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Three year outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder 有自闭症和/或注意缺陷多动障碍家族史的婴儿的三年结果
Pub Date : 2023-08-02 DOI: 10.1002/jcv2.12189
Tony Charman, Greg Pasco, Alexandra Hendry, Tessel Bazelmans, Nisha Narvekar, Amy Goodwin, Hanna Halkola, Mary Agyapong, Rebecca Holman, Jannath Begum Ali, Mutluhan Ersoy, Mark H. Johnson, Andrew Pickles, Emily J. H. Jones, The STAARS Team

Background

Most research on early outcomes in infants with a family history (FH) of autism has focussed on categorically defined autism, although some have language and developmental delays. Less is known about outcomes in infants with a FH of attention deficit hyperactivity disorder (ADHD).

Methods

Infants with and without a FH of autism and/or ADHD, due to a first-degree relative with either or both conditions, were recruited at 5 or 10 months. Three year outcomes were characterised using latent profile analysis (LPA) across measures of cognitive ability, adaptive functioning and autism, ADHD and anxiety traits (n = 131). We additionally ran an LPA using only autism and ADHD measures, and the broader LPA in an independent cohort (n = 139) and in both cohorts combined (n = 270).

Results

A Low Developmental Level + High Behavioural Concerns class had elevated autism, ADHD and anxiety scores, low cognitive and adaptive function, and included all but one child with autism. A Low Developmental Level + Typical Behaviour class had average cognitive ability and typical behaviour but low adaptive function. A Typical Developmental Level + Some Behavioural Concerns class had average cognitive and adaptive function but slightly elevated behaviour scores. A High Developmental Level + Typical Behaviour class had above average cognitive ability and typical behaviour. All four LPAs identified classes characterised by combinations of either, or both, Low Development Level and elevated behaviour scores, as well as a typically developing class. No classes had elevated autism or ADHD traits in isolation.

Conclusions

Some infants with a FH of autism or ADHD have atypical developmental and behavioural outcomes, but do not show strong autism or ADHD traits in isolation. The field needs to recalibrate aims and methods to embrace the broader transdiagnostic pattern of outcomes seen in these infants.

大多数关于有自闭症家族史(FH)的婴儿早期结果的研究都集中在明确定义的自闭症上,尽管有些人有语言和发育迟缓。对于FH婴儿的注意缺陷多动障碍(ADHD)的结果知之甚少。在5个月或10个月时招募患有或不患有自闭症和/或ADHD的婴儿,因为有一级亲属患有其中一种或两种情况。使用潜在轮廓分析(LPA)对认知能力、适应功能、自闭症、多动症和焦虑特征的测量进行三年结果表征(n = 131)。此外,我们仅使用自闭症和ADHD测量方法进行LPA,并在独立队列(n = 139)和两个队列联合(n = 270)中进行更广泛的LPA。低发育水平+高行为关注班的自闭症、多动症和焦虑得分较高,认知和适应功能较低,除了一名自闭症儿童外,其他所有儿童都患有自闭症。低发育水平+典型行为组的认知能力和典型行为一般,但适应功能较低。一个典型的发展水平+一些行为问题班的认知和适应功能一般,但行为得分略高。高发展水平+典型行为班认知能力和典型行为均高于平均水平。所有四个指标都确定了以低发展水平和高行为分数的组合或两者的组合为特征的类别,以及典型的发展类别。在孤立的班级中,没有自闭症或ADHD特征升高的班级。一些患有自闭症或多动症的婴儿有非典型的发育和行为结果,但孤立地不表现出强烈的自闭症或多动症特征。该领域需要重新调整目标和方法,以接受在这些婴儿中看到的更广泛的转诊模式。
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引用次数: 1
More frequent naps are associated with lower cognitive development in a cohort of 8–38-month-old children, during the Covid-19 pandemic 在一组8-38个月大的儿童中,在2019冠状病毒病大流行期间,更频繁的小睡与较低的认知发育有关
Pub Date : 2023-07-27 DOI: 10.1002/jcv2.12190
Teodora Gliga, Alexandra Hendry, Shannon P. Kong, Ben Ewing, Catherine Davies, Michelle McGillion, Nayeli Gonzalez-Gomez

Background

How often a child naps, during infancy, is believed to reflect both intrinsic factors, that is, the need of an immature brain to consolidate information soon after it is acquired, and environmental factors. Difficulty accounting for important environmental factors that interfere with a child's sleep needs (e.g., attending daycare) has clouded our ability to understand the role of intrinsic drivers of napping frequency.

Methods

Here we investigate sleep patterns in association with two measures of cognitive ability, vocabulary size, measured with the Oxford-Communicative Development Inventory (N = 298) and cognitive executive functions (EF), measured with the Early EF Questionnaire (N = 463), in a cohort of 8–38-month-olds. Importantly, because of the social distancing measures imposed during the Covid-19 Spring 2020 lockdown, in the UK, measures of sleep were taken when children did not access daycare settings.

Results

We find that children with more frequent but shorter naps than expected for their age had lower concurrent receptive vocabularies, lower cognitive EF and a slower increase in expressive vocabulary from spring to winter 2020, when age, sex, and SES were accounted for. The negative association between vocabulary and frequency of naps became stronger with age.

Conclusions

These findings suggest that the structure of daytime sleep is an indicator of cognitive development and highlight the importance of considering environmental perturbations and age when investigating developmental correlates of sleep.

儿童在婴儿期小睡的频率被认为反映了两个内在因素,即不成熟的大脑需要在获得信息后不久巩固信息,以及环境因素。难以解释影响儿童睡眠需求的重要环境因素(例如,参加日托),使我们无法理解午睡频率的内在驱动因素的作用。方法研究了8- 38个月大婴儿的睡眠模式与两项认知能力指标的关系:词汇量(用牛津交际发展量表(N = 298)测量)和认知执行功能(EF)(用早期EF问卷(N = 463)测量)。重要的是,由于在2020年春季Covid-19封锁期间实施的社会距离措施,在英国,当儿童无法进入日托机构时,采取了睡眠措施。结果我们发现,当考虑到年龄、性别和社会经济地位时,从2020年春季到冬季,比同龄儿童更频繁但更短的小睡的儿童同时接受性词汇量更低,认知EF更低,表达性词汇量增长更慢。词汇量和小睡频率之间的负相关关系随着年龄的增长而增强。这些发现表明,白天睡眠结构是认知发展的一个指标,并强调了在研究睡眠发育相关因素时考虑环境扰动和年龄的重要性。
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引用次数: 1
Relationship between elimination disorders and internalizing-externalizing problems in children: A systematic review and meta-analysis 儿童消除障碍和内化外化问题之间的关系:一项系统综述和荟萃分析。
Pub Date : 2023-07-27 DOI: 10.1002/jcv2.12185
Claudia Aymerich, Borja Pedruzo, Malein Pacho, Jon Herrero, María Laborda, Marta Bordenave, Gonzalo Salazar de Pablo, Eva Sesma, Aranzazu Fernández-Rivas, Ana Catalan, Miguel Ángel González-Torres

Background

Elimination disorders are highly prevalent in childhood and often associated with clinically relevant comorbid psychological disorders. The aim of this study is to determine if, and to what extent, children with elimination disorders show higher internalizing and externalizing problems than their healthy peers.

Methods

A multistep literature search was performed from database inception until May 1st, 2022. PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022303555) were used to identify studies reporting on internalizing and/or externalizing symptoms in children with an elimination disorder and a healthy control (HC) group. First, a systematic review was provided. Second, where data allowed for it, a quantitative meta-analysis with random effects model was conducted to analyze the differences between the elimination disorder and the HC groups for internalizing and externalizing symptoms. Effect size was standardized mean difference. Meta-regression analyses were conducted to examine the effect of sex, age, and study quality. Funnel plots were used to detect a publication bias. Where found, the trim and fill method was used to correct it.

Results

36 articles were included, 32 of them reporting on enuresis (n = 3244; mean age = 9.4; SD = 3.4; 43.84% female) and 7 of them on encopresis (n = 214; mean age = 8.6; SD = 2.3; 36.24% female). Children with an elimination disorder presented significantly lower self-concept (ES:0.42; 95%CI [0.08; 9.76]; p = 0.017) and higher symptom scores for thought problems (ES:−0.26; 95%CI: −0.43;−0.09]; p = 0.003), externalizing symptoms (ES: −0.20; 95%CI [−0.37;−0.03]; p = 0.020), attention problems (ES:−0.37; 95%CI [−0.51;−0.22]; p = 0.0001), aggressive behavior (ES:−0.33; 95%CI [−0.62;−0.04]; p = 0.025) and social problems (ES:−0.39; 95%CI [−0.58;−0.21]; p = 0.0001). Significant publication biases were found across several of the studied domains. No significant effect of sex, age or quality of the study score was found.

Conclusions

Children with an elimination disorder may have significant internalizing and externalizing problems, as well as impaired self-concept. It is recommendable to screen for them in children with enuresis or encopresis and provide appropriate interventions.

背景:消除障碍在儿童时期非常普遍,通常与临床相关的共病心理障碍有关。这项研究的目的是确定患有消除障碍的儿童是否以及在多大程度上比他们的健康同龄人表现出更高的内化和外化问题。方法:从数据库建立到2022年5月1日,进行多步骤文献检索。PRISMA/MOOSE依从性系统综述(PROSPERO:CDR42022303555)用于确定报告消除障碍儿童和健康对照组(HC)的内化和/或外化症状的研究。首先,进行了系统的审查。其次,在数据允许的情况下,采用随机效应模型进行了定量荟萃分析,以分析消除障碍组和HC组在内化和外化症状方面的差异。效应大小为标准化平均差。进行荟萃回归分析以检验性别、年龄和学习质量的影响。漏斗图用于检测发表偏倚。结果:纳入36篇文章,其中32篇报道了遗尿(n=3244;平均年龄=9.4;SD=3.4;43.84%为女性),其中7篇报道了遗尿(n=214;平均年龄=8.6;SD=2.3;36.24%为女性)。患有消除障碍的儿童表现出显著较低的自我概念(ES:0.42;95%CI[0.08;9.76];p=0.017)和较高的思维问题症状得分(ES:0.26;95%CI:-0.43;-0.09];p=0.003)、外化症状(ES:0.20;95%CI[-0.37;-0.03];p=0.020)、注意力问题(ES:0.37;95%CI[-0.51;-0.22];p=0.001),攻击性行为(ES:0.33;95%CI[-0.62;-0.04];p=0.025)和社会问题(ES:0.39;95%CI[-0.58;-0.21];p=0.0001)。在几个研究领域中发现了显著的发表偏差。没有发现性别、年龄或研究评分质量的显著影响。结论:消除障碍儿童可能存在显著的内化和外化问题,以及自我概念受损。建议对遗尿或尿崩儿童进行筛查,并提供适当的干预措施。
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引用次数: 1
Opportunities of measuring hierarchical models of psychopathology 测量精神病理学层次模型的机会
Pub Date : 2023-07-22 DOI: 10.1002/jcv2.12187
Erik Pettersson

All psychiatric phenomena are positively associated, and several different models can account for this observation. These include the correlated factors, network, general psychopathology as outcome, and hierarchical models. Advantages of hierarchical models, which consist of one general and several (general factor-residualized) specific factors, is that the general factor provides an opportunity to reliably measure global distress and impairment, while the specific factors might improve the ability to discriminate between individuals with different kinds of problems. Nevertheless, other models also have their respective advantages, and it remains challenging to empirically determine which model best accounts for the positive manifold in psychiatry. Instead, I present two non-empirical arguments in favor of hierarchical models. First, by measuring the general factor in isolation, the specific factors tend to include both favorable and unfavorable correlates, which might reduce stigma compared to psychiatric diagnoses that by and large are associated with only unfavorable outcomes. Second, the general psychopathology factor displays an unusual psychometric property in that it includes symptoms of opposite meaning if they have similar valence (e.g., self-reported symptoms such as gullible and paranoid, lazy and workaholic, and terrified and apathetic load in the same direction), which one might want to measure in isolation from variance capturing the content of symptoms. I conclude by speculating that tests designed based on hierarchical models might help clinical assessment.

所有的精神现象都是正相关的,有几种不同的模型可以解释这一观察结果。这些包括相关因素、网络、作为结果的一般精神病理和层次模型。由一个一般因素和几个(一般因素-残差)特定因素组成的分层模型的优点是,一般因素提供了一个可靠地衡量整体痛苦和损害的机会,而特定因素可能提高区分具有不同问题的个体的能力。尽管如此,其他模型也有各自的优势,并且从经验上确定哪种模型最能解释精神病学中的积极因素仍然具有挑战性。相反,我提出了两个支持分层模型的非经验论点。首先,通过孤立地测量一般因素,具体因素往往包括有利和不利的相关因素,这可能会减少耻辱,而精神病诊断总体上只与不利的结果相关。第二,一般精神病理因素表现出一种不同寻常的心理测量特性,如果它们具有相似的效价,它就包括了意义相反的症状(例如,自我报告的症状,如易受骗和偏执,懒惰和工作狂,以及恐惧和冷漠的负荷在同一方向),人们可能希望将其与捕获症状内容的方差隔离开来进行测量。我的结论是推测基于层次模型设计的测试可能有助于临床评估。
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引用次数: 0
Do single-case experimental designs lead to randomised controlled trials of cognitive behavioural therapy interventions for adolescent anxiety and related disorders recommended in the National Institute of Clinical Excellence guidelines? A systematic review 美国国家临床卓越研究所指南中推荐的针对青少年焦虑和相关障碍的认知行为治疗干预的单例实验设计是否导致随机对照试验?系统的回顾。
Pub Date : 2023-07-04 DOI: 10.1002/jcv2.12181
Tom Cawthorne, Anton Käll, Sophie Bennett, Elena Baker, Emily Cheung, Roz Shafran

Background

Although Cognitive Behavioural Therapy (CBT) is effective for 60% of adolescents with anxiety disorders, only 36% are in remission post-intervention. This indicates that more effective treatments are needed which should be reflected in the NICE guidelines. We hypothesised that Single-case experimental designs (SCEDs) may provide a framework for accelerating the development of novel interventions. The primary purpose of this review was to investigate whether SCEDs are currently followed by randomised controlled trials (RCTs) of CBT intervention for adolescent anxiety disorders named in the NICE guidelines. The secondary objective was to investigate whether using SCEDs prior to RCTs could be a helpful approach.

Method

For the primary search of SCEDs five databases were used (PsycINFO, PubMed, PsycArticles, Web of Science and ProQuest). Nineteen articles met eligibility criteria including a total of 107 participants. For the secondary search of RCTs named in the NICE guidelines for adolescent anxiety disorders 53 articles met inclusion criteria and were included in the systematic review.

Results

The 19 SCED studies included in the review were conducted with participants with a diverse range of anxiety disorders and across a range of CBT formats. Two of the SCEDs were followed by RCTs, but neither of these were named in the NICE guidelines for anxiety disorders. All of the SCEDs identified were rated as low quality with none meeting the criteria for the highest or second highest quality rating. From the secondary searches, none of the RCTs named in the NICE guide were preceded by SCEDs.

Conclusions

It was concluded that currently SCEDs were not followed by RCTs of CBT interventions named in the NICE guidelines for adolescent anxiety disorders. However, it was suggested that SCEDs may provide an important framework for the development of more effective interventions for adolescents with anxiety.

背景:尽管认知行为疗法(CBT)对60%的焦虑症青少年有效,但只有36%的青少年在干预后病情缓解。这表明需要更有效的治疗,这应该反映在NICE指南中。我们假设,单例实验设计(SCED)可能为加快新干预措施的开发提供一个框架。本综述的主要目的是调查目前是否在SCED之后进行NICE指南中命名的CBT干预青少年焦虑症的随机对照试验(RCT)。次要目的是调查在随机对照试验之前使用SCED是否是一种有用的方法。方法:采用5个数据库(PsycINFO、PubMed、PsycArticles、Web of Science和ProQuest)对SCED进行初步检索。19篇文章符合资格标准,共有107名参与者。在NICE青少年焦虑症指南中命名的随机对照试验的二次搜索中,有53篇文章符合纳入标准,并被纳入系统综述。结果:综述中包括的19项SCED研究是针对患有各种焦虑症和CBT形式的参与者进行的。其中两个SCED之后进行了随机对照试验,但这两个都没有在NICE焦虑症指南中命名。所有确定的SCED都被评为低质量,没有一个符合最高或第二高质量评级的标准。从二次搜索来看,NICE指南中命名的随机对照试验之前没有SCED。结论:目前SCED之后没有NICE指南针对青少年焦虑症命名的CBT干预的随机对照研究。然而,有人认为,SCED可能为制定更有效的焦虑青少年干预措施提供一个重要框架。
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引用次数: 1
Exploring the differentiation of behavioural and emotional problems across childhood: A prospective longitudinal cohort study 探索儿童时期行为和情绪问题的差异:一项前瞻性纵向队列研究
Pub Date : 2023-06-30 DOI: 10.1002/jcv2.12176
Adrian Dahl Askelund, Helga Ask, Eivind Ystrom, Alexandra Havdahl, Laurie J. Hannigan

Background

An individual's overall burden of behavioural and emotional problems across childhood is associated with increased likelihood of later mental health conditions. However, the relative extent of behavioural versus emotional problems - that is, the extent to which the domains are differentiated from one another - may provide additional information about who is at risk of developing a mental health condition. Here, we seek to validate differentiation as an independent predictor of later mental health conditions, and to explore its aetiology.

Methods

We analysed data from ~79,000 children in the population-based Norwegian Mother, Father, and Child Cohort Study, and linked health-care registries. In preregistered analyses, we modelled the extent and rate of differentiation of behavioural and emotional problems between ages 1.5–5 years, and estimated associations with later symptoms (age 8) and diagnoses (after age 8). We also explored the aetiology of differentiation by estimating associations with early life exposures and, in a subset of 23,945 full siblings, assessing the impact of accounting for unobserved familial confounding.

Results

Differentiation of behavioural and emotional problems was associated with later symptoms and diagnoses of mental health conditions, independent of total problems. Maternal at-risk drinking (β = 0.04 [0.02, 0.06]) and parental relationship problems (β = 0.04 [0.02, 0.05]) were associated with higher behavioural relative to emotional problems at age 5. Maternal prenatal distress (|β| = 0.04 [0.03, 0.06]), concurrent distress (|β| = 0.04 [0.02, 0.06]) and parental education (|β| = 0.05 [0.04, 0.07]) predicted higher emotional relative to behavioural problems at age 5. Estimates for maternal prenatal distress and at-risk drinking were consistent across both unadjusted and adjusted analyses accounting for unobserved familial risk.

Conclusions

Differentiation of behavioural and emotional problems in early childhood represents a valid source of inter-individual variability linked to the later emergence of psychopathology and may be relevant for early detection and prevention strategies for mental health.

一个人在童年时期的行为和情绪问题的总体负担与后来出现精神健康状况的可能性增加有关。然而,行为问题与情绪问题的相对程度——也就是说,这两个领域相互区分的程度——可能会提供关于谁有发展精神健康状况的风险的额外信息。在这里,我们试图验证分化作为后期心理健康状况的独立预测因子,并探索其病因。方法:我们分析了基于人口的挪威母亲、父亲和儿童队列研究中约79000名儿童的数据,以及相关的卫生保健登记。在预先登记的分析中,我们模拟了1.5-5岁之间行为和情绪问题分化的程度和速度,并估计了与后期症状(8岁)和诊断(8岁以后)的关联。我们还通过估计与早期生活暴露的关联来探索分化的病因学,并在23,945名全兄妹的亚组中,评估未观察到的家族混杂因素的影响。结果行为和情绪问题的区分与后来的症状和心理健康状况的诊断相关,独立于整体问题。5岁时,母亲饮酒风险(β = 0.04[0.02, 0.06])和父母关系问题(β = 0.04[0.02, 0.05])与较高的情绪问题相关。母亲产前焦虑(|β| = 0.04[0.03, 0.06])、同时焦虑(|β| = 0.04[0.02, 0.06])和父母教育(|β| = 0.05[0.04, 0.07])与5岁儿童的情绪行为问题相关。考虑到未观察到的家族风险,在未调整和调整的分析中,对产妇产前窘迫和高危饮酒的估计是一致的。幼儿期行为和情绪问题的区分是个体间差异的有效来源,与后期精神病理学的出现有关,可能与早期发现和预防心理健康策略有关。
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引用次数: 1
Can we diagnose mental disorders in children? A large-scale assessment of machine learning on structural neuroimaging of 6916 children in the adolescent brain cognitive development study 我们能诊断儿童的精神障碍吗?在青少年大脑认知发展研究中,机器学习对6916名儿童结构神经成像的大规模评估
Pub Date : 2023-06-28 DOI: 10.1002/jcv2.12184
Richard Gaus, Sebastian Pölsterl, Ellen Greimel, Gerd Schulte-Körne, Christian Wachinger

Background

Prediction of mental disorders based on neuroimaging is an emerging area of research with promising first results in adults. However, research on the unique demographic of children is underrepresented and it is doubtful whether findings obtained on adults can be transferred to children.

Methods

Using data from 6916 children aged 9–10 in the multicenter Adolescent Brain Cognitive Development study, we extracted 136 regional volume and thickness measures from structural magnetic resonance images to rigorously evaluate the capabilities of machine learning to predict 10 different psychiatric disorders: major depressive disorder, bipolar disorder (BD), psychotic symptoms, attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, post-traumatic stress disorder, obsessive-compulsive disorder, generalized anxiety disorder, and social anxiety disorder. For each disorder, we performed cross-validation and assessed whether models discovered a true pattern in the data via permutation testing.

Results

Two of 10 disorders can be detected with statistical significance when using advanced models that (i) allow for non-linear relationships between neuroanatomy and disorder, (ii) model interdependencies between disorders, and (iii) avoid confounding due to sociodemographic factors: ADHD (AUROC = 0.567, p = 0.002) and BD (AUROC = 0.551, p = 0.002). In contrast, traditional models perform consistently worse and predict only ADHD with statistical significance (AUROC = 0.529, p = 0.002).

Conclusion

While the modest absolute classification performance does not warrant application in the clinic, our results provide empirical evidence that embracing and explicitly accounting for the complexities of mental disorders via advanced machine learning models can discover patterns that would remain hidden with traditional models.

基于神经影像学的精神障碍预测是一个新兴的研究领域,在成人中有希望的初步结果。然而,对儿童独特人口统计的研究代表性不足,对成人的研究结果是否可以转移到儿童身上也值得怀疑。方法利用多中心青少年大脑认知发展研究中6916名9-10岁儿童的数据,从结构磁共振图像中提取136个区域体积和厚度测量值,严格评估机器学习预测10种不同精神疾病的能力:重度抑郁症、双相情感障碍(BD)、精神病性症状、注意缺陷多动障碍(ADHD)、对立违抗性障碍、行为障碍、创伤后应激障碍、强迫症、广泛性焦虑障碍、社交焦虑障碍。对于每种疾病,我们进行了交叉验证,并评估模型是否通过排列测试发现了数据中的真实模式。结果使用先进的模型(i)允许神经解剖学与疾病之间的非线性关系,(ii)建立疾病之间的相互依赖关系,(iii)避免社会人口因素造成的混淆,10种疾病中的2种可以被检测出具有统计学意义:ADHD (AUROC = 0.567, p = 0.002)和BD (AUROC = 0.551, p = 0.002)。相比之下,传统模型的表现一直较差,仅预测ADHD具有统计学意义(AUROC = 0.529, p = 0.002)。虽然适度的绝对分类性能不能保证临床应用,但我们的研究结果提供了经验证据,表明通过先进的机器学习模型拥抱和明确地考虑精神障碍的复杂性可以发现传统模型所隐藏的模式。
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引用次数: 0
Following the children of depressed parents from childhood to adult life: A focus on mood and anxiety disorders 从童年到成年跟踪抑郁父母的孩子:关注情绪和焦虑障碍
Pub Date : 2023-06-18 DOI: 10.1002/jcv2.12182
Victoria Powell, Jessica Lennon, Rhys Bevan Jones, Alice Stephens, Bryony Weavers, David Osborn, Judith Allardyce, Robert Potter, Ajay Thapar, Stephan Collishaw, Anita Thapar, Jon Heron, Frances Rice

Background

Parental depression increases risk for anxiety and depression in offspring. The transition from adolescence to adulthood is a common risk period for onset of such disorders. However, relatively few studies have considered development of these disorders from childhood to adulthood including multiple assessments during this transition period.

Method

Offspring of depressed parents aged 9–17 years at baseline were followed prospectively for 13 years (n = 337). Average length of follow-up was 16 months between the first and second waves, 13 months between the second and third, and 8 years between the third and fourth. Current (3-month) psychopathology was assessed at each wave using diagnostic interviews. We derived estimates of 3-month prevalence, age at first diagnosis, course and comorbidity of disorders. Social functioning in adult life was assessed at the final wave and we assessed how prior and current disorder impacted adult functioning.

Results

A quarter of young people met criteria for a mood disorder and a third for anxiety disorder at least once. Mood and anxiety disorder prevalence increased from 4.5% and 15.8% respectively in childhood (9–11 years) to 22.3% and 20.9% respectively by age 23–28. Increased prevalence across the transition from adolescence to adulthood was particularly marked in males, while prevalence increased earlier in adolescence in females. Age at first diagnosis varied widely (mood disorder mean = 16.5 years (range 9–26); anxiety disorder mean = 14.5 years (range 9–28)). Over half (52%) reported functional impairment in early adulthood, 31% harmful alcohol use, and 10% self-harm or a suicide attempt. Both previous and current mood or anxiety disorder were associated with functional impairment in early adulthood.

Conclusions

There is a prolonged risk period for mood and anxiety disorders in this group, with prevalence peaking in early adulthood. This highlights the need for prolonged vigilance and effective targeted interventions in the offspring of depressed parents.

背景:父母的抑郁会增加后代患焦虑和抑郁的风险。从青春期到成年期是此类疾病发作的常见风险期。然而,相对较少的研究考虑了这些疾病从儿童到成年的发展,包括在这一过渡时期的多项评估。方法:对基线年龄为9-17岁的抑郁父母的后代进行前瞻性随访13年(n=337)。第一波和第二波的平均随访时间为16个月,第二波和第三波为13个月,而第三波和第四波为8年。目前(3个月)的精神病理学
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引用次数: 2
Mothers' symptoms of anxiety and depression and the development of child temperament: A genetically informative, longitudinal investigation 母亲的焦虑和抑郁症状与儿童气质的发展:一项遗传信息的纵向调查
Pub Date : 2023-06-13 DOI: 10.1002/jcv2.12171
Y. I. Ahmadzadeh, E. M. Eilertsen, R. Cheesman, C. Rayner, E. Ystrom, L. J. Hannigan, T. A. McAdams

Background

Child temperament traits and mothers' emotional symptoms relating to anxiety and depression may drive changes in one another, leading to their ‘co-development’ across time. Alternatively, links between mother and child traits may be attributable to shared genetic propensities. We explored longitudinal associations between mothers' emotional symptoms and child temperament traits and adjusted for genetic effects shared across generations.

Methods

This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). Mothers (n = 34,060) reported on their symptoms of anxiety and depression, and temperament among offspring (n = 42,526), at child ages 1.5, 3 and 5 years. Structural equation models parameterised developmental change in traits, and an extended family design adjusted for genetic effects.

Results

We found individual differences in stable trait scores and rate of change for all study variables. Longitudinal stability in mothers' emotional symptoms was associated with longitudinal stability in offspring emotionality (r = 0.143), shyness (r = 0.031), and sociability (r = −0.015). Longitudinal change in mothers' symptoms showed very small or negligible correlations with longitudinal change in child temperament. Both genetic and environmental influences explained the stable longitudinal association between mothers' symptoms and child emotionality.

Conclusions

The studied associations between mother and child traits across time appeared to be due to stable, trait-like factors, involving genetic and environmental influence, rather than their co-development. Findings contribute knowledge on how emotional symptoms develop in families across time, and the methods with which we can explore such development.

孩子的气质特征和母亲的焦虑和抑郁情绪症状可能会相互影响,导致它们随着时间的推移而“共同发展”。另外,母亲和孩子之间的联系可能归因于共同的遗传倾向。我们探索了母亲的情绪症状和孩子的气质特征之间的纵向联系,并调整了世代共享的遗传效应。方法本研究基于挪威母亲、父亲和儿童队列研究(MoBa)。母亲(n = 34,060)报告了她们在孩子1.5岁、3岁和5岁时的焦虑和抑郁症状,以及子女(n = 42,526)的气质。结构方程模型参数化了性状的发育变化,一个大家庭设计调整了遗传效应。结果我们发现所有研究变量的稳定性状得分和变化率存在个体差异。母亲情绪症状的纵向稳定性与后代情绪(r = 0.143)、害羞(r = 0.031)和社交(r = - 0.015)的纵向稳定性相关。母亲症状的纵向变化与儿童气质的纵向变化的相关性非常小或可以忽略不计。遗传和环境影响都解释了母亲症状和儿童情绪之间稳定的纵向关联。经研究的母亲和孩子的性格特征之间的关联似乎是由于稳定的、类似性格的因素,包括遗传和环境影响,而不是它们的共同发展。研究结果有助于了解情绪症状在家庭中如何随着时间的推移而发展,以及我们可以探索这种发展的方法。
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引用次数: 1
Toward an optimized assessment of adolescent psychopathology risk: Multilevel environmental profiles and child irritability as predictors 青少年精神病理学风险的优化评估:多层次环境概况和儿童易怒作为预测因素
Pub Date : 2023-06-13 DOI: 10.1002/jcv2.12180
Qiongru Yu, Brianna Hernandez, Conner Swineford, Nia Walker, Leigha MacNeill, Yudong Zhang, Lauren S. Wakschlag, Jillian L. Wiggins

Background

Adolescence is a developmental period during which youth experience vulnerability to psychopathology. To build the foundation for a parsimonious psychopathology risk calculator while capturing the complexity and dynamic nature of the environment, the current study aimed to identify distinct risk and resilience profiles with a wide range of environmental factors guided by Bronfenbrenner's biopsychosocial ecological system theory. The association between the early-mid childhood risk profiles and psychopathology in adolescence were examined. Moreover, the predictive utility of early childhood irritability was evaluated in addition to the risk profiles.

Methods

The data from Future of Families and Child Wellbeing Study a nation-wide longitudinal study, were used in the latent profile analyses to identify the risk profiles with family, school, and neighborhood characteristics from 3 to 9 years old. To capture the socio-environmental and cultural nuances, we extracted three subsamples, including Black/African American (n = 2587), Hispanic/Latinx (n = 1577), and White (n = 776) for separate analyses. Risk profile memberships were used to predict adolescence psychopathology, including depression, anxiety, attention deficits, oppositional defiant disorder, and conduct disorder symptoms. The predictive utility of early childhood irritability above and beyond environmental risk profiles was evaluated using stepwise regression.

Results

Three risk profiles were identified in the Hispanic/Latinx and Black/African American subsamples, while four profiles were identified in White subsample. Almost all risk profile membership predicted both internalizing and externalizing psychopathology, while some profiles are predictive of externalizing symptoms only. Higher level of irritability predicted higher symptomatology in all five mental health outcomes above and beyond the environmental profiles.

Conclusions

Distinct risk and resilience profiles primarily driven by parent and family characteristics were identified for all three major race/ethnicity groups. Our findings lay the foundation for a more efficient multi-tiered information gathering process in mental health clinical settings to aid the decision making for intervention and prevention.

背景青春期是青少年易受精神病理影响的发育时期。为了建立一个简洁的精神病理学风险计算器,同时捕捉环境的复杂性和动态性,本研究旨在以Bronfenbrenner的生物心理社会生态系统理论为指导,在广泛的环境因素下识别不同的风险和恢复力特征。研究了儿童早期中期风险概况与青春期精神病理之间的关系。此外,除了风险概况外,还评估了早期儿童易怒的预测效用。方法采用全国纵向研究“家庭未来与儿童健康研究”的数据进行潜在特征分析,确定3 - 9岁儿童的家庭、学校和社区特征的风险特征。为了捕捉社会环境和文化的细微差别,我们提取了三个子样本,包括黑人/非裔美国人(n = 2587),西班牙裔/拉丁裔(n = 1577)和白人(n = 776)进行单独分析。风险概况成员被用来预测青少年精神病理,包括抑郁、焦虑、注意力缺陷、对立违抗性障碍和行为障碍症状。采用逐步回归法评估儿童早期易怒的预测效用高于环境风险概况。结果在西班牙裔/拉丁裔和黑人/非裔美国人亚样本中确定了3种风险特征,而在白人亚样本中确定了4种风险特征。几乎所有的风险档案成员都能预测内化和外化的精神病理,而有些档案只能预测外化症状。较高的易怒程度在所有五种心理健康结果中都预示着高于环境特征的较高症状。结论:在所有三个主要种族/族裔群体中,主要由父母和家庭特征驱动的风险和恢复能力特征明显。我们的研究结果为在心理健康临床设置中更有效的多层次信息收集过程奠定了基础,以帮助干预和预防决策。
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引用次数: 0
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