Gender-Specific Trajectories of Conduct Problems from Ages 3 to 11

Longitudinal Patterns of Special Education/Inclusive Classroom Placement of Children with Conduct Problems: Correlates and Risk of School Dropout

Conduct problems are among the most common reasons of referral to special education services and placement in special classrooms. Students with conduct problems are at a high risk of school dropout. However, little is known about the association between placement in special classrooms and the risk of school dropout for students with conduct problems. We employed data from a longitudinal study of students with conduct problems who were receiving special education services in special or in inclusive classrooms at study entry (N = 302). Five patterns of placement in special (vs. inclusive) classrooms were identified. Higher academic performance and receptive vocabulary, and lower externalizing problems reduce the odds of persistent placement in special classrooms. Students with a persistent or delayed placement had higher risk of school dropout in comparison to students with no placement history. Students in special classrooms at study entry did not have a greater risk of school dropout if they later transitioned to inclusive classrooms. Strengthening the academic performance and receptive vocabulary of students with conduct problems could prevent placement in special classrooms. Limiting persistent and delayed placement in special classrooms may decrease the risk of school dropout among students with conduct problems.

Heterogeneity of early-onset conduct problems: assessing different profiles, predictors and outcomes across childhood

BACKGROUND

Among early-onset conduct problems (CP), associated with more disruptive behaviors of greater intensity and stability, several domains have been proposed from a variable-centered perspective to capture their heterogeneity: oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional traits (CU). Using a person-centered approach, the present study aims to identify distinct profiles of child CP, examining different predictors and developmental outcomes.

METHODS

Data included parent- and teacher-reported questionnaires from an ongoing longitudinal study (ELISA). Latent profiles were identified first in a community sample (n = 2,103; age 4-8 years; 50.9% boys) and replicated in a high-CP subsample (n = 168; 70.24% boys).

RESULTS

Four profiles emerged in the community sample (Normative Development, Daring/Impulsive, Low prosociality + Fear; Low prosociality + Psychopathic Traits [PP]), and three in the high-CP sample (same except the normative). The identified CP profiles aligned with the ADHD and CU domains, but not the ODD domain. Differences in activity, punitive and inconsistent parenting emerge as the most significant predictors. Regarding the outcomes, the Low prosociality + PP profile stands out as the group with the most severe emotional, social and behavioral maladjustment.

CONCLUSIONS

These findings highlight the heterogeneity within CP, and the importance of designing specific and tailored interventions for each identified profile.

Understanding Early Risk Factors of Preschool Disruptive Behaviors in a Population-Based Birth Cohort: Why Does Comorbidity Matter?

BACKGROUND/OBJECTIVES

Research on early risk factors for disruptive behaviors (DBs: hyperactivity-impulsivity/HI, non-compliance/NC, or physical aggression/PA) has predominantly focused on individual DBs in silos (i.e., HI, NC, or PA) or the broader category of externalizing, reporting mostly common risk factors among them. However, studies addressing DB comorbidity, i.e., the simultaneous occurrence of more than one DB, showed differences in risk factors among DB comorbid profiles. Aiming to clarify this discrepancy, the present study compared the early risk factors associated with different longitudinal patterns (i.e., trajectories) of single-DBs (HI, NC, PA) with risk factors associated with monomorbid (HIonly, NConly, PAonly) and comorbid (HI + NC, NC + PA, HI + NC + PA) joint-DBs trajectories during the preschool period.

METHODS

In a population-based birth cohort (N = 2045), parents' pre-conception characteristics, pregnancy and perinatal conditions, and age 5 months child and family characteristics were used to compare children following single-DB and joint-DBs high trajectories to children following low or moderate trajectories. The DB trajectories were derived from mother ratings at ages 1½, 2½, 3½, 4½, and 5 years.

RESULTS

More risk factors were identified for single-DB high trajectories than for joint-DBs high trajectories. On average, children on a single-DB high trajectory shared only 44.2% of their risk factors with children on a related joint-DBs high trajectory. Moreover, high trajectories of single-DBs shared a larger proportion of their risk factors than did high trajectories of joint-DBs. The findings show that categories of DBs include different subgroups of children based on their comorbidity patterns across DBs, which are differentially linked to early risk factors.

CONCLUSIONS

Addressing comorbidity when investigating early risk factors of preschool DBs may improve our understanding of the etiological processes leading to these distinct but related behaviors and increase our ability to intervene upstream to prevent the earliest forms of potentially life-altering psychopathological conditions.

A Multicomponent Preventive Intervention in the Early Elementary Years: A Look at Academic and Social Adjustment Outcomes

Cogent indicated prevention with young children at risk for early onset conduct problems needs to address multiple domains of influence in school and home settings. A multicontextual preventive intervention (MPI) spanning grades one and two was conducted in schools serving economically disadvantaged communities and evaluated separately for boys and girls. The cluster randomized design evaluated children nested within schools receiving either the MPI (6 schools), which consisted of after-school reading-mentoring, home-based family, peer coping-skills, and classroom components, or a control condition (6 schools) involving a school-wide conflict management program without targeted intervention. Drawn at the end of kindergarten based on elevated behavioral difficulties and first-grade attendance at one of the 12 schools, the two subsamples consisted of 193 boys and 171 girls (63% in households with annual income < $15,000; 95% Black children). Extensive fidelity data indicated that the MPI components were well implemented. The two post-intervention third-grade outcomes in this report are academic performance and social/behavioral adjustment. The analyses involved a linear mixed effects model controlling for school. The key finding for the male subsample was that the MPI produced greater overall and language-arts/reading achievement, measured by report cards for the entire third-grade school year, compared with the control group. MPI-control differences did not emerge for externalizing problems and social competence assessed via teacher and parent report. In the face of elevated risk and poverty, the study underscored the importance of contributions from community-based reading-mentors, positive and inclusive classrooms, and nurturing family contexts in achieving academic gains.

Joint Developmental Trajectories of Conduct Problems and Hyperactivity/Inattention: Antecedent Risk Markers for Group Membership

This study investigated joint trajectories of conduct problems and hyperactivity/inattention from age three to nine in a cohort of 7,507 children in Ireland (50.3% males; 84.9% Irish). The parent-reported Strengths and Difficulties Questionnaire was used to collect information on conduct problems (CP) and hyperactivity/inattention (HI). Information regarding risk markers was collected when participants were nine-months-old via parent report and standardised assessments. Using a person-centred approach (i.e., group-based multi trajectory modelling), six trajectories were identified: no CP/low HI, low-stable CP/HI, low-declining CP/stable HI, desisting co-occurring CP/HI, pure-increasing HI, and high chronic co-occurring CP/HI. Specific risk markers for group membership included: male sex; birth complications; perceived difficult temperament; lower primary caregiver age and education level, and higher stress level; prenatal exposure to smoking, and indicators of lower socioeconomic status. Primary caregiver-child bonding and having siblings were protective markers against membership in elevated groups. Results suggest support for both 'pure' HI and co-occurring trajectories of CP and HI emerging in toddlerhood. However, no support was found for a 'pure' CP trajectory, which may support the suggestion that children on a persistent CP trajectory will have coexisting HI. Intervention efforts may benefit from starting early in life and targeting multiple risk markers in families with fewer resources.

Associations between trajectories of adolescent conduct problems and psychological well-being in young women

INTRODUCTION

Despite the clinical relevance, little is known about variability in positive adult outcomes (i.e., flourishing, life satisfaction) of female adolescent conduct problems (CP), or interpersonal factors that promote these types of well-being. We hypothesized differential associations between adolescent CP trajectories and indicators of adult well-being due to level of positive relationships with caregivers during ages 12-17.

METHOD

Data were drawn from participants (N = 1965) of the Pittsburgh Girls Study, a longitudinal study of girls' development. Caregiver reported CP, adolescent reports of parental trust and positive parenting, and adolescent-reported peer delinquency were assessed annually between ages 12-17. Well-being in young adulthood was measured using self-reported flourishing and life satisfaction between ages 18-22.

RESULTS

Latent class growth analysis of adolescent CP revealed four trajectories characterized as low stable (20.0%), moderate stable (63.9%), adolescent-onset (8.1%), and high quadratic (8.0%). Main effects of trust and positive relationships with caregivers during adolescence on well-being in early adulthood were found. Positive parenting was found to moderate the association between CP trajectory and flourishing. The magnitude of the negative association between the high quadratic trajectory group and life satisfaction decreased as positive parenting increased.

CONCLUSION

These results support the importance of intervention in adolescence to focus on increasing trusting and positive relationships with caregivers for all females, as this may increase well-being in adulthood regardless of adolescent CP history.

Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study

Background

Early uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study.

Methods

Total maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years.

Results

Children of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%).

Conclusions

Lower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12141-5.

Mental Health in Ethnic Minority Populations in the UK: Developmental Trajectories from Early Childhood to Mid Adolescence

A large body of literature has demonstrated that there are developmental differences in mental health problems. However, less is known about the development of mental health problems in ethnic minority children, particularly at the population level. Using a detailed ethnic classification and nationally representative data from the UK Millennium Cohort Study (n = 18, 521, 49% female, 18% ethnic minority), this study examines ethnic differences in children's mental health problems and trajectories of mental health from ages 3 to 14 years. Growth curve modeling revealed that ethnic minority children followed different developmental trajectories of internalizing and externalizing problems than white children, either in terms of the mean-level and/or rate of change across age. These differences were not explained by child sex, socioeconomic status, maternal depressive symptoms, and maternal immigrant status, highlighting the need for further research exploring the factors that underpin ethnic inequalities in child mental health.

Mental Health in Ethnic Minority Populations in the UK: Developmental Trajectories from Early Childhood to Mid Adolescence

A large body of literature has demonstrated that there are developmental differences in mental health problems. However, less is known about the development of mental health problems in ethnic minority children, particularly at the population level. Using a detailed ethnic classification and nationally representative data from the UK Millennium Cohort Study (n = 18, 521, 49% female, 18% ethnic minority), this study examines ethnic differences in children's mental health problems and trajectories of mental health from ages 3 to 14 years. Growth curve modeling revealed that ethnic minority children followed different developmental trajectories of internalizing and externalizing problems than white children, either in terms of the mean-level and/or rate of change across age. These differences were not explained by child sex, socioeconomic status, maternal depressive symptoms, and maternal immigrant status, highlighting the need for further research exploring the factors that underpin ethnic inequalities in child mental health.

Unpacking Associations between Mood Symptoms and Screen Time in Preadolescents: a Network Analysis

Mounting evidence highlights the link between screen time and adolescent mood problems. However, there are several shortcomings to the extant literature: (1) this link is underexplored in preadolescents, (2) most existing studies look at mood problems using categorical diagnoses rather than from a symptom-level perspective, despite the heterogeneity within mood disorders, (3) few studies have simultaneously examined the links of mood symptoms with different types of screen time, and (4) family/child-level factors that have shown links to youth psychopathology are not typically considered. This study, for the first time, examined the relationships of mood symptoms with different types of screen time, while accounting for theoretically important factors-parental monitoring and the behavioral inhibition/activation systems (BIS/BAS)-in preadolescents aged 9 to 10 from 9986 families participating in the Adolescent Brain and Cognitive Development Study. Using mixed graphical models, we found that screen time involving age-inappropriate content was stably and significantly associated with various elevated mood symptoms, independent from other types of screen time, BIS/BAS, and parental monitoring. Additionally, age-inappropriate screen time was associated with increased overall symptom connectivity. Further, preadolescents engaged in high levels of age-inappropriate screen time reported different symptom profiles (i.e., differences in symptom centralities) from common pediatric mood problems. Our findings underline the multifaceted role (i.e., direct associations with symptoms, a moderator for symptom relationships, associations with distinct symptom profiles) of age-inappropriate screen time in preadolescent mood problems. These findings serve as foundations for future research that may facilitate early detection of preadolescents at risk of mood problems.

Gendered Pathways of Internalizing Problems from Early Childhood to Adolescence and Associated Adolescent Outcomes

Despite trends indicating worsening internalizing problems, characterized by anxiety and depression, there is dearth of research examining gender differences in developmental trajectories of internalizing problems from early childhood to adolescence. Drawing on the UK Millennium Cohort Study (n = 17,206, 49% female), this study examines trajectories of parent-reported, clinically-meaningful (reflecting the top 10%) internalizing problems from ages 3 to 14 years and their early predictors and adolescent outcomes. Group-based modelling revealed three trajectories when examining boys and girls together, but there were significant gender differences. When examining boys and girls separately, four trajectories were identified including two relatively stable trajectories showing either high or low probabilities of internalizing problems. An increasing trajectory was also found for both boys and girls, showing an increasing probability of internalizing problems which continued to rise for girls, but levelled off for boys from age 11. A decreasing trajectory was revealed for boys, while a moderate but stable trajectory was identified for girls. Boys and girls in the increasing and high probability groups were more likely to report a number of problematic outcomes including high BMI, self-harm, low mental wellbeing, depressive symptoms, and low educational motivation than the low group. Girls on the increasing trajectory also reported more cigarette and cannabis use and early sexual activity at age 14 compared to girls on the low trajectory. Findings suggest that intervention strategies take a systemic view, targeting not only internal feelings, but also behaviours potentially associated with later negative outcomes.

Examining income dynamics and externalizing and internalizing trajectories through a developmental psychopathology lens: A nationally representative study

Prior research has documented elevations in levels of internalizing and externalizing behaviors among children in lower income families in comparison to more advantaged peers. However, most studies focus on behavior problems at a single point in time or within a short developmental period. Associations between income dynamics and developmental trajectories of behavior problems over time are less understood. To address this, the current study uses data from the National Longitudinal Study of Youth (N = 7,476; 50.8% male) to examine how income dynamics (annual income and income volatility) across three distinct developmental periods from early childhood to early adolescence relate to trajectories of externalizing and internalizing problems. Group-based mixture modeling revealed a five-group trajectory model for externalizing behavior and a four-group trajectory model for internalizing behavior. Higher cumulative annual income predicted greater likelihood of belonging to the low-stable group compared to the other, more problematic groups for both externalizing and internalizing trajectories. In addition, income losses predicted higher risk of membership in any group other than the low-stable group for internalizing and externalizing behavior. Developmental period-specific income dynamics, though not as consistent as cumulative dynamics, also predicted trajectory group membership.

Do Conduct Problem Pathways Differ for Black and Minority Ethnic Children in the UK? An Examination of Trajectories from Early Childhood to Adolescence

A substantial body of evidence has examined developmental pathways into and out of conduct problems. However, there is a dearth of research examining whether the same conduct problem pathways are evident in minority ethnic, as in white, populations. Drawing on the UK Millennium Cohort Study (MCS), a nationally representative longitudinal study of children born between 2000 and 2002, this study examines differences in group-based trajectories of conduct problems according to broad categories of ethnicity. Using pathways identified in a prior study (n = 17,206, 49% female, 18% ethnic minority), including persistently high (8%), childhood-limited (23%), adolescent-onset (13%), and low (56%), significant ethnic differences were found. As a result, trajectories of conduct problems were identified separately for Asian, black, mixed ethnicity, and white children. For Asian, black, and mixed ethnicity children, three trajectories were identified: persistently high, childhood-limited, and low, but not adolescent-onset. Although these pathways have similar labels, their patterns and shapes seem to differ among the three ethnic groups. For white children, the same four trajectory groups were identified as in the prior study. Risk factors also differed among the groups according to ethnicity, although a worse child-parent relationship was a significant predictor of the higher problem trajectories for all ethnic groups. Overall, the findings suggest that black and minority ethnic children may follow different developmental pathways of conduct problems than white children, particularly during adolescence, having implications for service use and early intervention.

Internalising and externalising behaviour profiles across childhood: The consequences of changes in the family environment

Internalising and externalising behaviours may have heterogeneous patterns across childhood. Different aspects of young children's proximal family environments may influence these behavioural profiles. Previous studies have used indicators of family instability at one point in time or collapsed several indicators into an index. We assess whether patterns in internalising and externalising behaviours across childhood are in part determined by changes and events in multiple domains of the family environment across early childhood. Using Millennium Cohort Study data and Latent Profile Analysis, we created longitudinal latent profiles for internalising and externalising behaviour using child behaviour scores at ages 3, 5, 7, and 11. Time-varying markers of children's environments from ages 3-11 years included: poverty, family structure, number of siblings, residential moves, maternal depression, and hospital admissions. We derived five internalising profiles and two externalising profiles. Transitions into and out of poverty (ORs range: 1.9-3.3), changes in maternal depression (ORs range: 2.3-7.8), and persistent experiences of poverty and maternal depression had the strongest and most consistent associations with children's behaviours at all ages; early childhood experiences of maternal depression and poverty had independent longitudinal associations with children's behaviours; and residential moves were only related to externalising behaviours. This study emphasises the importance of investigating interrelated features of a child's proximal family environment alongside examining patterns in children's behaviour across childhood. To best support children and their families, policy solutions should focus on alleviating family poverty and depression and consider the holistic nature of a child's family environment.

Developmental Trajectories of Conduct Problems and Cumulative Risk from Early Childhood to Adolescence

Pathways into and out of conduct problems differ by circumstances experienced since infancy. There is a research gap in understanding how these developmental patterns vary according to the timing and persistence of risk and whether there are differences across ecological domains. This study examines variations in trajectories of conduct problems between ages 3 to 14 years and associated child, family and socio-economic risk factors from ages 9 months to 14 years, drawing on the UK Millennium Cohort Study (n = 17,206, 49% female), a nationally representative longitudinal study of children born between 2000/02. Group-based modeling was used to identify four distinct trajectories of conduct problems: low (56%), persistent high (8%), childhood-limited (23%) and adolescent-onset (13%). All three problem pathways were associated with high levels of exposure to risk, particularly early socio-economic and persisting child and family risks. However, while for the persistent and adolescent-onset pathways, exposure to higher levels of family and child risks continued through adolescence, it receded for the childhood-limited trajectory. The effects of early socio-economic disadvantage persisted for those on the adolescent-onset trajectory, highlighting the importance of early markers for this later onset group. Maternal smoking in pregnancy continued to be a significant predictor for all three conduct problem groups, even up to age 14 years. The findings indicate that different influences and processes may explain diverse pathways of conduct problems. This offers insights into who and what might be targeted and when might be the most effective developmental window for intervention.