Effects of environmental enrichment at ages 3-5 years on schizotypal personality and antisocial behavior at ages 17 and 23 years

OBJECTIVE: Methods to prevent two major mental disorders, schizophrenia and conduct disorder, have been elusive. This study assessed the effects of an early nutritional, educational, and physical exercise enrichment program on adult outcome for schizotypal personality, conduct disorder, and criminal behavior. METHOD: Eighty-three children were assigned to an experimental enrichment program from ages 3 to 5 years and matched on temperament, nutritional, cognitive, autonomic, and demographic variables with 355 children who experienced usual community conditions (control group). Both self-report and objective measures of schizotypal personality and antisocial behavior were obtained when the subjects were ages 17 and 23 years. RESULTS: Subjects who participated in the enrichment program at ages 3-5 years had lower scores for schizotypal personality and antisocial behavior at age 17 years and for criminal behavior at age 23 years, compared with the control subjects. The beneficial effects of the intervention were greater for children who showed signs of malnutrition at age 3 years, particularly with respect to outcomes for schizotypy at ages 17 and 23 and for antisocial behavior at age 17. CONCLUSIONS: The results are consistent with an increasing body of knowledge that implicates an enriched, stimulating environment in beneficial psychological and behavioral outcomes. These findings have potential implications for the prevention of schizophrenia and criminal behavior.     

Increased psychophysiological arousal and orienting at ages 3 and 11 years in persistently schizotypal adults

Abnormalities of psychophysiological arousal and orienting are thought to predispose to schizophrenia, but there have been no prior studies of early psychophysiological functioning in "persistent schizotypals" who remain stably schizotypal across time. This study assessed skin conductance (SC) arousal and orienting at ages 3 and 11 years, electroencephalography (EEG) at age 11 years, and behavior problems at age 17 years in 52 individuals who were stably schizotypal from ages 17 to 23 years, and 104 normal controls. Schizotypy was assessed at age 17 with the Schizophrenism scale, and at age 23 with the Schizotypal Personality Questionnaire (SPQ). Schizotypals had significantly increased SC arousal and increased SC amplitudes to neutral and aversive stimuli at both ages 3 and 11, and also reduced slow-wave left hemisphere EEG power at the beginning of the Continuous Performance Task (CPT) at age 11. Group differences in SC were greater for aversive than neutral stimuli. Schizotypals also had higher age 17 behavior ratings on psychotic behavior, anxiety-withdrawal, and conduct disorder. Findings indicate that heightened SC arousal and orienting in early childhood is a significant risk factor for later schizotypal personality, support a left hemisphere overactivation hypothesis of schizotypy, and illustrate the potential value of a longitudinal definition of persistent schizotypy.     

Early predictors of antisocial developmental pathways among boys and girls

Objective: We investigated in a high‐risk sample the differential impact of biological and psychosocial risk factors on antisocial behaviour pathways. Method: One hundred and thirty‐eight boys and 155 girls born at differing degrees of obstetric and psychosocial risk were examined from birth until adolescence. Childhood temperament was assessed by a highly‐structured parent‐interview and standardized behavioural observations, adolescent temperament was measured by self‐report. Neurodevelopmental variables were assessed by age‐specific developmental tests. Emotional and behaviour problems were measured at the ages of 8 and 15 by the Achenbach scales. Results: In both genders, psychosocial adversity and early self‐control temperament were strongly associated with early‐onset persistent (EOP) antisocial behaviour. Psychosocial adversity and more severe externalizing problems differentiated the EOP from childhood‐limited (CL) pathway. In girls, adolescent‐onset (AO) antisocial behaviour was strongly associated with novelty seeking at 15 years. Conclusion: Our findings emphasize the need for early support and intervention in psychosocially disadvantaged families.     

Early childhood heart rate does not predict externalizing behavior problems at age 7 years

OBJECTIVE: In previous research, low resting heart rate in childhood and adolescence has been shown to predict aggressive and/or delinquent behavior at subsequent ages. It has been found that heart rate recorded as early as age 3 years could predict externalizing behavior at age 11 years. This study explored the possibility of a similar relationship between heart rate and externalizing behavior problems. METHOD: Heart rate recorded at ages 14, 20, 24, 36 months and 7 years was used to predict combined parental ratings on the Aggressive and Delinquent Behavior scales of the Child Behavior Checklist (CBCL/4-18) as well as the Externalizing composite scale measured at age 7 years. Subjects consisted of same-sex twin pairs, treated as singletons in the present study, participating in the MacArthur Longitudinal Twin Study. Subjects were grouped into high and low heart rate groups and also into high CBCL/4-18 scoring and low CBCL/4-18 scoring groups. RESULTS: Heart rate was not significantly related to scores on either of the 2 subscales or the Externalizing composite scale at any age. Heart rate group membership did not predict CBCL/4-18 scores. Conversely, CBCL/4-18 group membership did not predict heart rate at any age. CONCLUSION: In this sample, heart rate does not predict externalizing behavior at age 7.     

Longitudinal bidirectional association between sleep and behavior problems at age 6 and 11 years

BackgroundAlthough a growing number of longitudinal studies have found that sleep problems precede behavior problems, few have examined potential bidirectional relationships longitudinally. The present study examined prospective associations between sleep problems and internalizing, externalizing, and attention problems over the course of childhood.MethodsParticipants included 775 children from the China Jintan Cohort Study. Sleep problems were rated by mothers at ages six and 11.5, as well as self-reported by children at age 11.5. Behavior problems were rated by mothers and teachers at ages six and 11.5, and self-reported by children at age 11.5.ResultsAt age six, 15.0% of children were reported to have sleep problems as rated by mothers. At age 11, this prevalence was 12% as rated by mothers and 20% as rated by youth. Bidirectional relationships between sleep problems and behavior problems were observed. Mother-reported sleep problems at age six were predictive of self-reported internalizing and attention problems at age 11.5, even after controlling for baseline behavioral problems. At age six, teacher-reported externalizing, internalizing, and attention problems, and mother-rated internalizing and externalizing problems were all related to sleep problems at age 11.5, even after controlling for baseline sleep problems. Other sociodemographic covariates including child sex, age, and parental education were controlled for.ConclusionsFindings provide further support for the reciprocal relationship between sleep problems and behavior problems. Early interventions that target both types of problems may be especially effective in preventing this aggravating health–behavior cycle.     

The continuity of psychopathology from early childhood to preadolescence

Objective To study the continuity of psychopathology from the age of 3–12 years. Methods In a population-based birth cohort, children’s emotional and behavioral problems were assessed at age 3 using the Child Behavior Checklist 2–3 (CBCL 2–3), and at age 12 by parents using the CBCL 11–18, and the Youth Self Report (YSR) completed by the children. Behavioral ratings were obtained from 800 subjects at both time points. Results externalizing problems at age 3 predicted both externalizing and internalizing problems among both genders in preadolescence. In girls, internalizing behavior at age 3 predicted parent-reported internalizing behavior, and associated negatively with externalizing behavior in self-reports at age 12. Aggressive behavior was found to be remarkably stable, and both aggressive and destructive behavior independently predicted a wide range of later externalizing and internalizing problems. Parent ratings of withdrawal showed stability from early childhood to preadolescence in both genders. Somatic complaints of 3-year-old girls independently predicted both externalizing and internalizing problems. Conclusions The results show the complexity of pathways in psychopathology from early childhood to preadolescence. In particular, aggressive and destructive behaviors in very early childhood predict later problems and necessitate early recognition and possible intervention at an early age. An instrument like the CBCL 2–3 is valuable in the early detection of children at risk of long-term problems.     

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.     

Externalizing Risk Pathways for Adolescent Substance Use and Its Developmental Onset: A Canadian Birth Cohort Study: Trajectoires de comportements extériorisés et le risque pour l’initiation et l’usage de substances des adolescents : Une étude de cohorte de naissance canadienne

Objective:Only a minority of drug and alcohol users develops a substance use disorder. Previous studies suggest that this differential vulnerability commonly reflects a developmental trajectory characterized by diverse externalizing behaviors. In this study, we examined the relation between child and adolescent externalizing behaviors and adolescent substance use in a prospectively followed Canadian birth cohort, accounting for the temporal sequence of a wide variety of contributing factors.Methods:Two hundred and forty-two adolescents followed since birth (date range: 1996 to 2012) were assessed on externalizing behavior (age 17 months to 16 years), alcohol and cannabis use at age 16, age of alcohol use onset, family history of substance use problems, family functioning (age 11 to 15), sensation seeking (age 16), prenatal substance exposure, socioeconomic status (age 1 to 9), and sex.Results:Age of alcohol use onset was predicted by a family history of substance use problems, externalizing traits from ages 6 to 10 and 11 to 16, sensation seeking at age 16, prenatal alcohol and tobacco exposure and family functioning at ages 11 to 15. High frequencies of alcohol and cannabis use at age 16 were both predicted by externalizing traits from ages 11 to 16, a family history of substance use problems and sensation seeking after controlling for other individual, environmental and familial variables. The association between familial substance use problems and substance use during adolescence was partially mediated by externalizing traits from age 11 to 16.Conclusions:The present findings provide prospective evidence for a developmental risk pathway for adolescent substance use, potentially identifying those who could benefit from early interventions.     

Behavior problems at ages 6 and 11 and high school academic achievement: Longitudinal latent variable modeling

Previous studies documented long-run effects of behavior problems at the start of school on academic achievement. However, these studies did not examine whether the observed effects of early behavior problems are explained by more proximate behavior problems, given the tendency of children's behavior problems to persist. Latent variable modeling was applied to estimate the effects of behavior problems at ages 6 and 11 on academic achievement at age 17, using data from a longitudinal study (n = 823). Behavior problems at ages 6 and 11, each stage independently of the other, predicted lower math and reading test scores at age 17, controlling for intelligence quotient (IQ), birth weight, maternal characteristics, family and community environment, and taking into account behavior problems at age 17. Behavior problems at the start of school, independent of later behavior problems, exert lingering effects on achievement by impeding the acquisition of cognitive skills that are the foundation for later academic progress.     

Father–infant interaction patterns as precursors of children’s later externalizing behavior problems

AIM: This study examined the extent to which fathers' and infants' interaction behavior were related to children's externalizing behavior problems at age 8 and 11 years. METHODS: In a prospective longitudinal study of children at risk for later psychopathology, 72 fathers and their 3-month-old children were videotaped and evaluated during a standardized playing and nursing situation. Externalizing behavior problems at age 8 and 11 years were assessed using Achenbach's Child Behavior Checklist. RESULTS: In the high externalizing group, fathers were found to be less responsive and less sensitive (the latter only with respect to girls) during early interaction than fathers of the low externalizing group, while children were more positive with their fathers. Furthermore, low scores on the interaction pattern of "sensitive fathering/negative infant" and high scores on the "nonresponsive fathering or active infant" pattern were associated with more externalizing problems. CONCLUSION: These findings suggest that father and infant interaction behaviors during early infancy may predict later problem behaviors at school age, although the mechanisms underlying this relationship have yet to be identified.     

Internalizing and externalizing problems in childhood and adolescence as predictors of work incapacity in young adulthood

Background

There is limited information regarding the association between youth mental health problems and work incapacity in adulthood. We investigated whether internalizing (depressive, anxious, somatic complaints) and externalizing (aggressive, rule-breaking) behavior problems in childhood and adolescence were associated with sickness absence (SA) and disability pension (DP) in young adulthood.

Methods

Data were used from the population-based and prospective Twin Study of Child and Adolescent Development (TCHAD) which includes all Swedish twins born in 1985–1986 (N = 2570). Internalizing and externalizing behavior problems were assessed with the Child Behavior Checklist at ages of 8–9, 13–14, 16–17, and 19–20 years. Individuals participating in TCHAD were followed regarding SA and DP during 2001–2013 using nationwide registers. Cox regression models were applied to assess hazard ratios (HR) with 95% confidence intervals (CI).

Results

Each one-unit increase of rule-breaking behavior implied a significant higher risk for SA in early adulthood, despite of age at assessment, with the highest HR of 1.12 (95% CI 1.05–1.19) at age of 8–9 years. Higher levels of anxious and depressive symptoms in childhood and adolescence were associated with DP in early adulthood despite age at assessment, with the highest risk at age 19–20 years [HR 1.31 (95% CI 1.12–1.53)]. The associations attenuated slightly when familial factors were taken into account.

Conclusions

Internalizing and externalizing behavior problems identified at an early age (8–9 years) increased risk for SA and DP in young adulthood. These findings indicate that early prevention and intervention efforts to reduce behavior problems may promote a successful start in working life.

     

Association of testosterone and dihydrotestosterone with externalizing behavior in adolescent boys and girls

BACKGROUND: While an association between androgens and different types of aggression has been well documented in male offenders, the influence of androgens on externalizing behavior in adolescents at risk for antisocial behavior has not been investigated so far. METHODS: Plasma levels of the main androgen metabolites testosterone (T) and 5alpha-dihydrotestosterone (DHT) were measured in N = 87 fourteen-year-old (36 boys, 51 girls) from a prospective longitudinal study of children at risk. Externalizing behavior at age 8, 11 and 14 was assessed using the Achenbach Child Behavior Checklist (CBCL) and Teacher Report Form (TRF). RESULTS: Significant higher androgen levels (T, DHT) were found in male, but not in female adolescents with elevated scores of externalizing behavior. Moreover, boys with persistent externalizing behavior exhibited the highest levels of plasma androgens. CONCLUSIONS: There is a link between T, DHT and externalizing behavior in male adolescents at risk for psychopathology. Due to the findings of highest androgen levels in boys with persistent externalizing behavior, a role of androgens in the development of disruptive or later antisocial disorders can be hypothesized.     

A longitudinal twin study on IQ, executive functioning, and attention problems during childhood and early adolescence

Variation in human behavior may be caused by differences in genotype and by non-genetic differences ("environment") between individuals. The relative contributions of genotype (G) and environment (E) to phenotypic variation can be assessed with the classical twin design. We illustrate this approach with longitudinal data collected in 5 and 12-year-old Dutch twins. At age 5 data on cognitive abilities as assessed with a standard intelligence test (IQ), working memory, selective and sustained attention, and attention problems were collected in 237 twin pairs. Seven years later, 172 twin pairs participated again when they were 12 years old and underwent a similar protocol. Results showed that variation in all phenotypes was influenced by genetic factors. For IQ the heritability estimates increased from 30% at age 5, to 80% at age 12. For executive functioning performance genetic factors accounted for around 50% of the variance at both ages. Attention problems showed high heritabilities (above 60%) at both ages, for maternal and teacher ratings. Longitudinal analyses revealed that executive functioning during childhood was weakly correlated with IQ scores at age 12. Attention problems during childhood, as rated by the mother and the teacher were stronger predictors (r = -0.28 and -0.36, respectively). This association could be attributed to a partly overlapping set of genes influencing attention problems at age 5 and IQ at age 12. IQ performance at age 5 was the best predictor of IQ at age 12. IQ at both ages was influenced by the same genes, whose influence was amplified during development.     

Intelligence and other predisposing factors in exposure to trauma and posttraumatic stress disorder: a follow-up study at age 17 years

CONTEXT: Prospective data on standardized measures of early predispositions would allow a strong test of hypotheses about suspected risk factors of posttraumatic stress disorder (PTSD) and exposure to traumatic events. OBJECTIVE: To prospectively examine the extent to which intelligence, anxiety disorders, and conduct problems in childhood influence the risk for PTSD and for exposure to traumatic events. DESIGN: A longitudinal study of a randomly selected sample assessed at age 6 years and followed up to age 17 years. SETTING: Samples were randomly selected from the 1983-1985 newborn discharge lists of 2 major hospitals in southeast Michigan (N=823). PARTICIPANTS: Cohort members with follow-up data at age 17 years (n=713; 86.6% of the initial sample). MAIN OUTCOME MEASURES: Cumulative exposure up to age 17 years of qualifying traumatic events; DSM-IV PTSD among participants who have experienced 1 or more traumatic events. RESULTS: Youth with teacher ratings of externalizing problems above the normal range at age 6 years were at increased risk for exposure to assaultive violence (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.9). Youth aged 6 years with an IQ greater than 115 had decreased risk for exposure to traumatic events (adjusted odds ratio for assaultive violence, 0.3; 95% confidence interval, 0.2-0.7); a decreased risk for nonassaultive trauma (adjusted odds ratio, 0.6; 95% confidence interval, 0.3-0.9); and a decreased conditional risk for PTSD (adjusted odds ratio, 0.2; 95% confidence interval, 0.1-0.9). The conditional risk for PTSD was increased for youth with anxiety disorders and teacher ratings of externalizing problems above the normal range at 6 years of age. CONCLUSIONS: The results of this prospective community study highlight the role of intelligence in avoidance of exposure to traumatic experiences and their PTSD effects. They underscore the need for investigating cognitive processes in persons' responses to traumatic experiences and the involvement of general intelligence in these processes.     

Hyperactives as young adults: a controlled prospective ten-year follow-up of 75 children.

This study reports on a variety of outcome variables from 75 hyperactive and 44 matched control subjects aged 17 to 24 years (mean ages, 19.5 and 19.0 years, respectively). All hyperactive subjects have been followed up for 10 to 12 years; they were first evaluated at 6 to 12 years of age. None of the hyperactive subjects was treated with methylphenidate, although a subgroup received chlorpromazine or a mixture of drugs (excluding methylphenidate). The hyperactive subjects had less education than the controls and a history of more car accidents and more geographical moves. However, only a minority were still engaged in continued antisocial behavior or had evidence of severe psychopathology. No subjects were found to be psychotic, but two were diagnosed as borderline psychotic. There was evidence that hyperactive subjects had some continued symptoms from the hyperkinetic child syndrome, including impulsive personality traits.     

A 30-year prospective follow-up study of hyperactive boys with conduct problems: adult criminality

OBJECTIVE: To compare the official arrest records for a large number of hyperactive boys (N = 179), most with conduct problems, and 75 control boys; to examine childhood IQ, socioeconomic status, and parent reports of childhood hyperactivity and conduct problems for their contribution to criminal behavior in adulthood; and to compare adult outcome for multimodality-treated (MMT) and drug-treated-only (DTO) hyperactives. METHOD: We report on the official arrest history from early to mid- (18 to 38 years of age) adulthood in these 254 white subjects. RESULTS: Ninety one percent of subjects were followed up. California official arrest records were obtained on all of these subjects. Hyperactive subjects had significantly higher arrest, conviction, and incarceration rates compared with controls. Childhood antisocial behaviors, socioeconomic status, and IQ predicted adult criminality. Multimodality-treated boys with Hyperactive/ADHD (attention-deficit/hyperactivity disorder) did not fare better than DTO boys with ADHD. CONCLUSIONS: Hyperactive/ADHD boys with conduct problems are at increased risk for adult criminality. Hyperactive boys without childhood conduct problems are not at increased risk for later criminality. An intensive 3-year MMT treatment of 6- to 12-year-old hyperactive boys is insufficient to prevent later adult criminality.     

Aggressive behavior,emotional, and attention problems across childhood and academic attainment at the end of primary school

Purpose

To assess whether aggressive behavior and emotional problems from early childhood onwards are related to academic attainment at the end of primary education, and whether these associations are independent of attention problems.

Methods

Data on 2546 children participating in a longitudinal birth cohort in Rotterdam were analyzed. Aggressive behavior, attention and emotional problems at ages 1½, 3, 5 and 10 years were assessed with the Child Behavior Checklist. Academic attainment at the end of primary school (12 years of age) was measured with the CITO test, a national Dutch academic test score.

Results

Aggressive behavior from age 1½ to 10 years was negatively associated with academic attainment, but these associations attenuated to non-significance when accounting for comorbid attention problems. For emotional problems, first, only problems at 10 years were associated with poorer academic attainment. Yet, when accounting for attention problems, the association reversed: more emotional problems from 1½ to 10 years were associated with a better academic attainment. Attention problems at ages 1½ to 10 years were negatively associated with academic attainment, independent of comorbid emotional problems or aggressive behavior.

Conclusions

Attention problems across childhood are related to a poorer academic attainment, while emotional problems predicted better academic attainment. Moreover, the relationship between aggressive behavior and academic attainment was explained by comorbid attention problems. Future research should determine the mechanisms through which attention problems and emotional problems affect academic attainment, to inform strategies for the promotion of better educational attainment.

     

Age at onset of problem behaviour in boys,and later disruptive and delinquent behaviours

The paper reports on the relationship between boys’ easy-not easy status in the preschool years and the youngsters’ pattern of aggressive, hyperactive and withdrawn behaviours at ages 10–16 years. At follow-up 5 years later, when the boys were 15–21 years of age, children originally reported by their parents as not easy had an officially reported rate of delinquency that was twice as high as that of children reported easy. About one in five of the problematic children had become multiple offenders, compared to one in twenty for the easy children. In addition, the self-reported delinquency rate of the problematic children was significantly higher than that of the easy children, with a marginally significant trend for the former to have engaged in serious antisocial acts. The relationship between early problem status in the preschool years and the rate of offending up to ages 15–21 years held when various aspects regarding the quality of the parents’ child-rearing practices had been partialled out. The early problem status was more related to the later development of aggression-stealing and aggression-hyperactive than with aggression-withdrawn behaviour patterns. The implications of the findings for intervention are discussed.     

Behavior of children with seizures. Comparison with norms and effect of seizure type.

Scores for 112 children aged 6 to 12 years, with well-controlled seizures and of average or higher IQ, were compared for problem behavior with established norms. As assessed on the Conners' Teacher Rating Scale, the group with seizures was comparable to the normative group on two subscales and superior on two others. In contrast, parents of children in the seizure group rated them as significantly worse on all six subscales of the Revised Behavior Problem Checklist. In a larger group of 133 children with seizures, from which this sample was selected, the relationship of age, sex, and seizure type to behavior problems was examined. Subjects with partial seizures were rated as slightly more aggressive and antisocial than those with generalized seizures. Findings were discussed in regard to differences in perception of behavior by parents and teachers and the possible relevance of seizure type to the expression of behavior problems.     

Psychopathology and age at onset of conduct problems in juvenile delinquents

BACKGROUND: This study aimed to assess psychopathology among incarcerated Russian juvenile delinquents in relation to the onset of conduct problems. METHOD: 358 male juvenile delinquents were interviewed from January to September 1999, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Early behavior problems, current antisocial behavior, and psychopathology were also assessed through self-reports. The presence of conduct disorder (CD) and other diagnoses was determined according to DSM-IV criteria. RESULTS: 73.2% of the incarcerated youths met criteria for CD. 23.5% of the total sample reported at least 1 criterion for CD being present before the age of 10 years. All participants from this early-onset group fulfilled the criteria for CD. This group also had significantly higher rates of psychopathology, and particularly of externalizing behaviors, as compared with youths whose conduct problems began at or after the age of 10 years. CONCLUSION: Poor psychosocial adaptation and future prognosis in juvenile delinquents with early-onset conduct problems may be related to their greater degree of psychiatric disturbance compared with later-onset delinquent youths. Need for psychiatric treatment should be carefully considered in prevention and rehabilitation efforts for troubled youths.