RESUMEN
Spatial life course epidemiological approaches offer promise for prospectively examining the impacts of air pollution exposure on longer-term health outcomes, but existing research is limited. An essential aspect, often overlooked is the comprehensiveness of exposure data across the lifecourse. The primary objective was to meticulously reconstruct historical estimates of air pollution exposure to include prenatal exposure as well as annual exposure from birth to 10 years (1977-1987) for each cohort member. We linked these data from a birth cohort of 1,265 individuals, born in Aotearoa/New Zealand in mid-1977 and studied to age 40, to historical air pollution data to create estimates of exposure from birth to 10 years (1977-1987). Improvements in air quality over time were found. However, outcomes varied by demographic and socioeconomic factors. Future research should examine how inequitable air pollution exposure is related to health outcomes over the life course.
Asunto(s)
Contaminación del Aire , Exposición a Riesgos Ambientales , Nueva Zelanda/epidemiología , Humanos , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Femenino , Masculino , Exposición a Riesgos Ambientales/efectos adversos , Adulto , Embarazo , Cohorte de Nacimiento , Preescolar , Lactante , Recién Nacido , Estudios de Factibilidad , Niño , Efectos Tardíos de la Exposición Prenatal/epidemiología , Estudios de Cohortes , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/efectos adversos , Adulto Joven , AdolescenteRESUMEN
Attention problems are common in school-age children born very preterm (VPT; < 32 weeks gestational age), but the contribution of aberrant functional brain connectivity to these problems is not known. As part of a prospective longitudinal study, brain functional connectivity (fc) was assessed alongside behavioral measures of selective, sustained, and executive attention in 58 VPT and 65 full-term (FT) born children at corrected-age 12 years. VPT children had poorer sustained, shifting, and divided attention than FT children. Within the VPT group, poorer attention scores were associated with between-network connectivity in ventral attention, visual, and subcortical networks, whereas between-network connectivity in the frontoparietal, cingulo-opercular, dorsal attention, salience and motor networks was associated with attention functioning in FT children. Network-level differences were also evident between VPT and FT children in specific attention domains. Findings contribute to our understanding of fc networks that potentially underlie typical attention development and suggest an alternative network architecture may help support attention in VPT children.
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Atención/fisiología , Encéfalo/diagnóstico por imagen , Conectoma/métodos , Recien Nacido Extremadamente Prematuro , Red Nerviosa/diagnóstico por imagen , Encéfalo/crecimiento & desarrollo , Niño , Femenino , Humanos , Recien Nacido Extremadamente Prematuro/crecimiento & desarrollo , Recién Nacido , Estudios Longitudinales , Imagen por Resonancia Magnética/métodos , Masculino , Red Nerviosa/crecimiento & desarrollo , Estudios ProspectivosRESUMEN
Individuals born very preterm (<32 weeks gestation) are at increased risk for neuromotor impairments. The ability to characterize the structural and functional mechanisms underlying these impairments remains limited using existing neuroimaging techniques. Resting state-functional magnetic resonance imaging (rs-fMRI) holds promise for defining the functional network architecture of the developing brain in relation to typical and aberrant neurodevelopment. In 58 very preterm and 65 term-born children studied from birth to age 12 years, we examined relations between functional connectivity measures from low-motion rs-fMRI data and motor skills assessed using the Movement Assessment Battery for Children, 2nd edition. Across all subscales, motor performance was better in term than very preterm children. Examination of relations between functional connectivity and motor measures using enrichment analysis revealed between-group differences within cerebellar, frontoparietal, and default mode networks, and between basal ganglia-motor, thalamus-motor, basal ganglia-auditory, and dorsal attention-default mode networks. Specifically, very preterm children exhibited weaker associations between motor scores and thalamus-motor and basal ganglia-motor network connectivity. These findings highlight key functional brain systems underlying motor development. They also demonstrate persisting developmental effects of preterm birth on functional connectivity and motor performance in childhood, providing evidence for an alternative network architecture supporting motor function in preterm children.
Asunto(s)
Ganglios Basales/fisiopatología , Cerebelo/fisiopatología , Corteza Cerebral/fisiopatología , Desarrollo Infantil/fisiología , Conectoma/métodos , Recien Nacido Extremadamente Prematuro/fisiología , Destreza Motora/fisiología , Red Nerviosa/fisiopatología , Tálamo/fisiopatología , Ganglios Basales/diagnóstico por imagen , Cerebelo/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Red Nerviosa/diagnóstico por imagen , Tálamo/diagnóstico por imagenRESUMEN
OBJECTIVE: Examine sources, predictors and child outcomes associated with neonatal intensive care unit (NICU)-related stress for mothers of infants born very preterm (VPT). STUDY DESIGN: Participants were 133 mothers of VPT infants admitted to a regional level-III NICU. At term equivalent, mothers completed the Parental Stressor Scale: NICU and were interviewed about their psychological well-being and family circumstances. Infant clinical data were also collected. At corrected age 4 years, 49 children were assessed for cognition, language and socio-emotional development. RESULT: Mothers reported moderate to low stress, with parental role alteration considered most stressful and parent-staff communications least stressful. Predictors of overall stress included maternal educational underachievement, stressful life events, postnatal depression and infant unsettled-irregular behavior. NICU-related stress was associated with child anxiety and poorer language development. CONCLUSION: Parental well-being is an important focus of care in the neonatal setting. Strategies are needed to optimize early engagement and reduce stress levels to assist improved child outcomes.
Asunto(s)
Desarrollo Infantil , Recién Nacido de muy Bajo Peso , Cuidado Intensivo Neonatal/psicología , Madres/psicología , Estrés Psicológico , Adulto , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Masculino , Nueva ZelandaRESUMEN
AIM: To investigate early medical and family factors associated with later feeding risk in preterm infants. METHODS: For this longitudinal study, 136 infants born ≤30 weeks gestation were enrolled. Medical and social background factors were assessed at term equivalent age. Infants underwent magnetic resonance imaging, neurobehavioral evaluation and feeding assessment. Parent involvement in the neonatal intensive care unit was tracked, and maternal mental health was assessed at neonatal intensive care unit discharge. At age 2 years, feeding outcome was assessed using the Eating Subscale of the Infant-Toddler Social Emotional Assessment (n = 80). Associations between feeding problems at age 2 years and (i) early medical factors, (ii) neurobehavioral functioning and feeding at term equivalent age, (iii) cerebral structure and (iv) maternal mental health were investigated using regression. RESULTS: Eighteen (23%) children had feeding problems at age 2 years. Feeding problems were associated with early hypotonia (p = 0.03; ß = 0.29) and lower socio-economic status (p = 0.046; ß = -0.22). No associations were observed between early medical factors, early feeding performance, cerebral structure alterations or maternal well-being and feeding outcome. CONCLUSION: Early hypotonia may disrupt the development of oral-motor skills. Hypotonia and poor feeding also may share a common aetiology. Associations with lower socio-economic status highlight the potential influence of family background factors in feeding problems in the preterm infant.
Asunto(s)
Trastornos de Ingestión y Alimentación en la Niñez/epidemiología , Recien Nacido Prematuro , Ansiedad , Cerebro/anatomía & histología , Preescolar , Nutrición Enteral , Conducta Alimentaria , Trastornos de Ingestión y Alimentación en la Niñez/etiología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Intubación , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Bienestar Materno , Missouri/epidemiología , Hipotonía Muscular/complicaciones , Factores Socioeconómicos , Estrés Psicológico/complicacionesRESUMEN
BACKGROUND: In this study, 30-year longitudinal data from the Christchurch Health and Development Study (CHDS) were used to examine the associations between childhood exposure to sexual abuse and intimate relationship outcomes at age 30. In addition, a broad range of early childhood and family confounding factors were tested, and the role of intervening factors from adolescence was explored. METHOD: The investigation analyzed data from a birth cohort of over 900 New Zealand adults studied to the age of 30. At ages 18 and 21 cohort members reported on any exposure to sexual abuse prior to age 16. This information, along with prospective data gathered in childhood and adolescence, was used to predict partnership outcomes at age 30. RESULTS: After adjustment for early childhood and family factors, exposure to more severe forms of childhood sexual abuse (CSA) was associated with earlier and more frequent cohabitation, higher rates of perpetrated interpartner violence (IPV), and early parenthood, lower relationship satisfaction and investment. Several factors from adolescence partially or fully mediated these associations, notably a history of early consensual sexual intercourse, higher number of sexual partnerships, substance abuse problems, and self-esteem. After adjustment for intervening factors, exposure to CSA remained significantly associated with IPV. CONCLUSIONS: The findings support a causal chain process, whereby early childhood and family factors place some individuals at risk for CSA. The extent of CSA exposure is related to adolescent risk taking, which in turn leads to early and more frequent cohabitation, risk of IPV, and lower relationship satisfaction and investment.
Asunto(s)
Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Composición Familiar , Relaciones Interpersonales , Adolescente , Adulto , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Factores de Riesgo , Adulto JovenRESUMEN
Ankylosing spondylitis can present significant challenges to the anaesthetist as a consequence of the potential difficult airway, cardiovascular and respiratory complications, and the medications used to reduce pain and control the disease. There is also an increased risk of neurological complications in the peri-operative period. Awake fibreoptic intubation is the safest option in those patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a definitive airway. Neurophysiological monitoring (somatosensory and motor evoked potentials) should be considered in patients undergoing surgery for cervical spine deformity. The medical management of the disease has improved with the use of anti-tumour necrosis factor-alpha agents. There is potential for increased wound infection in patients taking these drugs. This article reviews the anaesthetic issues in patients with ankylosing spondylitis. The challenge to the anaesthetist is in the understanding of these issues so that appropriate management can be planned and undertaken.
Asunto(s)
Anestesia/métodos , Espondilitis Anquilosante/complicaciones , Adulto , Antirreumáticos/uso terapéutico , Femenino , Humanos , Intubación Intratraqueal/métodos , Masculino , Espondilitis Anquilosante/diagnóstico , Espondilitis Anquilosante/tratamiento farmacológico , Espondilitis Anquilosante/cirugía , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adulto JovenRESUMEN
OBJECTIVES: Neurodevelopmental outcomes associated with preterm birth are of major health and educational concern. This study examined the neuromotor, cognitive, language and emotional/behavioural outcomes of a regional cohort of 4-year-old children born extremely preterm (EPT: 23-27 weeks' gestation), very preterm (VPT: 28-33 weeks) and full term (FT: 38-41 weeks). Of particular interest were children's risks of impairment across multiple neurodevelopmental domains. METHODS: Data were gathered as part of a prospective longitudinal study of 105 very preterm (< or = 33 weeks gestation) and 107 FT children born during 1998-2000. At 4 years corrected age, children underwent a comprehensive multidisciplinary assessment that included a paediatric neurological examination, cognitive and language testing, and an assessment of child emotional and behavioural adjustment. RESULTS: At age 4 years, compared to FT children, EPT and VPT children had increased risks of cerebral palsy (EPT 18%, VPT 15%, FT 1%), cognitive delay (EPT 33%, VPT 36%, FT 13%), language delay (EPT 29%, VPT 29%, FT 10%) and emotional/behavioural adjustment problems (EPT 37%, VPT 13%, FT 11%). EPT and VPT children were three times more likely to have multiple domain impairments than FT children (EPT 30%, VPT 29%, FT 10%). CONCLUSIONS: A substantial proportion of preschool children born very preterm show clinically significant problems in at least one neurodevelopmental domain, with impairment in multiple domains being common. There is a need to monitor preschool development across a range of functional domains and to consider the likely cascading effects of multiple impairments on later development.
Asunto(s)
Discapacidades del Desarrollo/psicología , Enfermedades del Prematuro/psicología , Discapacidades para el Aprendizaje/psicología , Trastornos Psicomotores/psicología , Desarrollo Infantil , Preescolar , Discapacidades del Desarrollo/epidemiología , Emociones , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/epidemiología , Discapacidades para el Aprendizaje/epidemiología , Masculino , Nueva Zelanda/epidemiología , Trastornos Psicomotores/epidemiología , Valores de ReferenciaRESUMEN
Group A streptococcal sepsis is an uncommon management challenge and has a potentially fulminate course. We present the case of a 25-year-old woman who, within 24h of spontaneous vaginal delivery at 32 weeks of gestation, developed signs of systemic infection and multi-organ failure requiring admission to the intensive care unit. Recombinant human activated protein C and intravenous immunoglobulin were used; subsequently heparin-induced thrombocytopenia and pulmonary embolus also required treatment.
Asunto(s)
Inmunoglobulinas Intravenosas/uso terapéutico , Proteína C/uso terapéutico , Infección Puerperal/tratamiento farmacológico , Choque Séptico/tratamiento farmacológico , Infecciones Estreptocócicas/tratamiento farmacológico , Adulto , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Recuento de Células Sanguíneas , Cuidados Críticos , Femenino , Heparina/efectos adversos , Heparina/uso terapéutico , Humanos , Insuficiencia Multiorgánica/complicaciones , Insuficiencia Multiorgánica/terapia , Embarazo , Infección Puerperal/diagnóstico , Embolia Pulmonar/tratamiento farmacológico , Proteínas Recombinantes/uso terapéutico , Pruebas de Función Respiratoria , Choque Séptico/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Trombocitopenia/inducido químicamente , Trombocitopenia/tratamiento farmacológicoRESUMEN
OBJECTIVE: This study examined associations between the extent of anxiety disorder in adolescence (14-16 years) and young people's later risks of a range of mental health, educational, and social role outcomes (16-21 years). METHOD: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1,265 New Zealand children. Measures collected included (1) an assessment of DSM-III-R anxiety disorders between the ages of 14 and 16 years; (2) assessments of mental health, educational achievement, and social functioning between the ages of 16 and 21 years; and (3) measures of potentially confounding social, family, and individual factors. RESULTS: Significant linear associations were found between the number of anxiety disorders reported in adolescence and later risks of anxiety disorder; major depression; nicotine, alcohol, and illicit drug dependence; suicidal behavior; educational underachievement; and early parenthood. Associations between the extent of adolescent anxiety disorder and later risks of anxiety disorder, depression, illicit drug dependence, and failure to attend university were shown to persist after statistical control for the confounding effects of sociofamilial and individual factors. CONCLUSIONS: Findings suggest that adolescents with anxiety disorders are at an increased risk of subsequent anxiety, depression, illicit drug dependence, and educational underachievement as young adults. Clinical and research implications are considered.
Asunto(s)
Conducta del Adolescente , Trastornos de Ansiedad/psicología , Trastornos Mentales/psicología , Adolescente , Adulto , Trastornos de Ansiedad/complicaciones , Estudios de Cohortes , Depresión , Escolaridad , Femenino , Humanos , Masculino , Trastornos Mentales/etiología , Pronóstico , Factores de Riesgo , Trastornos Relacionados con SustanciasRESUMEN
AIMS: To describe the lifetime prevalence of teenage pregnancy and parenthood, in addition to the psychosocial backgrounds and current circumstances of young parents in a sample of 533 young women studied from bith to 21 years. METHODS: The data were gathered as part of the Christchurch Health and Development Study. This study consists of a cohort of 1265 young people born in the Christchurch urban area during mid 1977 and who have been regularly assessed up to the age of 21 years. Information was collected on all pregnancies and births from ages 14-21 years. RESULTS: By age 21 years, 26% of the sample had been pregnant and 14% had become parents. Most pregnancies occurred between ages 17-21 years. Young women who became pregnant were characterised by higher rates of educational under-achievement, conduct problems, sexual risk taking, family adversity, and were more likely to identify themselves as Maori. Amongst those who became pregnant, there was a tendency for young women with a personal history of family adversity to proceed with their pregnancy and become young mothers. CONCLUSIONS: By age 21 years, at least a quarter of all young women studied had been pregnant at least once. The wide range of personal and social factors associated with teenage pregnancy and parenthood suggests that teenage pregnancy does not solely reflect the effects of problematic adolescent sexual practices. Implications for teen pregnancy prevention and the health and development of children born to younger mothers are discussed.
Asunto(s)
Embarazo en Adolescencia/estadística & datos numéricos , Adolescente , Adulto , Estudios de Cohortes , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Recién Nacido , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Nueva Zelanda/epidemiología , Embarazo , Embarazo en Adolescencia/etnología , Carencia Psicosocial , Asunción de Riesgos , Factores Socioeconómicos , Rendimiento Escolar BajoRESUMEN
This study investigates the relationships between unemployment following school leaving and psychosocial adjustment problems (mental health, substance use, crime, suicidal behaviours and teenage pregnancy) in a birth cohort of over 1000 New Zealand born young people. The data were gathered during the course of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1265 children born in the Christchurch (NZ) urban region who have been studied from birth to age 21. Data were gathered by personal interview on: (a) exposure to unemployment and (b) personal adjustment over the period from age 16 to age 21. Measures of personal adjustment included mental health (depression, anxiety), substance use, crime, suicidal behaviours and (for females) teenage pregnancy. Data were analysed using a fixed effects regression model that took into account both observed and non-observed sources of confounding and the possibility of reverse causal associations between personal adjustment and unemployment. Before adjustment for confounding and reverse causality there were significant (p < 0.001) associations between exposure to unemployment and measures of mental health, substance use, crime, suicidal behaviours and teenage pregnancy. Adjustment for confounding factors and reverse causality reduced these associations quite substantially and after control for sources of confounding a number of associations became nonsignificant. Nonetheless, after such control, exposure to unemployment remained significantly (p < 0.05) associated with suicidal ideation, substance abuse and criminal behaviours. It is concluded that, in part, the associations between unemployment and personal adjustment are spurious and reflect the presence of confounding factors that are related to both unemployment and adjustment. Nonetheless, the findings suggest that exposure to unemployment may be associated with increased risks of suicidal thoughts, crime and substance use.
Asunto(s)
Trastorno de la Conducta Social/epidemiología , Desempleo/psicología , Adolescente , Adulto , Causalidad , Estudios de Cohortes , Factores de Confusión Epidemiológicos , Trastorno Depresivo/epidemiología , Salud de la Familia , Femenino , Humanos , Delincuencia Juvenil/estadística & datos numéricos , Estudios Longitudinales , Masculino , Nueva Zelanda/epidemiología , Trastorno de la Conducta Social/psicología , Trastornos Relacionados con Sustancias/epidemiología , Suicidio/psicología , Suicidio/estadística & datos numéricosRESUMEN
This paper examines the extent to which conduct problems at age 13 are associated with a range of educational, psychosocial, and sexual outcomes at age 18 in a birth cohort of 488 young women. Significant associations were found between early adolescent conduct problems and later risks of educational failure, juvenile crime, substance abuse, mental health problems, and adverse sexual outcomes by late adolescence. These elevated risks were explained, in part, by social, family, and personal disadvantages associated with adjustment at age 13. In addition, there was evidence of a causal chain process in which early adolescent conduct problems were associated with a series of adolescent risk-taking behaviours, including delinquent peer affiliations, early-onset sexual behaviour, substance use, and school problems that were, in turn, associated with increased risks of later adverse outcomes.
Asunto(s)
Logro , Trastornos de la Conducta Infantil/diagnóstico , Delincuencia Juvenil/estadística & datos numéricos , Conducta Sexual/psicología , Adolescente , Niño , Preescolar , Familia/psicología , Femenino , Humanos , Inteligencia , Entrevista Psicológica , Encuestas y CuestionariosRESUMEN
BACKGROUND: The aims of this study were to use longitudinal report data on physical and sexual abuse to examine the stability and consistency of abuse reports. METHODS: The study was based on the birth cohort of young people studied in the Christchurch Health and Development Study. At ages 18 and 21 years, these young people were questioned about their childhood exposure to physical punishment and sexual abuse. Concurrent with these assessments, sample members were also assessed on measures of psychiatric disorder and suicidal behaviour. RESULTS: Reports of childhood sexual abuse and physical punishment were relatively unstable and the values of kappa for test-retests of abuse reporting were in the region of 0.45. Inconsistencies in reporting were unrelated to the subject's psychiatric state. Latent class analyses suggested that: (a) those not abused did not falsely report being abused; and (b) those who were abused provided unreliable reports in which the probability of a false negative response was in the region of 50%. Different approaches to classifying subjects as abused led to wide variations in the estimated prevalence of abuse but estimates of the relative risk of psychiatric adjustment problems conditional on abuse exposure remained relatively stable. CONCLUSIONS: There was substantial unreliability in the reporting of child abuse. This unreliability arose because those who were subject to abuse often provided false negative reports. The consequences of errors in reports appear to be: (a) that estimates of abuse prevalence based on a single report are likely to seriously underestimate the true prevalence of abuse; while (b) estimates of the relative risk of psychiatric adjustment problems conditional on abuse appear to be robust to the effects of reporting errors.
Asunto(s)
Maltrato a los Niños/diagnóstico , Revelación de la Verdad , Adolescente , Adulto , Niño , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Reacciones Falso Negativas , Femenino , Humanos , Estudios Longitudinales , Masculino , Salud Mental , Prevalencia , Escalas de Valoración Psiquiátrica , Reproducibilidad de los Resultados , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To examine associations between attentional difficulties at age 13 and a range of adverse driving outcomes measured at 21 years. METHOD: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1,265 New Zealand children. Data collection included the following: (1) parent and teacher report measures of attentional difficulties (13 years); (2) measures of driving behavior, including involvement in an accident, drinking and driving, and traffic violations (18-21 years); and (3) measures of a range of potentially confounding individual, sociofamilial, and driving-related factors. RESULTS: Young people with high levels of attentional difficulties were at greater risk of involvement in a motor vehicle accident, drinking and driving, and traffic violations. These associations were largely explained by the personal characteristics (gender, conduct problems) and driving experience (length of time respondent held a license, distance driven) of young people with attentional difficulties. Even after adjustment for the effects of confounding factors, adolescent attentional difficulties placed young people at increased risk of an injury accident, driving without a license, and other traffic violations. CONCLUSIONS: Associations between adolescent attentional difficulties and subsequent driving risks largely reflect the effects of confounding factors correlated with attentional difficulties and driving outcomes. However, even after adjustment for confounding, adolescent attentional difficulties contributed to later injury accident risk and possibly also to risky driving behavior.
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Accidentes de Tránsito/estadística & datos numéricos , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Conducción de Automóvil , Adolescente , Conducta del Adolescente/psicología , Adulto , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Áreas de Influencia de Salud , Femenino , Estudios de Seguimiento , Humanos , Masculino , Nueva Zelanda/epidemiologíaRESUMEN
This paper examines relations between the extent of children's peer relationship problems at age 9 and their later risks of educational under-achievement and unemployment by the age of 18 years. Results showed that children with high rates of early peer relationship problems were at increased risk of under-achievement and unemployment when compared with children with low rates of early peer relationship problems. These elevated educational and occupational risks were explained by two processes. First, associations between early peer difficulties and later disadvantage were in part noncausal, and arose because of the personal characteristics (IQ and attentional problems) and social backgrounds (socioeconomic adversity, exposure to parental change, and punitive parent-child interaction) of children with early peer problems. Second, problematic peer relations during childhood appeared to place young people at increased risk of a range of adolescent interpersonal and school-related difficulties, including weaker peer attachments, interpersonal problems with teachers, school truancy, suspension, and early school leaving. In turn, these experiences and behaviours served to reduce the educational and employment opportunities of children with early peer problems. Results highlight the importance of childhood peer relationships for academic and occupational success.
Asunto(s)
Trastornos de la Conducta Infantil/diagnóstico , Relaciones Interpersonales , Grupo Paritario , Rendimiento Escolar Bajo , Desempleo , Adolescente , Niño , Trastornos de la Conducta Infantil/psicología , Preescolar , Familia/psicología , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Inteligencia , Masculino , Relaciones Padres-Hijo , Factores de Riesgo , Factores de TiempoRESUMEN
BACKGROUND: This study examined associations between childhood circumstances, adolescent mental health and life events, and the development of suicidal behaviour in young people aged between 15 and 21 years. METHOD: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1265 children born in New Zealand. The measures collected included: (1) patterns of suicidal behaviour (ideation, attempt) (15-21 years); (2) social background, family functioning, parental and individual adjustment during childhood (0-16 years); and (3) time dynamics of mental health and stressful life events during adolescence and early adulthood (15-21 years). RESULTS: By the age of 21 years, 28.8% of the sample reported having thought about killing themselves and 7.5% reported having made a suicide attempt. The childhood profile of those at greatest risk of suicidal behaviour was that of a young person reared in a family environment characterized by socio-economic adversity, marital disruption, poor parent-child attachment and exposure to sexual abuse, and who as a young adolescent showed high rates of neuroticism and novelty seeking. With the exception of the socio-economic and personality measures, the effects of childhood factors were largely mediated by mental health problems and exposure to stressful life events during adolescence and early adulthood. Mental health problems including depression, anxiety disorders, substance use disorder, and to some extent conduct disorder, in addition to exposure to adverse life events, were significantly associated with the onset of suicidal behaviours. CONCLUSIONS: Findings support a life course model of the aetiology of suicidal behaviour in which risk of developing suicidal behaviour depends on accumulative exposure to a series of social, family, personality and mental health factors.
Asunto(s)
Acontecimientos que Cambian la Vida , Salud Mental , Intento de Suicidio/psicología , Adolescente , Adulto , Salud de la Familia , Femenino , Humanos , Masculino , Relaciones Padres-Hijo , Psicología del Adolescente , Factores de Riesgo , Clase SocialRESUMEN
Using prospective longitudinal data from the Christchurch Health and Development Study, this article examined the relationship between children's peer relationship problems in middle childhood and their subsequent risk of forming deviant peer affiliations in adolescence. The analysis proceeded in three steps. First, a structural equation model demonstrated a moderate association between early peer relationship problems and later deviant peer affiliations (r = .27). Second, the model was extended to include a latent variable measure of early conduct problems. This analysis revealed that when the confounding effects of concurrently measured conduct problems were taken into account, peer relationship problems in middle childhood were no longer significantly related to young people's choice of deviant peers in adolescence. Third, the model was further extended to include lagged variables, permitting an examination of possible reciprocal relationships between early conduct problems and peer relationship problems. Results suggested that both early peer relationship problems and adolescent deviant peer involvement are symptomatic of early child behavioral adjustment. The implications of these findings for explanations of deviant peer selection are discussed.
Asunto(s)
Trastorno de la Conducta/psicología , Relaciones Interpersonales , Delincuencia Juvenil/psicología , Grupo Paritario , Adolescente , Análisis de Varianza , Niño , Femenino , Humanos , Funciones de Verosimilitud , Estudios Longitudinales , Masculino , Modelos Psicológicos , Nueva Zelanda , Factores de Riesgo , Factores SexualesRESUMEN
The relationships between maternal age (at birth) and educational and psychosocial outcomes at age 18 were examined in a birth cohort of 1025 New Zealand children. This analysis indicated the presence of consistent tendencies for increasing maternal age to be associated with declining risks of educational underachievement, juvenile crime, substance misuse, and mental health problems. Children with teenage mothers had risks of later adverse outcomes that were 1.5 to 8.9 times higher than the risks for offspring of mothers aged over 30. Subsequent analyses revealed that the associations between maternal age and later educational and psychosocial outcomes were largely, but not wholly, explained by associations between maternal age and the child-rearing practices and home environments experienced by children. In general, increasing maternal age tended to be associated with more nurturant, supportive, and stable home environments. In turn, these linkages between maternal and childhood environment explained most of the association between maternal age and later outcomes. The theoretical and applied implications of these results are considered.
Asunto(s)
Salud de la Familia , Edad Materna , Trastornos Mentales/epidemiología , Desarrollo de la Personalidad , Ajuste Social , Adolescente , Adulto , Niño , Crianza del Niño , Hijo de Padres Discapacitados/estadística & datos numéricos , Factores de Confusión Epidemiológicos , Estudios Transversales , Escolaridad , Femenino , Humanos , Delincuencia Juvenil/estadística & datos numéricos , Estudios Longitudinales , Masculino , Trastornos Mentales/etiología , Nueva Zelanda/epidemiología , Factores de Riesgo , Medio Social , Estadística como AsuntoRESUMEN
The relationship between conduct problems at age 8 years and teenage pregnancy by the age of 18 years was analyzed in a birth cohort of 491 girls. A statistically significant association was found between early conduct problems and later risk of teenage pregnancy, with girls in the most disturbed 10% of the cohort having a pregnancy rate that was 5.3 times higher (p < .001) than the rate found in the least disturbed 50% of the cohort. The elevated risk of teenage pregnancy amongst girls with early conduct problems was in part, explained by social and family factors that were correlated with early conduct problems, and in part, by a causal chain process in which early conduct problems were associated with increased rates of risk taking behaviors in adolescence, which in turn led to an increased risk of teenage pregnancy. These results suggest that the higher rate of teenage pregnancy among girls with early conduct problems reflected both their relatively disadvantaged family backgrounds and their tendencies to risk taking behavior in adolescence.