Childhood multi-trajectories of shyness, anxiety and depression: Associations with adolescent internalizing problems

Are Children Following High Trajectories of Disruptive Behaviors in Early Childhood More or Less Likely to Follow Concurrent High Trajectories of Internalizing Problems?

The developmental association between disruptive behaviors (DBs: hyperactivity-impulsivity, non-compliance, physical aggression) and internalizing problems in early childhood is not well understood and has generated competing hypotheses and mixed results. Using a person-centered strategy, the present study aimed to examine concurrent trajectories of DBs and trajectories of internalizing problems from age 1.5 to 5 years in a population-representative sample (N = 2057; 50.7% boys). Six trajectories of DBs and three trajectories of internalizing problems, based on parent reports and obtained via latent growth modeling across five periods of assessment, were used as longitudinal indicators of each type of behaviors. Children following low or moderate trajectories served as the reference class. Compared to children in the reference class, those in trajectory classes characterized by high levels of co-occurring DBs (OR = 6.60) and, to a lesser extent, those in single high DB classes (OR = 2.78) were more likely to follow a high trajectory of internalizing problems simultaneously. These results support a multiple problem hypothesis regarding the association between DBs and internalizing problems, consistent with a developmental perspective that includes a general factor underpinning different psychopathologies. These findings highlight the importance of considering the co-occurrence between DBs and internalizing problems when studying either construct in children.

Children's shyness and frontal electroencephalogram delta-beta correlation in the pediatric surgical setting

The prospect of surgery is a unique psychologically threatening context for children, often leading to experiences of preoperative anxiety. Recent research suggests that individual differences in children's temperament may influence responses to the surgical setting. In the present study, we examined whether individual differences in shyness were related to differences in frontal electroencephalogram (EEG) delta-beta correlation, a proposed neural correlate of emotion regulation and dysregulation, among children anticipating surgery. Seventy-one children (36 boys, M_age  = 10.3 years, SD_age  = 1.7 years) undergoing elective surgery self-reported on their own shyness, and their parents also reported on their child's shyness. Using a mobile, dry sensor EEG headband, frontal EEG measures were collected and self- and observer-reported measures of state anxiety were obtained at the children's preoperative visit (Time 1) and on the day of surgery (Time 2). A latent cluster analysis derived classes of low shy (n = 37) and high shy (n = 34) children using the child- and parent-reported shyness measures. We then compared the two classes on frontal EEG delta-beta correlation using between- and within-subjects analyses. Although children classified as high versus low in shyness had higher self- and observer-reported state anxiety across both time periods, frontal EEG delta-beta correlation increased from T1 to T2 only among low shy children using a between-subjects delta-beta correlation measure. We discuss the interpretation of a relatively higher delta-beta correlation as a correlate of emotion regulatory versus dysregulatory strategies for some children in a "real-world," surgical context.

Profiles of Anxious and Depressive Symptoms Among Adolescent Boys and Girls: Associations with Coping Strategies

Most existing studies investigating profiles of anxious and depressive symptoms in adolescent boys and girls do not consider the high cooccurrence between them, which prevents from identifying how heterogeneous groups might distinctly use coping strategies. To address this gap, the current study relies on a sample of 976 adolescents (56.0% girls (n = 547), aged 12-15 y.o., M = 12.92, SD = 0.75) to identify profiles of self-reported internalizing symptoms while properly disaggregating youth's global levels of internalizing symptoms from their specific levels of anxious and depressive symptoms. The study also assesses whether similar profiles will be identified with the same frequency among boys and girls, as well as the associations between profile membership and coping strategies (problem-solving, social support, cognitive restructuring, cognitive avoidance, and behavioral avoidance) and whether these associations vary between sexes. Bifactor-confirmatory factor analyses confirmed the presence of a global internalizing factor and six specific factors reflecting anxious and depressive symptoms. Latent profile analyses identified three similar profiles among boys and girls but with different prevalence: Low internalizing symptoms (29.97% (n = 164) girls; 70.77% (n = 304) boys), Internalizing and specific anxious symptoms (40.15% (n = 220) girls, 14.75% (n = 63) boys), and Internalizing and specific depressive symptoms (29.86% (n = 163) girls, 14.48% (n = 62) boys). Girls in the Internalizing and specific anxious profile reported more frequent use of four coping strategies compared to boys (problem-solving, social support, cognitive restructuring, and cognitive avoidance). Among boys and girls, the Internalizing and specific depressive profile was associated with the least strategic use of coping strategies (low problem-solving, social support, and cognitive restructuring, and high cognitive and behavioral avoidance). The Internalizing and specific anxious profile was associated with high levels of all coping strategies (except behavioral avoidance). Overall, the study demonstrates that disaggregating global and specific internalizing symptoms allow identifying qualitatively distinct profiles, which then raised questions on the efficacy of the coping strategies used by youth with an Internalizing and specific anxious profile. These results support the adoption of a transdiagnostic approach of treatment based on a holistic representation of all aspects of adolescent boys' and girls' internalizing symptoms to better accompany them in the selection of their coping strategies.

Externalizing problems mediate the relationship between motor proficiency and internalizing problems in children: An extension of the Environmental Stress Hypothesis

The Environmental Stress Hypothesis (ESH) is a causal theoretical framework that provides a flexible context for understanding factors that mediate the relationship between low motor proficiency and internalizing problems in children. The purpose of the present study was to use the ESH framework to determine whether body mass index (BMI), physical activity levels, psychosocial health and physical health, self-efficacy, perceived social status, prosocial behavior and externalizing problems were potential mediators between motor proficiency and internalizing factors in a population of Brazilian children. 431 children aged 7- to 10 years (240 females, 191 males) participated in the study. The variables were measured with the Movement Assessment Battery for Children, 2^nd ed. (MABC-2), the Pediatric Quality of Life Inventory (PedsQL), the Strengths and Difficulties Questionnaire (SDQ), the MacArthur Subjective Social Status Scale (MacArthur SSS), the Self-efficacy Sense Assessment Roadmap (RASAE), and the Physical Activity Questionnaire (PAQ). The results indicated a direct relationship between motor proficiency and internalizing problems in a population of Brazilian children, with externalizing problems being the only variable mediating that relationship. To the best of our knowledge, this is the first time that externalizing problems were tested in the context of the ESH. Understanding and evaluating potential mediators in the relationship between motor proficiency and internalizing problems using the ESH framework is essential to promote prevention policies and interventions for school-age children.

Links between Child Shyness and Indices of Internalizing Problems during the COVID-19 Pandemic: The Protective Role of Positivity

Shyness in childhood has been linked to socio-emotional difficulties such as anxiety, depression, and loneliness. On the contrary, positivity (i.e., a personal tendency to see oneself, life, and future in a positive light) has been described as a protective factor. Given the challenges experienced by children during the first wave of the COVID-19 pandemic (e.g., closure of school and confinement), we aimed to test the potential protective role of positivity and how it may link child shyness and indices of internalizing problems (i.e., anxiety, depression, loneliness) during the first wave of the pandemic. Participants were N = 236 children (M_age = 9.25 years, SD = 1.20) from Italy, Spain, and the United Kingdom, the three worst-hit countries in Europe when the data were collected (April-June, 2020). Children completed online self-evaluation scales to assess temperamental shyness, positivity, and indices of internalizing problems during the COVID-19 pandemic. Results from a multivariate regression analysis revealed significant interaction effects between shyness and positivity in the prediction of outcome variables. Follow-up simple slope analyses indicated that shyness was positively related to depression only among children with lower levels of positivity. The study highlights the role of children's positivity in buffering the pernicious link between shyness and their negative feelings during the pandemic. The practical implications of these findings are discussed.

Polygenic scores differentially predict developmental trajectories of subtypes of social withdrawal in childhood

BACKGROUND

Children who consistently withdraw from social situations face increased risk for later socioemotional difficulties. Twin studies indicate that genetic factors substantially account for the persistence of social withdrawal over time. However, the molecular genetic etiology of chronic courses of social wariness and preference for solitude, two dimensions of social withdrawal, remains undocumented. The objectives of the present study were (a) to identify high-risk trajectories for social wariness and preference for solitude in childhood and (b) to examine whether falling on these high-risk trajectories can be predicted by specific polygenic scores for mental health traits and disorders and by a general polygenic predisposition to these traits.

METHODS

Teachers evaluated 971 genotyped children at five occasions (age 6 to 12 years) from two prospective longitudinal studies, the Quebec Newborn Twin Study and the Quebec Longitudinal Study of Child Development. Developmental trajectories for social wariness and preference for solitude were identified. We tested whether polygenic scores for attention deficit hyperactivity disorder, autism spectrum disorder, depression, loneliness, and subjective well-being, as well as a general mental health genetic risk score derived across these traits, were associated with the developmental trajectories.

RESULTS

Polygenic scores differentially predicted social wariness and preference for solitude. Only the loneliness polygenic score significantly predicted the high trajectory for social wariness. By contrast, the general mental health genetic risk score factor was associated with the trajectory depicting high-chronic preference for solitude.

CONCLUSIONS

Distinct associations were uncovered between the polygenic scores, social wariness, and preference for solitude.

Cohort Profile: Quebec Longitudinal Study of Child Development (QLSCD)

PURPOSE

The Quebec Longitudinal Study of Child Development (QLSCD) was designed to examine the long-term associations of preschool physical, cognitive, social, and emotional development with biopsychosocial development across childhood, adolescence, and young adulthood.

METHODS

QLSCD is an ongoing prospective cohort including 2120 singletons born in 1997/1998 in the Canadian province of Quebec. So far, data have been collected annually or every 2 years from child ages 5 months to 21 years. The cohort currently includes 1245 participants. Data available include a range of environmental (e.g., family characteristics, child behaviour, educational attainment, mental health), biological (e.g., hair cortisol, genetic, epigenetic), and administrative data.

RESULTS

QLSCD has contributed to the understanding of children's psychosocial development, including the development of physical aggression and anxiety. QLSCD articles have advanced scientific knowledge on the influence of early childhood factors on childhood, adolescent, and young adult mental health, including the effect of participation in early childcare on cognitive and behavioural development, the developmental origins of adolescent and young adult mental health problems and suicide risk, and the development of interpersonal difficulties (e.g., peer victimisation) from preschool years to adolescence.

CONCLUSION

QLSCD has given major contributions to our understanding of the link between different aspects of child development and biopsychosocial development during the first two decades of life. Unique features include the presence of environmental, biological, and administrative data, long-term follow-up with frequent data collections, and use of data from multiple informants, including teachers, mothers, fathers, and the children themselves.

Prenatal and postnatal maternal anxiety and amygdala structure and function in young children

Anxiety symptoms are relatively common during pregnancy and are associated with behavioural problems in children. The amygdala is involved in emotion regulation, and its volume and function are associated with exposure to prenatal maternal depression. The associations between perinatal maternal anxiety and children's amygdala structure and function remain unclear. The objective of this study was to determine associations between prenatal and postnatal maternal anxiety and amygdala structure and function in children. Maternal anxiety was measured during the second trimester of pregnancy and 12 weeks postpartum. T1-weighted anatomical data and functional magnetic resonance imaging data were collected from 54 children (25 females), between the ages of 3-7 years. Amygdala volume was calculated and functional connectivity maps were created between the amygdalae and the rest of the brain. Spearman correlations were used to test associations between amygdala volume/functional connectivity and maternal anxiety symptoms, controlling for maternal depression symptoms. Second trimester maternal anxiety symptoms were negatively associated with functional connectivity between the left amygdala and clusters in bilateral parietal regions; higher maternal anxiety was associated with increased negative connectivity. Postnatal maternal anxiety symptoms were positively associated with child amygdala volume, but this finding did not remain significant while controlling for total brain volume. These functional connectivity differences may underlie behavioral outcomes in children exposed to maternal anxiety during pregnancy.

Trajectories of Overprotective Parenting and Hyperactivity-Impulsivity and Inattention Among Moderate-Late Preterm Children: A Population-Based Study

Parents of preterm children are more likely to adopt non-optimal parenting behaviors than parents of full-term (FT) children. However, there is a lack of studies on parents of children born moderate to late preterm (MLP; 32-36 gestational weeks). In this study, we aimed to examine: (1) the association between MLP birth status and the trajectory of parental overprotection throughout preschool years, and (2) the role of parental overprotection, MLP birth status, and their interaction in the prediction of the trajectories of hyperactivity-impulsivity and inattention throughout childhood. Data comes from a Canadian representative population-based cohort including 2028 FT, 100 MLP children, and their parents. Overprotective parenting was measured when children were 5, 17, and 29 months old. Hyperactivity-impulsivity and inattention symptoms were measured repeatedly from 4 to 8 years of age. Trajectories of parents' overprotectiveness and children's hyperactivity-impulsivity and inattention were modeled. MLP birth status was associated with an increase in parental overprotectiveness across the preschool period. MLP birth status and parental overprotection were both found to be associated with higher levels of hyperactivity-impulsivity symptoms across childhood. No interaction was found between birth status and parental overprotection. The results suggest that parents of MLP children become more overprotective across time compared to parents of FT children and that children born MLP and/or exposed to higher levels of parental overprotection demonstrated higher levels of hyperactivity-impulsivity symptoms across childhood.

Adolescent internalizing symptoms: The importance of multi-informant assessments in childhood

BACKGROUND

Childhood internalizing symptoms can be associated with adolescent internalizing symptoms, but only a small proportion of symptomatic children are at long-term risk. Our objectives were to (1) distinguish between typical and atypical levels of internalizing symptoms using mother- and teacher-assessments and (2) test the association between childhood internalizing symptoms and adolescent generalized anxiety, depression, and social phobia symptoms in boys and girls.

METHODS

Multi-trajectory models were used to estimate the evolution of mother- and teacher-reported internalizing symptoms across childhood (1.5 to 12 years) in a large population-based cohort (n = 1431). Multiple linear regression models were implemented to estimate the association between childhood group membership of internalizing symptoms and self-reported specific internalizing symptoms at 15 years by sex.

RESULTS

Five groups of childhood internalizing symptoms were identified: Mother & teacher low (22.6%), Mother moderate/teacher low (37.9%), Mother moderate/teacher high (18.3%), Mother high/teacher low (11.8%) and Mother & teacher high (9.5%). Multiple linear regression models showed that compared to the low group, (1) boys in the high group reported higher social phobia symptoms (p = 0.04), (2) girls in the high group reported higher depression (p = 0.01) and generalized anxiety (p < 0.01) symptoms, and (3) girls in the moderate/high group reported higher generalized anxiety symptoms (p = 0.02) in adolescence.

LIMITATIONS

The main limitation is that mothers' and teachers' assessments mostly covered different developmental periods.

CONCLUSIONS

A multi-informant assessment of childhood internalizing symptoms improves adolescent specific internalizing symptoms identification in a general population sample over reliance on a single informant.