Publications by authors named "William Bor"

95 Publications

Does the millennial generation of women experience more mental illness than their mothers?

BMC Psychiatry 2021 07 17;21(1):359. Epub 2021 Jul 17.

Mental Health Research Programme, QIMR Berghofer Medical Research Institute, Herston, Australia.

Background: There is concern that rates of mental disorders may be increasing although findings disagree. Using an innovative design with a daughter-mother data set we assess whether there has been a generational increase in lifetime ever rates of major depressive disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD) experienced prior to 30 years of age.

Methods: Pregnant women were recruited during 1981-1983 and administered the Composite International Diagnostic Interview (CIDI) at the 27-year follow-up (2008-11). Offspring were administered the CIDI at the 30-year follow-up (2010-2014). Comparisons for onset of diagnosis are restricted to daughter and mother dyads up to 30 years of age. To address recall bias, disorders were stratified into more (≥12 months duration) and less persistent episodes (< 12 months duration) for the purposes of comparison. Sensitivity analyses with inflation were used to account for possible maternal failure to differentially recall past episodes.

Results: When comparing life time ever diagnoses before 30 years, daughters had higher rates of persistent generalised anxiety disorder, and less persistent major depressive disorder, generalised anxiety disorder and PTSD.

Conclusions: In the context of conflicting findings concerning generational changes in mental disorders we find an increase in generational rates of persistent generalised anxiety disorders and a range of less persistent disorders. It is not clear whether this finding reflects actual changes in symptom levels over a generation or whether there has been a generational change in recognition of and willingness to report symptoms of mental illness.
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http://dx.doi.org/10.1186/s12888-021-03361-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285825PMC
July 2021

Evaluation of a collaborative group intervention for mothers with moderate to severe perinatal mental illness and their infants in Australia.

Infant Ment Health J 2021 07 25;42(4):560-572. Epub 2021 Jun 25.

Queensland Centre for Perinatal and Infant Mental Health, Child and Youth Mental Health, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.

Perinatal mental illness is a known risk to maternal-infant attachment and healthy infant development. Mothers experiencing complex mental health issues in the first year following birth are less likely to become involved in parenting programs or day stay interventions because of their mental health difficulties and perceived stigma. Currently, most perinatal day or group treatment programs only include the mother and not their infant. This paper describes "Together in Mind," a perinatal and infant mental health day program developed by the Queensland Centre for Perinatal and Infant Mental Health, targeting mothers with moderate to severe mental illness and their infants under 12 months. The service model was a 6-week, 1 day per week psychoeducation intervention. Psychoeducational material and support were provided across each day session by an adult perinatal mental health clinician, an infant mental health clinician, and a child health nurse working in collaboration. The program was trialed across seven Hospital and Health Service sites in Queensland, Australia, during 2016-18. In total, 24 group day programs were delivered with 84 mothers and their infants. Pre and post intervention quantitative measures and a post-program qualitative survey about participant satisfaction were collected. Statistically significant improvements in all quantitative measures showed a large to medium effect size on the: Health of the Nation Outcome Scale (HoNOS) (d = 0.82; p < .000); Depression, Anxiety and Stress Scale (DASS-21) (d = 0.5; p < .000); Karitane Parenting Confidence Scale (KPCS) (d = 0.63; p < .000); Maternal Postnatal Attachment Scale (MPAS) (d = 0.49; p < .000), Ages and Stages Questionnaire: Social-Emotional (6 months) (d = 0.83; p < .000). The results indicate collaboration and early intervention contributes to strengthening the emerging development of the maternal-infant relationship within the context of complex maternal mental health issues.
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http://dx.doi.org/10.1002/imhj.21922DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453701PMC
July 2021

Bereavement is different: A multinational bereavement symptom model validation.

Psychiatry Res 2021 06 8;300:113926. Epub 2021 Apr 8.

Child and Youth Mental Health Service, Children's Health Queensland, Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, Brisbane, Australia.

Clinicians need to rule out an appropriate grief reaction when diagnosing major depression. This study identifies symptom differences by bereavement status and validates a symptom model of bereavement. Symptom features from six national cross-sectional epidemiological samples were analyzed and estimates pooled. Crying often, thinking of death, appetite loss, waking up early, trouble sleeping, and depending on others were significantly more likely in the bereaved. Symptoms of thinking of or attempting suicide, feeling one would be better off dead or wanting to die, worthlessness, social conflict, worthlessness with difficulty making decisions, being discouraged, feeling less than others, being troubled, not coping, feeling hopeless, sleeping more, being upset and history of an anxiety disorder were all significantly less likely among the bereaved. Moderate to good model discrimination effect sizes were found. Good model performance was found when narrowly defined complicated bereavement cases were excluded. On the whole the bereaved are more likely to report symptoms consistent with a normal grief reaction. As depression screening becomes the norm in primary care, normal grief that meets Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) symptom criteria for a MDE likely has a high risk of being diagnosed inappropriately as pathological depression.
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http://dx.doi.org/10.1016/j.psychres.2021.113926DOI Listing
June 2021

Poverty over the early life course and young adult cardio-metabolic risk.

Int J Public Health 2020 Jul 15;65(6):759-768. Epub 2020 Jul 15.

School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia.

Objectives: There is little known about whether exposure to family poverty at specific periods of the early life course independently contributes to coronary heart disease risk beyond the contribution of concurrent poverty.

Methods: Children were recruited in early pregnancy and additional survey data obtained during the pregnancy and at the 5-, 14- and 30-year follow-ups. Fasting blood samples were also obtained at the 30-year follow-up. Analyses are multinominal logistic regressions stratified by gender and with adjustments for confounding.

Results: For male offspring, family poverty at different stages of the early life course was not associated with measures of cardio-metabolic risk. For females early life course, poverty predicted obesity, homeostatic model assessment of insulin resistance (HOMA-IR) and total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), as well as concurrent family poverty associated with obesity, HOMA-IR, TC/HDL-C, HDL-C and increased systolic and diastolic blood pressure.

Conclusions: Family poverty in the early life course independently predicts increased levels of cardio-metabolic risk of females. The primary finding, however, is that concurrent poverty is independently and strongly associated with increased cardio-metabolic risk levels in young adulthood.
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http://dx.doi.org/10.1007/s00038-020-01423-1DOI Listing
July 2020

Illicit drug use by mothers and their daughters in Australia: A comparison of two generations.

Addict Behav 2020 07 20;106:106321. Epub 2020 Jan 20.

Institute for Social Science Research, University of Queensland, 80 Meiers Road, Indooroopilly, Qld 4068, Australia.

Background: While recent decades have witnessed an increase in the use of illicit drugs in Australia, the extent to which the types of drugs used has changed over a generation of young women has not been documented.

Methods: Data are from a prospective birth cohort study. Mothers were recruited in early pregnancy (1981-83) and then they and their child were followed up, with mothers interviewed 27 years (2008-2011), and daughters 30 years (2010-14), after the birth. At these most recent interviews both mothers and daughters were administered the Composite International Diagnostic Interview (CIDI III). Comparisons are for mothers and daughters separated by a 25 year period. For this study, we compare levels of lifetime use of a range of illicit drugs and drug use disorders reported by mothers and their daughters (N = 998 mother/daughter pairs) with adjustment for family income, marital status, education and occupation.

Results: There has been a generational increase in the use of illicit substances and prevalence of substance use disorders experienced by Australian women. Mothers' use of illicit drugs was generally restricted to cannabis. By contrast the majority of daughters report lifetime use of an illicit drug with cannabis, club drugs and stimulants the most common. Compared to the mothers, daughters used club drugs 50 times, cocaine 19 times and inhalants 20 times more often. Daughters report experiencing 12 times the rate of cocaine use disorders, 9 times the rate of stimulant disorders and 7 times the rate of cannabis use disorders compared to their mothers.

Conclusions: Mothers of the current generation of 30 year old Australian women rarely used illicit drugs and few experienced a drug use disorder. The current generation of young women report commonly using one or more illicit drugs with a substantial minority experiencing a drug use disorder. It is unlikely that the use of illicit drugs by young women in Australia will be reversed in the foreseeable future. Government policies and treatment practices need to be calibrated to the reality of the much greater contact with illicit drugs being exhibited by younger women.
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http://dx.doi.org/10.1016/j.addbeh.2020.106321DOI Listing
July 2020

Current pharmacotherapy options for conduct disorders in adolescents and children.

Expert Opin Pharmacother 2019 04 31;20(5):571-583. Epub 2019 Jan 31.

h Townsville Clinical School, College of Medicine and Dentistry , James Cook University , Townsville , Australia.

Introduction: Conduct disorder (CD) is a common mental health disorder of childhood and adolescence. CD's complexity, with its heterogenous clinical manifestations and overlapping comorbidities makes the application of evidence-based management approaches challenging. This article aims to combine a systematic review of the available literature, with a consensus opinion from both child and adolescent psychiatrists and developmental pediatricians on the clinical and pharmacological management of children and adolescents with conduct disorder (CD).

Areas Covered: The authors review the CD population and provide a systematic review and meta-analysis of the effectiveness and safety of pharmacotherapies using preferred reporting items for systematic review and meta-analysis (PRISMA) and strength of evidence recommendation taxonomy (SORT) guidelines. The authors then provide an expert clinical opinion for the use of different pharmacotherapies to address aggressive and disruptive behavior in children.

Expert Opinion: Atypical antipsychotics (e.g. risperidone) demonstrate evidence for efficacy in CD. Other pharmacotherapies (e.g. mood stabilizers, anticonvulsants, psychostimulants and selective norepinephrine reuptake inhibitors) have a low level of evidence for CD alone, however, can sometimes be effective in managing the symptoms of CD when other psychiatric disorders are also present.
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http://dx.doi.org/10.1080/14656566.2018.1561862DOI Listing
April 2019

The inter- and intra- generational transmission of family poverty and hardship (adversity): A prospective 30 year study.

PLoS One 2018 23;13(1):e0190504. Epub 2018 Jan 23.

School of Pharmacy, the University of Queensland, Brisbane, Australia.

Background: Children exposed to family poverty have been found to have higher morbidity and mortality rates, poorer mental health and cognitive outcomes and reduced life chances across a wide range of life domains. There is, however, very little known about the extent to which poverty is experienced by children over their early life course, particularly in community samples. This study tracks changes in family poverty and the main factors that predict family poverty (adverse life experiences) over a 30-year period since the birth of the study child.

Methods: Data are from a prospective, longitudinal, birth cohort study conducted in Brisbane, Australia. Consecutive families were recruited at the mothers' first obstetrical visit at one of two major obstetrical hospitals in Brisbane. Data are available for 2087 families with complete data at the 30-year follow-up. Poverty was measured using family income at each time point (adjusted for inflation).

Findings: Poverty affects about 20% of families at any time point. It is common for families to move in and out of poverty, as their circumstances are affected by such adversities as unemployment and marital breakdown. Over the period of the study about half the families in the study experienced poverty on at least one occasion. Only a very small minority of families experienced persistent poverty over the 30-year duration of the study. Logistic regressions with time lag show that family poverty predicts subsequent adversities and adverse events predict subsequent poverty.

Conclusions: Experiences of poverty and adversity are common and may vary greatly over the child's early life course. In assessing the health consequences of poverty, it is important to distinguish the timing and chronicity of early life course experiences of poverty and adversity.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190504PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779648PMC
February 2018

Pharmacotherapy of conduct disorder: Challenges, options and future directions.

J Psychopharmacol 2016 10 19;30(10):967-75. Epub 2016 Jul 19.

School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia.

Unlabelled: There is a critical need for evaluation of the pharmacotherapies used in conduct disorder (CD), due to the high incidence of off-label prescribing. The aim of this review was to identify concerns associated with the safety, efficacy and impact on quality of life (QOL) that pharmacotherapy has in children and adolescents with CD. A systematic review was undertaken using pre-defined search criteria and four databases, including reference searches. We assessed these studies using the Strength of Recommendation Taxonomy, Grading of Recommendations Assessment, Development and Evaluation, and Review Manager Risk of Bias (RevMan®) tools. There were 12 randomised controlled trials that met our inclusion criteria.

Studies Included: antipsychotics, atomoxetine, lithium, clonidine, divalproex sodium and psychostimulants. The antipsychotics demonstrated efficacy, but were associated with adverse effects. Other agents demonstrated mixed responses, highlighting the lack of clinical significance and increased incidence of adverse effects. The management of related adverse effects was addressed to assist with clinical gaps. Overall, there is limited evidence regarding the role of pharmacotherapy in CD. More research is needed that takes into account the heterogeneity of CD and analysis of pharmacotherapy in pure CD.
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http://dx.doi.org/10.1177/0269881116658985DOI Listing
October 2016

Age at first tobacco use and risk of subsequent psychosis-related outcomes: A birth cohort study.

Aust N Z J Psychiatry 2016 Jun 19;50(6):577-83. Epub 2015 May 19.

Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia Discipline of Psychiatry, University of Queensland, Herston, QLD, Australia The University of Queensland Centre for Clinical Research, Herston, QLD, Australia Royal Brisbane and Women's Hospital, Herston, QLD, Australia

Objective: Compared to the substantial body of research examining links between cannabis use and psychosis, there has been relatively little attention to the role of tobacco as a potential risk factor for psychosis. This study explored the association between age at first tobacco use and psychosis-related outcomes in a birth cohort.

Method: This study is based on a large birth cohort (the Mater-University Study of Pregnancy). At approximately 21 years of age, cohort members (N = 3752) were assessed for three psychosis-related outcomes (International Classification of Diseases non-affective psychosis, the presence of any hallucination and total count of delusional-like experiences) with the Composite International Diagnostic Interview and the Peters Delusional Inventory. Associations between age at first tobacco use and psychosis-related outcomes were examined using logistic regression in a model (a) adjusted for sex and age and (b) in a second model excluding all respondents who had a history of past problematic and current cannabis use.

Results: When adjusted for age and sex, those who commenced tobacco at 15 years of age or younger were significantly more likely to (a) have non-affective psychosis, (b) be in the highest quartile of total score of the Peters Delusional Inventory and (c) report hallucinations. After excluding all those with a history of a cannabis use disorder, or who were current (last month) cannabis users, a significant association between age at first tobacco use and the presence of hallucinations persisted.

Conclusion: There is an association between age at first tobacco use and subsequent psychosis-related outcomes in young adults. While the findings cannot be used to deduce causality, it adds weight to the hypothesis that early tobacco use may contribute to the risk of developing psychosis-related outcomes.
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http://dx.doi.org/10.1177/0004867415587341DOI Listing
June 2016

Cohort Profile Update: The Mater-University of Queensland Study of Pregnancy (MUSP).

Int J Epidemiol 2015 Feb 16;44(1):78-78f. Epub 2014 Dec 16.

Schools of Population Health and Social Science, Mater Misericordiae Hospital, School of Pharmacy, Queensland Brain Institute, Mater Clinical School, The University of Queensland, UQ Centre of Clinical Research and Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.

The Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes began in 1981 with data collected on 7223 pregnant woman-child pairs (6753 mothers, of whom 520 had 2 study children, less 50 who had multiple births). These women, and their children, were initially followed for up to 21 years. Since then there have been additional follow-ups of the mothers (27 years) and their children (30 years). There has also been a substantial increase in the breadth of topics addressed, with the collection of biological samples, the administration of structured clinical assessments of mental health and cognitive capacity, and markers of physical health such as lung function and blood pressure. MUSP was originally developed as a birth cohort study. It has become a longitudinal study of growth, development and ageing with an emphasis on the generational transmission of a wide range of factors impacting on adult health outcomes. We welcome interest in our study; for study background and publications visit [www.socialscience.uq.edu.au/musp] or contact [[email protected]].
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http://dx.doi.org/10.1093/ije/dyu234DOI Listing
February 2015

Improving collaboration: a qualitative assessment of inter-agency collaboration between a pilot Multisystemic Therapy Child Abuse and Neglect (MST-CAN) program and a child protection team.

Australas Psychiatry 2014 Aug 18;22(4):370-373. Epub 2014 Jun 18.

Senior Practitioner, Department of Communities, Brisbane, QLD and; Child Safety Service Centre, Brisbane, QLD, Australia.

Objective: Child protection inter-agency collaboration is characterized by strengths and problems. Some literature notes positive attitudes and high trust between teams. However, difficulties with communication, confidentiality, roles, boundaries and divergent paradigms reconciling child protection and parent mental health needs have been documented. This study investigated whether a pilot model of intensive family intervention for maltreated children and associated intensive inter-agency cooperation delivered an effective collaboration.

Method: At the completion of the pilot program, a child protection team was interviewed. A qualitative assessment by semi-structured group interview format of inter-agency collaboration was undertaken and evaluated by a thematic analysis.

Results: The analysis identified: strong endorsement of the collaborative model; no changes in perception of referred patients; changes in treatment approaches. No perceived conflict between child protection and parent mental health needs were noted.

Conclusions: The changes noted may be due to the unique structure and functioning of the pilot Multisystemic Therapy Child Abuse and Neglect program, which encouraged high levels of team communication, strong client engagement, availability and intensive treatment of child and parent mental health problems. The implications for future collaborations are discussed as well as limitations of the study.
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http://dx.doi.org/10.1177/1039856214539572DOI Listing
August 2014

Are child and adolescent mental health problems increasing in the 21st century? A systematic review.

Aust N Z J Psychiatry 2014 Jul 14;48(7):606-16. Epub 2014 May 14.

Queensland Alcohol and Drug Research and Education Centre (QADREC), The University of Queensland, Herston, QLD, Australia.

Objective: Up to one in five children experience mental health problems. Social and cultural factors may influence emergence of mental health problems. The 21st century has led to changes in many of these factors, but it is unclear whether rates of internalizing and externalizing problems have also changed in recent cohorts of young people.

Methods: A comprehensive literature search was undertaken to locate cohort or population studies that examined changes in mental health of children over time, where participants were aged 18 years and under, and the time frame for change was at least 10 years, with data for at least one time point in the 21st century being statistically compared to at least one time point in the 20th century. Studies were reviewed for quality and outcome.

Results: Nineteen studies met criteria for review. These included studies of toddlers, children, and adolescents. Seventeen studies examined internalizing problems, and 11 studies examined externalizing problems. For both children and toddlers, recent cohorts did not exhibit worsening of mental health symptoms. In adolescents, the burden of externalizing problems appear to be stable. However, the majority of studies report an increase in internalizing problems in adolescent girls. The findings for internalizing problems in boys were mixed.

Conclusions: These findings suggest that recent cohorts of adolescent girls are experiencing increases in internalizing symptoms compared to previous cohorts. Approaches for prevention and early intervention should be explored.
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http://dx.doi.org/10.1177/0004867414533834DOI Listing
July 2014

A randomized, controlled, crossover trial of fish oil treatment for impulsive aggression in children and adolescents with disruptive behavior disorders.

J Child Adolesc Psychopharmacol 2014 Apr 1;24(3):140-8. Epub 2014 Apr 1.

1 Kids in Mind Research, Mater Research , Mater Health Services, South Brisbane, QLD, Australia .

Objective: Epidemiological research links aggression to low serum concentrations of omega-3 fatty acids, such as those found in fish oil. However, no studies have specifically examined whether fish oil supplementation can reduce the frequency and severity of impulsive aggression in children with disruptive behavior disorders.

Methods: Children presenting with impulsive aggression and meeting research criteria for diagnosis of disruptive behavior disorders were randomized to receive either: 1) Fish oil capsules (4 g daily) for 6 weeks followed by placebo (identical-looking capsules) for 6 weeks; or 2) placebo for 6 weeks, followed by fish oil for 6 weeks, in a double-blind, crossover design. Primary outcomes were the Children's Aggression Scale and the Modified Overt Aggression Scale. Secondary outcomes included emotional and behavioral functioning (Strengths and Difficulties Questionnaire [SDQ]), hyperactivity symptoms (Attention-Deficit/Hyperactivity Disorder [ADHD] Rating Scale), family functioning (Family Assessment Device), and cognitive functioning (Stop Signal Task, Trail-Making Task, and Eriksen Flanker Task). Serum concentrations of omega-3 and omega-6 fatty acids were measured at baseline, and at 6 and 12 weeks.

Results: Twenty-one children participated (81% male; mean age 10.3±2.2 years; range 7-14). Fish oil treatment increased serum concentrations of eicosapentanoic acid (F=14.76, p<0.05) and total omega-3s (F=20.56, p<0.05), but did not influence primary ratings of aggression. In fact, a trend suggested that fish oil worsened a secondary measure of aggression (SDQ Conduct Subscale, F=4.34, p=0.06). Fish oil treatment was associated with an improvement in one rating of hyperactivity (SDQ Hyperactivity Subscale, F=2.22, p<0.05), but did not influence any other outcome measures.

Conclusions: These findings suggest that fish oil treatment does not improve aggression in children with disruptive behavior disorders.
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http://dx.doi.org/10.1089/cap.2013.0093DOI Listing
April 2014

Family structure, marital discord and offspring's psychopathology in early adulthood: a prospective study.

Eur Child Adolesc Psychiatry 2013 Nov 15;22(11):693-700. Epub 2013 Aug 15.

School of Population Health, University of Queensland, Herston Road, Herston, QLD, 4006, Australia,

With marital breakdown and discord relatively common, we examined whether family structure and the quality of marital relationship have a long-term impact on offspring's psychopathology in early adulthood. This study aimed to examine the association of family structure and marital discord in the family with a wide range of offspring's mental health and problem behaviours at 21 years. Data were from the Mater-University of Queensland Study of Pregnancy, a population based birth cohort study, which commenced in Brisbane, Australia in 1981. Mothers and children were followed up at birth, 6 months and 5, 14 and 21 years after the initial interview. Marital status and marital quality were assessed at the 14 year follow-up. Young Adult Self-Report sub-scales of mental health and problem behaviours were measured at the 21-year follow-up. Type of family structure and the quality of marital relationship (at the 14-year follow-up) predicted offspring's psychopathology at 21 years. When a selected group of confounding factors were included in the multivariate analyses, children who lived with a step-father, un-partnered mother, or in families where parents had conflict in marital relationship reported higher symptoms of psychopathology at 21 years. The association between marital problems and young adult psychopathology does not appear to be confounded by a wide range of confounding variables. Further research is needed to explore the mechanism of these associations to develop preventive programmes.
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http://dx.doi.org/10.1007/s00787-013-0464-0DOI Listing
November 2013

Can a multi-disciplinary assessment approach improve outcomes for children with attention deficit hyperactivity disorder?

Australas Psychiatry 2013 Oct 29;21(5):499-503. Epub 2013 Jul 29.

Director, Kids in Mind Research, Mater Medical Research Institute, Mater Hospital, Brisbane, QLD, Australia.

Objective: Public, consumer and professional views about attention deficit hyperactivity disorder, its assessment and treatment - especially with medication - remain a highly contested domain. Parents in particular express disquiet with services. One response to this tension is a multidisciplinary evaluation. Parental and education perceptions of this process have not been evaluated previously. A community multidisciplinary approach was assessed in terms of diagnostic outcomes and client satisfaction.

Method: A comprehensive multidisciplinary structured assessment of the first 50 referred children with severe attentional problems was documented. Demographic and symptom/behavioural profiles, developmental history and indicated multi-disciplinary evaluation were recorded. A team consensus process arrived at diagnostic classification. Post-assessment satisfaction of parents and school staff was surveyed.

Results: Thirteen children (26%) were diagnosed with attention deficit hyperactivity disorder and three commenced stimulants. The majority of parents and educators were satisfied with the service.

Conclusions: A multidisciplinary assessment clinic for children presenting with attention problems resulted in minimal prescribing. Overall, education staff and parents were satisfied with the service. The model may be a suitable response to the multiple concerns in the community.
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http://dx.doi.org/10.1177/1039856213497524DOI Listing
October 2013

Therapy implications of child abuse in multi-risk families.

Australas Psychiatry 2013 Aug 26;21(4):389-92. Epub 2013 Jun 26.

University of Queensland, South Brisbane, QLD, Australia.

Objectives: Our aim is to critique Australian child maltreatment policy, outline abuse trends and provide data on family risk factors.

Method: We identified policy gaps and reviewed family profiles within selective child maltreatment databases. Data sources included international and Australian literature, Queensland Department of Child Safety reports and a research clinical database.

Results: Data reviewed suggest that a pattern of co-occurring complex multiple system family problems characterize substantiated abuse cases.

Conclusions: The presence of multiple family problems suggests the need for a new treatment paradigm. Multisystemic Therapy for child physical abuse and neglect is an evidence-based intervention that matches the therapeutic needs of such families.
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http://dx.doi.org/10.1177/1039856213492350DOI Listing
August 2013

The association between adult attachment style and delusional-like experiences in a community sample of women.

J Nerv Ment Dis 2013 Jun;201(6):525-9

Department of Psychiatry, Princess Alexandra Hospital, Woolloongabba, Australia.

Community-based surveys have found that many otherwise well individuals endorse delusional-like experiences (DLEs). There is extensive literature that describes the demographic and psychosocial correlates of DLE; however, we know little about the association between DLE and attachment style. The association between DLEs (assessed by the Peters Delusional Inventory [PDI]) and interpersonal relationship style (as assessed by the Adult Attachment Questionnaire and the Dyadic Adjustment Scale) was examined in 3360 women. When adjusted for the presence of depressive and anxiety symptoms, high scores on the PDI (lowest versus highest quartiles) were associated with a) difficulties in adult attachment style particularly in the discomfort with closeness and preoccupation with relationships subscales and b) conflictual dyadic adjustment (adjusted odds ratios and 95% confidence intervals, 2.43 and 1.94-3.04, 2.50 and 1.99-3.14, and 2.90 and 1.38-6.06, respectively). The association between adult attachment style and DLE provides new clues into the causal pathway underpinning these common experiences.
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http://dx.doi.org/10.1097/NMD.0b013e318294a257DOI Listing
June 2013

Early childhood predictors of age of initiation to use of cannabis: a birth prospective study.

Drug Alcohol Rev 2013 May 14;32(3):232-40. Epub 2012 Oct 14.

School of Population Health, University of Queensland, Brisbane, Australia.

Introduction And Aims: Early age of cannabis use predicts subsequent illicit drug abuse and other psychosocial problems. Identification of factors associated with early cannabis use may contribute to the development of preventive interventions. This study aimed to examine the early life predictors of age of initiation to cannabis.

Design And Methods: Data were from Mater Hospital and University of Queensland Study of Pregnancy, a population-based prospective birth cohort study. Participants were a cohort of 3488 young adults who self-reported frequency and age of onset of cannabis use at the 21 year follow up.

Results: Of 3488 young adults, 48.9% (51.8% men and 46.4% women) reported having ever used cannabis. For those who had ever used cannabis, age of onset had mean and median of 15.8 and 16.0 years, respectively. In multivariate analysis child's gender, change in maternal marital status, quality of marital relationship, maternal cigarette smoking and alcohol consumption and maternal depression when the child was 5 years statistically significantly predicted age of initiation to cannabis use.

Discussion And Conclusions: The present study explores the impact of early childhood factors associated with age of onset of cannabis use. It is suggested that the family environment within which children are reared, including factors such as parents' marital circumstances, has a major influence on initiation to cannabis use in adolescence. Research is needed to disentangle the pathways of association between these early life factors and early initiation to use of cannabis.
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http://dx.doi.org/10.1111/j.1465-3362.2012.00520.xDOI Listing
May 2013

Long-term outcomes of infant behavioral dysregulation.

Pediatrics 2012 Nov 1;130(5):e1243-51. Epub 2012 Oct 1.

Mater Children's Hospital, Raymond Terrace, South Brisbane, Queensland, Australia.

Objectives: To determine whether maternal report of infant behavioral dysregulation at 6 months is associated with a higher prevalence of behavioral concerns at 5, 14, and 21 years of age; and to assess the extent to which maternal and social factors may affect reported child behavior outcomes.

Methods: From the Mater-University of Queensland Study of Pregnancy cohort of 7223 live singleton babies, information on dysregulation was available for 6389 children at 6 months. Of those children, behavior data were available for 4836 at 5 years by using a modified Child Behavior Checklist, 4746 at 14 years by using a full Child Behavior Checklist and Youth Self-Report, and 3558 at 21 years by using a Young Adult Self-Report. Of the youth with dysregulation data at 6 months, 2308 completed the Composite International Diagnostic Interview at 21 years. Potential confounding and mediating factors were analyzed by using logistic regression.

Results: Maternal-reported behavioral dysregulation at 6 months was associated with a significantly higher prevalence of maternal-reported behavior problems at 5 and 14 years (P < .001), but not youth self-reported problems at 14 or 21 years, or Composite International Diagnostic Interview-Diagnostic and Statistical Manual diagnoses at 21 years. The strength of association between infant dysregulation and maternal-reported behaviors was greater at 5 years than at 14 years, and was substantially reduced by adjusting for maternal, social, and infant factors, especially potentially the mediating factors of maternal anxiety and depression.

Conclusions: Infant behavioral dysregulation was a risk factor for maternal-reported behavior concerns at 5 and 14 years, although was unrelated to young adult mental health.
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http://dx.doi.org/10.1542/peds.2010-3517DOI Listing
November 2012

Association of breastfeeding and adolescents' psychopathology: a large prospective study.

Breastfeed Med 2012 Dec 21;7(6):480-6. Epub 2012 May 21.

School of Population Health, The University of Queensland, Herston, Queensland, Australia.

Purpose: There is little known about the association between breastfeeding and long-term child psychopathology. This study aimed to examine the impact of breastfeeding on child mental health and problem behavior at 14 years and whether this association is confounded by other variables.

Subjects And Methods: Data were from a pre-birth prospective study that included mothers and their children followed up from pregnancy to 14 years of the child's age in Brisbane, Australia. The child's anxiety/depression, withdrawal problems, somatic complaints, social problems, thought problems, attention problems, aggression, and delinquency were measured using the Achenbach Youth Self Report at 14 years. Breastfeeding was prospectively assessed at the 6-month follow-up of the study. The analysis was based on 4,502 adolescents who responded to the YSR questionnaire and for whom prospective data were available on breastfeeding.

Results: Breastfeeding as reported by mothers when the child was 6 months old predicted reduced symptoms of child mental health and problem behavior at 14 years. The impact of breastfeeding on the child's social problems, attention problems, and aggressive behavior remained statistically significant after controlling for the effect of other variables, such as unplanned pregnancy, maternal mental health, and substance use during pregnancy.

Conclusions: Our data suggest that breastfeeding for at least 4 months can have a significant protective effect on a child's social, attention, and aggression problems in early adolescence. Given the limitations of the existing evidence, further research is needed to investigate the robustness of the findings of this study and the mechanisms of long-term association between breastfeeding and reduced social, attention, and aggression problems of the offspring in adolescence.
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http://dx.doi.org/10.1089/bfm.2011.0136DOI Listing
December 2012

Sleepless nights: the effect of socioeconomic status, physical activity, and lifestyle factors on sleep quality in a large cohort of Australian women.

Arch Womens Ment Health 2012 Aug 15;15(4):237-47. Epub 2012 May 15.

School of Pharmacy, University of Queensland, Woolloongabba, Brisbane, QLD, Australia.

The aims of this study were to examine: (1) the association between sociodemographic and lifestyle factors and sleep quality in a population-based cohort of Australian women and (2) possible influence of reproductive status and mental and physical health factors on these associations. Data on 3,655 women (mean age = 46.6 years, range 34.3-67.4) were obtained from the Mater Hospital University of Queensland Study of Pregnancy for this cross-sectional study. Self-rated sleep quality was assessed using the Pittsburgh Sleep Quality Index. For the purpose of this study, two cutoff points (scores 5 and 10) were used to divide women into three categories: normal (65.2%), moderately poor (26.4%), and very poor sleep quality (8.5%). Other covariates were measured at 21-year follow-up as well. After adjusting for reproductive status, mental and physical health, there were significant associations between moderately poor sleep quality and education and between very poor sleep quality and unemployment, both measures of socioeconomic status. In addition, work-related exertion was associated with increased rates of moderately poor sleep quality, whereas those women undertaking moderate exercise were less likely to experience very poor sleep quality. Independent associations between sociodemographic factors and exercise with moderately poor and very poor sleep quality were identified. These findings demonstrate the dynamic nature of the association between exercise/exertion, socioeconomic status, and sleep quality and highlight the importance of taking these into consideration when dealing with issues of poor sleep quality in women.
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http://dx.doi.org/10.1007/s00737-012-0281-3DOI Listing
August 2012

Pre-trauma verbal ability at five years of age and the risk of post-traumatic stress disorder in adult males and females.

J Psychiatr Res 2012 Jul 8;46(7):933-9. Epub 2012 May 8.

School of Population Health, University of Queensland, Brisbane, Australia.

Previous studies have shown that high cognitive ability, measured in childhood and prior to the experience of traumatic events, is protective of PTSD development. Our aim was to test if the association between pre-trauma verbal ability ascertained at 5 years with DSM-IV lifetime post-traumatic stress disorder (PTSD) at 21 years was subject to effect modification by gender, trauma type or prior behaviour problems. Using a prospective birth cohort of young Australians, we found that both trauma type and behaviour problems did not change the association between cognitive ability and PTSD. During multivariate analysis, testing for the interactive effect of gender revealed that verbal ability was linearly and inversely associated with PTSD in females only, with those in the lowest verbal ability quintile having strongly increased odds of PTSD (OR=3.89: 95% CI; 1.50, 10.10) compared with those in the highest quintile. A graph of the interaction revealed lower verbal ability placed females, but not males, at an increased risk of PTSD. Our results indicate that lower verbal ability in early childhood is a vulnerability factor for PTSD in females but not in males, and may constitute a gender-specific risk factor responsible for part of the increased risk of PTSD found in females compared with males.
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http://dx.doi.org/10.1016/j.jpsychires.2012.04.002DOI Listing
July 2012

Young adults' gambling and its association with mental health and substance use problems.

Aust N Z J Public Health 2012 Apr 2;36(2):160-6. Epub 2012 Jan 2.

School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006.

Objective: To examine the socio-demographic characteristics of young adults' gambling and its association with mental health and substance use behaviour.

Methods: The study is based on 3,512 young adults (1648 males) for whom data from the Mater-University of Queensland Study of Pregnancy (MUSP) were available on self-report gambling, gambling expenditure, Achenbach's Young Adult Self Report and substance use at the 21-year follow-up of the MUSP. The participants' age ranged between 18.2 and 23.6 (mean = 20.6, standard deviation = 0.8) years.

Results: Two-fifths of the young adults reported gambling. Males reported more money spent on gambling and were significantly more likely to be at risk of problem gambling. Gambling and problem gambling were significantly more common in less-educated individuals, those who had higher income or those who had a paid job. Individuals who reported gambling were more likely to smoke cigarettes, drink more than a glass of alcohol per day, use illicit drugs, or exhibit high levels of externalising behaviour than non-gamblers.

Conclusions: The findings confirm the high prevalence of gambling and gambling expenditure in young adults. Individuals who are involved in gambling are more likely to report cigarette smoking, alcohol consumption, and use of illicit drugs. There is a need for further research to explore the mechanisms of association between gambling behaviour and individuals' mental health and substance use.

Implications: Substance abuse and mental health services are recommended to consider co-morbid gambling problems in treatment-seeking patients.
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http://dx.doi.org/10.1111/j.1753-6405.2011.00815.xDOI Listing
April 2012

Physical activity and intelligence: a causal exploration.

J Phys Act Health 2012 Feb;9(2):218-24

Griffith Health Institute and School of Psychology, Griffith University, Gold Coast, Australia.

Background: Studies involving animals and older adults suggest that physical activity (PA) might lead to improved cognitive ability in general, and enhanced intelligence scores (IQ) in particular. However, there are few studies involving young persons and none controlling for the possibility that those with better cognitive skills are more likely to engage in PA.

Methods: Data are from the Mater-University of Queensland Study of Pregnancy. We measured IQ at the 14-year follow-up and IQ and PA at 21 years. Mean IQ scores are presented at the 21-year follow-up adjusted for IQ at 14 years, and PA and other variables.

Results: Measures of vigorous exercise, less vigorous exercise, walking, and vigorous activity apart from exercise, produced inconsistent results. Increased levels of less vigorous exercise were associated with higher IQ, but neither higher levels of vigorous exercise nor walking were associated with IQ. For vigorous activity at work or in the home, the associations are curvilinear, with more and less activity both associated with lower IQ.

Conclusions: While there is an association between some indicators of PA and IQ, there was no consistent evidence that higher PA levels might lead to increased IQ scores.
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http://dx.doi.org/10.1123/jpah.9.2.218DOI Listing
February 2012

Longitudinal analysis of maternal risk factors for childhood sexual abuse: early attitudes and behaviours, socioeconomic status, and mental health.

Aust N Z J Psychiatry 2011 Aug 30;45(8):629-37. Epub 2011 Jun 30.

School of Population Health and Centre for Youth Substance Abuse Research, University of Queensland, Herston Road, Herston, Queensland 4006, Australia.

Objective: The objective of this study was to examine whether maternal factors such as socioeconomic status (SES), attitudes towards the baby, and mental health at 6 months or earlier, are associated with non-penetrative and penetrative childhood sexual abuse (CSA) in her offspring.

Methods: This was a prospective birth cohort study followed up to 21 years. Set in one of two obstetric hospitals in Brisbane, Australia, the Mater-University of Queensland Study of Pregnancy (MUSP) involves a prospective birth cohort from a population based sample of 7223 singletons whose mothers were enrolled between 1981 and 1984 at the first antenatal visit. The present cohort consisted of 2664 participants who provided CSA data, and whose mothers had responded to all relevant questions.

Results: About 16% of young adults reported non-penetrative sexual abuse before the age of sixteen and 9% reported penetrative abuse. After adjusting for all variables in the model, an increased risk for non-penetrative CSA was associated with the child being female, unwanted pregnancy, mother being a heavy smoker, and maternal anxiety. Increased risk for penetrative CSA was associated with the child being female, the mother having failed to complete a high school level education, living in an alternative arrangement other than marriage, and being either a moderate or heavy smoker. We found no associations between maternal age and CSA after correcting for other predictors.

Conclusion: CSA was not uncommon in this cohort with one in four reporting some form of sexual abuse before 16. The results suggest that several early factors may predict later CSA and that the associations are different according to type of CSA.
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http://dx.doi.org/10.3109/00048674.2011.587395DOI Listing
August 2011

Speech concerns at 5 years and adult educational and mental health outcomes.

J Paediatr Child Health 2011 Jul 28;47(7):423-8. Epub 2011 Jun 28.

Child Development and Rehabilitation Services, Mater Children's Hospital, Mater Health Services, South Brisbane, Queensland, Australia.

Aim: To determine if parent-reported speech concerns at 5 years predict poorer educational and mental health outcomes at 21 years independent of social context and child's receptive language, behaviour and motor concerns at 5 years. To determine if these adult outcomes are mediated by school performance at 14 years.

Methods:   Information on speech concerns at 5- and 21-year outcomes was available for 3193 participants from a birth cohort of 7223 infants. At 5, child behaviour was measured using a behavioural checklist, and at 21 years, it was measured by the Young Adult Self-Report. Peabody Picture Vocabulary Test-Revised at 5 years was not available for all children. Maternal mental health and social information at 5 years and educational outcomes at 14 years and 21 years were collected prospectively by questionnaire. Potential confounding and mediating factors were analysed using logistic regression.

Results: Children with speech concerns were less likely to have completed secondary school (P < 0.01) or gained better overall position (OP) scores (P < 0.001). OP scores rank students in Queensland applying for tertiary entrance. There was no association with mental health outcomes. Findings were independent of maternal and social factors, and motor concerns, though attenuated by behaviour and Peabody Picture Vocabulary Test-Revised scores. In the model adjusted for these factors, any concerns predicted OP score 1-11 (odds ratio 0.58; 95% confidence interval 0.42, 0.79), though if academic functioning at 14 was included, no associations were significant.

Conclusion: Maternal-reported speech concerns at 5 years predict poorer educational though not adult mental health outcomes.
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http://dx.doi.org/10.1111/j.1440-1754.2010.01994.xDOI Listing
July 2011

School performance and alcohol use problems in early adulthood: a longitudinal study.

Alcohol 2011 Nov 2;45(7):701-9. Epub 2011 Mar 2.

School of Population Health, University of Queensland, Herston, Queensland 4006, Australia.

There is inconsistent evidence about the association between school performance and subsequent use of alcohol and alcohol problems in adolescents and young adults. This study examines whether school performance at 14 years is associated with drinking problems in early adulthood; and whether this association is explained by family and individual factors in childhood and adolescence. Data were from a 21-year follow-up of 3,478 Australian young adults from birth to the age of 21 years when data on use of alcohol were collected. Child school performance (CSP) was assessed at 14 years via self- and maternal report. Alcohol consumption at 21 years was measured via self-report, and alcohol abuse and dependence were assessed by the computerized version of Composite International Diagnostic Interview (CIDI-Auto). Potential confounding factors were prospectively measured between the child's birth and age of 14 years. School performance at 14 years predicted young adults' alcohol consumption and alcohol use disorders (AUDs). After controlling for confounding, children who had lower school performance had increased risk of drinking more than two glasses of alcohol per day in early adulthood (odds ratio=1.7; 95% confidence interval: 1.1-2.6). There was a similar pattern of association between CSP and young adults' alcohol abuse and dependence (AUD) measured by CIDI-Auto. Level of academic performance in high school children predicts their drinking problems as young adults, independently of a selected group of individual and family confounders. Exploration of the pathway linking school performance and alcohol problems in young people may help identify opportunities for preventive interventions.
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http://dx.doi.org/10.1016/j.alcohol.2010.10.009DOI Listing
November 2011

Interactions between the COMT Val108/158Met polymorphism and maternal prenatal smoking predict aggressive behavior outcomes.

Biol Psychol 2011 Apr 26;87(1):99-105. Epub 2011 Feb 26.

Department of Psychology, 36 Eagle Row, Emory University, Atlanta, GA 30322, USA.

The purpose of the current study is to examine the moderating influence of the catechol O methyltransferase gene (COMT) on the maternal prenatal smoking/offspring externalizing disorder relationship. The sample consisted of 430 young adults born between 1981 and 1984 at the Mater Misericordiae Mother's Hospital in Brisbane, Australia, as well as their mothers and peers. Mothers reported their prenatal smoking status during pregnancy, and genetic data was obtained from the youth at a later follow-up in adulthood. The outcome measures in this study were mother and teacher reports of youth attention problems and aggression at age 15, and youth, mother and peer reports of youth attention problems and aggression at age 20 (combined to create latent factors of attention problems and aggression at each age). The COMT Val108/158Met polymorphism (rs4680) significantly interacted with maternal cigarette smoking during pregnancy to predict youth aggressive behavior at ages 15 and 20. This gene-environment interaction was not significant for youth attention problems.
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http://dx.doi.org/10.1016/j.biopsycho.2011.02.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081881PMC
April 2011

Child abuse and neglect and cognitive function at 14 years of age: findings from a birth cohort.

Pediatrics 2011 Jan 6;127(1):4-10. Epub 2010 Dec 6.

Department of Paediatrics, Logan Hospital, PO Box 4096, Loganholme DC 4129, Australia.

Objective: To examine the association between child maltreatment (abuse and neglect) and long-term cognitive outcomes within a prospective birth cohort.

Methods: A birth cohort of 7223 children was recruited. Independent reports of suspected child maltreatment were confidentially linked to the longitudinal study database. The principal predictor variable was notification to the state child-protection authority for suspected maltreatment (abuse, neglect, or both). The outcome variables were scores on the Wide Range Achievement Test (WRAT) reading test and Raven's Standard Progressive Matrices (RSPM), completed at 14 years of age. Multivariate regression analysis was used to adjust for potential confounders.

Results: A total of 3796 subjects completed either the WRAT or RSPM. There was a higher loss to follow-up among children who had been reported to the state as suspected victims of maltreatment. After controlling for a range of possible confounders and modifiers, notification to the state for child maltreatment (abuse, neglect, or both) was associated with a lower score on both the WRAT (mean difference: -4.4 when the SD is 15 [95% confidence interval: -6.3 to -2.5]) and RSPM (mean difference: -4.8 when the SD is 15 [95% confidence interval: -6.7 to -2.9]). Both reported abuse and neglect were independently associated with lower reading ability and perceptual reasoning.

Conclusions: Both child abuse and child neglect are independently associated with impaired cognition and academic functioning in adolescence. These findings suggest that both abuse and neglect have independent and important adverse effects on a child's cognitive development.
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http://dx.doi.org/10.1542/peds.2009-3479DOI Listing
January 2011

Relationship between childhood short stature and academic achievement in adolescents and young adults--a longitudinal study.

J Paediatr Child Health 2010 Nov;46(11):660-7

Queensland Health, Paediatrics and Child Health University of Queensland, Queensland, Australia.

Aim: To determine if short stature at 14 or 21 years and patterns of 'catch-up' growth from 5 to 14 or 21 years are related to academic achievement in adolescents.

Methods: The Mater University of Queensland Study of Pregnancy is a longitudinal study of 7223 singleton infants born between 1981 and 1984. Data were available for cross-sectional analyses of 3785 adolescents of whom 2149 were seen as young adults. Longitudinal patterns of growth were examined for 2936 subjects from 5 to 14 years and 1753 subjects from 5 to 21 years.

Results: Adolescents or young adults with height <10th centile had a lower mean Wide Range Achievement Test (WRAT) score in adolescence and at 21 years than those of normal height (2.7 and 3.0 points, respectively) and increased odds of a WRAT score <85 (1.57 and 1.87, respectively) and learning difficulties (1.61 and 1.78, respectively). For growth patterns from 5 to 14 years, adolescents short at 5 years, irrespective of height at 14 years, had a lower mean WRAT score and increased odds of WRAT score <85 and learning difficulties. However, for growth patterns from 5 to 21 years, only the group short at both ages had increased learning difficulties.

Conclusions: Youth short at 14 years or at 21 years and those persistently short have an increased prevalence of academic difficulties. Catch-up growth by 21, although not 14 years, was associated with improved outcomes.
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http://dx.doi.org/10.1111/j.1440-1754.2010.01816.xDOI Listing
November 2010
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