The Generation R Study: a review of design, findings to date, and a study of the 5-HTTLPR by environmental interaction from fetal life onward

The polygenic and reactive nature of observed parenting

In Wertz et al. (2019), parents' polygenic scores of educational attainment (PGS-EA) predicted parental sensitive responses to the child's needs for support, as observed in a dyadic task (i.e., observed sensitivity). We aimed to replicate and expand these findings by combining longitudinal data, child genotype data and several polygenic scores in the Generation R Study. Mother-child dyads participated in two developmental periods, toddlerhood (14 months old; n = 648) and early childhood (3-4 years old, n = 613). Higher maternal PGS-EA scores predicted higher observed sensitivity in toddlerhood (b = 0.12, 95% CI 0.03, 0.20) and early childhood (b = 0.16, 95% CI 0.08, 0.24). Child PGS-EA was significantly associated with maternal sensitivity in early childhood (b = 0.11, 95% CI 0.02, 0.21), and the effect of maternal PGS-EA was no longer significant when correcting for child PGS-EA. A latent factor of PGSs based on educational attainment, intelligence (IQ) and income showed similar results. These polygenic scores might be associated with maternal cognitive and behavioral skills that help shape parenting. Maternal PGSs predicted observed sensitivity over and above the maternal phenotypes, showing an additional role for PGSs in parenting research. In conclusion, we replicated the central finding of Wertz et al. (2019) that parental PGS-EA partially explains parental sensitivity. Our findings may be consistent with evocative gene-environment correlation (rGE), emphasizing the dynamic nature of parenting behavior across time, although further research using family trios is needed to adequately test this hypothesis.

Mapping Inequalities in the Physical, Built and Social Environment in Population-Based Studies of Brain Health

This mini-tutorial describes how combining aggregate-level data about the physical, built and social environment can facilitate our understanding of factors shaping the human brain and, in turn, brain health. It provides entry-level information about methods and approaches one can use to uncover how inequalities in the local environment lead to health inequalities in general, and those in brain health in particular. This background knowledge should be helpful to those who are interested in using neuroimaging to investigate how environmental factors shape inter-individual variations in the human brain.

Maternal Psychological Problems During Pregnancy and Child Externalizing Problems: Moderated Mediation Model with Child Self-regulated Compliance and Polygenic Risk Scores for Aggression

A potential pathway underlying the association between prenatal exposure to maternal psychological problems and childhood externalizing problems is child self-regulation. This prospective study (N = 687) examined whether self-regulated compliance mediates the relation between maternal affective problems and hostility during pregnancy and childhood externalizing problems, and explored moderation by child polygenic risk scores for aggression and sex. Self-regulated compliance at age 3 was observed in mother-child interactions, and externalizing problems at age 6 were reported by mothers and teachers. Polygenic risk scores were calculated based on a genome-wide association study of aggressive behavior. Self-regulated compliance mediated the associations between maternal psychological problems and externalizing problems. Aggression PRS was associated with higher externalizing problems reported by mothers. No evidence was found of moderation by aggression PRS or sex. These findings support the hypothesis that maternal psychological problems during pregnancy might influence externalizing problems through early self-regulation, regardless of child genetic susceptibility or sex.

Editorial: Subclinical Psychopathology and the Developing Brain

Adolescence is an important developmental window, characterized by critical changes in brain development (eg cortical thinning), and also by the peak time of onset for many mental health disorders.¹ Understanding the neurodevelopmental roots of psychopathology has been a major focus in our field. Researchers have been charged with providing the foundational knowledge needed to guide the design of effective, neurobiologically based prevention and early intervention efforts.² Although we have made some gains, we still have far to go. The questions that need to be answered require large-scale, longitudinal studies examining brain development beginning early in life, prior to the onset of mental health disorders, with repeated, multi-level assessments to understand the intertwining cascade of alterations in brain, behavior, and experience over time.

Brain morphology, autistic traits, and polygenic risk for autism: A population-based neuroimaging study

Autism spectrum disorders (ASD) are associated with widespread brain alterations. Previous research in our group linked autistic traits with altered gyrification, but without pronounced differences in cortical thickness. Herein, we aim to replicate and extend these findings using a larger and older sample. Additionally, we examined whether (a) brain correlates of autistic traits were associated with polygenic risk scores (PRS) for ASD, and (b) autistic traits are related with brain morphological changes over time in a subset of children with longitudinal data available. The sample included 2400 children from the Generation R cohort. Autistic traits were measured using the Social Responsiveness Scale (SRS) at age 6 years. Gyrification, cortical thickness, surface area, and global morphological measures were obtained from high-resolution structural MRI scans at ages 9-to-12 years. We performed multiple linear regression analyses on a vertex-wise level. Corresponding regions of interest were tested for association with PRS. Results showed that autistic traits were related to (a) lower gyrification in the lateral occipital and the superior and inferior parietal lobes, (b) lower cortical thickness in the superior frontal region, and (c) lower surface area in inferior temporal and rostral middle frontal regions. PRS for ASD and longitudinal analyses showed significant associations that did not survive correction for multiple testing. Our findings support stability in the relationship between higher autistic symptoms and lower gyrification and smaller surface areas in school-aged children. These relationships remained when excluding ASD cases, providing neurobiological evidence for the extension of autistic traits into the general population. LAY SUMMARY: We found that school-aged children with higher levels of autistic traits had smaller total brain volume, cerebellum, cortical thickness, and surface area. Further, we also found differences in the folding patterns of the brain (gyrification). Overall, genetic susceptibility for autism spectrum disorders was not related to these brain regions suggesting that other factors could be involved in their origin. These results remained significant when excluding children with a diagnosis of ASD, providing support for the extension of the relationship between autistic traits and brain findings into the general population.

Lateralization of Resting-State Networks in Children: Association with Age, Sex, Handedness, Intelligence Quotient, and Behavior

Introduction: Lateralization in brain function has been associated with age and sex in previous work; however, there has been less focus on lateralization of functional networks during development. Aim: We aim to examine laterality in typical development; a clearer understanding of how and to what extent functional brain networks are lateralized in typical development may eventually prove to hold predictive information in psychopathology. Material and Methods: In this study, we examine the lateralization of resting-state networks assessed with a group-independent component analysis using resting-state functional magnetic resonance imaging from a large cohort consisting of 774 children, ages 6-10 years. This is an extension of our previous work on normal aging in adults, where we now assess whether there are similar patterns in children. Results: Unlike the results from our study of healthy aging in adults, which showed a decrease in laterality with increasing age, in this study we found both decreases and increases in lateralization in multiple networks with development. For example, auditory and sensorimotor regions had greater bilateral connectivity with development, whereas regions including the dorsolateral frontal cortex (Brodmann area left 9 and left 46) showed an increase in left lateralization with development. Conclusion: Our findings support a complex, nonlinear association between laterality and age in school-age children, a time when brain function and structure are developing rapidly. We also found brain networks in which laterality was significantly associated with sex, handedness, and intelligence quotient, but we did not find any significant association with behavioral scores. Impact statement Lateralization in brain function has been associated with age and sex in several previous studies; however, there has been less focus on lateralization of functional networks during development. A clearer understanding of how and to what extent functional brain networks are lateralized in typical development may eventually prove to hold predictive information in psychopathology. In this study, we examine the lateralization of resting-state networks assessed with a group-independent component analysis using resting-state functional magnetic resonance imaging from a large cohort consisting of 774 children, ages 6-10 years.

Genetic scores for adult subcortical volumes associate with subcortical volumes during infancy and childhood

Individual differences in subcortical brain volumes are highly heritable. Previous studies have identified genetic variants that underlie variation in subcortical volumes in adults. We tested whether those previously identified variants also affect subcortical regions during infancy and early childhood. The study was performed within the Generation R study, a prospective birth cohort. We calculated polygenic scores based on reported GWAS for volumes of the accumbens, amygdala, brainstem, caudate nucleus, globus pallidus, putamen, and thalamus. Participants underwent cranial ultrasound around 7 weeks of age (range: 3-20), and we obtained metrics for the gangliothalamic ovoid, a predecessor of the basal ganglia. Furthermore, the children participated in a magnetic resonance imaging (MRI) study around the age of 10 years (range: 9-12). A total of 340 children had complete data at both examinations. Polygenic scores primarily associated with their corresponding volumes at 10 years of age. The scores also moderately related to the diameter of the gangliothalamic ovoid on cranial ultrasound. Mediation analysis showed that the genetic influence on subcortical volumes at 10 years was only mediated for 16.5-17.6% of the total effect through the gangliothalamic ovoid diameter at 7 weeks of age. Combined, these findings suggest that previously identified genetic variants in adults are relevant for subcortical volumes during early life, and that they affect both prenatal and postnatal development of the subcortical regions.

Klotho gene polymorphism, brain structure and cognition in early-life development

Variation in the klotho gene is linked to differences in health outcomes: klotho allele KL-VS heterozygosity is associated with longevity, better cognition and greater right frontal grey matter volume in late life. Contradicting reports, however, suggest that KL-VS’s effect on health might be age-dependent. Here we examine the relationship between KL-VS genotype, cognition and brain structure in childhood and adolescence. We hypothesized that KL-VS has early influences on cognitive and brain development. We investigated the associations of KL-VS carrier status with cognition and brain morphology in a cohort of 1387 children and adolescents aged 3–21 years, examining main effects and interactions between age, sex and socioeconomic circumstance. KL-VS had no main effect on either cognition or brain structure, though there was a significant KL-VS × age interaction for cognition (specifically executive function, attention, episodic memory, and general cognition), total grey matter and total brain volume. KL-VS heterozygotes had better cognition than non-carriers before age 11, but lower cognition after age 11. Heterozygotes had smaller brains than non-carriers did in early childhood. Sex moderated the association between KL-VS and white matter volume. Among girls, KL-VS heterozygotes had smaller white matter volumes than non-carriers. Among boys, heterozygotes had greater white matter volumes than non-carriers. However, a replication in a cohort of 2306 children aged 6–12 years showed no significant associations. In contrast to findings in late life, these results show that KL-VS does not have a main effect on cognition and brain structure. Furthermore, KL-VS’s influence may depend on age and sex.

White Matter Microstructure and the General Psychopathology Factor in Children

OBJECTIVE

Co-occurrence of behavioral and emotional problems in childhood is widespread, and previous studies have suggested that this reflects vulnerability to experience a range of psychiatric problems, often termed a general psychopathology factor. However, the neurobiological substrate of this general factor is not well understood. We tested the hypothesis that lower overall white matter microstructure is associated with higher levels of the general psychopathology factor in children and less with specific factors.

METHOD

Global white matter microstructure at age 10 years was related to general and specific psychopathology factors. These factors were estimated using a latent bifactor model with multiple informants and instruments between ages 6 and 10 years in 3,030 children from the population-based birth cohort Generation R. The association of global white matter microstructure and the psychopathology factors was examined with a structural equation model adjusted for sex, age at scan, age at psychopathology assessment, parental education/income, and genetic ancestry.

RESULTS

A 1-SD increase of the global white matter factor was associated with a β = -0.07SD (standard error [SE] = 0.02, p < .01) decrease in general psychopathology. In contrast, a 1-SD increase of white matter microstructure predicted an increase of β = +0.07 SD (SE = 0.03, p < .01) specific externalizing factor levels. No association was found with the specific internalizing and specific attention factor.

CONCLUSION

The results suggest that general psychopathology in childhood is related to white matter structure across the brain and not only to specific tracts. Taking into account general psychopathology may also help reveal neurobiological mechanisms behind specific symptoms that are otherwise obscured by comorbidity.

Environment-Wide Association Study (En WAS) of Prenatal and Perinatal Factors Associated With Autistic Traits: A Population-Based Study

A combination of genetic and environmental factors contributes to the origins of autism spectrum disorder (ASD). While a number of studies have described specific environmental factors associating with emerging ASD, studies that compare and contrast multiple environmental factors in the same study are lacking. Thus, the goal of this study was to perform a prospective, data-driven environmental-wide association study of pre- and perinatal factors associated with the later development of autistic symptoms in childhood. The participants included 3891 6-year-old children from a birth cohort with pre- and perinatal data. Autistic symptoms were measured using the Social Responsiveness Scale in all children. Prior to any analyses, the sample was randomly split into a discovery set (2920) and a test set (921). Multiple linear regression analyses were performed for each of 920 variables, correcting for six of the most common covariates in epidemiological studies. We found 111 different pre- and perinatal factors associated with autistic traits during childhood. In secondary analyses where we controlled for parental psychopathology, 23 variables in the domains of family and interpersonal relationships were associated with the development of autistic symptoms during childhood. In conclusion, a data-driven approach was used to identify a number of pre- and perinatal risk factors associating with higher childhood autistic symptoms. These factors include measures of parental psychopathology and family and interpersonal relationships. These measures could potentially be used for the early identification of those at increased risk to develop ASD. LAY SUMMARY: A combination of genetic and environmental factors contributes to the development of autism spectrum disorder (ASD). Each environmental factor may affect the risk of ASD. In a study on 6-year-old children, a number of pre- and perinatal risk factors were identified that are associated with autistic symptoms in childhood. These factors include measures of parental psychopathology and family and interpersonal relationships. These variables could potentially serve as markers to identify those at increased risk to develop ASD or autistic symptoms. Autism Res 2020, 13: 1582-1600. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

Genetic risk for Alzheimer disease in children: Evidence from early-life IQ and brain white-matter microstructure

It remains unclear whether the genetic risk for late‐onset Alzheimer disease (AD) is linked to premorbid individual differences in general cognitive ability and brain structure. The objective of the present study was to determine whether the genetic risk of late‐onset AD is related to premorbid individual differences in intelligence quotient (IQ) and characteristics of the cerebral white‐matter in children. The study sample included children of the Generation R Study from Rotterdam, The Netherlands. IQ was measured using a well‐validated Dutch nonverbal IQ test (n = 1908) at ages 5 to 9 years. White‐matter microstructure was assessed by measuring fractional anisotropy (FA) of white‐matter tracts using diffusion tensor imaging (DTI) (n = 919) at ages 9 to 12 years. Genetic risk was quantified using three biologically defined genetic risk scores (GRSs) hypothesized to be related to the pathophysiology of late‐onset AD: immune response, cholesterol/lipid metabolism and endocytosis. Higher genetic risk for late‐onset AD that included genes associated with immune responsivity had a negative influence on cognition and cerebral white‐matter microstructure. For each unit increase in the immune response GRS, IQ decreased by 0.259 SD (95% CI [−0.500, −0.017]). For each unit increase in the immune response GRS, global FA decreased by 0.373 SD (95% CI [−0.721, −0.026]). Neither cholesterol/lipid metabolism nor endocytosis GRSs were associated with IQ or cerebral white‐matter microstructure. Our findings suggest that elevated genetic risk for late‐onset AD may in part be manifest during childhood neurodevelopment through alterations in immune responsivity.

General psychopathology, internalising and externalising in children and functional outcomes in late adolescence

BACKGROUND

Internalising and externalising problems commonly co-occur in childhood. Yet, few developmental models describing the structure of child psychopathology appropriately account for this comorbidity. We evaluate a model of childhood psychopathology that separates the unique and shared contribution of individual psychological symptoms into specific internalising, externalising and general psychopathology factors and assess how these general and specific factors predict long-term outcomes concerning criminal behaviour, academic achievement and affective symptoms in three independent cohorts.

METHODS

Data were drawn from independent birth cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), N = 11,612; Generation R, N = 7,946; Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN), N = 408). Child psychopathology was assessed between 4 and 8 years using a range of diagnostic and questionnaire-based measures, and multiple informants. First, structural equation models were used to assess the fit of hypothesised models of shared and unique components of psychopathology in all cohorts. Once the model was chosen, linear/logistic regressions were used to investigate whether these factors were associated with important outcomes such as criminal behaviour, academic achievement and well-being from late adolescence/early adulthood.

RESULTS

The model that included specific factors for internalising/externalising and a general psychopathology factor capturing variance shared between symptoms regardless of their classification fits well for all of the cohorts. As hypothesised, general psychopathology factor scores were predictive of all outcomes of later functioning, while specific internalising factor scores predicted later internalising outcomes. Specific externalising factor scores, capturing variance not shared by any other psychological symptoms, were not predictive of later outcomes.

CONCLUSIONS

Early symptoms of psychopathology carry information that is syndrome-specific as well as indicative of general vulnerability and the informant reporting on the child. The 'general psychopathology factor' might be more relevant for long-term outcomes than specific symptoms. These findings emphasise the importance of considering the co-occurrence of common internalising and externalising problems in childhood when considering long-term impact.

Brain Development and Stochastic Processes During Prenatal and Early Life: You Can't Lose It if You've Never Had It; But It's Better to Have It and Lose It, Than Never to Have Had It at All

Brain development, although largely driven by genetic processes, also is influenced by environmental factors. However, there has been little discussion in the psychiatric literature on the role of stochastic, or chance, events that take place during neurodevelopment. Studies suggest that the brain capitalizes on and regulates the extent of stochastic processes during development. Furthermore, because neurodevelopment is influenced by environmental factors, there is emerging evidence that fostering those positive environmental factors during prenatal and early life could optimize neurodevelopment and provide greater resilience, including those potentially resulting from stochastic processes. Evidence for the role of environmental factors in optimizing early brain development is supported by work in large population-based studies of child development, randomized control trials in high-risk populations, and early-life adoption studies. The public health message is that creating an environment that fosters optimal brain development during prenatal and early life could prevent psychopathology and provide the developing brain the best chance against negative stochastic processes and potential stressors that are inevitable later in life.

Like Father, like Child: Early Life Family Adversity and Children's Bullying Behaviors in Elementary School

Family adversity has been associated with children’s bullying behaviors. The evidence is, however, dominated by mothers’ perceptions of the family environment and a focus on mothers’ behaviors. This prospective population-based study examined whether children’s bullying behaviors were associated with mother- and father-reported family adversity, assessed before and after child birth. Peer-nominations were used to assess bullying behaviors of 1298 children in elementary school (mean age 7.5 years). The following paternal risk factors were prospectively associated with children’s bullying behaviors: (1) father-reported prenatal family distress, (2) fathers’ hostility at preschool age, and (3) fathers’ harsh disciplinary practices at preschool age, but effect sizes were relatively small. The effect of maternal risk factors was less consistent, only mother-reported family distress in childhood was associated with children’s bullying behaviors. The associations were independent of background family risk factors (i.e., life stress, contextual factors, and other background factors such as parental education and risk taking record) and early childhood externalizing problems. Moreover, our results indicated that father-reported family adversity predicted children’s bullying behaviors over and above the background family risk factors, early childhood externalizing problems and mother-reported family adversity. We also demonstrated that the association of fathers’ prenatal hostility and family distress with subsequent bullying behavior of their child at school was partly mediated by fathers’ harsh disciplinary practices at preschool age. Our findings highlight the importance of fathers’ behaviors in the development of children’s bullying behaviors.

International findings with the Achenbach System of Empirically Based Assessment (ASEBA): applications to clinical services, research, and training

The purpose of this invited article is to present multicultural norms and related international findings obtained with the Achenbach System of Empirically Based Assessment (ASEBA) by indigenous researchers in over 50 societies. The article describes ASEBA instruments for which multicultural norms are available, plus procedures for constructing the multicultural norms. It presents applications to clinical services, including use of multi-informant data for assessing children and their parents. The Multicultural Family Assessment Module (MFAM) enables mental health providers to view side-by-side bar graphs of child and parent scores on syndromes, DSM-oriented scales, Internalizing, Externalizing, and Total Problems. Evidence-based assessment of progress and outcomes is facilitated by the Progress & Outcomes App (P&O App). Research applications are outlined, including longitudinal and outcomes research. Applications to training mental health providers include having trainees study standardized multi-informant assessment data prior to interviewing children and their parents. Trainees can also sharpen their clinical skills by completing assessment forms to describe children and their parents, and then using ASEBA software to compare their ratings with ratings by children, parents, and other informants. Practical evidence-based assessment instruments with multicultural norms enable mental health providers, researchers, and trainees to perform intake, progress, and outcome assessments of children and their parents in terms of a standardized international clinical data language.

Translating basic research knowledge on the biological embedding of early-life stress into novel approaches for the developmental programming of lifelong health

This review integrates scientific knowledge obtained over the past few decades on the biological mechanisms that contribute to the profound association between exposure to early adversity, including childhood trauma and prenatal stress, and the lifelong elevated risk to develop a broad range of diseases. We further discuss insights into gene-environment interactions moderating the association between early adversity and disease manifestation and we discuss the role of epigenetic and other molecular processes in the biological embedding of early adversity. Based on these findings, we propose potential mechanisms that may contribute to the intergenerational transmission of risk related to early adversity from the mother to the fetus. Finally, we argue that basic research knowledge on the biological embedding of early adversity must now be translated into novel intervention strategies that are mechanism-driven and sensitive to developmental timing. Indeed, to date, there are no diagnostic biomarkers of risk or mechanism-informed interventions that we can offer to victims of early adversity in order to efficiently prevent or reverse adverse health outcomes. Such translational efforts can be expected to have significant impact on both clinical practice and the public health system, and will promote precision medicine in pediatrics and across the lifespan.

Common Polygenic Variations for Psychiatric Disorders and Cognition in Relation to Brain Morphology in the General Pediatric Population

OBJECTIVE

This study examined the relation between polygenic scores (PGSs) for 5 major psychiatric disorders and 2 cognitive traits with brain magnetic resonance imaging morphologic measurements in a large population-based sample of children. In addition, this study tested for differences in brain morphology-mediated associations between PGSs for psychiatric disorders and PGSs for related behavioral phenotypes.

METHOD

Participants included 1,139 children from the Generation R Study assessed at 10 years of age with genotype and neuroimaging data available. PGSs were calculated for schizophrenia, bipolar disorder, major depression disorder, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, intelligence, and educational attainment using results from the most recent genome-wide association studies. Image processing was performed using FreeSurfer to extract cortical and subcortical brain volumes.

RESULTS

Greater genetic susceptibility for ADHD was associated with smaller caudate volume (strongest prior = 0.01: β = -0.07, p = .006). In boys, mediation analysis estimates showed that 11% of the association between the PGS for ADHD and the PGS attention problems was mediated by differences in caudate volume (n = 535), whereas mediation was not significant in girls or the entire sample. PGSs for educational attainment and intelligence showed positive associations with total brain volume (strongest prior = 0.5: β = 0.14, p = 7.12 × 10^-8; and β = 0.12, p = 6.87 × 10^-7, respectively).

CONCLUSION

The present findings indicate that the neurobiological manifestation of polygenic susceptibility for ADHD, educational attainment, and intelligence involve early morphologic differences in caudate and total brain volumes in childhood. Furthermore, the genetic risk for ADHD might influence attention problems through the caudate nucleus in boys.

Using Food to Soothe in Infancy is Prospectively Associated with Childhood BMI in a Population-Based Cohort

BACKGROUND

Feeding practices have been implicated in childhood overweight, but the long-term effects of using food to comfort a distressed child remain unknown.

OBJECTIVE

This study examined whether the use of food to soothe in infancy was associated with later body composition, and whether children's eating behaviors mediate this relation.

METHODS

Participants were 3960 children of Generation R, a population-based birth cohort in the Netherlands. Parents reported on the use of food to soothe when infants were 6 mo old and on child eating behavior (food responsiveness, emotional eating) at ages 4 and 10 y. Body mass index (BMI), fat mass, and fat-free mass were measured at ages 6 and 10 y. Linear regression and mediation analyses were conducted, accounting for various potential confounding factors.

RESULTS

The use of food to soothe when infants were 6 mo old predicted a higher BMI from age 6 y onwards, independently of infant weight, maternal BMI, and other confounders. Specifically, frequent use was associated with a BMI z score 0.13 higher at age 10 y (95% CI: 0.03, 0.22) as compared with never use. Children's emotional eating mediated this association (indirect effect B = 0.04; 95% CI: 0.02, 0.06). The feeding-body composition association was most evident for fat mass (P for trend = 0.014) and somewhat less for fat-free mass (P for trend = 0.079).

CONCLUSIONS

The use of food to comfort a distressed infant was consistently associated with obesogenic eating behaviors and an unhealthy body composition throughout middle and late childhood. As our design precludes conclusions on causal associations, we recommend further studies with precise, repeated assessments of infant feeding practices. Such research can help ascertain the direction of effect, which is needed for establishing evidence-based guidelines for parents regarding the use of food to soothe early in life.

Prenatal Maternal Distress: A Risk Factor for Child Anxiety?

The deleterious association between various types of prenatal maternal psychological distress (PNMS, anxiety, depression, psychological distress, stress) and childhood anxiety symptomatology (internalizing behaviors, anxiety symptoms) has been established using both retrospective and prospective longitudinal studies across varied demographic cohorts and throughout development. Yet, the existing literature cannot claim maternal distress during pregnancy to be a specific risk factor for anxiety symptomatology, as studies utilizing such observational designs are unable to adequately account for confounding of potential genetic factors and the postnatal environment. In this review, we examine studies that attempt to minimize such confounding and thus disentangle the unique intrauterine exposure effect of varying types of PNMS on childhood anxiety symptomatology. Such methodologies include paternal versus maternal comparison studies, sibling comparisons, prenatal cross-fostering designs and timing of exposure studies (including disaster studies). Of the identified studies, findings indicate that prenatal maternal distress is likely to constitute a risk factor for anxiety symptomatology, although more studies are needed to replicate current findings in order to determine whether there are clear differences in effects across specific types of PNMS and for specific subpopulations. We review the methodological limitations and strengths of the literature prior to exploring avenues of future research and implications for theory and clinical practice.

Frequent Bullying Involvement and Brain Morphology in Children

Background: Over the past few decades, bullying has been recognized as a considerable public health concern. Involvement in bullying is associated with poor long-term social and psychiatric outcomes for both perpetrators and targets of bullying. Despite this concerning prognosis, few studies have investigated possible neurobiological correlates of bullying involvement that may explain the long-term impact of bullying. Cortical thickness is ideally suited for examining deviations in typical brain development, as it has been shown to detect subtle differences in children with psychopathology. We tested associations between bullying involvement and cortical thickness using a large, population-based cohort. Methods: The study sample consisted of 2,602 participants from the Generation R Study. When children were 8 years old, parents and teachers reported on common forms of child bullying involvement (physical, verbal, and relational). Questions ascertained whether a child was involved as a perpetrator (n = 82), a target of bullying (n = 92), as a combined perpetrator and target of bullying (n = 47), or uninvolved in frequent bullying (n = 2,381). High-resolution structural MRI was conducted when children were 10 years of age. Cortical thickness estimates across the cortical mantle were compared among groups. Results: Children classified as frequent targets of bullying showed thicker cortex in the fusiform gyrus compared to those uninvolved in bullying (B = 0.108, p _corrected < 0.001). Results remained consistent when adjusted for socioeconomic factors, general intelligence, and psychiatric symptoms. Children classified as frequent perpetrators showed thinner cortex in the cuneus region; however, this association did not survive stringent correction for multiple testing. Lastly, no differences in cortical thickness were observed in perpetrator-targets. Discussion: Bullying involvement in young children was associated with differential cortical morphology. Specifically, the fusiform gyrus, often involved in facial processing, showed thicker cortex in targets of frequent bullying. Longitudinal data are necessary to demonstrate the temporality of the underlying neurobiology associated with bullying involvement.

Prenatal stress and genetic risk: How prenatal stress interacts with genetics to alter risk for psychiatric illness

Risk for neuropsychiatric disorders is complex and includes an individual's internal genetic endowment and their environmental experiences and exposures. Embryonic development captures a particularly complex period, in which genetic and environmental factors can interact to contribute to risk. These environmental factors are incorporated differently into the embryonic brain than postnatal one. Here, we comprehensively review the human and animal model literature for studies that assess the interaction between genetic risks and one particular environmental exposure with strong and complex associations with neuropsychiatric outcomes-prenatal maternal stress. Gene-environment interaction has been demonstrated for stress occurring during childhood, adolescence, and adulthood. Additional work demonstrates that prenatal stress risk may be similarly complex. Animal model studies have begun to address some underlying mechanisms, including particular maternal or fetal genetic susceptibilities that interact with stress exposure and those that do not. More specifically, the genetic underpinnings of serotonin and dopamine signaling and stress physiology mechanisms have been shown to be particularly relevant to social, attentional, and internalizing behavioral changes, while other genetic factors have not, including some growth factor and hormone-related genes. Interactions have reflected both the diathesis-stress and differential susceptibility models. Maternal genetic factors have received less attention than those in offspring, but strongly modulate impacts of prenatal stress. Priorities for future research are investigating maternal response to distinct forms of stress and developing whole-genome methods to examine the contributions of genetic variants of both mothers and offspring, particularly including genes involved in neurodevelopment. This is a burgeoning field of research that will ultimately contribute not only to a broad understanding of psychiatric pathophysiology but also to efforts for personalized medicine.

Multi-Informant and Multicultural Advances in Evidence-Based Assessment of Students’ Behavioral/Emotional/Social Difficulties

Abstract. This article presents practical tools for evidence-based assessment of students’ behavioral/emotional/social difficulties and strengths in culturally sensitive ways. The assessment instruments obtain teacher, parent, and student ratings, plus observations in classrooms and other group settings, in interviews, and in testing sessions. To document differences in students’ functioning in school and other contexts, plus differences between teacher, parent, and student perspectives, users can display cross-informant comparisons of ratings of specific difficulties items. Users can also display cross-informant comparisons between bar graphs of scores on empirically derived syndromes, DSM-oriented scales, Internalizing, Externalizing, and Total Problems. Scale scores are standardized according to norms for students’ gender and age, type of informant (teacher, parent, student), and multicultural norms. Multicultural norms are based on teacher, parent, and student ratings of population samples of students in many societies. The ratings were used to construct gender-, age-, and informant-specific norms for societies having relatively low difficulties scores, medium scores, or high scores. The assessment instruments can be used to identify students who need help and to tailor interventions to students’ needs. The same instruments can be used to measure changes by comparing pre- versus post-intervention scores. Brief instruments assess progress over short periods.

Polygenic scores for schizophrenia and educational attainment are associated with behavioural problems in early childhood in the general population

BACKGROUND

Genome-wide association studies in adults have identified numerous genetic variants related to psychiatric disorders and related traits, such as schizophrenia and educational attainment. However, the effects of these genetic variants on behaviour in the general population remain to be fully understood, particularly in younger populations. We investigated whether polygenic scores of five psychiatric disorders and educational attainment are related to emotional and behaviour problems during early childhood.

METHODS

From the Generation R Study, we included participants with available genotype data and behavioural problems measured with the Child Behavior Checklist (CBCL) at the age of 3 (n = 1,902), 6 (n = 2,202) and 10 years old (n = 1,843). Polygenic scores were calculated for five psychiatric disorders and educational attainment. These polygenic scores were tested for an association with the broadband internalizing and externalizing problem scales and the specific CBCL syndrome scale scores.

RESULTS

Analysis of the CBCL broadband scales showed that the schizophrenia polygenic score was associated with significantly higher internalizing scores at 3, 6 and 10 years and higher externalizing scores at age 3 and 6. The educational attainment polygenic score was associated with lower externalizing scores at all time points and lower internalizing scores at age 3. No associations were observed for the polygenic scores of bipolar disorder, major depressive disorder and autism spectrum disorder. Secondary analyses of specific syndrome scores showed that the schizophrenia polygenic score was strongly related to the Thought Problems scores. A negative association was observed between the educational attainment polygenic score and Attention Problems scores across all age groups.

CONCLUSIONS

Polygenic scores for adult psychiatric disorders and educational attainment are associated with variation in emotional and behavioural problems already at a very early age.

Maternal depressive symptoms during pregnancy are associated with amygdala hyperresponsivity in children

Depression during pregnancy is highly prevalent and has a multitude of potential risks of the offspring. Among confirmed consequences is a higher risk of psychopathology. However, it is unknown how maternal depression may impact the child's brain to mediate this vulnerability. Here we studied amygdala functioning, using task-based functional MRI, in children aged 6-9 years as a function of prenatal maternal depressive symptoms selected from a prospective population-based sample (The Generation R Study). We show that children exposed to clinically relevant maternal depressive symptoms during pregnancy (N = 19) have increased amygdala responses to negative emotional faces compared to control children (N = 20) [F(1,36) 7.02, p = 0.022]. Strikingly, postnatal maternal depressive symptoms, obtained at 3 years after birth, did not explain this relation. Our findings are in line with a model in which prenatal depressive symptoms of the mother are associated with amygdala hyperresponsivity in her offspring, which may represent a risk factor for later-life psychopathology.

Paediatric population neuroimaging and the Generation R Study: the second wave

Paediatric population neuroimaging is an emerging field that falls at the intersection between developmental neuroscience and epidemiology. A key feature of population neuroimaging studies involves large-scale recruitment that is representative of the general population. One successful approach for population neuroimaging is to embed neuroimaging studies within large epidemiological cohorts. The Generation R Study is a large, prospective population-based birth-cohort in which nearly 10,000 pregnant mothers were recruited between 2002 and 2006 with repeated measurements in the children and their parents over time. Magnetic resonance imaging was included in 2009 with the scanning of 1070 6-to-9-year-old children. The second neuroimaging wave was initiated in April 2013 with a total of 4245 visiting the MRI suite and 4087 9-to-11-year-old children being scanned. The sequences included high-resolution structural MRI, 35-direction diffusion weighted imaging, and a 6 min and 2 s resting-state functional MRI scan. The goal of this paper is to provide an overview of the imaging protocol and the overlap between the neuroimaging data and metadata. We conclude by providing a brief overview of results from our first wave of neuroimaging, which highlights a diverse array of questions that can be addressed by merging the fields of developmental neuroscience and epidemiology.

Automated quality assessment of structural magnetic resonance images in children: Comparison with visual inspection and surface-based reconstruction

Motion-related artifacts are one of the major challenges associated with pediatric neuroimaging. Recent studies have shown a relationship between visual quality ratings of T₁ images and cortical reconstruction measures. Automated algorithms offer more precision in quantifying movement-related artifacts compared to visual inspection. Thus, the goal of this study was to test three different automated quality assessment algorithms for structural MRI scans. The three algorithms included a Fourier-, integral-, and a gradient-based approach which were run on raw T₁ -weighted imaging data collected from four different scanners. The four cohorts included a total of 6,662 MRI scans from two waves of the Generation R Study, the NIH NHGRI Study, and the GUSTO Study. Using receiver operating characteristics with visually inspected quality ratings of the T₁ images, the area under the curve (AUC) for the gradient algorithm, which performed better than either the integral or Fourier approaches, was 0.95, 0.88, and 0.82 for the Generation R, NHGRI, and GUSTO studies, respectively. For scans of poor initial quality, repeating the scan often resulted in a better quality second image. Finally, we found that even minor differences in automated quality measurements were associated with FreeSurfer derived measures of cortical thickness and surface area, even in scans that were rated as good quality. Our findings suggest that the inclusion of automated quality assessment measures can augment visual inspection and may find use as a covariate in analyses or to identify thresholds to exclude poor quality data.

Infant Neuromotor Development and Childhood Problem Behavior

BACKGROUND

Research of adults and school-aged children suggest a neurodevelopmental basis for psychiatric disorders. We examined whether infant neuromotor development predicted internalizing and externalizing problems in young children.

METHODS

In Generation R, a population-based cohort in the Netherlands (2002-2006), trained research assistants evaluated the neuromotor development of 4006 infants aged 2 to 5 months by using an adapted version of Touwen's Neurodevelopmental Examination (tone, responses, and senses and other observations). We defined nonoptimal neuromotor development as scores in the highest tertile. Mothers and fathers rated their children's behavior at ages 1.5, 3, 6, and 10 years with the Child Behavior Checklist (n = 3474, response: 86.7%). The associations were tested with generalized linear mixed models.

RESULTS

Overall, neuromotor development predicted internalizing scores, but no association was observed with externalizing scores. Nonoptimal muscle tone was associated with higher internalizing scores (mothers' report: β = .07; 95% confidence interval [CI]: 0.01 to 0.13; fathers' report: β = .09, 95% CI: 0.00 to 0.16). In particular, nonoptimal low muscle tone was associated with higher internalizing scores (mothers' report: β = .11; 95% CI: 0.05 to 0.18; fathers' report: β = .13; 95% CI: 0.04 to 0.22). We also observed an association between senses and other observations with internalizing scores. There was no relationship between high muscle tone or reflexes and internalizing scores.

CONCLUSIONS

Common emotional problems in childhood have a neurodevelopmental basis in infancy. Neuromotor assessment in infancy may help identify vulnerability to early internalizing symptoms and offer the opportunity for targeted interventions.

Structure, longitudinal invariance, and stability of the Child Behavior Checklist 1½-5's Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Disorder scale: Findings from Generation R (Rotterdam)

Although the Child Behavior Checklist 1½-5's 12-item Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Problems Scale (formerly called Pervasive Developmental Problems scale) has been used in several studies as an autism spectrum disorder screener, the base rate and stability of its items and its measurement model have not been previously studied. We therefore examined the structure, longitudinal invariance, and stability of the Child Behavior Checklist 1½-5's Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Problems Scale in the diverse Generation R (Rotterdam) sample based on mothers' ratings at 18 months (n = 4695), 3 years (n = 4571), and 5 years (n = 5752). Five items that seemed especially characteristic of autism spectrum disorder had low base rates at all three ages. The rank order of base rates for the 12 items was highly correlated over time (Qs ⩾ 0.86), but the longitudinal stability of individual items was modest (phi coefficients = 0.15-0.34). Confirmatory factor analyses indicated that the autism spectrum disorder scale model manifested configural, metric, and scalar longitudinal invariance over the time period from 18 months to 5 years, with large factor loadings. Correlations over time for observed autism spectrum disorder scale scores (0.25-0.50) were generally lower than the correlations across time of the latent factors (0.45-0.68). Results indicated significant associations of the autism spectrum disorder scale with later autism spectrum disorder diagnoses.

Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description

The Adolescent Brain and Cognitive Development (ABCD) Study incorporates a comprehensive range of measures assessing predictors and outcomes related to both mental and physical health across childhood and adolescence. The workgroup developed a battery that would assess a comprehensive range of domains that address study aims while minimizing participant and family burden. We review the major considerations that went into deciding what constructs to cover in the demographics, physical health and mental health domains, as well as the process of selecting measures, piloting and refining the originally proposed battery. We present a description of the baseline battery, as well as the six-month interim assessments and the one-year follow-up assessments. This battery includes assessments from the perspectives of both the parent and the target youth, as well as teacher reports. This battery will provide a foundational baseline assessment of the youth's current function so as to permit characterization of stability and change in key domains over time. The findings from this battery will also be utilized to identify both resilience markers that predict healthy development and risk factors for later adverse outcomes in physical health, mental health, and substance use and abuse.

Agreement between Weight Status and Perceived Body Size and the Association with Body Size Satisfaction in Children

OBJECTIVE

Extensive evidence suggests that children and adolescents often inaccurately perceive their body size. However, the extent of this misperception is unclear. This paper describes the agreement between children's actual weight and the perception of body size (self-reported and maternally reported) and the association of actual weight with self-reported body satisfaction.

METHODS

In a population-based cohort study of 3,408 children aged 9 to 10 years, we assessed the children's self-perception and ideal perception of their body size with the Children's Body Image Scale. Maternal perception of offspring body size was assessed with the question "How would you describe your child at the moment?" Children's height and weight were measured.

RESULTS

Children tended to rate themselves toward average proportions; e.g., 83.0% of 499 children with overweight/obesity perceived themselves as less heavy then they were. Of those who underestimated their body size, most (79.2%) had a desire to be thinner; all of the children who correctly recognized their overweight/obesity had such a desire.

CONCLUSIONS

Despite the misperception of body size, the majority of children with overweight/obesity indicated dissatisfaction with their body size, suggesting more self-awareness than would be assumed based on the self-perception assessment of body size alone.

Children with Obsessive-Compulsive Symptomology in the General Population: Different Subtypes?

OBJECTIVE

Obsessive-compulsive disorder (OCD) is a moderately prevalent neurodevelopmental disorder, and many children suffer from subclinical obsessive-compulsive (OC) symptoms. The disorder is heterogeneous and has high comorbidity rates. In early disease stages of psychiatric disorders, symptoms are typically hard to attribute exclusively to specific disorders. The authors investigated whether profiles of neuropsychiatric symptoms can be distinguished within a large population-based study of school-aged children (7-10 years) scoring high on OC symptoms.

METHODS

OC symptoms and comorbid symptoms common in pediatric OCD were assessed: symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, autism, and anxiety. Latent profile analysis was performed on the subgroup of children scoring high on OC symptoms (high-OC sample, n = 209, i.e., 4.5% of total sample, n = 4632) using the z scores of the measures of comorbid symptoms as indicators.

RESULTS

Three distinguishable profiles were found within the high-OC sample. The first subgroup ("OC-specific"; 81.3%, 3.7% of total sample) had only OC-specific problems, the second subgroup ("Comorbid OC"; 11.0%, 0.5% of total sample) had high scores on all measures of comorbid symptomology, and the third subgroup ("Autistic OC"; 7.7%, 0.3%, of total sample) scored especially high on autism.

CONCLUSION

The findings show that profiles based on neuropsychiatric symptoms can be distinguished within a population-based sample of school-aged children scoring high on obsessive-compulsive symptoms. These profiles may be useful in establishing patterns of symptom course during development. Longitudinal follow-up is necessary to ascertain whether at a later age these subgroups still differ in their symptom profile and neuropsychiatric trajectory.

Predicting hair cortisol levels with hair pigmentation genes: a possible hair pigmentation bias

Cortisol concentrations in hair are used to create hormone profiles spanning months. This method allows assessment of chronic cortisol exposure, but might be biased by hair pigmentation: dark hair was previously related to higher concentrations. It is unclear whether this association arises from local effects, such as increased hormone extractability, or whether the association represents systemic differences arising from population stratification. We tested the hypothesis that hair pigmentation gene variants are associated with varying cortisol levels independent of genetic ancestry. Hormone concentrations and genotype were measured in 1674 children from the Generation R cohort at age 6. We computed a polygenic score of hair color based on 9 single nucleotide polymorphisms. This score was used to predict hair cortisol concentrations, adjusted for genetic ancestry, sex, age and corticosteroid use. A 1-standard deviation (SD) higher polygenic score (darker hair) was associated with 0.08 SD higher cortisol levels (SE = 0.03, p = 0.002). This suggests that variation in hair cortisol concentrations is partly explained by local hair effects. In multi-ancestry studies this hair pigmentation bias can reduce power and confound results. Researchers should therefore consider adjusting analyses by reported hair color, by polygenic scores, or by both.

Neuroanatomical correlates of donating behavior in middle childhood

The neurobiological correlates of prosocial behavior are largely unknown. We examined brain structure and functional connectivity correlates of donating to a charity, a specific, costly, form of prosocial behavior. In 163 children, donating was measured using a promotional clip for a charity including a call for donations. Children could decide privately whether and how much they wanted to donate from money they had received earlier. Whole brain structural MRI scans were obtained to study associations between cortical thickness and donating behavior. In addition, resting state functional MRI scans were obtained to study whole brain functional connectivity and to examine functional connectivity between regions identified using structural MRI. In the lateral orbitofrontal cortex/pars orbitalis and pre-/postcentral cortex, a thicker cortex was associated with higher donations. Functional connectivity with these regions was not associated with donating behavior. These results suggest that donating behavior is not only situationally driven, but is also related brain morphology. The absence of functional connectivity correlates might imply that the associations with cortical thickness are involved in different underlying mechanisms of donating.

The honest truth about deception: Demographic, cognitive, and neural correlates of child repeated deceptive behavior

This study examined situational, psychological, and neurobiological factors associated with deceptive behavior in 8-year-old children. By assessing deception in low- and high-risk conditions, we differentiated between children displaying some dishonesty and children who deceived repeatedly, and we assessed the correlates of deception in 163 children. A large majority of the children were deceptive in the low-risk condition (n=121, 74.2%), but most children refrained from deception when at risk for getting caught (69 of 121). Using an aggregate score, children who continued deceiving could be discriminated from other children based on gender, lower age, lower IQ, less effortful control, and lower educated mothers. Compared with honest children and high-risk deceivers, low-risk deceivers differed on an aggregate score, suggesting that they were more likely to be girls and to come from higher income families. Compared with the other children, high-risk deceivers showed decreased activation in the bilateral anterior cingulate cortex (ACC) and right frontal pole during the low-risk condition, suggesting decreased engagement in conflict monitoring and error detection during opportunities for deception. In high-risk deceivers, high-risk deception was associated with increased bilateral ACC and right paracingulate gyrus activation compared with low-risk deception. High-risk deceivers may require a higher level of risk to engage the ACC to the same degree as low-risk deceivers or honest children. Our results suggest that deceptive behavior in children seems to be largely dependent on the estimated likelihood of getting caught. High-risk deceivers form a distinct group with different cognitive and neurobiological characteristics compared with honest children and low-risk deceivers.

The Prospective Association of the Diurnal Cortisol Rhythm With Sleep Duration and Perceived Sleeping Problems in Preschoolers: The Generation R Study

OBJECTIVE

Cortisol, the end product of the hypothalamic-pituitary-adrenal axis, plays an important role in modulating sleep. Yet, studies investigating the association between diurnal cortisol rhythm and sleep patterns in young children are scarce. We tested the hypothesis that the diurnal cortisol rhythm is associated with shorter sleep duration and more sleep problems across early childhood.

METHODS

This study was embedded in Generation R, a population-based cohort from fetal life onward. Parents collected saliva samples from their infant at five moments during day 1. In 322 infants aged 12 to 20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Sleep duration and sleep behavior were repeatedly assessed across ages of 14 months to 5 years. Generalized estimating equation models were used to assess related cortisol measures to sleep duration and sleep behavior.

RESULTS

The diurnal cortisol slope and the CAR, but not the AUC, were associated with sleep duration across childhood. Children with flatter slopes and children with a more positive CAR were more likely to have shorter nighttime sleep duration (β per nmol/L/h slope = -0.12, 95% confidence interval = -0.19 to -0.05, p = .001; β per nmol/L CAR = -0.01, 95% confidence interval = -0.02 to 0.00, p = .04). Cortisol measures did not predict sleep problems.

CONCLUSIONS

The present study suggests that a flatter diurnal cortisol slope and a more marked morning rise, which can indicate stress (or hypothalamic-pituitary-adrenal dysregulation), have a long-term association with sleep regulation.

Insensitive parenting may accelerate the development of the amygdala–medial prefrontal cortex circuit

This study examined whether the association between age and amygdala–medial prefrontal cortex (mPFC) connectivity in typically developing 6- to 10-year-old children is correlated with parental care. Resting-state functional magnetic resonance imaging scans were acquired from 124 children of the Generation R Study who at 4 years old had been observed interacting with their parents to assess maternal and paternal sensitivity. Amygdala functional connectivity was assessed using a general linear model with the amygdalae time series as explanatory variables. Higher level analyses assessing Sensitivity × Age as well as exploratory Sensitivity × Age × Gender interaction effects were performed restricted to voxels in the mPFC. We found significant Sensitivity × Age interaction effects on amygdala–mPFC connectivity. Age was related to stronger amygdala–mPFC connectivity in children with a lower combined parental sensitivity score (b = 0.11, p = .004, b = 0.06, p = .06, right and left amygdala, respectively), but not in children with a higher parental sensitivity score, (b = –0.07, p = .12, b = –0.06, p = .12, right and left amygdala, respectively). A similar effect was found for maternal sensitivity, with stronger amygdala–mPFC connectivity in children with less sensitive mothers. Exploratory (parental, maternal, paternal) Sensitivity × Age × Gender interaction analyses suggested that this effect was especially pronounced in girls. Amygdala-mPFC resting-state functional connectivity has been shown to increase from age 10.5 years onward, implying that the positive association between age and amygdala–mPFC connectivity in 6- to 10-year-old children of less sensitive parents represents accelerated development of the amygdala–mPFC circuit.

Bi-directional associations between child fussy eating and parents' pressure to eat: Who influences whom?

Background

Fussy eating is common in young children, often raising concerns among parents. The use of pressuring feeding practices may provoke or worsen child fussiness, but these practices could equally be a parent’s response to child fussy eating.

Objective

In longitudinal analyses, we assessed directionality in the relation between fussy eating and parent’s pressure to eat across childhood.

Methods

Study participants were 4845 mother-child dyads from the population-based Generation R cohort in the Netherlands. The Child Behavior Checklist was used to assess fussy eating (2 items) at child ages 1½, 3 and 6 years. Parents’ pressure to eat was assessed with the Child Feeding Questionnaire (4 items) when children were 4 years old. All scale scores were standardized.

Results

Linear regression analyses indicated that preschoolers’ fussy eating prospectively predicted higher levels of parents’ pressure to eat at child age 4 years, independently of confounders (adjusted B=0.24, 95% CI: 0.21, 0.27). Pressure to eat at 4 years also predicted more fussiness in children at age 6 years, independently of confounders and of fussy eating at baseline (adjusted B=0.14, 95% CI: 0.11, 0.17). Path analyses indicated that the relation from fussy eating at 3 years to parenting one year later was stronger than from pressure at 4 years to fussy eating two years later (p<0.001).

Conclusions

Our findings suggest bi-directional associations with parental pressuring feeding strategies being developed in response to children’s food avoidant behaviors, but also seemingly having a counterproductive effect on fussiness. Thus, the use of pressure to eat should be reconsidered, while providing parents alternative techniques to deal with their child’s fussy eating.

Infant muscle tone and childhood autistic traits: A longitudinal study in the general population

In a longitudinal population-based study of 2,905 children, we investigated if infants' neuromotor development was associated with autistic traits in childhood. Overall motor development and muscle tone were examined by trained research assistants with an adapted version of Touwen's Neurodevelopmental Examination between ages 2 and 5 months. Tone was assessed in several positions and items were scored as normal, low, or high tone. Parents rated their children's autistic traits with the Social Responsiveness Scale (SRS) and the Pervasive Developmental Problems (PDP) subscale of the Child Behavior Checklist at 6 years. We defined clinical PDP if scores were >98th percentile of the norm population. Diagnosis of autism spectrum disorder (ASD) was clinically confirmed in 30 children. We observed a modest association between overall neuromotor development in infants and autistic traits. Low muscle tone in infancy predicted autistic traits measured by SRS (adjusted beta = 0.05, 95% CI for B: 0.00-0.02, P = 0.01), and PDP (adjusted beta = 0.08, 95% CI for B: 0.04-0.10, P < 0.001). Similar results emerged for the association of low muscle tone and clinical PDP (adjusted OR = 1.36, 95% CI: 1.08-1.72, P = 0.01) at age 6 years. Results remained unchanged if adjusted for child intelligence. There was no association between high muscle tone and SRS or PDP. Exclusion of children with ASD diagnosis did not change the association. This large study showed a prospective association of infant muscle tone with autistic traits in childhood. Our findings suggest that early detection of low muscle tone might be a gateway to improve early diagnosis of ASD. Autism Res 2017, 10: 757-768. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

The Stability of Problem Behavior Across the Preschool Years: An Empirical Approach in the General Population

This study examined the stability of internalizing and externalizing problems from age 1.5 to 6 years, while taking into account developmental changes in the presentation of problems. The study comprised a population-based cohort of 7,206 children (50.4 % boys). At ages 1.5, 3, and 6 years, mothers reported on problem behavior using the Child Behavior Checklist/1.5-5 (CBCL/1.5-5). At each age we performed latent profile analysis on the CBCL/1.5-5 scales. Latent transition analysis (LTA) was applied to study the stability of problem behavior. Profiles of problem behavior varied across ages. At each age, 82–87 % of the children did not have problems whereas approximately 2 % showed a profile of co-occurring internalizing and externalizing problems. This profile was more severe (with higher scores) at 6 years than at earlier ages. A predominantly internalizing profile only emerged at 6 years, while a profile with externalizing problems and emotional reactivity was present at each age. LTA showed that, based on profiles at 1.5 and 3 years, it was difficult to predict the type of profile at 6 years. Children with a profile of co-occurring internalizing and externalizing problems early in life were most likely to show problem behavior at 6 years. This study shows that the presentation of problem behavior changes across the preschool period and that heterotypic continuity of problems is very common among preschoolers. Children with co-occurring internalizing and externalizing problems were most likely to show persisting problems. The use of evidence-based treatment for these young children may prevent psychiatric problems across the life course.

Beyond main effects of gene-sets: harsh parenting moderates the association between a dopamine gene-set and child externalizing behavior

BACKGROUND

In a longitudinal cohort study, we investigated the interplay of harsh parenting and genetic variation across a set of functionally related dopamine genes, in association with children's externalizing behavior. This is one of the first studies to employ gene-based and gene-set approaches in tests of Gene by Environment (G × E) effects on complex behavior. This approach can offer an important alternative or complement to candidate gene and genome-wide environmental interaction (GWEI) studies in the search for genetic variation underlying individual differences in behavior.

METHODS

Genetic variants in 12 autosomal dopaminergic genes were available in an ethnically homogenous part of a population-based cohort. Harsh parenting was assessed with maternal (n = 1881) and paternal (n = 1710) reports at age 3. Externalizing behavior was assessed with the Child Behavior Checklist (CBCL) at age 5 (71 ± 3.7 months). We conducted gene-set analyses of the association between variation in dopaminergic genes and externalizing behavior, stratified for harsh parenting.

RESULTS

The association was statistically significant or approached significance for children without harsh parenting experiences, but was absent in the group with harsh parenting. Similarly, significant associations between single genes and externalizing behavior were only found in the group without harsh parenting. Effect sizes in the groups with and without harsh parenting did not differ significantly. Gene-environment interaction tests were conducted for individual genetic variants, resulting in two significant interaction effects (rs1497023 and rs4922132) after correction for multiple testing.

CONCLUSION

Our findings are suggestive of G × E interplay, with associations between dopamine genes and externalizing behavior present in children without harsh parenting, but not in children with harsh parenting experiences. Harsh parenting may overrule the role of genetic factors in externalizing behavior. Gene-based and gene-set analyses offer promising new alternatives to analyses focusing on single candidate polymorphisms when examining the interplay between genetic and environmental factors.

Resting-state networks in 6-to-10 year old children

Resting-state functional magnetic resonance imaging provides a non-invasive approach to the study of intrinsic functional brain networks. When applied to the study of brain development, most studies consist of relatively small samples that are not always representative of the general population. Descriptions of these networks in the general population offer important insight for clinical studies examining, for instance, psychopathology or neurological conditions. Thus our goal was to characterize resting-state networks in a large sample of children using independent component analysis (ICA). The study further aimed to describe the robustness of these networks by examining which networks occur frequently after repeated ICA. Resting-state networks were obtained from a sample of 536 6-to-10 year old children. Distributions of networks were built from repeated subsampling and group ICA analyses, and meta-ICA was used to construct a representative set of components. Within- and between-network properties were tested for age-related developmental associations using spatio-temporal regression. After repeated ICA, many networks were present over 95% of the time suggesting the components are highly reproducible. Some networks were less robust, and were observed less than 70% of the time. Age-related associations were also observed in a selection of networks, including the default-mode network, offering further evidence of development in these networks at an early age. ICA-derived resting-state networks appear to be robust, although some networks should further scrutinized if subjected to group-level statistical analyses, such as spatiotemporal regression. The final set of ICA-derived networks and an age-appropriate T₁ -weighted template are made available to the neuroimaging community, https://www.nitrc.org/projects/genr. Hum Brain Mapp 37:4286-4300, 2016. © 2016 Wiley Periodicals, Inc.