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Association between early lead exposure and externalizing behaviors in adolescence: A developmental cascade.

ABSTRACT: BACKGROUND:Lead (Pb) exposure is associated with adverse neurological development. Most notably, it has been observed through externalizing behavior symptoms, as observed among Inuit children from northern Québec. Evidence for a persistent neurological impact of early Pb exposure later in life is however scarce. Pb exposure may initiate a developmental cascade that increases the risk of long-term behavior problems. OBJECTIVES:Testing for direct associations between childhood Pb concentrations and adolescent externalizing symptoms and substance use, as well as indirect associations through childhood behavior assessments. METHODS:The study sample is a longitudinal cohort of Inuit children (n?=?212) followed since birth. Blood Pb concentrations were measured during childhood (median age?=?11.4 years) and adolescence (median age?=?18.5 years). Externalizing/inattentive behavior were teacher-assessed through the Teacher Report Form and the Disruptive Behavior Disorders Rating Scale for children. At the adolescence follow-up, behavior problems were self-reported by filling Achenbach's Youth Self-Report, the Barkley Adult ADHD-IV Rating Scale, and the Diagnostics Interview Schedule for Children. Adolescent substance use was also self-assessed through the DEP-ADO. Direct and indirect associations of child Pb concentrations with adolescent outcomes were tested through mediation models. RESULTS:Child blood Pb concentrations were not directly associated with any adolescent outcomes. On the contrary, childhood Pb exposure was indirectly associated, through childhood externalizing behavior assessments, with adolescent externalizing behaviors, binge drinking, and cannabis use. These indirect associations held after controlling for adolescents' concurrent Pb blood concentrations. DISCUSSION:Our results highlight the indirect but lasting effects of child Pb exposure on adolescent behavior problems, and the importance of childhood externalizing behavior in this relationship. Adverse early-life environment put children on a riskier developmental trajectory, increasing their likelihood of lifelong psychological, social and health problems.

SUBMITTER: Desrochers-Couture M

PROVIDER: S-EPMC6759380 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Association between early lead exposure and externalizing behaviors in adolescence: A developmental cascade.

Desrochers-Couture Mireille M Courtemanche Yohann Y Forget-Dubois Nadine N Bélanger Richard E RE Boucher Olivier O Ayotte Pierre P Cordier Sylvaine S Jacobson Joseph L JL Jacobson Sandra W SW Muckle Gina G

Environmental research 20190819

<h4>Background</h4>Lead (Pb) exposure is associated with adverse neurological development. Most notably, it has been observed through externalizing behavior symptoms, as observed among Inuit children from northern Québec. Evidence for a persistent neurological impact of early Pb exposure later in life is however scarce. Pb exposure may initiate a developmental cascade that increases the risk of long-term behavior problems.<h4>Objectives</h4>Testing for direct associations between childhood Pb co ...[more]

PMID: 31454729

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Project description:BackgroundExposure to high levels of fine particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) via air pollution may be a risk factor for psychiatric disorders during adulthood. Yet few studies have examined associations between exposure and the trajectory of symptoms across late childhood and early adolescence.ObjectiveThe current study evaluated whether PM2.5 exposure at 9-11 y of age affects both concurrent symptoms as well as the longitudinal trajectory of internalizing and externalizing behaviors across the following 3 y. This issue was examined using multiple measures of exposure and separate measures of symptoms of internalizing disorders (e.g., depression, anxiety) and externalizing disorders (e.g., conduct disorder), respectively.MethodsIn a sample of more than 10,000 youth from the Adolescent Brain Cognitive Development (ABCD) Study, we used a dataset of historical PM2.5 levels and growth curve modeling to evaluate associations of PM2.5 exposure with internalizing and externalizing symptom trajectories, as assessed by the Child Behavioral Check List. Three distinct measures of PM2.5 exposure were investigated: annual average concentration during 2016, number of days in 2016 above the US Environmental Protection Agency (US EPA) 24-h PM2.5 standards, and maximum 24-h concentration during 2016.ResultsAt baseline, higher number of days with PM2.5 levels above US EPA standards was associated with higher parent-reported internalizing symptoms in the same year. This association remained significant up to a year following exposure and after controlling for PM2.5 annual average, maximum 24-h level, and informant psychopathology. There was also evidence of an association between PM2.5 annual average and externalizing symptom levels at baseline in females only.DiscussionResults suggested PM2.5 exposure during childhood is associated with higher symptoms of internalizing and externalizing disorders at the time of exposure and 1 y later. In addition, effects of PM2.5 exposure on youth internalizing symptoms may be most impacted by the number of days of exposure above US EPA standards in comparison with annual average and maximum daily exposure. https://doi.org/10.1289/EHP13427.

Project description:Importance:Although multiple cross-sectional and longitudinal studies have established that sleep problems and behavioral difficulties are associated in children, the directionality of this association and whether sleep problems are differentially associated with different types of childhood behavioral difficulties are unclear. Understanding these associations will inform the focus and timing of interventions. Objective:To determine whether longitudinal and reciprocal associations exist between child sleep problems and externalizing, internalizing, or both behavioral difficulties. Design, Setting, and Participants:Prospective cohort study using nationally representative data from the first 5 waves (2004, 2006, 2008, 2010, and 2012) of the kindergarten cohort (4983 children aged 4-5 years in 2004) collected for the Longitudinal Study of Australian Children. Associations were evaluated using cross-lagged structural equation model analyses performed from May 25, 2016, to September 20, 2017. Main Outcomes and Measures:Child sleep problems and internalizing and externalizing behavioral difficulties. Sleep problems were defined using parent-reported child sleep problem severity and specific difficulties (ie, difficulty getting to sleep at night, not happy sleeping alone, waking during the night, and restless sleep) on 4 or more nights of the week. Child behavioral difficulties were defined using the parent-reported Strengths and Difficulties Questionnaire for externalizing difficulties (conduct problems and hyperactivity/inattention subscales) and internalizing difficulties (emotional problems subscale). Results:The 4983 children enrolled in 2004 had a mean (SD) age of 4.7 (0.2) years and comprised a similar percentage of boys (2536 [50.9%]) and girls. In 2012, 3956 children (79.4%) aged 12 to 13 years were retained. Significant bidirectional associations were detected between sleep problems and externalizing difficulties during the elementary school transition period, with greater sleep problems associated with later externalizing behavior and vice versa (cross-lagged path coefficient, 0.04 [95% CI, 0.01-0.08] to 0.09 [95% CI, 0.06-0.13]). Although sleep was a significant driver of later internalizing difficulties (coefficient, 0.10 [95% CI, 0.07-0.14] to 0.16 [95% CI, 0.12-0.19]), the reverse association was not significant. In the final model that included all 3 constructs, the associations were attenuated but remained significant over time. Conclusions and Relevance:These results suggest that future studies should investigate whether implementing sleep problem intervention decreases the occurrence of both externalizing and internalizing difficulties. Interventions targeting externalizing, but not internalizing, difficulties may benefit childhood sleep.

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Association between early lead exposure and externalizing behaviors in adolescence: A developmental cascade.

Publications

Association between early lead exposure and externalizing behaviors in adolescence: A developmental cascade.

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