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

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

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

The normative development of child and adolescent problem behavior. [IF 3.2]

The aim of this study was to identify normative developmental trajectories of parent-reported problems assessed with the Child Behavior Checklist (CBCL; T. M. Achenbach, 1991) in a representative sample of 2,076 children aged 4 to 18 years from the general population. The trajectories were determined by multilevel growth curve analyses on the CBCL syndromes in a longitudinal multiple birth-cohort sample that was assessed 5 times with 2-year intervals. Most syndromes showed a linear increase or decrease with age or a curvilinear trajectory, except for thought problems. Trajectories for most syndromes differed for boys versus girls, except those for withdrawn, social problems, and thought problems. These normative developmental trajectories provide information against which developmental deviance in childhood and adolescence can be detected

Pathways of self-reported problem behaviors from adolescence into adulthood

OBJECTIVE: The authors determined the impact of different pathways of psychopathological development on adult outcome in subjects followed from ages 11-18 to ages 21-28. METHOD: Problem behaviors of subjects from a general population sample were assessed through the Youth Self-Report and the Young Adult Self-Report given at four time points (1987, 1989, 1991, and 1997). In addition, DSM-IV diagnoses, information pertaining to signs of maladjustment, and measures of social functioning were obtained at the last assessment. On the basis of the self-report ratings, four contrasting developmental pathways of psychopathology were determined: persistent, decreasing, increasing, and consistently normal. RESULTS: Subjects whose overall level of psychopathology was persistent over time had a higher lifetime prevalence of DSM-IV diagnoses and a poorer general outcome in adulthood than did subjects whose level of psychopathology increased. Subjects whose level of psychopathology returned to normal after high levels of problems in adolescence were only slightly different in terms of outcome from subjects with consistently normal ratings. CONCLUSIONS: 1) People who showed high levels of problems in early adolescence but whose level of psychopathology diminished by adulthood seemed to be as healthy as people who never attained a serious level of psychopathology. 2) An ongoing devious pathway into adulthood had negative effects on many domains of functioning. These two findings are both powerful arguments for early intervention in adolescence

Differential predictive value of parents' and teachers' reports of children's problem behaviors: A longitudinal study

This study investigated the prediction of signs of disturbance in 946 children originally aged 4 to 11 years from the general population across a 6-year period. Parents' and teachers' ratings obtained via the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) were tested as predictors of (a) academic problems, (b) school behavior problems, (c) receipt of mental health services, (d) child's need for professional help, (e) suicidal behavior, and (f) police contacts. Total problem scores in the deviant range on the CBCL or TRF were significantly associated with poor outcomes 6 years later. The combination of deviant scores on both the CBCL and TRF was a powerful predictor of poor outcomes with 56% of the girls, and 36% of the boys with total problem scores in the deviant range on both instruments maladjusted 6 years later. The CBCL syndromes Attention Problems and Delinquent Behavior, and the TRF syndromes Delinquent Behavior, Somatic Complaints, and Social Problems significantly predicted poor outcomes. Teachers' reports predicted poor outcomes equally well or even somewhat better than parents' reports. It is important to include teacher information in the diagnostic assessment of children

Genetic analyses of teacher ratings of problem behavior in 5-year-old twins

Behavioral problems in young children can be assessed by asking their parents or teachers to rate their behaviors. Genetic analyses of parental ratings show relatively large heritabilities for emotional and behavioral problems in young children, but data from teachers for this age group are scarce. Sources of variation in the Teacher's Report Form (TRF) problem scales were examined. The TRF was completed for 211 Dutch 5-year-old twin pairs and 4 single twins. Twins rated by different teachers had higher means and variances than twins rated by the same teacher, in addition twin correlations were lower in this group. In both groups monozygotic (MZ) correlations were generally higher than dizygotic (DZ) correlations. A model for twin resemblance was tested that allowed for these effects. For 5 problem scales (Withdrawn, Social Problems, Aggressive Behavior, Rule Breaking Behavior and Attention Problems) a model with genetic and unique environmental sources of variation fitted best to the data. For 3 problem scales (Anxious/Depressed, Thought Problems and Somatic Complaints) there were familial influences but it was not possible to distinguish between common environmental influences or genetic influences. Heritability was 63% for Attention problems, around 45% for Withdrawn, Social Problems, Aggressive Behavior and Rule Breaking Behavior, and around 30% for Anxious/Depressed, Thought Problems and Somatic Complaints