Internalizing and externalizing problems in adolescence: general and dimension-specific effects of familial loadings and preadolescent temperament traits

An examination of the relationship between conduct problems and depressive symptoms comorbidity and temperament among elementary school children

Although the comorbidity between conduct problems (CP) and depressive symptoms (DS) is associated with a host of negative outcomes, the factors, such as temperament, that might explain this comorbidity in school-aged boys and girls are poorly understood. This study compared elementary school children presenting co-occurring CP and DS to children with DS only, CP only, and those with low-level symptoms on temperament dimensions, and explored the moderating role of child sex in the associations. Participants are 487 children (M = 8.38 years, SD = 0.92, 52.2% girls) divided into four groups (CP + DS, DS only, CP only, control). Findings suggest that boys with CP and DS presented a lower level of fear than boys with DS and boys from the control group. They also presented higher levels of activity than boys with DS. Girls with CP and DS presented lower levels of fear than girls with DS, lower levels of approach and activity than girls with CP, and higher levels of shyness than girls from the control group. These findings suggest that temperament may discriminate children with comorbid CP and DS from those presenting only CP or DS.

Functional Gastrointestinal Symptoms in Children with Autism and ADHD: Profiles of Hair and Salivary Cortisol, Serum Leptin Concentrations and Externalizing/Internalizing Problems

BACKGROUND

Functional Gastrointestinal Disorders (FGIDs) present a higher prevalence in individuals with Neurodevelopmental Disorders (NDDs). The Stress System and the Gut-Brain axis (GBA) may mediate these relations. We aimed to assess the prevalence and profile of FGIDs in a clinical sample of children with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) compared to typically developing children (TD) as well as to investigate possible relations between stress-related biomarkers and internalizing/externalizing problems in children with NDDS.

METHODS

In total, 120 children, aged between 4 and 12 years old, formed three groups (N = 40, each): ADHD, ASD and TD. Salivary cortisol, hair cortisol and serum leptin were measured.

RESULTS

The ASD group had more FGID problems than the TD group (p = 0.001). The ADHD and ASD groups had higher total internalizing/externalizing problems than the TD group (p < 0.0001, p < 0.0001, p = 0.005, respectively). Children with FGIDs showed more total, internalizing and externalizing problems compared to children without FGIDs (p < 0.0001, p < 0.0001, p = 0.041, respectively). The ADHD group showed lower AUCg values (p < 0.0001), while the hair cortisol was higher for the TD group (p < 0.0001).

CONCLUSION

In conclusion, children with NDDs had more FGID symptoms and present higher internalizing and externalizing problems. Children with ADHD and FGIDs had more internalizing problems compared to those without FGIDs. No differences in stress-related biomarkers were shown to differentiate children with NDDs with and without FGIDs. Future prospective studies including a greater number of children may elucidate the biological pathways linking these comorbidities.

Family dysfunction, stressful life events, and mental health problems across development in the offspring of parents with an affective disorder

BACKGROUND

Offspring of parents with affective disorders (OAD) are at risk of developing a wide range of mental disorders. Deficits in the rearing environment and high levels of stress are well-known risk factors for negative outcomes in OAD. Building on prior research, we aim to examine the longitudinal relationships between family dysfunction, stressful life events, and mental health in OAD and control offspring of parents with no affective disorder. In the present study, we hypothesized that high levels of family dysfunction would be associated with more internalizing and externalizing problems across time in OAD than in controls, and that family dysfunction would mediate the relationship between stressful life events in adolescence and poor mental health in adulthood, particularly in OAD.

METHODS

As part of the TRacking Adolescents' Lives Survey (TRAILS), 2230 participants (51% female, Mage = 11.1 years, SD = 0.6, at baseline) and their parents completed measures across six time points, spanning 15 years. Mental health, family dysfunction, and stressful life events were assessed with the Youth and Adult Self-Report, Family Assessment Device, and an in-house measure, respectively.

RESULTS

Multi-group structured equation modeling revealed that family dysfunction was linked to internalizing and externalizing problems in OAD, but not controls, across time. Risk status did not moderate family dysfunction's mediation of the relationship between stressful life events and negative outcomes in adulthood.

CONCLUSIONS

OAD show high sensitivity to dysfunction in the rearing environment across childhood and adolescence, which supports the use of family based interventions to prevent the development of mental disorders in high-risk youth.

Distal-to-proximal etiologically relevant variables associated with the general (p) and specific factors of psychopathology

BACKGROUND

The general factor of psychopathology, often denoted as p, captures the common variance among a broad range of psychiatric symptoms. Specific factors are co-modeled based on subsets of closely related symptoms. This paper investigated the extent to which wide-ranging genetic, personal, and environmental etiologically relevant variables are associated with p and specific psychopathology factors.

METHODS

Using data from four waves (ages 11-19) of TRAILS, we modeled a bifactor model of p and four specific factors [internalizing, externalizing, ADHD, Autism Spectrum Disorder (ASD)]. Next, we examined the associations of 19 etiologically relevant variables with these psychology factors using path models that organized the variables according to the distal-to-proximal risk principle.

RESULTS

Collectively, the etiologically relevant factors, including temperament traits, accounted for 55% of p's variance, 46% in ADHD, 35% in externalizing, 19% in internalizing, and 7% in ASD. The low 7% is due to insufficient unique variance in ASD indicators that load more strongly on p. Excluding temperament, variables accounted for 29% variance in p, 9% ADHD, 14% EXT, 7% INT, and 4% ASD. Most etiologically relevant factors were generic, predicting p. In addition, we identified effects on specific factors in addition to effects on p (e.g., parental SES, executive functioning); only effects on specific factors (e.g., parental rejection); opposite effects on different factors [e.g., diurnal cortisol (high INT but low EXT, p); developmental delay (high ASD and p but low EXT)]. Frustration, family functioning, parental psychopathology, executive functioning, and fearfulness had strong effects on p.

CONCLUSIONS

(1) Strong generic effects on p suggest that etiologically relevant factors and psychopathology tend to cluster in persons. (2) While many factors predict p, additional as well as opposite effects on specific factors indicate the relevance of specific psychopathology factors in understanding mental disorder. (3) High frustration, neurodevelopmental problems, and a disadvantaged family environment primarily characterize p.

Early childhood hospitalization and problematic behaviors: A propensity score analysis

Existing research suggests that children who experience poverty and hospitalization in early childhood are at risk of developing behavior problems. We examined whether the association between early childhood hospitalization and children's internalizing and externalizing behaviors were moderated by family poverty status and child sex. Participants included 224 children from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. There was no direct association between hospitalization and problematic behaviors. Poverty status during early childhood, but not child sex, significantly moderated the association between hospitalization and externalizing problems. Findings support the need for community programs that promote an integrative approach to healthcare for families experiencing poverty.

Associations between cannabis use, opioid misuse and severe psychological distress in adolescents: A cross-sectional school-based study

BACKGROUND

Cannabis use and nonmedical use of prescription opioids are consumed by a small to moderate number of adolescents. However, little is known about their combined influence on mental health in this age group. This study examined the association between cannabis use, nonmedical use of prescription opioids, or both with serious psychological distress among adolescents and tested if sex could moderate these associations.

METHODS

We based our analyses on cross-sectional data from the 2019 Ontario Student Drug Use and Health Survey, a provincially representative sample of students in grades 7 through 12 (aged 11-20 years or older) across Ontario, Canada (n= 7097; mean age: 15.2 ± 1.2 years). Logistic regression analyses were adjusted for important covariates.

RESULTS

We found that 20.5% reported cannabis use only, 5.8% reported opioid use only, and 5% reported both cannabis and opioid use. Cannabis use only (odds ratio [OR]:1.91; 95% confidence interval [CI]:1.53-2.37), opioid use only (OR: 2.21; 95% CI: 1.63-3.00), and both cannabis and opioid use (OR: 3.24; 95% CI: 2.25-4.66) were associated with greater odds of serious psychological distress after adjustment for covariates. Associations were similar for males and females.

CONCLUSION

The use of both cannabis and opioids is significantly associated with serious psychological distress among adolescents. Adolescents who use both cannabis and opioids represent a small and vulnerable group that should be targeted in future interventions against mental health problems. Health professionals should consider screening for polysubstance use, especially when working with adolescents who use cannabis.

Maternal and Child Depressive Symptoms in a Sample of Low-income Families of Color: The Mediating Role of Child Adaptability

Maternal depressive symptoms are linked with child internalizing concerns, such as depressive symptoms. The impact that maternal depressive symptoms have on the onset and maintenance of child depressive symptoms might be especially salient in families of color who are low-income because of elevated rates of maternal depressive symptoms and environmental stressors in those populations. The relationship between maternal and child depressive symptoms might be partially explained by a child's capacity to flexibly respond to stressors in the environment, a construct known as adaptability. A simple mediation model was conducted with a sample of low-income, Black/African American and Latina mothers and their children (n = 128). Results suggested that child adaptability partially mediated the link between maternal and child depressive symptoms. We discussed how this study can inform research and practice that aim to assist low-income families of color with mental health needs.

Longitudinal patterns of childhood homelessness and early adolescent trajectories of internalising and externalising behaviour

BACKGROUND

Child homelessness has been associated with elevated mental health problems during early adolescence, a period of onset for psychiatric problems. Prior literature has relied on cross-sectional studies, limiting the understanding of temporality and trajectories of psychopathology. We extend prior literature by examining associations between child homelessness and internalising and externalising symptom trajectories in early adolescence, with consideration of timing and persistence of homelessness.

METHODS

Using population-based longitudinal data from the Avon Longitudinal Study of Parents and Children, we used multilevel models to examine the effects of homelessness prior to age 9, the timing of homelessness (eg, early vs middle childhood) and cumulative exposure to homelessness on internalising and externalising trajectories across ages <0-9 years. We also tested for sex differences in these associations.

RESULTS

Of the 8391 participants, 5.5% reported exposure to homelessness at least once before age 9. Children who experienced homelessness had elevated internalising and externalising symptoms compared with their consistently housed peers, with excess risk evident among children who first experienced homelessness in middle childhood (relative to early childhood) and children who experienced recurrent homelessness. We did not observe changes in symptom trajectories over the course of 4 years. Men who experienced homelessness displayed a more pronounced risk of internalising symptoms relative to women and men who did not experience homelessness.

CONCLUSION

Childhood homelessness is associated with persistently elevated internalising and externalising symptoms across early adolescence compared with their consistently housed peers. Interventions and policies to address family homelessness may lead to better mental health among adolescents.

Trajectories of temperament from late childhood through adolescence and associations with anxiety and depression in young adulthood

Anxiety and depression are pervasive and pernicious mental health problems for young adults. Developmental trajectories of adolescent temperament (Effortful Control, Negative Emotionality, and Positive Emotionality) may help us predict who will experience anxiety/depression during young adulthood. The present study used longitudinal data from a large, community sample of Mexican-origin youth ( N = 674) to examine how temperament develops across adolescence (age 10–16) and whether the developmental trajectories of temperament are associated with anxiety/depression during young adulthood (ages 19 and 21). Results indicate that Effortful Control, Negatively Emotionality, and the Affiliation facet of Positive Emotionality tend to decrease across adolescence, whereas Surgency tends to increase. Smaller decreases in Effortful Control and greater increases in Positive Emotionality across adolescence were associated with fewer anxiety/depression symptoms during young adulthood, whereas smaller decreases in Negative Emotionality were associated with more anxiety/depression symptoms later on. Thus, temperament development serves as both a protective factor (Effortful Control, Positive Emotionality) and a risk factor (Negative Emotionality) for later anxiety/depression in Mexican-origin youth.

Latent classes of maladaptive personality traits exhibit differences in social processing

OBJECTIVE

Social processing (SP) deficits manifest across numerous mental disorders. However, this research has been plagued by heterogeneity and a piecemeal approach whereby skills are examined in isolation rather than as part of an integrated cognitive system. Here, we combined two dimensional frameworks of psychopathology to address these limitations.

METHOD

We utilized the Alternative Model for Personality Disorders (AMPD) to distill trait-related heterogeneity within a community sample (n = 200), and the Research Domain Criteria (RDoC) 'Systems for Social Processes' to comprehensively assess SP. We first applied latent class analyses (LCA) to derive AMPD-based groups and subsequently contrasted the performance of these groups on a SP test battery that we developed to align with the RDoC SP constructs.

RESULTS

Our LCA yielded four distinct subgroups. The recognizable trait profiles and psychopathological symptoms of these classes suggested they were clinically meaningful. The subgroups differed in their SP profiles: one displayed deficits regarding the self, a second displayed deficits in understanding others, a third displayed more severe deficits including affiliation problems, whilst the fourth showed normal performance.

CONCLUSIONS

Our results support the link between clusters of maladaptive personality traits and distinctive profiles of SP deficits, which may inform research on disorders involving SP dysfunctions.

Prevalence and early risk factors for bulimia nervosa symptoms in inner-city youth: gender and ethnicity perspectives

BACKGROUND

Research on risk factors associated with bulimia nervosa symptoms (BN) in ethnic minorities has been limited. This study adds to the existing literature by providing the ethnicity- and gender-specific prevalence of BN in US inner-city youth and by exploring the longitudinal associations between a clinical level of BN and early risk factors assessed one year previously.

METHODS

The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2794; 54.1% female; age 11-16 years old (M(SD) = 12.77(1.29)); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on BN and early risk factors (e.g., depressive and anxiety symptoms, posttraumatic stress, somatic complaints). Multivariate analysis of covariance was used to examine the longitudinal associations.

RESULTS

The 3-month BN prevalence was higher in girls (5.1%) than in boys (2.3%) (ratio 2.22:1). Significant differences in BN rates were found between White and African American students (higher in Whites), whereas Hispanic-Americans did not differ significantly from either group. Individuals with BN had significantly higher levels of early risk factors one year prior.

CONCLUSIONS

Timely recognition of BN and associated early risk factors is important for early prevention and intervention strategies.

Effects of Self-Concept on Narcissism: Mediational Role of Perceived Parenting

An increase in narcissism has been reported by experts over the years. Narcissists bring a lot of negative consequences to themselves and to the people around them. This study investigates that perceived parenting leads to the development of inflated, unstable self-concept. The inflated self-concept lays the framework for the development of narcissistic traits among individuals; perceived parenting affects this relationship. A sample of 628 adults was taken from North Cyprus through purposive sampling. Scales for perceived parenting, self-concept, and narcissism were administered. Results showed that the statistically significant variance in the self-concept is explained by perceived parenting. Both mothers and fathers contributed significantly to the development of inflated self-concept. Moreover, multiple linear regression results showed a higher significant variance in narcissistic traits due to self-concept compared with perceived parenting. Mediational tests also showed that high levels of narcissistic traits were indirectly related to self-concept through perceived parenting. The study findings have challenged the notion of only mothers being responsible for narcissistic traits among their children. The study results also suggest that targeting self-concept in individuals with narcissistic traits may be a good directive for therapeutic interventions.

Intergenerational Associations in Crime for an At-Risk Sample of US Men: Factors that May Mitigate or Exacerbate Transmission

PURPOSE

To examine moderation of intergenerational transmission of crime and antisocial behavior of parents to adult arrests of sons (from age 18 years to ages 37-38 years). Moderators examined were from late childhood (constructive parenting and sons' inhibitory control, internalizing symptoms, and cognitive function), adolescence (delinquency and deviant peer association), and early adulthood (educational achievement, employment history, substance use, deviant peer association, and partner antisocial behavior).

METHODS

Study participants were parents and sons (N = 206) from the longitudinal Oregon Youth Study, recruited from schools in the higher crime areas of a medium-sized metropolitan region in the Pacific Northwest. Assessment included official arrest records, school data, interviews, and questionnaires.

RESULTS

As hypothesized, parents' and sons' histories of two or more arrests were significantly associated. Predictions of sons' arrests from a broader construct of parental antisocial behavior were significantly moderated by sons' late childhood cognitive function and early adult employment history, substance use, and romantic partner's antisocial behavior. Overall, there was relatively little intergenerational association in crime at low levels of these moderators.

CONCLUSIONS

Findings indicate relatively large intergenerational associations in crime. The identified moderators may be used as selection criteria or targeted in prevention and treatment efforts aimed at reducing such associations.

Psychometric properties of infant electroencephalography: Developmental stability, reliability, and construct validity of frontal alpha asymmetry and delta-beta coupling

Resting-state electroencephalography (EEG) provides developmental neuroscientists a noninvasive view into the neural underpinnings of cognition and emotion. Recently, the psychometric properties of two widely used neural measures in early childhood-frontal alpha asymmetry and delta-beta coupling-have come under scrutiny. Despite their growing use, additional work examining how the psychometric properties of these neural signatures may change across infancy is needed. The current study examined the developmental stability, split-half reliability, and construct validity of infant frontal alpha asymmetry and delta-beta coupling. Infants provided resting-state EEG data at 8, 12, and 18 months of age (N = 213). Frontal alpha asymmetry and delta-beta coupling showed significant developmental change from 8 to 18 months. Reliability for alpha asymmetry, and alpha, delta, and beta power, individually, was generally good. In contrast, the reliability of delta-beta coupling scores was poor. Associations between frontal alpha asymmetry and approach tendencies generally emerged, whereas stronger (over-coupled) delta-beta coupling scores were associated with profiles of dysregulation and low inhibition. However, the individual associations varied across time and specific measures of interest. We discuss these findings with a developmental lens, highlighting the importance of repeated measures to better understand links between neural signatures and typical and atypical development.

Differential Susceptibility or Diathesis-Stress: Testing the Moderating Role of Temperament and Cortisol Levels between Fathers' Parenting and Children's Aggressive Behavior

Aggression is a multidimensional behavior that could be caused by different biopsychosocial variables. The aim of this study was to explore whether temperament, cortisol and sex moderate the relation between fathers’ parenting style and aggressive behavior in school-aged children, and whether this corresponds to differential susceptibility or diathesis-stress. Participants were 158 children (88 boys and 70 girls) aged 8 years. Aggressive behavior was measured using the Direct and Indirect Aggression Scale and fathers informed about their child’s temperament and their own parenting style through the Children’s Behavior Questionnaire and the Parenting Styles and Dimensions Questionnaire (respectively). Children’s’ baseline saliva cortisol levels were analyzed through an enzyme immunoassay technique. The results revealed that high cortisol levels moderated the relation between fathers’ low levels of authoritative parenting and boys’ aggression. Moreover, high negative emotionality moderated the relation between permissive paternal parenting and girls’ aggressive behavior, with both these relations being consistent with the diathesis-stress theory.

Positive University Environment and Agreeableness as Protective Factors Against Antisocial Behavior in Mexican University Students

Violence in schools is a global issue. Approximately 32% of Mexican students have experienced some form of violence in the school setting in their lives. Previous research has tended to focus on the causes of violence and antisocial behaviors in offenders or adolescent samples and has found evidence to suggest the underlying role of environmental and personal factors. The present study investigates the effect of positive school environment and agreeableness as protective factors against antisocial behaviors in a sample of undergraduate and graduate students (n = 304) from northwestern Mexico. Our results demonstrate that a positive school environment has a negative effect on antisocial behaviors via mood and anxiety disorders as well as in interaction with agreeableness, suggesting an interplay between personality and environment. These findings can provide some basis for the development of university programs aimed at fostering positive environments that promote student mental health and protect against antisocial behaviors.

Genetic influences on externalizing psychopathology overlap with cognitive functioning and show developmental variation

BACKGROUND

Questions remain regarding whether genetic influences on early life psychopathology overlap with cognition and show developmental variation.

METHODS

Using data from 9,421 individuals aged 8-21 from the Philadelphia Neurodevelopmental Cohort, factors of psychopathology were generated using a bifactor model of item-level data from a psychiatric interview. Five orthogonal factors were generated: anxious-misery (mood and anxiety), externalizing (attention deficit hyperactivity and conduct disorder), fear (phobias), psychosis-spectrum, and a general factor. Genetic analyses were conducted on a subsample of 4,662 individuals of European American ancestry. A genetic relatedness matrix was used to estimate heritability of these factors, and genetic correlations with executive function, episodic memory, complex reasoning, social cognition, motor speed, and general cognitive ability. Gene × Age analyses determined whether genetic influences on these factors show developmental variation.

RESULTS

Externalizing was heritable (h2 = 0.46, p = 1 × 10-6), but not anxious-misery (h2 = 0.09, p = 0.183), fear (h2 = 0.04, p = 0.337), psychosis-spectrum (h2 = 0.00, p = 0.494), or general psychopathology (h2 = 0.21, p = 0.040). Externalizing showed genetic overlap with face memory (ρg = -0.412, p = 0.004), verbal reasoning (ρg = -0.485, p = 0.001), spatial reasoning (ρg = -0.426, p = 0.010), motor speed (ρg = 0.659, p = 1x10-4), verbal knowledge (ρg = -0.314, p = 0.002), and general cognitive ability (g)(ρg = -0.394, p = 0.002). Gene × Age analyses revealed decreasing genetic variance (γg = -0.146, p = 0.004) and increasing environmental variance (γe = 0.059, p = 0.009) on externalizing.

CONCLUSIONS

Cognitive impairment may be a useful endophenotype of externalizing psychopathology and, therefore, help elucidate its pathophysiological underpinnings. Decreasing genetic variance suggests that gene discovery efforts may be more fruitful in children than adolescents or young adults.

Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report

Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents' Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10-12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.

Bulimia symptoms in Czech youth: prevalence and association with internalizing problems

OBJECTIVE

Although clinical studies suggest that bulimia symptoms are common in youth, research on the prevalence of such symptoms and of their association with comorbid internalizing problems in the general population has been limited. This study aimed to evaluate the gender-specific prevalence of bulimia symptoms in Czech youth and explored the association between a clinical level of self-reported bulimia symptoms (CLBS) and internalizing problems by gender, controlling for age, socio-economic status and puberty status.

METHOD

The study was conducted on a representative national sample of Czech youth (N = 4430, 57.0% female) using self-report scales. Multivariate analysis of covariance (MANCOVA) was used to examine the associations.

RESULTS

The 3-month CLBS prevalence was higher in girls (11.4%) than in boys (3.8%) and in both genders a CLBS was associated with higher levels of comorbid internalizing problems.

DISCUSSION

Timely recognition of bulimia symptoms and associated risk factors is important for early prevention and intervention strategies.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study (according to Oxford (UK) CEBM Levels of Evidence, 2011).

The General Factor of Psychopathology

An important advance in understanding and defining mental disorders has been the development of empirical approaches to mapping dimensions of dysfunction and their interrelatedness. Such empirical approaches have consistently observed intercorrelations among the many forms of psychopathology, leading to the identification of a general factor of psychopathology (the p factor). In this article, we review empirical support for p, including evidence for the stability and criterion validity of p. Further, we discuss the strong relationship between p and both the general factor of personality and the general factor of personality disorder, substantive interpretations of p, and the potential clinical utility of p. We posit that proposed substantive interpretations of p do not explain the full range of symptomatology typically included in p. The most plausible explanation is that p represents an index of impairment that has the potential to inform the duration and intensity of a client's mental health treatment.

Characteristics of youth with reported family history of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort

Little is known about the impact of family history of psychosis on youth from community samples. To fill this gap, we compared youth with a first-degree relative with psychosis spectrum symptoms (i.e. family history of psychosis spectrum symptoms, FHPS) to youth without FHPS in a cross-sectional analysis of the Philadelphia Neurodevelopmental Cohort (PNC). The PNC is a racially diverse community sample of 9498 youth ages 8-21 years old, of whom 8928 completed the Family Interview for Genetic Studies to determine FHPS status. Polygenic risk score for schizophrenia (PRSS) was available for a subsample of 4433 European Americans. FHPS youth (n = 489) constituted 5.5% of the analytic sample. After adjusting for environmental risk factors (sociodemographic variables and traumatic stressful events), FHPS youth had lower functioning on the Children's Global Assessment Scale and elevated psychosis spectrum, mood, externalizing, and fear symptoms compared to non-FHPS youth (all p < .001). In the European-American subsample, FHPS status was associated with poorer functioning and greater symptom burden in all four psychopathology domains (all p < .001), even after covarying for PRSS. Thus, ascertaining FHPS is important because it is uniquely associated with symptoms and functional impairment in community youth beyond PRS-S and the environmental risk factors we investigated. Future research identifying environmental causes of FHPS-associated impairment could inform the development of interventions for the broad array of symptoms observed in FHPS youth.

Adolescent Personality Pathology and the Alternative Model for Personality Disorders: Self Development as Nexus

This paper reviews maladaptive trait development (DSM-5 Section III Criterion B), the development of DSM-5 Section II borderline personality disorder, and research on the development of identity, self-direction, empathy/mentalizing, and intimacy (DSM-5 Section III Criterion A). Combined, these previously disparate literatures begin to point to an integrated developmental theory of personality pathology, which suggests that Criterion A concepts (identity, self-direction, empathy, and intimacy) coalesce around the development of self, marking a discontinuous (qualitative) developmental shift. This developmental shift is a function of the demands placed on individuals to take on independent adult role function, combined with biologically-based maturational cognitive and emotional advances during adolescence. Section II personality disorder ensues when an integrated and coherent sense of self fails to develop, resulting in nonfulfilment of adult role function. In this sense, Criterion A self function can account for the onset of Section II personality disorder in adolescence, while Criterion B provides a useful descriptive account of continuous aspects of personality function over time.

Associations between Effortful Control, Cortisol Awakening Response, and Depressive Problems in Latino Preadolescents

The present study examined associations between effortful control, a trait marker of self-regulation, adaptive HPA system functioning (as reflected by the CAR), and concurrent and longitudinal depressive problems, in a sample of preadolescent Latino youth (N = 119, mean age = 11.53 years, 59% female). We hypothesized that trait readiness for self-regulation (e.g., effortful control) could be related to physiological state readiness for self-regulation (e.g., CAR), and that both may counter depressive problems. We found that youth's CAR was positively associated with effortful control, and negatively with youth depressive problems. Effortful control and youth depressive problems were also negatively associated. Longitudinal relations of CAR and effortful control on depressive problems at T2 were not significant in the structural equation model after controlling for T1 depressive problems, although these variables were significant in the bivariate correlations. Results suggest that both trait-regulation and physiological regulation may counter depressive problems in Latino youth.

Searching for Social Support Moderates the Relationship Between Polyvictimization and Externalizing Symptoms: A Brief Report

Externalizing disorders emerge most readily during adolescence, especially in traumatized population. In this context, it is necessary to determine the factors influencing these disorders. The aim of this study was to evaluate the role of polyvictimization in developing externalizing symptoms while considering the possible effects of active coping related to the search for social support. The participants were 78 adolescents ( M = 14.18, SD = 1.63) cared for in child and adolescent protection public services in Chile. The results of multiple regression analysis indicated that polyvictimization was a good predictor of externalizing symptoms, but searching for social support acted as a moderator in that relationship. The results show that searching for social support acts as a protective factor and decreases the adverse influence of polyvictimization over externalizing symptoms. Prevention and intervention programs should consider improvements in the coping strategies of poly-victims with externalizing problems.

Assessing Associations in Substance Use across Three Generations: From Grandparents to Sons and from Sons to Their Children

The Three Generational Study (3GS) began in the early 90s and involves the third generation (G3) offspring of second generation (G2) fathers who were originally recruited in 1984 as part of the Oregon Youth Study (OYS) in mid childhood (ages 9-10 years) along with their first- generation (G1) parents. As boys, the G2 fathers lived in higher delinquency neighborhoods of a medium-sized Pacific Northwestern United States city. The OYS-3GS examines questions concerning socially mediated intergenerational transmission versus discontinuity (or moderation) of antisocial behavior, substance use, and related problem behaviors. Questions address influences of the grandparents, or Generation 1 (G1), on their sons in G2 and in turn of these sons and their partners on their own children in G3. In this article, we present an overview of the study design-and underlying theory-related to general and outcome-specific transmission pathways. We then summarize key issues and findings to date related to the current main focus of the study regarding intergenerational associations in substance use.

Perceptual Sensitivity and Response to Strong Stimuli Are Related

To shed new light on the long-standing debate about the (in)dependence of sensitivity to weak stimuli and overreactivity to strong stimuli, we examined the relation between these tendencies within the neurobehavioral framework of the Predictive and Reactive Control Systems (PARCS) theory (Tops et al., 2010, 2014). Whereas previous studies only considered overreactivity in terms of the individual tendency to experience unpleasant affect (punishment reactivity) resulting from strong sensory stimulation, we also took the individual tendency to experience pleasant affect (reward reactivity) resulting from strong sensory stimulation into account. According to PARCS theory, these temperamental tendencies overlap in terms of high reactivity toward stimulation, but oppose each other in terms of the response orientation (approach or avoid). PARCS theory predicts that both types of reactivity to strong stimuli relate to sensitivity to weak stimuli, but that these relationships are suppressed due to the opposing relationship between reward and punishment reactivity. We measured punishment and reward reactivity to strong stimuli and sensitivity to weak stimuli using scales from the Adult Temperament Questionnaire (Evans and Rothbart, 2007). Sensitivity was also measured more objectively using the masked auditory threshold. We found that sensitivity to weak stimuli (both self-reported and objectively assessed) was positively associated with self-reported punishment and reward reactivity to strong stimuli, but only when these reactivity measures were controlled for each other, implicating a mutual suppression effect. These results are in line with PARCS theory and suggest that sensitivity to weak stimuli and overreactivity are dependent, but this dependency is likely to be obscured if punishment and reward reactivity are not both taken into account.

Adolescents' and mothers' temperament types and their roles in early adolescents' socioemotional functioning

The present study examined adolescents’ and mothers’ temperament types and their roles in the socioemotional functioning of early adolescents. A total of 869 sixth-grade students and 668 mothers participated in the study. The students rated their temperament and socioemotional functioning and the mothers rated their own temperament. Latent profile analyses identified four temperament types among the adolescents (resilient, reserved, average, and mixed) and three types among the mothers (resilient, average, and mixed). The results showed that the adolescents with resilient or reserved temperaments reported significantly fewer conduct problems and emotional symptoms, less hyperactivity, and higher prosociality than adolescents with a mixed temperament type. The most adaptive adolescent–mother temperament matches were between a resilient or reserved adolescent and a resilient or average mother; these adolescents reported the highest levels of socioemotional functioning. Mothers with mixed or average temperaments were related to fewer conduct problems and emotional symptoms and less hyperactivity among adolescents with a mixed temperament, while mothers with a resilient temperament type were beneficial for prosocial behavior among adolescents with a mixed temperament. These findings increase understanding of the role of temperament and the interplay between adolescents’ and mothers’ temperaments in the development of early adolescents’ socioemotional adjustment.

Parenting and the development of effortful control from early childhood to early adolescence: A transactional developmental model

Poor effortful control is a key temperamental factor underlying behavioral problems. The bidirectional association of child effortful control with both positive parenting and negative discipline was examined from ages approximately 3 to 13-14 years, involving five time points, and using data from parents and children in the Oregon Youth Study-Three Generational Study (N = 318 children from 150 families). Based on a dynamic developmental systems approach, it was hypothesized that there would be concurrent associations between parenting and child effortful control and bidirectional effects across time from each aspect of parenting to effortful control and from effortful control to each aspect of parenting. It was also hypothesized that associations would be more robust in early childhood, from ages 3 to 7 years, and would diminish as indicated by significantly weaker effects at the older ages, 11-12 to 13-14 years. Longitudinal feedback or mediated effects were also tested. The findings supported (a) stability in each construct over multiple developmental periods; (b) concurrent associations, which were significantly weaker at the older ages;

Age-dependent role of pre- and perinatal factors in interaction with genes on ADHD symptoms across adolescence

Little is known about the effects of risk factors on attention-deficit/hyperactivity disorder (ADHD) symptom over time. Here, we longitudinally studied the role of candidate genes, pre- and perinatal factors, and their interactions on ADHD symptoms between ages 10 and 18 years. Subjects were part of the general population or clinic-referred cohort of the TRacking Adolescents' Individual Lives Survey (n = 1667). At mean ages of 11.1 (T1), 13.4 (T2), and 16.2 years (T3), ADHD symptoms were assessed with the Child Behavior Checklist. Linear Mixed Models were used to examine the association of candidate genes (i.e., DRD4, DRD2, 5-HTTLPR, COMT, and MAOA), pre- and perinatal factors (i.e., index measure of various pregnancy and delivery complications, maternal smoking, maternal drinking, and low birth weight), and their interactions with ADHD symptoms across adolescence. Pregnancy and delivery complications were associated with a higher level of ADHD symptoms across all time points, but with a significantly declining influence over time (p = 0.006). We found no main effects of the candidate genes on ADHD symptoms throughout adolescence. The simultaneous presence of the low activity MAOA genotype and low birth weight (p < 0.001) and of the 5-HTTLPR LL-allele and respectively pregnancy and delivery complications (p = 0.04) and maternal smoking (p = 0.04) were associated with more ADHD symptoms particularly during early adolescence, and these influences significantly decreased over time. Findings suggest an age-dependent role of gene-environment interactions on ADHD symptoms across adolescence.

The predictive value of childhood subthreshold manic symptoms for adolescent and adult psychiatric outcomes

BACKGROUND

Childhood subthreshold manic symptoms may represent a state of developmental vulnerability to Bipolar Disorder (BD) and may also be associated with other adverse psychiatric outcomes. To test this hypothesis we examined the structure and predictive value of childhood subthreshold manic symptoms for common psychiatric disorders presenting by early adulthood.

METHODS

Subthreshold manic symptoms at age 11 years and lifetime clinical outcomes by age 19 years were ascertained in the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective Dutch community cohort. We used latent class analysis to identify subthreshold manic symptom profiles at baseline. The association between class membership and subsequent clinical diagnoses of BD (comprising BD-I, BD-II, mania and hypomania), depressive, anxiety and substance abuse disorders was determined using Cox proportional-hazard ratio (HR) models.

RESULTS

At age 11 years, we identified a normative (n=916; 47%), a mildly symptomatic (n=843; 43%) and a highly symptomatic class (n=198; 10%). Referenced to the normative class, the sex- and age-adjusted risk of new-onset BD by the age of 19 years was significantly increased in the mildly (HR=2.01, 95%CI 1.13-3.59) and highly symptomatic classes (HR=5.02, 95%CI 2.48-10.16). These estimates remained significant after further adjustments for cognitive and family function, parental socioeconomic status, parental psychiatric morbidity, and comorbid disorders at baseline (p-value for linear trend across classes<0.01). Class membership did not show significant associations with incident depressive, anxiety and substance abuse disorders in the fully adjusted regression models.

LIMITATIONS

The period of risk for adult-onset BD extends beyond the observational period of the study.

CONCLUSIONS

Elevated childhood subthreshold manic symptoms are associated with increased risk of BD by early adulthood and are therefore a potentially useful phenotype for the early identification of at-risk individuals.

Violent relationships at the social-ecological level: A multi-mediation model to predict adolescent victimization by peers, bullying and depression in early and late adolescence

BACKGROUND

From the social-ecological perspective, exposure to violence at the different developmental levels is fundamental to explain the dynamics of violence and victimization in educational centers. The following study aims at analyzing how these relationships are produced in the Peruvian context, where structural violence situations exist.

METHODS

A multi-mediation structural model with 21,416 Peruvian adolescents (M = 13.69; SD = 0.71) was conducted to determine the influence of violence in the school environment on violence perceived within school and violence exercised by teachers. In addition, it was also intended to determine whether these violent relationships predict depression through loneliness, and bullying through peer victimization. The existence of differences between early and late adolescence was also verified.

RESULTS

Results confirm that violence in the school setting has high influence on violence exercised by adolescents and teachers within the school. Teacher violence is the most important predictor of depression through loneliness, and encourages peer victimization and the emergence of aggressive behavior. Exposure to violence exercised by support sources-teachers and classmates-explains more than 90% of the total variance explained in bullying behavior. Differences were found between early and late adolescence models.

CONCLUSION

The high prevalence of structural violence in school settings facilitates the bullying/victimization dynamics within school. From a social-ecological perspective, this result suggests the importance of network cooperation at a mesosystem level, with teachers from educational centers playing a crucial role in the prevention of bullying/victimization.

Why Does Frustration Predict Psychopathology? Multiple Prospective Pathways over Adolescence: A Trails Study

Adolescents’ temperamental frustration is a developmental precursor of adult neuroticism and psychopathology. Because the mechanisms that underlie the prospective association between adolescents’ high frustration and psychopathology (internalizing/externalizing) have not been studied extensively, we quantified three pathways: stress generation [mediation via selection/evocation of stressful life events (SLEs)], cross–sectional frustration–psychopathology overlap (‘carry–over’/common causes), and a direct (non–mediated) vulnerability effect of frustration, including moderation of SLE impact. Frustration and psychopathology were assessed at age 16 with the Early Adolescent Temperament Questionnaire and the Youth Self–Report. No gender differences in frustration were observed. At age 19, psychopathology was reassessed by using the Adult Self–Report, while occurrence of endogenous (self–generated) and exogenous (not self–generated) SLEs during the interval (ages 16–19) were ascertained with the Life Stress Interview, an investigator–based contextual–stressfulness rating procedure (N = 957). Half of the prospective effect of frustration on psychopathology was explained by baseline overlap, including effects of ‘carry–over’ and common causes, about 5% reflected stress generation (a ‘vicious’ cycle with the environment adolescents navigate and shape), and 45% reflected unmediated association: a direct vulnerability effect including stress sensitivity or moderation of SLE impact. After adjustment for their overlap, frustration predicted the development of externalizing but not internalizing symptoms. Copyright © 2016 European Association of Personality Psychology

Using Response Surface Analysis to Interpret the Impact of Parent-Offspring Personality Similarity on Adolescent Externalizing Problems

Personality similarity between parent and offspring has been suggested to play an important role in offspring's development of externalizing problems. Nonetheless, much remains unknown regarding the nature of this association. This study aimed to investigate the effects of parent-offspring similarity at different levels of personality traits, comparing expectations based on evolutionary and goodness-of-fit perspectives. Two waves of data from the TRAILS study (N = 1587, 53% girls) were used to study parent-offspring similarity at different levels of personality traits at age 16 predicting externalizing problems at age 19. Polynomial regression analyses and Response Surface Analyses were used to disentangle effects of different levels and combinations of parents and offspring personality similarity. Although several facets of the offspring's personality had an impact on offspring's externalizing problems, few similarity effects were found. Therefore, there is little support for assumptions based on either an evolutionary or a goodness-of-fit perspective. Instead, our findings point in the direction that offspring personality, and at similar levels also parent personality might impact the development of externalizing problems during late adolescence. © 2017 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology.

Dimensions of Mindfulness and Their Relations with Psychological Well-Being and Neuroticism

In this study we examined whether differences in the habitual use of mindfulness skills were associated with specific well-being and neuroticism aspects. Two hundred eleven volunteers aged 21-84 years completed measures of mindfulness, neuroticism, psychological well-being (PWB), and subjective well-being (SWB). Describing, observing, and acting with awareness (i.e., the mindfulness "what" skills) were positively correlated with personal growth, purpose in life, and autonomy (i.e., the "core" eudaimonic components of PWB). Nonreactivity and nonjudging (i.e., the mindfulness "how" skills) were negatively associated with neuroticism aspects, such as withdrawal (e.g., depression) and volatility (e.g., anger). Describing and nonreactivity were the only mindfulness skills significantly correlated with the SWB measures. Acting with awareness mediated the effect of both withdrawal and volatility on eudaimonic well-being outcomes. Describing had consistent mediation effects across all well-being measures, but only for the withdrawal aspect. Nonreactivity and nonjudging did not mediated withdrawal when considering eudaimonic well-being as outcomes. Mediation effects for nonjudging and nonreactivity were found between volatility and SWB markers as well as between volatility and self-acceptance, environmental mastery, and positive relations with others (i.e., the "other" eudaimonic PWB components). In sum, the mindfulness "what" skills were important for eudaimonic well-being, especially for internalizing individuals. Authors discuss the usefulness of a facet-level analysis of mindfulness for examining incremental validity of some facets over others in accounting for different well-being outcomes measures. Clinical implications are also discussed.

Role of temperament in early adolescent pure and co-occurring internalizing and externalizing problems using a bifactor model: Moderation by parenting and gender

We contribute to the literature on the relations of temperament to externalizing and internalizing problems by considering parental emotional expressivity and child gender as moderators of such relations and examining prediction of pure and co-occurring problem behaviors during early to middle adolescence using bifactor models (which provide unique and continuous factors for pure and co-occurring internalizing and externalizing problems). Parents and teachers reported on children's (4.5- to 8-year-olds; N = 214) and early adolescents' (6 years later; N = 168) effortful control, impulsivity, anger, sadness, and problem behaviors. Parental emotional expressivity was measured observationally and with parents' self-reports. Early-adolescents' pure externalizing and co-occurring problems shared childhood and/or early-adolescent risk factors of low effortful control, high impulsivity, and high anger. Lower childhood and early-adolescent impulsivity and higher early-adolescent sadness predicted early-adolescents' pure internalizing. Childhood positive parental emotional expressivity more consistently related to early-adolescents' lower pure externalizing compared to co-occurring problems and pure internalizing. Lower effortful control predicted changes in externalizing (pure and co-occurring) over 6 years, but only when parental positive expressivity was low. Higher impulsivity predicted co-occurring problems only for boys. Findings highlight the probable complex developmental pathways to adolescent pure and co-occurring externalizing and internalizing problems.

Configurations of Adolescents' Peer Experiences: Associations With Parent-Child Relationship Quality and Parental Problem Behavior

Adolescents' peer experiences embrace behavior, relationship quality, status, and victimization, but studies that account for multiple dimensions are rare. Using latent profile modeling and measures of peer behavior, relationship quality, peer status, and victimization assessed from 1,677 adolescents, four profiles were identified: High Quality, Low Quality, Low Quality Victimized, and Deviant Peers. Multinomial logistic regressions showed that negative parent-child relationships in preadolescence reduced the likelihood of High Quality peer relations in mid-adolescence but only partly differentiated between the other three profiles. Moderation by gender was partly found with girls showing greater sensitivity to parent-child relationship quality with respect to peer experiences. Results underline the multifaceted nature of peer experiences, and practical and theoretical implications are discussed.

Behavioral Problems in Juvenile Idiopathic Arthritis: A Controlled Study to Examine the Risk of Psychopathology in a Chronic Pediatric Disorder

Children with juvenile idiopathic arthritis (JIA) are prone to the problems that can delay their psychosocial development; however, the existing literature has not reached a consensus on the psychological problems related to JIA. A total of 51 children and adolescents with JIA and 75 healthy controls aged 6 to 18 years were examined using the Child Behavioral Checklist (CBCL). Our results represented that 70 percent of JIA group reached “borderline clinical” range or “clinical” range in internalizing problems, while this percentage in the control group was 18 percent. In addition, our results indicated that JIA group has gotten significantly higher scores (more than twofold) in externalizing behaviors compared to control group. Furthermore, children with JIA showed higher rate of anxiety/depression, withdrawal/depression, somatic complaints, rule breaking behaviors, and aggressive behaviors as well as thought and social problems compared to control group (p < 0.001). As a conclusion, children and adolescents with JIA compared to healthy controls may show higher rate of both internalizing and externalizing problems. Furthermore, our novel findings on externalizing, social, and thought problems in JIA warrant further investigation on affected children who may be at greater risk of future psychopathologies.

Temperament, environment, and antisocial behavior in a population sample of preadolescent boys and girls

Antisocial behavior can be triggered by negative social experiences and individuals' processing of these experiences. This study focuses on risk-buffering interactions between temperament, perceived parenting, socio-economic status (SES), and sex in relation to antisocial behavior in a Dutch population sample of preadolescents ( N = 2230). Perceived parenting (overprotection, rejection, emotional warmth) was assessed by the EMBU (a Swedish acronym for My Memories of Upbringing) for children, temperament (effortful control and frustration) by the parent version of the Early Adolescent Temperament Questionnaire-Revised, SES by information on parental education, occupation, and income, and antisocial behavior by the Child Behavior Checklist (parent report) and the Youth Self-Report (child report). All parenting and temperament factors were significantly associated with antisocial behavior.The strongest risk-buffering interactions were found for SES which was only related to antisocial behavior among children with a low level of effortful control or a high level of frustration. Furthermore, the associations of SES with antisocial behavior were more negative for boys than for girls. Thus, the effects of SES depend on both the temperament and sex of the child.

Temperament, Development, and Personality

Understanding temperament is central to our understanding of development, and temperament constructs are linked to individual differences in both personality and underlying neural function. In this article, I review findings on the structure of temperament, its relation to the Big Five traits of personality, and its links to development and psychopathology. In addition, I discuss the relation of temperament to conscience, empathy, aggression, and the development of behavior problems, and describe the relation between effortful control and neural networks of executive attention. Finally, I present research on training executive attention.

Chronic Stress and Adolescents' Mental Health: Modifying Effects of Basal Cortisol and Parental Psychiatric History. The TRAILS Study

Large individual differences in adolescent mental health following chronic psychosocial stress suggest moderating factors. We examined two established moderators, basal cortisol and parental psychiatric history, simultaneously. We hypothesized that individuals with high basal cortisol, assumed to indicate high context sensitivity, would show relatively high problem levels following chronic stress, especially in the presence of parental psychiatric history. With Linear Mixed Models, we investigated the hypotheses in 1917 Dutch adolescents (53.2 % boys), assessed at ages 11, 13.5, and 16. Low basal cortisol combined with the absence of a parental psychiatric history increased the risk of externalizing but not internalizing problems following chronic stress. Conversely, low basal cortisol combined with a substantial parental psychiatric history increased the risk of internalizing but not externalizing problems following chronic stress. Thus, parental psychiatric history moderated stress- cortisol interactions in predicting psychopathology, but in a different direction than hypothesized. We conclude that the premise that basal cortisol indicates context sensitivity may be too crude. Context sensitivity may not be a general trait but may depend on the nature of the context (e.g., type or duration of stress exposure) and on the outcome of interest (e.g., internalizing vs. externalizing problems). Although consistent across informants, our findings need replication.

Trajectories of internalizing and externalizing symptoms among adults with autism spectrum disorders

Individuals with autism spectrum disorder (ASD) experience higher rates of psychopathology than their typically developing peers or peers with other intellectual or developmental disabilities. Little is known about the developmental course of psychiatric symptoms such as internalizing and externalizing behaviors in this population. Individual characteristics and aspects of the family environment may explain variability in outcomes for adults with ASD. The present study extends our current understanding of psychopathology among individuals with ASD by examining group-based trajectories of internalizing and externalizing symptoms in adulthood. Overall, the results showed that symptoms became less severe over time. Distinct patterns of change in psychopathology were observed and associated with differential profiles of psychotropic medication use, comorbid mental health diagnoses, and residential placement. The likelihood of following each developmental trajectory was estimated based on characteristics of the adults with ASD (gender, adaptive behavior, and autistic symptoms) and maternal expressed emotion (criticism and warmth). Maternal criticism and warmth were identified as key risk and protective factors, respectively, with important implications for future research and intervention for individuals with ASD.

Family dissolution and offspring depression and depressive symptoms: A systematic review of moderation effects

BACKGROUND

Parental separation is associated with increased risk for offspring depression; however, depression outcomes are divergent. Knowledge of moderators could assist in understanding idiosyncratic outcomes and developing appropriately targeted prevention programs for those at heightened risk of depression following parental separation. Therefore, the objective of the review was to identify and evaluate studies that examined moderators of the relationship between parental separation and offspring depression

METHODS

A search of scientific, medical and psychological databases was conducted in April 2015 for longitudinal research that had evaluated any moderator/s of the relationship between parental separation or divorce and offspring depression or depressive symptoms. Papers were assessed for quality by evaluating the study's sample, attrition rates, methodology and measurement characteristics.

RESULTS

Fourteen quantitative studies from five countries assessed sixteen moderating factors of the relationship between parental separation and offspring depression or depressive symptoms. A number of factors were found to moderate this relationship, including offspring gender, age (at assessment and at depression onset), genotype, preadolescent temperament, IQ, emotional problems in childhood and maternal sensitivity.

LIMITATIONS

While robust longitudinal research was selected for inclusion, common issues with longitudinal studies such as low rates of participation and attrition were among the methodological concerns evident in some of the reviewed papers.

CONCLUSIONS

The current review is the first to assess interaction effects of the relationship between parental separation and offspring depression or depressive symptoms. While further research is recommended, this assessment is critical in understanding variation in heterogeneous populations and can inform targeted policy and prevention.

Parenting stress and child behavior problems within families of children with developmental disabilities: Transactional relations across 15 years

Parents of children with developmental disabilities (DD) are at increased risk of experiencing psychological stress compared to other parents. Children's high levels of internalizing and externalizing problems have been found to contribute to this elevated level of stress. Few studies have considered the reverse direction of effects, however, in families where a child has a DD. The present study investigated transactional relations between child behavior problems and maternal stress within 176 families raising a child with early diagnosed DD. There was evidence of both child-driven and parent-driven effects over the 15-year study period, spanning from early childhood (age 3) to adolescence (age 18), consistent with transactional models of development. Parent-child transactions were found to vary across different life phases and with different domains of behavior problems.

Negative events in childhood predict trajectories of internalizing symptoms up to young adulthood: an 18-year longitudinal study

BACKGROUND

Common negative events can precipitate the onset of internalizing symptoms. We studied whether their occurrence in childhood is associated with mental health trajectories over the course of development.

METHODS

Using data from the TEMPO study, a French community-based cohort study of youths, we studied the association between negative events in 1991 (when participants were aged 4-16 years) and internalizing symptoms, assessed by the ASEBA family of instruments in 1991, 1999, and 2009 (n = 1503). Participants' trajectories of internalizing symptoms were estimated with semi-parametric regression methods (PROC TRAJ). Data were analyzed using multinomial regression models controlled for participants' sex, age, parental family status, socio-economic position, and parental history of depression.

RESULTS

Negative childhood events were associated with an increased likelihood of concurrent internalizing symptoms which sometimes persisted into adulthood (multivariate ORs associated with > = 3 negative events respectively: high and decreasing internalizing symptoms: 5.54, 95% CI: 3.20-9.58; persistently high internalizing symptoms: 8.94, 95% CI: 2.82-28.31). Specific negative events most strongly associated with youths' persistent internalizing symptoms included: school difficulties (multivariate OR: 5.31, 95% CI: 2.24-12.59), parental stress (multivariate OR: 4.69, 95% CI: 2.02-10.87), serious illness/health problems (multivariate OR: 4.13, 95% CI: 1.76-9.70), and social isolation (multivariate OR: 2.24, 95% CI: 1.00-5.08).

CONCLUSIONS

Common negative events can contribute to the onset of children's lasting psychological difficulties.

Risk score for predicting adolescent mental health problems among children using parental report only: the TRAILS study

OBJECTIVE

To construct a risk score for adolescent mental health problems among children, using parental data only and without potentially stigmatizing mental health items.

METHODS

We prospectively derived a prediction model for mental health problems at age 16 using data from parent report on 1676 children aged 11 from the general population. Mental health problems were considered present in the top 15% scores on the combined Achenbach ratings. The model was validated in a separate cohort (n = 336) children. A risk score was constructed for practical application.

RESULTS

In the derivation cohort, 248 (14.8%) had mental health problems at follow-up. Predictors in the final model were gender, maternal educational level, family history of psychopathology, math achievement at school, frequently moving house, severe disease or death in the family, parental divorce, and child frustration level. The model was well calibrated, showed good discriminatory power (area under the curve 0.75; 95% confidence interval 0.72-0.78), and validated well. The risk score stratified children in classes of risk ranging from 6.6% to 52.2%.

CONCLUSIONS

A risk score based on parent-reported data only and without mental health items accurately estimated the 5-year risk of adolescent mental health problems among children from the general population. Children with high risk may benefit from further monitoring or intervention. The risk score may be particularly suitable when parents want to circumvent an explicit discussion on possible mental health problems of their child.