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A Common Family Factor Underlying Language Difficulties and Internalizing Problems: Findings From a Population-Based Sibling Study.

ABSTRACT: Studies have identified concurrent, longitudinal, and bidirectional associations between language difficulties and internalizing problems. This is commonly explained by social exclusion or withdrawal from peers, but underlying mechanisms are not well understood. This study uses sibling data to investigate if the comorbidity between language difficulties and internalizing problems is best explained by familial factors shared by siblings, such as genes or family environment, or nonfamilial factors specific to each child, such as peer environment. Data include 5,568 siblings at 5 years and 3,654 siblings at 8 years participating in the Norwegian Mother, Father and Child Cohort Study (MoBa). We constructed a latent factor model at 5 and 8 years, including a family comorbidity factor capturing correlations between language and internalizing problems that were equally strong between as within siblings. Results showed that the correlation between one sibling's internalizing problems and the other sibling's language problems was mostly accounted for by a family comorbidity factor. The best-fitting longitudinal model included stability of the family comorbidity factor and stability of language and internalizing problems within each sibling and no cross-sibling or cross-trait longitudinal associations. This suggests that the association between language and internalizing problems may be best explained by family factors.

SUBMITTER: Helland SS

PROVIDER: S-EPMC7433392 | biostudies-literature | 2020 Sep/Oct

REPOSITORIES: biostudies-literature

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A Common Family Factor Underlying Language Difficulties and Internalizing Problems: Findings From a Population-Based Sibling Study.

Helland Siri Saugestad SS Røysamb Espen E Brandlistuen Ragnhild Eek RE Melby-Lervåg Monica M Gustavson Kristin K

Journal of learning disabilities 20200324 5

Studies have identified concurrent, longitudinal, and bidirectional associations between language difficulties and internalizing problems. This is commonly explained by social exclusion or withdrawal from peers, but underlying mechanisms are not well understood. This study uses sibling data to investigate if the comorbidity between language difficulties and internalizing problems is best explained by familial factors shared by siblings, such as genes or family environment, or nonfamilial factors ...[more]

PMID: 32207357

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Project description:During pregnancy, many women experience sleep problems and anxiety that require treatment. The long-term safety for the child of maternal benzodiazepine (BZD) and z-hypnotic use during pregnancy remains controversial.We conducted a cohort and a sibling control study using data from the Norwegian Mother and Child Cohort Study. Data on use of BZD and z-hypnotics, internalizing and externalizing outcomes, and covariates were collected from mothers at gestational weeks 17 and 30 and when children were 0.5, 1.5, and 3 years of age. The total sample consisted of 71,996 children (19,297 siblings) at 1.5 years and 55,081 children (13,779 siblings) at 3 years. Short-term use was defined as use in one pregnancy period only. Long-term use was defined as use in two or more pregnancy periods. Linear full cohort random-effect and sibling-matched fixed-effect regression models were used to compare internalizing and externalizing behavior in children prenatally exposed compared to those unexposed in the full cohort of pregnancies accounting for family clusters, as well as within sibling clusters comparing pregnancies with discordant exposures. Propensity score (PS) adjustment included variables on indication for use (sleep problems, symptoms of anxiety and depression) and other potential confounding factors.Long-term prenatal exposure to BZD or z-hypnotics was associated with increased internalizing behavior in crude cohort analyses and at age 1.5 years after PS adjustment in sibling-matched fixed-effect models [β 0.60, 95% confidence interval 0.17-0.95]. Analyses on specific drug groups showed that prenatal exposure to BZD-anxiolytics was associated with increased internalizing problems at both 1.5 years [β 0.25, 0.01-0.49] and 3 years [β 0.26, 0.002-0.52] while exposure to z-hypnotics was not associated with any adverse outcomes after adjustment.The findings suggest a moderate association between BZD-anxiolytic exposure and child internalizing problems that is not likely due to stable familial confounding factors.

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.

Project description:BACKGROUND:Symptoms of anxiety and depression are common mental health problems in children and are often referred to as internalizing symptoms. Youth with such symptoms are at greater risk for poor academic achievement, school non-completion, and future mental health problems, all of which, lead to public health consequences and costs to society. The aim of the current study was to investigate associations between young school children's internalizing symptoms and school functioning, as assessed separately by the teachers and the children. METHODS:This study is a cross-sectional study including children (N?=?750. 58% girls) from the ages of 8-12?years with elevated levels of self-reported symptoms of anxiety (MASC-C) and/or depression (SMFQ). Teachers reported the academic achievement, school adaptation (TRF) and internalizing symptoms (BPM-T) of the children. Associations were analyzed using linear regression analyses. RESULTS:Both teacher-reported internalizing symptoms and children's self-reported depressive symptoms were associated with poor academic achievement and school adaptation, while self-reported symptoms of anxiety were not. Symptoms of depression as assessed by the children were associated with teacher-rated internalizing symptoms, while self-reported symptoms of anxiety were not. CONCLUSION:We found negative associations between school functioning and internalizing symptoms, as assessed by both the teachers and the children. The dual findings strengthen the validity of these relationships. Thus, prevention of depressive and anxiety symptoms in children may lead to positive changes in school domains such as academic achievement and school adaptation. We also identified a negative association between teacher-rated internalizing symptoms and children's self-report of depressive symptoms, indicating that teachers may have difficulties recognizing children with these symptoms. TRIAL REGISTRATION:Clinical Trials NCT02340637, Registered on June 12, 2014, Retrospectively registered.

Dataset Information

A Common Family Factor Underlying Language Difficulties and Internalizing Problems: Findings From a Population-Based Sibling Study.

Publications

A Common Family Factor Underlying Language Difficulties and Internalizing Problems: Findings From a Population-Based Sibling Study.

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