of age of onset, were significantly taller and had greater body bulk than controls. Although groups tended to differ on weight, they did not differ on body mass index. In addition, APDs and adolescent-limited individuals reported greater psychosocial adversity than the other groups. Adversity did not account for height or bulk differences. Results suggest prior findings on height and bulk may apply to APD and support differentiating adolescent-limited and life-course persistent subgroups.     

Acute stress alters individual risk taking in a time‐dependent manner and leads to anti‐social risk

Decision‐making processes can be modulated by stress, and the time elapsed from stress induction seems to be a crucial factor in determining the direction of the effects. Although current approaches consider the first post‐stress hour a uniform period, the dynamic pattern of activation of the physiological stress systems (i.e., the sympathetic nervous system and hypothalamic‐pituitary‐adrenal axis) suggests that its neurobehavioural impact might be heterogeneous. Here, we evaluate economic risk preferences on the gain domain (i.e., risk aversion) at three time points following exposure to psychosocial stress (immediately after, and 20 and 45 min from onset). Using lottery games, we examine decisions at both the individual and social levels. We find that risk aversion shows a time‐dependent change across the first post‐stress hour, evolving from less risk aversion shortly after stress to more risk averse behaviour at the last testing time. When risk implied an antisocial outcome to a third party, stressed individuals showed less regard for this person in their decisions. Participants’ cortisol levels explained their behaviour in the risk, but not the antisocial, game. Our findings reveal differential stress effects in self‐ and other‐regarding decision‐making and highlight the multidimensional nature of the immediate aftermath of stress for cognition.     

Self-reported and parent-reported quality of life of children and adolescents with new-onset epilepsy

Purpose: To investigate the self‐reported quality of life (QOL) of children and adolescents with new‐onset epilepsy and explore parent’s perceptions of their child’s QOL and the impact of epilepsy on the family. Methods: As part of the Standard and New Antiepileptic Drug (SANAD) trial, 248 children (aged 8–15 years) with new‐onset epilepsy and their parents completed batteries of QOL measures. Children completed the KINDL and subscales of the QOLIE‐AD‐48. Parental questionnaires included the Rutter Parent Scales, Adverse Events Profile, and subscales of the Child Health Questionnaire. Key Findings: Compared with published norms, children with epilepsy had significantly poorer QOL across multiple domains compared with healthy children and children with asthma. Parents, particularly of younger children and those with other long‐term health problems, were affected by their child’s health or behavior, which affected their emotional well‐being and time for their own needs. Significance: Children with new‐onset epilepsy, particularly those with comorbid conditions, are at risk of reduced QOL at the time of diagnosis. It is important that children with epilepsy and their families are assessed for psychosocial problems so that early intervention can be undertaken.     

Predictors of antisocial behaviour in children with attention deficit hyperactivity disorder

Abstract Introduction Antisocial behaviour is an important adverse outcome of ADHD. The aim of this review is to examine what is known about the clinical, genetic and environmental factors that contribute to the link between ADHD and antisocial behaviour. Methods Electronic literature searches for the years 1980–2004 and examination of key reference books were undertaken. Results ADHD symptom severity and pervasiveness predict the development of antisocial behaviour. Genetic factors contribute substantially to the risk of developing both problems, although specific genes that influence the development of antisocial behaviour in ADHD have yet to be identified. Some of these genetic effects may be indirectly mediated through environmental risk (gene-environment correlation) or by increasing individual susceptibility to specific environmental adversity (gene-environment interaction). Antisocial behaviour in children with ADHD is also linked with family adversity as well as peer rejection, although some of this adversity may arise as a result of the child’s symptoms. Conclusion Despite the increased risk of antisocial outcomes in those with ADHD, relatively little is known about what risk factors and mechanisms contribute to the link between both these problems. Given the need for appropriate intervention and prevention strategies and targeting resources, more research is needed in this area.     

Temperament in the developmental course: a longitudinal comparison of New York Longitudinal Study-derived dimensions with the Junior Temperament and Character Inventory

OBJECTIVE: Despite theoretical discrepancies between different concepts of temperament, some core dimensions are thought to be common to the various models. We compared temperamental traits derived from the New York Longitudinal Study (NYLS) model and the Cloninger dimensions in the developmental course and investigated the associations of temperament with sex as well as with obstetric risks or psychosocial risks present at birth. METHODS: Participants were 151 boys and 157 girls born at differing degrees of obstetric and psychosocial risk from a longitudinal study on a high-risk community sample. In infancy and childhood, NYLS-derived temperamental characteristics were assessed by a highly structured parent interview and standardized behavioral observations. At age 15 years, the Junior Temperament and Character Inventory/12-18 was administered. RESULTS: Moderate correlations were found between Junior Temperament and Character Inventory scales in adolescence and NYLS-derived factors in childhood. The psychosocial risk load seemed to influence the expression of novelty seeking or corresponding NYLS-derived factors, whereas the obstetric risks did not contribute to variation in temperament. Our findings further support highly sex-specific gene x environment interactions on temperament in the developmental course. CONCLUSION: The content of our NYLS-derived factors and the specific type of association across different temperament constructs fit into the increasing consensus regarding a small number of higher-order temperamental traits.     

The association of parental alcohol abuse and depression with severe emotional and behavioural problems in adolescents: a clinical study

BACKGROUND: Earlier studies have indicated associations between parental psychiatric problems, such as depression, and substance abuse and adolescent problems. AIMS: This study aimed to determine whether parental psychiatric problems are associated with problems and problem behaviour in adolescents in a clinical sample. METHODS: The study subjects were 70 outpatient adolescents (age 13-18 years, boys 30%) and their parents. The adolescents were assessed using the structural clinical interview for DSM-III-R (SCID) and a semi-structured questionnaire, and the parents were interviewed using a semi-structured questionnaire. RESULTS: Maternal alcohol abuse and depression were associated with serious problems, especially among girls, and paternal alcohol abuse was associated with adolescent health-compromising behaviour. Maternal depression and alcohol abuse had no association with adolescent health-compromising behaviour. Maternal depression without alcohol abuse was associated with the diagnosis of major depressive disorder in adolescents, but not with other adolescent problems, while paternal depression without alcohol abuse was not associated with any adolescent problems. CONCLUSIONS: Despite the small study sample, these findings indicate that parental psychiatric problems and alcohol abuse are correlated with adolescent psychological problems and should be considered and assessed when assessing adolescents.     

Peer-relationship patterns and their association with types of child abuse and adolescent risk behaviors among youth at-risk of maltreatment

IntroductionThis study investigates underlying patterns of peer relationships using diverse concepts (i.e., peer dynamics, peer popularity, and deviant peer affiliation). It also examines whether the patterns of peer relationships differ by type of child abuse, as well as the association between peer relationships and adolescent risk behaviors.MethodsThis study included a sample of 659 youth (328 boys, 331 girls) at-risk of maltreatment, primarily low-income and living in the U.S. Peer dynamics were assessed using five separate components (self-report). Peer popularity was measured using teacher's estimation of child's peer status. Deviant peer affiliation was assessed using a modified version of the Youth Risk Behavior and Monitoring the Future Survey. Each type of abuse was assessed at age 12 using a self-report method. Self-reported adolescent sexual risk behaviors and substance use were assessed at age 16.ResultsLatent class analysis identified 4 distinct patterns: 1) Friendly, with prosocial peer groups (10.2%); 2) Socially ignored, with prosocial peer groups (55.2%); 3) Severely antisocial peer groups (6.8%); and 4) Moderately antisocial peer groups (27.8%). Among all types of child abuse, emotionally abused youth were more likely to be involved in severely antisocial peer groups. Additionally, youth in the severely antisocial peer groups were more likely to exhibit adolescent risk behaviors.ConclusionsThese findings argue clearly for the need to gain a deeper understanding of the role played by peer relationships, and of the effect of emotional abuse on the likelihood of membership in severely antisocial peer groups.     

Precocious Puberty in Adolescent Girls: A Biomarker of Later Psychosocial Adjustment Problems

We have investigated the hypothesis that stress condition will accelerate pubertal maturation in adolescent girls and that faster maturing girls will display more behavioral problems than their on-time or late-maturing peers during pubertal development. Longitudinal data were collected yearly from 1986 to 1997. Parents of 1039 French-speaking Canadian girls completed a questionnaire about their characteristics as well as those of their family. To predict onset of puberty by time and cumulative risk factors, a Hierarchical Regression Analysis and a Survival Regression Analysis were conducted. Results revealed that: (1) anxiety at 8 years old, lower level of anxiety a year earlier and more adverse family condition predict a younger age at first menses; and (2) Body Mass Index, conflicts, and sleep disturbances significantly predict the onset of puberty. Complementary standard regression analyses demonstrated that situational stress mediated the effect of these variables. We concluded that precocious puberty could be an indicator of stress in a child, thus, allowing professionals to intervene early and to prevent later problems in psychosocial adjustment.The Making of an 8-Year-Old Woman,’ The New York Times, December 2000.     

Early-Onset Oppositional Defiant Disorder: What Factors Predict Its Course?

Although the early onset of Oppositional Defiant Disorder (ODD) is associated with an elevated risk of later psychopathology (including but not limited to conduct disorder and antisocial personality disorder), little is known about the factors influencing the course of this disorder in early life. In this article we first review data and theory from four conceptually-distinct domains of risk factors for disruptive disorders (child characteristics reflecting biologic vulnerabilities, parent-child attachment, parenting practices, and family adversity). Then we describe an empirical study that examined the power of these four domains (representing 10 specific risk factors) to predict the prognosis of clinic-referred, preschool boys with ODD; risk factors were assessed when these youngsters were first evaluated in the clinic and outcomes were measured 2 years later. The primary goal was to determine the unique importance of risk factors in the context of others examined simultaneously, a strategy that few previous studies have used. We found that the four-factor risk model predicted significant variance in mother's reports of externalizing (disruptive) behavior problems at the 2-year follow-up; however, the model did not predict teacher externalizing scores or clinicians' assessments of Diagnostic and Statistical Manual (DSM) disorders, as hypothesized. Analyses of specific factors within domains suggested that three were most consistently related to the negative outcomes of ODD boys: greater use of physical discipline by parents, greater life stress for families, and a greater number of pre- and perinatal complications. Nearly a third of the variance in mothers' reports of internalizing (inhibited) problems was attributable to two of these risk factors (life events stress and birth history) and to a third factor, delayed child development.