2010 › Trails



Internalizing and externalizing problems: Non-right-handedness and mental health problems among adolescents from the general population: The Trails Study

Authors: Van der Hoorn AV, Oldehinkel AJ, Ormel J, Bruggeman R, Uiterwaal CSPM, Burger H

To determine whether the association between non-right-handedness and mental problems among adolescents is specific for psychotic symptoms, we included a group of 2096 adolescents with a mean age of 14 years from the general population. Mental health problems were assessed using the parent, self-report, and teacher versions of the Child Behavior Checklist. Internalising problems comprised anxious and depressed, withdrawn and depressed, and somatic complaints. Externalising problems consisted of delinquent behaviour and aggressive behaviour. The remaining problems consisted of social problems, attention problems, and thought problems. The latter were divided into psychotic and non-psychotic items. A total of 14.3% of the adolescents were non-right-handed. We observed positive associations of non-right-handedness with thought problems, social problems, and being withdrawn and depressed. Externalising problems showed no associations with handedness. Within the thought problems subscale, the effect sizes associated with non-right-handedness for psychotic and non-psychotic items were 0.18 (p=0.005) and 0.04 (p=0.459), respectively. In conclusion, non-right-handedness is predominantly associated with psychosis-related mental problems as early as in adolescence. Handedness could be taken into account when identifying adolescents at risk for psychosis.

Internalizing and externalizing problems: Life stressors as mediators of the relation between socio-economic position and mental health problems in early adolescende.The TRAILS Study

Authors: Amone-P'Olak K, Ormel J, Huisman M, Oldehinkel AJ, Burger H

Objective: Life stressors and family socioeconomic position have often been associated with mental health status. The aim of the present study is to contribute to the understanding of the pathways from low socioeconomic position and life stressors to mental problems. Method: In a cross-sectional analysis using data from a longitudinal study of early adolescents (N = 2,149, 51% girls; mean age 13.6 years, SD 0.53, range 12Y15), we assessed the extent of mediation of the association between family socioeconomic position and mental health problems by different types of life stressors in multiple regression models. Stressors were rated as environment-related or person-related. Information on socioeconomic position was obtained directly from parents, and internalizing and externalizing problem behaviors were assessed by reports from multiple informants (parents, self, and teachers). Results: Low socioeconomic position was associated with more mental health problems and more life stressors. Both environment-related and person-related stressors predicted mental health problems independently of socioeconomic position. The associations between socioeconomic position and all mental health outcomes were partly mediated by environment-related life stressors. Mediation by environment-related and person-related stressors as assessed by linear regression amounted to 56% (95% confidence interval [CI] 35%Y78%) and 7% (95% CI j25% to 38%) for internalizing problems and 13% (95% CI 7%Y19%) and 5% (95% CI j2% to 13%) for externalizing problems, respectively. Conclusions: Environment-related, but not person-related, stressors partly mediated the association between socioeconomic position and adolescent mental problems. The extent of mediation was larger for internalizing than for externalizing problems. Because the effect sizes of the associations were relatively small, targeted interventions to prevent impaired mental health may have only modest benefits to adolescents from low socioeconomic background.

Internalizing and externalizing problems: Early Findings of Preventive Child Healthcare Professionals Predict Psychosocial Problems in Preadolescence: The TRAILS Study

Authors: Jaspers M, De Winter AF, De Meer G, Stewart RE, Verhulst FC, Ormel, Reijneveld SA

Objective To develop and validate a prediction model for psychosocial problems in preadolescence using data on early developmental factors from routine Preventive Child Healthcare (PCH).
Study design The data come from the 1692 participants who take part in the TRacking Adolescents’ IndividualLives Survey, a longitudinal study. Information on early developmental factors (ages 0 to 4 years) was collected fromthe PCH file. Parents complete the Child Behavior Checklist when their child is age 11. To examine the predictivevalue of PCH-registered developmental factors on preadolescent problems, several multiple logistic regression analysis were performed, in a derivation sample (n = 1058). The predictive performance of the models was then assessed with area under the curve (AUC) in a validation sample (n = 643) to evaluate the validity of these models. Results PCH-registered behavioral problems, attention/hyperactivity problems, enuresis, education level of the father, and being male were found to significantly predict externalizing problems (odds ratios [OR] between 1.4 and 3.7). Internalizing problems were predicted by maternal smoking during pregnancy, sleep problems, and being male (ORs between 1.7 and 3.0). The model for externalizing problems had a modest discriminatory power (AUC 0.66, 95% confidence interval 0.59-0.72). However, for internalizing problems the AUC was 0.54 (95% confidence interval 0.47-0.60), indicating poor discriminatory power. Conclusions Findings on early development as registered by PCH are modestly predictive for externalizing problems in preadolescents, but only slightly for internalizing problems.

Internalizing and externalizing problems: Peer stressors and gender differences in adolescents’ mental health. The TRAILS study

Authors: Bakker MP, Ormel J, Verhulst FC, Oldehinkel AJ

This study tested two hypotheses about gender-specific mental health effects of peer stressors during early adolescence: (1) boys and girls are sensitive to different types of peer stressors, and (2) peer stress is associated with different mental health problems in boys and girls. These two hypotheses were tested in a prospective large population cohort of 2084 Dutch young adolescents. Internalizing and externalizing problems were measured at baseline and follow-up, while stressful life events in the period between baseline and follow-up were measured retrospectively at follow-up. We performed the analyses with two types of peer stressors; victimization at school and relationship losses. Relationship losses were more strongly associated with internalizing and externalizing problems in girls than boys, supporting the first hypothesis. Peer victimization at school was also associated with both types of mental health problems, but equally strong in both genders. Peer stress is unlikely to be associated with different mental health problems in boys and girls. Instead, boys and girls are more likely to be susceptible to different types of peer stressors.

Internalizing and externalizing problems: Cognitive ability, parental socioeconomic position and internalising and externalising problems in adolescence: Findings from two European cohort studies

Authors: Huisman M, Araya R, Lawlor DA, Ormel J, Verhulst FC, Oldehinkel AJ

We investigated whether cognitive ability (CA) may be a moderator of the relationship of parental socioeconomic position (SEP) with internalising and externalising problems in adolescents. We used data from two longitudinal cohort studies; the Avon Longitudinal Study of Parents and Children (ALSPAC) and the Tracking Adolescents' Individual Lives Survey (TRAILS). Indicators of SEP were mother's education and household income. CA was estimated with IQ scores, derived from the Wechsler Intelligence Scale for Children. Internalising and externalising problems were measured with the Strengths and Difficulties Questionnaire in ALSPAC and with the Child Behavior Checklist in TRAILS. Logistic regression analyses were used to estimate the relative index of inequality (RII) for each outcome; the RII provides the odds ratio comparing the most to least deprived for each measure of SEP was estimated. In fully adjusted models an association of mother's education with externalising problems was observed [ALSPAC RII 1.42 (95%CI: 1.01-1.99); TRAILS RII 2.21 (95%CI: 1.37-3.54)], and of household income with internalising and externalising problems [pooled ALSPAC & TRAILS internalising RII 1.30 (95%CI: 0.99-1.71); pooled ALSPAC & TRAILS externalising RII 1.38 (95%CI: 1.03-1.84)]. No consistent associations were observed between mother's education and internalising problems. Results of stratified analyses and interaction-terms showed no evidence that CA moderated the association of SEP with internalising or externalising problems.

Internalizing and externalizing problems: Rejection and Acceptance across Contexts: Parents and Peers as Risks and Buffers for Early Adolescent Psychopathology. The TRAILS Study

Authors: Sentse M, Lindenberg S, Omvlee A, Ormel J, Veenstra R

In a large sample of early adolescents (T2: n = 1023; M age = 13.51; 55.5% girls) it was investigated whether the effects of parental and peer acceptance and rejection on psychopathology (externalizing and internalizing problems) remain when taking into account both contexts simultaneously. Moreover, we examined whether acceptance in one context can buffer rejection in the other. It was found that when analyzing peer and parent effects simultaneously (1) the protective effect of parental acceptance and the risk effect of peer rejection were diminished; (2) the protective effect of peer acceptance and the risk-effect of parental rejection remained strong; and (3) peer acceptance buffered parental rejection but parental acceptance did not buffer peer rejection. The results imply that the parent and peer contexts are interdependent. Implications and directions for future research are given.