Risk Of Psychopathology In Children Research Articles

Socioeconomic status and risk for child psychopathology: exploring gene-environment interaction in the presence of gene-environment correlation using extended families in the Norwegian Mother, Father and Child Birth Cohort Study.

Low socioeconomic status (SES) is associated with increased risk for emotional and behavioural problems among children. Evidence from twin studies has shown that family SES moderates genetic and environmental influences on child mental health. However, it is also known that SES is itself under genetic influence and previous gene-environment interaction (G×E) studies have not incorporated the potential genetic overlap between child mental health and family SES into G×E analyses. We applied a novel approach using extended family data to investigate the moderation of aetiological influences on child emotional and behavioural problems by parental socioeconomic status in the presence of modelled gene-environment correlation. The sample comprised >28,100 children in extended-family units drawn from the Norwegian Mother, Father and Child Cohort Study (MoBa). Mothers reported children's emotional and behavioural symptoms. Parents' income and educational attainment were obtained through linkage to administrative register data. Bivariate moderation Multiple-Children-of-Twins-and-Siblings (MCoTS) models were used to analyse relationships between offspring outcomes (emotional and behavioural symptom scores) and parental socioeconomic moderators (income rank and educational attainment). The aetiology of child emotional symptoms was moderated by maternal and paternal educational attainment. Shared environmental influences on child emotional symptoms were greater at lower levels of parents' education. The aetiology of child behavioural symptoms was moderated by maternal, but not paternal, socioeconomic factors. Genetic factors shared between maternal income and child behavioural symptoms were greater in families with lower levels maternal income. Nonshared environmental influences on child behavioural symptoms were greater in families with higher maternal income and education. Parental socioeconomic indicators moderated familial influences and nonshared environmental influences on child emotional and behavioural outcomes. Maternal SES and child mental health share aetiological overlap such that shared genetic influence was greater at the lower end of the socioeconomic distribution. Our findings collectively highlight the role that family socioeconomic factors play in shaping the origins of child emotional and behavioural problems.

Social experiences and youth psychopathology during the COVID-19 pandemic: A longitudinal study.

The early stages of the COVID-19 pandemic and associated stay-at-home orders resulted in a stark reduction in daily social interactions for children and adolescents. Given that peer relationships are especially important during this developmental stage, it is crucial to understand the impact of the COVID-19 pandemic on social behavior and risk for psychopathology in children and adolescents. In a longitudinal sample (N=224) of children (7-10y) and adolescents (13-15y) assessed at three strategic time points (before the pandemic, during the initial stay-at-home order period, and six months later after the initial stay-at-home order period was lifted), we examine whether certain social factors protect against increases in stress-related psychopathology during the pandemic, controlling for pre-pandemic symptoms. Youth who reported less in-person and digital socialization, greater social isolation, and less social support had worsened psychopathology during the pandemic. Greater social isolation and decreased digital socialization during the pandemic were associated with greater risk for psychopathology after experiencing pandemic-related stressors. In addition, children, but not adolescents, who maintained some in-person socialization were less likely to develop internalizing symptoms following exposure to pandemic-related stressors. We identify social factors that promote well-being and resilience in youth during this societal event.

Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years: stress in pregnancy study.

Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children. Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2-5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent-report structured diagnostic interview developed for preschool-age children. Sixty-six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS-related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age,race, SES, maternal substance use, and normative prenatal stress. Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p = .030), anxiety disorders (HR = 5.1, p < .0001), and attention-deficit/disruptive behavioral disorders (HR = 3.4, p = .02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p = .004), attention-deficit/hyperactivity disorder (ADHD; HR = 5.5, p = .01), oppositional-defiant disorder (ODD; HR = 3.8, p = .05), and separation-anxiety disorder (SAD; HR = 3.5, p = .001). Males had distinctively elevated risks for attention-deficit/disruptive behavioral disorders (HR = 7.8, p = .02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p < .0001), phobia (HR = 2.8, p = .02) and depressive disorders (HR = 30.0, p = .03), including SAD, GAD, and dysthymia. The findings demonstrate that in utero exposure to a major weather-related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.

Associations of Maternal Prenatal Stress and Depressive Symptoms With Childhood Neurobehavioral Outcomes in the ECHO Cohort of the NICHD Fetal Growth Studies: Fetal Growth Velocity as a Potential Mediator.

Maternal prenatal stress and mood symptoms are associated with risk for child psychopathology. Within the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies (ECHO-FGS), a racially and ethnically diverse cohort, we studied associations between prenatal stress and depressive symptoms with child neurobehavior, and potential mediation by fetal growth velocity (FGV) in low-risk pregnancies. For 730 mother-child pairs, we had serial ultrasound measurements, self-reports of prenatal stress and depression, observations of child executive functions and motor skills from 4 to 8 years, and maternal reports of child psychiatric problems. We tested associations between prenatal stress and depressive symptoms with child neurobehavior in regression analyses, and associations with FGV in mixed effect models. Post hoc we tested severity of prenatal symptoms; FGV at 25th, 50th, and 75th percentiles; and moderation by biological sex and by race and ethnicity. Prenatal stress and depressive symptoms were associated with child psychiatric problems, and prenatal depressive symptoms with decrements in executive functions and motor skills, especially in biological male children. Neither prenatal stress nor depressive symptoms were associated with FGV. In one of the largest cohorts with observed child outcomes, and the first with broad representation of race and ethnicity in the United States, we found that prenatal stress and depressive symptoms were associated with greater reports of child psychiatric symptoms. Only prenatal depressive symptoms were associated with observed decrements in cognitive abilities, most significantly in biological male children. Stress during low-risk pregnancies may be less detrimental than theorized. There was no mediation by FGV. These findings support the need to attend to even small changes in prenatal distress, as these may have long-lasting implications.

Executive function as a mechanism linking socioeconomic status to internalizing and externalizing psychopathology in children and adolescents

IntroductionThe association between low socioeconomic status (SES) in childhood and increased risk for psychopathology is well established, but the mechanisms explaining this relationship are poorly understood. Here, we investigate the potential role of difficulties in executive functioning (EF) as a mechanism linking childhood and adolescent SES with externalizing and internalizing psychopathology. MethodsWe examined whether difficulties with EF mediated the association between SES and externalizing and internalizing psychopathology in two cross-sectional samples of children and adolescents (Study 1: N = 94, ages 6–18, 51.1% male; Study 2: N = 259, ages 8–16, 54.1% male) from diverse SES backgrounds in the United States. EF was measured through behavioral tasks and parent-reported behavioral regulation (BR). ResultsIn both samples, children and adolescents from lower SES families were more likely to experience both externalizing and internalizing psychopathology than youth from more advantaged backgrounds and exhibited greater EF difficulties – they had lower performance on a task measuring inhibitory control and lower parent-rated BR. Reduced inhibitory control and BR, in turn, were associated with higher externalizing and internalizing psychopathology. In Study 1, difficulties with BR mediated the association of low-SES with both externalizing and internalizing psychopathology. In Study 2, low inhibitory control mediated the association between low-SES and externalizing psychopathology. These findings largely persisted after adjusting for exposure to violence, a form of adversity that is common in children from low-SES backgrounds. ConclusionsThese findings suggest that reduced EF may be an underlying mechanism through which low-SES confers risk for psychopathology in children and adolescents.

Environmental Risk Score of subclinical Psychopathology risk in children

Current knowledge on environmental causation for psychiatric disorders suggests a complex picture with a multitude of social, physical and chemical exposures occurring at different stages of life. Researchers who want to explain or predict mental illness need to jointly study a multitude of environmental exposures, which may be summed up in cumulative poly-environmental scores. As part of the ATHLETE project, we aim to build a predictive poly-environmental score (E-score) of subclinical manifestation of psychopathology (e.g. psychotic, autistic, depressive and anxious symptoms) in 1546 children aged around 8 years drawn from the general population from six European birth cohorts with extensive data on environmental exposures (HELIX cohorts). The E-score will be replicated and tested in an independent population drawn from the INMA-Valencia and Gipuzkoa birth cohorts (Spain) for validation (N=916). We identified 35 environmental factors with meta-analytic evidence of association extracted from umbrella reviews with at least one psychiatric disorder, including schizophrenia, autism, bipolar disorder, major depression and anxiety disorders, that can occur in early in life (up to childhood). Among these, 19 were available in the cohorts including factors related to obstetrics complications, sleep, diet quality, urbanicity and metabolic health. We then tested the association between each of the E-scores (predicting combined and individual psychopathology symptoms) and behavioural symptoms that were assessed using the Child Behaviour Checklist (CBCL) at 6-12 years. The E-score for subclinical psychotic symptoms was positively associated with the CBCL subscale for thought problems using negative binomial regression (1.81 [CI, 0.89; 3.66]). These findings indicate that the E-score approach shows promise to be used in the early detection of psychopathology and inform potential public health policies aimed to prevent mental disorders. Additionally, we will generate polygenic risk scores for main psychiatric disorders in order to examine potential genetic modifying effects of E-scores.

Neighborhood Deprivation Shapes Motivational-Neurocircuit Recruitment in Children

Implementing motivated behaviors on the basis of prior reward is central to adaptive human functioning, but aberrant reward-motivated behavior is a core feature of neuropsychiatric illness. Children from disadvantaged neighborhoods have decreased access to rewards, which may shape motivational neurocircuits and risk for psychopathology. Here, we leveraged the unprecedented neuroimaging data from the Adolescent Brain Cognitive Development (ABCD) study to test the hypothesis that neighborhood socioeconomic disadvantage shapes the functional recruitment of motivational neurocircuits in children. Specifically, via the ABCD study’s monetary-incentive-delay task (N = 6,396 children; age: 9–10 years), we found that children from zip codes with a high Area Deprivation Index demonstrate blunted recruitment of striatum (dorsal and ventral nuclei) and pallidum during reward anticipation. In fact, blunted dorsal striatal recruitment during reward anticipation mediated the association between Area Deprivation Index and increased attention problems. These data reveal a candidate mechanism driving elevated risk for psychopathology in children from socioeconomically disadvantaged neighborhoods.

Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial

Early social deprivation can negatively affect domains of functioning. We examined psychopathology at age 12 years in a cohort of Romanian children who had been abandoned at birth and placed into institutional care, then assigned either to be placed in foster care or to care as usual. We used follow-up data from the Bucharest Early Intervention Project (BEIP), a randomised controlled trial of abandoned children in all six institutions for young children in Bucharest, Romania. In the initial trial, 136 children, enrolled between ages 6-31 months, were randomly assigned to either care as usual or placement in foster care. In this study we followed up these children at age 12 years to assess psychiatric symptoms using the Diagnostic Interview Schedule for Children (4th edition; DISC-IV). We also recruited Romanian children who had never been placed in an institution from paediatric clinics and schools in Bucharest as a comparator group who had never been placed in an institution. The primary outcome measure was symptom counts assessed through DISC-IV scores for three domains of psychopathology: internalising symptoms, externalising symptoms, and attention-deficit hyperactivity disorder (ADHD). We compared mean DISC-IV scores between trial participants and comparators who had never been placed in an institution, and those assigned to care as usual or foster care. Analyses were done by modified intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00747396. We followed up 110 children from the BEIP trial between Jan 27, 2011, and April 11, 2014, and 49 children as comparators who had never been placed in an institution. The 110 children who had ever been placed in an institution had higher symptom counts for internalising disorders (mean 0·93 [SD 1·68] vs 0·45 [0·84], difference 0·48 [95% CI 0·14-0·82]; p=0·0127), externalising disorders (2·31 [2·86] vs 0·65 [1·33], difference 1·66 [1·06-2·25]; p<0·0001), and ADHD (4·00 [5·01] vs 0·71 [1·85], difference 3·29 [95% CI 2·39-4·18]; p<0·0001) than did children who had never been placed in an institution. Compared with 55 children randomly assigned to receive care as usual, the 55 children in the foster-care group had fewer externalising symptoms (mean 2·89 [SD 3·00] for care as usual vs 1·73 [2·61] for foster care, difference 1·16 [95% CI 0·11 to 2·22]; p=0·0255), but symptom counts for internalising disorders (mean 1·00 [1·59] for care as usual vs 0·85 [1·78] for foster care, difference 0·15 [-0·35 to 0·65]; p=0·5681) and ADHD (mean 3·76 [4·61] for care as usual vs 4·24 [5·41] for foster care, difference -0·47 [-2·15 to 1·20; p=0·5790) did not differ. In further analyses, symptom scores substantially differed by stability of foster-care placement. Early foster care slightly reduced the risk of psychopathology in children who had been living in institutions, but long-term stability of foster-care placements is an important predictor of psychopathology in early adolescence. National Institute of Mental Health and the John D and Catherine T MacArthur Foundation.

Psychological adversity in pregnancy: what works to improve outcomes?

Purpose – Foetal programming is one of the key mechanisms by which physical and social adversity is biologically embedded during pregnancy. While early interest in such programming focused on the long-term impact of the mother's nutritional state on the child's later physical health, more recent research has identified an increased risk of psychopathology in children of women who have experienced stress, anxiety and depression during pregnancy. The purpose of this paper is to examine the literature addressing the impact of stress in pregnancy and the implications for practice. Design/methodology/approach – An overview of the literature has been provided. Findings – Both anxiety and depression in pregnancy are common, with a prevalence in the region of 20 per cent. Exposure in pregnancy to anxiety, depression and stress from a range of sources (e.g. bereavement, relationship problems, external disasters and war), is associated with a range of physical (e.g. congenital malformations, reduced birthweight and gestational age), neurodevelopmental, cognitive, and emotional and behavioural (e.g. ADHD, conduct disorder) problems. The magnitude is significant, with the attributable risk of childhood behaviour problems due to prenatal stress being between 10 and 15 per cent, and the variance in cognitive development due to prenatal stress being around 17 per cent. A range of methods of intervening are effective in improving both maternal anxiety and depression, and in the longer term should improve outcomes for the infant and child. Research limitations/implications – This research highlights the importance of intervening to support the psychological wellbeing of pregnant women to improve outcomes for infants and children, and points to the need for further research into innovative ways of working, particularly with high-risk groups of pregnant women. Originality/value – The paper provides an update of earlier overviews.

Severity of Psychological Maltreatment and Accumulative Risk for Psychopathology in Children of Mothers Exposed to Intimate Partner Violence

Psychological maltreatment (PM) is an extremely heterogeneous phenomenon that includes several subtypes. The aim of this work is to explore whether the accumulation of different subtypes of PM has a greater impact on the child’s psychopathology and functional impairment. One hundred and sixty-eight children and adolescents aged between 4 and 17 whose mothers had been exposed to intimate partner violence (IPV) participated. Psychopathology was assessed through a rating scale and a diagnostic interview. Polynomial contrasts by means of Generalized Estimated Equations explored linear and quadratic trends. The greater the number of PM subtypes suffered by children, the greater the adverse effects in psychopathology and functioning. When a child suffers four PM subtypes, the number of DSM disorders is, on average, twice as high compared with children who are suffering only one PM subtype. Linear trends were mainly found in internalizing problems. The importance of accurately assessing characteristics and severity of PM, and design efficient programs of prevention and treatment, is highlighted.

Affective and physiological responses to stress in girls at elevated risk for depression

Children of depressed parents are significantly more likely to develop depression and other mental health disorders than are children of never-depressed parents. Investigations of the physiological mechanisms underlying this elevated risk have generally focused on basal functioning. It is important to note, however, that physiological reactivity or responses to stress are also critical determinants of mental and physical health. In the current study, we examined whether children of depressed parents exhibit altered physiological responses to stress. In two studies, never-depressed adolescent daughters of either recurrently depressed mothers (RISK) or never-depressed mothers (CTL) underwent social stressors while their physiological responses were measured (cortisol in Study 1, heart rate in Study 2). In both studies, affective responses to the stressors predicted physiological responses in RISK girls, but not in never-depressed girls. For RISK girls, decreased positive affect in response to stress predicted increased cortisol reactivity; in addition, decreased positive affect and increased negative affect were associated with poorer heart rate recovery and habituation, respectively. Future research is needed to examine explicitly whether this coherence between affect and physiology is a mechanism underlying the increased risk for psychopathology in children of depressed parents.

Effect of Relocation and Parental Psychopathology on Earthquake Survivor-Children's Mental Health

Earthquakes may increase the risk for psychopathology in children because the disaster may disrupt family functioning through causing psychopathology in the parents or disrupting social network through migration, school changes, or socioeconomic status changes caused by the job losses of the parents. This study aimed to investigate the effects of parental psychopathology on the traumatic stress and depression of earthquake survivor-children 4 years after the earthquake. A convenience sample of 104 earthquake survivor-children (43 boys, 61 girls) and their parents were assessed at their homes for earthquake experience and traumatic stress symptoms. The outcome variables were the factor scores of a child/adolescent traumatic stress questionnaire (Traumatic Stress Symptom Checklist for Children and Adolescents). The predictors of child's factor scores were examined using linear regression analyses. The traumatic stress factor score of the children was predicted two variables: the child's reported fear during the earthquake and the father's traumatic stress factor score. The depression factor score, on the other hand, was predicted using the depression factor score of the mother only. Demographic variables or relocation status were not predictive for either of children's factor scores. The results of the present study show that maternal and paternal psychopathologies have differential effects on the psychological status of earthquake survivor-children. Traumatic stress in the child is predicted using the traumatic stress of father, whereas depression in the child is predicted by mother's depression levels. Social network disruption does not seem to have a negative effect on children once parental psychopathology is taken into account.

The Risk of Psychopathology in Children with Craniosynostosis

The purpose of this study was to assess the prevalence of behavioral and emotional problems in patients with craniosynostosis and to determine the prospective association of a beaten-copper pattern before 18 months of age with behavioral and emotional problems in patients with craniosynostosis. The authors performed a follow-up study of 115 craniosynostosis patients at the Erasmus Children's University Hospital in Rotterdam. Behavioral and emotional problems were assessed with the Child Behavior Checklist at a mean age of 8 years. The presence of beaten-copper pattern before the age of 18 months was assessed on presurgical radiographs. Analyses were adjusted for intelligence quotient. Whereas craniosynostosis patients with intelligence quotients of 85 or greater did not differ from children in the normal group, craniosynostosis patients with intelligence quotients less than 85 had a higher risk of behavioral and emotional problems. However, these results were comparable to the findings of other studies assessing psychopathology in children with lower intelligence levels. Type of craniosynostosis (single suture versus complex) and a beaten-copper pattern before the age of 18 months did not affect the risk for behavioral and emotional problems in children with craniosynostosis. When intelligence is taken into account, craniosynostosis is not associated with an increased risk of behavioral and emotional problems, nor is type of craniosynostosis or a beaten-copper pattern before the age of 18 months.

Risk factors for psychiatric disturbance in children with intellectual disability

Children with intellectual disability (ID) have a higher risk for psychiatric disturbance than their peers with normal intelligence, but research data on risk factors are insufficient and partially conflicting. The subjects comprised 75 children with ID aged 6-13 years. Data were obtained from case files and the following four questionnaires completed by their parents or other carers: Developmental Behaviour Checklist, American Association of Mental Deficiency (AAMD) Adaptive Behavior Scale, a questionnaire on additional disabilities, and a questionnaire on family characteristics and child development. The risk of psychopathology was most significantly increased by moderate ID, limitations in adaptive behaviour, impaired language development, poor socialization, living with one biological parent, and low socio-economic status of the family. The risk of psychopathology in children with ID is increased by factors related to family characteristics and child development. Identifying these factors will help diagnose and possibly prevent psychiatric disorders in these children.

Age of attaining nocturnal bladder control and adolescent suicidal behavior

Background Nocturnal enuresis and delayed attainment of nocturnal bladder control are associated with increased risk for psychopathology in children and adolescents. It has long been known that psychopathology is a major risk factor for youth suicide. However, no studies have examined the association between the age of attainment of nocturnal bladder control and adolescent suicidal behavior. Methods A community sample of 1920 adolescents aged 11–16 years from one prefecture of mainland China participated in the study. Parents completed a structured questionnaire including adolescents' developmental history, suicidal behavior, depressive symptoms, aggressive behavior, and family environment. Results Multivariate logistic regression models indicated that attaining nocturnal bladder control after 3 years was significantly associated with increased risk for adolescent suicidal behavior, after controlling for a number of child and family covariates. A dose–response relationship between the age of attaining nocturnal bladder control and suicidal behavior was observed (OR = 2.1 for children attaining bladder control at 3–4 years and OR = 3.6 for children attaining bladder control at 5 years or later). Mediating models indicated that depression and aggressive behavior mediated, at least in part, the effect of delayed nocturnal bladder control on suicidal behavior. Limitations This is retrospective study. Suicidal behaviors were reported by parents. Conclusions Delayed nocturnal bladder control may be an earlier neurodevelopmental predictor of youth suicidal behavior. Further research is suggested to explore earlier neurodevelopmental risk factors and potential mechanisms of youth suicidal behavior.

Experience‐Dependent Affective Learning and Risk for Psychopathology in Children

The influence of childhood affective experiences across development may be understood in terms of preparedness to learn about emotion, combined with general immaturity and neuro-plasticity of perceptual systems. Early in development, processing resources are relatively immature and limited in capacity, thereby constraining how much information the young child can absorb. But it is clear that learning about emotions proceeds swiftly in nearly all children, suggesting biological preparedness to track associations between certain stimuli and outcomes. It is proposed here that limited processing capacity, in tandem with dispositions to filter or select key privileged stimuli in the environment, facilitates adaptive, rapid, affective learning. The developmental organization of affective systems is contingent upon those features of input that are most learnable, such as signals that are particularly salient, frequent, or predictable. Therefore, plasticity confers risk for maladaptation in that children's learning will be based upon these prominent features of the environment, however aberrant.

Clinical Correlates of Enuresis in ADHD and Non‐ADHD Children

Enuresis and attention deficit hyperactivity disorder (ADHD) are common childhood disorders that often co-occur. Although each has been linked to neurodevelopmental immaturity and increased risk for psychopathology, the clinical correlates of enuresis remain unclear. Subjects were 140 6-17-year-old boys with DSM-III-R ADHD and 120 non-ADHD controls. Information on enuresis and psychiatric diagnoses was obtained in a standardized manner blind to the child's clinical status. Our results show that (1) enuresis did not increase the risk for psychopathology in children with or without ADHD; (2) enuresis was not associated with psychosocial adversity or developmental immaturity; (3) enuresis was associated with increased risk for learning disability, impaired intellectual functioning, and impaired school achievement in normal control children but not in children with ADHD; and (4) the same pattern of findings was obtained after stratifying children with enuresis by primary versus secondary and by nocturnal versus diurnal subtypes. These results suggest that the clinical implications of enuresis may differ for ADHD and non-ADHD children.

Adaptation of children of parents suffering from cancer: A preliminary study of a new field for primary prevention research

An important new field for primary prevention research is proposed: the adaptation of normal children to the stress of normal parents who suffer from cancer. A pilot retrospective investigation of adolescent daughters of mothers who has mastectomy for breast cancer revealed a high level of motivation to participate in the study. Most girls were significantly upset and felt inadequately supported during periods of peak stress in their mothers caused by the illness and its treatment. Prospective studies are proposed that will develop and evaluate methods to ameliorate suffering and to lower the risk of psychopathology in children of parents with cancer.