Hyperactivity-inattention Symptoms Research Articles

Facing Pediatric Rheumatic Diseases: The Role of Disease Activity and Parental Emotion Regulation Strategy in Parents' and Children's Psychological Adjustment.

Pediatric rheumatic diseases (PRDs) are a group of chronic disorders that start in childhood and are characterized by periodic exacerbations and remissions of symptoms, with limitations in family, school, and social activities. The aim of this study was to detect differences in parents' psychological adjustment and emotion regulation strategies, and parent-reported children's adjustments in families of children with active and inactive PRDs. Fifty-four parents (38 mothers and 16 fathers) of children with PRD were recruited from a pediatric unit. Disease activity was evaluated by their pediatric rheumatologist, while parents' depressive and anxiety symptoms, emotion regulation strategies, and children's emotional difficulties and hyperactivity-inattention symptoms were assessed through a web-based survey. Parents of children with active PRDs reported higher levels of their child's emotional difficulties and hyperactivity-inattention symptoms. Linear regression analysis demonstrated that having a child in the active phases of PRD and lower use of cognitive reappraisal lead to higher children's emotional symptoms, while active disease, low use of cognitive reappraisal, and greater expressive suppression were associated with higher hyperactivity-inattention symptoms. Our study highlights that children with PRDs and their parents may be at increased risk for psychological problems, especially during the active disease phase, highlighting the importance of a multidisciplinary approach.

Parental Influence on Child Mental Health Post-Hurricane Harvey

PurposeMany children who face natural disasters experience significant mental health consequences. Parents play a prominent role in the likelihood of child mental health outcomes after a weather-related disaster. This study aimed to examine the relationship between parent risk factors and children’s psychological well-being post Hurricane Harvey.MethodsParents (n = 140) completed a survey that measured hurricane exposure, parental depression and anxiety, parenting behaviors, and assistance given and received during or after Hurricane Harvey. Additionally, parents were asked to complete questionnaires assessing one of their children’s post-disaster psychosocial functioning and distress.ResultsResults indicated that heightened parent anxiety was significantly associated with an increased risk for emotional symptoms, conduct problems, and hyperactivity-inattention symptoms in children. Additionally, inconsistency in parental discipline was significantly associated with an increased risk of child conduct problems. Further, higher numbers of assistance types received by parents—a proxy indicator of resource loss—was associated with higher child emotional distress scores.ConclusionsBroader systems-level interventions that address parents’ physical and emotional needs may help mitigate maladaptive reactions in children and facilitate greater post-disaster psychosocial adjustment.

Lifestyle Patterns of Children Experiencing Homelessness: Family Socio-Ecological Correlates and Links with Physical and Mental Health

Diet, screen time, physical activity, and sleep combine into lifestyle patterns with synergistic effects on health. This study aimed to identify lifestyle patterns in children without housing and assess their associations with physical and mental health and family socio-ecological factors. In the 2013 ENFAMS cross-sectional survey (children aged 6-12 experiencing homelessness, Greater Paris area, n = 235), parents reported socio-ecological factors, children's behaviours, and mental health (the latter was also child-reported). Nurses measured children's haemoglobin concentrations and body mass index. Principal component analysis was used to derive sex-specific lifestyle patterns. Hierarchical linear regressions and "outcome-wide" analyses assessed, respectively, these patterns' relations to health and family socio-ecological factors. A rather healthy lifestyle pattern-similarly characterized by diverse diet and high sleep time-was identified, with slight differences by sex. Scores for this pattern were higher for children in food-secure or higher-income households, whose parents were proficient in French, who slept longer, or who received more social support compared to their counterparts, with some nuances by sex. Higher scores for this pattern were associated with higher prosocial behaviour scores (girls) and lower anxiety and hyperactivity-inattention symptoms scores (boys), but not with physical health. For this underserved and understudied population, the results highlight the importance of family socio-ecological factors in shaping the lifestyles and mental health of children.

Maternal pre-pregnancy obesity and offspring hyperactivity-inattention symptoms at 5 years in preterm and term children: a multi-cohort analysis

The objective of this study was to determine the relationship between maternal pre-pregnancy body mass index (BMI) and child hyperactivity-inattention symptoms (HIS) at 5 years, including preterm and term-born children, and to determine whether this association varied with gestational age. Maternal pre-pregnancy BMI and offspring HIS were assessed in 10,898 participants born ≥ 33 weeks of gestation from the ELFE cohort and 2646 children born between 23 and 34 weeks from the EPIPAGE 2 cohort. Reported pre-pregnancy weight (kg) and measured height (m) were collected from mothers at inclusion and used to classify BMI (kg/m2). Child HIS were evaluated using the Strengths and Difficulties Questionnaire around 5 years of age. Logistic regression estimated odds ratios (OR) of a high HIS score (≥ 90th percentile) in the ELFE cohort and generalized estimated equations were used in EPIPAGE 2 to account for non-independence of multiple births. As a negative control, paternal BMI was also considered as an exposure of interest in sensitivity analyses. Maternal pre-pregnancy obesity and overweight were associated with child HIS at 5 years in ELFE (adjusted OR [aOR] for obesity 1.27 [1.06, 1.53]; overweight aOR 1.16 [1.00, 1.36]) and pre-pregnancy obesity was associated with high HIS scores in preterm infants of EPIPAGE 2 (aOR 1.48 [1.06, 2.08]). In ELFE, the magnitude of the association increased with decreasing gestational age (interaction p = 0.02). High maternal pre-pregnancy BMI is associated with greater likelihood of high HIS scores in both at-term and preterm children at 5 years of age.

Prospective associations of lifestyle patterns in early childhood with socio-emotional and behavioural development and BMI: An outcome-wide analysis of the EDEN mother-child cohort.

Children's energy balance-related behaviours (EBRB), comprising diet, screen time, physical activity, and sleep, combine into "lifestyle patterns", which may exert a synergistic effect on health. To date, studies investigating this synergy have primarily focused on obesity risk, without addressing other facets of health. To examinethe prospective associations of preschoolers' lifestyle patterns with socio-emotional, behavioural, and body mass index (BMI) outcomes at 8 years. Participants were 876 children from the EDEN mother-child cohort. Three lifestyle patterns (unhealthy, healthy, and mixed) were previously identified at age 5, separately in boys and girls. At age 8, height and weight measures generated BMI z-scores while social-emotional and behavioural development was assessed by parents using the Strengths and Difficulties Questionnaire (SDQ). Drawing from the outcome-wide approach, sex- and outcome-specific adjusted linear regressions were fitted. Boys' adherence to a healthy lifestyle pattern (combining a nutrient-dense diet and limited screen time) at 5 years was positively associated with prosocial behaviours (β= 0.14; 95% confidence interval [CI] 0.01, 0.26) and inversely related to hyperactivity-inattention symptoms (β= -0.12; 95% CI -0.23, -0.01) at 8 years. Girls' mixed lifestyle pattern (sugar or artificially sweetened beverages, high screen, physical activity and low sleep times) was associated with prosocial behaviours (β= 0.12; 95% CI 0.01, 0.23). There was no evidence of associations between lifestyle patterns and BMI z-scores. Findings suggest synergistic benefits of engaging in a combination of optimal EBRBs, especially in boys, and support intervention efforts at preschool age to enhance some dimensions of their later socio-emotional and behavioural development.

Comparing parental distress and children’s difficulties between parents of children with rheumatic diseases and parents of healthy children in families facing the COVID-19 pandemic

The COVID-19 pandemic could be a threat for the health status of children with a chronic condition. The present study aimed to explore parents’ and children’s psychological adjustment during the current pandemic, pursuing a triple objective: to compare the psychological adjustment of parents of children with pediatric rheumatic diseases (PRDs) and parents of healthy children; to analyze children’s psychological symptoms (emotional problems and hyperactivity) before and during the COVID-19 pandemic, and with or without a PRDs diagnosis; to explore the associations of children’s emotional problems and hyperactivity with parents’ psychological adjustment, parent–child interactions and belonging or not to families with PRDs. This cross-sectional study involved 56 parents of children with PRDs and 53 parents of healthy children. Self-report questionnaires about parents’ depression, anxiety, parenting stress, and children’s emotional symptoms and hyperactivity-inattention were administered. No differences were detected on psychological adjustment between parents of children with PRDs and parents of healthy children. Parents of children with PRDs reported statistically significant higher levels of children’s emotional problems and hyperactivity before the pandemic, compared to parents of healthy children; during COVID-19 pandemic, emotional symptoms increased for both groups, while hyperactivity-inattention symptoms increased only in the group of healthy children. Children’s emotional difficulties were associated with higher levels of parental anxiety, worse parent–child interaction and having PRDs; children’s hyperactivity symptoms were related to parent–child difficult interaction and higher levels of parental depression. Findings suggest the importance to target the children in relation to their parents, when approaching the psychological aspects of PRDs.

Maternal pre-pregnancy BMI and offspring hyperactivity-inattention trajectories from 3 to 8years in the EDEN birth cohort study.

Evidence suggests obesity during pregnancy is associated with offspring attention-deficit hyperactivity disorder. However, studies have been limited to evaluating the association at a single age with inadequate data on important maternal lifestyle confounders and unmeasured familial confounding. The objective of this study was to examine the association between maternal pre-pregnancy body mass index (BMI) and child hyperactivity-inattention symptoms (HIS) at 3, 5 and 8years. Data came from the EDEN mother-child cohort. Maternal pre-pregnancy BMI status (kg/m2) was calculated using pre-pregnancy weight and height (self-reported by mothers or measured by midwives). HIS were assessed by parental-report on the Strengths and Difficulties Questionnaire at 3, 5 and 8years of age and used to derive developmental trajectories of HIS (n = 1428). Multivariate models were adjusted for confounders including socioeconomic status, maternal lifestyle behaviours (exercise, diet, smoking, alcohol), childcare and a stimulating home environment. Paternal BMI was used as a negative control. Compared to a normal pre-pregnancy BMI, pre-pregnancy maternal obesity was positively associated with increased odds of a high HIS trajectory between 3 and 8years old in both unadjusted and adjusted logistic regression (adjusted odds ratio [aOR] 1.87 [95% CI 1.12, 3.12]). Pre-pregnancy overweight was not significantly associated after adjustment for confounders (aOR 1.32 [0.87, 2.01]). Maternal pre-pregnancy obesity, but not overweight, was associated with increased likelihood of a high HIS trajectory in children from 3 to 8years old. This association persisted despite controlling for many important maternal lifestyle factors and paternal BMI. Further research is warranted to identify possible mediators involved.

Longitudinal Associations of Children’s Hyperactivity/Inattention, Peer Relationship Problems and Mobile Device Use

Children with emotional, behavioral or relationship problems may be more inclined to use mobile touchscreen devices (MTSDs: mobiles and tablets) to regulate their emotions or compensate for the lack of social relationships, which, in turn, may affect their symptoms. Bi-directional longitudinal associations between behavioral difficulties and MTSD use were analyzed. Participants were parents of children aged 4–6 years old at first data collection (n = 173), and 7–9 years old at second data collection (n = 98). They reported on their child’s MTSD use and behavioral difficulties at two time points (T1 and T2). It was analyzed whether T1 MTSD use predicts T2 behavioral difficulties (controlling for demographics and T1 behavioral difficulties); and whether T1 behavioral difficulties predict T2 MTSD use (controlling for demographics and T1 MTSD use). Additionally, cross-sectional associations between behavioral difficulties and MTSD use were analyzed. Children’s T1 hyperactivity/inattention score positively associated with T2 MTSD use, and peer relationship problems and MTSD use positively associated in T2. Pre-schoolers with more hyperactive inattentive symptoms may use MTSDs more to regulate their emotions. The association between peer relationship problems and MTSD use in T2 is consistent with poorer socio-cognitive skills in MTSD user children and may be bi-directional.

Psychological problems in tunisian children during the covid-19 pandemic

IntroductionThe Covid-19 outbreak and the subsequent lockdown have profoundly impacted families’ daily life. Children may be among the most exposed to the psychosocial consequences of the pandemic.ObjectivesTo assess the psychological well-being of children during the COVID-19 pandemic.MethodsThis was a descriptive study shared on social media during the period from 8 to 20 April 2021, targeting mothers of children aged 2 to 18 years. The first part included socio-demographic data of mothers and children. Then, to assess the behavior and coping skills of children and adolescents, we administered the Strengths and Difficulties Questionnaire (SDQ).ResultsOur study included 65 middle-aged moms = 35.28 years. Among mothers, 1.5% reported having at least one child with a psychiatric, medical or genetic illness. The average age of the children was 8.54 years, the sex ratio was 1.03 and they were in primary school in 52.3%. Moms had talked to their child about COVID in 93.8%, using scientific data in 69.4% of cases. The total average SDQ score was 10.82; and overall mental health was at risk in 15.4% of the children. They had risky emotional symptoms in 9.2%, risky aggressive behaviors in 12.3%, risky hyperactivity-inattention symptoms in 16.9%, relationship behaviors with at-risk pairs in 24.6%, and risky prosocial behavior in 9.2% of cases.ConclusionsResearchers and government officials should be more concerned about the mental health of children who are often neglected as a result of the pandemic due to their comparatively lower mortality than older adults.DisclosureNo significant relationships.

Children’s Diet at 2 Years and Trajectories of Hyperactivity-Inattention Symptoms and Conduct Problems Between 3 and 8 Years: The EDEN Cohort

BackgroundAlthough the role of diet is increasingly acknowledged in psychiatry, data are still scarce regarding its early impact on the most significant behavioral disorders of childhood (i.e., hyperactivity-inattention and conduct problems). ObjectivesThe objective of this study was to explore the relation between children’s dietary patterns at 2 years and developmental trajectories of hyperactivity-inattention and conduct problems between 3 and 8 years. MethodsWe recruited 1432 mother-child dyads from the French EDEN (etude sur les déterminants pré- et postnatals du développement et de la santé de l’enfant) mother-child cohort to conduct the analyses. Three dietary patterns, labeled guidelines, processed and fast foods, and baby foods, were identified using an FFQ in children aged 2 years in a previous study. The Strengths and Difficulties Questionnaire was used to assess hyperactivity-inattention and conduct problems at 3, 5, and 8 years of age and build related trajectories from 3 to 8 years. The relation between children’s dietary patterns at 2 years and the worst developmental trajectories of hyperactivity-inattention and conduct problems were determined with multivariable logistic regressions adjusted for potential socioeconomic, maternal, and child confounders. ResultsThe score on the guidelines dietary pattern was negatively associated with the risk of hyperactivity-inattention problems (OR: 0.75; 95% CI: 0.60–0.94), contrary to adherence to the baby foods dietary pattern (OR: 1.41; 95% CI: 1.16–1.71). ConclusionsDistinct patterns of children’s diet at 2 years were predictive of developmental trajectories of hyperactivity-inattention problems between 3 and 8 years. These results highlight the relevance of conducting further studies to clarify the mechanisms involved.

Observed parenting aspects of child compliance in custodial grandfamilies

AbstractObjectiveThis study explored differences between the observed parenting behaviors of custodial grandmothers (CGMs) with grandchildren varying in symptoms of hyperactivity–inattention (HI).BackgroundLittle is known about the parenting practices of grandparent caregivers, and most extant studies are based on self‐report data rather than direct observations of grandparent–grandchild interactions.MethodCustodial grandmothers (N = 170) completed ratings of grandchild HI and participated in a dyadic interaction task with their grandchild so that the relative positivity of their comments and type and number of their commands could be coded. We also coded grandchildren's behavioral responses to each of their CGM's commands.ResultsControlling for child age, there were no differences in parenting variables between high and low HI groups. Hierarchical regression analyses revealed that, controlling for child age, child HI did moderate the relationship between commands given by a grandmother and child compliance, where children lower in HI were more likely than children high in HI symptoms to comply in the face of high levels of commands. In general, however, CGMs were effective in eliciting child compliance. A second hierarchical regression model, also controlling for child age, suggested that for some children, grandmothers’ encouragement and praise (vs. criticism and discouragement) was an effective method of gaining compliance without overrelying on commands.ConclusionThis study revealed complex relationships among positive and negative parenting practices, direct and indirect commands, and compliance. Such relationships transcend grandchild HI status but, in part, vary with grandchild age.ImplicationsThis study provides unique insights into the childrearing practices of CGMs and has implications for interventions targeting grandparent caregivers’ parenting skills.

The COVID-19 lockdown and psychological distress among Italian parents: Influence of parental role, parent personality, and child difficulties.

The Italian lockdown following the spread of COVID‐19 exposed residents to a long and unexpected period of managing offspring at home. Throughout this time, most parents continued to work remotely. The present research aimed at assessing multiple sociodemographic and psychological variables for parental well‐being during the lockdown. An online survey was administered from 6 to 11 April 2020. Respondents were 917 parents aged 23–67 years with up to six children, aged 3–13 years. The measures employed were: 14 demographic questions, the Big Five Inventory (BFI‐10), the Emotional Symptoms and Hyperactivity‐Inattention subscales of the Strength and Difficulties Questionnaire (SDQ‐P), and the General Health Questionnaire (GHQ‐12). Multiple moderated linear regression analyses were performed. Motherhood, higher levels of education, higher neuroticism, lower extroversion, and more child emotional and hyperactivity‐inattention symptoms were found to be significant predictors of parent distress. Furthermore, a significant two‐way interaction between child emotional problems and parent extroversion was found. Overall, parents showed high rates of psychological distress, signalling severe difficulties during the lockdown. Families with a child suffering from emotional and behavioural difficulties should immediately be detected by social services to activate support interventions to prevent chronic and amplified manifestations of these problems.

Behavioral problems in children with primary monosymptomatic nocturnal enuresis

Background and objectivesPrimary monosymptomatic nocturnal enuresis (PMNE) is a common distressing condition to children and parents. This study aimed to determine frequencies, severities and characteristics of behavioral problems with PMNE. MethodsThis cross-sectional study included 80 children with PMNE (age: 12.58 ± 1.24 yrs.; boys = 58, girls = 22) and 60 healthy children. Behavioral symptoms were assessed by Strength and Difficulties Questionnaire (SDQ). ResultsThis study included 80 children (boys/girls ratio = 2.64:1) with PMNE. They had mean age of 12.58 ± 1.24 yrs. The majority (70%) had good response to medical treatment. Compared to controls, children with enuresis had higher frequencies of emotional, conduct and hyperactivity-inattention symptoms and peer relationship and prosocial problems and higher total (P = 0.001) and different subscales' scores of SDQ. There was an overlap of behavioral problems in 52.2% of children with nocturnal enuresis. Compared to children without behavioral symptoms, children with behavioral symptoms were significantly older at age at presentation (P = 0.046) regardless of gender, residence and type or response to medications. Multiple regression analysis showed that emotional [β = 0.053 (95%CI = 0.037–0.084), P = 0.024] and hyperactivity-inattention symptoms [β = 0.063 (95%CI = 0.028–0.097), P = 0.001] were significantly associated with enuresis independent to other problems. ConclusionPMNE is associated with higher risk of behavioral problems particularly emotional and hyperactivity-inattention symptoms indicating externalizing and internalizing problems, therefore, the importance of early non-pharmacological or/and drug interventions. The comorbid behavioral disorders should be treated separately according to evidence-based recommendations to prevent persistence of enuresis and the development of psychiatric disorders in the future.

Behavioral assessment of females with congenital adrenal hyperplasia.

Patients with congenital adrenal hyperplasia (CAH) have an increased risk of psychological/psychiatric symptoms and disorders. This study aimed to assess the behavior of girls with CAH and its independent risk variables. This cross-sectional study included 55 girls with CAH due to 21-hydroxylase deficiency (mean age 12.64 ± 1.52years; salt-wasting (SW) form = 20, simple virilizing (SV) form = 35). Psychiatric interviewing and the Strength and Difficulties Questionnaire (SDQ) (parent-reporting questionnaires) were used to assess behavior. Compared to controls (n = 60), patients had a high total SDQ score (P = 0.001) and emotional, conduct, and hyperactivity-inattention symptoms, peer relationship problems (P = 0.001 for all), and prosocial behavior (p = 0.01) subscale scores, indicating externalizing and internalizing behavioral problems. Severe emotional symptoms and poor disease control were found with SW compared to the SV form. Multiple linear regression showed that bone age (BA) (β = 0.331, t = 3.608; P = 0.001) and 17-OHP (β = 0.408, t = 4.220; P = 0.001), testosterone (β = 0.348, t = 3.220; P = 0.001), and androstenedione (β = 0.238, t = 2.487; P = 0.015) levels were independently associated with behavioral problems. Females with CAH had frequent and severe behavioral symptoms. Excess androgenization, which was in part due to suboptimal steroid therapy, was the cause of the behavioral problems. Therefore, early optimization of CAH management should be stressed to prevent psychological consequences.

Effects of Discontinuing Methylphenidate on Strengths and Difficulties, Quality of Life and Parenting Stress

Objectives: To study the effects of discontinuation of long-term methylphenidate use on secondary outcome measures of strengths and difficulties, quality of life (QoL), and parenting stress. Methods: Ninety-four children and adolescents aged 8 to 18 years who had used methylphenidate for over 2 years were randomly assigned to double-blind continuation of treatment for 7 weeks (36 or 54 mg extended release methylphenidate) or to gradual withdrawal over 3 to 4 weeks placebo. We used mixed models for repeated measures to investigate effects on parent, teacher, and child ratings of hyperactivity/inattention and comorbid symptoms with the Strengths and Difficulties Questionnaire (SDQ), investigator- and teacher-rated oppositional symptoms (Conners Teacher Rating Scale-Revised: short form [CTRS-R:S]), and parent-rated aggression with the Retrospective Modified Overt Aggression Scale. QoL was assessed with the Revised Questionnaire for Children and Adolescents to record health-related quality of life and parenting stress with the Nijmegen Parental Stress Index. Results: Hyperactivity/inattention scores from the parent- and teacher-rated SDQ (difference in mean change over time of respectively: -1.1 [95% confidence interval, CI, -2.0 to -0.3]; p = 0.01; -2.9 [95% CI -2.9 to -0.7; p = 0.01]) and oppositional scores of the teacher-rated CTRS-R:S (difference in mean change -1.9 95% CI [-3.1 to -0.6; p < 0.01]) deteriorated to a significantly larger extent in the discontinuation group than in the continuation group. We did not find effects on other symptom domains, aggression, QoL, and parenting stress after discontinuation of methylphenidate. Conclusion: Our study suggests beneficial effects of long-term methylphenidate use beyond 2 years for oppositional behaviors in the school environment. Similarly, beneficial effects were found on hyperactivity-inattention symptoms as rated by parent and teacher scales, confirming our primary study on investigator ratings of attention-deficit/hyperactivity disorder. However, discontinuation of methylphenidate did not appear to have impact on other comorbid problems or aspects of the child's or parental functioning.

Prenatal diet and children's trajectories of hyperactivity-inattention and conduct problems from 3 to 8years: the EDEN mother-child cohort.

Evidence shows that diet contributes substantially to lifelong physical and mental health. Although dietary exposure during gestation and early postnatal life is critical, human epidemiological data are limited regarding its link with children's subsequent externalizing issues. The aim of this study was to investigate the role of maternal diet during pregnancy in offspring's symptoms of hyperactivity-inattention and conduct problems from ages 3 to 8years. We used data of 1,242 mother-child pairs from a French cohort followed up from pregnancy until the children were 8years of age. Dietary patterns (DP) of the mother during pregnancy were assessed with food frequency questionnaires. Children's externalizing behavior was assessed with the Strength and Difficulties Questionnaire at ages 3, 5, and 8years, from which trajectories of hyperactivity-inattention symptoms and conduct problems were derived. We conducted multivariable logistic models to study associations adjusted for a range of potential confounders. Results showed significant relationships between maternal 'low Healthy diet' (adjusted Odds Ratio (aOR)=1.61; IC 95%: 1.09-2.37) and 'high Western diet' (aOR=1.67; IC 95%: 1.13-2.47) during pregnancy and children's trajectories of high symptoms of hyperactivity-inattention. The associations took into account relevant confounders such as DP of the children at age 2years, maternal stress and depression, gestational diabetes, and socioeconomic variables. Maternal diet during pregnancy was independently associated with children's hyperactivity-inattention symptoms but not with conduct problems. Early prevention addressing lifestyle should specifically target diet in pregnant women.

Mechanisms in the relation between GABRA2 and adolescent externalizing problems.

Conduct problems, alcohol problems and hyperactive-inattentive symptoms co-occur at a high rate and are heritable in adolescence. The γ-aminobutyric acid A receptor, α2 gene (GABRA2) is associated with a broad spectrum of externalizing problems and disinhibitory-related traits. The current study tested whether two important forms of disinhibition in adolescence, impulsivity and sensation seeking, mediated the effects of GABRA2 on hyperactive-inattentive symptoms, conduct problems, and alcohol problems. Participants were assessed at two waves (11-17 and 12-18 years old; N = 292). Analyses used the GABRA2 SNP, rs279858, which tags the two complementary (yin-yang) GABRA2 haplotypes. Multiple informants reported on adolescents' impulsivity and sensation seeking and adolescents self-reported their hyperactive-inattentive symptoms, conduct problems and lifetime alcohol problems. Impulsivity mediated the effect of GABRA2 on alcohol problems, hyperactive-inattentive symptoms, and conduct problems, whereas sensation seeking mediated the effect of GABRA2 on alcohol problems (AA/AG genotypes conferred risk). GABRA2 directly predicted adolescent alcohol problems, but the GG genotype conferred risk. Results suggest that there may be multiple pathways of risk from GABRA2 to adolescent externalizing problems, and suggest important avenues for future research.

Links Between Co-occurring Social-Communication and Hyperactive-Inattentive Trait Trajectories

ObjectiveThere is overlap between an autistic and hyperactive-inattentive symptomatology when studied cross-sectionally. This study is the first to examine the longitudinal pattern of association between social-communication deficits and hyperactive-inattentive symptoms in the general population, from childhood through adolescence. We explored the interrelationship between trajectories of co-occurring symptoms, and sought evidence for shared prenatal/perinatal risk factors.MethodStudy participants were 5,383 singletons of white ethnicity from the Avon Longitudinal Study of Parents and Children (ALSPAC). Multiple measurements of hyperactive-inattentive traits (Strengths and Difficulties Questionnaire) and autistic social-communication impairment (Social Communication Disorder Checklist) were obtained between 4 and 17 years. Both traits and their trajectories were modeled in parallel using latent class growth analysis (LCGA). Trajectory membership was subsequently investigated with respect to prenatal/perinatal risk factors.ResultsLCGA analysis revealed two distinct social-communication trajectories (persistently impaired versus low-risk) and four hyperactive-inattentive trait trajectories (persistently impaired, intermediate, childhood-limited and low-risk). Autistic symptoms were more stable than those of attention-deficit/hyperactivity disorder (ADHD) behaviors, which showed greater variability. Trajectories for both traits were strongly but not reciprocally interlinked, such that the majority of children with a persistent hyperactive-inattentive symptomatology also showed persistent social-communication deficits but not vice versa. Shared predictors, especially for trajectories of persistent impairment, were maternal smoking during the first trimester, which included familial effects, and a teenage pregnancy.ConclusionsOur longitudinal study reveals that a complex relationship exists between social-communication and hyperactive-inattentive traits. Patterns of association change over time, with corresponding implications for removing exclusivity criteria for ASD and ADHD, as proposed for DSM-5.

P01-285 - Childhood hyperactivity-inattention symptoms and risk behaviors in young adulthood

IntroductionAttention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) are associated with Risk Behaviors (RB) such as substance-related problems, suicidal behaviors and sex risk behaviors. However, some issues remain controversials: is ADHD an independent risk factor for RB? Is CD a confounding factor of the relationship between ADHD and RB?AimTo assess the link between childhood hyperactivity-inattention symptoms and subsequent RB, controlling for other risk factors among which conduct disorder symptoms.MethodsWe have conducted multivariate analyses from a French community-based sample (N = 1107) belonging to the youth GAZEL cohort. The sample was first assessed at ages 4 to 18, and then assessed 8 years later. Child psychopathology and RB patterns were evaluated through parent and adolescent self-reports.ResultsIn males, results show an effect of hyperactivity-inattention symptoms on more severe RB such as regular cannabis use, illicit drug experimentation and suicidal behaviors (adjusted OR = 2 to 5, all Ps significants). In females, they show an effect of hyperactivity-inattention symptoms on regular tobacco use (adjusted OR = 2, P &lt; .05). The risk of RB initiation was increased in youths with high levels of conduct disorder symptoms, particularly in combination with simultaneously high levels of hyperactivity-inattention symptoms (adjusted OR = 2, P &lt; .05).ConclusionsThis work enhances the knowledge of a link between disruptive behaviors in childhood and subsequent risk behaviors. It underscores the importance of a better acknowledgement of these disorders, in order to better identify and treat them to prevent negative long-term outcomes.

147. Being in Trouble with the Police and Associations with Mental Health Outcomes Amongst Alternative Education Students in New Zealand

Students who are excluded from mainstream education are vulnerable to negative health, social and educational outcomes. The purpose of this analysis to is to explore whether being in trouble with the Police is associated with mental health problems such as depressive symptoms, conduct problems, hyperactivity-inattention symptoms, marijuana use and binge drinking for students attending Alternative Education (AE) in New Zealand.