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Cortisol, the end product of the hypothalamic-pituitary-adrenal axis, plays an important role in modulating sleep. Yet, studies investigating the association between diurnal cortisol rhythm and sleep patterns in young children are scarce. We tested the hypothesis that the diurnal cortisol rhythm is associated with shorter sleep duration and more sleep problems across early childhood. This study was embedded in Generation R, a population-based cohort from fetal life onward. Parents collected saliva samples from their infant at five moments during day 1. In 322 infants aged 12 to 20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Sleep duration and sleep behavior were repeatedly assessed across ages of 14 months to 5 years. Generalized estimating equation models were used to assess related cortisol measures to sleep duration and sleep behavior. The diurnal cortisol slope and the CAR, but not the AUC, were associated with sleep duration across childhood. Children with flatter slopes and children with a more positive CAR were more likely to have shorter nighttime sleep duration (β per nmol/L/h slope = −0.12, 95% confidence interval = −0.19 to −0.05, p = .001; β per nmol/L CAR = −0.01, 95% confidence interval = −0.02 to 0.00, p = .04). Cortisol measures did not predict sleep problems. The present study suggests that a flatter diurnal cortisol slope and a more marked morning rise, which can indicate stress (or hypothalamic-pituitary-adrenal dysregulation), have a long-term association with sleep regulation.

It has been shown that following exposure to mild perinatal adversity, children have greater susceptibility to both the negative and positive aspects of their subsequent environment. In a large population-based cohort study (N = 1,776), we investigated whether mild perinatal adversity moderated the association between maternal harsh parenting and children's hair cortisol levels, a biomarker of chronic stress. Mild perinatal adversity was defined as late preterm birth (gestational age at birth of 34-37 weeks, 6 days) or small for gestational age (birth weight between the 2.5th and 10th percentile for full term gestational age). Harsh parenting was assessed by maternal self-report at 3 years. Children's hair cortisol concentrations were measured from hair samples collected at age 6. There were no significant bivariate associations between mild perinatal adversities and harsh parenting and hair cortisol. However, mild perinatal adversities moderated the association between maternal harsh parenting and hair cortisol levels. Children with mild perinatal adversity had lower cortisol levels if parented more harshly and higher cortisol levels in the absence of harsh parenting than children who did not experience mild perinatal adversity. These results provide further evidence that mild perinatal adversity is a potential marker of differential susceptibility to environmental influences.

Background: Prenatal maternal depression has been associated with multiple problems in offspring involving affect, cognition, and neuroendocrine functioning. This suggests that prenatal depression influences neurodevelopment. However, the underlying neurodevelopmental mechanism remains unclear. We prospectively assessed whether maternal depressive symptoms during pregnancy and at the child's age 3 years are related to white matter microstructure in 690 children. The association of paternal depressive symptoms with childhood white matter microstructure was assessed to evaluate genetic or familial confounding. Methods: Parental depressive symptoms were measured using the Brief Symptom Inventory. In children aged 6-9 years, we used diffusion tensor imaging to assess white matter microstructure characteristics including fractional anisotropy (FA) and mean diffusivity (MD). Results: Exposure to maternal depressive symptoms during pregnancy was associated with higher MD in the uncinate fasciculus and to lower FA and higher MD in the cingulum bundle. No associations of maternal depressive symptoms at the child's age of 3 years with white matter characteristics were observed. Paternal depressive symptoms also showed a trend toward significance for a lower FA in the cingulum bundle. Conclusions: Prenatal maternal depressive symptoms were associated with higher MD in the uncinate fasciculus and the cingulum bundle. These structures are part of the limbic system, which is involved in motivation, emotion, learning, and memory. As paternal depressive symptoms were also related to lower FA in the cingulum, the observed effect may partly reflect a genetic predisposition and shared environmental family factors and to a lesser extent a specific intrauterine effect.

Background: Parental restrictive feeding (i.e., limiting food intake of children) has been linked to childhood overweight. However, the directionality of the causal pathway remains unknown. Objective: The objectives of this study were to examine the bidirectional association of maternal restrictive feeding with children's weight and body composition across childhood and to explore a possible mediating role of maternal concern about child weight. Design: Data were available for 4689 mother-child dyads participating in Generation R, a prospective birth cohort in the Netherlands. At ages 4 and 10 y, restrictive feeding was assessed with the parent-reported Child Feeding Questionnaire, and children's body mass index (BMI) was measured. At age 6 y, fat mass index (FMI) and fat-free mass index (FFMI) were measured with dual-energy X-ray absorptiometry. Both directions of the relation between restriction and child body composition were examined with multivariable linear regression analyses and cross-lagged modeling. Mediation analyses were performed to examine concern about child weight (mother reported at child age of 10 y) as a potential mediator. Results: Higher child sex- and age-adjusted BMI SD scores (zBMI) at age 4 y predicted more restrictive feeding at age 10 y (B = 0.15; 95% CI: 0.11, 0.18). Both sex- and age-adjusted FMI SD scores (zFMI) and sex-and age-adjusted FFMI SD scores (zFFMI) at 6 y were also positively associated with restrictive feeding at 10 y. Maternal concern about child weight partially mediated these associations from child body composition to restrictive feeding (e.g., for zBMI at 4 y: Bindirect = 0.10; 95% CI: 0.07, 0.13). There was no temporal association from restrictive feeding at age 4 y to child zBMI at age 10 y after adjustment for baseline zBMI. Conclusions: The continued use of restrictive feeding practices at age 10 y appeared to be primarily a response of mothers to an unhealthy weight of their child rather than a cause of children's overweight. Guidelines discouraging restrictive feeding for preventing childhood overweight should therefore be reconsidered.

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

Extensive evidence suggests that children and adolescents often inaccurately perceive their body size. However, the extent of this misperception is unclear. This paper describes the agreement between children's actual weight and the perception of body size (self-reported and maternally reported) and the association of actual weight with self-reported body satisfaction.In a population-based cohort study of 3,408 children aged 9 to 10 years, we assessed the children's self-perception and ideal perception of their body size with the Children's Body Image Scale. Maternal perception of offspring body size was assessed with the question "How would you describe your child at the moment?" Children's height and weight were measured.Children tended to rate themselves toward average proportions; e.g., 83.0% of 499 children with overweight/obesity perceived themselves as less heavy then they were. Of those who underestimated their body size, most (79.2%) had a desire to be thinner; all of the children who correctly recognized their overweight/obesity had such a desire.Despite the misperception of body size, the majority of children with overweight/obesity indicated dissatisfaction with their body size, suggesting more self-awareness than would be assumed based on the self-perception assessment of body size alone.

BACKGROUND: Research of adults and school-aged children suggest a neurodevelopmental basis for psychiatric disorders. We examined whether infant neuromotor development predicted internalizing and externalizing problems in young children. METHODS: In Generation R, a population-based cohort in the Netherlands (2002–2006), trained research assistants evaluated the neuromotor development of 4006 infants aged 2 to 5 months by using an adapted version of Touwen’s Neurodevelopmental Examination (tone, responses, and senses and other observations). We defined nonoptimal neuromotor development as scores in the highest tertile. Mothers and fathers rated their children’s behavior at ages 1.5, 3, 6, and 10 years with the Child Behavior Checklist (n = 3474, response: 86.7%). The associations were tested with generalized linear mixed models. RESULTS: Overall, neuromotor development predicted internalizing scores, but no association was observed with externalizing scores. Nonoptimal muscle tone was associated with higher internalizing scores (mothers’ report: β = .07; 95% confidence interval [CI]: 0.01 to 0.13; fathers’ report: β = .09, 95% CI: 0.00 to 0.16). In particular, nonoptimal low muscle tone was associated with higher internalizing scores (mothers’ report: β = .11; 95% CI: 0.05 to 0.18; fathers’ report: β = .13; 95% CI: 0.04 to 0.22). We also observed an association between senses and other observations with internalizing scores. There was no relationship between high muscle tone or reflexes and internalizing scores. CONCLUSIONS: Common emotional problems in childhood have a neurodevelopmental basis in infancy. Neuromotor assessment in infancy may help identify vulnerability to early internalizing symptoms and offer the opportunity for targeted interventions.

We studied cortical morphology in relation to sports participation and type of sport using a large sample of healthy children (n = 911). Sports participation data was collected through a parent-reported questionnaire. Magnetic resonance scans were acquired, and different morphological brain features were quantified. Global volumetric measures were not associated with sports participation. We observed thicker cortex in motor and premotor areas associated with sports participation. In boys, team sports participation, relative to individual sports, was related to thinner cortex in prefrontal brain areas involved in the regulation of behaviors. This study showed a relationship between sports participation and brain maturation.

BACKGROUND: The modified Yale Preoperative Anxiety Scale is widely used to assess children's anxiety during induction of anesthesia, but requires training and its administration is time-consuming. A Visual Analog Scale, in contrast, requires no training, is easy-to-use and quickly completed. AIM: The aim of this study was to evaluate a Visual Analog Scale as a tool to assess anxiety during induction of anesthesia and to determine cut-offs to distinguish between anxious and nonanxious children. METHODS: Four hundred and one children (1.5-16 years) scheduled for daytime surgery were included. Children's anxiety during induction was rated by parents and anesthesiologists on a Visual Analog Scale and by a trained observer on the modified Yale Preoperative Anxiety Scale. Psychometric properties assessed were: (i) concurrent validity (correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores); (ii) construct validity (differences between subgroups according to the children's age and the parents' anxiety as assessed by the State-Trait Anxiety Inventory); (iii) cross-informant agreement using Bland-Altman analysis; (iv) cut-offs to distinguish between anxious and nonanxious children (reference: modified Yale Preoperative Anxiety Scale ≥30). RESULTS: Correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores were strong (0.68 and 0.73, respectively). Visual Analog Scale scores were higher for children ≤5 years compared to children aged ≥6. Visual Analog Scale scores of children of high-anxious parents were higher than those of low-anxious parents. The mean difference between parents' and anesthesiologists' Visual Analog Scale scores was 3.6, with 95% limits of agreement (-56.1 to 63.3). To classify anxious children, cut-offs for parents (≥37 mm) and anesthesiologists (≥30 mm) were established. CONCLUSIONS: The present data provide preliminary data for the validity of a Visual Analog Scale to assess children's anxiety during induction. ispartof: PEDIATRIC ANESTHESIA vol:27 issue:9 pages:955-961 ispartof: location:France status: published

BackgroundThere is growing interest in linking vitamin D deficiency with autism spectrum disorders (ASDs). The association between vitamin D deficiency during gestation, a critical period in neurodevelopment, and ASD is not well understood.AimsTo determine the association between gestational vitamin D status and ASD.MethodBased on a birth cohort (n=4334), we examined the association between 25-hydroxyvitamin D (25OHD), assessed from both maternal mid-gestation sera and neonatal sera, and ASD (defined by clinical records; n=68 cases).ResultsIndividuals in the 25OHD-deficient group at mid-gestation had more than twofold increased risk of ASD (odds ratio (OR)=2.42, 95% confidence interval (CI) 1.09 to 5.07, P=0.03) compared with the sufficient group. The findings persisted in analyses including children of European ethnicity only.ConclusionsMid-gestational vitamin D deficiency was associated with an increased risk of ASD. Because gestational vitamin D deficiency is readily preventable with safe, inexpensive and readily available supplementation, this risk factor warrants closer scrutiny.

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

We examined the mental health problems of Dutch young adult domestic adoptees ( N = 75) relative to Dutch non-adopted peers and Dutch international adoptees. We found small differences in favor of the non-adopted peers ( N = 2021), while a minority of male domestic adoptees were at risk of anxiety/depression problems. Domestic adoptees showed somewhat less problems behavior than international adoptees ( N = 1331). Domestic and international adoptees differed in search status (non-searcher, searcher, reunited), although this could not explain any differences in mental health problems. Social workers and clinicians should support (male) adult adoptees in coping with possible feelings of anxiety and depression. Future studies should pay attention to gender differences in adoptees.

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

To conduct international comparisons of parent-adolescent cross-informant agreement in clinical samples, we analyzed ratings on the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) for 6,762 clinically referred adolescents ages 11-18 from 7 societies (M = 14.5 years, SD = 2.0 years; 51% boys). Using CBCL and YSR data, we asked the following questions: (a) Do parents report more problems for their adolescent children than the adolescents report about themselves? (b) How do cross-informant correlations (rs) for scale scores differ by problem type and by society? (c) How well do parents and adolescents, on average, agree regarding which problems they rate as low, medium, or high? (d) How does within-dyad item agreement vary within and between societies? (e) How do societies vary in dichotomous cross-informant agreement with respect to the deviance status of the adolescents? CBCL and YSR scores were quite similar, with small and inconsistent informant effects across societies. Cross-informant rs averaged .47 across scales and societies. On average, parents and adolescents agreed well regarding which problem items received low, medium, or high ratings (M r = .87). Mean within-dyad item agreement was moderate across all societies, but dyadic agreement varied widely within every society. In most societies, adolescent noncorroboration of parent-reported deviance was more common than parental noncorroboration of adolescent-reported deviance. Overall, somewhat better parent-adolescent agreement and more consistency in agreement patterns across diverse societies were found in these seven clinical samples than in population samples studied using the same methods.

Background Fussy eating is common in young children, often raising concerns among parents. The use of pressuring feeding practices may provoke or worsen child fussiness, but these practices could equally be a parent's response to child fussy eating. Objective In longitudinal analyses, we assessed directionality in the relation between fussy eating and parent's pressure to eat across childhood. Methods Study participants were 4845 mother-child dyads from the population-based Generation R cohort in the Netherlands. The Child Behavior Checklist was used to assess fussy eating (2 items) at child ages 1½, 3 and 6 years. Parents' pressure to eat was assessed with the Child Feeding Questionnaire (4 items) when children were 4 years old. All scale scores were standardized. Results Linear regression analyses indicated that preschoolers' fussy eating prospectively predicted higher levels of parents' pressure to eat at child age 4 years, independently of confounders (adjusted B = 0.24, 95% CI: 0.21, 0.27). Pressure to eat at 4 years also predicted more fussiness in children at age 6 years, independently of confounders and of fussy eating at baseline (adjusted B = 0.14, 95% CI: 0.11, 0.17). Path analyses indicated that the relation from fussy eating at 3 years to parenting one year later was stronger than from pressure at 4 years to fussy eating two years later (p Conclusions Our findings suggest bi-directional associations with parental pressuring feeding strategies being developed in response to children's food avoidant behaviors, but also seemingly having a counterproductive effect on fussiness. Thus, the use of pressure to eat should be reconsidered, while providing parents alternative techniques to deal with their child's fussy eating.

Little is known about the development of children’s lying. The present study examined whether observed social and non-social fear in preschoolers predicts children’s consistent cheating ( N = 460; M = 4.3 years of age) and consistent lying about cheating. When left alone, 155 (34%) children cheated in both games conducted. Of these consistently cheating children, 54 (35%) children lied about their cheating after both games, whereas the remaining 101 children confessed to cheating after at least one game. Children’s temperamental fear did not predict consistent cheating. However, non-social (but not social) fear did predict consistent lying. Children with lower levels of non-social fear were more likely to lie. These findings suggest that non-social fear plays a role in the development of children’s antisocial lying.

Executive function and intelligence are negatively associated with aggression, yet the role of executive function has rarely been examined in the context of school bullying. We studied whether different domains of executive function and non-verbal intelligence are associated with bullying involvement in early elementary school. The association was examined in a population-based sample of 1,377 children. At age 4 years we assessed problems in inhibition, shifting, emotional control, working memory and planning/organization, using a validated parental questionnaire (the BRIEF-P). Additionally, we determined child non-verbal IQ at age 6 years. Bullying involvement as a bully, victim or a bully-victim in grades 1-2 of elementary school (mean age 7.7 years) was measured using a peer-nomination procedure. Individual bullying scores were based on the ratings by multiple peers (on average 20 classmates). Analyses were adjusted for various child and maternal socio-demographic and psychosocial covariates. Child score for inhibition problems was associated with the risk of being a bully (OR per SD = 1.35, 95%CI: 1.09-1.66), victim (OR per SD = 1.21, 95%CI: 1.00-1.45) and a bully-victim (OR per SD = 1.55, 95%CI: 1.10-2.17). Children with higher non-verbal IQ were less likely to be victims (OR = 0.99, 95%CI: 0.98-1.00) and bully-victims (OR = 95%CI: 0.93-0.98, respectively). In conclusion, our study showed that peer interactions may be to some extent influenced by children's executive function and non-verbal intelligence. Future studies should examine whether training executive function skills can reduce bullying involvement and improve the quality of peer relationships.

Both structural (i.e., SES, familial psychopathology, family composition) and dynamic (i.e., parental warmth and rejection) family characteristics have been associated with aggressive and depressive problem development. However, it is unclear to what extent (changes in) dynamic family characteristics have an independent effect on problem development while accounting for stable family characteristics and comorbid problem development. This issue was addressed by studying problem development in a large community sample (N = 2,230; age 10–20) of adolescents using Linear Mixed models. Paternal and maternal warmth and rejection were assessed via the Egna Minnen Beträffande Uppfostran for Children (EMBU-C). Aggressive and depressive problems were assessed via subscales of the Youth/Adult Self-Report. Results showed that dynamic family characteristics independently affected the development of aggressive problems. Moreover, maternal rejection in preadolescence and increases in paternal rejection were associated with aggressive problems, whereas decreases in maternal rejection were associated with decreases in depressive problems over time. Paternal and maternal warmth in preadolescence was associated with fewer depressive problems during adolescence. Moreover, increases in paternal warmth were associated with fewer depressive problems over time. Aggressive problems were a stable predictor of depressive problems over time. Finally, those who increased in depressive problems became more aggressive during adolescence, whereas those who decreased in depressive problems became also less aggressive. Besides the effect of comorbid problems, problem development is to a large extent due to dynamic family characteristics, and in particular to changes in parental rejection, which leaves much room for parenting-based interventions.Keywords: Internalizing, Externalizing, Adolescence, Development, Parenting

Background: Little is known about the genetic determinants of sensitive parenting. Two earlier studies examined the effect of the serotonin transporter polymorphism (5-HTTLPR) on sensitive parenting, but reported opposite results. In a large cohort we further examined whether 5-HTTLPR is a predictor of observed maternal sensitivity and whether observed child social fearfulness moderates the effect of 5-HTTLPR on maternal sensitivity. Methods: The population-based cohort consisted of 767 mother–child dyads. Maternal sensitivity was repeatedly observed at the child’s age of 14 months, 36 months and 48 months. Sensitivity was coded using the Ainsworth’s rating scales for sensitivity and cooperation and the revised Erickson rating scales for Supportive presence and Intrusiveness. Child social fearfulness was observed using the Stranger Approach episode of the Laboratory Temperament Assessment Battery at 36 months. Results: Repeated measurement analyses showed a consistent main effect of maternal 5-HTTLPR on sensitivity; mothers carrying the S-allele were more sensitive toward their children (p = .005). This effect was not explained by the child’s 5-HTTLPR genotype. We found no evidence that child social fearfulness moderated the effect of 5-HTTLPR on sensitivity. Conclusions: This study suggests that variations in maternal 5-HTTLPR genotype appear to be involved in the etiology of parenting behavior. The observed effects of this genetic variation are consistent with the notion that parenting may have a genetic component, but large studies are needed to find the specific small molecular effects. Keywords: 5-HTTLPR, serotonin transporter polymorphism, maternal sensitivity, parenting, social fearfulness.

Objective: The progression to depression in children with attention-deficit/hyperactivity disorder (ADHD) is not clearly understood. To clarify this relationship, we tested the following hypotheses in a population-based study: (1) children with ADHD have a higher risk of developing depression than children without ADHD; (2) the pathway from ADHD to depression is mediated (partly) through anxiety and disruptive behavior disorders; and (3) mediation through anxiety is more prevalent in girls, and mediation through disruptive behavior disorders is more prevalent in boys.Method: From October 2008 to September 2010, the Composite International Diagnostic Interview was used to assess ADHD, major depressive episodes, anxiety disorders, and disruptive behavior disorders in 1,584 participants from the TRacking Adolescents' Individual Lives Survey (TRAILS) cohort. Cox regression was used to model the effects of ADHD, anxiety, and disruptive behaviors on depression. Risk of and pathways to depression were studied in both children with ADHD and children with subthreshold ADHD.Results: Comorbid depression was present in 36% of children with a diagnosis of ADHD, 24% of children with subthreshold ADHD, and 14% of children with no ADHD. Anxiety and disruptive behaviors mediated 32% of depression in ADHD. Pathways through anxiety and disruptive behavior disorders were independent of gender. Disruptive behavior disorder was a stronger mediator than anxiety for both genders (all PConclusions: These findings may help forewarn of impending depression and therefore allow opportunities for interventions when comorbid anxiety and/or disruptive behavior disorders are present in a child with ADHD. (C) Copyright 2014 Physicians Postgraduate Press, Inc.

This study examined the relationship between media violence exposure and Attention-deficit/hyperactivity disorder (ADHD)-related behaviors. Using survey (parent-reported) and genetic data of 1,612 Dutch children (aged 5 to 9 years), we examined genetic disposition as a possible cause of individual differences in children's use of and susceptibility to media violence. The gene variant of interest was the 5-HTTLPR polymorphism, which has been associated with ADHD-related behaviors in previous research. Results showed that the "long" variant of the gene polymorphism was related to greater violent media use, which in turn was related to more ADHD-related behaviors. The 5-HTTLPR genotype did not moderate the effect of media violence on ADHD-related behaviors. This study provides insight into the role of genetic factors in media effects.

Risk factors prior to birth can be subdivided according to timing, duration, dosage of exposure, and their mode of action; these variables determine which tissues/organs in the offspring are affected and to what extent. The central nervous system (CNS) as the most complex human organ is frequently affected. Sometimes exposures cause gross damage to the brain, but subtle effects due to exposures to single and frequently multiple risk factors are much more common. Multiple risk factors with small effects are difficult to unravel and trace back to their individual effect. In the preconception phase, the parental haploid genomes can harbor genetic polymorphisms and molecular genetic or chromosomal aberrations that are associated with variations in CNS functioning of the offspring. Depending on the developmental gene regulation, structural and/or functional damage to the CNS ensues pre or postnatally. The extent to which functionally relevant epigenetic alterations are transmitted via the germ lines is currently a subject of scientific debate. After conception, short or longer acting risk factors can affect brain function via diverse mechanisms including epigenetic modifications of specific genes. Drugs can cross the placenta and exert their detrimental effect by binding to the respective receptors in the developing brain; such receptors are frequently already expressed in the embryonic stage. The reduction of placental blood flow as a consequence of the exposure to specific risk factors—like alcohol, nicotine and/or cannabis use—is one example of a mechanism that may indirectly impact offspring CNS function. The prenatal period typically refers to the time from conception to birth, during which a host of maternal exposures to for example drugs, medications, toxins, infectious agents, radiation as well as maternal psychological factors can directly or indirectly influence the offspring’s brain structure and/or function. Due to the rapid development from zygote to term newborn within approximately 270 days, the timing at which an embryo (first 8 weeks after conception) or fetus is exposed to nongenetic risk factors is crucial; particularly early exposure can entail substantial CNS structural aberrations or even lead to intrauterine death. Maternal malnutrition and other factors associated with poverty represent examples of risk factors, which continuously impinge on the embryo/fetus. Unfortunately, it is not uncommon for multiple risk factors (genetic and non-genetic) to be present at the same time. Thus, pregnant women who drink alcohol frequently also smoke; their genetic makeup and social environment predispose them to stress, depression, violence and poor nutrition both prior to and during pregnancy. Such interrelated exposures to a range of risk factors entail serious methodological problems for determining the effects of any single factor; this is even more so the case, because the same risk factors can remain operative postnatally. According to the dual hit hypothesis, a risk factor during intrauterine development may entail functionally non-overt alterations, which require a second postnatal factor to result in an overt, perturbed function, such as a psychiatric disorder, later in life. The genome of the offspring can attenuate or aggravate the effect of a risk factor. J. Hebebrand Department of Child and Adolescent Psychiatry, Rheinische Kliniken, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany e-mail: johannes.hebebrand@uni-due.de

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.

Objective With increasing life expectancy, there is a focus on "healthy ageing". Most activities in this area focus on the elderly. However, the ageing process starts much earlier. Childhood offers an important window to lay a base for future healthy ageing. Thus, to address the full ageing process, we should include younger populations in ageing research. If we aim for healthy ageing across the life course, we need to clarify the meaning of health at different ages. The aim of this paper was to develop a conceptual framework for child health, which can be used as a starting point for healthy ageing research from a life course perspective. Results We conceptualize child health as: "a dynamic state, not merely the absence of disease or disability, but also adequate resilience that permits optimal physical, mental, and social functioning, and optimal quality of life in order to achieve full potential and to become an independent, functional, and social individual." We propose five core dimensions of child health: Absence of physical disease; absence of psychiatric disorders; optimal physical, mental, and social functioning, including adequate development; good quality of life or well-being; and adequate resilience. Conclusion This conceptualization of child health and its dimensions can be seen as a first step towards building a framework for future studies into healthy ageing across the life course.

A vast body of literature shows that maternal depression has long-term adverse consequences for children. However, only very few studies have documented the effect of maternal depression on children's ability to process emotional expressions and even fewer incorporated measures of observed maternal sensitivity to further tease apart whether it is the symptoms per se or the associated impact via maternal sensitivity that affects children's developing emotion-processing abilities. In a large community sample of Dutch preschoolers (N= 770), we examined independent and mediated effects of maternal depressive symptoms and sensitivity on children's ability to recognize emotional expressions using a nonverbal and a verbal task paradigm. Maternal depressive symptoms predicted less accurate emotion labeling in children, while maternal sensitivity was associated with more accurate emotion matching, especially for sadness and anger. Maternal sensitivity did not mediate the observed associations between mothers’ depressive symptoms and children's emotion recognition, and effects were similar for boys and girls. Given that maternal depressive symptoms and sensitivity affected nonoverlapping areas of young children's emotion recognition, prevention and intervention efforts should focus on both alleviating maternal depressive symptoms and improving maternal sensitivity at the same time in order to maximize benefit.

Background: Low heart rate predicts externalising and delinquent behaviour in adults, adolescents and school-age children. In younger children the evidence is less clear. Moreover, the specificity of the relation between the autonomic nervous system and different forms of externalising behaviour is uncertain. We investigated the longitudinal relation between resting mean heart rate and different externalising behaviours. Methods: In 412 children of the Generation R Study, we measured resting mean heart rate at 14 months. At 3 years, child problem behaviour was assessed by the mother with the Child Behavior Checklist. In a gift delay task, we observed whether children were compliant and whether they lied about their noncompliance. The association of heart rate with behaviour was contrasted with the effect of harsh parenting. Results: In our main analysis, we examined the association between heart rate and reported and observed child behaviour. For comparison, the association of heart rate with behaviour was contrasted with the effect of harsh parenting. Mean heart rate was positively associated with Anxious/Depressed scale scores (b = .1, 95% CI = 0.01; 0.2, p = .04), but not with Aggressive Behaviour (b = .02; 95% CI = 0.1; 0.1, p = .8) nor Attention Problem scale scores (b = .08, 95% CI = 0.3; 0.5, p = .8). We could not demonstrate an association between mean heart rate and noncompliance during the gift delay task (OR = 1.14, 95% CI = 0.9; 1.1, p = .2), but lower heart rate predicted higher odds of the child lying (OR = 0.56, 95% CI = 0.3; 0.9, p = .03). In contrast, harsh parenting was associated with mother-reported Aggressive Behaviour (b = .7, 95% CI = 0.4; 0.9, p < .001) and Attention Problems (b = .2, 95% CI = 0.1; 0.3, p < .001), but not with observed lying (OR = 1.03, 95% CI = 0.8; 1.4, p = .8). Conclusions: Lower resting mean heart rate at age 14 months predicts low anxiety symptoms and higher odds of lying at age 3 years. Low resting mean heart rate may be less an indicator of early childhood aggression than of fearless behaviour. Keywords: Child, heart rate, anxiety, externalising behaviour, parenting, compliance.

BACKGROUND: Oppositional defiant disorder (ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. METHODS: Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid-Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study. RESULTS: Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. CONCLUSIONS: Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior. Language: en

Childhood adversities have been proposed to modify later stress sensitivity and risk of depressive disorder in several ways: by stress sensitization, stress amplification, and stress inoculation. Combining these models, we hypothesized that childhood adversities would increase risk of early, but not later, onsets of depression (Hypothesis 1). In those without an early onset, childhood adversities were hypothesized to predict a relatively low risk of depression in high-stress conditions (Hypothesis 2a) and a relatively high risk of depression in low-stress conditions (Hypothesis 2b), compared to no childhood adversities. These hypotheses were tested in 1,584 participants of the Tracking Adolescents' Individual Lives Survey, a prospective cohort study of adolescents. Childhood adversities were assessed retrospectively at ages 11 and 13.5, using self-reports and parent reports. Lifetime DSM-IV major depressive episodes were assessed at age 19, by means of the Composite International Diagnostic Interview. Stressful life events during adolescence were established using interview-based contextual ratings of personal and network events. The results provided support for all hypotheses, regardless of the informant and timeframe used to assess childhood adversities and regardless of the nature (personal vs. network, dependent vs. independent) of recent stressful events. These findings suggest that age at first onset of depression may be an effective marker to distinguish between various types of reaction patterns.

In this study we describe the PEERS Measure, a computerized assessment instrument that takes an innovative approach to using the peer-nomination method to identify bullying among elementary school children in Grades 1-2. Its psychometric characteristics were measured in 4,017 children from 190 school classes. The intercorrelations between the peer-nomination scores showed congruence of the data (e. g., bullying and peer rejection r = .51, defending and prosocial behavior r = .71). Boys were more involved in bullying, more rejected, and less prosocial. As reports by different informants were used, correlations of peer-reported bullying with aggressive behavior reported by a child him-or herself (r = .37) or by a teacher (r = .42) were in the expected range. Good test-retest reliability as measured by the intraclass correlations (average: .72) further suggests that the instrument has good psychometric properties. In line with earlier research, lower maternal educational levels, younger maternal age, and lower household income were related to more bullying and victimization. Overall, our findings show that the instrument provides a reliable measure of peer relations, thus making the use of peer nominations feasible in early elementary school.

Aim To characterise the relationship between preschool lexical delay and language comprehension and nonverbal intelligence at school age. Methods The mothers of 2724 children completed the MacArthur Communicative Development Inventory when their child reached 1.5 years and the Language Development Survey and the Parent Report of Children's Ability at 2.5 years. When the children were 6 years old, we assessed vocabulary comprehension and nonverbal intelligence using Dutch batteries for language and nonverbal intelligence. Results Demographic factors explained 9.9% of the variance in vocabulary comprehension and 8.7% of the variance in nonverbal intelligence at 6 years. Male gender, low maternal education and non-Western ethnic background predicted vocabulary comprehension delay at 6 years. Lexical development at 1.5 and 2.5 years explained only 3.8% of the variance in language comprehension at the age of six. Late onset expressive vocabulary delay increased the risk of language comprehension and nonverbal intelligence delay at 6 years (OR=2.31, 95% CI: 1.62-3.29 and OR=1.74, 95% CI: 1.17–2.58, respectively). Conclusion Sociodemographic factors are important predictors of delays in language and nonverbal abilities as children enter school. In contrast, early expressive lexical delays, in particular before the age of two, have limited predictive power for language delays at the age of six.

The purpose of this study is to examine whether maternal depressive symptoms predict low positive emotionality and high temperamental fearfulness in preschool children. Maternal depressive symptoms were assessed prenatally and at 2, 6, and 36 months postnatally. Positive emotionality and temperamental fearfulness were assessed using laboratory observations in a large cohort of typically developing Dutch preschoolers (N = 799; 404 boys) at age 36 months (M = 37.53, SD = 1.50). Children exposed to elevated levels of maternal depressive symptoms in the first 3 years of life behaved less fearfully at age 3 years in a novel context that primarily elicited a startle response (B = -0.08, SE = 0.03, p = .01). The severity rather than timing of or change in maternal depressive symptoms accounted for the observed effect. In the present sample, maternal depressive symptoms were not associated with positive emotionality in the offspring (p .05). Findings suggest a relation between maternal depressive symptoms and decreased offspring fearfulness in a low-risk community sample of young children.

It is well known that smoking during pregnancy can affect offspring health. Prenatal tobacco exposure has been associated with negative behavioral and cognitive outcomes in childhood, adolescence, and young adulthood. These associations between prenatal tobacco exposure and psychopathology in offspring could possibly be explained by the influence of prenatal tobacco exposure on brain development. In this prospective study, we investigated the association between prenatal tobacco exposure, behavioral and emotional functioning and brain morphology in young children. On the basis of age and gender, we matched 113 children prenatally exposed to tobacco with 113 unexposed controls. These children were part of a population-based study in the Netherlands, the Generation R Study, and were followed from pregnancy onward. Behavioral and emotional functioning was assessed at age 6 with the Child Behavior Checklist. We assessed brain morphology using magnetic resonance imaging techniques in children aged 6–8 years. Children exposed to tobacco throughout pregnancy have smaller total brain volumes and smaller cortical gray matter volumes. Continued prenatal tobacco exposure was associated with cortical thinning, primarily in the superior frontal, superior parietal, and precentral cortices. These children also demonstrated increased scores of affective problems. In addition, thickness of the precentral and superior frontal cortices was associated with affective problems. Importantly, brain development in offspring of mothers who quit smoking during pregnancy resembled that of nonexposed controls (no smaller brain volumes and no thinning of the cortex). Our findings suggest an association between continued prenatal tobacco exposure and brain structure and function in school-aged children.

Little is known about the relationship between diurnal cortisol secretion patterns and cognitive function early in life. This population-based study examined whether diurnal cortisol rhythms and cognitive functioning in toddlers are related. Within the Generation R Study, parents of 364 infants (median age: 14.2 months) collected saliva samples at five moments during one day. We assessed the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Verbal cognitive functioning and fine motor development was determined at age 18 months. Nonverbal cognitive functioning was assessed at age 30 months. A more positive CAR was associated with a lower risk of delay in language comprehension (OR per 1-SD CAR: 0.62, 95%CI: 0.40-0.98, p =.04), a lower risk of nonoptimal fine motor development (OR per 1-SD slope: 0.74, 95%CI: 0.57-0.96, p =.03), and a lower risk of delay in nonverbal cognitive development (OR per 1-SD CAR: 0.58, 95%CI: 0.38-0.90, p =.02). Also, children with flatter slopes had a lower risk of delay in nonverbal cognitive development (OR per 1-SD slope: 0.51, 95%CI: 0.34-0.76, p =.001). Higher AUC levels were associated with a higher risk of delay in language production. These results show that variations in diurnal cortisol rhythms are already associated with variations in cognitive functioning at a young age. Infants with a diurnal cortisol pattern indicative of less stress and more cortisol reactivity, that is, lower AUC levels and a more positive CAR, show a lower risk of delay in cognitive functioning as toddlers.

textabstractObjectives: Little is known about the impact of sleep disturbances on the structural properties of the developing brain. This study explored associations between childhood sleep disturbances and brain morphology at 7 years. Methods: Mothers from the Generation R cohort reported sleep disturbances in 720 children at ages 2 months, 1.5, 2, 3, and 6 years. T1-weighted Magnetic Resonance Imaging (MRI) images were used to assess brain structure at 7 years. Associations of sleep disturbances at each age and of sleep disturbance trajectories with brain volumes (total brain volume, cortical and subcortical grey matter, white matter) were tested with linear regressions. To assess regional differences, sleep disturbance trajectories were tested as determinants for cortical thickness in whole-brain analyses. Results: Sleep disturbances followed a declining trend from toddlerhood onwards. Infant sleep was not associated with brain morphology at age 7. Per SD sleep disturbances (one frequent symptom or two less frequent symptoms) at 2 and 3 years of age, children had-6.3 (-11.7 to-0.8) cm3 and-6.4 (-11.7 to-1.7) cm3 smaller grey matter volumes, respectively. Sleep disturbances at age 6 years were associated with global brain morphology (grey matter:-7.3 (-12.1 to-2.6), p value = .01). Consistently, trajectory analyses showed that more adverse developmental course of childhood sleep disturbances are associated with smaller grey matter volumes and thinner dorsolateral prefrontal cortex. Conclusion: Sleep disturbances from age 2 years onwards are associated with smaller grey matter volumes. Thinner prefrontal cortex in children with adverse sleep disturbance trajectories may reflect effects of sleep disturbances on brain maturation.

The diagnostic process in child and adolescent psychiatry relies heavily on information from multiple informants, including parents, teachers, and the child itself. It has long been well known that information from informants who see the child in different settings may differ, but that each type of informant may contribute useful and unique information to the prediction of mental health problems.1 The diagnosis of attention-deficit/hyperactivity disorder (ADHD) depends on reports from informants who see the child in different settings. This is illustrated in the DSM-5, in which the diagnostic criteria require several inattentive or hyperactive-impulsive symptoms to be present in two or more settings.

The original version of this article contained an error in Table 1. The correct table is presented below.

Altered patterns of facial expression recognition (FER) have been linked to internalizing and externalizing problems in school children and adolescents. In a large sample of preschoolers (N = 727), we explored concurrent and prospective associations between internalizing/externalizing problems and FER. Internalizing/ externalizing problems were rated by parents at 18 and 36 months using the Child Behavior Checklist. FER was assessed at 36 months using age-appropriate computer tasks of emotion matching and emotion labeling. Internalizing problems were associated with emotion-specific differences at both ages: at 18 months they predicted more accurate labeling of sadness; at 36 months they were associated with less accurate labeling of happiness and anger. Externalizing problems at both ages were associated with general FER deficits, particularly for matching emotions. Findings suggest that in preschoolers, internalizing problems contribute to emotion-specific differences in FER, while externalizing problems are associated with more general FER deficits. Knowledge of the specific FER patterns associated with internalizing/ externalizing problems can be proven useful in the refinement of emotion-centered preventive interventions.

The frequency of problems in children and adolescents varies between times within populations in the same geographical area. It has often been suggested that problems in children and adolescents have increased and that present-day youth fare less well than youth in the past. These concerns are fed by the assumed negative impact of societal change on individual development. It has been 20years since (Rutter and Smith, 1995. Psychosocial disorders in young people: Time trends and their causes. Chicester: Wiley) published their findings on child and adolescent problem behaviors that occur at different points in time in western societies in the latter part of the 20th century. They concluded that, despite a lack of rigorous epidemiological data, there was some evidence for a secular increase in adolescents' conduct problems, substance abuse, depression and suicide. Fergusson argued that factors implied by Rutter and Smith as risks for adjustment problems, such as changes in social, economic, educational, family and other structures associated with child rearing and child development, may equally well lead to positive developments. He argued that increasing social diversity may lead to increasing variability in adolescent adjustment patterns with on the one end increasing numbers of young people showing psychopathology (as was shown by Rutter and Smith) and on the other end increasing numbers of young people who show responsible prosocial behaviors. However, there were no data available to test the possibility that social change has had both positive and detrimental effects for adolescents. Rutter and Smith's review also made clear that there were numerous methodological obstacles hampering firm conclusions about secular changes in rates of disorder that may well reflect changes in diagnostic criteria, use of mental health services, or record keeping such as police or suicide records. Twenty years ago, few epidemiological comparisons were available in which changes in problems in representative samples of children and adolescents from western societies at different points in time were assessed with similar standardized procedures. This situation has changed drastically over the last couple of years. In the current Annual Research Review, Collishaw gives an impressively thorough overview of studies published over the last two decades on secular trends in child and adolescent mental health with an emphasis on studies that compare rates of child and adolescent problems over time in one geographically defined population. The review also raises a number of issues related to existing time-trend research worth mentioning... Read the full article at doi

AimsTo examine whether early onset of tobacco or alcohol use, and continued use of tobacco or alcohol in early adolescence, are related to a higher likelihood of developing a cannabis use disorder during adolescence. Design and settingData were used from four consecutive assessment waves of the TRacking Adolescents' Individual Lives Survey (TRAILS), a general Dutch population study. TRAILS is an ongoing longitudinal study that will follow the same group of adolescents from the ages of 10 to 24 years. ParticipantsThe sample consisted of 1108 (58% female) adolescents (mean ages at the four assessment waves are 11.09, 13.56, 16.27 and 19.05 years, respectively) MeasurementsCannabis use disorders were assessed using the Composite International Diagnostic Interview 3.0 (CIDI). Adolescent tobacco and alcohol use were assessed using self-report questionnaires. FindingsEarly-onset tobacco use [odds ratio (OR)=1.82, confidence interval (CI)=1.05-3.14, P0.05), was associated with a higher likelihood of developing a cannabis use disorder. Similarly, adolescents who reported continued use of tobacco (OR=2.47, CI=1.02-5.98, P0.05), were more likely to develop a cannabis use disorder. ConclusionsEarly-onset and continued tobacco use appear to predict the development of a cannabis use disorder in adolescence, whereas early onset and continued alcohol use do not.

In this longitudinal population-based study (N = 544), we investigated whether early parenting and corpus callosum length predict child executive function abilities at 4 years of age. The length of the corpus callosum in infancy was measured using postnatal cranial ultrasounds at 6 weeks of age. At 3 years, two aspects of parenting were observed: maternal sensitivity during a teaching task and maternal discipline style during a discipline task. Parents rated executive function problems at 4 years of age in five domains of inhibition, shifting, emotional control, working memory, and planning/organizing, using the Behavior Rating Inventory of Executive Function-Preschool Version. Maternal sensitivity predicted less executive function problems at preschool age. A significant interaction was found between corpus callosum length in infancy and maternal use of positive discipline to determine child inhibition problems: The association between a relatively shorter corpus callosum in infancy and child inhibition problems was reduced in children who experienced more positive discipline. Our results point to the buffering potential of positive parenting for children with biological vulnerability.

It remains unclear why individuals with autism spectrum disorder (ASD) tend to respond in an atypical manner in social situations. Investigating autonomic and subjective responses to social vs. nonsocial stimuli may help to reveal underlying mechanisms of these atypical responses. This study examined autonomic responses (skin conductance level and heart rate) and subjective responses to social vs. nonsocial pictures in 37 adolescents with an ASD and 36 typically developing (TD) adolescents. Thirty-six pictures from the International Affective Picture System were presented, divided into six categories based on social content (social vs. nonsocial) and pleasantness (pleasant, neutral, and unpleasant). Both in adolescents with ASD as well as TD adolescents, pictures with a social content resulted in higher skin conductance responses (SCRs) for pleasant and unpleasant pictures than for neutral pictures. No differences in SCRs were found for the three nonsocial picture categories. Unpleasant pictures, both with and without a social content, showed more heart rate deceleration than neutral pictures. Self-reported arousal ratings were influenced by the social and affective content of a picture. No differences were found between individuals with ASD and TD individuals in their autonomic and subjective responses to the picture categories. These results suggest that adolescents with ASD do not show atypical autonomic or subjective responses to pictures with and without a social content. These findings make it less likely that impairments in social information processing in individuals with ASD can be explained by atypical autonomic responses to social stimuli.

It has been suggested that atypical eye contact of individuals with autism spectrum disorders (ASDs) arises from an unusually high level of autonomic activity elicited by another person's gaze. The present study investigated visual fixation duration and autonomic reactivity (heart rate, skin conductance response) simultaneously, while adolescents looked towards photographs of neutral faces, with either direct eye gaze, averted eye gaze or closed eyes. Both cognitively able adolescents with ASD (n = 31, mean age = 16 years, mean IQ = 104) and typically developing (TD) adolescents (n = 34, mean age = 16 years, mean IQ = 108) looked significantly longer towards the eye region of faces with direct eye gaze compared with faces with averted eye gaze or closed eyes. The adolescents with ASD did not show higher levels of autonomic activity than TD adolescents while they were instructed to look at the eye region. This suggests that looking at the eye region of static faces does not particularly trigger high autonomic arousal in adolescents with ASD.

This study aimed to contribute to the Diagnostic and Statistical Manual (DSM) debates on the conceptualization of autism by investigating (1) whether empirically based distinct phenotypic profiles could be distinguished within a sample of mainly cognitively able children with pervasive developmental disorder (PDD), and (2) how profiles related to diagnoses and co-occurring behavioral and emotional problems. Six classes with distinct profiles were discerned. Three classes showed profiles not completely in line with the proposed DSM-5 conceptualization of autism. These classes included relatively many cognitively able individuals with PDD-not otherwise specified. However, profiles seemed to suit other diagnostic categories, such as social communication disorder. These alternative diagnoses could retain eligibility for services, and might adequately fit more specifically targeted interventions.

Item does not contain fulltext Objective: Physical activity is inversely associated with depression in adolescents, but the overall associations are fairly weak, suggesting individual differences in the strength of the associations. The aim of this study was to investigate whether plasticity genes modify the reciprocal prospective associations between physical activity and depressive symptoms found previously. Methods: In a prospective population-based study (N = 1,196), physical activity and depressive symptoms were assessed three times, around the ages of 11, 13.5, and 16. Structural Equation Modeling was used to examine reciprocal effects of physical activity and depressive symptoms over time. The plasticity genes examined were 5-HTTLPR, DRD2, DRD4, MAOA, TPH1, 5-HTR2A, COMT, and BDNF. A cumulative gene plasticity index consisting of three groups (low, intermediate, and high) according to the number of plasticity alleles carried by the adolescents was created. Using a multigroup approach, we examined whether the associations between physical activity and depressive symptoms differed between the three cumulative plasticity groups, as well as between the individual polymorphisms. Results: We found significant cross-sectional and cross-lagged paths from physical activity to depressive symptoms and vice versa. Neither the cumulative plasticity index nor the individual polymorphisms modified the strengths of these associations. Conclusion: Associations between adolescents' physical activity and depressive symptoms are not modified by plasticity genes. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

We assessed if the Revised Child Anxiety and Depression Scale (RCADS) measures anxiety symptoms similarly across age groups within adolescence. This is crucial for valid comparison of anxiety levels between different age groups. Anxiety symptoms were assessed biennially in a representative population sample (n = 2226) at three time points (age range 10–17 years) using the RCADS anxiety subscales (generalized anxiety disorder [GAD], obsessive‐compulsive disorder [OCD], panic disorder [PD], separation anxiety [SA], social phobia [SP]). We examined longitudinal measurement invariance of the RCADS, using longitudinal confirmatory factor analysis, by examining the factor structure (configural invariance), factor loadings (metric invariance) and thresholds (strong invariance). We found that all anxiety subtypes were configural invariant. Metric invariance held for items on the GAD, OCD, PD and SA subscales; yet, for the SP subscale three items showed modest longitudinal variation at age 10–12. Model fit decreased modestly when enforcing additional constraints across time; however, model fit for these models was still adequate to excellent. We conclude that the RCADS measures anxiety symptoms similarly across time in a general population sample of adolescents; hence, measured changes in anxiety symptoms very likely reflect true changes in anxiety levels. We consider the instrument suitable to assess anxiety levels across adolescence. Copyright © 2013 John Wiley & Sons, Ltd.

The goal of this study is to clarify the relation between maternal sensitivity and internalizing problems during the preschool period. For this purpose, a longitudinal, bidirectional model was tested in two large prospective, population-based cohorts, the Generation R Study and the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD), including over 1,800 mother-child dyads in total. Maternal sensitivity was repeatedly observed in mother-child interaction tasks and information on child internalizing problems was obtained from maternal reports. Modest but consistent associations between maternal sensitivity and internalizing problems were found in both cohorts, confirming the importance of sensitive parenting for positive development in the preschool years. Pathways from maternal sensitivity to child internalizing problems were consistently observed but child-to-mother pathways were only found in the NICHD SECCYD sample.

Aims To examine the direction of the longitudinal association between vulnerability for psychosis and cannabis use throughout adolescence. Design Cross-lagged path analysis was used to identify the temporal order of vulnerability for psychosis and cannabis use, while controlling for gender, family psychopathology, alcohol use and tobacco use. Setting A large prospective population study of Dutch adolescents [the TRacking Adolescents' Individual Lives Survey (TRAILS) study]. Participants A total of 2120 adolescents with assessments at (mean) age 13.6, age 16.3 and age 19.1. Measurements Vulnerability for psychosis at the three assessment points was represented by latent factors derived from scores on three scales of the Youth Self-Report and the Adult Self-Report, i.e. thought problems, social problems and attention problems. Participants self-reported on cannabis use during the past year at all three waves. Findings Significant associations (r = 0.12-0.23)were observed between psychosis vulnerability and cannabis use at all assessments. Also, cannabis use at age 16 predicted psychosis vulnerability at age 19 (Z = 2.6, P < 0.05). Furthermore, psychosis vulnerability at ages 13 (Z = 2.0, P < 0.05) and 16 (Z = 3.0, P < 0.05) predicted cannabis use at, respectively, ages 16 and 19. Conclusions Cannabis use predicts psychosis vulnerability in adolescents and vice versa, which suggests that there is a bidirectional causal association between the two. © 2012 The Authors.

Contains fulltext : 125369.pdf (Publisher’s version ) (Open Access) For clinically referred children with Autism Spectrum Disorder (ASD) or Attention Deficit/Hyperactivity Disorder (ADHD) several early indicators have been described. However, knowledge is lacking on early markers of less severe variants of ASD and ADHD from the general population. The aim of the present study is to identify early indicators of high risk groups for ASD and ADHD problems based on routine data from community pediatric services between infancy and age four. Data are from 1,816 participants who take part in Tracking Adolescents' Individual Lives Survey (TRAILS), a longitudinal study. Information on early developmental factors was extracted from charts of routine Preventive Child Healthcare (PCH) visits. To assess ASD and ADHD problems, respectively, we used the Children's Social Behavior Questionnaire (CSBQ) and the Child Behavior Checklist (CBCL), filled out by parents three times between the ages of 11 and 17. Note that these are parent ratings and not diagnostic instruments performed by trained clinicians. Male gender, low birth weight, low level of education of the mother, social, behavioral, language, psychomotor and eating problems significantly predicted ASD problems (odds ratios (OR) between 1.34 and 2.41). ADHD problems were also predicted by male gender and low level of education of the mother and by maternal smoking during pregnancy, good gross motor skills in first year, early attention and hyperactivity problems, and absence of parent-reported positive behavior (ORs between 1.36 and 1.74). Routine data on early childhood from PCH services are predictive for ASD and ADHD problems in adolescents in the general population. The PCH services are a useful setting to identify high risk groups, and to monitor them subsequently.

CME Educational Objectives 1. List parental risk factors for the development of psychopathology in children. 2. Describe the relationship between treatment of maternal psychopathology and level of child symptomatology. 3. Understand family risk factors for psychopathology in children with chronic medical illness. Psychiatrists who treat adult patients with children can practice preventatively by considering the potential impact of treatment interventions on the mental health and resiliency of their patients’ offspring. Parental psychopathology is associated with increased risk of a wide range of social, cognitive, and behavioral problems in children. 1 Genetic and environmental factors likely contribute, although which parental factors influence resilience in children remains largely unknown. Resilience is an interactive phenomenon, and significant heterogeneity exists in the individual child’s response to environmental influences. Despite exposure to serious adversities known to result in negative child outcomes, some children seem to do relatively well. Unraveling protective versus risk factors can help identify determinants of resilience as it relates to both mental and physical health outcomes in offspring.