ABSTRACT Clinical home visitation (CHV) was empirically tested in a randomized study to determine if it could reduce a child's externalizing behaviors while alleviating parental stress. Clinic-referred waitlisted young children (n = 33) with symptoms suggesting an externalizing disorder were randomly offered a CHV intervention composed of a developmentally guided dyadic-centered syllabus. Families were recruited to participate in an experimental (n = 21) or control group (n = 12). Mothers completed the Parenting Stress Index (PSI) and the Child Behavior Checklist. Results of paired-samples t-tests indicated that postintervention aggression scores were significantly different from the pretest scores for the entire sample. The Difficult Child domain was the only significant PSI subscale. The results did not support definitive conclusions about CHV as an effective intervention to reduce an externalizing disorder or to alleviate parenting stress. Future research should include larger numbers of children with externalizing disorders pooled from the clinic-referred and community samples. To address the complexities involved in treating externalizing disorders, CHV could be offered as part of a multimodal intervention (e.g., CHV combined with parent and family education).
Background : Latent liability for schizophrenia (schizotypy) is expressed in various combinations of cognitive, psychological, and behavioural characteristics evident in the general population. Historical models propose that distinct classes of individuals expressing different forms of schizotypy may represent manifestations of differential levels of genetic and environmental risk for schizophrenia (or related illness). However, there has been little investigation of developmental models of schizotypy in childhood. Here, we sought to delineate latent profiles of schizotypy among children aged 11–12 years, and to examine associations between emerging schizotypal profiles and parental history of mental illness (as a proxy for genetic risk), early life trauma, and childhood contact with health services for mental illness up to age 13 years. Methods : Latent profiles of schizotypy were distinguished among 22,137 children (mean age=11.9 years) for whom intergenerational records of health service contact for mental illness and child protection reports were linked to the Middle Childhood Survey (MCS) within the NSW Child Development Study.1 Selected MCS items were used to index schizotypy across six domains (Unusual Experiences, Cognitive Disorganisation, Impulsive Nonconformity, Introversion, Dysphoria and Self-Other disturbance). Using Latent Profile Analyses (LPA), four groups emerged according to patterns of expression across these domains; membership of three putative schizotypy groups were examined in relation to the likelihood of being exposed to childhood maltreatment and parental mental illness, and the child’s own mental illness up to age 13 years, relative to the no risk group. Results : Four classes emerged from the LPA: (1) ‘schizotypy’ (n=1323; 6%); (2) ‘dysphoric pseudo-schizotypy’ (n=4261, 19%); (3) ‘introverted pseudoschizotypy’ (n=4473; 20%) and; (4) ‘no psychopathology’ (no-risk, n=12,080; 55%). Children in the schizotypy group had the greatest odds of being the subject of a child protection report (OR=2.9, 95% CI 2.6–3.3) and in contact with health services for mental illness by age 13 years (OR=2.7, 95% CI 2.2–3.3), relative to the no-risk group. The odds of child protection reports and childhood mental disorders were smaller, yet significantly increased, among dysphoric pseudo-schizotypy (ORs=1.9 and 1.8, respectively) and introverted pseudo-schizotypy (ORs=1.7 and 1.4, respectively), relative to the no-risk group. Parental mental illness exposure was greatest among the schizotypy (OR=2.3, 95% CI 2.0–2.6) subgroup, and was also increased in dysphoric pseudo-schizotypy (OR=1.6, 95% CI 1.5–1.8) and introverted pseudo-schizotypy (OR=1.4, 95% CI 1.3–1.5), relative to the no-risk group. Discussion : We provide evidence for distinct subtypes of children expressing different forms of schizotypy among a large Australian sample from the general population. The subgroup of children labeled ‘schizotypy’ (6%) characterized by high levels of cognitive disorganisation, impulsive non-conformity, introversion, and self-other disturbance may be at highest risk for developing schizophrenia or other mental illness in adulthood, and had a greater likelihood of childhood maltreatment and parental mental illness history, than other ‘pseudo-schizotypy’ groups.
Several pre/perinatal factors (e.g., birth complications, maternal substance use, low birth weight) have been associated with early neuropsychological deficits and negative behavioural outcomes in infancy, childhood, and adolescence. The current study examines the relationship between maternal substance use during pregnancy and its impact on physical aggression and sexual behaviours in a sample of preschoolers. This study is based on a sample of children (<em>n</em> = 129), boys and girls, recruited as part of the KD-BEAR project, an ongoing longitudinal study conducted in Vancouver, British Columbia, Canada. The sample consisted of clinical referrals for an externalizing disorder and children recruited in daycares located in at-risk neighbourhoods. Semi-structured interviews were completed with the primary caregiver. A series of structural equation modelling showed that children showing higher levels of physical aggression and sexual behaviours were more likely to have been exposed to maternal substance use and pregnancy-related complications. Implications of the study are discussed in light of the scientific literature on the early prevention of aggression and violence.
Abstract Background and Hypothesis Schizotypy provides a framework for understanding the developmental nature of psychotic disorders and a means of identifying “at-risk” individuals early in the lifespan. However, there is a lack of prospective longitudinal research examining the relationship between schizotypy in childhood and later psychotic and other mental disorders. We hypothesized that distinct profiles of schizotypy in childhood would be differentially associated with psychotic and other mental disorders emerging later in adolescence. Study Design In a large population cohort of Australian young people (n = 26 837), we prospectively examined the relationship between person-centered profiles of schizotypy identified in middle childhood (age ~11 years) and adolescent diagnoses (age ~13–18 years) across 7 types of mental disorders using multinomial logistic regression. Results Membership in any of 3 childhood schizotypy profiles (true schizotypy, affective schizotypy, or introverted schizotypy) was associated with an increased likelihood of being diagnosed with any type of mental disorder in adolescence; effects were strongest for the true schizotypy group (aOR = 3.07, 95% CI = 2.64, 3.57), followed by the introverted (aOR = 1.94, 95% CI = 1.75, 2.15) and affective (aOR = 1.29, 95% CI = 1.13, 1.47) schizotypy groups. Six of the 7 types of mental disorders measured (including psychotic disorders) were associated with at least 1 schizotypy group. Conclusions Schizotypy in middle childhood is an important correlate of mental disorders in adolescence; however, it does not appear to be specifically associated with psychotic disorders in this age group.
Currently, there is a limited number of reliable and valid assessment tools for multi-problem youth which can be used at the earliest developmental stages (e.g., conception to birth and early childhood — birth through age 5). The current study examined a revised version of the CRACOW, a risk/needs instrument for multi-problem violent youth in early childhood which was first proposed by Corrado (2002). The CRACOW was designed to be a multi-stage instrument representing the risk/needs factors in youth at various developmental stages, starting at the pre/perinatal period and extending to adolescence to account for exposure and accumulation of a number of dynamic risk factors that may influence the risk of youth violence. The instrument was designed to be comprehensive, parsimonious, while being theoretically and empirically guided to assist government and community agencies in developing individual, familial, and community interventions intended to reduce the risk of youth violence.
The CRACOW is an assessment tool that includes three interrelated sections. The first section refers to the risk/needs factors associated with multi-problem youth. The CRACOW takes into consideration that some of these factors operate earlier than others in the child’s development, whether it is at birth, early childhood, middle/late childhood, or adolescence. The second section refers to treatment interventions, more specifically the parents and the child responses to all interventions aimed at the risk/needs factors. Finally, the third section allows for the assessment of externalizing behaviours, including aggression and violence.
The current study examines the validity of the first section of the CRACOW instrument. More specifically, the study tests whether the risk/needs factors in early childhood included in the CRACOW help to identify the most physically aggressive preschoolers. The study is based on the first 100 children (boys, n=58; girls, n=42) recruited as part of the Vancouver Longitudinal Study on the Psychosocial Development of Children (KD-BEAR Project; Kids’ Development of Behavioural, Emotional and Aggression Regulation) conducted in Vancouver, British Columbia, Canada. The KD-BEAR Project is an on-going longitudinal project, which aims to inform policymakers about the key early risk and protective factors of aggression and violence in at-risk children from the earliest developmental periods.
Abstract Background The transition from primary to secondary school presents a challenging developmental milestone which often marks a decline in academic performance. Social–emotional skills are recognized as fundamental to academic success but longitudinal research is needed to determine the extent of their association over this transition period. Aim This study sought to determine the association between self‐reported social–emotional competencies of students in their final year of primary school (Year 6; age ~11 years) and reading and numeracy performance in their first year of secondary school (Year 7; age ~12 years). Sample The study used a large Australian sample ( n = 23,865), drawn from the New South Wales Child Development Study population cohort. Methods The Middle Childhood Survey–Social–Emotional Learning assessment, administered during Year 6, comprises the five competencies defined by the Collaborative for Academic, Social and Emotional Learning (CASEL): Self‐Awareness, Self‐Management, Social Awareness, Relationship Skills and Responsible Decision‐Making. These data were linked with students' Year 7 reading and numeracy scores from the standardized National Assessment Program–Literacy and Numeracy measure. Associations were examined in multi‐level structural equation models which accounted for prior (Year 5) academic achievement and sociodemographic covariates. Multi‐group analyses explored invariance across girls and boys. Results Self‐Awareness and Self‐Management demonstrated significant and meaningful positive relationships with reading and numeracy performance. Associations with reading were invariant by sex but boys demonstrated significantly stronger associations than girls on numeracy. Conclusion Findings suggest that bolstering primary school students' intrapersonal social–emotional competencies may safeguard their academic achievement over the transition into secondary school.
Objectives: The rate of mental health services provided to children and young people is increasing worldwide, including in Australia. The aim of this study was to describe patterns of hospital and ambulatory mental health service use among a large population cohort of adolescents followed from birth, with consideration of variation by age, sex and diagnosis. Methods: Characteristics of services provided for children with mental disorder diagnoses between birth and age 17.5 years were ascertained for a population cohort of 85,642 children (52.0% male) born between 2002 and 2005, from ‘Admitted Patients’, ‘Emergency Department’ and ‘Mental Health Ambulatory’ records provided by the New South Wales and Australian Capital Territory Health Departments. Results: A total of 11,205 (~13.1%) children received at least one hospital or ambulatory health occasion of service for a mental health condition in the observation period. More than two-fifths of children with mental disorders had diagnoses spanning multiple categories of disorder over time. Ambulatory services were the most heavily used and the most common point of first contact. The rate of mental health service contact increased with age across all services, and for most categories of mental disorder. Girls were more likely to receive services for mental disorders than boys, but boys generally had an earlier age of first service contact. Finally, 3.1% of children presenting to mental health services experienced involuntary psychiatric inpatient admission. Conclusions: The extent of hospital and ambulatory-based mental healthcare service among children emphasises the need for primary prevention and early intervention.
Several policies have been implemented to manage the risk of sex offenders in the community. These policies, however, tend to target older repeat sex offenders. This is the first study to examine and describe the offending trajectories of adult sex offenders from early adolescence to adulthood. The current study is based on a quasipopulation of convicted adult sex offenders in the province of Quebec, Canada. The number of convictions was examined from the period of adolescence up to age 35 using a group-based modeling technique. The study uncovered four offending trajectories: (a) very low-rate group (56%); (b) late-bloomers (12%); (c) low-rate desistors (25%); and (d) high-rate chronics (8%). These trajectories differed on several key criminal career dimensions such as age of onset, frequency, diversity, and specialization in different offence types. The study findings challenge the conception of sex offenders’ risk as high, stable, and linear. The implications for the risk assessment and the risk prediction of recidivism are discussed.
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