Maternal asthma symptoms during pregnancy on child behaviour and executive function: A Bayesian phenomics approach.

OBJECTIVE: Maternal history of inflammatory conditions has been linked to offspring developmental and behavioural outcomes. This phenomenon may be explained by the maternal immune activation (MIA) hypothesis, which posits that dysregulation of the gestational immune environment affects foetal neurodevelopment. The timing of inflammation is critical. We aimed to understand maternal asthma symptoms during pregnancy, in contrast with paternal asthma symptoms during the same period, on child behaviour problems and executive function in a population-based cohort. METHODS: Data were obtained from 844 families from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort. Parent asthma symptoms during the prenatal period were reported. Asthma symptoms in children were reported longitudinally from two to five years old, while behavioural problems and executive functioning were obtained at seven years old. Parent and child measures were compared between mothers with and without prenatal asthma symptoms. Generalized linear and Bayesian phenomics models were used to determine the relation between parent or child asthma symptoms and child outcomes. RESULTS: Children of mothers with prenatal asthma symptoms had greater behavioural and executive problems than controls (Cohen's d: 0.43-0.75; all p < 0.05). This association remained after adjustments for emerging asthma symptoms during the preschool years and fathers' asthma symptoms during the prenatal period. After adjusting for dependence between child outcomes, the Bayesian phenomics model showed that maternal prenatal asthma symptoms were associated with child internalising symptoms and higher-order executive function, while child asthma symptoms were associated with executive function skills. Paternal asthma symptoms during the prenatal period were not associated with child outcomes. CONCLUSIONS: Associations between child outcomes and maternal but not paternal asthma symptoms during the prenatal period suggests a role for MIA. These findings need to be validated in larger samples, and further research may identify behavioural and cognitive profiles of children with exposure to MIA.

Socioeconomic status and risk for child psychopathology: exploring gene-environment interaction in the presence of gene-environment correlation using extended families in the Norwegian Mother, Father and Child Birth Cohort Study.

BACKGROUND: Low socioeconomic status (SES) is associated with increased risk for emotional and behavioural problems among children. Evidence from twin studies has shown that family SES moderates genetic and environmental influences on child mental health. However, it is also known that SES is itself under genetic influence and previous gene-environment interaction (G×E) studies have not incorporated the potential genetic overlap between child mental health and family SES into G×E analyses. We applied a novel approach using extended family data to investigate the moderation of aetiological influences on child emotional and behavioural problems by parental socioeconomic status in the presence of modelled gene-environment correlation. METHODS: The sample comprised >28,100 children in extended-family units drawn from the Norwegian Mother, Father and Child Cohort Study (MoBa). Mothers reported children's emotional and behavioural symptoms. Parents' income and educational attainment were obtained through linkage to administrative register data. Bivariate moderation Multiple-Children-of-Twins-and-Siblings (MCoTS) models were used to analyse relationships between offspring outcomes (emotional and behavioural symptom scores) and parental socioeconomic moderators (income rank and educational attainment). RESULTS: The aetiology of child emotional symptoms was moderated by maternal and paternal educational attainment. Shared environmental influences on child emotional symptoms were greater at lower levels of parents' education. The aetiology of child behavioural symptoms was moderated by maternal, but not paternal, socioeconomic factors. Genetic factors shared between maternal income and child behavioural symptoms were greater in families with lower levels maternal income. Nonshared environmental influences on child behavioural symptoms were greater in families with higher maternal income and education. CONCLUSIONS: Parental socioeconomic indicators moderated familial influences and nonshared environmental influences on child emotional and behavioural outcomes. Maternal SES and child mental health share aetiological overlap such that shared genetic influence was greater at the lower end of the socioeconomic distribution. Our findings collectively highlight the role that family socioeconomic factors play in shaping the origins of child emotional and behavioural problems.

Preschool-level socio-economic deprivation in relation to emotional and behavioural problems among preschool children in Sweden.

AIMS: The aim of this study was to explore the association between preschool-level socio-economic deprivation and emotional and behavioural problems among preschool children in Sweden using a multilevel approach. METHODS: In this cross-sectional study, we used data on 2267 children whose parents and preschool teachers had responded to items measuring individual-level socio-economic deprivation and the Strengths and Difficulties Questionnaire (SDQ) for assessment of emotional and behavioural problems. Further, the Socioeconomic Structure Compensation Index (SSCI), collected from Uppsala municipality, was used to assess preschool-level socio-economic deprivation. Unadjusted and adjusted multilevel logistic regression models were used to explore the relations between preschool-level socio-economic deprivation and emotional and behavioural problems. RESULTS: In unadjusted models, children who attended preschools classified as highly deprived had elevated odds for emotional symptoms (odds ratio (OR) 1.71) as rated by parents. However, this association did not remain significant after adjusting for individual-level socio-economic deprivation factors. In both unadjusted and adjusted models, children who attended preschools classified as moderately deprived had elevated odds for peer-relationship problems as rated by parents (OR 1.63; adjusted OR 1.48). There were no significant associations between preschool deprivation and emotional and behavioural problems as rated by preschool teachers. CONCLUSIONS: Swedish preschools may have a compensatory capacity in addressing children's emotional and behavioural problems, whereas preschool-level deprivation remained significantly associated with peer-relationship problems after controlling for individual-level socio-economic deprivation factors. This implies that peer-relationship problems in deprived preschools need to be addressed in a broader community context.

Associations of parental age at pregnancy with adolescent cognitive development and emotional and behavioural problems: a birth cohort in rural Western China.

BACKGROUND: The relationship between parental age at pregnancy and offspring development in low- and middle-income countries remains unclear. We aimed to examine the associations of parental age at pregnancy with adolescent development in rural China. METHODS: We conducted a prospective birth cohort study of offspring born to pregnant women who participated in an antenatal micronutrient supplementation trial in rural Western China. Adolescent cognitive development and emotional and behavioural problems were assessed by using the Wechsler Intelligence Scale for Children-IV and the Youth Self-Report-2001, respectively. After accounting for the possible nonlinear relationships, we examined the linear associations between parental age (in years) at pregnancy and scores of adolescent cognitive development and emotional and behavioural problems by performing generalized estimating equations. RESULTS: Among 1897 adolescents followed from birth to early adolescence, 59.5% were male with a mean age of 11.8 (standard deviation (SD): 0.8) years. The mean ages of mothers and fathers at pregnancy were 24.6 (SD: 4.4) and 27.9 (SD: 4.1) years old, respectively. All the P values of the nonlinear terms between parental age and adolescent development in all domains were greater than 0.05. Each one-year increase in maternal age at pregnancy was associated with a 0.29-point (95% confidence interval (CI) 0.06, 0.52) increase in the full-scale intelligence quotient in early adolescence. After parental age was categorized into quartiles, the total behavioural problem scores of adolescents with fathers with an age in the fourth quartile (Q4) were 6.71 (95% CI 0.86, 12.57) points higher than those of adolescents with fathers with an age in the first quartile (Q1), with a linear trend P value of 0.01. Similarly, higher scores (worse behavioural problems) were observed for internalizing behavioural problems and other emotional and behavioural symptoms related to anxiety, withdrawal, social problems, thought problems and aggressive behaviour. CONCLUSIONS: At conception, older maternal age was independently linked to better adolescent cognitive development, whereas advanced paternal age was independently associated with a greater risk of adolescent emotional and behavioral problems. These findings suggest that public health policies targeting an optimal parental age at pregnancy should be developed in the context of offspring developmental consequences.

The cumulative impact of attention deficit hyperactivity disorder, autism and intellectual disability for young people.

BACKGROUND: Neurodevelopmental conditions frequently co-occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred to as autism) and intellectual disability, and (2) behavioural and socio-emotional problems and the level of clinician-rated functioning for young males and females. METHODS: In this cross-sectional study, diagnostic information, caregiver-rated behavioural and socio-emotional data (as conceptualised by the Strengths and Difficulties Questionnaire) and clinician-rated functioning scores (as conceptualised by the Children's Global Assessment Scale) were extracted from electronic patient records for 2768 young people aged 3-17 years (mean = 11.55, SD = 3.46). All data were extracted at baseline, that is, at the time the young person was diagnosed with attention deficit hyperactivity disorder, autism and/or an intellectual disability. Ordinal regression analyses tested associations between the number of neurodevelopmental conditions met (i.e. 1, 2 or 3) and behavioural and socio-emotional outcomes and functioning. RESULTS: After controlling for age and biological sex, the number of neurodevelopmental conditions was associated with higher levels of inattention/hyperactivity and peer problems, lower levels of prosocial behaviour and poorer clinician-rated functioning. Although these findings were consistent for males, a cumulative association was not identified for females, except for clinician-rated functioning. CONCLUSIONS: For young people, the presence of multiple neurodevelopmental conditions may have a cumulative impact across domains, but this may differ between males and females.

Child characteristics associated with child quality of life and parenting stress in Angelman syndrome.

BACKGROUND: Angelman syndrome (AS) is a rare neurodevelopmental disorder characterised by severe intellectual disability, movement disorder, epilepsy, sleeping problems, and behavioural issues. Little is known on child health-related quality of life (HRQoL) in AS. AS family studies have reported elevated parenting stress and a high impact of the child's syndrome on the parent. It is unclear which factors influence child HRQoL and parenting stress/impact in AS. METHODS: We collected data prospectively through standardised clinical assessments of children with AS at the ENCORE Expertise centre for Angelman Syndrome at the Erasmus MC Sophia Children's Hospital. A linear regression analysis was conducted for the following outcome variables: (1) child HRQoL (Infant and Toddler Quality of Life Questionnaire); (2) the impact of the child's syndrome on the parent (Infant and Toddler Quality of Life Questionnaire); and (3) parenting stress (Parenting Stress Index). Predictor variables were child genotype, epilepsy, sleeping problems (Sleep Disturbance Scale for Children), cognitive developmental level (Bayley Cognition Scale), autistic features (Autism Diagnostic Observation Schedule) and emotional/behavioural problems (Child Behaviour Checklist). Covariates were sex, age and socio-economic status. RESULTS: The study sample consisted of 73 children with AS, mean age = 9.1 years, range = 2-18 years. Emotional/behavioural problems were the strongest significant predictor of lowered child HRQoL. Internalising problems were driving this effect. In addition, having the deletion genotype and higher age was related to lower child HRQoL. Sleeping problems were related to a higher impact of the child's syndrome on the parent. Finally, emotional/behavioural problems were associated with higher parenting stress. Cognitive developmental level, autistic features and epilepsy were not a significant predictor of child HRQoL and parenting stress/impact. CONCLUSIONS: These results suggest that interventions aimed at increasing child HRQoL and decreasing parenting stress/impact in AS should focus on child emotional/behavioural problems and sleeping problems, using a family-centred approach.

How to improve the system of care for adolescents with emotional and behavioural problems from the perspective of care providers: a concept mapping approach.

BACKGROUND: Emotional and behavioural problems (EBP) are the most common mental health issues during adolescence, and their incidence has increased in recent years. The system of care for adolescents with EBP is known to have several problems, making the provision of care less than optimal, and attention needs to be given to potential improvements. We, therefore, aimed to examine what needs to be done to improve the system of care for adolescents with EBP and to assess the urgency and feasibility of the proposed measures from the perspective of care providers. METHODS: We used Concept mapping, a participatory mixed-method research, based on qualitative data collection and quantitative data analysis. A total of 33 stakeholders from 17 institutions participated in our study, including psychologists, pedagogues for children with special needs, teachers, educational counsellors, social workers and child psychiatrists. RESULTS: Respondents identified 43 ideas for improving of the system of care for adolescents with EBP grouped into 5 clusters related to increasing the competencies of care providers, changes at schools and school systems, support for existing services, transparency of the care system in institutions and public administration, and the adjustment of legislative conditions. The most urgent and feasible proposals were related to the support of awareness-raising activities on the topic of EBP, the creation of effective screening tools for the identification of EBP in adolescents, strengthening the role of parents in the process of care, comprehensive work with the family, creation of multidisciplinary support teams and intersectoral cooperation. CONCLUSIONS: Measures which are more accessible and responsive to the pitfalls of the care system, together with those strengthening the role of families and schools, have greater potential for improvements which are in favour of adolescents with EBP. Care providers should be invited more often and much more involved in the discussion and the co-creation of measures to improve the system of care for adolescents with EBP.

Home Learning Environment and Screen Time Differentially Mediate the Relationship Between Socioeconomic Status and Preschoolers' Learning and Behavioural Profiles.

Environmental variables related to the home context, including home literacy and numeracy, screen exposure and Socioeconomic Status (SES) are potential risks or protective factors for children's academic achievements and behaviour. The present multi-informant study aims to contribute to this issue by investigating SES's direct and indirect relationships in early learning (i.e., literacy, numeracy, and cognitive) and behavioural skills within a large sample of young children. One parent and one teacher for each of 1660 preschoolers filled out a questionnaire investigating SES, tablet and TV use, home learning activities, behavioural problems/strengths (parents' questionnaire), and children's learning skills and behaviour (teachers' questionnaire). Results of path analysis showed that tablet time and home learning environment mediate the effect of SES on early learning as assessed by teachers; as for the home learning environment, it was also a mediator of the relationship between SES and behavioural problems. Implications of these results for research in the field and educational policies are discussed.

Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4-year-old children.

Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4-year follow-up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110-130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15-65 µg/L), and normal-high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5-5 years and the Behaviour Rating Inventory of Executive Function-Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5-5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal-high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4-year-old children.

Commentary: Promoting positive mental health during pregnancy-reflections on Lähdepuro et al. (2023).

Lähdepuro et al. performed a sound large-scale prospective pregnancy cohort study showing an association between positive maternal prenatal mental health and a reduced risk of developing clinically diagnosed childhood mental and behavioral disorders. Beneficial effects were also observed among the offspring of mothers experiencing mental health problems before and during pregnancy. The pathbreaking findings of Lähdepuro et al. set the stage for future research to shed more light on the so far almost unknown (neuro)biological mechanisms underlying the link between positive maternal prenatal mental health and child outcomes. More knowledge is needed about prenatal psychological and social factors enacting the potential of positive mental health as a resilience source buffering against maternal prenatal mental health problems and by this protecting subsequent child development. This also calls for further development, optimization, and evaluation of positive mental health-enhancing interventions during pregnancy, especially for future mothers having mental health problems.

Socioeconomic and sex inequalities in parent-reported adolescent mental ill-health: time trends in four British birth cohorts.

BACKGROUND: Studies using symptom-based screeners have suggested that mental ill-health has increased in adolescents in recent decades, however, few studies have tested the equivalence of their instruments, which is critical for inferring changes in prevalence. In addition, little research has explored whether socioeconomic position (SEP) and sex inequalities in adolescent mental health have changed over time. METHODS: Using structural equation modelling, we explored SEP and sex differences in harmonised parent reports of emotional and behavioural problems, using data from four UK birth cohorts: the 1958 National Child Development Study (NCDS'58; n = 10,868), the 1970 British Cohort Study (BCS'70; n = 8,242), the 1991-92 Avon Longitudinal Study of Parents and Children (ALSPAC'91; n = 5,389), and the 2000-01 Millennium Cohort Study (MCS'01; n = 9,338). RESULTS: Compared with the two earliest cohorts, members of MCS'01 had higher latent mean scores on emotional problems (both sexes), and lower scores on behavioural problems (females only). The associations between four indicators of SEP and emotional problems were strongest in MCS'01, with housing tenure having the strongest association. All four SEP indicators were associated with behavioural problems in each cohort, with housing tenure again more strongly associated with problems in the MCS'01. Mediation analyses suggested that the increase in emotional problems occurred despite broadly improving socioeconomic conditions. CONCLUSIONS: Our findings suggest that parent reports of adolescent emotional problems, but not behavioural problems, have risen in recent generations and this trend is not solely due to reporting styles. A failure to address widening social inequalities may result in further increases in mental ill-health amongst disadvantaged young people.

Association between obstetric mode of delivery and emotional and behavioural problems in children and adolescents: the children of the 90s health study.

PURPOSE: Existing evidence on the relationship between mode of delivery and offspring emotional and behavioural problems, especially in older age groups, is limited and inconsistent. This study aimed to examine the association between obstetric mode of delivery and emotional and behavioural problems in offspring aged 3-16 years. METHODS: The sample for this study comprised participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom. The study cohort ranged from 7074 (at 3 years of age) to 4071 (at 16 years of age) mother-offspring pairs. Data on obstetric mode of delivery were abstracted from obstetric records by trained research midwives and classified as spontaneous vaginal delivery, assisted vaginal delivery and caesarean delivery (elective and emergency). Offspring emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ) when the child was 3, 7, 9, 11, and 16 years. Logistic regression analyses were used to examine associations. RESULTS: Assisted vaginal delivery was associated with an increased risk of emotional problems at age 11 years (OR = 1.42; 95% CI 1.11-1.81). No significant associations were observed at ages 3, 7, 9 and 16. We found no evidence of associations between caesarean delivery (elective or emergency) and emotional and behavioural measures in offspring across all age groups. CONCLUSION: Mode of delivery does not appear to be associated with emotional and behavioural problems in children and adolescents. Further research is needed to understand the potential longer-term effects of assisted vaginal deliveries on offspring emotional development.

Facial emotion recognition in adopted children.

Children adopted from public care are more likely to experience emotional and behavioural problems. We investigated two aspects of emotion recognition that may be associated with these outcomes, including discrimination accuracy of emotions and response bias, in a mixed-method, multi-informant study of 4-to-8-year old children adopted from local authority care in the UK (N = 42). We compared adopted children's emotion recognition performance to that of a comparison group of children living with their birth families, who were matched by age, sex, and teacher-rated total difficulties on the Strengths and Difficulties Questionnaire (SDQ, N = 42). We also examined relationships between adopted children's emotion recognition skills and their pre-adoptive histories of early adversity (indexed by cumulative adverse childhood experiences), their parent- and teacher-rated emotional and behavioural problems, and their parents' coded warmth during a Five Minute Speech Sample. Adopted children showed significantly worse facial emotion discrimination accuracy of sad and angry faces than non-adopted children. Adopted children's discrimination accuracy of scared and neutral faces was negatively associated with parent-reported behavioural problems, and discrimination accuracy of angry and scared faces was associated with parent- and teacher-reported emotional problems. Contrary to expectations, children who experienced more recorded pre-adoptive early adversity were more accurate in identifying negative emotions. Warm adoptive parenting was associated with fewer behavioural problems, and a lower tendency for children to incorrectly identify faces as angry. Study limitations and implications for intervention strategies to support adopted children's emotion recognition and psychological adjustment are discussed.

Screening for behavioural problems in children aged 3 to 5 years.

OBJECTIVE: We aim to investigate the association between undergoing behavioural screening and having a diagnosis of behavioural problems and to explore factors associated with receiving treatment with counselling versus medication in children 3 to 5 years old. METHODS: This cross-sectional data analysis consisted of children 3-5 years old from the US National Study of Children's Health, 2017-2018. Pearson's χ2 test was used to assess the association between formal and informal screening and having a behavioural problem. Prevalence of behavioural screening, behavioural problems, and covariates were calculated. Survey binomial logistic regression was used to evaluate the association between formal and informal screening and treatment with counselling versus medication in children with behavioural problems. RESULTS: A total of 7837 children 3-5 years old were included in the analysis. Combined formal and informal screening for behavioural problems was 18.1%, 12.3% of children had informal screening only, and 10.8% had formal screening, as reported by parents. Five percent of children had a diagnosis of behavioural problem, for which 6.8% had formal screening only, 16.5% had informal screening only, and 58% had both. Children who had both types of screening were about 10 times as likely to have behavioural problems, and about 4 times as likely if they only had informal screening. Children with behavioural problems who had both types of screening were about 5 times as likely to be treated with medication. CONCLUSION: Formal behavioural screening was low in children 3 to 5 years old but, when done in conjunction with informal screening such as addressing parental concerns, was associated with a diagnosis of behavioural problems and receipt of treatment with medication.

Pakistani orphanage caregivers' perspectives regarding their caregiving abilities, personal and orphan children's psychological wellbeing.

BACKGROUND: Pakistan is home to 4.6 million children who have been orphaned. Limited data on caregiving in orphanages suggests that caregivers do not have specialized training and experience heavy workloads and high-stress levels. Supporting these caregivers to provide responsive and consistent caregiving can improve their well-being along with the psychological and physical development of children who have been orphaned. This research explored the main caregiving-related challenges faced by caregivers in orphanage settings, their professional and personal needs and perceived emotional and behavioural problems manifesting in children under their care. METHOD: This research adopted a qualitative research design with a thematic analysis approach. Semi-structured interviews were conducted with 14 caregivers who were currently caring for four to 12-year-old children in Pakistani orphanages. RESULTS: Five main themes: (1) religiosity, (2) economic relief, (3) caregivers' needs and well-being, (4) caring for children who have been orphaned and (5) need for context specific training, emerged from the data, which included several subthemes. Findings revealed the presence of positive religious views regarding the upbringing and care of children who have been orphaned. Work-provided accommodation was an important economic relief. Caregivers' psychological, physiological and personal lives were affected by job-related stress and demands. Many helpful and unhelpful parenting practices were documented, and challenges such as children's verbal and physical aggression, stealing, non-cooperation and poor social skills were reported. The main professional issues included low salary, high numbers of children in care and lack of context specific professional caregiving training provided. CONCLUSION: This study established the need for a tailored programme that suits the context specific caregiving needs in Pakistani orphanages to support the training and professional growth of caregivers and promote their wellbeing along with positive developmental outcomes in the children under their care.

Food insecurity is associated with multiple psychological and behavioural problems among adolescents in five Caribbean countries.

The study aimed to assess associations between food insecurity and multiple psychological and behavioural problems among adolescents in five Caribbean countries. Data from national and cross-sectional school health surveys from 9,956 adolescents (15 years, median age) in Trinidad and Tobago, Suriname, Jamaica, Anguilla and the Dominican Republic in 2016-2017 were analyzed in 2016-2017. Results show that the prevalence of moderate (rarely or sometimes) past-month food insecurity was 35.9% and severe (mostly or always) food insecurity was 4.6%. Severe food insecurity among adolescents ranged from 2.9% in Dominican Republic to 11.2% in Suriname. In adjusted logistic regression analyses, the higher severity of food insecurity was associated with negative psychological outcomes (loneliness, suicidal ideation, suicide plan, suicide attempt, anxiety, current tobacco use and any trouble from alcohol use) and negative behavioural outcomes (truancy, bullied, physically attacked, physical injury, and multiple sexual partners). Two out of five adolescents experienced some form of food security. Food interventions, such as school feeding programmes, are warranted to reduce negative psychosocial outcomes.

Association Between Intellectual Functioning and Autistic Traits in the General Population of Children.

Autistic traits are continuously distributed in the general population. The associations between autistic traits and intellectual functioning and/or behavioural difficulties, and the impact of intellectual functioning on behavioural difficulties are unclear. The study aims to describe the distribution of autistic traits in a population-based cross-sectional sample of children. Further aims are to examine the association between intellectual functioning and autistic traits, and between autistic traits and behavioural difficulties. Wechsler scales and ratings of autistic traits and behavioural problems in 874 children aged 7-9 years in the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study were assessed. We found a continuous distribution of autistic traits. Intellectual functioning was negatively associated with autistic traits but not with behavioural difficulties. Behavioural difficulties were associated with autistic traits.

Attachment and alexithymia predict emotional-behavioural problems of institutionalized, late-adopted and community adolescents: An explorative multi-informant mixed-method study.

OBJECTIVE: Compared to community adolescents (COM), adolescents placed in residential care (RC) or late adopted (LA) appear to show more emotional-behavioural problems. They also appear vulnerable in variables linked to emotional-behavioural problems, such as insecure-disorganized attachment and alexithymia. This study employs a mixed-method multi-informant approach to (1) compare adolescents placed in RC, LA and COM in emotional-behavioural problems, attachment and alexithymia and (2) investigate relationships and interplay of attachment and alexithymia concerning emotional-behavioural problems in these three groups. METHOD: Participants were 174 adolescents (50 RC, 33 LA and 91 COM; Mage = 15, 53% boys and 47% girls). Adolescents' internalizing and externalizing problems were assessed through both caregiver-reported and self-reported questionnaires, while attachment and alexithymia were assessed with a mixed method, using interviews and self-report questionnaires. RESULTS: The results showed RC adolescents as more vulnerable in all variables, while LA and COM did not differ. Accounting for the group, attachment and alexithymia cumulatively predicted 25-43% of internalizing problems, and 19-43% of externalizing problems depending on the method of assessment or problems' informant (all p < 0.01). Alexithymia was both an independent predictor and interacted with preoccupied attachment in predicting internalizing problems, while no predictors were isolated for externalizing ones, and the group never indicate an effect on problems' rates. CONCLUSIONS: The authors discuss the utility to maintain a research focus on attachment and alexithymia, also suggesting future directions of research. A need to determine potential distortions of results because of problems' informant and method of assessment is also highlighted.

The impact of lockdown on young people with genetic neurodevelopmental disabilities: a study with the international participatory database GenIDA.

BACKGROUND: Previous publications suggested that lockdown is likely to impact daily living issues of individuals with intellectual disabilities. The authors notably suspected an intensification of behavioural, eating and sleep problems. METHODS: To test these hypotheses, we conducted an international online survey about the impact of COVID-19-associated first lockdown on people with genetic neurodevelopmental disorders. This survey was carried out using GenIDA, an international participatory database collecting medical information on genetic neurodevelopmental disorders. Patients' relatives took part in this online survey from 30/04/2020 to 09/06/2020. This survey adapted from GenIDA standard questionnaire requested information on diagnosis, lifestyle and was based on yes/no answers to questions regarding behaviour, diet, and sleep, in the 6-months period before lockdown and during lockdown. We also asked relatives to evaluate the intensity of these problems by severity level. Finally, relatives could freely comment in open fields on the medical and/or quality of life problems they had encountered during lockdown. RESULTS: In total 199 participants-144 children and 45 adults-with neurodevelopmental disorders (intellectual disability (79.4%) and/or autism spectrum disorder (21.6%)) of various genetic origins, with near-equal male/female (96/103) contribution and originating mainly from Europe and Northern America, were included. The average lockdown duration at time of the survey was 57 days. We did not find differences in the frequency of behavioural, eating and sleep problems before and during lockdown. Moreover, there was no apparent difference in the intensity of eating and sleep disorders between both periods. However, for persons with behavioural problems at both periods, relatives reported an increase in aggressivity, self-aggressivity, depressiveness, stereotypies, and restricted interests during lockdown, all of which might be interpreted as consequences of a lack of stimulation or a reaction to unexpected changes in daily habits. CONCLUSIONS: Our results support previous studies that suggest that the negative impact of lockdown does not depend on the intellectual disability per se but on the associated comorbidities such as behavioural disorders. This study addresses the need for prevention of behavioural disturbance in the vulnerable population with genetic neurodevelopmental disabilities.

Nonsuicidal self-injury behaviour in a city of China and its association with family environment, media use and psychopathology.

INTRODUCTION: It is not clear whether there are differences in the risk factors for nonsuicidal self-injury (NSSI) between children and early adolescents. Clarifying this question is crucial for identifying actionable prevention strategies for NSSI in these two age groups. METHOD: The study, comprising 8611 children and early adolescents (4409 (51.2%) children, 4202 (48.8%) early adolescents), was based on the baseline data of the Chengdu Positive Child Development (CPCD) in China. NSSI behaviours, emotional and behavioural problems and family environment were assessed and obtained via self-reports and parent reports. RESULTS: Overall, 2520 (29.26%) participants reported having ever engaged in NSSI. There was a higher lifetime NSSI rate in males than in females during childhood, contrasting with higher NSSI rates in females than in males during early adolescence. Furthermore, NSSI shared similar risk factors, including major family conflict and poor relationships with caregivers, in both age groups. Specifically, in children, the risk of NSSI increased along with thought and attention problems (OR, 95% CI: 1.194, 1.106-1.288 and 1.114, 1.028-1.207, respectively), whereas in early adolescents, it increased with anxiety and depressive problems (OR, 95% CI: 1.259, 1.116-1.422). CONCLUSIONS: The findings suggested the need for difference in preventive strategies for NSSI in the two age groups. It may be more efficacious to screen for NSSI in children with thought and attention problems and in early adolescents with anxiety and depressive problems.