Offspring Behavioral Problems Research Articles

Hypertensive Diseases of Pregnancy and the Development of Behavioral Problems in Childhood and Adolescence: The Western Australian Pregnancy Cohort Study

To examine whether maternal gestational hypertension and preeclampsia are associated with behavioral problems in offspring throughout childhood and early adolescence. We conducted a prospective cohort study of 2804 women in the Western Australian Pregnancy Cohort Study and their children observed at age 2, 5, 8, 10, and 14 years. The Child Behavior Checklist (CBCL) was used to measure problem child behavior with continuous z-scores and clinical cutoff points. Control variables included known biomedical, sociodemographic, and psychological factors. After adjustment, with general linear model analyses children of women with gestational hypertension were shown to be more likely to have higher CBCL z-scores, indicative of poorer behavior, from 8 years on, with the largest difference seen at 14 years. Children of mothers with preeclampsia were more likely to have lower CBCL z-scores, indicative of pro-social behaviors. The multivariable logistic regression analysis showed that gestational hypertension was predictive of clinically significant CBCL T-scores from age 8 to 14 years. This association was significant for externalizing behavior, such as delinquent and aggressive behavior, and for internalizing behavior at age 14 years. Unexpectedly, preeclampsia reduced internalizing morbidity at ages 5 and 8 years. The opposing effect on child and adolescent behavior of gestational hypertension and preeclampsia warrants further attention.

No Ifs, Ands, or Butts: Quitting Smoking During Pregnancy Might Help Infant Temperament

Although maternal smoking during pregnancy is associated with increased risk for behavior problems in offspring, little is known about the early

A behavior genetic investigation of adolescent motherhood and offspring mental health problems.

The present study examines the relations between adolescent motherhood and children's behavior, substance use, and internalizing problems in a sample of 1,368 children of 712 female twins from Australia. Adolescent motherhood remained significantly associated with all mental health problems, even when using a quasiexperimental design capable of controlling for genetic and environmental confounds. However, the relation between adolescent motherhood and offspring behavior problems and substance use was partially confounded by family background variables that influence both generations. The results are consistent with a causal relation between adolescent motherhood and offspring mental health problems, and they highlight the usefulness of behavior genetic designs when examining putative environmental risks for the development of psychopathology. The generalizability of these results to the United States, which has a higher adolescent birth rate, is discussed.

Smoking during teenage pregnancies: Effects on behavioral problems in offspring

We prospectively examined the relationship between prenatal tobacco exposure (PTE) and child behavior in a birth cohort of 357 offspring of teenage mothers. PTE was defined as any exposure across pregnancy and, in separate analyses, exposure within each trimester. Outcomes included measures of behavior problems, activity, and attention. On average, the children were 6.4 years of age, 48% were females, and 69% were Black. Data on maternal tobacco and other substance use were collected prenatally and postnatally: 46% of the mothers smoked in the first trimester and 58% smoked 6 years later. Child urinary cotinine measured exposure to environmental tobacco smoke (ETS). Stepwise multiple regressions were run. PTE predicted significantly increased offspring activity; impulsivity; and aggression, externalizing, and total behavior problems in step 1. PTE remained a significant predictor of increased activity when maternal psychological characteristics, home environment, and ETS were added. The results were similar when PTE was examined by trimesters, although later pregnancy tobacco exposure predicted the most behavioral outcomes. In the final model, PTE (all three trimesters) and PTE (second trimester) were significant predictors of increased activity and attention problems, respectively. Other predictors of child behavior included maternal anxiety, depression, hostility, and home environment. ETS was not a significant predictor of child behavior when PTE was considered. Smoking during pregnancy among adolescents is a significant predictor of increased activity and attention problems in their offspring after controlling for covariates in the prenatal and current environments. Smoking cessation interventions are recommended for this population to avoid the effects of PTE on the offspring of pregnant adolescents. This is particularly important because these mothers will likely become pregnant again and many will increase their level of tobacco use as they mature.

A follow-up study of postpartum depressed women: recurrent maternal depressive symptoms and child behavior after four years

To investigate the prevalence of depressive symptoms and self reported health of women who have shown previous postpartum depressive symptoms. To examine the behavior of four-year-old children born to mothers affected by postpartum depression. Longitudinal study. The index group (n = 251) constituted of all women with postpartum depressive symptoms on the Edinburgh Postnatal Depression Scale (EPDS), in a population-based study made in the late 1990s. The control group (n = 502) consisted of women without postpartum depressive symptoms on the EPDS at the same occasion. Approximately four years after delivery these women were asked to answer a short questionnaire on general health, the EPDS, and also to assess their child's behavior with the Richman Pre-School Behaviour Checklist. Women with a history of postpartum depressive symptoms were approximately 6 times more likely to have recurrent depressive symptoms (OR = 5.82, 95% CI: 3.79-8.93), compared to those without postpartum depressive symptoms, and they were also more likely to experience physical and mental illness. Although postpartum depressive symptoms in the mothers were involved in explaining the likelihood of behavioral problems in their four-year-old children, mothers with current depressive symptoms were the most likely to have a child with behavioral problems (OR = 4.71, 95% CI: 1.88-11.78). Postpartum depressive illness constitutes a risk for future illness as well as maternal perceived behavioral problems in offspring. In order to diminish long-term adverse consequences for the mother and the child there is a great need to recognize and treat women with postpartum depressive symptoms as early as possible.

Depressive symptoms over time in women partners of men with and without alcohol problems.

In a sample of 202 adult women and their families, the authors examined the effects of their male partners' alcohol problems and antisociality, the women's alcohol problems and antisociality, family conflict, and offspring behavioral problems on the women's depressive symptoms over a 3-year period. The women's antisociality and alcohol problems were more strongly related to family conflict, offspring behavioral problems, and the women's depressive symptoms than were the men's antisociality and alcohol problems. The women's antisociality and family conflict most strongly predicted increases in the women's depressive symptoms over time. In addition, family conflict mediated the effects of maternal antisociality on the women's depressive symptoms.

Parenting Behaviors Associated With Risk for Offspring Personality Disorder During Adulthood

Research has suggested that some types of parental child-rearing behavior may be associated with risk for offspring personality disorder (PD), but the association of parenting with offspring PD has not been investigated comprehensively with prospective longitudinal data. To investigate the association of parental child-rearing behavior with risk for offspring PD during adulthood. The Children in the Community study, a prospective longitudinal investigation. A community-based sample of 593 families interviewed during childhood (mean age, 6 years), adolescence (mean ages, 14 and 16 years), emerging adulthood (mean age, 22 years), and adulthood (mean age, 33 years) of the offspring. The Structured Clinical Interview for DSM-IV Personality Disorders. Ten types of parenting behavior that were evident during the child-rearing years were associated with elevated offspring risk for PD during adulthood when childhood behavioral or emotional problems and parental psychiatric disorders were controlled statistically. Parental behavior in the home during the child-rearing years was associated with elevated risk for offspring PD at mean ages of 22 and 33 years. Risk for offspring PD at both assessments increased steadily as a function of the number of problematic parenting behaviors that were evident. Low parental affection or nurturing was associated with elevated risk for offspring antisocial (P = .003), avoidant (P = .01), borderline (P = .002), depressive (P = .02), paranoid (P = .002), schizoid (P = .046), and schizotypal (P<.001) PDs. Aversive parental behavior (eg, harsh punishment) was associated with elevated risk for offspring borderline (P = .001), paranoid (P = .004), passive-aggressive (P = .046), and schizotypal (P = .02) PDs. Parental behavior during the child-rearing years may be associated with risk for offspring PD that endures into adulthood. This risk may not be attributable to offspring behavioral and emotional problems or parental psychiatric disorder, and it may not diminish over time. Low parental nurturing and aversive parental behavior during child rearing may both be associated with elevated risk for offspring PDs.

Maternal Psychiatric Disorders, Parenting, and Maternal Behavior in the Home During the Child Rearing Years

Data from the Children in the Community Study, a community-based longitudinal study, were used to investigate associations between maternal psychiatric disorders and child-rearing behaviors. Maternal psychiatric symptoms and behavior in the home were assessed in 782 families during the childhood and adolescence of the offspring. Maternal anxiety, depressive, disruptive, personality, and substance use disorders were independently associated with current and subsequent parenting difficulties and other problems in the home during the child rearing years, after co-occurring disorders and offspring behavior problems were controlled statistically. Maternal personality disorders were most consistently associated with problems in the home during the child rearing years. Less than 1 of 3 mothers with disorders reported having received treatment. Those who received treatment were significantly less likely to experience multiple difficulties in the home during the child rearing years. These findings suggest that maternal psychiatric disorder may be an important determinant of problematic maternal behavior in the home during the child rearing years. Improved recognition and treatment of maternal psychiatric disorders may help to reduce the amount of maladaptive parenting behavior that many youths might otherwise be likely to experience.

A genetically informed study of the association between harsh punishment and offspring behavioral problems.

Conclusions about the effects of harsh parenting on children have been limited by research designs that cannot control for genetic or shared environmental confounds. The present study used a sample of children of twins and a hierarchical linear modeling statistical approach to analyze the consequences of varying levels of punishment while controlling for many confounding influences. The sample of 887 twin pairs and 2,554 children came from the Australian Twin Registry. Although corporal punishment per se did not have significant associations with negative childhood outcomes, harsher forms of physical punishment did appear to have specific and significant effects. The observed association between harsh physical punishment and negative outcomes in children survived a relatively rigorous test of its causal status, thereby increasing the authors' conviction that harsh physical punishment is a serious risk factor for children.

Relationship of maternal smoking during pregnancy with criminal arrest and hospitalization for substance abuse in male and female adult offspring.

Maternal prenatal smoking has been found to be related to externalizing behavior problems in male offspring, but this relationship has rarely been examined in female offspring. Preliminary evidence suggests that maternal prenatal smoking may be particularly related to antisocial behavior outcomes in male offspring and substance abuse problems in female offspring. This study attempted to replicate these findings in a large-scale, longitudinal community cohort study. Subjects were a birth cohort of 4,169 male and 3,943 female offspring born between 1959 and 1961 in Copenhagen, Denmark. During the third trimester of pregnancy, the subjects' mothers self-reported the number of cigarettes smoked on a daily basis. When the offspring were adults, their criminal arrest histories and psychiatric hospitalizations for substance abuse were checked in national registers. Additional data were collected concerning maternal rejection of the infant, socioeconomic status, maternal age, pregnancy and delivery complications, use of drugs in pregnancy, paternal criminal history, and parental psychiatric hospitalization. Results indicate a dose-response relationship between the amount of maternal prenatal smoking and both criminal arrest and psychiatric hospitalization for substance abuse in male and female offspring. These relationships remained significant after potential demographic, parental, and perinatal risk confounds were controlled. Hospitalization of offspring for substance abuse mediated the relationship between maternal prenatal smoking and criminal arrest for female but not for male offspring. Maternal prenatal smoking is related to criminal and substance abuse outcomes in male and female offspring. Higher rates of index arrests for female offspring may be related to their substance abuse problems.

Does Psychiatric History Bias Mothers' Reports? An Application of a New Analytic Approach

To evaluate whether mothers' psychiatric history biases reports of their children's behavior problems, mothers' and teachers' reports of children's behavior problems were compared using a recently developed statistical approach. Child Behavior Checklists and Teacher's Report Forms were completed by mothers and teachers, respectively, about 801 six-year-old children. Mother's history of major depression, anxiety disorders, and substance use disorder was assessed by using the National Institute of Mental Health Diagnostic Interview Schedule. Generalized estimating equations were used for data analysis. According to both teachers and mothers, maternal history of major depression was associated with more internalizing problems; the association was significantly stronger when mothers were the informants. Mothers with history of any psychiatric disorder reported more externalizing problems in their children than expected, whereas teachers' reports of externalizing behaviors were unrelated to maternal psychiatric history. These findings could not be explained by variations in children's behaviors across settings. The generalized estimating equation models enabled simultaneous examination of whether children of depressed mothers have excess behavior problems and whether depressed mothers overreport behavior problems in their children. The results indicate that children of depressed mothers have more internalizing problems. In addition, depressed mothers overstate and overgeneralize their offspring's behavior problems. This study broadens the concerns with reporting bias beyond maternal depression to include other psychiatric problems. The results emphasize the potential for bias in family history studies that rely on informants.

RESEARCH FOR PRACTICE

Pregnant women are advised to avoid alcohol, of which no safe level has been identified. In fact, as little as one drink per day has been shown to cause untoward effects in offspring. The teratogenic effects of alcohol were first documented in 1973, when researchers discovered similar patterns in eight unrelated children of alcoholic mothers: craniofacial, limb, and cardiovascular defects, along with prenatal-onset growth deficiency and developmental delay.1 In the succeeding 27 years, alcohol's teratogenic effects have been confirmed by a large body of animal research as well as by clinical and epidemiologic studies in humans. These effects are dose-related. A recent study of 464 children followed from birth to 14 years of age revealed that greater maternal alcohol consumption was related to greater learning difficulties and behavioral problems in offspring, including antisocial behavior, substance abuse, self-reported intellectual and academic problems, and observer-reported negativity and impulsivity. This relationship between higher doses of alcohol and greater effects in offspring was evident even though the mothers generally drank socially. (A typical drinker reported consuming, on average, one drink per day prior to recognition of her pregnancy and less than half a drink per day midpregnancy.) The results also showed that drinking early in pregnancy and binge drinking were associated with the greatest risk to offspring.2 The most severe consequence of fetal alcohol exposure known to date is fetal alcohol syndrome (FAS), characterized by prenatal or postnatal growth retardation, central nervous system disturbance (neurologic abnormalities, behavioral dysfunction, intellectual impairment, and structural abnormalities such as microcephaly), and a characteristic face (elongated midface, thin upper lip, and flattened maxilla).3 In February 2000, researchers revealed that alcohol triggers widespread neurodegeneration in the developing forebrains of rats. The authors of the study suggest that the destruction of millions of neurons in the developing human brain could explain the reduced brain mass and neurobehavioral disturbances exhibited in offspring with FAS.4 The incidence of FAS is docu-

Family dysfunction as a risk factor in the development of antisocial behavior.

Many studies have indicated a positive correlation between family dysfunction and subsequent cognitive and behavioral problems in offspring. The purpose of this study was to compare the family histories of 118 inmates with those of 45 college students and to document differential patterns. The possible social implications of the data are discussed as well as directions for further research.