Adolescent borderline symptoms in the community: prognosis for functioning over 20 years

Background:  The long-term prognosis associated with adolescent symptoms of borderline personality disorder (BPD) in the general population is virtually unknown. In this study, the relationship of early borderline symptoms to subsequent psychosocial functioning and attainment was investigated based on data from the Children in the Community cohort.
Method:  Using multilevel linear regression, symptoms of BPD at mean age 14 were employed as predictors of work/school/homemaker role function, social function (social support, relationship quality), and life satisfaction over the subsequent 20 years. Borderline symptoms were also employed as predictors of attainment at 20-year follow-up.
Results:  On average, those with higher levels of early adolescent borderline symptoms scored consistently lower in role function, social function, and life satisfaction from mid-adolescence through mid-adulthood. Borderline symptoms predicted lower academic and occupational attainment, less partner involvement, and fewer attained adult developmental milestones. Adolescent borderline symptoms were also associated with adult borderline symptoms, borderline diagnosis, general impairment, and need for services at mean age 33. These effects were evident despite symptom decline with age and were independent of adolescent Axis I disorders.
Conclusions:  Adverse prognosis associated with youth symptoms of BPD appeared early and persisted in important and interrelated life domains. These findings lend support to the utility of DSM-IV BPD symptoms assessed by self-report in early adolescence.     

Borderline personality symptoms differentiate non‐suicidal and suicidal self‐injury in ethnically diverse adolescent outpatients

Background: There is little research on how specific borderline personality disorder (BPD) symptoms relate to suicide attempts or suicide and non‐suicidal self‐injury (NSSI) within adolescent populations, which is important to know given the recent proposal of an NSSI disorder. Even less well known is whether specific BPD symptoms distinguish NSSI from suicide attempts or differentiate single from repeated acts of either suicide or NSSI. Method: Archival, de‐identified outpatient clinical charts from 441 ethnically diverse (4.3% Caucasian; 70.9% female) adolescents (mean age = 14.9, SD = 1.61) were reviewed. Data pertaining to NSSI, suicide attempt history, BPD symptoms, and psychiatric diagnoses were obtained from self‐report measures and semi‐structured interviews administered at intake. Results: MANOVA and logistic regression analyses revealed significant differences across groups, with the BPD symptoms of ‘confusion about self’ and ‘unstable interpersonal relationships’ significantly predicting NSSI and NSSI+Suicide group status. The number of BPD criteria met plus high levels of confusion about self significantly predicted single vs. repeat self‐harm group membership. Conclusions: Two BPD symptoms exhibit distinct relationships to NSSI and suicide attempts, but there is not strong variation in their relationship to BPD. Treatment addressing BPD symptoms may be useful to reducing both NSSI and suicide in ethnically diverse adolescents.     

Victimization and suicide ideation in the TRAILS study: specific vulnerabilities of victims

Background:  Scientific studies have provided some support for a link between being a victim of bullying and suicide ideation. We examine whether (1) parental psychopathology and (2) feelings of rejection (at home and at school) exacerbate vulnerability to suicide ideation in victims of bullying (pure victims and bully-victims).
Method:  Data were from a population-based cohort study of Dutch children ( n  =   1526, mean age   =   12.29 years). Using peer nominations, three groups were established: (1) victim only; (2) bully-victims (children who are victims and who also bully others); (3) uninvolved. Self-report data on suicide ideation were obtained using two items from the Youth Self-Report ( Achenbach, 1991 ). Parental internalising and externalising disorders were assessed, as were self-reported feelings of rejection at home and social well-being among classmates.
Results:  The association between victimisation and suicide ideation was moderated by parental internalising disorders (but not externalising disorders) and feelings of rejection at home. Victims (but not bully-victims) with parents with internalising disorders reported elevated levels of suicide ideation compared to children uninvolved in bullying. Victims feeling more rejected at home also reported more suicide ideation. There were no overall sex differences in suicide ideation. Surprisingly, bully-victims did not report higher levels of suicide ideation compared to children uninvolved in bullying.
Conclusions:  Parental internalising disorders and feelings of rejection at home confer a specific vulnerability for suicide ideation among victims of bullying.     

Parenting and the development of conduct disorder and hyperactive symptoms in childhood: a prospective longitudinal study from 2 months to 8 years

BACKGROUND: This study investigated the early processes involved in the development of symptoms of conduct disorder and hyperactivity. METHOD: The study employed a prospective design, over a period from 2 months to 8 years. Detailed observational data of early and later mother-child interactions were collected, infant prefrontal function (the A not B task) was assessed, and symptoms of child conduct disorder and hyperactivity were rated by maternal report at age 5 and 8 years. RESULTS: The principal findings of the study were that emotional dysregulation on the A not B task at 9 months predicted symptoms of conduct disorder at 5 and 8 years, and delayed object reaching times on the same task predicted hyperactive symptoms at 5 years. These two developmental trajectories were associated with distinct patterns of early parenting that were strongly influenced by infant gender. Thus, in boys early emotional dysregulation was predicted by rejecting and coercive parenting, and delayed reaching on the A not B task by coercive parenting, whereas in girls only continuity from earlier infant behaviour could be demonstrated. There was strong continuity between these early infant behaviours and later child disturbance that was partially mediated by parenting for conduct disorder symptoms (maternal hostile parenting in boys, and maternal coercive parenting in girls), but not for hyperactive symptoms. CONCLUSIONS: These data would suggest that only in boys was there evidence for the existence of a sensitive period for the development of hyperactive symptoms, and to a lesser extent, conduct disorder symptoms.     

The associations between feeding difficulties and behaviours and dietary patterns at 2 years of age: the ALSPAC cohort

Little is known about the dietary patterns of toddlers. This period of life is important for forming good dietary habits later in life. Using dietary data collected via food frequency questionnaire (FFQ) at 2 years of age, we examined the dietary patterns of children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Principal component analysis was performed for 9599 children and three patterns were extracted: ‘family foods’ associated with traditional British family foods such as meat, fish, puddings, potatoes and vegetables; ‘sweet and easy’ associated with foods high in sugar (sweets, chocolate, fizzy drinks, flavoured milks) and foods requiring little preparation (crisps, potatoes, baked beans, peas, soup); ‘health conscious’ associated with fruit, vegetables, eggs, nuts and juices. We found clear associations between dietary pattern scores and socio‐demographic variables, with maternal education being the most important. Higher levels of education were associated with higher scores on both the ‘family foods’ and the ‘health conscious’ patterns, and decreased scores on the ‘sweet and easy’ pattern. Relationships were evident between dietary pattern scores and various feeding difficulties and behaviours. Notably, children who were introduced late to lumpy (chewy) solids (after 9 months) scored lower on both the ‘family foods’ and the ‘health conscious’ patterns. Further analyses are required to determine the temporal relationship between perceived feeding difficulties and behaviours, and it will be important to assess the contribution of the age of introduction to lumpy solids to these relationships.     

The association of serum 25-hydroxyvitamin D3 and D2 with depressive symptoms in childhood--a prospective cohort study

Background: Depression in adolescence is common and early onset predicts worse outcome in adulthood. Studies in adults have suggested a link between higher total 25‐hydroxyvitamin D [25(OH)D] concentrations and lower risk of depression. Objectives: To investigate (a) the association between serum 25(OH)D₂ and 25(OH)D₃ concentrations and depressive symptoms in children, and (b) whether the associations of 25(OH)D₂ and 25(OH)D₃ are different from, and independent of, each other. Methods: Prospective cohort study with serum 25(OH)D₂ and 25(OH)D₃ concentrations measured at mean age of 9.8 years and depressive symptoms assessed with the Mood and Feelings Questionnaire by a trained interviewer at the mean ages of 10.6 years (n = 2,759) and 13.8 years (n = 2,752). Results: Higher concentrations of 25(OH)D₃ assessed at mean age 9.8 years were associated with lower levels of depressive symptoms at age 13.8 years [adjusted risk ratio (RR; 95% confidence interval (CI)): 0.90 (0.86–0.95)], but not at age 10.6 years [adjusted RR (95% CI): 0.98 (0.93–1.03)] and with increased odds of decreasing symptoms between age 10.6 and 13.8 years [adjusted RR (95% CI): 1.08 (1.01–1.16)]. Serum 25(OH)D₂ concentrations were not associated with depressive symptoms. Conclusions: This is the first study in children to suggest that the association between 25(OH)D₃ concentrations and depression emerges in childhood. The association is independent of a wide range of potential confounding factors, and appears to be stronger with greater time separation between assessment of 25(OH)D₃ and assessment of depressive symptoms. Confirmation of our findings in large prospective studies and trials would be valuable.     

Aggression,peer relationships,and depression in Chinese children: a multiwave longitudinal study

Background: Largely due to methodological problems in existing studies, issues concerning causal directions and confounding factors, such as the stability effect, remain to be clarified in the relations among aggression, peer relationships, and psychological adjustment. The purpose of this longitudinal study was to examine (a) reciprocal direct and indirect effects among aggression, peer relationships, and depression based on a full cross‐lagged model with the stability effect controlled, and (b) moderating effects of initial status on the growth of the variables. Method: A sample of Chinese children (N = 1,162) participated in the study. Four waves of longitudinal panel data were collected from the participants in ages 9–12 years from multiple sources including peer assessments, teacher ratings, sociometric nominations, and self‐reports. Results: Aggression negatively contributed, in both direct and indirect manners, to later peer relationships, and positively contributed to depression in late childhood. Peer relationships had negative direct and indirect effects on later aggression and depression. In addition, the initial level of aggression moderated the growth pattern of peer relationships. Conclusions: Early social and behavioral problems have proximal as well as long‐term cross‐domain effects on individual development. Moreover, children’s early behavioral characteristics may serve to facilitate the development of social competence and exacerbate the development of social problems. The study provided valuable information about how the important aspects of socioemotional functioning were associated with each other in Chinese children from a developmental perspective.     

Externalizing behavior in early childhood and body mass index from age 2 to 12 years: longitudinal analyses of a prospective cohort study

Background  

Some evidence suggests that obesity and behavior problems are related in children, but studies have been conflicting and have rarely included children under age 4. An association between behavior problems in early childhood and risk for obesity could suggest that a common set of factors contribute to both. Our research objectives were to determine the extent to which externalizing behavior in early childhood is related to body mass index (BMI) in early childhood and through age 12, and to evaluate whether these associations differ by sex and race.     

Twenty years' research on peer victimization and psychosocial maladjustment: a meta-analytic review of cross-sectional studies

Cross-sectional quantitative designs are often used to investigate whether peer victimization is positively related to psychosocial maladjustment. This paper presents a meta-analytic review of cross-sectional studies, published between 1978 and 1997, of the association of peer victimization with psychosocial maladjustment. Mean effect sizes were calculated for the association between peer victimization and each form of maladjustment (depression, loneliness, generalized and social anxiety, and global and social self-worth) assessed. The results suggested that victimization is most strongly related to depression, and least strongly related to anxiety. There was no evidence that victimization is more strongly related to social than to psychological forms of maladjustment. Effect sizes were stronger when the same informants were used to assess both victimization and maladjustment than when different informants were used. There were some design limitations to the studies reviewed, but all together their results provide a strong background for more complex research into the course and treatment of victims' distress.