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Associations between conduct problems in childhood and adverse outcomes in emerging adulthood: a longitudinal Swedish nationwide twin cohort.

ABSTRACT: BACKGROUND:We examined whether childhood conduct problems predicted a wide range of adverse outcomes in emerging adulthood and whether the association with internalizing problems remained after adjusting for general comorbidity and externalizing problems. METHODS:Participants were 18,649 twins from the Child and Adolescent Twin Study in Sweden. At age 9/12, parents rated their children on eight conduct problems. Adverse outcomes were retrieved from national registers in emerging adulthood (median follow-up time = 9.2 years), including diagnoses of six psychiatric disorders, prescriptions of antidepressants, suicide attempts, criminality, high school ineligibility, and social welfare recipiency. We estimated risk for the separate outcomes and examined if conduct problems predicted an internalizing factor above and beyond a general comorbidity and an externalizing factor. We used twin analyses to estimate genetic and environmental contributions to these associations. RESULTS:On the average, each additional conduct symptom in childhood was associated with a 32% increased risk of the adverse outcomes in emerging adulthood (mean hazard ratio = 1.32; range = 1.16, 1.56). A latent childhood conduct problems factor predicted the internalizing factor in emerging adulthood (?boys = .24, standard error, SE = 0.03; ?girls = .17, SE = 0.03), above and beyond its association with the externalizing (?boys = 0.21, SE = 0.04; ?girls = 0.17, SE = 0.05) and general factors (?boys = 0.45, SE = 0.03; ?girls = 0.34, SE = 0.04). These associations were differentially influenced by genetic and environmental factors. CONCLUSIONS:It is important to monitor boys and girls with conduct problems not only for future externalizing problems, but also for future internalizing problems. Prevention of specific outcomes, however, might require interventions at different levels.

SUBMITTER: Lichtenstein P

PROVIDER: S-EPMC7384167 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Project description:Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointestinal comorbidities, in children with restrictive eating problems.A parental telephone interview was conducted in 9- or 12-year old twins (n = 19,130) in the Child and Adolescent Twin Study in Sweden. Cases of restrictive eating problems and comorbid problems were established using the Autism, Tics-AD/HD and other Comorbidities inventory, parental reports of comorbidity as well as data from a national patient register. In restrictive eating problem cases, presence of psychiatric and gastrointestinal comorbidity was mapped individually in probands and their co-twin. Two-tailed Mann-Whitney U tests were used to test differences in the mean number of coexisting disorders between boys and girls. Odds ratios were used to compare prevalence figures between individuals with or without restrictive eating problems, and Fisher exact test was used to establish significance.Prevalence of restrictive eating problems was 0.6% (concordant in 15% monozygotic and 3% of dizygotic twins). The presence of restrictive eating problems drastically increased odds of all psychiatric problems, especially autism spectrum disorder in both sexes (odds ratio = 11.9 in boys, odds ratio = 10.1 in girls), obsessive-compulsive disorder in boys (odds ratio = 11.6) and oppositional defiant disorder in girls (odds ratio = 9.22). Comorbid gastrointestinal problems, such as lactose intolerance (odds ratio = 4.43) and constipation (odds ratio = 2.91), were the most frequent in girls. Boy co-twins to a proband with restrictive eating problems generally had more psychiatric problems than girl co-twins and more girl co-twins had neither somatic nor any psychiatric problems at all.In children with restrictive eating problems odds of all coexisting psychiatric problems and gastrointestinal problems are significantly increased. The study shows the importance of considering comorbidities in clinical assessment of children with restrictive eating problems.

Project description:OBJECTIVE:The aims of this study were to examine whether dispositional interpersonal callousness, negative emotionality, and hyperactivity/impulsivity uniquely influence the development of childhood-onset conduct problems and persistent criminal behavior in males, and to determine whether specific facets of negative emotionality (dysregulated anger versus anxiety) in childhood are differentially associated with the development of chronic antisocial behavior. METHOD:Childhood dispositional features and conduct problems were assessed semiannually using parent- and teacher-report measures across 9 consecutive assessments in a school-based sample of 503 boys (?7-11 years of age). Participants' criminal behavior was assessed using official records from adolescence into the early 30s. RESULTS:Interpersonal callousness, dysregulated anger, and hyperactivity/impulsivity were uniquely associated with the development of childhood-onset conduct problems. None of these features significantly predicted official records of juvenile offending after controlling for co- occurring conduct problems. However, interpersonal callousness was robustly and uniquely associated with a pattern of persistent and violent adult offending that continued into the early 30s. In contrast, anxiety problems were inversely associated with criminal offending in adolescence and adulthood after controlling for conduct problems and the other dispositional factors. CONCLUSION:Findings are consistent with theoretical models indicating that interpersonal callousness, dysregulated anger, and hyperactivity/impulsivity influence the development of childhood conduct problems. In contrast, anxiety problems in childhood tend to reduce the likelihood that boys will engage in later criminal offending. Results suggest that delinquency prevention programs should target children exhibiting features of interpersonal callousness, given that they are at high risk for engaging in chronic and violent offending in adulthood.

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Associations between conduct problems in childhood and adverse outcomes in emerging adulthood: a longitudinal Swedish nationwide twin cohort.

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