Prenatal and early postnatal brain development: The Generation R Study

Several psychiatric disorders in childhood and adulthood have been hypothesized to be neurodevelopmental in origin. Numerous studies have provided evidence for subtle deviations in brain morphology in children and adults with attention-defi cit hyperactivity disorder, autism spectrum disorders, and schizophrenia, compared to healthy children and adults. It is still unclear whether these subtle changes emerge in prenatal life or during brain maturation in childhood and adolescence. Findings supporting the hypothesis that (child) psychiatric disorders are related to an adverse environment in fetal life and early postnatal life include increased risk for schizophrenia in persons born after exposure to severe famine in utero and increased frequency of obstetric complications in patients with neurodevelopmental disorders. This thesis aimed to extend existing knowledge on the prenatal and early neurodevelopmental basis of behavioral and emotional problems. The studies in this thesis were conducted in the Generation R Study, a data collection project from fetal life until young adulthood in Rotterdam, the Netherlands

The Dutch perspective

To understand the subtleties of the Dutch penal law system related to forensic assessment, a few interrelated procedural characteristics are of great importance in shaping its context. This chapter addresses more substantive characteristics related to sentencing, such as criminal responsibility and the nature of sentences may be of equal impact on the contents of the assessment. As in most continental European jurisdictions, the criminal process may be best characterised as an inquisitorial system, in which the judge is the driving force in fact-finding, in contrast with adversarial justice systems, generally stemming from the Anglo-American common law tradition, in which parties play that role. The Dutch sentencing system has evolved away from its former dogmatic rigidity to a highly flexible system in many aspects. The presence of behavioural experts in some decision-making bodies, like the RSJ and the Penitentiary Chamber, serves in a sense as a review on the expert assessment

Endocrine markers of puberty timing and antisocial behaviour in girls and boys

Background: Early puberty is associated with higher than average risk of antisocial behaviour, both in girls and boys. Most studies of such association, however, have focused on psychosocial mediating and moderating factors. Few refer to coterminous hormonal measures. Aim: The aim of this review is to consider the role of hormonal markers as potential mediating or moderating factors between puberty timing and antisocial behaviour. Method: A systematic literature search was conducted searching Medline, Embase, Web of Science, Scopus, Psycinfo, Cochrane and Google Scholar. Results: Just eight studies were found to fit criteria, all cross-sectional. Measurements were too heterogeneous to allow meta-analysis. The most consistent associations found were between adrenal hormones—both androgens and cortisol—which were associated with early adrenarche and antisocial behaviours in girls and later adrenarche and antisocial behaviour in boys. Conclusions: The findings from our review suggest that longitudinal studies to test bidirectional hormone–behaviour associations with early or late puberty would be worthwhile. In view of the interactive processes between hypothalamic–pituitary–adrenal and hypothalamic–pituitary–gonadal

Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: a 14-year follow-up during childhood, adolescence, and young adulthood

OBJECTIVE: The goal of this study was to predict the onset of mood and anxiety disorders from parent-reported emotional and behavioral problems in childhood across a 14-year period from childhood into young adulthood. METHOD: In 1983, parent reports of behavioral and emotional problems were obtained with the Child Behavior Checklist for children and adolescents 4-16 years of age from the Dutch general population. At follow-up 14 years later, lifetime mood and anxiety diagnoses were obtained by a standardized DSM-IV interview for 1,580 subjects. Cox proportional hazards models were used to predict the incidence of mood and anxiety disorders from childhood problems and demographic covariates. RESULTS: Mood disorders were significantly predicted by high scores on the anxious/depressed scale and on the internalizing composite (withdrawn, somatic complaints, and anxious/depressed). Anxiety disorders were significantly predicted by the social problems scale and the externalizing composite (delinquent behavior and aggressive behavior). Anxiety disorders predominantly started in childhood and early adolescence, whereas the incidence of mood disorders increased sharply in adolescence and young adulthood. CONCLUSIONS: These results suggest different developmental pathways for mood and anxiety disorders. The predictions based on problem behavior remained stable during the 14-year period across adolescence and young adulthood. The results therefore underline the importance of early intervention and prevention of behavioral and emotional problems in childhood

How are you coping?:Stress, coping, burnout, and aggression in forensic mental healthcare workers

IntroductionPerceived stress at work has been linked to several adverse outcomes in workers, including increased risk of burnout and aggression (e.g., anger and irritability). However, much remains unknown about factors that might mitigate the negative influences of perceived stress on workers' well-being. This study focusses on coping as a possible protective factor against perceived stress and its consequences in forensic mental healthcare workers. We aimed to identify which higher-order coping factors were present in this worker sample and to investigate whether these coping factors modify the associations between perceived stress and burnout or aggression.MethodsFor this observational survey study, 116 forensic mental healthcare workers completed questionnaires assessing changes in work situation since the start of COVID-19, perceived stress, coping, burnout symptoms, and aggression.ResultsResults from principal component analysis indicated that four higher-order coping factors could be distinguished: social support and emotional coping, positive cognitive restructuring, problem-focused coping, and passive coping. Higher perceived stress levels were associated with higher levels of both burnout and aggression in workers. Problem-focused coping was associated with less burnout symptoms in workers. Furthermore, positive cognitive restructuring was associated with less aggression in workers.DiscussionIn conclusion, problem-focused coping and positive cognitive restructuring may protect workers against burnout symptoms and aggression and these results may inform future studies on preventive interventions aimed at promoting worker's well-being

Children's eating behavior, feeding practices of parents and weight problems in early childhood: Results from the population-based Generation R Study

Background: Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examinin

Cross-sectional association between metabolic parameters and psychotic-like experiences in a population-based sample of middle-aged and elderly individuals

Background: Metabolic alterations are often found in patients with clinical psychosis early in the course of the disorder. Psychotic-like experiences are observed in the general population, but it is unclear whether these are associated with markers of metabolism. Methods: A population-based cohort of 1890 individuals (mean age 58.0 years; 56.3% women) was included. Metabolic parameters were measured by body-mass index (BMI), concentrations of low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C), total cholesterol, triglycerides, and fasting glucose and insulin in blood. Frequency and distress ratings of psychotic-like experiences from the positive symptom dimension of the Community Assessment of Psychic Experience questionnaire were assessed. Cross-sectional associations were analysed using linear regression analyses. Results: Higher BMI was associated with higher frequency of psychotic-like experiences (adjusted mean difference: 0.04, 95% CI 0.02–0.06) and more distress (adjusted mean difference: 0.02, 95% CI 0.01–0.03). Lower LDL-C was associated with more psychotic-like experiences (adjusted mean difference: −0.23, 95% CI −0.40 to −0.06). When restricting the sample to those not using lipid-lowering medication, the results of BMI and LDL-C remained and an association between lower HDL-C and higher frequency of psychotic-like experiences was found (adjusted mean difference: −0.37, 95% CI −0.69 to −0.05). We observed no significant associations between cholesterol, triglycerides, glucose, insulin or homeostatic model assessment and psychotic-like experiences. Conclusions: In a population-based sample of middle-aged and elderly individuals, higher BMI and lower LDL-C were associated with psychotic-like experiences. This suggests that metabolic markers are associated with psychotic-like experiences across the vulnerability spectrum.</p

Associations of maternal folic acid supplementation and folate concentrations during pregnancy with foetal and child head growth: the Generation R Study

Purpose: Folic acid supplementation during pregnancy has been associated with a reduced risk of common neurodevelopmental delays in the offspring. However, it is unclear whether low folate status has effects on the developing brain. We evaluated the associations of maternal folic acid supplementation and folate concentrations during pregnancy with repeatedly measured prenatal and postnatal head circumference in the offspring. Methods: Within a population-based prospective cohort, we measured maternal plasma folate concentrations at approximately 13 weeks of gestation (90 % range 10.5–17.2) and assessed folic acid supplementation by questionnaire (2001–2005). Up to 11 repeated mea

Evidence for a shared etiological mechanism of psychotic symptoms and obsessive-compulsive symptoms in patients with psychotic disorders and their siblings

The prevalence of obsessive-compulsive disorder in subjects with psychotic disorder is much higher than in the general population. The higher than chance co-occurrence has also been demonstrated at the level of subclinical expression of both phenotypes. Both extended phenotypes have been shown to cluster in families. However, little is known about the origins of their elevated co-occurrence. In the present study, evidence for a shared etiological mechanism was investigated in 3 samples with decreasing levels of familial psychosis liability: 987 patients, 973 of their unaffected siblings and 566 healthy controls. The association between the obsessive-compulsive phenotype and the psychosis phenotype c.q. psychosis liability was investigated. First, the association was assessed between (subclinical) obsessive-compulsive symptoms and psychosis liability. Second, in a cross-sib cross-trait analysis, it was examined whether (subclinical) obsessive-compulsive symptoms in the patient were associated with (subclinical) psychotic symptoms in the related unaffected sibling. Evidence was found for both associations, which is compatible with a partially shared etiological pathway underlying obsessive-compulsive and psychotic disorder. This is the first study that used a cross-sib cross-trait design in patients and unaffected siblings, thus circumventing confounding by disease-related factors present in clinical samples