Search

BACKGROUND: Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk. METHODS: Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11-36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones. RESULTS: Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20). CONCLUSIONS: Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.

BACKGROUND: Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4-6 years. METHODS: Childrens internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures-residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity-averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms. RESULTS: Children were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant. CONCLUSIONS: Our findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.

Objectives: Cannabis legalization has triggered an increase in prenatal cannabis use. Given that tobacco is commonly co-used with cannabis, determining outcomes associated with prenatal cannabis and tobacco co-exposure is crucial. While literature exists regarding the individual effects of prenatal cannabis and tobacco exposure on childhood behaviour, there is a gap regarding their combined use, which may have interactive effects. Therefore, we investigated whether prenatal cannabis and tobacco co-exposure was associated with greater externalizing and internalizing problems in middle childhood compared to prenatal exposure to either substance alone or no exposure. Methods: Baseline data from the Adolescent Brain Cognitive Development (ABCD) Study (collected in children ages 9–11) were used to explore differences in externalizing and internalizing scores derived from the Childhood Behavior Checklist across four groups: children with prenatal cannabis and tobacco co-exposure (CT, n = 290), children with prenatal cannabis-only exposure (CAN, n = 225), children with prenatal tobacco-only exposure (TOB, n = 966), and unexposed children (CTL, n = 8,311). We also examined if the daily quantity of tobacco exposure modulated the effect of cannabis exposure on outcomes. Results: Adjusting for covariates, a 2 × 2 ANCOVA revealed significant main effects for prenatal cannabis (p = 0.03) and tobacco exposure (p < 0.001), and a significant interaction effect on externalizing scores (p = 0.032); no significant main effects or interactions were found for internalizing scores. However, interactions between daily quantity of cannabis and tobacco exposure significantly predicted both externalizing and internalizing scores (p < 0.01). Conclusions: These findings indicate that co-exposure is associated with greater externalizing problems than exposure to either substance alone, which did not differ from each other. Further, greater tobacco exposure may amplify the negative effect of cannabis exposure on both externalizing and internalizing behaviours in children. These findings underscore the need for interventions that target cannabis and tobacco co-use in pregnant women to circumvent their adverse impact on middle childhood behaviour. Plain Language Summary Title: Prenatal Cannabis and Tobacco Co-exposure and its Association with Middle Childhood Behaviours Plain Language Summary: Given the high rates of both cannabis and tobacco use during pregnancy, we explored if their combined use was associated with greater problematic behaviour in 10-year-old children compared to either substance alone or no substance use. We found that children with prenatal co-exposure had greater externalizing behaviours, such as attention problems and aggression, compared to children with prenatal exposure to one of the substances or no exposure. Prenatal co-exposure, cannabis-only exposure and tobacco-only exposure had no effect on childhood internalizing behaviours (e.g., depression, anxiety). However, the amount of tobacco consumed by the mother amplified the negative effect of cannabis on both childhood externalizing and internalizing behaviours. These findings emphasize the need for specialized treatment for cannabis and tobacco co-use in pregnant women to circumvent the adverse impact of these substances on externalizing behaviours in middle childhood. [ABSTRACT FROM AUTHOR]

This 10-year study followed 134 caregivers of young adults with autism and intellectual disabilities, examining the effects of caregivers' coping strategies, sociodemographic features, and young adult symptomatology on caregiver well-being and depression. Lower caregiver education and higher young adult externalizing behaviors predicted lower well-being and higher depression among caregivers. Caregivers who were Black or mixed-race experienced higher depression than White caregivers. All five coping strategies investigated predicted changes in caregiver well-being and/or depression, with some effects moderated by young adult externalizing behaviors and sociodemographic features. Notably, higher use of positive coping among caregivers of adults with high externalizing behaviors predicted higher caregiver well-being and lower depression. Findings highlight the importance of effective coping strategies for improving caregiver mental health. [ABSTRACT FROM AUTHOR]

Introduction: Numerous early-life risk factors are thought to significantly contribute to the development of psychological problems in toddlerhood. However, these factors have seldom been investigated concomitantly and longitudinally, and few studies include both mothers and fathers. This study examines the longitudinal impact of early environmental, parental, and child-specific risk factors on children's internalizing and externalizing symptomatology at age 4. Methods: Families were recruited from a perinatal center at birth and completed self-report questionnaires at birth, 4 weeks postpartum, 6 months postpartum, and annually thereafter. The final population-based sample consisted of n = 560 mothers (and fathers) who gave birth after June 2015, with children who turned 4 years old before March 31, 2021. The primary outcomes, children's internalizing and externalizing symptomatology at age 4, were measured using the Strengthsand Difficulties Questionnaire. Linear mixed effect models were used to estimate growth curves for predictors between 4 weeks and 4 years postpartum, which were subsequently entered into multivariable linear regressions to predict internalizing and externalizing symptomatology at age 4. Results: The study identified several key risk factors: environmental (lack of social support, lower parental education, male sex), parental (poor parental mental health, increased parenting stress, parental sleep difficulties) and child-specific (children's low physical health, children's reduced sleep quality, temperament). Discussion: The findings underscore that most identified risk factors are related to children's temperament, mental and physical health of parents, their experienced stress, and families' social support networks. These insights highlight the importance of targeted interventions focusing on improving parental mental health, reducing stress, and enhancing social support to mitigate early-life psychological problems in children. [ABSTRACT FROM AUTHOR]

The research program Spit For Science was launched at Virginia Commonwealth University (VCU) in 2011. Since then, more than 10,000 freshmen have been enrolled in the program, filling out extensive questionnaires about their drinking, general substance use, and related behaviors, and also contributing saliva for genotyping. The goals of the program, as initially stated by the investigators, were to find the genes underlying the heritability of alcohol use and related behaviors, and in addition to put genetic knowledge to work in ways that might aid university administrators and mental health professionals in the prevention and treatment of substance abuse. We review every empirical paper involving genetic data that has emerged from the program, and reach a surprising conclusion: the study has never identified a single genetic effect of more than trivial magnitude. Although the quantitative results of the studies were reported transparently, the theoretical ramifications of the negligible results have never been acknowledged. To the contrary, most of the papers ignore the tiny effects, reaching optimistic conclusions about the prospects for future genetic explanations of alcohol use. We explore the implications of these results for the broader prospects of applied psychiatric genetics. [ABSTRACT FROM AUTHOR]

In this review, we analyzed the possible relationship between the excessive use of screens and sleep patterns, and how this may affect certain behavioral and cognitive factors in preschool children. The selection, extraction and synthesis of the data were conducted according to PRISMA guidelines. The search was carried out in the electronic databases Medline (PubMed), PsycINFO (American Psychological Association), Scopus and Web of Science (WOS). Of the 597 articles initially identified, 13 met the inclusion criteria. The risk of bias of the articles selected was evaluated using a specific scale created for this purpose. The results found indicate that excessive use of screens is associated with a negative impact on the duration and quality of sleep-in preschoolers, and this worsening of sleep in infancy is related with a greater probability of the appearance of internalizing and externalizing behavioral problems and certain cognitive problems. The results also suggest that sleep could play a mediating or moderating role as a bioregulatory system that attenuates or increases the onset of behavioral and cognitive difficulties in those children most exposed to digital devices. [ABSTRACT FROM AUTHOR]

Housing instability is associated with numerous poor child outcomes in domains such as behavioral and emotional problems. The impacts of housing instability on child outcomes are typically investigated in the context of sociodemographic risk; however, exploring the role of protective factors (e.g., family routines, parental warmth) in these contexts allows for a more thorough understanding of the effect of housing instability and how potential negative outcomes might be mitigated. The present study further explored the relation between early housing instability and child behavioral and emotional outcomes in middle childhood in addition to the potential moderating role of family routines and parental warmth in early childhood. Longitudinal data of 4,898 families from the Future of Families and Child Wellbeing Study were used to explore these associations. Using structural equation modeling, the present analyses indicated that when controlling for key sociodemographic covariates, housing instability in early childhood was not related to child outcomes at age 9. Greater parental warmth at age 5 was significantly associated with lower levels of behavioral and emotional problems at age 9. Categorical models using the product indicator approach indicated that greater parental warmth attenuates the relation between moving one to two times and later child behavioral problems. Parental warmth emerged as a significant promotive factor for later child emotional problems. Further implications are discussed below. [ABSTRACT FROM AUTHOR]

A large body of literature has established that chaos in the home environment, characterized by high levels of disorganization, lack of household routine, crowding, noise, and unpredictability, undermines social–emotional and behavioral development in early childhood. It is less clear whether household chaos is linked to elevated risk for behavior problems in adolescence. The aims of this study were 3fold: (1) characterize the variability of adolescent and caregiver reports of household chaos over time; (2) examine associations among caregiver and adolescent reports of chaos over a 9‐month period; (3) consider how between‐ and within‐ individual variability in household chaos predicts adolescent externalizing and internalizing problems. This study drew data from the Family Income Dynamics study, a 9‐month longitudinal study. Participants included 104 adolescents between 14 and 16 years old (55% female; M age = 14.85) and their caregiver (92% female) from low‐ and middle‐income families. Results showed that adolescent‐reports of household chaos were more variable over time compared to caregivers' reports. Adolescent‐reports of household chaos had positive within‐ and between‐level associations with externalizing problems and between‐level associations with internalizing, while caregiver‐reports of chaos had no links to behavior. This work highlights the importance of adolescents' own perceptions of household chaos when considering its links to adolescent development. [ABSTRACT FROM AUTHOR]

Background: While accumulating research has tested the hypothesis that screen time causes psychiatric symptoms in children, less attention has been paid to the hypothesis that children with psychiatric symptoms change their patterns of screen time and digital media use. We aimed to test whether children with psychiatric symptoms subsequently change their patterns of screen time and digital media use. Methods: N = 9,066 children primarily aged 9–10 in the Adolescent Brain Cognitive Development Study at baseline and 1-year later. Psychiatric symptoms included internalizing, attention, and externalizing symptoms. Screen time was measured as ordinally defined weekday and weekend time on social and nonsocial [e.g., YouTube] digital media). Models assessed psychiatric symptoms as predictors of screen time, and screen time as predictors of psychiatric symptoms, controlled for baseline measures of each, sex, age, race/ethnicity, and income. Results: Children with psychiatric symptoms spent more time on non-social media one year later compared with peers. Considering total psychiatric problems, clinical levels of problems predicted higher levels of weekday (OR = 1.22, 95% CI 1.22–1.23) and weekend (OR = 1.10, 95% CI 1.09–1.11) nonsocial screen time. For nearly all analyses of psychiatric symptoms predicting screen time, associations were highest for a non-social screen time outcome rather than a social screen time outcome (Highest OR = 1.65, 95% CI 1.63–1.67, clinical rule breaking predicting weekday nonsocial screen time). Comparable magnitude associations were observed for social and nonsocial media use predicting future psychiatric symptoms, suggesting bidirectionality. Conclusion: Children with psychiatric symptoms have different subsequent media use patterns, including higher rates of subsequent nonsocial engagement. Ensuring that ongoing data collection and analysis efforts attend to temporality and transitions in the relation between media use and psychiatric symptoms will accelerate progress in the field. [ABSTRACT FROM AUTHOR]

Background/Objectives: Research on early risk factors for disruptive behaviors (DBs: hyperactivity–impulsivity/HI, non-compliance/NC, or physical aggression/PA) has predominantly focused on individual DBs in silos (i.e., HI, NC, or PA) or the broader category of externalizing, reporting mostly common risk factors among them. However, studies addressing DB comorbidity, i.e., the simultaneous occurrence of more than one DB, showed differences in risk factors among DB comorbid profiles. Aiming to clarify this discrepancy, the present study compared the early risk factors associated with different longitudinal patterns (i.e., trajectories) of single-DBs (HI, NC, PA) with risk factors associated with monomorbid (HIonly, NConly, PAonly) and comorbid (HI + NC, NC + PA, HI + NC + PA) joint-DBs trajectories during the preschool period. Methods: In a population-based birth cohort (N = 2045), parents' pre-conception characteristics, pregnancy and perinatal conditions, and age 5 months child and family characteristics were used to compare children following single-DB and joint-DBs high trajectories to children following low or moderate trajectories. The DB trajectories were derived from mother ratings at ages 1½, 2½, 3½, 4½, and 5 years. Results: More risk factors were identified for single-DB high trajectories than for joint-DBs high trajectories. On average, children on a single-DB high trajectory shared only 44.2% of their risk factors with children on a related joint-DBs high trajectory. Moreover, high trajectories of single-DBs shared a larger proportion of their risk factors than did high trajectories of joint-DBs. The findings show that categories of DBs include different subgroups of children based on their comorbidity patterns across DBs, which are differentially linked to early risk factors. Conclusions: Addressing comorbidity when investigating early risk factors of preschool DBs may improve our understanding of the etiological processes leading to these distinct but related behaviors and increase our ability to intervene upstream to prevent the earliest forms of potentially life-altering psychopathological conditions. [ABSTRACT FROM AUTHOR]

Introduction: Children and adolescents treated in specialty mental health services are more likely to have sleep disturbances than those without mental health problems. Few studies have investigated the relationship between sleep and psychopathology in broad clinical samples of children. We examined the relationship between sleep disturbance and age on internalizing and externalizing psychopathology in a sample who sought treatment at children's mental health centers. Methods: Secondary data analyses were completed on a sample of children (N = 13,472; aged 4 to 18; 55% male) from 39 children's mental health agencies in Ontario, Canada, who completed a semi-structured assessment, the interRAI Children and Youth Mental Health (ChYMH). A split-half sample approach was utilized (S1 n = 6,773, S2 n = 6,699). Hierarchical regressions examined the effects of sleep disturbances (i.e., difficulty falling asleep, staying asleep, night waking, bedtime resistance, falling asleep during the day) on internalizing and externalizing symptoms, above and beyond established child- (i.e., age, sex, sensory sensitivity, pain) and family-level variables (family functioning, caregiver distress, parenting strengths). Age was tested as a moderator for sleep disturbances on both outcome variables. Results: Overall, 6.7% of children had clinically significant sleep disturbance scores (≥10 out of 16) on the interRAI ChYMH. In both samples, sleep disturbances predicted internalizing (S1 ΔR2 = 10%, S2 ΔR2 = 10%) and externalizing symptoms (S1 ΔR2 = 2%, S2 ΔR2 = 1%), above and beyond child and family variables. Age moderated the relationship between sleep disturbances and internalizing symptoms (S1 ß = 0.07; S2 ß = 0.07; ΔR2 = 0.004 in both samples), but not externalizing symptoms; sleep disturbance was more strongly related to internalizing symptoms amongst adolescents (ß = 0.98) than children (ß = 0.62). Discussion: The relationship between sleep and internalizing symptoms appears to change as children move through development. Further, sleep was a stronger predictor of internalizing problems in adolescents than children, suggesting an additional focus of clinician efforts in this age group. These findings strengthen the importance of routine assessment of sleep, as is done with the interRAI ChYMH. [ABSTRACT FROM AUTHOR]

Risky sexual behavior (RSB) has been linked to externalizing problems, substance use, and, in a recent study by our lab, internalizing problems. The current study builds upon previous work investigating the relationship between RSB and internalizing problems (INT) by controlling for externalizing problems (EXT) to account for the correlation between INT and EXT. We used a twin sample from Colorado (N = 2,544) to investigate phenotypic and genetic relationships between the three latent constructs, as well as potential sex differences in those relationships. We hypothesized that the relationship between RSB and INT would be stronger for females than for males, whereas the relationship between RSB and EXT would be stronger for males than for females. We used phenotypic confirmatory factor analysis and multivariate twin analyses to address research questions. Our results show significant phenotypic relationships among RSB, INT, and EXT and provide modest evidence in males for a significant association between RSB and INT that persists when controlling for EXT, a finding which we interpret with caution. Our sex differences hypothesis was not fully supported, although the direction of effects was in the direction hypothesized for the association between RSB and INT. We discuss the complexity of RSB as a phenotype and the potential implications for public health. [ABSTRACT FROM AUTHOR]

Psychophysiology can help elucidate the structure and developmental mechanisms of psychopathology, consistent with the Research Domain Criteria initiative. Cross-sectional research using categorical diagnoses indicates that P300 is an electrocortical endophenotype indexing genetic vulnerability to externalizing problems. However, current diagnostic systems' limitations impede a precise understanding of risk. The Hierarchical Taxonomy of Psychopathology (HiTOP) overcomes these limitations by delineating reliable dimensions ranging in specificity from broad spectra to narrow syndromes. The current study used a HiTOP-aligned approach to clarify P300's associations with a higher-order externalizing factor versus syndrome-specific manifestations within externalizing and internalizing spectra during middle and late adolescence. Participants from the Minnesota Twin Family Study's Enrichment Sample contributed psychophysiological and clinical data at age 14 (N = 930) and follow-up clinical data at age 17 (N = 913). Blunted target P300 at age 14 was selectively associated with externalizing as manifested at age 17 at the superspectrum level (rather than specific externalizing syndromes). Unlike in prior work, target P300 amplitude was positively associated with age 17 depressive symptoms (once controlling for standard stimuli). No association was observed with lifetime symptoms of childhood externalizing or depression evident by age 14. The results indicate that blunted target P300 elucidates specific risk for the development of late-adolescent/young-adult expressions of general externalizing, over and above symptoms evident by middle adolescence. Additionally, the findings speak to the synergistic utility of studying HiTOP-aligned dimensions using multiple measurement modalities to build a more comprehensive understanding of the development of psychopathology. General Scientific Summary: This study suggests that a brain response known to be reduced among people with substance use disorders and antisocial personality disorder is associated with the serious behavioral dysregulation shared among these conditions in late adolescence and not with other forms of disruptive behavior evident by middle adolescence. These findings deepen our understanding of the neural signatures of risk for mental illness, how they transcend diagnostic boundaries, and how they change with age. [ABSTRACT FROM AUTHOR]

Introduction: Along with pubertal development, the transition to adolescence brings about increased risk for sleep disturbances and mental health problems. Functional connectivity of overlapping large-scale brain networks, such as increased connectivity between the default mode and dorsal attention networks, has been reported to relate to both sleep and mental health problems. Clarifying whether pubertal development interacts with sleep disturbances and functional brain networks to predict mental health may provide information to improve the timing and design of interventions targeting sleep disturbances in adolescents. Methods: To examine how pubertal status and tempo relate to sleep disturbances and shape the relationship between sleep disturbances and mental health problems, we harnessed a large sample of children aged 10-14 years from the Adolescent Brain and Cognitive Development (ABCD) Study (N ~ 3,000-10,000). We used graph theoretical tools to probe how pubertal development concurrently interacts with sleep disturbances and brain network organization to predict mental health problems. Results: We found that advanced pubertal status, but not pubertal tempo, predicted sleep disturbances; however, both pubertal status and tempo interact with sleep disturbances to predict mental health problems and engage in three-way interactions with sleep and brain network organization to predict mental health problems. Discussion: Overall, this work suggests that less advanced pubertal status and slower tempo are risk factors for the strongest links between sleep disturbances, brain organization, and mental health problems. Further, our findings speak to the importance of accounting for interactions in the constellation of factors that surround complex behavioral and clinical syndromes, here internalizing and externalizing disorders, and provide new context to consider for targeted interventions. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a global public health problem and is highly prevalent among justice-involved populations. Pediatric TBI is linked with long-term negative outcomes and is correlated with substance use, criminal behavior, psychiatric disorders, and disruptions in neurocognition. These same TBI correlates are evident among youth with psychopathic traits. Given ongoing neurobiological and social development in adolescence, understanding the link between psychopathic traits and TBI in justice-involved youth is critical. A sample of 263 male adolescents were recruited from a maximum-security juvenile justice facility. Using a structural equation modeling (SEM) framework, measurement invariance of psychopathic traits (TBI ±) was tested, and psychopathy scores were accounted for in terms of TBI variables (severity, age of first TBI, total number), participant's age, IQ, substance use, and internalizing psychopathology. There was evidence of strong invariance across TBI status and those with TBI had higher affective and impulsive lifestyle psychopathic traits than adolescents without TBI. The SEM indicated that TBI severity was associated with lower IQ scores, which in turn were associated with increased lifestyle/antisocial (Factor 2) psychopathic traits. Total number of TBIs was associated with higher substance use, which was associated with both increased interpersonal/affective (Factor 1) and Factor 2 psychopathic traits. These TBI variables also had indirect associations with psychopathic traits through IQ and substance use. The findings indicate that TBI is associated with psychopathic traits and suggest that disturbances in cognition and substance use may be treatment targets for youth with TBI and psychopathic traits. [ABSTRACT FROM AUTHOR]

Introduction: The co-occurrence of mental disorder symptoms is common in people who use substances. It is unclear whether patterns of comorbidity in a population-based sample of adults are consistent with prior work. The study goal was to identify this comorbidity structure and evaluate its stability over time. Methods: Using Waves 1, 2, and 3 of the Population Assessment of Tobacco and Health Study, this study applied latent class analysis to identify comorbid substance use, internalizing and externalizing mental disorder symptoms, and their stability over time. Results: A four-class solution was identified for Wave 1 as: (1) low symptom (N = 23,571, 72.9%), (2) internalizing (N = 4,098, 12.7%), (3) externalizing (N = 2,691, 8.3%), and (4) comorbid (N = 1,960, 6.1%). Similar latent profiles emerged across the three waves specifically where the low symptom class was largest (65.5% to 72.9%), and the comorbid class was smallest (6.1% to 8.2%). However, the composition of the classes changed in Wave 3 with low comorbid (N = 5,400, 20.6%) and substance use (N = 1,524, 5.8%) classes emerging. Overall, when individuals transitioned from preceding to subsequent wave, they typically transitioned into the low symptom class. Conclusion: The comorbidity structure of substance use behaviors, including cigarette and e-cigarette use, and mental disorder symptoms in a population-based sample of U.S. adults was characterized by four classes. Psychiatric comorbidity may vary in severity within a population and by specific sociodemographic factors. When comparing the latent classes over three years of data, the results suggest that the comorbidity structure may change as participants age. [ABSTRACT FROM AUTHOR]

Recent statistics suggest that student externalizing behaviors are increasing in Western and Asian countries; however, there is a paucity of research on teachers' perspectives of these behaviors in Middle Eastern countries. A mixed-methods research design was used to investigate Kuwaiti public elementary and middle school teachers' perceptions of their classroom behavior management (CBM) experiences, including their (a) academic preparation; (b) use of CBM practices to support students with externalizing behaviors; (c) observations of student externalizing behaviors; and (d) perceptions on administrative support and family involvement. Participants included 2,140 general and special education teachers randomly recruited from 45 schools. Results indicated that fewer than half of the teachers surveyed had prior instruction in CBM, reported using a wide variety of CBM practices in response to student behavior problems, and perceived higher levels of administrative support than family involvement. Implications of the study's findings and suggestions for further research were discussed [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have a profound impact on individuals, shaping their long-term health and life opportunities. This study delves into the complex ties between ACEs and the socioemotional development of Australian children and youth by examining the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors. This study utilized data from the Longitudinal Study of Australian Children and employed the generalized estimating equation method to investigate the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in Australian children and adolescents. Adverse childhood experiences such as physical punishment, hostile parenting, parental conflicts, separation, financial strain, and parental mental health issues increased the risk of externalizing and internalizing behaviors while reducing prosocial behaviors. The risk increases with the number of ACEs, as evidenced by the incidence ratio (IR); for example, for externalizing behaviors, an ACEs score of one leads to IR = 1.69, while an ACEs score of 4 results in IR = 3.34. Similar trends were observed for internalizing and prosocial behaviors. The presence of imbalanced longitudinal data, arising from variations in the number of observations across different time points, challenges robust inferences. Furthermore, this study investigates the relationship between ACEs and behavioral problems, without establishing causality. Consequently, the results should be interpreted with caution. The findings of this study highlight that adverse childhood experiences significantly influence behavioral outcomes in children and adolescents. These findings underscore the critical need for early detection and intervention to mitigate the consequences of traumatic childhood experiences. • Adverse childhood experiences (ACEs) significantly impact the socioemotional development of children and adolescents. • Higher ACEs scores correspond to an elevated risk of externalizing, and internalizing, while diminishing prosocial behaviors. • Early detection and intervention are needed to reduce the detrimental effects of ACEs on children's behavior. [ABSTRACT FROM AUTHOR]

This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems). The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4–5, 8–9, 16–17, and 26–27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4–5, 8–9, and 16–17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26–27 years after the birth of the first child. Complete follow-up data were available for 168 mothers. We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning. Maternal and child measures were based on maternal reports only. The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children. • We present maternal depressive symptom trajectories over 27 years (1989–2017) • The maternal symptom trajectories were Very Low, Low Stable and High Stable • Low Stable trajectory predicted the best and High Stable the least optimal outcome • Child's problems predicted mother's problems but not her adaptive functioning [ABSTRACT FROM AUTHOR]

Background/aim: Migraine is a prevalent neurological disorder that can lead to disability in children and adolescents. It is frequently accompanied by psychiatric comorbidities, both internalizing and externalizing disorders. While the relationship between migraine and internalizing disorders has been studied, there is limited research on the link between migraine and attention deficit hyperactivity disorder (ADHD). Materials and methods: A total of 280 pediatric headache patients, 107 with externalizing (ADHD) and 173 with internalizing disorders (depression and/or anxiety), were included. The dataset was composed using the Turkish headache database, Mersin Branch. Pain characteristics, associated symptoms, and accompanying comorbidities were evaluated retrospectively. Results: Two hundred four patients were followed up with episodic migraine (EM) and 76 patients with chronic migraine (CM). One hundred forty-six boys and 134 girls were evaluated, and internalizing disorders were more common in the girls (p < 0.001). It was a much more prominent accompaniment in chronic migraine internalizing disorders (p = 0.038). EM, on the other hand, was more frequent in ADHD. Pain intensity and frequency were greater in those with internalizing disorders (p = 0.007), while photophobia was more prevalent in those with ADHD (OR; 0.555, p = 0.044). Moreover, we observed that individuals with internalizing disorders were predominantly female (p = 0.003) and had a higher mean age (p < 0.001) than those with externalizing disorders. Conclusion: Internalizing disorders seem to be a risk factor for migraine chronification in pediatric migraine. ADHD is a prototypic externalizing disorder more associated with EM. This outcome provides an opportunity to follow our patients in terms of prognosis and offers us the chance for a better evaluation. Identifying factors that contribute to the chronicity of migraine may lead to better management and reduced disability for migraine sufferers. [ABSTRACT FROM AUTHOR]

Externalizing behaviors encompass manifestations of risk-taking, self-regulation, aggression, sensation-/reward-seeking, and impulsivity. Externalizing research often includes substance use (SUB), substance use disorder (SUD), and other (non-SUB/SUD) "behavioral disinhibition" (BD) traits. Genome-wide and twin research have pointed to overlapping genetic architecture within and across SUB, SUD, and BD. We created single-factor measurement models—each describing SUB, SUD, or BD traits—based on mutually exclusive sets of European ancestry genome-wide association study (GWAS) statistics exploring externalizing variables. We then assessed the partitioning of genetic covariance among the three facets using correlated factors models and Cholesky decomposition. Even when the residuals for indicators relating to the same substance were correlated across the SUB and SUD factors, the two factors yielded a large correlation (rg = 0.803). BD correlated strongly with the SUD (rg = 0.774) and SUB (rg = 0.778) factors. In our initial decompositions, 33% of total BD variance remained after partialing out SUD and SUB. The majority of covariance between BD and SUB and between BD and SUD was shared across all factors, and, within these models, only a small fraction of the total variation in BD operated via an independent pathway with SUD or SUB outside of the other factor. When only nicotine/tobacco, cannabis, and alcohol were included for the SUB/SUD factors, their correlation increased to rg = 0.861; in corresponding decompositions, BD-specific variance decreased to 27%. Further research can better elucidate the properties of BD-specific variation by exploring its genetic/molecular correlates. [ABSTRACT FROM AUTHOR]

Anxiety and externalizing concerns create notable challenges for families. One factor that has been widely studied in relation to anxiety concerns, which may also be influenced by externalizing symptoms, is parental accommodation. Most research on parental accommodation has tended to focus on behaviors, while not accounting for accommodation beliefs. The current study sought to examine the relation between both parental accommodation beliefs and behaviors and also determine to what extent externalizing symptoms may influence this relation in youth. Treatment-seeking youth (N = 260; M age = 13.48, range: 8–17) and their caregivers in the U.S. Midwest completed measures on anxiety symptoms, externalizing symptoms, and parental accommodation. Results indicated that parental accommodation behaviors had a direct influence on anxiety-related family impairment and avoidance but not anxiety symptom severity. There were no direct associations for parental accommodation beliefs. Externalizing symptoms moderated the relation between accommodation behaviors and family impairment, suggesting that the influence of parental accommodation on reported family impairment is attenuated at greater levels of externalizing symptoms. These findings highlight the importance of considering externalizing symptoms when examining the relation between parental accommodation and anxiety presentations, as well as further researching how accommodation-specific beliefs may influence accommodation behaviors and anxiety in youth. [ABSTRACT FROM AUTHOR]

This study investigated child-reported family obligation values (FOVs) in early adolescence as a moderator for associations between mother-, father-, and child-reported parental psychological control (PC) in early adolescence and child-reported internalizing and externalizing symptoms in middle and late adolescents in the Philippines. Data were drawn from three waves of a larger longitudinal study, when the Filipino youth were in late elementary grades (age M = 12.04, SD = 0.58; N = 91), in junior high school (age M = 15.03, SD = 0.59; N = 80), and in senior high school (age M = 17.00, SD = 0.59, N = 75). Results revealed that high levels of FOV buffered the positive associations between mother-reported PC and internalizing symptoms in late adolescence, and between child-reported PC and internalizing symptoms in middle and late adolescence, as well as externalizing symptoms in late adolescence. Conversely, low levels of FOV exacerbated the associations between mother- and child-reported PC on externalizing symptoms in late adolescence. Findings suggest that FOV may shape the meaning and influence of PC for children and adolescents in contexts where familial obligations are normative and important. [ABSTRACT FROM AUTHOR]

Recent research has reported effects of socioeconomic status on neurobehavioral development as early as infancy, including positive associations between income and brain structure, functional connectivity, and behavior later in childhood (Ramphal, Whalen, et al., 2020; Triplett et al., 2022). This study extends this literature by investigating the relation of maternal prenatal social disadvantage (PSD) to neonatal amygdala and hippocampus functional connectivity and whether socioeconomic-related alterations in functional connectivity subsequently predict behavior at age 12 months in a large, socioeconomically diverse sample (N = 261 mother–infant dyads). PSD was assessed across gestation; neonatal magnetic resonance imaging was completed within the first weeks of life; and infant internalizing and externalizing symptoms were evaluated using the Infant–Toddler Social and Emotional Assessment at age 12 months. The results showed that PSD was significantly related to neonatal right amygdala and left hippocampus functional connectivity with prefrontal and motor-related regions. Social disadvantage-related right amygdala and left hippocampus functional connectivity with these regions was subsequently related to infant externalizing and internalizing symptoms at age 12 months. Building off an emerging literature exploring prenatal impacts on neonatal functional connectivity, this study further emphasizes the important role of the maternal environment during gestation on infant brain function and its relationship with externalizing and internalizing behavior in the first years of life. The results suggest that the prenatal socioeconomic environment may be a promising target for interventions aimed at improving infant neurobehavioral outcomes. Public Significance Statement: This study suggests that mothers' prenatal social disadvantage (PSD) impacts the brain function of their infants in the weeks shortly after birth. Additionally, the study reports a link between infant brain function shortly after birth and infant behavior 1 year later. The study results suggest that mother's PSD may be a promising target for interventions that improve infant health. [ABSTRACT FROM AUTHOR]

Adolescents' general growth is greatly aided by their families, which are crucial in shaping their emotional, behavioral, social, and academic outcomes and interpersonal relationships. The conflict between parents can significantly hinder this growth, leading to externalizing and internalizing behaviors and affecting their overall functioning. This study compiles pertinent data to identify IPC's dimensions, elements, and effects on adolescents. This scoping review examined the literature using both inclusion and exclusion criteria. Out of 120 relevant publications, 15 were evaluated. The publications were found in electronic databases like PubMed, Scopus, Research Gate, and Google Scholar and were published between 2016 and 2023. The search strategy adhered to Arksey and O'Malley's five-step protocol, which included formulating a research question, locating pertinent literature, choosing a subset of the literature for assessment, graphing data from particular publications, and summarizing and presenting the findings. This literature review indicates that IPC is a serious problem that results in adolescents' externalizing behaviors. The results of this scoping review have consequences for policy and practice. Given the significant extent and weight of adolescent exposure to interparental conflict, the need of the time is to develop an intervention program to protect this vulnerable population and reduce their externalizing behaviors. [ABSTRACT FROM AUTHOR]

Longitudinal trajectories of psychopathology in previously institutionalized (PI) youth were identified and biobehavioral emotion regulation processes were examined as developmental mechanisms that predict these trajectories. Mental health data were collected from PI (N = 132) and nonadopted (NA; N = 175) youth across four time points (participant age ranged from 7- to 21-year-old). Using semiparametric group-based methods, the probability that each individual belonged to a distinct group that followed a specific pattern of behavior across time was estimated. We then tested whether unique aspects of emotion regulation (global, observed, and biological) were differentially associated with membership in externalizing and internalizing trajectory groups using multinomial logistic regression models. Four externalizing trajectories were identified for the PI and NA groups. For PI youth, global, observed, and biological emotion regulation processes were uniquely predictive of more adaptive externalizing trajectories. For NA youth, only parent-reported global emotion regulation was predictive of externalizing patterns. Three internalizing trajectories were identified for PI and NA youth. Generally, only parent-reported global emotion regulation predicted internalizing group membership for both PI and NA youth. Results suggest that biobehavioral emotion regulation processes may be particularly important predictors and potential points of intervention when targeting trajectories of externalizing behaviors in PI children. [ABSTRACT FROM AUTHOR]

Children who experience maltreatment are prone to exhibit interpersonal deficits and lack secure attachment, which can lead to internalizing and externalizing symptomatology. This study investigated timing and chronicity of maltreatment and its impacts on psychopathology outcomes in young adulthood. Two interpersonal mediators were examined: problems with peers and childhood attachment security. Children with and without maltreatment exposure were recruited to take part in a 1-week research summer camp (N = 697; mean [SD] age = 11.29 [0.97] years; 71.3% Black or African American; 50.5% male). Participants were recontacted in young adulthood to complete a second wave of assessments (n = 427; mean [SD] age = 19.67 [1.16] years; 78.0% Black or African American; 48.9% male). Structural equation modeling was used to estimate indirect effects from child maltreatment timing to young adult internalizing and externalizing symptomatology via childhood attachment security and peer problems. Findings highlighted the detrimental impact of chronic maltreatment, which was associated with higher levels of peer problems (β =.24, p <.001) and less secure attachment (β = −.13, p <.01) in childhood. Also, lower attachment quality in childhood mediated the association between chronic maltreatment and self-reported internalizing (a × b = 0.02, p <.05) and externalizing symptomatology (a × b = 0.02, p <.05). Additionally, childhood peer problems mediated the association between chronic maltreatment and caregiver-reported internalizing problems (a × b = 0.04, p <.05). Chronic maltreatment is particularly harmful for interpersonal outcomes of children. Mediation findings differed by who reported on psychopathology, showing the importance of considering multireporter measures of psychopathology. Child maltreatment is an interpersonal stressor that may impact developmental outcomes throughout a youth's life. In this study of 697 children who participated in a 1-week research summer camp and were contacted in young adulthood, the authors found that chronic maltreatment significantly increased the risk of difficulties in forming secure attachments as well as having problems with peers during childhood. In turn, these challenges were linked to emotional and behavioral symptomology in young adulthood. These findings emphasize the need to support children facing chronic maltreatment to improve their long-term mental health. [ABSTRACT FROM AUTHOR]

Background: We used a polygenic score for externalizing behavior (extPGS) and structural MRI to examine potential pathways from genetic liability to conduct problems via the brain across the adolescent transition. Methods: Three annual assessments of child conduct problems, attention‐deficit/hyperactivity problems, and internalizing problems were conducted across across 9–13 years of age among 4,475 children of European ancestry in the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Results: The extPGS predicted conduct problems in each wave (R2 = 2.0%–2.9%). Bifactor models revealed that the extPRS predicted variance specific to conduct problems (R2 = 1.7%–2.1%), but also variance that conduct problems shared with other measured problems (R2 =.8%–1.4%). Longitudinally, extPGS predicted levels of specific conduct problems (R2 = 2.0%), but not their slope of change across age. The extPGS was associated with total gray matter volume (TGMV; R2 =.4%) and lower TGMV predicted both specific conduct problems (R2 = 1.7%–2.1%) and the variance common to all problems in each wave (R2 = 1.6%–3.1%). A modest proportion of the polygenic liability specific to conduct problems in each wave was statistically mediated by TGMV. Conclusions: Across the adolescent transition, the extPGS predicted both variance specific to conduct problems and variance shared by all measured problems. The extPGS also was associated with TGMV, which robustly predicted conduct problems. Statistical mediation analyses suggested the hypothesis that polygenic variation influences individual differences in brain development that are related to the likelihood of conduct problems during the adolescent transition, justifying new research to test this causal hypothesis. [ABSTRACT FROM AUTHOR]

This longitudinal study assessed how parent-child relationship quality during the first COVID-19 lockdown was related to changes in internalizing, externalizing, and sleep problems during the first months of the pandemic: during lockdown, partial deconfinement, and total deconfinement. Participants included 167 children (9–12 year) and their parents recruited in the province of Quebec, Canada. Child behavior problems decreased between lockdown and the two deconfinement assessments, but more sleep and behavior problems were associated with lower levels of relationship quality (more conflict, less closeness, and more insecure attachment). Significant interaction effects showed that changes in externalizing and sleep problems varied as a function of parent-child relationship. Results support the critical importance of the parent-child relationship with regard to child adjustment in middle childhood in times of crisis such as a pandemic. They also highlight resilience in children aged 9 to 12, with a decrease in problems over time. [ABSTRACT FROM AUTHOR]

The influence of socio‐economic status (SES) on child temperament and psychological symptoms was examined using a nationally representative sample in Singapore. Data were available for 2169 children from 1987 families. Caregivers' reports were obtained on children aged 4–6. SES was operationalized as an aggregation of household income per capita, parental education level and housing type. Compared to their counterparts from higher SES families, children from low‐SES families tended to exhibit (a) higher negative affectivity but lower effortful control, and (b) higher internalizing and externalizing symptoms. In addition, children with a 'resilient' temperamental profile (i.e. low negative affectivity and high effortful control) were more likely to come from families with much higher SES, relative to children with other profiles. Children with high internalizing symptoms tended to come from low‐SES backgrounds, regardless of their externalizing symptoms. Among children with low internalizing symptoms, those with high externalizing symptoms came from lower SES backgrounds compared to those with low externalizing symptoms. Parental warmth and distress mediated the association between SES and child temperament and symptom profiles, with the exception of distress in the SES–temperament link. These findings supported the family stress model and highlighted the novel perspective of SES's influence on configurations of child temperament and symptom characteristics. [ABSTRACT FROM AUTHOR]

The present study investigated whether distinct developmental patterns of externalizing behaviors (EBs: hyperactivity–impulsivity, noncompliance, physical aggression) based on parent reports were repeatedly and differentially associated with separate dimensions of internalizing problems such as general anxiety, separation anxiety, and depressive symptoms across the early, middle, and late preschool years in a population birth cohort (N = 2,057, 50.7% boys). Six high trajectory classes obtained by latent growth modeling were used as longitudinal indicators of single EB and co-occurrent EBs. Children following low or moderate trajectories for all EBs served as the reference class. Results revealed that children in trajectory classes reflecting high levels of co-occurring EBs showed higher levels of general anxiety, separation anxiety, and depressive symptoms across the preschool years. In contrast, children in trajectory classes reflecting single EB manifested higher levels of some, but not all, dimensions of internalizing problems. In addition, their scores varied from one period to another. No sex differences were observed in the above associations. These results underline the need for comprehensive assessments across distinct types of EBs and internalizing problems to better reflect the characteristics that distinguish individual children. Finally, results suggest that children showing early co-occurrent EBs and internalizing symptoms may be an important group to target for in-depth assessment and possibly preventive intervention. Public Significance Statement: Children who show a high level of externalizing behaviors (EB: hyperactivity–impulsivity, noncompliance, or physical aggression) from the early to late preschool years—and especially preschoolers with high levels of multiple EBs—also present higher levels of anxiety, separation anxiety, and depressive symptoms. These findings are consistent with a developmental approach to psychopathology and emphasize the importance of early preventive evaluation and potential intervention with these children. [ABSTRACT FROM AUTHOR]

The direct associations between two dimensions of parent emotion regulation within the parent-youth relationship (dysregulation; suppression), mindful parenting, and youth internalizing and externalizing problems were examined among 759 parents of youth with significant behavioural or emotional problems. The indirect associations of parent emotion regulation and mindful parenting with youth functioning through youth attachment anxiety and avoidance were also investigated. Parent dysregulation was associated with internalizing symptoms both directly and through attachment anxiety, and with externalizing symptoms directly and through attachment anxiety and avoidance. Parent suppression was associated with internalizing symptoms through attachment anxiety, and with externalizing symptoms through attachment anxiety and avoidance. Mindful parenting was associated with lower internalizing symptoms through attachment anxiety and with lower externalizing symptoms through attachment anxiety and avoidance. Emotion regulation within parent-child relationships and mindful parenting may be critical components of parenting programs aimed at promoting youth attachment security and mental health. [ABSTRACT FROM AUTHOR]

Activation parenting includes behaviors that challenge children to approach novel situations, explore their environments, and take physical and socioemotional risks through a balance of encouragement and limit-setting. Although components of activation parenting have been linked to lower levels of children's problem behaviors, comprehensive measures of activation parenting and longitudinal research on families from low socioeconomic backgrounds are lacking. The goal of the present study was to test associations between paternal activation parenting at age 3 and children's externalizing and internalizing problems at age 5 in a sample of low-income, ethnically diverse fathers. Participating fathers (N = 171; 9% Black, 47% white, 8% Latinx; mean household income = $25,145) and their children (51% female) were drawn from the Early Steps Multisite Study. Activation parenting during a teaching task at child age 3 was associated with lower levels of internalizing problems at age 5 and decreases in externalizing problems from baseline (age 2). Implications of the current findings are presented for future research on associations between activation parenting and child problem behaviors, including the potential for the development of prevention and intervention programs. [ABSTRACT FROM AUTHOR]

IntroductionNumerous early-life risk factors are thought to significantly contribute to the development of psychological problems in toddlerhood. However, these factors have seldom been investigated concomitantly and longitudinally, and few studies include both mothers and fathers. This study examines the longitudinal impact of early environmental, parental, and child-specific risk factors on children’s internalizing and externalizing symptomatology at age 4.MethodsFamilies were recruited from a perinatal center at birth and completed self-report questionnaires at birth, 4 weeks postpartum, 6 months postpartum, and annually thereafter. The final population-based sample consisted of n = 560 mothers (and fathers) who gave birth after June 2015, with children who turned 4 years old before March 31, 2021. The primary outcomes, children’s internalizing and externalizing symptomatology at age 4, were measured using the Strengthsand Difficulties Questionnaire. Linear mixed effect models were used to estimate growth curves for predictors between 4 weeks and 4 years postpartum, which were subsequently entered into multivariable linear regressions to predict internalizing and externalizing symptomatology at age 4.ResultsThe study identified several key risk factors: environmental (lack of social support, lower parental education, male sex), parental (poor parental mental health, increased parenting stress, parental sleep difficulties) and child-specific (children’s low physical health, children’s reduced sleep quality, temperament).DiscussionThe findings underscore that most identified risk factors are related to children’s temperament, mental and physical health of parents, their experienced stress, and families’ social support networks. These insights highlight the importance of targeted interventions focusing on improving parental mental health, reducing stress, and enhancing social support to mitigate early-life psychological problems in children.

BackgroundResearchers have identified genetic and neural risk factors for externalizing behaviors. However, it has not yet been determined if genetic liability is conferred in part through associations with more proximal neurophysiological risk markers.MethodsParticipants from the Collaborative Study on the Genetics of Alcoholism, a large, family-based study of alcohol use disorders were genotyped and polygenic scores for externalizing (EXT PGS) were calculated. Associations with target P3 amplitude from a visual oddball task (P3) and broad endorsement of externalizing behaviors (indexed via self-report of alcohol and cannabis use, and antisocial behavior) were assessed in participants of European (EA; N = 2851) and African ancestry (AA; N = 1402). Analyses were also stratified by age (adolescents, age 12-17 and young adults, age 18-32).ResultsThe EXT PGS was significantly associated with higher levels of externalizing behaviors among EA adolescents and young adults as well as AA young adults. P3 was inversely associated with externalizing behaviors among EA young adults. EXT PGS was not significantly associated with P3 amplitude and therefore, there was no evidence that P3 amplitude indirectly accounted for the association between EXT PGS and externalizing behaviors.ConclusionsBoth the EXT PGS and P3 amplitude were significantly associated with externalizing behaviors among EA young adults. However, these associations with externalizing behaviors appear to be independent of each other, suggesting that they may index different facets of externalizing.

BACKGROUND: Maladaptive family environments harm child development and are passed across generations. Childhood interventions may break this intergenerational cycle by improving the family environments children form as adults. The present study investigates this hypothesis by examining follow-up data collected 18 years after the end of the childhood Fast Track intervention designed to prevent externalizing problems. METHODS: We examined whether Fast Track assignment from grades 1 to 10 prevented the emergence of maladaptive family environments at age 34. A total of 400 (n = 206 in intervention condition, n = 194 controls) Fast Track participants who were parents at age 34 were surveyed about 11 aspects of their current family environment. The hypotheses and analytic plan were preregistered at https://osf.io/dz9t5 and the Fast Track trial was registered at clinicaltrials.gov (NCT01653535). RESULTS: Multiple group linear regression models revealed that mothers who participated in the Fast Track intervention as children had lower depression symptoms, alcohol problems, drug problems, corporal punishment use, and food insecurity compared to control group mothers. All effects were modest in magnitude. However, for these same mothers, the Fast Track intervention had no effect on cannabis problems, experiences of romantic partner violence, or maternal use of physical aggression or warmth with their children. Additionally, mothers in the Fast Track intervention group reported higher levels of family chaos than those in the control group, but this effect may be a byproduct of the higher number of children per household in the intervention group. No intervention effects were found for fathers who participated in the Fast Track intervention as children. CONCLUSIONS: Childhood assignment to Fast Track has some beneficial effects for girls, but not boys, on the family environments these individuals formed as adults 18 years later.

Background: Due to limitations of categorical definitions of mental illness, there is a need for quantitative empirical investigations of the dimensional structure of psychopathology. Using exploratory bifactor methods, this study investigated a comprehensive and representative structure of psychopathology in children to better understand how psychotic‐like experiences (PLEs), autism spectrum disorder (ASD) symptoms, impulsivity, and sensitivity to reward and punishment, may be integrated into extant general factor models of psychopathology. Methods: We used seven child‐report and three parent‐report instruments capturing diverse mental health symptoms in 11,185 children aged 9–10 from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study. We built on previous modeling frameworks by conducting both split sample and full sample factor analytic approaches that harnessed recent methodological advances in bifactor exploratory structural equation modeling (B‐ESEM) to examine a wide range of psychopathology measures not previously integrated into a single analysis. Validity of psychopathology dimensions was examined by investigating associations with sex, age, cognition, imaging measures, and medical service usage. Results: All four factor analytic models showed excellent fit and similar structure within informant. PLEs loaded most highly onto a general psychopathology factor, suggesting that they may reflect non‐specific risk for mental illness. ASD symptoms loaded separately from attention/hyperactivity symptoms. Symptoms of impulsivity and sensitivity to reward and punishment loaded onto specific factors, distinct from externalizing and internalizing factors. All identified factors were associated with clinically relevant risk factors, providing preliminary evidence for their construct validity. Conclusion: By integrating diverse child‐report and parent‐report psychopathology measures for children in the ABCD sample, we deliver data on the quantitative structure of psychopathology for an exceptionally large set of measurements and discuss implications for the field. [ABSTRACT FROM AUTHOR]

School absenteeism among children and adolescents has been associated with a myriad of adverse outcomes. Despite a substantial amount of research on school attendance, our understanding of absenteeism in elementary-aged children with mental health difficulties is limited. The current study used a mixed-method sequential explanatory design to gain a better understanding of the links between children's mental health symptoms, age, gender and school absenteeism. The study included two phases: Phase I presented a quantitative investigation of the links between absenteeism and mental health symptoms in a large sample (N = 750) of primarily White (74%) clinic-referred children aged 5–12 years. Phase II used a participant selection model and chart review design to garner a deeper understanding of how school absenteeism presents in children with mental health problems in the elementary years. Results suggested that internalizing symptoms were significantly related to school attendance problems, and this association worsens as children age and as internalizing symptoms increase in severity. Externalizing symptoms were associated with absenteeism as well, but these findings showed that school attendance problems were worse for younger children with low to moderate levels of externalizing symptoms. The qualitative chart review illustrates the complex interplay of school absenteeism and child mental health, particularly for children experiencing co-occurring internalizing and externalizing problems. Children often struggled academically and socially, with some exhibiting increasing levels of school refusal and truancy and others displaying aggressive behaviors resulting in suspensions. Future studies that examine additional contextual factors, such as school and family variables, with longitudinal cross-lagged models and diverse families are needed to develop a comprehensive understanding of causal associations and their impact on children's school attendance across children's development. [ABSTRACT FROM AUTHOR]

To examine the additive or moderating influences of caregiver COVID-19–related stress, social support, and discrimination on children's behavior problems across racially diverse populations. In this Environmental influences on Child Health Outcomes (ECHO) cohort study (N = 1,999 caregiver/child pairs), we operationalized caregiver COVID-19–related stress in 2 ways: first, as the number of stressors (eg, financial concerns, social distancing); and second, as the level of pandemic-related traumatic stress symptoms reported via questionnaires administered between April 2020 and August 2022. At the same assessment visit, caregivers also reported their current levels of discrimination, and a subsample (n = 968) reported their emotional and instrumental support. Either concurrently or at a later assessment visit, caregivers reported on their children's internalizing and externalizing behavior problems using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18). Multivariable analyses controlling for maternal education, marital status, child age, and child sex revealed that COVID-19–related stress (caregiver stressors and symptoms) and discrimination were positively associated, and that perceived support was negatively associated with child internalizing and externalizing behavior problems. Unexpectedly, neither emotional nor instrumental support attenuated the relationship between caregiver COVID-19–related stressors nor traumatic stress symptoms and child behavior problems. In the subset of Black American participants, caregiver perceived discrimination moderated the relationship between caregiver COVID-19 traumatic stress symptoms and child internalizing problems, such that the association was stronger at higher levels of discrimination. Our findings highlight the potential importance of relieving caregiver stress and increasing caregiver social support to optimize children's behavioral outcomes. [ABSTRACT FROM AUTHOR]

This study examined parents' report of behaviour in preschoolers after a mild traumatic brain injury (mTBI), compared the proportion of preschoolers with elevated behaviour ratings between the mTBI and limb injury (LI) groups, and explored injury, premorbid child, and parent variables that may be associated with parents' report of behaviour at three months post-injury. Children aged 2–5 years with a mTBI (n = 13) or mild LI (n = 6) were recruited from the emergency department. Behaviour was assessed using the Child Behaviour Checklist. Preliminary findings showed that post-injury behaviour ratings remained in the normal range. The mTBI group had higher scores than the LI group at three months post-injury in terms of sleep; however, this may have been pre-existing. Two children with mTBI received borderline-clinically significant ratings on diagnostic-level anxiety problems at the three-month follow-up, while none of the limb-injured controls obtained elevated behaviour ratings. Parent-rated post-injury behaviour was significantly associated with premorbid child functioning and parental stress, which needs to be explored in greater detail using larger preschool mTBI samples. [ABSTRACT FROM AUTHOR]

Mother's positive parenting predicts children's development of concern for others; however, it is unclear which distinct positive parenting behaviors contribute to children's concern for others. We examined the bidirectional associations between mothers' warmth and reasoning and children's concern toward an adult in distress at 4 and 6 years. We tested these associations in two independent samples with parallel methods, a U.S. community sample (Study 1, N = 83, 44% female, 73.6% White, median income range = $75,000–$90,000 USD) and a Canadian sample at risk for externalizing problems (Study 2, N = 98, 50% female, 82.7% White, median income range = $70,000–$80,000 CND). Child gender and externalizing problems were examined as moderators of these bidirectional socialization processes. In Study 1, a cross‐lagged model (CLM) found that maternal warmth positively predicted children's concern for others over 2 years, whereas children's concern for others inversely predicted future maternal reasoning. Multigroup comparisons found these lagged effects were unique to boys only. Study 2 partially replicated Study 1, revealing fully bidirectional socialization effects unique to boys. Maternal reasoning positively predicted the development of boys' concern for others over 2 years, and boys' greater concern for others at age 4 elicited greater maternal reasoning over 2 years. Maternal warmth positively predicted concern for others only for children with elevated externalizing problems. These findings support a differentiated approach to positive parenting research, revealing that distinct parenting behaviors may meet individual child needs uniquely. [ABSTRACT FROM AUTHOR]

Externalizing psychopathology has been found to have small to moderate associations with neighborhood and family sociodemographic characteristics. However, prior studies may have used suboptimal operationalizations of neighborhood sociodemographic characteristics and externalizing psychopathology, potentially misestimating relations between these constructs. To address these limitations, in the current study we test different measurement models of these constructs and assess the structural relations between them. Using a population-representative sample of 2,195 twins and siblings from the Georgia Twin Study and data from the National Neighborhood Data Archive and 2000 U.S. Census, we assessed the fit of competing measurement models for family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics. In structural models, we regressed a general externalizing dimension on different operationalizations of these variables separately and then simultaneously in a final model. Latent variable operationalizations of family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics explained no more variance in broad externalizing psychopathology than other operationalizations. In an omnibus model, family sociodemographic characteristics showed a small association with externalizing psychopathology, while neighborhood sociodemographic and environmental characteristics did not. Family sociodemographic characteristics showed small associations with neighborhood sociodemographic and environmental characteristics, and neighborhood sociodemographic characteristics were moderately associated with neighborhood environment. These findings suggest that family sociodemographic characteristics are more associated with the development of broad externalizing psychopathology in youth than neighborhood sociodemographic characteristics and neighborhood environment. General Scientific Summary: The current study finds that some ways of measuring family sociodemographic characteristics and neighborhood environment are better than others at explaining externalizing psychopathology in children and adolescents. It also finds the strongest support for direct associations between family sociodemographic characteristics and externalizing psychopathology. [ABSTRACT FROM AUTHOR]

The ongoing war in Ukraine is expected to negatively impact the mental health of the country's population. This study aims to provide a preliminary estimate of the degree of change in the mental health problems of Ukrainian children following Russia's invasion in February 2022, and to identify the sociodemographic and war-related risk factors associated with these changes. A nationwide, opportunistic sample of 1238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected between July 15th and September 5th, 2022. Participants completed modified versions of the Pediatric Symptom Checklist (PSC-17) which was adapted to capture change in the frequency of symptoms since the beginning of the war. Parents reported increases across all 17 indicators of internalizing, externalizing, and attention problems of the PSC-17. Increased problems were most pronounced within the internalizing domain, with 35% of parents reporting that their child worried more since the beginning of the war. A number of individual, parental, and war-related factors were associated with increases across the three domains. Exposure to war trauma, pre-existing mental health problems, and child age were among the strongest predictors of change. This survey provides preliminary evidence that the Russian war on Ukraine has led to an increase in common mental health problems among children in the general population. Further research is required to determine the extent and sequela of this increase, and to develop intervention strategies for those most in need. [ABSTRACT FROM AUTHOR]

Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4–17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4–11 (not 12–17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology. [ABSTRACT FROM AUTHOR]

The early caregiving environment can have lasting effects on child mental health. Animal models suggest that glucocorticoid receptor gene (NR3C1) DNA methylation plays a mediating role in linking more responsive caregiving to improved behavioral outcomes by its impact on the stress regulatory system. In this longitudinal study, we examined whether children's NR3C1 methylation levels mediate an effect of maternal sensitivity in infancy on levels of child internalizing and externalizing behavior in a community sample. Maternal sensitivity of 145 mothers was rated at infant age 5 weeks, 12 months, and 30 months by observing mother–infant interactions. Buccal DNA methylation was assessed in the same children at age 6 years and maternal-reported internalizing and externalizing behavior was assessed at age 6 and 10 years. Higher sensitivity at age 5 weeks significantly predicted lower DNA methylation levels at two NR3C1 CpG loci, although methylation levels at these loci did not mediate an effect of maternal sensitivity on levels of child internalizing and externalizing behavior. Overall, the study provides evidence that maternal sensitivity in early infancy is associated with DNA methylation levels at loci involved in stress regulation, but the significance of this finding for child mental health remains unclear. [ABSTRACT FROM AUTHOR]