Internalising Symptoms Research Articles

Prospective associations between internalising symptoms and educational achievement in youth: A monozygotic twin differences study

BackgroundEducational achievement is an independent predictor of many life outcomes and so it is important to understand its causes and correlates. Internalising symptoms, encompassing anxiety and depression symptoms, are one candidate influence. MethodsUsing a prospective and genetically-informative design, the present study investigated the associations between internalising symptoms and educational achievement, controlling for IQ at age 7 years and socioeconomic status, among participants of the Twin and Early Development Study (up to N = 10,791). Internalising symptoms were measured by the parent-rated Anxiety Related Behaviours Questionnaire (ages 7, 9, 16 years), and educational attainment were indexed by UK-wide standardized examination results at ages 16 and 18 years, and self-reported transition to university education. ResultsNegative affect was the only internalising symptom subtype that was uniquely associated with academic underachievement at all timepoints, from mid-adolescence to early adulthood. The association between negative affect and achievement became non-significant when using MZ twin difference scores, suggesting that the majority of the relationship is accounted for by genetic and shared environmental effects. LimitationsLimitations include the reliance on parent-reported internalising symptoms. ConclusionsNegative affect in youth may be an important marker of later academic underachievement. Findings suggest that academic underachievement is not simply a consequence of the disruption caused by negative affect symptoms and therefore educational interventions may be required to optimise outcomes.

Internet Gaming Disorder in Children and Adolescents with Attention Deficit Hyperactivity Disorder.

Although Attention Deficit Hyperactivity Disorder (ADHD) has been related to an increased risk for behavioral addictions, the relationship between ADHD and Internet Gaming Disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ADHD youth, compared to a normal control group, and by assessing selected psychopathological and cognitive features in ADHD patients with and without IGD. One hundred and eight patients with ADHD (mean age 11.7 ± 2.6 years, 96 males) and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) were included in the study and received structured measures for IGD. In the ADHD group, 44% of the sample were above the IGD cut-off, compared to 9.5% in the NC group. ADHD patients with IGD presented with greater severity and impairment, more severe ADHD symptomatology, more internalizing symptoms, particularly withdrawal/depression and socialization problems, and more prominence of addiction and evasion dimensions. A binary logistic regression showed that the degree of inattention presented a greater weight in determining IGD. These findings may be helpful for identifying, among ADHD patients, those at higher risk for developing a superimposed IGD.

Neurodevelopmental Trajectories in Children With Internalizing, Externalizing and Emotion Dysregulation Symptoms.

IntroductionChildhood and adolescence are crucial periods for brain and behavioral development. However, it is not yet clear how and when deviations from typical brain development are related to broad domains of psychopathology.MethodsUsing three waves of neuroimaging data within the population-based Generation R Study sample, spanning a total age range of 6–16 years, we applied normative modeling to establish typical development curves for (sub-)cortical volume in 37 brain regions, and cortical thickness in 32 brain regions. Z-scores representing deviations from typical development were extracted and related to internalizing, externalizing and dysregulation profile (DP) symptoms.ResultsNormative modeling showed regional differences in developmental trajectories. Psychopathology symptoms were related to negative deviations from typical development for cortical volume in widespread regions of the cortex and subcortex, and to positive deviations from typical development for cortical thickness in the orbitofrontal, frontal pole, pericalcarine and posterior cingulate regions of the cortex.DiscussionTaken together, this study charts developmental curves across the cerebrum for (sub-)cortical volume and cortical thickness. Our findings show that psychopathology symptoms, are associated with widespread differences in brain development, in which those with DP symptoms are most heavily affected.

The Impact of the COVID-19 Outbreak on Mental Wellbeing in Children with a Chronic Condition Compared to Healthy Peers.

The aim of this study was to assess the impact of the COVID-19 pandemic on the mental wellbeing of children 8–18 years old with chronic conditions, by comparing pandemic data with pre-pandemic data and with healthy peers. Data were obtained from two ongoing longitudinal cohorts: the PROactive cohort study following children with a chronic condition, and the WHISTLER population cohort. Mental wellbeing was assessed by three indicators: life satisfaction, internalising symptoms, and psychosomatic health. The stringency of the COVID-19-related lockdown was considered a moderating factor. Data on chronic patients were recorded before (n = 934, 65% girls) and during (n = 503, 61% girls) the pandemic, and compared to healthy peers during the pandemic (n = 166, 61% girls). Children with a chronic condition reported lower life satisfaction, but no clinically relevant changes in internalising symptoms or psychosomatic health, during the pandemic compared to before. In comparison to healthy peers, children with a chronic condition experienced decreased life satisfaction and psychosomatic health, but internalising symptoms did not differ between groups during the COVID-19 pandemic. The lockdown stringency was negatively associated with all indicators of mental wellbeing—worse life satisfaction, more internalising symptoms, and more psychosomatic symptoms.

Promotive factors associated with internalising symptoms amongst college students during the COVID-19 lockdown in Enugu metropolis, Nigeria.

BackgroundThe outbreak of the coronavirus disease 2019 (COVID-19) pandemic has caused a high burden of psychological distress amongst adolescents.AimThis study aimed to evaluate associations of personal strengths including resilience and social support with internalising symptoms amongst college students during the lockdown in the wake of the COVID-19 pandemic.SettingThe study population included students from senior and junior college classes in public schools in Enugu metropolis, Nigeria.MethodA school-based cross-sectional study design was employed for the study. A two-stage sampling technique was used to select 496 students (mean age = 16.5, s.d. = 1.9 years; 52.2% female) in six out of 33 public colleges in Enugu metropolis, Nigeria during the lockdown period occasioned by the COVID-19 pandemic. Validated questionnaires assessing anxiety, depression, resilience and social support were used to collect information.ResultsMost of the students reported depressive symptoms, whilst just over a third of the sample reported anxiety or both depressive and anxiety symptoms. Chi-square and logistic regression analyses revealed that being male and reporting higher levels of social support and the ability to bounce back from stress were associated with less anxiety. Being younger and reporting a moderate level of support were associated with more depressive symptoms, whilst the ability to bounce back was associated with fewer depressive symptoms.ConclusionsGood social support and the ability to bounce back from stress were linked to lower levels of anxiety and depressive symptoms amongst college adolescents during the lockdown in the wake of the COVID-19 pandemic despite high prevalence rates.

The Relation between Parent Mental Health and Child Internalizing Symptoms in Parent–Child Interaction Therapy

The Relation between Parent Mental Health and Child Internalizing Symptoms in Parent–Child Interaction Therapy

Sex and age moderate the trajectory of guilt among children and adolescents with and without recent suicidal ideation

ABSTRACT We aimed to examine whether the trajectories of ecologically derived guilt differ among a transdiagnostic sample of youth with and without recent suicidal ideation and whether sex and age moderated this association. We assessed guilt 3 times a day over a 2-week period via ecological momentary assessment (EMA) technology in 102 children recruited from the community, outpatient, and inpatient settings. The average age of children was 10.95 y.o. (SD = 2.26, range 8–16) and the majority were male (54.9%) and White (76.5%). We found that the real-world guilt during a two-week EMA period was higher among youth with greater suicidal ideation severity in the past six months. Moreover, there was a significant moderating effect of sex and age on this association, such that the association between suicidal ideation severity and guilt was particularly strong among females compared to males and youth who were 10 years old or older. The findings were maintained when we adjusted for the relevant demographic and clinical characteristics, including age, minority status, parental income, EMA response rate, and current internalising symptoms. These preliminary findings highlight the clinical relevance of assessing and targeting feelings of guilt in the day-to-day lives of youth, particularly for females and older youth.

Exposure to family stressful life events in autistic children: Longitudinal associations with mental health and the moderating role of cognitive flexibility.

Mental health problems are prevalent in autistic youth, but the underpinning mechanisms are not well explored. In neurotypical youth, stressful life events are an established risk factor for mental health problems. This study tested longitudinal bidirectional associations between family-level stressful life events and mental health problems and whether these were moderated by cognitive flexibility, in a cohort of autistic children (N = 247). Family-stressful life events, assessed using the parent-reported Family Inventory of Life Events and Changes, and mental health problems, assessed using the teacher-reported Child Behavior Checklist Internalizing and Externalizing Symptoms subscales, were measured at multiple points between 7 and 11 years. Analyses showed no significant pathways from internalizing or externalizing symptoms to family-stressful life events or from family-stressful life events to internalizing or externalizing symptoms. There was some evidence of moderation by cognitive flexibility; the family-stressful life events to internalizing symptoms pathway was non-significant in the group with typical shifting ability but significant in the group with clinically significant shifting problems. Information about family-level stressful life event exposure and cognitive flexibility may be helpful in identifying autistic youth who may be at higher risk of developing mental health problems. Established risk factors for mental health problems in neurotypical populations are relevant for understanding mental health in autistic youth.Lay abstractExperiencing stressful life events, such as a parent having had serious illness, parental divorce, bullying and victimization, is known to increase risk for mental health difficulties in neurotypical children. However, few studies have looked at whether stressful life events have a similar impact in autistic youth and if any individual characteristics may moderate the impact of said life events. In this study, we tested whether in autistic children aged 7–11 years, exposure to family-level stressful life events predicted later mental health symptoms (and vice versa). We also tested whether associations between stressful life events and mental health symptoms differed depending on the child’s level of cognitive flexibility. We found stressful life events only predicted internalizing symptoms (such as anxiety and depression) in children with clinically significant difficulties in cognitive flexibility (as rated by their parents). Mental health symptoms did not predict future exposure to stressful life events. Results suggest that information about exposure to stressful life events and cognitive inflexibility may be helpful in identifying autistic children who may be at risk of developing anxiety and depression symptoms.

The Effects of Parenting Practices, Victimization and Peer Relationships in Children’s Internalizing Symptoms: A MiniReview

The Effects of Parenting Practices, Victimization and Peer Relationships in Children’s Internalizing Symptoms: A MiniReview

A Longitudinal Study on the Effects of Parental Mental Health and Handheld Devices on Child Outcomes

Children have been thrust into a “portable age” where handheld devices, such as smartphones, tablets or iPads, have become a part of the daily norm. Parental factors and early life experiences, such as engaging in screen devices, have been widely established as major influences on children’s outcomes. This study aimed to investigate the relationships between the mental health of parents, parental and child screen time (ST), and child outcomes. A longitudinal study of mothers and fathers (<I>N = </I>214) were recruited at two time points (T1, April 2019-February 2020; T2, September 2020-February 2021). Due to loss to follow-up, the final sample consisted of 101 participants (97 mothers, 4 fathers) with a mean age of 37.55 (<I>SD</I> = 4.14). Children of participants had a mean age of T1 = 5.25 (<I>SD </I>= .44) and T2=6.51 (<I>SD </I>= .52). Participants completed a battery of self-report questionnaires regarding their own mental health, their child’s and their own engagement with handheld devices, as well as their child’s internalising and externalising behaviour. The study demonstrated that parental anxiety significantly predicted child internalising symptoms, whereas both parental anxiety and depression significantly predicted child externalising symptoms, across time. These findings suggest that after controlling for ST, parental mental health is predictive of temporal child outcomes. Future studies should consider early intervention programs that target parents with mental health concerns, examining children who engage in excessive ST, and consider context and content of ST amongst these trends.

Youth's personal relationships, psychological symptoms, and the use of different substances: A population-based study.

Background: Externalising symptoms and peer influence are well-established predictors of youth's substance use in general. However, there is little integrative research that compares the relative contribution of psychological and social relationship characteristics as predictors of the use of specific substances among youth in different developmental stages. Methods: A representative sample of Danish adolescents (n = 1,168) and emerging adults (EA; n = 1,878) reported last-month prevalence use of cigarettes, cannabis, and other illicit drugs (OID), and four indices of alcohol use. Predictor variables included internalising and externalising symptoms, and major characteristics of the youth's relationships (e.g., parental drug use, number of close friends). Results: Having a close friend who used illicit drugs, and high externalising symptoms, predicted the risk for using all substances across both age groups. Alcohol use was more consistently related to peer-related variables than to symptoms. Smoking cigarettes, cannabis use, and OIDs use were related to peer and symptom variables. Age group moderated some associations. Parental separation was related more strongly to alcohol use among adolescents than among EA, and higher internalising symptoms were more strongly related to smoking and using OIDs among adolescents than among EA. Male EAs had higher risk for using alcohol than female EAs. Conclusion: Beyond having a close friend who used illicit drugs, and externalising problems, the use of each substance was better explained by a different group of variables. There were few but important moderations by age group. The findings highlight the need for research on risk factors for substance use that is developmentally sensitive, particularly for adolescents, and for specific substances. Thus, interventions and policies should address social, developmental, and psychological factors.

Multi‐family therapy for separated parents in conflict and their children: intervention development and pilot evaluation

AbstractEvidence demonstrates the deleterious impact of ongoing and poorly resolved parental conflict on children’s wellbeing. ‘No Kids in the Middle’ (NKM) is a multi‐family programme that aims to help high‐conflict separated parents find new ways of communicating. The aim of this study was to adapt, deliver and evaluate NKM in three UK pilot sites. This paper reports findings from interviews exploring families’ experiences of this intervention, and questionnaires which measured change for families over the course of the programme. Parents reported reductions in hostility and conflict when discussing parenting issues. Children reported improved wellbeing with respect to family life, and a reduction in ‘avoidance’ with respect to talking or thinking about parental conflict. Parents reported reduced internalising symptoms in children. The findings indicate that NKM could be a promising intervention for high‐conflict separated parents and their children, deliverable by frontline practitioners. Practitioner points Inter‐parental conflict can negatively impact children’s wellbeing Multi‐family therapy may be a promising approach for separated parents experiencing co‐parenting conflict After the NKM multi‐family programme, parents reported reduced levels of hostility and conflict when discussing parenting issues At the end of the NKM programme, children reported improved wellbeing with respect to family life, and a reduction in ‘avoidance’ with respect to talking or thinking about family conflict. Relatedly, parents reported reduced internalising symptoms in children

Impact of Sibling Victimization on Child Internalizing Symptoms.

The current study examined associations between sibling victimization and anxiety and depression symptoms while also considering peer victimization within time and six months later among elementary school-age youth. Both sibling and peer victimization were associated with depression symptoms within as well as across time when considered independently. However, when examined together, peer victimization was only uniquely associated with depression symptoms within time and sibling victimization was only uniquely associated with depression symptoms across time. Sibling and peer victimization were associated with anxiety symptoms within, but not across, time when examined independently, and no associations were evident when sibling and peer victimization were examined simultaneously. No interactive effects of sibling and peer victimization were evident for depression or anxiety symptoms, indicating unique rather than cumulative contributions. Findings suggest that the impact of sibling victimization on depression symptoms is more robust than effects of peer victimization over time.

Fluoride exposure during early adolescence and its association with internalizing symptoms

BackgroundEarly, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest a link between fluoride exposure and internalizing behaviors. No human studies have examined the impact of fluoride on internalizing behaviors during adolescence. ObjectiveEvaluate the relationship between urinary fluoride and early adolescent internalizing symptoms in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). MethodsParticipants in CCAAPS provided non-fasting spot urine samples at age 12 years (n = 286). Urine samples were analyzed using a microdiffusion method to determine childhood urinary fluoride (CUF) concentrations and were log-transformed for analyses. Caregivers of CCAAPS participants completed the Behavior Assessment System for Children-2 (BASC-2) at the age 12 study visit to assess internalizing symptoms (e.g., anxiety, depression, somatization), and a composite score of the three domains; T-scores ≥ 60 were used to identify adolescents in a clinically “at-risk” range. Race, age of the adolescent, household income, maternal age at birth, caregiver depression, caregiver-child relationships, and age 12-year serum cotinine concentrations were considered covariates in regression models. Sex-specific effects of fluoride exposures were investigated through the inclusion of interaction terms. ResultsHigher CUF concentrations were significantly associated with increased somatization (β = 3.64, 95% CI 0.49, 6.81) and internalizing composite T-scores in a clinically “at-risk” range (OR = 2.9, 95% CI 1.24, 6.9). Compared to females, males with higher CUF concentrations had more internalizing (pinteraction = 0.04) and somatization symptoms (pinteraction = 0.02) and were nearly seven times more likely to exhibit “at-risk” internalizing symptomology. CUF concentrations were not significantly associated with depression or anxiety symptoms. ConclusionsThis is the first study to link fluoride exposure and internalizing symptoms, specifically somatization. Somatization represents an interface of physical and psychological health. Continued follow-up will help shed light on the sex-specific relationship between fluoride and mental health and the role of somatization.

Regularity and Timing of Sleep Patterns and Behavioral Health Among Adolescents.

Sleep is vital to supporting adolescent behavioral health and functioning; however, sleep disturbances remain under-recognized and undertreated in many health care settings. One barrier is the complexity of sleep, which makes it difficult for providers to determine which aspects-beyond sleep duration-may be most important to assess and treat to support adolescent health. This study examined associations between 2 sleep indices (regularity and timing) and adolescent behavioral health and functioning over and above the impact of shortened/fragmented sleep. Eighty-nine adolescents recruited from the community (mean age = 14.04, 45% female participants) completed 7 days/nights of actigraphy and, along with a parent/guardian, reported on behavioral health (internalizing and externalizing symptoms) and psychosocial functioning. Stepwise linear regressions examined associations between sleep timing and regularity and behavioral/functional outcomes after accounting for shortened/fragmented sleep. Delayed sleep timing was associated with greater self-reported internalizing (F[6,82] = 11.57, p = 0.001) and externalizing (F[6,82] = 11.12, p = 0.001) symptoms after accounting for shortened/fragmented sleep. Irregular sleep was associated with greater self-reported and parent-reported externalizing symptoms (self: F[7,81] = 6.55, p = 0.01; parent: F[7,80] = 6.20, p = 0.01) and lower psychosocial functioning (self: F[7,81] = 6.03, p = 0.02; parent: F[7,78] = 3.99, p < 0.05) after accounting for both shortened/fragmented sleep and delayed sleep timing. Sleep regularity and timing may be critical for understanding the risk of poor behavioral health and functional deficits among adolescents and as prevention and intervention targets. Future work should focus on developing and evaluating convenient, low-cost, and effective methods for addressing delayed and/or irregular adolescent sleep patterns in real-world health care settings.

Cross-sectional and longitudinal associations of park coverage, greenness exposure and neighbourhood median household income with children's depressive and anxiety symptoms.

Internalising symptoms and disorders often emerge in childhood and are associated with negative health outcomes into adulthood. Studies have shown neighbourhood characteristics (e.g. socio-economic composition, greenspace exposure) to be associated with depression and anxiety symptoms in adults; however, research that explores these relationships longitudinally in children is lacking. This study examined cross-sectional and longitudinal associations of neighbourhood characteristics with developmental trajectories of internalising symptoms in 202 children (ages 8-12) from the Mothers' and Their Children's Health (MATCH) Study. The MATCH Study is a Los Angeles-based longitudinal observational investigation of children's health outcomes with six semi-annual assessment waves across 3 years. Latent growth curve modelling was used to examine cross-sectional and longitudinal associations between child's self-reported anxiety or depressive symptoms and their neighbourhood's park coverage, greenness exposure and median household income. All models included the following as covariates: child's age, sex, ethnicity, family household income and mother's mental health measures. Cross-sectionally, results indicated that neighbourhood median household income was negatively associated with children's depressive symptoms at baseline. Longitudinally, neighbourhood median household income was associated with steeper increases in children's depressive symptoms. Neither greenness exposure nor park coverage was associated with children's depressive or anxiety symptoms cross-sectionally or longitudinally. Childhood plays a key factor in setting the foundations for healthy mental, social, physical and cognitive growth. Our study suggests future mental health prevention programmes in youth should cater to a multilevel approach that integrates individual, familial and neighbourhood interventions and pay special attention to their neighbourhood SES levels.

The relationship between ultra-processed food consumption and internalising symptoms among adolescents from São Paulo city, Southeast Brazil.

To investigate the association between ultra-processed food (UPF) consumption and internalising symptoms (IS) among adolescents. It is a cross-sectional study. Paper-pencil survey was completed in classroom with information on UPF consumption, IS and selected covariates. IS were assessed with the Internalizing Symptoms sub-scale from the Social Behaviour Questionnaire (IS-SBQ). UPF was evaluated with a FFQ extracted from the Brazilian National School Health Survey. Crude and adjusted association between UPF and IS was investigated with structural equation models. São Paulo, SP, Brazil. A total of 2680 students, Mage = 14·85; (95 % CI 14·81, 14·88). UPF consumption was associated with higher scores in IS in the crude (β = 0·14; P < 0·001) and adjusted (β = 0·12; P < 0·001) models. The higher the consumption of UPF, the higher is the IS score. The following variables were associated with a lower risk of UPF consumption: male sex, public school and having more meals with parents. The change in the magnitude of the standardised score was almost negligible, but the model was significantly improved with the inclusion of covariates. Our results provide evidence about the positive association between UPF consumption and IS among adolescents. The association, despite its low magnitude, remained significant after adjusting for potential confounders. These results are relevant considering the increase in UPF consumption worldwide and in low- and middle-income countries. Also, our study emphasises the importance of a healthy diet with a reduction in UPF consumption among adolescents.

Analysis of the Behavioural and Emotional Profile of Adolescent Judo Practitioners

In recent decades, the number of social projects that use sports as a tool has been increasing dramatically, necessi- tating rigorous investigations into their immediate and long-term effects and the behavioural changes in children and adolescents who participate in these projects. This study aimed to assess the behavioural and emotional profile of adolescent judo practitioners. The participants of the Judo Social Project in São José do Rio Preto answered the Brazilian version of the “Youth Self-Report” (YSR/2001). In the analysis of scores, the borderline range was grouped with the clinical range to minimize the occurrence of false negatives, specifically, the number of adolescents with scores outside the clinical range on the YSR/11-18 scale (t scores ≥60 for the clinical range) who required psycholog- ical or psychiatric care. The scores on the anxiety and depression scale were significantly higher for female partici- pants (p=0.0431). On the total scale of emotional and behavioural problems, 34.4% (N=106) of the study population had mean scores considered in the clinical range. Of these, the scores were found to be in the clinical range in 24.8% (N=31) of the female participants and 41% (N=75) of the male participants. The comparison between the sexes indi- cated that internalization symptoms (anxiety and depression) were more frequent in female participants, whereas externalization problems (rule-breaking and behavioural problems) were more frequent in male participants.

A randomised controlled trial of a family-group cognitive-behavioural (FGCB) preventive intervention for the children of parents with depression: short-term effects on symptoms and possible mechanisms

ObjectiveParental depression is one of the biggest risk factors for youth depression. This parallel randomized controlled trial evaluates the effectiveness of the German version of the family-group-cognitive-behavioral (FGCB) preventive intervention for children of depressed parents.MethodsFamilies with (i) a parent who has experienced depression and (ii) a healthy child aged 8–17 years (mean = 11.63; 53% female) were randomly allocated (blockwise; stratified by child age and parental depression) to the 12-session intervention (EG; n = 50) or no intervention (CG; usual care; n = 50). Self-reported (unblinded) outcomes were assessed immediately after the intervention (6 months). We hypothesized that CG children would show a greater increase in self-reported symptoms of depression (DIKJ) and internalising/externalising disorder (YSR/CBCL) over time compared to the EG. Intervention effects on secondary outcome variables emotion regulation (FEEL-KJ), attributional style (ASF-KJ), knowledge of depression and parenting style (ESI) were also expected. Study protocol (Belinda Platt, Pietsch, Krick, Oort, & Schulte-Körne, 2014) and trial registration (NCT02115880) reported elsewhere.ResultsWe found significant intervention effects on self-reported internalising (eta_{p}^{2} = 0.05) and externalising (eta_{p}^{2} = 0.08) symptoms but did not detect depressive symptoms or parent-reported psychopathology. Parental depression severity did not modify these effects. Both groups showed equally improved knowledge of depression (eta_{p}^{2} = 0.06). There were no intervention effects on emotion regulation, attributional style or parenting style.ConclusionThe German version of the FGCB intervention is effective in reducing symptoms of general psychopathology. There was no evidence that the mechanisms targeted in the intervention changed within the intervention period.

1305Early chronic inflammation and behavioural problems in children at age two: a longitudinal study

Abstract Background Inflammation has been suggested to contribute to the pathogenesis of adult mental illness and been implicated mechanistically in childhood behavioural problems like internalising and externalising symptoms. High-sensitive C-reactive protein (hsCRP) and glycoprotein acetyls (GlycA) are biomarkers of chronic low-grade inflammation. We aimed to investigate whether hsCRP and GlycA, and environmental factors that influence these inflammatory biomarkers, were associated with internalising and externalising behaviours in early childhood. Methods The Barwon Infant Study is a population-derived birth cohort recruited using an unselected antenatal sampling frame in Victoria, Australia. Infant bloods collected at birth and 12-month were analysed for hsCRP by ELISA and GlycA by NMR. Environmental factors were derived from questionnaires undertaken antenatally to four years postnatally. Internalising and externalising behaviours at age two were measured by the Child Behaviour Checklist. Associations between inflammatory biomarkers and behavioural outcomes were assessed by multivariable regression analyses adjusted for relevant factors. Results Increased GlycA levels at birth (GlycAbirth)(β = 5.22 T-score units; 95% confidence interval (CI)(1.22, 9.21; P=0.01) and decreased GlycA levels at 12 months (GlycA12months)(β=-6.47 T-score units; 95% CI(-11.44, -1.50); P=0.01) were associated with increased internalising behaviours at age two. Association persisted for GlycAbirth, but not for GlycA12months when adjusted for GlycA at both time points within the same model. Weak associations were observed for hsCRP at both time points and externalising behaviours at age two. Conclusions Our findings document an association between increased GlycAbirth and greater internalising behaviours in children aged two years. Elevated early chronic inflammation may be an important pathway in adverse behavioural development in children. Key messages Increased GlycA levels at birth is associated with greater internalising behaviours in children at age two years.