This study examined the stability of internalizing and externalizing problems from age 1.5 to 6 years, while taking into account developmental changes in the presentation of problems. The study comprised a population-based cohort of 7,206 children (50.4 % boys). At ages 1.5, 3, and 6 years, mothers reported on problem behavior using the Child Behavior Checklist/1.5-5 (CBCL/1.5-5). At each age we performed latent profile analysis on the CBCL/1.5-5 scales. Latent transition analysis (LTA) was applied to study the stability of problem behavior. Profiles of problem behavior varied across ages. At each age, 82–87 % of the children did not have problems whereas approximately 2 % showed a profile of co-occurring internalizing and externalizing problems. This profile was more severe (with higher scores) at 6 years than at earlier ages. A predominantly internalizing profile only emerged at 6 years, while a profile with externalizing problems and emotional reactivity was present at each age. LTA showed that, based on profiles at 1.5 and 3 years, it was difficult to predict the type of profile at 6 years. Children with a profile of co-occurring internalizing and externalizing problems early in life were most likely to show problem behavior at 6 years. This study shows that the presentation of problem behavior changes across the preschool period and that heterotypic continuity of problems is very common among preschoolers. Children with co-occurring internalizing and externalizing problems were most likely to show persisting problems. The use of evidence-based treatment for these young children may prevent psychiatric problems across the life course.Electronic supplementary materialThe online version of this article (doi:10.1007/s10802-015-9993-y) contains supplementary material, which is available to authorized users.

Objective Children with co-occurring internalizing and externalizing problems have higher levels of impairment and worse outcomes later in life, but it is unclear whether these children can be distinguished validly from children who have problems in a single domain. We used a person-centered statistical approach to examine whether a group of children with co-occurring internalizing and externalizing problems can be identified in a general-population sample of young children. Method This study included a population-based sample of 6,131 children, aged 5 to 7 years. Mothers (92.6%) reported emotional and behavioral problems using the Child Behavior Checklist/1.5–5 (CBCL). A latent profile analysis was performed on the CBCL syndrome scales. Identified classes were compared on early socioeconomic and parental risk factors using multinomial logistic regression. Results We identified 4 classes: 1) a class scoring high on all internalizing and externalizing scales (1.8%), 2) a class with internalizing problems (5.3%), 3) a class with externalizing problems and emotional reactivity (7.3%), and 4) a class without problems (85.6%). The first class, with co-occurring problems, was associated with higher levels of maternal and paternal affective symptoms and hostility than the other 3 classes. Conclusions The class with co-occurring internalizing and externalizing problems appears to be highly similar to the CBCL Dysregulation Profile described in older children. This empirically-based dysregulation profile offers a promise to the study of the development of poor self-regulation.

MSM follow different trajectories of changing sexual risk behaviour over time. Early identification of MSM following a trajectory of falling or rising high-risk behaviour and adequate timing of individual-based preventive interventions may reduce HIV transmission.

Background: Omega 3 (n-3) and 6 (n-6) long-chain polyunsaturated fatty acids (LC-PUFAs) and the n-3:n-6 ratio are important for brain development. Whether maternal LC-PUFA status during pregnancy affects risk of problem behavior in later childhood is unclear. Methods: Within a population-based cohort, we measured maternal plasma docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (AA) concentrations and n-3:n-6-ratio in mid-pregnancy. Child emotional and behavioral problems at 6 y of age were assessed by parents (child behavior checklist), teachers (teacher report form), and combined parent/teacher report. results: Higher maternal DHA and n-3:n-6 ratio were associated with fewer child emotional problems using parent (odds ratio (OR) DHA = 0.82; 95% confidence interval (CI): 0.70, 0.96; P = 0.02 and OR n-3:n-6 = 0.83; 95% CI: 0.71, 0.96; P = 0.01; n = 5,307) and combined parent/teacher scores (OR DHA = 0.79; 95% CI: 0.66, 0.95; P = 0.01 and OR n-3:n-6 = 0.77; 95% CI: 0.65, 0.92; P < 0.01; n = 2,828). Higher AA was associated with more child behavioral problems using teacher (OR = 1.10; 95% CI: 1.00, 1.20; P = 0.04; n = 3,365) and combined parent/teacher scores (OR = 1.12; 95% CI: 1.02, 1.22; P = 0.02; n = 2,827). Maternal EPA was not associated with child problem behavior. conclusion: Indications of associations of maternal LC-PUFA status with child emotional and behavioral problems were found. Future research is needed to identify LC-PUFAsensitive periods of fetal brain development by including multiple assessments of prenatal LC-PUFA status. t wo families of polyunsaturated fatty acids (PUFAs), the omega 3 (n-3) and 6 (n-6) fatty acids (FAs), are nutrients that play a major role in brain development and functioning. They affect numerous processes, including membrane fluidity, neurotransmission, and gene expression (1). The long-chain PUFAs (LC-PUFAs), eicosapentaenoic acid (EPA; C20:5n-3), docosahexaenoic acid (DHA; C22:6n-3), and arachidonic acid (AA; C20:4n-6) are the main FAs that are metabolically active.In addition, the ratio between n-3 and n-6 FAs is important for optimal brain functioning. During the last century, however, the Western diet has provided a lower n-3 and higher n-6 intake than that in previous generations, diminishing the n-3:n-6 ratio (2).Because of their role in brain function and development, maternal LC-PUFAs during fetal development have been hypothesized to affect child problem behavior. Approximately half of the dry weight of the brain is lipid, of which 35% are PUFA, most of which is LC-PUFA (1). Increase in AA and DHA content of brain tissue starts during the third trimester of pregnancy (3), indicating that the fetal period possibly is a sensitive period. Moreover, the fetus mostly depends on maternal LC-PUFA supply for its development, because fetal LC-PUFA synthesis is limited (4).Research in this field is however scarce, and results are conflicting. Two studies on maternal fish intake, a major source of DHA, during pregnancy and offspring problem beha...

Each year, 15 million babies worldwide are born preterm. Preterm birth is associated with adverse neurodevelopmental outcomes across the life span. Recent registry-based studies suggest that preterm birth is associated with decreased wealth in adulthood, but the mediating mechanisms are unknown. This study investigated whether the relationship between preterm birth and low adult wealth is mediated by poor academic abilities and educational qualifications. Participants were members of two British population-based birth cohorts born in 1958 and 1970, respectively. Results showed that preterm birth was associated with decreased wealth at 42 years of age. This association was mediated by decreased intelligence, reading, and, in particular, mathematics attainment in middle childhood, as well as decreased educational qualifications in young adulthood. Findings were similar in both cohorts, which suggests that these mechanisms may be time invariant. Special educational support in childhood may prevent preterm children from becoming less wealthy as adults. Keywordspreterm birth, wealth, mathematics, reading, intelligence, adulthood outcomes Received 1/7/15; Revision accepted 6/24/15 Worldwide, 11% of infants are born preterm (< 37 weeks gestation), which amounts to around 15 million births per year (Blencowe et al., 2012;Goldenberg, Culhane, Iams, & Romero, 2008). Rates of preterm birth are increasing globally, rising from 7.2% to 8.6% between 1990 and 2010 in developed countries alone (Blencowe et al., 2012). Preterm birth is a syndrome resulting from multiple causes (Goldenberg et al., 2008) and is associated with widespread brain alterations (Volpe, 2009). Prematurity is associated with adverse developmental and psychological outcomes across the life span (Johnson & Wolke, 2013;Moster, Lie, & Markestad, 2008;Saigal, 2014).Recent registry-based studies have documented decreased wealth in adulthood following preterm birth (Heinonen et al., 2013;Lindstrom, Winbladh, Haglund, & Hjern, 2007;Moster et al., 2008). In a Scandinavian sample, adults born preterm had, on average, lower job-related incomes and were found to be more likely to receive social security benefits at the ages of 20 to 36 years than adults born at term (Moster et al., 2008). These negative outcomes do not apply only to high-risk groups, such as those born very preterm (< 32 weeks gestation); they have also been found for adults born moderately preterm (32-33 weeks gestation) and late preterm (34-36 weeks gestation; Heinonen et al., 2013;Lindstrom et al., 2007), who together comprise up to 84% of all preterm births (Shapiro-Mendoza & Lackritz, 2012). These registry-based studies have important strengths, including unbiased measures and the use of large, unselected samples. However, they do not provide information on potential mechanisms leading to decreased wealth in adulthood that could aid the development of intervention strategies.Mediators that may explain decreased wealth in preterm adults include poor abilities in several academic fields. P...

Psychiatric symptoms in childhood are closely related to neurocognitive deficits. However, it is unclear whether internalising and externalising symptoms are associated with general or distinct cognitive problems. We examined the relation between different types of psychiatric symptoms and neurocognitive functioning in a population-based sample of 1177 school-aged children. Internalising and externalising behaviour was studied both continuously and categorically. For continuous, variable-centred analyses, broadband scores of internalising and externalising symptoms were used. However, these measures are strongly correlated, which may prevent identification of distinct cognitive patterns. To distinguish groups of children with relatively homogeneous symptom patterns, a latent profile analysis of symptoms at age 6 yielded four exclusive groups of children: a class of children with predominantly internalising symptoms, a class with externalising symptoms, a class with co-occurring internalising and externalising symptoms, that resembles the CBCL dysregulation profile and a class with no problems. Five domains of neurocognitive ability were tested: attention/executive functioning, language, memory and learning, sensorimotor functioning, and visuospatial processing. Consistently, these two different modelling approaches demonstrated that children with internalising and externalising symptoms show distinct cognitive profiles. Children with more externalising symptoms performed lower in the attention/executive functioning domain, while children with more internalising symptoms showed impairment in verbal fluency and memory. In the most severely affected class of children with internalising and externalising symptoms, we found specific impairment in the sensorimotor domain. This study illustrates the specific interrelation of internalising and externalising symptoms and cognition in young children.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-016-0903-9) contains supplementary material, which is available to authorized users.

Children meeting the Child Behavior Checklist Dysregulation Profile (CBCL-DP) suffer from high levels of co-occurring internalizing and externalizing problems. Little is known about the cognitive abilities of these children with CBCL-DP. We examined the relationship between CBCL-DP and nonverbal intelligence. Parents of 6,131 children from a population-based birth cohort, aged 5 through 7 years, reported problem behavior on the CBCL/1.5-5. The CBCL-DP was derived using latent profile analysis on the CBCL/1.5-5 syndrome scales. Nonverbal intelligence was assessed using the Snijders Oomen Nonverbal Intelligence Test 2.5-7-Revised. We examined the relationship between CBCL-DP and nonverbal intelligence using linear regression. Analyses were adjusted for parental intelligence, parental psychiatric symptoms, socio-economic status, and perinatal factors. In a subsample with diagnostic interview data, we tested if the results were independent of the presence of attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders (ASD). The results showed that children meeting the CBCL-DP (n = 110, 1.8%) had a 11.0 point lower nonverbal intelligence level than children without problems and 7.2-7.3 points lower nonverbal intelligence level than children meeting other profiles of problem behavior (all p values <0.001). After adjustment for covariates, children with CBCL-DP scored 8.3 points lower than children without problems (p < 0.001). The presence of ADHD or ASD did not account for the lower nonverbal intelligence in children with CBCL-DP. In conclusion, we found that children with CBCL-DP have a considerable lower nonverbal intelligence score. The CBCL-DP and nonverbal intelligence may share a common neurodevelopmental etiology.

Objectives: Psychosocial factors have been hypothesized to increase the risk of cancer.This study aims (1) to test whether psychosocial factors (depression, anxiety, recent loss events, subjective social support, relationship status, general distress, and neuroticism) are associated with the incidence of any cancer (any, breast, lung, prostate, colorectal, smoking-related, and alcohol-related); (2) to test the interaction between psychosocial factors and factors related to cancer risk (smoking, alcohol use, weight, physical activity, sedentary behavior, sleep, age, sex, education, hormone replacement therapy, and menopausal status) with regard to the incidence of cancer; and (3) to test the mediating role of health behaviors (smoking, alcohol use, weight, physical activity, sedentary behavior, and sleep) in the relationship between psychosocial factors and the incidence of cancer. Methods:The psychosocial factors and cancer incidence (PSY-CA) consortium was established involving experts in the field of (psycho-)oncology, methodology, and epidemiology. Using data collected in 18 cohorts (N = 617,355), a preplanned two-stage individual participant data (IPD) meta-analysis is proposed. Standardized analyses will be conducted on harmonized datasets for each cohort (stage 1), and meta-analyses will be performed on the risk estimates (stage 2). Conclusion:PSY-CA aims to elucidate the relationship between psychosocial factors and cancer risk by addressing several shortcomings of prior meta-analyses.