Neuroendocrine and autonomic risk factors for disruptive behaviors in young adolescents

impact on families, schools, and communities, and predict delinquency and substance abuse in adulthood (e.g., Fergusson et al 1994; Frick et al 1993; Loeber 1982; Moffitt et al 1996, 2002; Nagin and Tremblay 1999; Robbins 1966). Therefore, research aimed at identifying early risk factors and at mechanisms that determine change in symptoms across time is needed (Côté et al 2002; Deater-Deckard et al 1998; Hinshaw 2002; Lahey et al 2002; Loeber et al 1995; Nagin and Tremblay 1999). Although it is clear that disruptive behaviors are influenced by familial, situational, and societal factors, increasing evidence underscores the importance of genetic and other biological processes (Brunner et al 1993; Caspi et al 2002; Coccaro et al 1996; Kruesi et al 1992). Alterations in the hypothalamic-pituitary-adrenal (HPA) system and the autonomic nervous system (ANS), two major physiological stress response systems, have often been associated with disruptive behavior problems in children and adolescents (e.g. Vanyukov et al 1993; Mc Burnett et al 2000; Pajer et al 2001; Shoal et al 2003; Van de Wiel et al 2004; Scerbo and Kolko, 1994; Ortiz and Raine 2004; Mezzacappa et al 1997; Allen et al 2000). The introduction comprises four main components. Firstly, the different constructs of disruptive behaviors as provided by the DSM-IV (APA 1994) will be described. The two stress response systems will then be discussed. By explaining the arousal theories in the following part, the link between disruptive behaviors and the stress response systems will be clarified. Thirdly, the aims of the thesis will be formulated and the TRAILS-sample will be described. The introduction concludes with an outline of this thesis

Reduced autonomic flexibility as a predictor for future anxiety in girls from the general population:The TRAILS study

The present present study investigated whether autonomic flexibility predicted future anxiety levels in adolescent boys and girls. This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study of Dutch adolescents. The current study included a subsample of 965 individuals. Measures of autonomic flexibility, i.e., heart rate (HR) and respiratory sinus arrhythmia (RSA), were determined during the first assessment wave (T1: participants 10-12 years old). Self-reported anxiety was assessed at the first and second assessment wave (T2: participants 12-14 years old). Possible gender differences and co-occurring depressive problems were examined. In girls, low RSA predicted anxiety levels 2 years later. In boys, no associations between HR and RSA and future anxiety were found. We conclude that in adolescent girls from the general population, signs of reduced autonomic flexibility (i.e., low RSA) predict future anxiety levels. Since the effect size was small, at this point, RSA reactivity alone cannot be used to identify individuals at risk for anxiety, but should be regarded as one factor within a large group of risk factors. However, if the present findings are replicated in clinical studies, intervention programmes - in the future - aimed at normalising autonomic functioning may be helpful. (C) 2009 Elsevier Ireland Ltd. All rights reserved.</p

Testing the tripartite model in young adolescents:Is hyperarousal specific for anxiety and not depress ion?

Background: To clarify the distinction between anxiety and depression, the tripartite model was introduced. According to this model, physiological hyperarousal (PH, i.e. autonomic hyperactivity) is specific for anxiety and not depression. Research on the relation between anxiety, depression and physiological measures representing arousal is lacking. Methods: Parent- and self-reported anxiety and depressive problems were assessed using the CBCL and RCADS. Heart rate (HR), heart rate variability in the low frequency (HRV LF) and respiratory sinus arrythmia (RSA) were used as, indices for autonomic arousal. Results: Parent-reported anxiety was associated with low RSA in supine posture. This association was also found for self-reported anxiety problems, but only in boys. These findings point towards high arousal in anxiety. Self-reported depressive problems were associated with low HRV LF in standing posture and high RSA in supine posture in boys, pointing towards low arousal in depression. However, self-reported depressive problems were also associated with high HR in standing posture and with low HRV LF in supine posture in girls, suggesting high arousal in depression. Limitations: Although HRV LF in standing posture is primarily sympathetically mediated, and HRV LF in supine posture is primarily vagally mediated, the association between HRV LF and sympathetic versus vagal function is not exclusive. Thus, HRV LF measures are merely approaches of high or low arousal. Conclusions: Some evidence was found for hyperarousal in anxiety, but also for hyperarousal in depression. Apparently, the idea of hyperarousal in anxiety arid not in depression is too simple to reflect the more complex reality. (c) 2007 Published by Elsevier B.V.

Detection of unsafety in families with parental and/or child developmental problems at the start of family support

Background Risk assessment is crucial in preventing child maltreatment as it can identify high-risk cases in need of child protection intervention. Despite this importance, there have been no validated risk assessment instruments available in the Netherlands for assessing the risk of child maltreatment. Therefore, the predictive validity of the California Family Risk Assessment (CFRA) was examined in Dutch families who received family support. In addition, the added value of a number of experimental items was examined. Finally, it was examined whether the predictive value of the instrument could be improved by modifying the scoring procedure. Methods Dutch families who experienced parenting and/or child developmental problems and were referred by the Centres for Youth and Family for family support between July 2009 and March 2011 were included. This led to a sample of 491 families. The predictive validity of the CFRA and the added value of the experimental items were examined by calculating AUC values. A CHAID analysis was performed to examine whether the scoring procedure could be improved. Results About half of the individual CFRA items were not related to future reports of child maltreatment. The predictive validity of the CFRA in predicting future reports of child maltreatment was found to be modest (AUC = .693). The addition of some of the experimental items and the modification of the scoring procedure by including only items that were significantly associated with future maltreatment reports resulted in a ‘high’ predictive validity (AUC = .795). Conclusions This new set of items might be a valuable instrument that also saves time because only variables that uniquely contribute to the prediction of future reports of child maltreatment are included. Furthermore, items that are perceived as difficult to assess by professionals, such as parental mental health problems or parents’ history of abuse/neglect, could be omitted without compromising predictive validity. However, it is important to examine the psychometric properties of this new set of items in a new dataset