De toekomst van het kind

Rede uitgesproken bij de aanvaarding van het ambt van gewoon hoogleraar in de Kinder-en Jeugdpsychiatrie aan de Erasmus Universiteit Rotterdam op donderdag, 5 november 198

Early risk indicators of internalizing problems in late childhood: A 9-year longitudinal study

Background: Longitudinal studies on risk indicators of internalizing problems in childhood are in short supply, but could be valuable to identify target groups for prevention. Methods: Standardized assessments of 294 children’s internalizing problems at the age of 2–3 years (parent report), 4–5 years (parent and teacher report) and 11 years (parent and teacher) were available in addition to risk indicators from the child, family and contextual domain. Results: Low socioeconomic status, family psychopathology at child age 2–3, parenting stress at child age 4–5 years, and parents’ reports of child internalizing problems at age 4–5 years were the strongest predictors of internalizing problems at the age of 11. If these early risk factors were effectively ameliorated through preventive interventions, up to 57% of internalizing cases at age 11 years could be avoided. Conclusions: Predictors from as early as 2–5 years of age are relevant for identifying children at risk of internalizing problems in late childhood. The methodological approach used in this study can help to identify children who are most in need of preventive interventions and help to assess the potential health gain and efficiency of such interventions. Keywords: Internalizing disorder, risk factors, prevention. Abbreviations: AF: attributable fraction; IRR: incidence rate ratio; LEQ: Life Events Questionnaire; NNT: numbers needed to be treated; RD: risk difference

Which better predicts conduct problems? The relationship of trajectories of Conduct Problems, with ODD and ADHD Symptoms from childhood into adolescence

Background: To assess the co-occurrence in deviant trajectories of parent-rated symptoms of conduct disorder (CD), oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) from age 4 to 18 years old in a general population sample of Dutch children. Methods: Developmental trajectories of CD, ODD, and ADHD were estimatedin a sample of 1,016 males and 1,060 females. Children's disruptive problem behaviors were rated at 5 time-points. The co-occurrence patterns between the deviant CD trajectory, and the high ODD and high ADHD trajectory were studied for males and females separately. Results: Four percent of males and 2% of females followed a deviant CD trajectory. Six percent of the sample followed a high ODD trajectory, and 5% a high ADHD trajectory. Engagement in the deviant CD trajectory was predicted by ODD and ADHD in females, but only by ODD in males. Conclusions: Although ADHD co-occurs with CD, the association between ADHD and CD is largely accounted for by accompanying ODD. Gender differences should be taken into account in understanding the onset of CD. © 2007 The Authors Journal compilation © 2007 Association for Child and Adolescent Mental Health

Developmental course of psychopathology in youths with and without intellectual disabilities

Background: We aimed to describe similarities and differences in the developmental course of psychopathology between children with and without intellectual disabilities (ID). Method: Multilevel growth curve analysis was used to analyse the developmental course of psychopathology, using the Child Behavior Checklist (CBCL), in two longitudinal multiple-birth-cohort samples of 6- to 18-year-old children with ID (N=978) and without ID (N=2,047) using three repeated measurements across a 6-year period. Results: Children with ID showed a higher level of problem behaviours across all ages compared to children without ID. A significant difference between the samples in the developmental courses was found for Aggressive Behaviour and Attention Problems, where children with ID showed a significantly larger decrease. Gender differences in the development of psychopathology were similar in both samples, except for Social Problems where males with ID showed a larger decrease in problem behaviour across time than females with ID and males and females without ID. Conclusion: Results indicate that children with ID continue to show a greater risk for psychopathology compared to typically developing children, although this higher risk is less pronounced at age 18 than it is at age 6 for Aggressive Behaviour. Contrary to our expectations, the developmental course of psychopathology in children with ID was quite similar from age 6 to 18 compared to children without ID. The normative developmental trajectories of psychopathology in children with ID, presented here, can serve as a yardstick against which development of childhood psychopathology can be detected as deviant. © 2007 The Authors Journal compilation © 2007 Association for Child and Adolescent Mental Health

Empirically based assessment and taxonomy of psychopathology: Cross-cultural applications. A review

This paper provides an overview of empirically based assessment and taxonomy, as illustrated by cross-cultural research on psychopathology. The empirically based approach uses standardized assessment procedures to score behavioral and emotional problems from which syndromes are derived by multivariate analyses. Items and syndromes are scored quantitatively to reflect the degree to which individuals manifest them, as reported by particular informants. Although the approach to assessing problems and to constructing taxonomic groupings differs from the ICD/DSM approach, there are no inherent contradictions between either their models for disorders nor the criterial features used to define disorders. Cross-cultural comparisons have yielded relatively small differences in problem rates and syndrome structure, plus considerable similarity in associations of problems with sex and SES, as well as similar correlations between reports by different types of informants. Research on variations in problems in relation to culture, sex, age, SES, and type of informant can contribute to improving both the ICD/DSM and empirically based approaches and to a more effective synthesis between them

A Genetic Study of Maternal and Paternal Ratings of Problem Behaviors in 3-Year-Old Twins

Genetic and environmental influences on problem behaviors were studied in 3-year-old twins. Fathers' and mothers' ratings of problem behaviors in twins-236 monozygotic (MZ) girls, 210 MZ boys. 238 dizygotic (DZ) girls, 265 DZ boys, and 409 DZ opposite sex pairs-were obtained with the Child Behavior Checklist for Ages 2-3 (T. M. Achenbach, 1992). Twin correlations and results from a model fitting approach showed that genetic, shared environmental, and nonshared environmental influences accounted on average for about 64%, 9%, and 27% of the variance. Although shared environmental influences were small for most scales, they were important for Total Problems and somewhat larger for Externalizing than for Internalizing behaviors. Significant sex differences in genetic and environmental influences and evidence for sibling contrast effects were found for the Overactive scale

Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs

OBJECTIVE: The purpose of this study was to compare syndromes of parent-reported problems for children in 12 cultures. METHOD: Child Behavior Checklists were analyzed for 13,697 children and adolescents, ages 6 through 17 years, from general population samples in Australia, Belgium, China, Germany, Greece, Israel, Jamaica, the Netherlands, Puerto Rico, Sweden, Thailand, and the United States. RESULTS: Comparisons of nine cultures for subjects ages 6 through 17 gave medium effect sizes for cross-cultural variations in withdrawn and social problems and small effect sizes for somatic complaints, anxious/depressed, thought problems, attention problems, delinquent behavior, and aggressive behavior. Scores of Puerto Rican subjects were the highest, whereas Swedish subjects had the lowest scores on almost all syndromes. With great cross-cultural consistency, girls obtained higher scores than boys on somatic complaints and anxious/depressed but lower scores on attention problems, delinquent behavior, and aggressive behavior. Although remarkably consistent across cultures, the developmental trends differed according to syndrome. Comparison of the 12 cultures across ages 6 through 11 supported these results. CONCLUSIONS: Empirically based assessment in terms of Child Behavior Checklist syndromes permits comparisons of problems reported for children from diverse cultures

Measuring quality of life in children referred for psychiatric problems: Psychometric properties of the PedsQLTM 4.0 Generic Core Scales [IF: 2.0]

Objective: The aim of this study was to assess the psychometric properties of the Dutch translation of the Pediatric Quality of Life Inventory™ (PedsQL™ 4.0) generic core scales and assess its usefulness in measuring quality of life (QoL) in a child psychiatric population. Methods: Reliability and validity of the PedsQL were assessed in 310 referred children (ages 6-18 years) and a comparison group consisting of 74 non-referred children (ages 7-18 years), and the parents in both groups. Results: Confirmatory factor analysis resulted in a four-factor solution. Internal consistency reliability for the PedsQL Total Scale Score (α = 0.84 child self-report, α = 0.87 parent proxy-report), Psychosocial Health Score (α, = 0.70 child self-report, α = 0.81 parent proxy-report), and most subscale scores were acceptable for group comparisons. Correlations between scores of fathers and mothers were large. Criterion-related validity was demonstrated by significantly lower PedsQL scores for referred vs. non-referred children. Significant correlations between PedsQL scales and measures of psychopathology showed convergent validity. Small correlations between PedsQL scales and intelligence of the child evidenced discriminant validity. Conclusion: The PedsQL seems a valid instrument in measuring QoL in children referred for psychiatric problems