Learning outcomes in primary school children with emotional problems: a prospective cohort study.

BACKGROUND: Academic difficulties are common in adolescents with mental health problems. Although earlier childhood emotional problems, characterised by heightened anxiety and depressive symptoms are common forerunners to adolescent mental health problems, the degree to which mental health problems in childhood may contribute independently to academic difficulties has been little explored. METHODS: Data were drawn from a prospective cohort study of students in Melbourne, Australia (N = 1239). Data were linked with a standardised national assessment of academic performance at baseline (9 years) and wave three (11 years). Depressive and anxiety symptoms were assessed at baseline and wave two (10 years). Regression analyses estimated the association between emotional problems (9 and/or 10 years) and academic performance at 11 years, adjusting for baseline academic performance, sex, age and socioeconomic status, and hyperactivity/inattention symptoms. RESULTS: Students with depressive symptoms at 9 years of age had lost nearly 4 months of numeracy learning two years later after controlling for baseline academic performance and confounders. Results were similar for anxiety symptoms. Regardless of when depressive symptoms occurred there were consistent associations with poorer numeracy performance at 11 years. The association of depressive symptoms with reading performance was weaker than for numeracy if they were present at wave two. Persistent anxiety symptoms across two waves led to nearly a 4 month loss of numeracy learning at 11 years, but the difference was not meaningful for reading. Findings were similar when including hyperactivity/inattention symptoms. CONCLUSIONS: Childhood anxiety and depression are not only forerunners of later mental health problems but predict academic achievement. Partnerships between education and health systems have the potential to not only improve childhood emotional problems but also improve learning.

Modelling timing and tempo of adrenarche in a prospective cohort study.

To better understand how health risk processes are linked to adrenarche, measures of adrenarcheal timing and tempo are needed. Our objective was to describe and classify adrenal trajectories, in terms of timing and tempo, in a population of children transitioning to adolescence with repeated measurements of salivary dehydroepiandrosterone (DHEA), DHEA-sulphate, and testosterone. We analysed data from the Childhood to Adolescence Transition Study (CATS), a longitudinal study of 1239 participants, recruited at 8-9 years old and followed up annually. Saliva samples were assayed for adrenal hormones. Linear mixed-effect models with subject-specific random intercepts and slopes were used to model longitudinal hormone trajectories by sex and derive measures of adrenarcheal timing and tempo. The median values for all hormones were higher at each consecutive study wave for both sexes, and higher for females than males. For all hormones, between-individual variation in hormone levels at age 9 (timing) was moderately large and similar for females and males. Between-individual variation in hormone progression over time (tempo) was of moderate magnitude compared with the population average age-slope, which itself was small compared with overall hormone level at each age. This suggests that between-individual variation in tempo was less important for modelling hormone trajectories. Between-individual variation in timing was more important for determining relative adrenal hormonal level in childhood than tempo. This finding suggests that adrenal hormonal levels at age 8-9 years can be used to predict relative levels in early adolescence (up to 13 years).

Diet quality and mental health problems in late childhood.

Objectives: There is evidence that diet quality is associated with mental health problems in adults and adolescents. Yet the extent to which overall diet quality (not individual nutrients or dietary patterns) may be associated with mental health problems in pre-adolescent children, a common time for first onset of symptoms, remains unclear. This study examined associations between overall diet quality, using a brief measure, and mental health problems during late childhood, in a large community sample. Methods: Participants were 787 eight and nine-year-old children taking part in the Childhood to Adolescence Transition Study. Parents reported on their child's mental health problems using the Strengths and Difficulties Questionnaire and on their child's diet quality, using a six-item screening tool. Results: Regression analyses were conducted, adjusting for child age, sex, body mass index, and family socioeconomic status. Overall diet quality was significantly associated with children's mental health before (beta = -0.11, 95% CI -0.18 to -0.04, p = 0.004) and after adjustments for age, sex, body mass index and family socioeconomic status (beta = -0.10, 95% CI -0.18 to -0.03, p = 0.007). Conclusion: Concordant with previous literature, results indicate that better overall diet quality is related to more positive mental health in pre-adolescent children. Additionally, these results support the utility and efficacy of a brief (six-item) parent-report questionnaire as an indicator of overall diet quality.

Social networking and symptoms of depression and anxiety in early adolescence.

BACKGROUND: Use of social networking in later childhood and adolescence has risen quickly. The consequences of these changes for mental health are debated but require further empirical evaluation. METHODS: Using data from the Childhood to Adolescence Transition Study (n = 1,156), duration of social networking use was measured annually at four time points from 11.9 to 14.8 years of age (≥1 h/day indicating high use). Cross-sectional and prospective relationships between social networking use and depressive and anxiety symptoms were examined. RESULTS: In adjusted (age, socioeconomic status, prior mental health history) cross-sectional analyses, females with high social networking use had greater odds of depressive (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.58-2.91) and anxiety symptoms (OR: 1.99; 95% CI: 1.32-3.00) than those that used a few minutes at most, while males with high social networking use had 1.60 greater odds of reporting depressive symptoms (95% CI: 1.09-2.35). For females, an increased odds of depressive symptoms at age 14.8 was observed for high social networking use at one previous wave and at two or three previous waves, even after adjustment (OR: 1.76; 95% CI: 1.11-2.78; OR: 2.06, 95% CI: 1.27-3.37, respectively) compared to no wave of high use. CONCLUSIONS: Our results suggest weak to moderate increased odds of depression and anxiety in girls and boys with high social networking use versus low/normal use. These findings indicate that prevention programs for early mental health problems might benefit from targeting social networking use in early adolescence.

Bullying Across Late Childhood and Early Adolescence: A Prospective Cohort of Students Assessed Annually From Grades 3 to 8.

OBJECTIVE: Bullying is a well-established risk factor for common adolescent mental disorders. Yet there has been little published on how patterns of bullying change across late childhood and early adolescence. We estimated the prevalence and patterns of being a victim of bullying across this period including changes with the transition from primary to secondary school. METHODS: A stratified random sample of 1239 Grade 3 students was recruited from 43 primary schools in Melbourne, Australia. Bullying frequency and form were assessed annually between Grades 3 and 8, and categorized into 5 groups: physical, verbal, spreading rumors, social exclusion, and cyber, together with multiform bullying. RESULTS: Rates of bullying were high across these Grades with 86% of students reporting bullying at least once in the past 4 weeks at any wave, 66% reporting frequent bullying and 37% reporting frequent multiform bullying. The commonest form of bullying was teasing, with cyberbullying the least common. For boys, there were marked falls in bullying with increasing age whereas for girls, bullying persisted at high levels into secondary school, with relational bullying the dominant pattern and cyberbullying increasing sharply in the early teens. Generally, the transition to secondary education brought lower risks for all forms of bullying. CONCLUSIONS: We found high rates of bullying across late childhood and early adolescence in both sexes, but more persistent bullying in girls. Declines across primary school and with the transition to secondary school suggest the potential for intervention across these grades to further reduce the prevalence of bullying.

Self-harm in primary school-aged children: Prospective cohort study.

INTRODUCTION: No prospective studies have examined the prevalence, antecedents or concurrent characteristics associated with self-harm in non-treatment-seeking primary school-aged children. METHODS: In this cohort study from Melbourne, Australia we assessed 1239 children annually from age 8-9 years (wave 1) to 11-12 years (wave 4) on a range of health, social, educational and family measures. Past-year self-harm was assessed at wave 4. We estimated the prevalence of self-harm and used multivariable logistic regression to examine associations with concurrent and antecedent factors. RESULTS: 28 participants (3% of the 1059 with self-harm data; 18 girls [3%], 10 boys [2%]) reported self-harm at age 11-12 years. Antecedent (waves 1-3) predictors of self-harm were: persistent symptoms of depression (sex-age-socioeconomic status adjusted odds ratio [aOR]: 7.8; 95% confidence intervals [CI] 2.6 to 24) or anxiety (aOR: 5.1; 95%CI 2.1 to 12), frequent bullying victimisation (aOR: 24.6; 95%CI 3.8 to 158), and recent alcohol consumption (aOR: 2.9; 95%CI 1.2 to 7.1). Concurrent (wave 4) associations with self-harm were: having few friends (aOR: 8.7; 95%CI 3.2 to 24), poor emotional control (aOR: 4.2; 95%CI 1.9 to 9.6), antisocial behaviour (theft-aOR: 3.1; 95%CI 1.2 to 7.9; carrying a weapon-aOR: 6.9; 95%CI 3.1 to 15), and being in mid-puberty (aOR: 6.5; 95%CI 1.5 to 28) or late/post-puberty (aOR: 14.4; 95%CI 2.9 to 70). CONCLUSIONS: The focus of intervention efforts aimed at preventing and reducing adolescent self-harm should extend to primary school-aged children, with a focus on mental health and peer relationships during the pubertal transition.

Electronic media use and academic performance in late childhood: A longitudinal study.

INTRODUCTION: The effects of electronic media use on health has received much attention but less is known about links with academic performance. This study prospectively examines the effect of media use on academic performance in late childhood. MATERIALS AND METHODS: 1239 8- to 9-year-olds and their parents were recruited to take part in a prospective, longitudinal study. Academic performance was measured on a national achievement test at baseline and 10-11 years of age. Parents reported on their child's duration of electronic media use. RESULTS: After control for baseline reading, watching more than two hours of television per day at 8-9 years of age predicted a 12-point lower performance in reading at 10-11 years, equivalent to the loss of a third of a year in learning. Using a computer for more than one hour a day predicted a similar 12-point lower numeracy performance. Regarding cross-sectional associations (presumed to capture short-term effects) of media use on numeracy, after controlling for prior media exposure, watching more than two hours of television per day at 10-11 years was concurrently associated with a 12-point lower numeracy score and using a computer for more than one hour per day with a 13-point lower numeracy performance. There was little evidence for concurrent effects on reading. There was no evidence of short- or long-term associations between videogame use and academic performance. DISCUSSION: Cumulative television use is associated with poor reading and cumulative computer use with poorer numeracy. Beyond any links between heavy media use and health risks such as obesity, physical activity and mental health, these findings raise a possibility of additional risks of both television and computer use for learning in mid-childhood. These findings carry implications for parents, teachers and clinicians to consider the type and timing of media exposure in developing media plans for children.

Statistical methods used in the estimation of age-specific paediatric reference intervals for laboratory blood tests: A systematic review.

INTRODUCTION: There is an emerging realisation that paediatric reference intervals (RIs) estimated using discrete age-groups may be misleading, especially close to age cut-off values. This limitation has been addressed by estimating RIs that vary continuously with age. This systematic review examines the range of statistical methods used over the past 25 years for estimation of age-specific RIs, and identifies trends in usage and reporting. METHODS: Literature searches were conducted using predefined search criteria for original publications between 1993 and 2018 on the MEDLINE and Embase databases. Data related to sample size, treatment of age (as categorical or continuous), and statistical methods were extracted from the selected publications. RESULTS: A total of 238 publications were reviewed. Not all publications reported the statistical methods used in different steps. Among the publications, 167 (70%) reported discrete age-group RIs, 54 (23%) reported continuous RIs and 17 (7%) reported both types of RIs. The nonparametric statistical method was commonly used for discrete age-group RIs (64%, n = 117), whereas a wide variety of curve-fitting approaches, including Cole's lambda-mu-sigma method (28%, n = 20), parametric curve-based methods (28%, n = 20), generalised additive model for location, scale and shape method (13%, n = 9) and quantile regression (11%, n = 8) were used for continuous RIs. CONCLUSIONS: Improvement in the reporting of statistical methods used for estimating age-specific paediatric RIs is required. There has been insufficient uptake of methods for producing continuous RIs, especially for biomarkers that display strong age-dependence.

Pain and learning in primary school: a population-based study.

Despite the frequency of pain among children, little is known about its effects on learning and school outcomes. The objective of this study was to quantify the association of pain and academic achievement while taking into account the presence of co-occurring emotional symptoms. A population-based stratified random sample of 1239 students aged 8 to 9 years from primary schools in Melbourne, Australia, was recruited for the Childhood to Adolescence Transition Study. Children indicated sites of pain that had lasted for a day or longer in the past month using a pain manikin. Depressive- and anxiety-related symptoms were assessed using child-reported items. National assessment results for reading and numeracy were used to measure academic achievement. Sixty-five percent of children reported pain in at least 1 body site and 16% reported chronic pain. Increasing number of pain sites was associated with poorer reading scores in a dose-response fashion (ß = -3.1; 95% confidence interval -4.9 to -1.3; P < 0.001). The association was only partly attenuated when adjusting for emotional symptoms (ß = -2.6; 95% confidence interval -4.5 to -0.8; P < 0.001) and was not moderated by emotional symptoms. Children with chronic pain were a year behind their peers in both reading and numeracy. Among primary school students, pain was associated with lower reading scores even after adjusting for the presence of emotional symptoms. Although population-based longitudinal studies will be required to ascertain consistency and possible causality, grounds exist for considering pain and emotional symptoms in the assessment of children with reading difficulties.

Academic Performance in Primary School Children With Common Emotional and Behavioral Problems.

BACKGROUND: Many emotional and behavioral problems first emerge in primary school and are the forerunners of mental health problems occurring in adolescence. However, the extent that these problems may be associated with academic failure has been explored less. We aimed to quantify the association between emotional and behavioral problems with academic performance. METHODS: A stratified random sample of 8- to 9-year-olds (N = 1239) were recruited from schools in Australia. Data linkage was performed with a national assessment of academic performance to assess reading and numeracy. Parent report assessed emotional and behavioral problems with students dichotomized into "borderline/abnormal" and "normal" categories. RESULTS: One in 5 grade 3 students fell in the "borderline/abnormal" category. Boys with total difficulties (ß = -47.8, 95% CI: -62.8 to -32.8), conduct problems, and peer problems scored lower on reading. Numeracy scores were lower in boys with total difficulties (ß = -37.7, 95% CI: -53.9 to -21.5) and emotional symptoms. Children with hyperactivity/inattention scored lower in numeracy. Girls with peer problems scored lower in numeracy. CONCLUSIONS: Boys with emotional and behavioral problems in mid-primary school were 12 months behind their peers. Children with emotional and behavioral problems are at high risk for academic failure, and this risk is evident in mid-primary school.

Peer Victimization and Academic Performance in Primary School Children.

OBJECTIVE: Peer victimization is a common antecedent of poor social and emotional adjustment. Its relationship with objectively measured academic performance is unclear. In this study we aimed to quantify the cross-sectional associations between peer victimization and academic performance in a large population sample of children. METHODS: Eight- to 9-year-old children were recruited from a stratified random sample of primary schools in Australia. Academic performance was measured on a national achievement test (1 year of learning equals 40 points). Physical and verbal victimization were measured according to child self-report. RESULTS: Multilevel mixed-effects linear regression analyses were conducted. For female children, verbal victimization was associated with poorer academic performance on writing (ß = 17.2; 95% confidence interval [CI], -28.2 to -6.2) and grammar/punctuation (ß = -20.8; 95% CI, -40.1 to -1.6). Physical victimization was associated with poorer performance on numeracy (male children: ß = -29.0; 95% CI, -53.8 to -4.1; female children: ß = -30.1; 95% CI, -56.6 to -3.5), and writing (female children: ß = -21.5; 95% CI, -40.4 to -2.7). Verbal and physical victimization were associated with poorer performance on reading (male children: ß = -31.5; 95% CI, -59.9 to -3.1; female children: ß = -30.2; 95% CI, -58.6 to -1.8), writing (female children: ß = -25.5; 95% CI, -42.8 to -8.2), spelling (female children: ß = -32.3; 95% CI, -59.6 to -4.9), and grammar/punctuation (female children: ß = -32.2; 95% CI, -62.4 to -2.0). CONCLUSIONS: Children who were physically victimized were 6 to 9 months behind their non-victimized peers on measures of academic performance. There are growing reasons for education systems to invest in the prevention of bullying and promotion of positive peer relationships from the earliest years of school.

The Association Between Electronic Media and Emotional and Behavioral Problems in Late Childhood.

OBJECTIVE: There is growing concern that rising rates of electronic media use might be harmful. However, the extent to which different types of electronic media use might be associated with emotional and behavioral problems is unclear. In this study we examined associations between emotional and behavioral problems and electronic media use during late childhood, in a large community sample. METHODS: Participants were 876 8- to 9-year-old children taking part in the Childhood to Adolescence Transition Study in Australia. Parents reported on their child's emotional and behavioral problems using the Strengths and Difficulties Questionnaire and on their child's duration of electronic media use (in hours: television, video games, general computer use). RESULTS: Logistic regression analyses were conducted with adjustments for age, socioeconomic status, and body mass index z score, separately for male and female participants. Boys who played more video games had significantly greater odds of scoring borderline/abnormal on conduct (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.12) and emotional problems (OR, 1.07; 95% CI, 1.04-1.11) for each additional hour of weekly use. This equates to 2.58-fold greater odds for a boy who plays on average 2 hours per day per week. Television viewing was associated with greater odds of hyperactivity/inattention in boys (OR, 1.04; 95% CI, 1.00-1.07). There were no significant relationships for girls. CONCLUSIONS: Because of the increasing rates of electronic media use in children, these results might have important implications for child mental health. Future interventions might be more effective if they are targeted at specific types of electronic media use.

Adrenarche and the Emotional and Behavioral Problems of Late Childhood.

PURPOSE: Mental and behavioral disorders increase in prevalence with the passage through puberty. Yet the first symptoms for many children emerge between seven and 11 years, before the pubertal rise in gonadal hormones. A possibility that symptom onset may be linked to the adrenarchal rise in androgens has been little explored. METHODS: The Childhood to Adolescence Transition Study recruited a stratified random sample of 1,239 eight-nine year olds from primary schools in Melbourne, Australia. Saliva samples were assayed for dehydroepiandrosterone, dehydroepiandrosterone-sulphate (DHEA-S), and testosterone. Emotional and behavioral problems were assessed through parental report on the Strengths and Difficulties Questionnaire. RESULTS: In males, high levels of all androgens were associated with greater total difficulties and peer problems. Higher dehydroepiandrosterone and testosterone were associated with emotional symptoms and DHEA-S with conduct problems. In females, DHEA-S was associated with peer problems. CONCLUSIONS: In late childhood, androgens are associated with emotional and behavioral problems in males, raising a possibility that the adrenarchal transition plays a contributing role. If so, the late primary school years may prove to be an important phase for preventing the onset of mental health and behavioral problems in boys.

Social Development Measures Associated with Problem Behaviours and Weight Status in Australian Adolescents.

During the adolescent years, substance use, anti-social behaviours and overweight/obesity are amongst the major public health concerns. We investigate if risk and protective factors associated with adolescent problem behaviours and substance use are also associated with weight status in young Australian adolescents. Data comes from the 2006 Healthy Neighbourhoods study, a cross-sectional survey of students attending primary (grade 6, mean age 11) and secondary (grade 8, mean age 12) schools in 30 communities across Australia. Adolescents were classified as not overweight, overweight or obese according to international definitions. Logistic and linear regression analyses, adjusted for age, gender and socio-economic disadvantage quartile, were used to quantify associations between weight status (or BMI z-score) and the cumulative number of problem behaviour risk and protective factors. Prevalence of overweight and obesity was 22.6 % (95 % confidence interval (CI), 21.2-24.0 %) and 7.2 % (CI, 6.3-8.3 %). Average number of risk and protective factors present was 4.0 (CI, 3.7-4.2) and 6.2 (CI, 6.1-6.3). Independently, total number of risk factors present was positively associated with likelihood of overweight and obesity, while number of protective factors present was inversely associated with the likelihood of being above a healthy weight. When both risk and protective factors were included in a regression model, only risk factors were associated with the likelihood of being overweight or obese. Average BMI z-score increased by 0.03 units with each additional risk factor present. Prevention programmes targeting developmental risk and protective factors in adolescents that reduce substance use and problem behaviours may also benefit physical health.

The cost of healthcare for children with mental health difficulties.

OBJECTIVE: Childhood mental health difficulties affect one in every seven children in Australia, posing a potential financial burden to society. This paper reports on the early lifetime individual and population non-hospital healthcare costs to the Australian Federal Government for children experiencing mental health difficulties. It also reports on the use and cost of particular categories of service use, including the Medicare Benefits Schedule (MBS) mental health items introduced in 2006. METHOD: Data from the Longitudinal Study of Australian Children (LSAC) were used to calculate total Medicare costs (government subsidised healthcare attendances and prescription medications) from birth to the 8th birthday associated with childhood mental health difficulties measured to 8-9 years of age. RESULTS: Costs were higher among children with mental health difficulties than those without difficulties. While individual costs increased with the persistence of difficulties, population-level costs were highest for those with transient mental health difficulties. Although attenuated, these patterns persisted after child, parent and family characteristics were taken into account. Use of the MBS-reimbursed mental health services among children with a mental health difficulty was very low (around 2%). CONCLUSIONS: Australian healthcare costs for young children with mental health difficulties are substantial and provide further justification for early intervention and prevention. The current provision of Medicare-rebated mental health services does not appear to be reaching young children with mental health difficulties.

Father mental health during the early parenting period: results of an Australian population based longitudinal study.

PURPOSE: The primary objective of this study was to report on the occurrence of mental health difficulties for a large national sample of Australian fathers of children aged 0-5 years (n = 3,471). Secondary objectives were to compare fathers' mental health against normative data for the general male adult population, and to examine the course of mental health problems for fathers across the early childhood period. METHODS: Secondary analysis of data from the infant cohort of the Longitudinal Study of Australian Children at three waves when children were 0-12 months, 2-3 and 4-5 years. Comparative data on the prevalence of psychological distress in the Australian adult male population sourced from the National Survey of Mental Health and Wellbeing. RESULTS: Approximately nine per cent of fathers reported symptomatic or clinical psychological distress at each wave, as measured by the Kessler-6. Approximately 30 % reporting distress at wave 1 continued to report distress at a similar or worse level across waves 2 and 3. Fathers not living with their children also had high rates of distress (14 % at wave 1 and 10 % at wave 2). Finally, fathers in the present study had 1.38 increased odds (95 % CI 1.12-1.69) for psychological distress compared with the Australian adult male population. CONCLUSIONS: Fathers are at risk of experiencing postnatal mental health difficulties, which may persist across the early childhood period for some fathers. The results suggest routine assessment of fathers' wellbeing should be undertaken in the postnatal period with mental health interventions and support provided across the early childhood period.

At what BMI are parents of pre-schoolers concerned? National cross-sectional study.

Many parents do not recognize that their young children are overweight or obese, possibly because epidemiological cutpoints may not reflect parent perceptions of overweight. We determined whether any Body mass index (BMI) cutpoint reliably triggers parent concern, drawing on the first wave (2004) of the Longitudinal Study of Australian Children (LSAC). BMI (kg/m(2)) and parent concern about their child's weight categorized in three different ways (any, moderately or greater, very) were available for 4,983 children aged 4-5. We used logistic regression to assess the relationship between BMI and parent concern, and receiver operating characteristic (ROC) curves to determine BMI cutpoints that best discriminate parent concern. Parent concern about their pre-schoolers' weight related only modestly to body mass and was not triggered by any definable BMI threshold. This may partly explain why current childhood obesity policies are ineffective, as they typically require individual concern leading to family behavioural change.

Sleep duration and body mass index in 0-7-year olds.

OBJECTIVES: To determine in children aged 0-7 years (1) cross-sectional relationships between body mass index (BMI) and sleep duration, and whether (2) sleep duration predicts later BMI and/or (3) BMI predicts later sleep duration. DESIGN: Longitudinal Study of Australian Children, Waves 1 and 2. PARTICIPANTS: Infants aged 0-1 years (Wave 1), followed at age 2-3 years (Wave 2); children aged 4-5 years (Wave 1), followed at age 6-7 years (Wave 2). MAIN OUTCOME MEASURES: BMI, sleep duration by time-use diary, parent-reported sleep problems (none/mild vs moderate/severe). ANALYSES: Cross-sectional, ANOVA (sleep duration) and χ(2) (sleep problems); longitudinal, linear regression. RESULTS: 3857 (76%) infants and 3844 (77%) children had BMI and sleep data. At every wave, approximately 15% and 5% of children were overweight and obese, respectively. Obesity was not associated with sleep duration at 0-1, 2-3 or 4-5 years, though obese 6-7-year olds slept approximately 30 min less (p<0.001). Sleep problems were similar across BMI categories at all ages. Wave 1 sleep duration did not predict Wave 2 BMI, nor did Wave 1 BMI predict Wave 2 sleep duration. CONCLUSIONS: In these large child population cohorts, sleep duration did not predict obesity up to age 6-7 years. Current trials of sleep interventions to prevent or manage obesity in young children may be premature.

Changes in body mass index and health related quality of life from childhood to adolescence.

OBJECTIVE: To determine longitudinal relationships between body mass index (BMI) and health-related quality of life (HRQoL) in an adolescent population sample. Design. Data collected in 2000 and 2005 within the Health of Young Victorians longitudinal cohort study. SETTING: Originally a community sample of elementary school students in Victoria, Australia. Follow-up occurred in either secondary schools or individuals homes. PARTICIPANTS: Cohort recruited in 1997 via a random sampling design from Victorian elementary schools. Originally comprising 1 943 children, 1 569 (80.8%) participated in 2000 (wave 2, 8-13 years) and 851 (54%) in 2005 (wave 3, 13-19 years). Main outcome measures. In both waves participants and their parents completed the PedsQL, a 23-item child HRQoL measure, and BMI z-scores and status (non-overweight, overweight or obese) were calculated from measured height and weight. Associations were tested cross-sectionally and longitudinally (linear regression, adjusted for baseline values) RESULTS: A total of 81.6% remained in the same BMI category, while 11.4% and 7.0% moved to higher and lower categories, respectively. Cross-sectional inverse associations between lower PedsQL and higher BMI categories were similar to those for elementary school children. Wave 2 BMI strongly predicted wave 3 BMI and wave 2 PedsQL strongly predicted wave 3 PedsQL. Only parent-reported Total PedsQL score predicted higher subsequent BMI, though this effect was small. Wave 2 BMI did not predict wave 3 PedsQL. CONCLUSIONS: This novel study confirmed previous cross-sectional associations, but did not provide convincing evidence that BMI is causally associated with falling HRQoL or vice versa across the transition from childhood to adolescence.

Employment conditions and maternal postpartum mental health: results from the Longitudinal Study of Australian Children.

Maternal postpartum mental health is influenced by a broad range of risk and protective factors including social circumstances. Forty percent of Australian women resume employment in the first year postpartum, yet poor quality employment (without security, control, flexibility or leave) has not been investigated as a potential social determinant of maternal psychological distress. This paper examines whether poor quality jobs are associated with an increased risk of maternal postpartum psychological distress. Data were collected from employed mothers of infants ≤12 months (n = 1,300) participating in the Longitudinal Study of Australian Children. Logistic regression analyses estimated the association between job quality and maternal psychological distress, adjusting for prior depression, social support, quality of partner relationship, adverse life events and sociodemographic characteristics. Only 21% of women reported access to all four optimal job conditions. After adjustment for known risk factors for poor maternal mood, mothers were significantly more likely to report psychological distress (adjusted OR = 1.39, 95% CI 1.09, 1.77) with each reduction in the number of optimal employment conditions. Interventions for maternal postpartum affective disorders are unlikely to be successful if major risk factors are not addressed. These results provide strong evidence that employment conditions are associated with maternal postpartum mood, and warrant consideration in psychosocial risk assessments and interventions.