Early family predictors of child and adolescent antisocial behaviour: who are the mothers of delinquents?

This study tested the utility of 29 maternal and familial characteristics for the purpose of prospectively identifying children who are at high risk for antisocial and delinquent outcomes. The family data were drawn from the archives of the Dunedin Multidisciplinary Health and Development Study. The study's design offers certain methodological advantages: the sample is a representative unselected birth cohort; the family measures were taken very early in childhood; information about the child's antisocial behaviour was collected from many different sources and at many different ages; a comparison group of children with other behaviour disorders was included, and it was possible to examine the influence of possible ‘confounding variables'. Three groups of 11-year-old children (antisocial (n = 50), other disorders (n = 37), and non-disordered (n = 220)) were compared on family variables. Nine family variables differentiated the antisocial children from the nondisordered children, the most important of which were parental disagreement about how to discipline the 5-year-old child, and many changes of the child's primary caretaker during childhood. In addition, among the children who were known to police by age 15, prospective family variables accounted for significant amounts of the variance in number of police contacts and age at first police contact.     

Identification of personality types at risk for poor health and injury in late adolescence

In an unselected general birth cohort of 862 18-year-olds, we sought to identify the personality characteristics associated with involvement in each of five different health-risk behaviours (unprotected sexual intercourse with multiple partners, dangerous driving habits, violent crime, alcohol dependence and marijuana dependence) as well as the personality characteristics associated with a syndrome of multiple health-risk behaviours. A unique configuration of traits differentiated youth involved in any given single health-risk behaviour from youth who were not. These youth were more impulsive, aggressive, alienated and tended to experience negative emotions in response to daily hassles. A different unique configuration of traits differentiated youth involved in a syndrome of multiple health-risk behaviours from youth involved in a single or in no health-risk behaviours. These youth were distinguished by a rejection of social norms, danger-seeking, impulsivity, a very low threshold for negative emotional responses such as anger, irritability and nervous tension, and by little need or capacity for connection to other people. In planning health campaigns, health professionals need to consider the unique psychological make-up of persons most at risk for health-risk behaviours and design programmes that will appeal to them.     

ACCURACY OF SURVEY QUESTIONS FOR GERIATRIC URINARY INCONTINENCE

Purpose

Risk factors, natural history, consequences, therapeutic responses and costs are all likely related to type of urinary incontinence, for example stress or urge. Yet few epidemiologic type specific data are available and only 1 study has been validated urodynamically. We compare the accuracy of a typical questionnaire used in a large epidemiologic study with the criterion standard of multichannel video urodynamic testing.

Materials and Methods

The questionnaire was administered before urodynamic testing to 132 subjects 65 years old or older, of whom 80% were women, all were mobile and none was severely demented. Responses to questionnaire items were compared to the criterion standard, singly and in combination, using a total of 4 a priori and post hoc strategies, including a computerized regression tree program.

Results

Overall, no analytic strategy correctly classified more than 67% of patients and none accurately classified even a single type of incontinence, including stress incontinence.

Conclusions

Short questionnaires commonly used in epidemiologic studies correlated poorly with video urodynamic testing in incontinent older adults. Previously published information regarding prevalence of the types of incontinence should be reviewed in the light of these data.