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Purpose: This study examines the association between mental health problems in adolescence and general practice (GP) costs during adulthood up to age 50 in the UK. Methods: We conducted secondary analyses of three British birth cohorts (individuals born in single weeks in 1946, 1958 and 1970). Data for the three cohorts were analysed separately. All respondents who participated in the cohort studies were included. Adolescent mental health status was assessed in each cohort using the Rutter scale (or, for one cohort, a forerunner of that scale) completed in interviews with parents and teachers when cohort members were aged around 16. Presence and severity of conduct and emotional problems were modelled as independent variables in two-part regression models in which the dependent variable was costs of GP services from data collection sweeps up to mid-adulthood. All analyses were adjusted for covariates (cognitive ability, mother's education, housing tenure, father's social class and childhood physical disability). Results: Adolescent conduct and emotional problems, particularly when coexisting, were associated with relatively high GP costs in adulthood up to age 50. Associations were generally stronger in females than males. Conclusion: Associations between adolescent mental health problems and annual GP cost were evident decades later, to age 50, suggesting that there could be significant future savings to healthcare budgets if rates of adolescent conduct and emotional problems could be reduced. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Previous factor-analytic studies identify significant comorbidity between interpersonal-callous (IC) traits and low prosocial behavior (LPB), which, in turn, is associated with high levels of childhood risk exposure and psychopathology. Longitudinal associations between IC, LPB, or their combination, and early-adult health and social functioning have not been investigated, however. Extending a previously-identified bifactor model within a prospective birth cohort, this study applied latent path analysis to test direct and indirect pathways (via adolescent delinquency, substance use, and physical activity) between these general and specific factors (age 13) and (i) emotional problems (age 18), (ii) physical health problems (age 18), and (iii) classification as 'not in education, employment, or training' (NEET; age 20). All models controlled for childhood adversity and IQ. Bifactor-specific estimates indicated that the residual IC factor did not reliably denote unique variance over and above a general factor (IC/LPB). IC/LPB itself was directly associated with NEET classification, while the residual LPB factor was associated with better emotional and physical health. IC/LPB also indirectly associated with emotional problems via greater adolescent delinquency, and with physical health problems via lower physical activity. In contrast, residual LPB variance was either non-significantly or negatively related to these adolescent domains. Findings indicate that the shared variance underlying IC and LPB confers an increased risk for poor health and functional outcomes in emerging adulthood, and highlight delinquency and physical inactivity as potential adolescent treatment targets that may mitigate the risk for health difficulties at high levels of this IC/LPB construct. [ABSTRACT FROM AUTHOR]

Background: Childhood maltreatment (abuse and neglect) can have long-term deleterious consequences, including increased risk for medical and psychiatric illnesses, such as bipolar disorder in adulthood. Emerging evidence suggests that a history of childhood maltreatment is linked to the comorbidity between medical illnesses and mood disorders. However, existing studies on bipolar disorder have not yet explored the specific influence of child neglect and have not included comparisons with individuals without mood disorders (controls). This study aimed to extend the existing literature by examining the differential influence of child abuse and child neglect on medical morbidity in a sample of bipolar cases and controls. Methods: The study included 72 participants with bipolar disorder and 354 psychiatrically healthy controls (average age of both groups was 48 years), who completed the Childhood Trauma Questionnaire, and were interviewed regarding various medical disorders. Results: A history of any type of childhood maltreatment was significantly associated with a diagnosis of any medical illness (adjusted OR = 6.28, 95% confidence intervals 1.70-23.12, p = 0.006) and an increased number of medical illnesses (adjusted OR = 3.77, 95% confidence intervals 1.34-10.57, p = 0.012) among adults with bipolar disorder. Exposure to child abuse was more strongly associated with medical disorders than child neglect. No association between childhood maltreatment and medical morbidity was detected among controls. Conclusions: To summarise, individuals with bipolar disorder who reported experiencing maltreatment during childhood, especially abuse, were at increased risk of suffering from medical illnesses and warrant greater clinical attention. [ABSTRACT FROM AUTHOR]

Little is known about early life diet as a risk factor for early-onset persistent conduct problems (EOP CP). To investigate this, we used data from the Avon Longitudinal Study of Parents and Children, a UK-based prospective epidemiological birth cohort. 5727 mother-child pairs (49.9 % boys) monitored since pregnancy (delivery date between 1 April, 1991 and 31 December, 1992) reported intake of fish and processed foods at 32 weeks gestation and, for the child, at 3 years; EOP (n = 666) and Low conduct problem (Low CP, n = 5061) trajectories were measured from 4 to 13 years; hyperactivity and emotional difficulties were assessed in childhood (4-10 years) and early adolescence (12-13 years), in addition to potential confounding factors (family adversity, birth complications, income). Compared to Low CP, mothers of EOP children consumed less fish (p < 0.01) and more processed food (p < 0.05) prenatally, while EOP children consumed more processed food at 3 years (p < 0.05). For EOP, but not Low CP children, consuming less than two servings/week of fish (vs. two or more servings/week, p < 0.05), and one or more servings/day of processed food (vs. less than one serving/day, p < 0.01), was associated with higher emotional difficulties in early adolescence.Conclusions: Findings suggest that prenatal and postnatal diets high in processed food, and low in fish, associate with an EOP CP trajectory and co-occurring difficulties in early adolescence. As small effect size differences were found, further studies are needed to investigate the long-term impact of early unhealthy diet. [ABSTRACT FROM AUTHOR]

Purpose: Childhood hyperactivity leads to mental health problems, but it is not known whether there are long-term risks for adult mood problems in unselected population cohorts that extend to mid-life. Aims were to examine links between childhood hyperactivity and mood problems up to age 50 years and to consider confounding factors and gender differences in associations.Methods: The National Child Development Study (NCDS) is a UK cohort of children born in 1958. Children with (N = 453) and without (N = 9192) pervasive and persistent hyperactivity were followed to age 50. Adult mood was assessed using the Malaise Inventory at ages 23, 33, 42, and 50 years and the CIS-R interview at 45 years.Results: Childhood hyperactivity predicted low mood at all adult assessments (ES = 0.27-0.45), including after covariate adjustment (childhood adversity, emotional and behavioural problems, and attainment).Conclusion: Hyperactivity has enduring risk effects on low mood throughout the life course that extend to middle age. [ABSTRACT FROM AUTHOR]

Purpose: Most children live in low- and middle-income countries (LMICs), many of which have high levels of violence. Research in high-income countries (HICs) shows that childhood behaviour problems are important precursors of crime and violence. Evidence is lacking on whether this is also true in LMICs. This study examines prevalence rates and associations between conduct problems and hyperactivity and crime and violence in Brazil and Britain. Methods: A comparison was made of birth cohorts in Brazil and Britain, including measures of behaviour problems based on parental report at age 11, and self-reports of crime at age 18 ( N = 3,618 Brazil; N = 4,103 Britain). Confounders were measured in the perinatal period and at age 11 in questionnaires completed by the mother and, in Brazil, searches of police records regarding parental crime. Results: Conduct problems, hyperactivity and violent crime were more prevalent in Brazil than in Britain, but nonviolent crime was more prevalent in Britain. Sex differences in prevalence rates were larger where behaviours were less common: larger for conduct problems, hyperactivity, and violent crime in Britain, and larger for nonviolent crime in Brazil. Conduct problems and hyperactivity predicted nonviolent and violent crime similarly in both countries; the effects were partly explained by perinatal health factors and childhood family environments. Conclusions: Conduct problems and hyperactivity are similar precursors of crime and violence across different social settings. Early crime and violence prevention programmes could target these behavioural difficulties and associated risks in LMICs as well as in HICs. [ABSTRACT FROM AUTHOR]

Extensive evidence supports associations between early pubertal timing and adolescent externalizing behavior, but how and under which conditions they are linked is not fully understood. In addition, pubertal development is also characterized by variations in the relative speed at which individuals mature, but studies linking pubertal 'tempo' and outcomes are scarce. This study examined the mediating and moderating roles of spare time activities in associations between pubertal development and later delinquency, using data from a large (4,327 girls, 4,250 boys) longitudinal UK cohort (Avon Longitudinal Study of Parents and Children). Self-reports of Tanner stage were available from ages 9 to 14, spare time activities at age 12 and delinquency at age 15. Pubertal development was examined using latent growth models. Spare time activities were categorized using factor analyses, yielding four types (hanging out at home, hanging out outside, consumerist behavior, and sports/games), which were examined as mediators and moderators. Earlier and faster maturation predicted delinquency in boys and girls. Spare time activities partially mediated these links such that early maturing girls more often engaged in hanging out outside, which placed them at greater risk for delinquency. In addition, compared to their later and slower maturing counterparts, boys who matured earlier and faster were less likely to engage in sports/games, a spare time activity type that is linked to lower delinquency risk. No moderation effects were found. The findings extend previous research on outcomes of early maturation and show how spare time activities act as proxies between pubertal development and delinquency. [ABSTRACT FROM AUTHOR]

Although conduct problems in childhood are stably associated with problem outcomes, not every child who presents with conduct problems is at risk. This study extends previous studies by testing whether childhood conduct problem trajectories are predictive of a wide range of other health and behavior problems in early adulthood using a general population sample. Based on 7,218 individuals from the Avon longitudinal study of parents and children, a three-step approach was used to model childhood conduct problem development and identify differences in early adult health and behavior problems. Childhood conduct problems were assessed on six occasions between age 4 and 13 and health and behavior outcomes were measured at age 18. Individuals who displayed early-onset persistent conduct problems throughout childhood were at greater risk for almost all forms of later problems. Individuals on the adolescent-onset conduct problem path consumed more tobacco and illegal drugs and engaged more often in risky sexual behavior than individuals without childhood conduct problems. Levels of health and behavior problems for individuals on the childhood-limited path were in between those for stable low and stable high trajectories. Childhood conduct problems are pervasive and substantially affect adjustment in early adulthood both in at-risk samples as shown in previous studies, but also in a general population sample. Knowing a child's developmental course can help to evaluate the risk for later maladjustment and be indicative of the need for early intervention. [ABSTRACT FROM AUTHOR]

Purpose: Risk factors for children's development are multifarious and co-occur, having cumulative as well as individual impacts. Yet common configurations of early childhood risks remain little understood. The current study aimed to identify patterns of early risk exposure and to examine their relationship with diverse outcomes in middle childhood. Methods: Using latent class analysis in a large, community-based, UK sample ( N = 13,699), we examined 13 putative risk factors to identify patterns of exposure. Results: Four risk configurations were identified: low (65 %), socio-demographic (14 %), family dysfunction (12 %), and multiple (9 %) risk classes. As expected, children in the low risk group fared best on all outcome measures, and those with multiple risk, worst. Importantly, specificity in associations with outcomes emerged, such that cognitive outcomes were predominantly linked with socio-demographic adversities, emotional difficulties with family dysfunction, and conduct problems increased across risk classes. Conclusions: Better understanding of configurations of childhood risk exposures may help to target resources for children in need. [ABSTRACT FROM AUTHOR]

Background: Despite evidence of an increased risk of violence among adults suffering from psychosis, very little is currently known about the relationship between early onset psychosis and aggressive behaviour. We aimed to identify and examine overlaps between aggressive behaviour and psychosis in a referred child and adolescent sample to assess whether potential risk factors and other associated features of this co-occurring pattern can be identified at a young age. Methods: Standardised item sheet data on young people referred to the Child and Adolescent Department of the Maudsley Hospital between 1973 and 2004 were used to contrast three groups: (1) aggressive-only ( n = 1,346), (2) psychosis-only ( n = 173), and (3) co-occurring aggression and psychosis ( n = 39) on a range of comorbid symptoms and potential risk factors. Results: Co-occurring cases presented with elevated rates of depersonalisation/derealisation, intrusive thoughts and restlessness, and were more likely to have received past treatment compared with both psychosis-only and aggressive-only cases. Although co-occurring cases resembled the psychosis-only group in many domains, including socio-demographic background and rates of emotional symptoms, they differed from 'pure' psychosis cases in having high levels of special educational needs, irritability, non-aggressive antisocial behaviours, as well as being more likely to be from a low social class and have increased contact with police and child care authorities. Conclusions: Our findings suggest that it is possible to identify early risk factors for aggression in individuals with psychosis. [ABSTRACT FROM AUTHOR]

Research has consistently demonstrated that environmental influences are important for explaining the variability in sleep quality observed in the general population. Although there is substantial evidence assessing associations between sleep quality and a host of environmental variables, it is possible that their effects are mediated by genetic influence. A monozygotic twin differences design was used to assess the specific contribution of nonshared environmental influences on sleep quality, whilst controlling for genetic and shared environmental effects in a sample of 380 monozygotic twins (mean age 19.8 years, SD = 1.26, range = 18-22 years). Participants completed the Pittsburgh Sleep Quality Index and questionnaires assessing several candidate 'environmental' measures. When controlling for genetic and shared environmental effects, within monozygotic twin-pair differences in sleep quality were associated with within monozygotic twin-pair differences in general health for males ( β = 1.56, p < 0.001) and relationship satisfaction for females ( β = 1.01, p < 0.05). For the remaining environmental measures the results suggest that these seemingly 'environmental' influences are actually in part dependent on genetics and/or the shared environment. These findings give insight into how specific environments affect sleep and the possible mechanisms behind these associations. [ABSTRACT FROM AUTHOR]

The coincidence of historical trends in youth antisocial behavior and change in family demographics has led to speculation of a causal link, possibly mediated by declining quality of parenting and parent-child relationships. No study to date has directly assessed whether and how parenting and parent-child relationships have changed. Two national samples of English adolescents aged 16-17 years in 1986 ( N = 4,524 adolescents, 7,120 parents) and 2006 ( N = 716 adolescents, 734 parents) were compared using identical questionnaire assessments. Youth-reported parental monitoring, expectations, and parent-child quality time increased between 1986 and 2006. Ratings of parental interest did not change. Parenting differences between affluent and disadvantaged families narrowed over time. There was thus little evidence of a decline in quality of parenting for the population as a whole or for disadvantaged subgroups. Parent-reported youth conduct problems showed a modest increase between 1986 and 2006. Findings suggested that the increase in youth conduct problems was largely unrelated to observed change in parent-child relationships. [ABSTRACT FROM AUTHOR]

Although both aggressive (AGG) and deceitful behaviors (DEC) are symptoms of childhood conduct problems, few studies have examined common vs. specific etiological influences. Early intervention is encouraged for conduct problems and findings from genetically informative studies can suggest whether interventions should focus on conduct problems in general or groupings of conduct problems more specifically. Twin model-fitting analyses were conducted on same and different teacher ratings of AGG and DEC for 872 9-year old male twin pairs. Common genetic influences were found to underlie the susceptibility for both AGG and DEC. The same teacher ratings resulted in somewhat higher heritability estimates than different teacher ratings. Results also indicated stronger environmental effects for DEC as compared with AGG, with a significant shared environmental component for same teachers and a substantial non-shared environmental component for different teachers. Our data suggest that AGG and DEC share risk genes and environmental factors may differentiate these two types of conduct problems. Characterizing these specific environmental factors may be useful when developing interventions. [ABSTRACT FROM AUTHOR]

Past studies have documented rising levels of conduct problems among UK adolescents in the last quarter of the twentieth century, and increased rates of emotional difficulties between the 1980s and 1990s. We used parent, teacher and youth ratings from two large scale, nationally representative studies of 5–15 year-old carried out in 1999 and 2004 to assess whether these increases continued into the early years of the new millennium. Ratings on most “problem” sub-scales remained stable or showed small declines over this period, and parent and teacher reports suggested small increases in levels of prosocial behaviours. The upward trends in rates of UK child adjustment problems noted since the 1970s and 1980s may have plateaued, and possibly begun to be reversed. [ABSTRACT FROM AUTHOR]

The relationship between severe early institutional deprivation and scholastic attainment at age 11 in 127 children (68 girls and 59 boys) adopted from institutions in Romania was compared to the attainment of 49 children (17 girls and 32 boys) adopted within the UK from a non-institutional background. Overall, children adopted from Romania had significantly lower attainment scores than those adopted within the UK; the children within the Romanian sample who had spent 6 months or more in an institution had significantly lower attainment scores than those who had spent less than 6 months in an institution, but there was no additional risk of low attainment associated with longer institutional care after 6 months. The lower scholastic attainment in the children adopted from Romanian institutions, as compared with domestic adoptees, was mediated by IQ, and to a lesser degree, inattention/overactivity. When these factors were taken into account, only small between-group differences in attainment remained. [ABSTRACT FROM AUTHOR]

Background: It is not unusual for researchers to make apparently minor modifications to existing instruments without checking if this alters psychometric properties.Method: Equivalent items on child mental health from two different versions of the Rutter parent questionnaire were compared: items from the standard version and from a modified version. The parents of 400 children aged 5-7 years were randomised into two groups: each group completed one version of the Rutter as well as an independent measure of psychopathology (the Strengths and Difficulties Questionnaire; SDQ).Results: The mean psychopathology scores of the two groups were comparable according to the SDQ but differed markedly between the two Rutter versions, principally because of changes in the response categories. Nevertheless, the validity of the two versions of the Rutter was similar as judged from Rutter-SDQ correlations.Conclusion: Seemingly minor changes in the wording of a measure can have a major impact on mean scores, thereby making it harder to compare or combine the results of studies using the original and the modified measure. [ABSTRACT FROM AUTHOR]

Comorbidity between antisocial behavior and depression in adolescence is widely recognized. This paper examines whether links with depressed mood differ among three subtypes of antisocial behavior: oppositionality, physical aggression and delinquency. In addition we examine two possible contributors to these links: negative life events that are dependent upon the individual's actions and depressogenic attributional style. Data are drawn from the G1219 large-scale community twin and sibling sample, and include 2409 questionnaire responses from youths aged between 13 and 19 living in the United Kingdom. Depressed mood was independently associated with both oppositionality and delinquency, but not with physical aggression. Dependent negative life events were strongly implicated in the association between delinquency and depressed mood, whereas depressogenic attributional style was implicated in the associations of both oppositionality and delinquency with depressed mood. Oppositionality remained a significant predictor of depressed mood after accounting for attributional style and life events whereas delinquency did not. The pattern of associations was largely similar in boys and girls. We discuss these results in terms of developmental models of the links between antisocial behavior and depressed mood. [ABSTRACT FROM AUTHOR]

Although reading difficulties show well-established overlaps with disruptive behavior disorders in childhood, much less is known about reading-disabled children's vulnerability to emotional difficulties. Using longitudinal data from 6 assessments of boys in the Pittsburgh Youth Study, we found robust links between severe, persistent reading problems and increased risk for depressed mood in a community sample of boys aged 7 and 10 years at initial assessment, though not in those who had already entered their teens. These associations could not be accounted for in terms of selected family risks or comorbid disruptive behaviors; instead, the pattern of the findings pointed to the existence of more direct causal processes whereby reading problems influence younger boys' risk of depressed mood. [ABSTRACT FROM AUTHOR]

Modeling the heterogeneous trajectories along which antisocial behavior develops in childhood and adolescence may contribute in important ways to understanding antecedents of offending in adult life. This paper examines the development of aggressive and non-aggressive conduct problems in the Great Smoky Mountains Study of Youth, a longitudinal study in the southeastern United States. Aggressive and non-aggressive conduct problems of clinical severity, police contact and arrest, and family and environmental correlates were assessed in four annual interviews for 789 boys and 630 girls aged 9 - 13 at first interview. The best fitting latent class model identified three developmental trajectories: stable low problem levels, stable high problem levels, and declining levels of conduct problems, for both aggressive and non-aggressive behaviors. Boys were over-represented in the stable high trajectory class on the aggressive trajectory, but sex differences in non-aggressive trajectories were less marked. The overlap between aggressive and non-aggressive trajectory classes was quite limited. Both classifications showed strong associations with risks of police contact and arrest in early adolescence, and with measures of family adversity. The results are discussed in relation to developmental models of conduct disorder and delinquency. [ABSTRACT FROM AUTHOR]

A follow-up of a representative sample of poor readers through secondary schooling confirmed persisting reading problems for most children. As a group, poor readers fell further behind a normal-reading comparison group during their early teens. Later reading progress was unrelated to gender, SES background, behavior problems or non-school attendance, though these factors did influence wider school attainments. Poor readers were more likely to leave school early, and had much depressed educational qualifications. There were no differences in the reading progress or academic attainments of specifically retarded (IQ-discrepant) and generally backward poor readers. [ABSTRACT FROM AUTHOR]