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Participants were 5,831 women in their third trimester of pregnancy, part of a large, longitudinal, pre-birth national cohort study. Women reported on their experience of pushing and shoving, throwing or breaking objects within their relationship over the past month. Univariable regression models examined the association of a large number of potential risk and protective factors. Those significant at the univariable level were carried forward into final multivariable analyses, stratified by New Zealand's four main ethnic groups: European, Māori, Pacific, and Asian peoples. Relationship commitment, reduced family cohesion, and perceived stress were associated with increased risk across ethnic groups. [ABSTRACT FROM AUTHOR]

Abstract Background Psychological therapies provided in primary care are usually briefer than in secondary care. There has been no recent comprehensive review comparing their effectiveness for common mental health problems. We aimed to compare the effectiveness of different types of brief psychological therapy administered within primary care across and between anxiety, depressive and mixed disorders. Methods Meta-analysis and meta-regression of randomized controlled trials of brief psychological therapies of adult patients with anxiety, depression or mixed common mental health problems treated in primary care compared to primary care treatment as usual. Results Thirty-four studies, involving 3962 patients, were included. Most were of brief cognitive behaviour therapy (CBT; n = 13), counselling (n = 8) or problem solving therapy (PST; n = 12). There was differential effectiveness between studies of CBT, with studies of CBT for anxiety disorders having a pooled effect size [d -1.06, 95% confidence interval (CI) -1.31 to -0.80] greater than that of studies of CBT for depression (d -0.33, 95% CI -0.60 to -0.06) or studies of CBT for mixed anxiety and depression (d -0.26, 95% CI -0.44 to -0.08). Counselling for depression and mixed anxiety and depression (d -0.32, 95% CI -0.52 to -0.11) and problem solving therapy (PST) for depression and mixed anxiety and depression (d -0.21, 95% CI -0.37 to -0.05) were also effective. Controlling for diagnosis, meta-regression found no difference between CBT, counselling and PST. Conclusions Brief CBT, counselling and PST are all effective treatments in primary care, but effect sizes are low compared to longer length treatments. The exception is brief CBT for anxiety, which has comparable effect sizes.

The link between behavioural and cognitive difficulties is well established. However, research is limited on whether persistence and change in behavioural difficulties relates to cognitive outcomes, particularly during preschool. We used a large New Zealand birth cohort to investigate how persistence and change in serious behavioural problems from ages 2 to 4.5 years related to measures of cognitive delay at 4.5 years (n = 5885). Using the Strengths and Difficulties total problems score at each time point, children were categorised as showing no difficulties, improved behaviour, concurrent difficulties, and persistent difficulties. Cognitive measures assessed included receptive language, early literacy ability, and executive control. Our results showed that children with concurrent and persistent behavioural difficulties were at a greater risk of showing delays within specific cognitive domains relative to children with no difficulties and were also more likely to show comorbid delays across multiple cognitive domains. [ABSTRACT FROM AUTHOR]

Aim: To investigate the interdependence between risk factors associated with long-term intellectual development in individuals with tuberous sclerosis complex (TSC).Method: The Tuberous Sclerosis 2000 Study is a prospective longitudinal study of individuals with TSC. In phase 1 of the study, baseline measures of intellectual ability, epilepsy, cortical tuber load, and mutation were obtained for 125 children (63 females, 62 males; median age=39mo). In phase 2, at an average of 8 years later, intellectual abilities were estimated for 88 participants with TSC and 35 unaffected siblings. Structural equation modelling was used to determine the risk pathways from genetic mutation through to IQ at phase 2.Results: Intellectual disability was present in 57% of individuals with TSC. Individuals without intellectual disability had significantly lower mean IQ compared to unaffected siblings, supporting specific genetic factors associated with intellectual impairment. Individuals with TSC who had a slower gain in IQ from infancy to middle childhood were younger at seizure onset and had increased infant seizure severity. Structural equation modelling indicated indirect pathways from genetic mutation, to tuber count, to seizure severity in infancy, through to IQ in middle childhood and adolescence.Interpretation: Early-onset and severe epilepsy in the first 2 years of life are associated with increased risk of long-term intellectual disability in individuals with TSC, emphasizing the importance of early and effective treatment or prevention of epilepsy.What This Paper Adds: Intellectual disability was present in 57% of individuals with tuberous sclerosis complex (TSC). Those with TSC without intellectual disability had significantly lower mean IQ compared to unaffected siblings. Earlier onset and greater severity of seizures in the first 2 years were observed in individuals with a slower gain in intellectual ability. Risk pathways through seizures in the first 2 years predict long-term cognitive outcomes in individuals with TSC. [ABSTRACT FROM AUTHOR]

There is limited research on the preschool version of the Strengths and Difficulties Questionnaire (SDQ), and comparisons between mothers and fathers as informants and whether the factor structure shows measurement invariance across parents is lacking. Our study involved mothers (n = 6,246) and fathers (n = 3,759) of 2-year-old children from the Growing Up in New Zealand birth cohort. Confirmatory factor analysis was used to evaluate the factor structure of the SDQ and test for measurement invariance across mothers and fathers. For fathers, we found support for a modified five-factor model that accounts for a positive construal method effect. Internal consistency was good for measures except peer problems. Full measurement invariance of this modified model was found across mothers and fathers, and parents showed moderate agreement in their SDQ ratings (0.34 ≤ r ≤ 0.44). More research is needed on whether mother- and father-reports differ in sensitivity when screening for early childhood psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objectives: The current study aimed to investigate factors associated with the persistence and change in behavioural difficulties during early childhood. Methods: The study used data from the Growing Up in New Zealand birth cohort. Maternal-rated behavioural difficulties were assessed when children were aged 2 and 4.5 years (N = 5885). The ninetieth percentile of the Strengths and Difficulties total difficulties score was used to identify children who showed serious behavioural difficulties at each time point, with children then categorised as showing no difficulties, improved behaviour, later difficulties, and persistent difficulties. Predictors of interest related to maternal-reported mental health and parenting behaviour, family social support and exposure to physical and verbal inter-parental conflict. Results: Poor maternal mental health at multiple time points and authoritarian and physical punishment parenting styles were associated with an increased likelihood of developing behavioural difficulties at 4.5 years and showing persistent difficulties from 2 to 4.5 years. Physical punishment and authoritarian parenting styles also mediated the association between a history of verbal inter-parental conflict and both developing later difficulties and persistent difficulties, whereas only physical punishment parenting style mediated this association for a history of physical inter-parental conflict. The only factor that distinguished children who improved from children who persisted was maternal parenting self-evaluation at 9 months; mothers who had a better self-evaluation were more likely to have children who persisted than improved. Conclusions: These results demonstrate the importance of addressing mothers' self-reported management of their children's behavioural difficulties, inter-parental conflict and maternal emotional wellbeing. [ABSTRACT FROM AUTHOR]

Behavioural difficulties during early childhood have significant implications for multiple outcomes later in life. Child behavioural difficulties at 2 years of age (N = 6246) were assessed by mothers enrolled in a longitudinal, population-based New Zealand cohort study. 10.1% of children had total difficulties scores in the abnormal range on the preschool version of the Strengths and Difficulties Questionnaire. After controlling for maternal education, poverty, and child's birth age/weight, several antenatal and postnatal maternal health and family risk factors were significant for: (i) emotional problems (antenatal maternal perceived stress, lack of periconceptional folate, and moderate to severe maternal postnatal anxiety); (ii) hyperactivity-inattention (antenatal maternal perceived stress, mothers' antenatal exposure to secondhand smoke, moderate to severe maternal postnatal anxiety, and low maternal self-evaluation); (iii) conduct problems and total difficulties (antenatal maternal perceived stress, verbal inter-parental conflict and low maternal self-evaluation). The identification of risk and protective factors associated with early childhood difficulties are vital for guiding intervention and prevention efforts. [ABSTRACT FROM AUTHOR]

When fathers live away from their children, taking an active paternal role may become challenging and can add to paternal psychological distress. In a large (N = 3,980) diverse cohort, we found that nonresident fathers are more likely to be psychologically distressed than resident fathers (27.4% vs. 15.2%) and more likely to report wanting a change in the level of involvement they have in their child's life (76.6% vs. 58.1%). Nonresident fathers were more likely to suffer economic hardship, unemployment, poor health, and have a depression and anxiety history (ps < .001). However, the factors associated with increased psychological distress were largely the same across resident and nonresident fathers. The biggest stressors were managing work alongside family responsibilities and commitments, arguments with the partner, prior history of depression, and economic hardship or deprivation. Fathers' actual levels of involvement and desired levels of involvement with their child did not predict their psychological distress. [ABSTRACT FROM AUTHOR]

The Strengths and Difficulties Questionnaire (SDQ) is a popular standardised instrument typically used for screening psychopathology in children and adolescents. However, peer reviewed studies evaluating the psychometric properties of the parent-rated preschool SDQ are lacking. The current study involved mothers of 5481 2 year olds (52 % male) from the Growing Up in New Zealand cohort, and investigated the psychometric properties of the preschool SDQ within this cohort. Confirmatory factor analysis was used to evaluate the SDQ's factor structure and test for measurement invariance of the factor model. Cronbach's alpha was used to measure the internal consistency of the subscales and total difficulties scale. We found support for a modified five-factor model, in which the prosocial factor was extended into a positive construal factor by allowing cross-loadings of reverse-scored items. Full measurement invariance was found across gender and socioeconomic status, and partial invariance was found across mother's ethnicity. Cronbach's alpha was satisfactory for all subscales (α range = 0.71-0.84), except peer problems (α = 0.54). Normative scores and bandings for normal, borderline and abnormal ranges are described for each subscale. Analyses revealed group differences in scores for child's gender, mother's ethnicity and socioeconomic status. Overall, satisfactory psychometric properties were found for the preschool SDQ in 2 year olds, indicating that that the questionnaire can be used in very young children. [ABSTRACT FROM AUTHOR]

Background: Studies in rodents have determined that intermittent exposure to alcohol vapor can increase subsequent ethanol self-administration, measured with operant and 2-bottle choice procedures. Two key procedural factors in demonstrating increased alcohol intake are the establishment of stable alcohol self-administration before alcohol vapor exposure and the number of bouts of intermittent vapor exposure. The present studies provide additional behavioral validation and initial pharmacological validation of this withdrawal-associated drinking procedure. Methods: Studies at 2 different sites (Portland and Scripps) examined the effect of intermittent ethanol vapor exposure (3 cycles of 16 hours of ethanol vapor+8 hours air) on 2-hour limited access ethanol preference drinking in male C57BL/6 mice. Separate studies tested 10 or 15% (v/v) ethanol concentrations, and measured intake during the circadian dark. In one study, before measuring ethanol intake after the second bout of intermittent vapor exposure, mice were tested for handling-induced convulsions (HICs) indicative of physical dependence on ethanol. In a second study, the effect of bilateral infusions of the corticotropin-releasing factor (CRF) receptor antagonistd-Phe-CRF(12–41) (0.25 μg/0.5 μL) into the central nucleus of the amygdala (CeA) on ethanol intake was compared in vapor-exposed animals and air controls. Results: Intermittent ethanol vapor exposure significantly increased ethanol intake by 30 to 40%, and the mice had higher blood ethanol concentrations than controls. Intra-amygdala infusions ofd-Phe-CRF(12–41) significantly decreased the withdrawal-associated increase in ethanol intake without altering ethanol consumption in controls. Following the second bout of intermittent vapor exposure, mice exhibited an increase in HICs, when compared with their own baseline scores or the air controls. Conclusions: Intermittent alcohol vapor exposure significantly increased alcohol intake and produced signs of physical dependence. Initial pharmacological studies suggest that manipulation of the CRF system in the CeA can block this increased alcohol intake. [ABSTRACT FROM AUTHOR]