Publications by authors named "Lars Wichstrøm"

113 Publications

Predictors of diagnostically defined insomnia in child and adolescent community samples: a literature review.

Sleep Med 2021 Sep 10;87:241-249. Epub 2021 Sep 10.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Diagnostically defined insomnia is prevalent, persistent, and associated with a range of negative outcomes in childhood and adolescence. To inform prevention and treatment, we need to identify relevant predictors that can be addressed in such intervention efforts. Therefore, a systematic search for longitudinal studies involving child and adolescent samples (ages 4 to 19) examining predictors of diagnostically defined insomnia adjusted for previous insomnia was conducted. The search identified 6419 studies, resulting in six included papers involving five samples (n = 9949) conducted in five different countries (the US, New Zealand, Norway, China, and Japan). Few longitudinal studies investigated the predictors of diagnostically defined insomnia in children and adolescents, and insomnia is rarely defined according to diagnostic manuals. The results suggested that poor mental health (most notably depression) and female sex may be involved in the etiology of diagnostically defined insomnia. Stress might be the most modifiable factor identified. However, the diversity of the predictors studied in previous reports combined with the lack of replication prevent any firm conclusions from being drawn. This review serves as a summary of the best available evidence.
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http://dx.doi.org/10.1016/j.sleep.2021.09.003DOI Listing
September 2021

Child and family predictors of insomnia from early childhood to adolescence.

Sleep Med 2021 Aug 27;87:220-226. Epub 2021 Aug 27.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: Insomnia is prevalent among children and adolescents and is associated with a wide range of negative outcomes. Knowledge about its determinants is therefore important, but due to the lack of longitudinal studies, such knowledge is limited. The aim of the present inquiry is to identify child and family predictors of future pediatric insomnia within a psycho-bio-behavioral framework.

Methods: A representative community sample (n = 1,037) was followed biennially from 4 to 14 years of age (2007-2017). Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and was diagnosed by a semistructured clinical interview of children (from age eight years of age) and parents (all ages). Predictors included parent ratings of child emotional reactivity, family functioning, and marital conflict; self-reports of personality; and teacher-rated emotion regulation skills.

Results: Random intercept cross-lagged analyses revealed that within-person increases (ie, relative to the child's typical levels across childhood) in emotional reactivity and decreases in emotion regulation skills predicted insomnia diagnosis two years later from ages 4 to 14 after adjusting for previous insomnia and all unmeasured time-invariant factors. Previous insomnia was the strongest predictor of later insomnia, whereas family functioning and marital conflict did not predict insomnia.

Conclusions: Increases in emotional reactivity and decreases in emotion regulation skills predicted insomnia above and beyond all unmeasured time-invariant factors and could be targets for interventions. Previous insomnia predicted later insomnia, thereby underscoring the importance of detecting, preventing, and treating insomnia at an early age.
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http://dx.doi.org/10.1016/j.sleep.2021.08.023DOI Listing
August 2021

Prevalence and course of anxiety disorders and symptoms from preschool to adolescence: a 6-wave community study.

J Child Psychol Psychiatry 2021 Jul 27. Epub 2021 Jul 27.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: The rate of various anxiety disorders in early childhood and whether they continue into middle childhood or adolescence is not known. We therefore report on the prevalence and stability of DSM-5-defined anxiety disorders and their symptoms, capturing the period from preschool to adolescence.

Methods: By means of interviewer-based clinical interviews, anxiety was measured in a sample of Norwegian children at six measurement points from age 4 to 14 (n = 1,041). To adjust for time-invariant factors, we applied random intercept cross-lagged panel models (RI-CLPMs) capturing within-person changes.

Results: Nearly 10% (95% CI = 7.29, 12.63) had an anxiety disorder at some timepoint. Specific phobia was the most prevalent disorder in early and middle childhood, whereas generalized anxiety disorder (GAD) increased in prevalence and became the most common anxiety disorder at age 14 (4.51%, 95% CI = 2.78, 6.23). When time-invariant confounding was adjusted for, homotypic continuity in anxiety symptoms typically first emerged in late middle childhood or adolescence. Even so, such within-person analyses revealed a heterotypic path from increased number of early childhood symptoms of specific phobia to increased number of GAD symptoms in middle childhood (B = .41, 95% CI = .06, .75). Increased separation anxiety in middle childhood predicted increased symptoms of GAD in adolescence (B = .38, 95% CI = .14, .62), and vice versa (B = .05, 95% CI = .00, .09). Only minor gender differences were revealed.

Conclusions: Anxiety disorders are prevalent in childhood. In early childhood, anxiety symptoms generally do not predict later anxiety symptoms. In middle childhood, however, such symptoms are less likely to vanish, indicating this developmental period to be particularly important for preventive and treatment efforts.
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http://dx.doi.org/10.1111/jcpp.13487DOI Listing
July 2021

Self-esteem in adolescents with reactive attachment disorder or disinhibited social engagement disorder.

Child Abuse Negl 2021 Aug 2;118:105141. Epub 2021 Jun 2.

Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.

Background: Low self-esteem predicts negative outcomes and mediates the association between childhood adversity and mental health problems in adolescence. Reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) are presumably caused by early insufficient care, but their association with self-esteem is unknown.

Objective: Investigate global and domain-specific self-esteem in adolescents with RAD or DSED.

Participants And Setting: All adolescents living in Norwegian residential youth care (RYC) (N = 306; age 12-20) were compared with a sample from the general Norwegian adolescent population (N = 10,480; age 12-20).

Methods: Self-esteem for scholastic competence (SC), social acceptance (SA), athletic competence (AC), physical appearance (PA), romantic appeal (RA), close friendship (CF), and self-worth (SW) was investigated using the revised version of the Self-Perception Profile for Adolescents.

Results: Compared to the general population, adolescents with RAD diagnosis had lower SC (mean difference, MD = -0.30, p = .020) and higher CF (MD = 0.25, p = .021), whereas adolescents with DSED diagnosis had lower SC (MD = -0.42, p = .005), SA (MD = -0.40, p = .015), AC (MD = -0.22, p = .038), PA (MD = -0.33, p = .048), and SW (MD = -0.37, p = .013). Compared to adolescents in RYC without RAD/DSED diagnoses, adolescents with DSED diagnoses had lower SA (MD = -0.42, p = .012) and SW (MD = -0.32, p = .037). More RAD symptoms were associated with lower SA (B = -0.051, p = .013), AC (B = -0.048, p = .028), RA (B = -0.053, p = .007), and CF (B = -0.052, p = .005). More DSED symptoms were associated with lower SC (B = -0.125, p = .038).

Conclusion: Both global and domain-specific self-esteem in adolescents with RAD or DSED should be assessed; developmental support and treatment plans should be adjusted accordingly.
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http://dx.doi.org/10.1016/j.chiabu.2021.105141DOI Listing
August 2021

Shared genetic architecture underlying sleep and weight in children.

Sleep Med 2021 07 26;83:40-44. Epub 2021 Apr 26.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Meta-analyses suggest shorter sleep as a risk factor for obesity in children. The prevailing hypothesis is that shorter sleep causes obesity by impacting homeostatic processes. Sleep duration and adiposity are both heritable, and the association may reflect shared genetic aetiology. We examined the association between a body mass index (BMI) genetic risk score (GRS) and objectively-measured total sleep time (TST) in a cohort of Norwegian children (enrolled at age four in 2007-2008) using cross-sectional data at age six. The analytical sample included 452 six-year old children with complete genotype and phenotype data. The outcome was actigraphic total sleep time (TST) measured at age six years. Genetic risk of obesity was inferred using a 32-single nucleotide polymorphism (SNP) weighted GRS of BMI. Covariates were BMI-Standard deviation scores (SDS) (which takes into account age and sex) and, in a sensitivity analysis socioeconomic status. Analyses consisted of Pearson's correlations and linear regressions. In our sample, 54% of participants were male; mean (SD) TST, age and BMI were 9.6 (0.8) hours, 6.0 (0.2) years and 15.3 (1.2) kg/m, respectively. BMI and TST were not correlated, r = -0.003, p = 0.946. However, the BMI GRS was associated with TST after adjusting for BMI-SDS, standardised β = -0.11; 95% confidence interval (CI) = -0.22, -0.01. To our knowledge, this is the first study to establish a relationship between genetic risk of obesity and objective sleep duration in children. Findings suggest some shared genetic aetiology underlying these traits. Future research could identify the common biological pathways through which common genes predispose to both shorter sleep and increased risk of obesity.
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http://dx.doi.org/10.1016/j.sleep.2021.04.021DOI Listing
July 2021

Persistent Short Sleep from Childhood to Adolescence: Child, Parent and Peer Predictors.

Nat Sci Sleep 2021 15;13:163-175. Epub 2021 Feb 15.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Purpose: Many children have periods when they sleep too little, with widely recognized detrimental effects. Less is known about persistent short sleep during childhood. Therefore, the present study aimed to investigate the prevalence of persistent short sleep in school-aged children and identify a set of child, parent, and peer predictors thereof.

Participants And Methods: Objectively measured sleep duration (hip-held accelerometer) was biennially assessed in a community sample followed from 6 to 14 years (n=801). A latent profile analysis was applied to assess whether a subgroup of children slept consistently short across time and predictors of persistent short sleep were determined through regression analysis.

Results: A subgroup of children (n=160; 20.2%) was identified as having persistent short sleep across time. Temperamental negative affectivity (β=0.08; 95% CI=0.01, 0.15; p=0.03) and low observer-assessed parental emotional availability (β=-.09; 95% CI=-.18, -.01; p=0.04) predicted membership to that group. Teacher ratings of victimization from bullying were not associated with persistent short sleep (β=0.01; 95% CI: -.10, 11; p=0.88).

Conclusion: High child temperamental negative affectivity and low parental emotional availability may be involved in the development of persistent short sleep through childhood.
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http://dx.doi.org/10.2147/NSS.S290586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894796PMC
February 2021

Depression from preschool to adolescence - five faces of stability.

J Child Psychol Psychiatry 2021 08 26;62(8):1000-1009. Epub 2020 Nov 26.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: The term 'stability' has different meanings, and its implications for the etiology, prevention, and treatment of depression vary accordingly. Here, we identify five types of stability in childhood depression, many undetermined due to a lack of research or inconsistent findings.

Methods: Children and parents (n = 1,042) drawn from two birth cohorts in Trondheim, Norway, were followed biennially from ages 4-14 years. Symptoms of major depressive disorder (MDD) and dysthymia were assessed with the Preschool Age Psychiatric Assessment (only parents) and the Child and Adolescent Psychiatric Assessment (age 8 onwards).

Results: (a) Stability of form: Most symptoms increased in frequency. The symptoms' importance (according to factor loadings) was stable across childhood but increased from ages 12-14, indicating that MDD became more coherent. (b) Stability at the group level: The number of symptoms of dysthymia increased slightly until age 12, and the number of symptoms of MDD and dysthymia increased sharply between ages 12-14. (c) Stability relative to the group (i.e., 'rank-order') was modest to moderate and increased from ages 12-14. (d) Stability relative to oneself (i.e., intraclass correlations) was stronger than stability relative to the group and increased from age 12-14. (e) Stability of within-person changes: At all ages, decreases or increases in the number of symptoms forecasted similar changes two years later, but more strongly so between ages 12-14.

Conclusions: Across childhood, while most symptoms of MDD and dysthymia become more frequent, they are equally important. The transition to adolescence is a particularly vulnerable period: The depression construct becomes more coherent, stability increases, the level of depression increases, and such an increase predicts further escalation. Even so, intervention at any time during childhood may have lasting effects on reducing child and adolescent depression.
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http://dx.doi.org/10.1111/jcpp.13362DOI Listing
August 2021

Reactive attachment disorder and disinhibited social engagement disorder in adolescence: co-occurring psychopathology and psychosocial problems.

Eur Child Adolesc Psychiatry 2020 Nov 13. Epub 2020 Nov 13.

Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway.

Insufficient care is associated with most psychiatric disorders and psychosocial problems, and is part of the etiology of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED). To minimize the risk of misdiagnosis, and aid treatment and care, clinicians need to know to which degree RAD and DSED co-occur with other psychopathology and psychosocial problems, a topic little researched in adolescence. In a national study of all adolescents (N = 381; 67% consent; 12-20 years old; 58% girls) in Norwegian residential youth care, the Child and Adolescent Psychiatric Assessment interview yielded information about psychiatric diagnoses and psychosocial problems categorized as present/absent, and the Child Behavior Check List questionnaire was applied for dimensional measures of psychopathology. Most adolescents with a RAD or DSED diagnosis had several cooccurring psychiatric disorders and psychosocial problems. Prevalence rates of both emotional and behavioral disorders were high in adolescent RAD and DSED, as were rates of suicidality, self-harm, victimization from bullying, contact with police, risky sexual behavior and alcohol or drug misuse. Although categorical measures of co-occurring disorders and psychosocial problems revealed few and weak associations with RAD and DSED, dimensional measures uncovered associations between both emotional and behavioral problems and RAD/DSED symptom loads, as well as DSED diagnosis. Given the high degree of comorbidity, adolescents with RAD or DSED-or symptoms thereof-should be assessed for co-occurring psychopathology and related psychosocial problems. Treatment plans should be adjusted accordingly.
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http://dx.doi.org/10.1007/s00787-020-01673-7DOI Listing
November 2020

The co-occurrence between symptoms of internet gaming disorder and psychiatric disorders in childhood and adolescence: prospective relations or common causes?

J Child Psychol Psychiatry 2020 08 5;61(8):890-898. Epub 2020 Jul 5.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: Internet gaming disorder (IGD) is highlighted as a condition for further study in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). Some studies indicate that IGD appears comorbid with other psychiatric disorders. We examine concurrent and prospective links between symptoms of IGD and symptoms of common psychiatric disorders in childhood and adolescence to determine whether observed comorbidity is a result of (a) reciprocal relations or (b) common underlying causes.

Methods: A community sample (n = 702) of Norwegian children completed the Internet Gaming Disorder Interview (IGDI) to assess DSM-5 defined IGD symptoms at ages 10, 12 and 14 years. The Child and Adolescent Psychiatric Assessment (CAPA) assessed symptoms of depression, anxiety, attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) at the same time points.

Results: A Random Intercept Cross-lagged Panel Model (RI-CLPM), which captures pure within-person changes and adjusts for all unmeasured time-invariant factors (e.g., genetics, parent education) revealed no associations between IGD symptoms and psychopathology, except that increased IGD symptoms at ages 10 and 12 predicted decreased symptoms of anxiety two years later.

Conclusions: No support emerged for concurrent or prospective relations between IGD and psychiatric symptoms, except in one case: increased IGD symptoms forecasted reduction in anxiety symptoms. Observed co-occurrence between IGD symptoms and mental health problems can mainly be attributed to common underlying factors.
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http://dx.doi.org/10.1111/jcpp.13289DOI Listing
August 2020

Predictors of community versus specialty mental health service use: a prospective cohort study.

Eur Child Adolesc Psychiatry 2021 Jun 18;30(6):953-960. Epub 2020 Jun 18.

Department of Psychology, Norwegian University of Science and Technology, 7491, Trondheim, Norway.

Child and adolescent mental health specialized services (CAMHS) are supposed to serve those who are most seriously disturbed and impaired. However, little is known about how children receiving treatment at different levels of care differ. The present study seeks to determine whether having a psychiatric disorder and resulting impairment measured in early childhood increases the odds of receiving help in CAMHS versus from community services during middle childhood or whether other factors (e.g., parenting stress, family functioning) also influence service utilization. A screen-stratified sample (n = 995 of the 2003-2004 birth cohorts) in Trondheim, Norway was assessed biennially from age 4-12 with semi-structured diagnostic interviews and recording of service use, family functioning, parental perceived need, and parenting stress. Behavioral disorders more strongly predicted CAMHS than community service use, whereas impairment predicted community service use. However, impairment increased the odds of receiving services in CAMHS if the parents perceived a need for help. Parental perceived need for help also increased the odds of CAMHS use independent of diagnosis and impairment. Having an emotional disorder, attention deficit/hyperactivity disorder (ADHD), parenting stress, previous service use, or family functioning did not predict service use at either level. Whereas children with behavioral disorders received help from CAMHS, children with emotional disorders did not receive services at either level. ADHD did not predict service use, indicating that young children with ADHD without comorbid disorders are not sufficiently detected. Efforts to detect, refer and treat emotional disorders and ADHD at the appropriate level should be increased.
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http://dx.doi.org/10.1007/s00787-020-01575-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140979PMC
June 2021

Prevalence and stability of insomnia from preschool to early adolescence: a prospective cohort study in Norway.

BMJ Paediatr Open 2020 3;4(1):e000660. Epub 2020 Jun 3.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: There is limited knowledge about the prevalence and stability of insomnia defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM). We therefore provide such estimates from preschool to early adolescence and explore potential sex differences.

Methods: We followed a representative community sample (n=1037) biennially from 4 to 14 years of age (2007-2017). Insomnia diagnoses and symptoms were captured by a semistructured clinical interview of parents and children (from age 8 years).

Results: At ages 4 and 6 years approximately 2.5% of children met the criteria for insomnia, whereas at ages 8, 10, 12 and 14 years the prevalence ranged from 7.5% to 12.3%. During the 10-year period examined nearly 1 in 5 children had insomnia at least once (18.7%). Sex differences were apparent with DSM-IV, but not DSM-5, criteria: boys (8.1%) had more insomnia than girls (4.5%) did at ages 4-10 years, whereas girls (11.4%) had more insomnia than boys (7.1%) did at ages 12 and 14 years. Insomnia proved stable, with 22.9%-40.1% of children retaining their diagnosis 2 years later. Having current insomnia produced medium to large ORs of between 5.1 (95% CI 2.6 to 9.8) and 15.3 (95% CI 4.4 to 52.9) for subsequent insomnia 2 years later compared with not having preceding insomnia.

Conclusions: Insomnia was less prevalent than previous research indicates, with nearly 1 in 5 participants having insomnia at least once between the ages of 4 and 14 years. Female preponderance emerged in early adolescence. Having insomnia at one time point was a considerable risk for subsequent insomnia, indicating that insomnia is persistent and warrants clinical attention.
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http://dx.doi.org/10.1136/bmjpo-2020-000660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279650PMC
June 2020

Temperament as a predictor of eating behavior in middle childhood - A fixed effects approach.

Appetite 2020 07 22;150:104640. Epub 2020 Feb 22.

Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll, 7491, Trondheim, Norway; Department of Child and Adolescent Psychiatry, St Olav's University Hospital, 7030, Trondheim, Norway.

Background: Individual differences in temperament are believed to influence the development of children's eating behavior. This hypothesis has predominantly been tested in cross-sectional designs and important confounders such as genetics and stable parenting factors have not been accounted for. The present study aims to establish more clearly than previous studies if temperament is involved in the etiology of eating behavior in middle childhood.

Methods: A community sample of Norwegian children (n = 997) were followed biennially from age 4 to age 10. Temperamental negative affectivity, effortful control, and surgency were measured by The Child Behavior Questionnaire (CBQ). The Children's Eating Behavior Questionnaire (CEBQ) captured four 'food approach' behaviors ('food responsiveness', 'enjoyment of food', 'emotional overeating', 'desire to drink') and four 'food avoidant' behaviors ('emotional undereating', 'satiety responsiveness', 'food fussiness', 'slowness in eating'). The prospective relationships between temperament and eating behavior were tested with fixed, random and hybrid effect models, which adjust for all unmeasured time-invariant factors (e.g. genetics, common methods over time) RESULTS: Over and above unmeasured time-invariant confounders, higher negative affectivity predicted more 'food approach' and 'food avoidant' behavior, as did low effortful control, although less consistently so. Greater surgency was prospectively related to more 'food approach' and less 'food avoidant' behavior, but only at some ages and with the exception of emotional over- and under-eating.

Conclusions: Our findings indicate that temperament is involved in the etiology of children's eating behavior. Negative affectivity, in particular, may affect both 'food approach' and 'food avoidant' behavior. Because children prone to react with negative affect are at increased risk of obesogenic and disordered eating behaviors, their parents should be particularly aware of how to support healthy eating.
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http://dx.doi.org/10.1016/j.appet.2020.104640DOI Listing
July 2020

Prevalence and stability of insufficient sleep measured by actigraphy: a prospective community study.

Pediatr Res 2020 07 31;88(1):110-116. Epub 2020 Jan 31.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: It is well established that reduced sleep has detrimental effects on school-aged children's functioning, but the prevalence and stability of objectively measured insufficient sleep throughout childhood is unknown.

Methods: A sample of 799 children was followed biennially with 24-h 7-day accelerometer (hip-placed) measurements from ages 6 to 12 years. Insufficient sleep was conceptualized as sleeping <7 h on average (AIS) and as the number of nights with <7 h of sleep (NNIS).

Results: The prevalence of AIS ranged from 1.1% to 13.6%. Of those without AIS, 15.1-64.5% had >1 NNIS. At ages 6-10 years, NNIS was higher on weekend nights, but at age 12 years NNIS was lower on weekends (18.1%) compared to weekdays (23.4%). The stability of AIS was low from ages 6 to 8 years and from 8 to 10 years, but increased from age 10 to 12 years, whereas NNIS evidenced higher stability, increasing sharply through late middle childhood.

Conclusions: The prevalence of AIS was low during the preschool and early school years but increased toward preadolescence. The 2-year stability of insufficient sleep was very low when conceptualized as AIS and moderate when defined as NNIS, hence NNIS might be more sensitive than AIS. Insufficient sleep appears transient in middle childhood and thus might not warrant intervention unless it fosters impairment and endures.
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http://dx.doi.org/10.1038/s41390-020-0768-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326701PMC
July 2020

Association Between Objectively Measured Sleep Duration and Symptoms of Psychiatric Disorders in Middle Childhood.

JAMA Netw Open 2019 12 2;2(12):e1918281. Epub 2019 Dec 2.

Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Importance: The long-term association between sleep duration and mental health in children is currently unknown.

Objective: To investigate the prospective associations between sleep duration and symptoms of emotional and behavioral disorders at ages 6, 8, 10, and 12 years.

Design, Setting, And Participants: This population-based cohort study obtained data from the Trondheim Early Secure Study in Trondheim, Norway. A representative, stratified random sample of children born between January 1, 2003, and December 31, 2004, were invited to participate. Participants were followed up biennially from age 4 years (2007-2008) to 12 years (2013-2014). Data analysis was conducted from January 2, 2019, to May 28, 2019.

Main Outcomes And Measures: Sleep duration was assessed with 1 week of continuous use of a triaxial accelerometer. Symptoms of emotional (anxiety and depression) and behavioral (oppositional defiant, conduct, and attention-deficit/hyperactivity) disorders were measured by semistructured clinical interviews (using the Preschool Age Psychiatric Assessment and the Child and Adolescent Psychiatric Assessment) with parents (at all ages) and children (from age 8 years).

Results: The analytical sample comprised 799 children (mean [SD] age at time point 2, 6.0 [0.2] years; 405 [50.7%] boys; and 771 [96.5%] Norwegian). Shorter sleep duration at age 6 years (β [unstandardized regression coefficient] = -0.44; 95% CI, -0.80 to -0.08; P = .02) and 8 years (β = -0.47; 95% CI, -0.83 to -0.11; P = .01) forecasted symptoms of emotional disorders 2 years later. Comparatively short sleep duration at age 8 years (β = -0.65; 95% CI, -1.22 to -0.08; P = .03) and 10 years (β = -0.58; 95% CI, -1.07 to -0.08; P = .02) was associated with symptoms of behavioral disorders 2 years later among boys but not among girls at age 8 years (β = -0.14; 95% CI,- 0.52 to 0.24; P = .48) or 10 years (β = -0.05; 95% CI, = -0.49 to 0.40; P = .84). These associations were statistically significant among boys compared with girls at age 8 years (Δχ21 = 13.26; P < .001) and 10 years (Δχ21 = 10.25; P = .001). Symptoms of psychiatric disorders did not forecast sleep duration at any age.

Conclusions And Relevance: This study found an association between short sleep duration and increased risk of future occurrence of emotional disorder symptoms in both boys and girls and between reduced sleep and behavioral disorder symptoms in boys. These results suggest that improving sleep in children may help protect against the development of symptoms of common psychiatric disorders and may be advantageous in the treatment of such disorders.
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http://dx.doi.org/10.1001/jamanetworkopen.2019.18281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6991225PMC
December 2019

Validity of reactive attachment disorder and disinhibited social engagement disorder in adolescence.

Eur Child Adolesc Psychiatry 2020 Oct 12;29(10):1465-1476. Epub 2019 Dec 12.

Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.

Although reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) are acknowledged as valid disorders in young children, controversy remains regarding their validity in adolescence. An unresolved question is whether symptoms of RAD and DSED are better conceptualized as other psychiatric disorders at this age. All adolescents (N = 381; 67% consent; 12-20 years old) living in residential youth care in Norway were interviewed to determine the symptoms and diagnosis of RAD/DSED and other common psychiatric disorders using the Child and Adolescent Psychiatric Assessment (CAPA). The construct validity of RAD and DSED, including structural and discriminant validity, was investigated using confirmatory factor analysis and latent profile analysis. Two-factor models distinguishing between symptoms of RAD and DSED and differentiating these symptoms from the symptoms of other psychiatric disorders revealed better fit than one-factor models. Symptoms of RAD and DSED defined two distinct latent groups in a profile analysis. The prevalence of RAD was 9% (95% CI 6-11%), and the prevalence of DSED was 8% (95% CI 5-11%). RAD and DSED are two distinct latent factors not accounted for by other common psychiatric disorders in adolescence. RAD and DSED are not uncommon among adolescents in residential youth care and therefore warrant easy access to qualified health care and prevention in high-risk groups.
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http://dx.doi.org/10.1007/s00787-019-01456-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7501108PMC
October 2020

Time spent gaming and psychiatric symptoms in childhood: cross-sectional associations and longitudinal effects.

Eur Child Adolesc Psychiatry 2020 Jun 6;29(6):839-847. Epub 2019 Sep 6.

NTNU Social Research, Trondheim, Norway.

There is sparse knowledge on how the amount of gaming overlaps with-and is longitudinally related to-psychiatric symptoms of ADHD and emotional problems throughout early and middle childhood. In this prospective study of 791 Norwegian children, we investigated the amount of electronic gaming at ages 6, 8, and 10 while also measuring DSM symptoms of such disorders. Cross-lagged longitudinal analyses showed that more ADHD symptoms at age 8 predicted more gaming at age 10, whereas gaming did not predict more psychiatric symptoms, controlled for gender and socio-economic status. Cross-sectional overlaps between gaming and symptoms were marginal but nonetheless increased with each age level. Hence, time spent gaming did not forecast more psychiatric problems at these ages, but children with more ADHD symptoms were more likely to increase their amount of gaming throughout middle childhood. Results indicate that the sheer amount of gaming is not harmful to children's mental health, but that poorly regulated children become more attracted to games throughout childhood. Findings are discussed in light of the coexistence of problematic gaming and psychiatric problems reported among adolescents and adults, as well as the potential beneficial psychological outcomes from gaming.
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http://dx.doi.org/10.1007/s00787-019-01398-2DOI Listing
June 2020

Parents' Personality-Disorder Symptoms Predict Children's Symptoms of Anxiety and Depressive Disorders - a Prospective Cohort Study.

J Abnorm Child Psychol 2019 12;47(12):1931-1943

Department of Psychology, Norwegian University of Science and Technology, 7491, Dragvoll, Trondheim, Norway.

Personality disorder (PD) symptomatology is characterized by interpersonal problems and emotional dysregulation, which may affect offspring of parents with PD symptoms. Notably though, studies are needed to discern (i) whether parental PDs forecast symptoms of psychiatric disorders in offspring during their childhood years and (ii) whether such prospective relations obtain after accounting for common causes (e.g., genetics, common methods). To address these issues, we followed up a community sample of Norwegian children biennially from ages 4 to 8 (n = 594), using a semi-structured psychiatric interview (PAPA/CAPA) to capture DSM-IV defined symptoms of emotional disorders. Parental symptoms of personality disorders were captured by the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q), whereas depression and anxiety in caregivers were measured using the Beck Depression Inventory -II and Beck Anxiety Inventory, respectively. Upon applying a hybrid fixed and random effects method that takes into account all unmeasured time-invariant confounders, we found that: (i) Parental symptoms of DSM-IV defined Cluster A and C were related to symptoms of anxiety disorders in offspring two years later, even after accounting for children's initial levels of anxiety and parental anxiety, whereas (ii) Parental DSM-IV Cluster B predicted symptoms of depressive disorders in children, adjusted for children's initial levels of depression and parental depression. Clinical implications of the results are discussed.
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http://dx.doi.org/10.1007/s10802-019-00568-9DOI Listing
December 2019

Time Spent Gaming and Social Competence in Children: Reciprocal Effects Across Childhood.

Child Dev 2020 05 23;91(3):861-875. Epub 2019 Apr 23.

Norwegian University of Science and Technology.

Electronic games are popular and many children spend much time on this activity. Here we investigate whether the quantity of time children spend on gaming is related to their social development, making this the first study to examine this relationship in children. We examine prospective relations between time spent gaming and social competence in a community sample of Norwegian 6 year olds (n = 873) followed up at ages 8, 10, and 12, controlling for socioeconomic status, body mass index, and time spent gaming together with friends. Results revealed that greater social competence at both 8 and 10 years predicted less gaming 2 years later and that more age-10 gaming predicted less social competence at age 12 but only among girls.
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http://dx.doi.org/10.1111/cdev.13243DOI Listing
May 2020

Parental predictors of children's executive functioning from ages 6 to 10.

Br J Dev Psychol 2019 09 28;37(3):410-426. Epub 2019 Feb 28.

NTNU Norwegian University of Science and Technology, Trondheim, Norway.

According to prominent models of child development, parental factors may contribute to individual differences in children's executive functioning (EF). Here, we examine the relative importance of parents' socio-economic status, mental health, and parenting as predictors of EF development, drawing on a large (n = 1,070) community sample of Norwegian children who received biennial EF assessments from 6 to 10 years of age. We measure EF by means of the Behavior Rating Inventory of Executive Function. We assess parenting through observer ratings of parent-child interactions and parental mental health via the Beck Anxiety Inventory, Beck Depression Inventory, and Hopkins Symptom Checklist. When we adjust for all time-invariant unmeasured confounders, higher parental education predicts superior EF development, whereas harsh parenting forecasts poorer EF development. However, parenting does not mediate the effect of parental education. These results indicate that harsh parenting should be targeted in interventions aimed at improving EF. Statement of contribution What is already known on this subject? Parental factors seem to affect child development of executive functions (EF). Specifically, parental socio-economic status, mental health, and their parenting seem to influence the developmental course of child EF. What does this study add? To what degree the parental influence on EF development is likely to be driven by time-invariant factors, for example, genetics. The relative influence of positive and negative parenting on EF development.
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http://dx.doi.org/10.1111/bjdp.12282DOI Listing
September 2019

Screen time and the development of emotion understanding from age 4 to age 8: A community study.

Br J Dev Psychol 2019 09 28;37(3):427-443. Epub 2019 Feb 28.

Norwegian University of Science and Technology, Trondheim, Norway.

Recent increase in children's screen activities has raised concerns that screen time may replace face-to-face interaction, and hence impair children's development of emotion understanding. This longitudinal community study of 960 Norwegian 4-year-olds, followed up at ages 6 and 8, examined bidirectional relations between screen use and emotion understanding. Results revealed that more screen time at age 4 predicted lower levels of emotion understanding at age 6. In addition, television in children's bedroom at age 6 forecasted lower levels of emotion understanding at age 8. The effect of TV watching on emotion understanding was gender moderated, with stronger effects of TV watching observed among girls, but no significant effects detected among boys. In contrast, gaming forecasted lower level of emotion understanding in boys, not girls. Results are discussed in the light of the importance of face-to-face interaction to preserve the development of social-emotional competence among young children. Statement of contribution What is already known on this subject? We know that children's screen activities correlate with poorer social competence and with decrease of the quantity and quality of interaction with parents and siblings. The capacity to understand emotions in others is primarily learned through interaction with primary caregivers, but little is known how children's screen use influences development of emotion understanding. What the present study adds? We found that more TV watching among girls at age 4 predicted lower levels of emotion understanding at age 6. Furthermore, TV in child's bedroom at age 6 forecasted lower levels of emotion understanding at age 8.
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http://dx.doi.org/10.1111/bjdp.12283DOI Listing
September 2019

Predictors of Physical Activity in Middle Childhood. A Fixed-Effects Regression Approach.

Front Public Health 2018 24;6:305. Epub 2018 Oct 24.

NTNU Social Research, Trondheim, Norway.

Moderate-to-vigorous physical activity (MVPA) has a range of health benefits across the life span. Although many putative determinants of children's MVPA have been identified, their causal status is uncertain due to difficulties in adjusting for potential confounders. To inform promotion of children's MVPA we therefore aimed to examine well-known child-, family- and contextual predictors of MVPA in middle childhood, by applying a fixed effects regression approach, which rules out the influence of all unmeasured time-invariant confounders. Two birth cohorts of children living in the city of Trondheim, Norway were invited to participate (82.0% consented). The participants were followed-up biennially from age 6 to 10 years ( = 800) between 2009 and 2014. MVPA in children was recorded by accelerometers and child-, family- and contextual factors were obtained through interviews and questionnaires. Predictors included (i) the child's time outdoors, organized sports participation, athletic self-concept, self-reported screen time and objectively measured sedentariness; (ii) self-reported parental MVPA and actively transporting the child to school; and (iii) parental socio-economic status (SES), access to playgrounds and ballparks, traffic safety, and having a garden. A three-wave prospective study was conducted with a hybrid fixed effects regressions analysis adjusting for all time-invariant confounders to examine predictors of MVPA. Children evidenced increased MVPA when they spent more time outside, spent less time being sedentary and when the family had a garden and lived in a traffic-safe area. Adjusting for measured time-varying and all unmeasured time-invariant confounders renders many previously identified child and family factors without impact on MVPA in children. However, several contextual factors may promote MVPA in middle childhood, and efforts to facilitate children being outside in environments that promote physical activity (e.g., being outside, in gardens, or otherwise traffic safe areas) may prove important.
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http://dx.doi.org/10.3389/fpubh.2018.00305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207689PMC
October 2018

Cohort Profile: The Trondheim Early Secure Study (TESS)-a study of mental health, psychosocial development and health behaviour from preschool to adolescence.

Int J Epidemiol 2018 10;47(5):1401-1401i

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

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http://dx.doi.org/10.1093/ije/dyy190DOI Listing
October 2018

Young children's television viewing and the quality of their interactions with parents: A prospective community study.

Scand J Psychol 2018 Oct 10;59(5):503-510. Epub 2018 Jul 10.

Norwegian University of Science and Technology, Trondheim, Norway.

Television is one of the most commonly viewed forms of media by children throughout the world. Excessive television viewing can influence the quality of children's relationships and interactions with their parents. We examined the emotional availability (EA) of children toward their parents by assessing child responsiveness and child involvement, using a cross-sectional and longitudinal design. We employed a large and representative community sample of Norwegian 4-year-olds (n = 995) who were followed up at 6 years old (n = 795). The results illustrate that, when viewing excessive amounts of television, children are less likely to be involved with their parents in ordinary toy-play. We argue in favor of the displacement hypothesis, stating that time-demanding technologies are negatively related to the quality of parent-child relationships because spending more time watching television will leave less time for developing nurturing social relationships.
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http://dx.doi.org/10.1111/sjop.12467DOI Listing
October 2018

Emotional Over- and Undereating in Children: A Longitudinal Analysis of Child and Contextual Predictors.

Child Dev 2019 11 29;90(6):e803-e818. Epub 2018 Jun 29.

Norwegian University of Science and Technology.

Eating more or eating less in response to negative emotions, called emotional over- and undereating, is common in children, but research on the etiology of these behaviors is in its infancy. Drawing on a large, representative community sample of Norwegian children followed up on a biennial basis from 6 to 10 years of age (analysis sample: n = 802), child and contextual predictors (i.e., child temperament, depression symptoms, serious life events, family functioning, parental sensitivity and structuring) of change in emotional over- and undereating were examined. Results revealed that low (temperamental) soothability and less parental structuring at age 6 predicted increased emotional overeating at age 10 and that lower family functioning at age 6 predicted more emotional undereating during the same period.
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http://dx.doi.org/10.1111/cdev.13110DOI Listing
November 2019

Symptoms of Internet Gaming Disorder in Youth: Predictors and Comorbidity.

J Abnorm Child Psychol 2019 01;47(1):71-83

NTNU Social Science, Trondheim, Norway.

Internet gaming disorder (IGD) was included in the Addendum to DSM-5 as a condition for further study. Studies of community samples using a diagnostic interview are lacking, and evaluations of the proposed symptoms, comorbidities, and predictors of IGD are scarce. To provide such information participants in a Norwegian prospective community study were assessed with a clinical interview at age 10 years. Symptoms of other psychiatric disorders were measured with the Child and Adolescent Psychiatric Assessment at ages 8 and 10 (n = 740). Children, parents, and teachers provided information on demographics, temperament, intelligence, executive functions, self-concept, social skills, victimization, emotion regulation, family climate, and parenting. Results indicated that IGD was present in 1.7% (95% confidence interval, 0.7-2.7) of the participants (3.0% boys and 0.5% girls). Factor analysis revealed two factors: heavy involvement and negative consequences. The positive predictive value of withdrawal, tolerance, and unsuccessful attempts to control gaming symptoms to the disorder was low. Symptoms of other common disorders correlated weakly with IGD-symptoms (i.e., from r = 0.07 to r = 0.15). Upon adjusting for gender and gaming at age 8, only limited social and emotion regulation skills at age 8 predicted more age-10 IGD symptoms. In conclusion, IGD is already present in a small percentage of Norwegian 10-year olds. At least three of the proposed symptoms -- withdrawal, tolerance and unsuccessful attempts to control gaming -- merit further study given their weak associations with the disorder. Symptoms of IGD are only marginally associated with symptoms of other psychiatric disorders and only predicted by social skills and emotion regulation deficits.
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http://dx.doi.org/10.1007/s10802-018-0422-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329732PMC
January 2019

Predictors of eating behavior in middle childhood: A hybrid fixed effects model.

Dev Psychol 2018 06 8;54(6):1099-1110. Epub 2018 Mar 8.

Norwegian University of Science and Technology.

Children's eating behavior influences energy intake and thus weight through choices of type and amount of food. One type of eating behavior, food responsiveness, defined as eating in response to external cues such as the sight and smell of food, is particularly related to increased caloric intake and weight. Because little is known about the potential determinants of such behavior, we focus herein on child and parent predictors of food responsiveness in a large community sample of Norwegian 6-year-olds, followed up at ages 8 and 10. To measure children's food responsiveness, parents completed the Children's Eating Behavior Questionnaire. Potential predictors were children's inhibition and symptoms of attention-deficit/hyperactivity disorder and depression, and parents' instrumental and controlling feeding practices as well as parental restrained eating. After accounting for children's initial levels of food responsiveness within a hybrid fixed effects method that takes into consideration all unmeasured time-invariant confounders, more child attention-deficit/hyperactivity disorder symptoms and greater restrained eating by parents predicted more food responsiveness at both ages 8 and 10. These results may provide important insights for efforts to prevent overeating. (PsycINFO Database Record
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http://dx.doi.org/10.1037/dev0000504DOI Listing
June 2018

Parent-child interactions during traditional and interactive media settings: A pilot randomized control study.

Scand J Psychol 2018 Apr 15;59(2):135-145. Epub 2017 Dec 15.

Norwegian University of Science and Technology, NTNU, Department of Psychology, Trondheim, Norway.

Parent-child interactions are pivotal for children's socioemotional development, yet might suffer with increased attention to screen media, as research has suggested. In response, we hypothesized that parent-child play on a tablet computer, as representative of interactive media, would generate higher-quality parent-child interactions than toy play or watching TV. We examined the emotional availability of mothers and their 2-year-old child during the previous three contexts using a randomized crossover design (n = 22) in a laboratory room. Among other results, mothers were more sensitive and structuring during joint gaming on a tablet than when engaged in toy play or watching TV. In addition, mothers were more hostile toward their children during play with traditional toys than during joint tablet gaming and television co-viewing. Such findings provide new insights into the impact of new media on parent-child interactions, chiefly by demonstrating that interactive media devices such as tablets can afford growth-enhancing parent-child interactions.
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http://dx.doi.org/10.1111/sjop.12420DOI Listing
April 2018

Body Size Estimation from Early to Middle Childhood: Stability of Underestimation, BMI, and Gender Effects.

Front Psychol 2017 21;8:2038. Epub 2017 Nov 21.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Individuals who are overweight are more likely to underestimate their body size than those who are normal weight, and overweight underestimators are less likely to engage in weight loss efforts. Underestimation of body size might represent a barrier to prevention and treatment of overweight; thus insight in how underestimation of body size develops and tracks through the childhood years is needed. The aim of the present study was therefore to examine stability in children's underestimation of body size, exploring predictors of underestimation over time. The prospective path from underestimation to BMI was also tested. In a Norwegian cohort of 6 year olds, followed up at ages 8 and 10 (analysis sample: = 793) body size estimation was captured by the Children's Body Image Scale, height and weight were measured and BMI calculated. Overall, children were more likely to underestimate than overestimate their body size. Individual stability in underestimation was modest, but significant. Higher BMI predicted future underestimation, even when previous underestimation was adjusted for, but there was no evidence for the opposite direction of influence. Boys were more likely than girls to underestimate their body size at ages 8 and 10 (age 8: 38.0% vs. 24.1%; Age 10: 57.9% vs. 30.8%) and showed a steeper increase in underestimation with age compared to girls. In conclusion, the majority of 6, 8, and 10-year olds correctly estimate their body size (prevalence ranging from 40 to 70% depending on age and gender), although a substantial portion perceived themselves to be thinner than they actually were. Higher BMI forecasted future underestimation, but underestimation did not increase the risk for excessive weight gain in middle childhood.
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http://dx.doi.org/10.3389/fpsyg.2017.02038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702321PMC
November 2017

Child and parent predictors of picky eating from preschool to school age.

Int J Behav Nutr Phys Act 2017 07 6;14(1):87. Epub 2017 Jul 6.

Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll, 7491, Trondheim, Norway.

Background: Picky eating is prevalent in childhood. Because pickiness concerns parents and is associated with nutrient deficiency and psychological problems, the antecedents of pickiness need to be identified. We propose an etiological model of picky eating involving child temperament, sensory sensitivity and parent-child interaction.

Methods: Two cohorts of 4-year olds (born 2003 or 2004) in Trondheim, Norway were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) and a screen-stratified subsample of 1250 children was recruited. We interviewed 997 parents about their child's pickiness and sensory sensitivity using the Preschool Age Psychiatric Assessment (PAPA). Two years later, 795 of the parents completed the interview. The Children's Behavior Questionnaire (CBQ) was used to assess children's temperament. Parent- child interactions were videotaped and parental sensitivity (i.e., parental awareness and appropriate responsiveness to children's verbal and nonverbal cues) and structuring were rated using the Emotional Availability Scales (EAS).

Results: At both measurement times, 26% of the children were categorized as picky eaters. Pickiness was moderately stable from preschool to school age (OR = 5.92, CI = 3.95, 8.86), and about half of those who displayed pickiness at age 4 were also picky eaters two years later. While accounting for pickiness at age 4, sensory sensitivity at age 4 predicted pickiness at age 6 (OR = 1.25, CI = 1.08, 2.23), whereas temperamental surgency (OR = 0.88, CI = 0.64, 1.22) and negative affectivity (OR = 1.17, CI = 0.75, 1.84) did not. Parental structuring was found to reduce the risk of children's picky eating two years later (OR = 0.90, CI = 0.82, 0.99), whereas parental sensitivity increased the odds for pickiness (OR = 1.10, CI = 1.00, 1.21).

Conclusions: Although pickiness is stable from preschool to school age, children who are more sensory sensitive are at higher risk for pickiness two years later, as are children whose parents display relatively higher levels of sensitivity and lower levels of structuring. Our findings suggest that interventions targeting children's sensory sensitivity, as well as parental sensitivity and structuring, might reduce the risk of childhood pickiness. Health care providers should support parents of picky eaters in repeatedly offering unfamiliar and rejected foods to their children without pressure and acknowledging child autonomy.
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http://dx.doi.org/10.1186/s12966-017-0542-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498871PMC
July 2017

Explaining the relationship between temperament and symptoms of psychiatric disorders from preschool to middle childhood: hybrid fixed and random effects models of Norwegian and Spanish children.

J Child Psychol Psychiatry 2018 03 3;59(3):285-295. Epub 2017 Jul 3.

Unitat d'Epidemiologia i Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Barcelona, Spain.

Background: Four explanations for the concurrent and prospective associations between temperament and psychopathology in children have been suggested: predisposition, complication/scar, common cause/continuity, and pathoplasty/exacerbation. Because the confounding effects of common causes have not been ruled out in prior work, the support for the various explanations is uncertain.

Methods: Screen-stratified community samples of 4-year olds in Trondheim, Norway (n = 1,042), and 3-year olds in Barcelona, Spain (n = 622), were assessed biennially for symptoms of attention-deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct (CD), anxiety, and depressive disorders through interviewer-based psychiatric interviews across four waves of data collection. The parents completed child temperament ratings. The data were analyzed with random and fixed effects regression adjusted for all time-invariant unmeasured confounders (e.g., genetics, common methods bias, item overlap).

Results: In both Norway and Spain and across ages, negative affect predisposed children to symptoms of all disorders except CD, low effortful control predisposed children to ADHD and ODD-symptoms, and surgency predisposed children to increased ADHD-symptoms. Complication effects were observed in the Spanish children for ADHD-symptoms, which increased surgency and diminished effortful control, and for ODD-symptoms, which decreased surgency. The common cause and pathoplasty/exacerbation explanations were not supported.

Conclusions: The present results are consistent with the view that temperament plays a causal role in the development of symptoms of psychiatric disorders in children. Because temperament is malleable, interventions targeting the affective, attentional, and behavioral regulatory components of temperament may reduce psychopathology in children.
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http://dx.doi.org/10.1111/jcpp.12772DOI Listing
March 2018
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