@article {268, title = {Criterion Validity and Utility of the General Factor of Psychopathology in Childhood: Predictive Associations With Independently Measured Severe Adverse Mental Health Outcomes in Adolescence}, journal = {Journal of the American Academy of Child \& Adolescent Psychiatry}, volume = {57}, year = {2018}, pages = {372 - 383}, abstract = {

Objective

We examined whether a parent-rated general factor of psychopathology in childhood would predict independently measured, severe adverse mental health outcomes in adolescence.

Method

We used the Child and Adolescent Twin Study in Sweden, which targets all twin children in Sweden. Parents rated their children (N = 16,806) on 43 symptoms of inattention, hyperactivity/impulsivity, conduct problems, and anxiety/emotionality when the twins turned 9 or 12 years of age. Adverse mental health outcomes in adolescence were retrieved from national registers, and included psychiatric diagnoses, prescription of anxiolytic or antidepressant medication, court convictions of crimes, and failure to achieve eligibility for high school.

Results

Parent-rated inattention, hyperactivity/impulsivity, conduct problems, and anxiety/emotionality in childhood predicted all adverse mental health outcomes in adolescence (mean odds ratio = 1.76; range = 1.41\−2.18; all p \< .05). However, several of these associations were nonsignificant in a multiple regression framework, suggesting the influence of common variance. A general factor of psychopathology uniquely predicted all outcomes (mean odds ratio = 1.58; range = 1.34\−1.84; all p \< .05), whereas the specific factors predicted only a subset of the outcomes.

Conclusion

Mental health problems in childhood are associated with a host of adverse outcomes in adolescence, and, to a considerable extent, these associations are driven by a general factor of psychopathology. The general factor may therefore be important to clinical prognosis, which informs clinical decision making for children.

}, keywords = {-factor, bifactor, General factor of psychopathology, heterotypic continuity}, issn = {0890-8567}, doi = {https://doi.org/10.1016/j.jaac.2017.12.016}, url = {http://www.sciencedirect.com/science/article/pii/S0890856718301667}, author = {Erik Pettersson and Benjamin B Lahey and Henrik Larsson and Paul Lichtenstein} } @article {247, title = {The relation between the age at diagnosis of problem behaviors related to aggression and distal outcomes in Swedish children}, journal = {European Child {\&} Adolescent Psychiatry}, year = {2018}, month = {Nov}, abstract = {

Severe childhood aggressive behaviors are known to predict negative outcomes later in life; however, little is known about the effect of when in childhood aggression problems are diagnosed. While an earlier first diagnosis of problematic aggressive behavior might be associated with increased severity and, thus, worse outcomes, it is also possible that an earlier diagnosis affords an earlier start of treatment programs or indicates that greater attention is being paid to behavioral problems, thus resulting in attenuation of the severity of childhood aggression\&$\#$39;s impact on distal outcomes. The current study analyzed data from the population-based Swedish Data Registries, which include data on all children formally diagnosed by the Swedish medical system with a wide range of aggression problems between ages 8 and 18 (N{\th}inspace}={\th}inspace}5816) during the years 1987\–2013, along with a matched control. Time-to-event analyses investigated whether the age at time of diagnosis affects later life outcomes while controlling for relevant confounders. Results show that for both boys and girls, those with a later diagnosis had lower average incomes (regression coefficient b{\th}inspace}={\th}inspace}\−{\th}inspace}0.055, p{\th}inspace}\<{\th}inspace}0.005) and a higher probability of having a criminal record (odds ratio 1.126, p{\th}inspace}\<{\th}inspace}0.005) than children with earlier diagnoses. The effect on suicide attempts was not significant after correcting for multiple testing (odds ratio 1.264, p{\th}inspace}={\th}inspace}0.016). Grade score was not significantly affected. The results warrant further research concerning the potential advantage of earlier diagnoses, especially concerning generalizability beyond the Swedish population.

}, issn = {1435-165X}, doi = {10.1007/s00787-018-1250-9}, url = {https://doi.org/10.1007/s00787-018-1250-9}, author = {Ian Campbell and Lundstr{\"o}m, Sebastian and Henrik Larsson and Lichtenstein, Paul and Gitta Lubke} } @article {267, title = {ADHD Medication and Substance-Related Problems}, journal = {American Journal of Psychiatry}, volume = {174}, year = {2017}, pages = {877-885}, abstract = {

Objective: substance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and long-term associations between ADHD medication treatment and substance-related events.

Method: the authors analyzed 2005\–2014 commercial health care claims from 2,993,887 (47.2\% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not.

Results: in adjusted within-individual comparisons, relative to periods in which patients did not receive ADHD medication, male patients had 35\% lower odds of concurrent substance-related events when receiving medication (odds ratio=0.65, 95\% CI=0.64\–0.67), and female patients had 31\% lower odds of concurrent substance-related events (odds ratio=0.69, 95\% CI=0.67\–0.71). Moreover, male patients had 19\% lower odds of substance-related events 2 years after medication periods (odds ratio=0.81, 95\% CI=0.78\–0.85), and female patients had 14\% lower odds of substance-related events 2 years after medication periods (odds ratio=0.86, 95\% CI= 0.82\–0.91). Sensitivity analyses supported most findings but were less consistent for long-term associations among women.

Conclusions: these results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.

}, doi = {10.1176/appi.ajp.2017.16060686}, url = {https://doi.org/10.1176/appi.ajp.2017.16060686}, author = {Quinn, Patrick D. and Chang, Zheng and Hur, Kwan and Gibbons, Robert D. and Benjamin B Lahey and Rickert, Martin E. and Sj{\"o}lander, Arvid and Lichtenstein, Paul and Henrik Larsson and D{\textquoteright}Onofrio, Brian M.} } @article {192, title = {Disentangling Heterogeneity of Childhood Disruptive Behavior Problems Into Dimensions and Subgroups}, journal = {American Academy of Child and Adolescent Psychiatry. Journal}, volume = {56}, year = {2017}, pages = {678{\textendash}686}, abstract = {

OBJECTIVE:

Irritable and oppositional behaviors are increasingly considered as distinct dimensions of oppositional defiant disorder. However, few studies have explored this multidimensionality across the broader spectrum of disruptive behavior problems (DBPs). This study examined the presence of dimensions and distinct subgroups of childhood DBPs, and the cross-sectional and longitudinal associations between these dimensions.

METHOD:

Using factor mixture models (FMMs), the presence of dimensions and subgroups of DBPs was assessed in the Generation R Study at ages 6 (n\ = 6,209) and 10 (n\ =\ 4,724) years. Replications were performed in two population-based cohorts (Netherlands Twin Registry, n\ = 4,402, and Swedish Twin Study of Child and Adolescent Development, n\ = 1,089) and a clinical sample (n\ = 1,933). We used cross-lagged modeling in the Generation R Study to assess cross-sectional and longitudinal associations between dimensions. DBPs were assessed using mother-reported responses to the Child Behavior Checklist.

RESULTS:

Empirically obtained dimensions of DBPs were oppositional behavior (age 6 years), disobedient behavior, rule-breaking behavior (age 10 years), physical aggression, and irritability (both ages). FMMs suggested that one-class solutions had the best model fit for all dimensions in all three population-based cohorts. Similar results were obtained in the clinical sample. All three dimensions, including irritability, predicted subsequent physical aggression (range, 0.08-0.16).

CONCLUSION:

This study showed that childhood DBPs should be regarded as a multidimensional phenotype rather than comprising distinct subgroups. Incorporating multidimensionality will improve diagnostic accuracy and refine treatment. Future studies need to address the biological validity of the DBP dimensions observed in this study; herein lies an important opportunity for neuroimaging and genetic measures.

}, doi = {10.1016/j.jaac.2017.05.019}, author = {Koen Bolhuis and Gitta Lubke and van der Ende, Jan and Meike Bartels and van Beijsterveldt, Toos and Paul Lichtenstein and Henrik Larsson and Vincent W.V. Jaddoe and Steven A. Kushner and Frank Verhulst and Dorret I. Boomsma and Henning Tiemeier} } @article {256, title = {Predictive validity of parent- and self-rated ADHD symptoms in adolescence on adverse socioeconomic and health outcomes}, journal = {European Child {\&} Adolescent Psychiatry}, volume = {26}, year = {2017}, month = {Jul}, pages = {857{\textendash}867}, abstract = {

There is scarcity of research investigating the validity of self-report of attention deficit hyperactivity disorder (ADHD) symptoms compared to other informants, such as parents. This study aimed to compare the predictive associations of ADHD symptoms rated by parents and their children across adolescence on a range of adverse socioeconomic and health outcomes in early adulthood. Parent- and self-rated ADHD symptoms were assessed in 2960 individuals in early (13\–14\ years) and late adolescence (16\–17\ years). Logistic regression analyses were used to compare the associations between parent- and self-rated ADHD symptoms at both time points and adverse life outcomes in young adulthood obtained from Swedish national registries. Both parent- and self-ratings of ADHD symptoms were associated with increased risk for adverse outcomes, although associations of parent-ratings were more often statistically significant and were generally stronger (OR\ =\ 1.12\–1.49, p\ \<\ 0.05) than self-ratings (OR\ =\ 1.07\–1.17, p\ \<\ 0.05). After controlling for the other informant, parent-ratings of ADHD symptoms in both early and late adolescence significantly predicted academic and occupational failure, criminal convictions and traffic-related injuries, while self-ratings of ADHD symptoms only in late adolescence predicted substance use disorder and academic failure. Our findings suggest that both parent- and self-ratings of ADHD symptoms in adolescence provides valuable information on risk of future adverse socioeconomic and health outcomes, however, self-ratings are not valuable once parent-ratings have been taken into account in predicting most outcomes. Thus, clinicians and researchers should prioritize parent-ratings over self-ratings.

}, issn = {1435-165X}, doi = {10.1007/s00787-017-0957-3}, url = {https://doi.org/10.1007/s00787-017-0957-3}, author = {Du Rietz, Ebba and Kuja-Halkola, Ralf and Brikell, Isabell and Jangmo, Andreas and Sariaslan, Amir and Lichtenstein, Paul and Kuntsi, Jonna and Henrik Larsson} } @article {253, title = {Childhood attention-deficit/hyperactivity disorder symptoms and the development of adolescent alcohol problems: A prospective, population-based study of Swedish twins}, journal = {American Journal of Medical Genetics Part B: Neuropsychiatric Genetics}, volume = {171}, year = {2016}, pages = {958-970}, abstract = {

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of problematic alcohol and other substance use in adolescence. This study used data from an ongoing, prospective, population-based twin study of Swedish children and adolescents to evaluate the extent to which the association between ADHD symptoms and alcohol problems reflects a unique source of genetic or environmental risk related to ADHD versus a broader predisposition to youth externalizing behavior. We used all available data from same-sex monozygotic (MZ) and dizygotic (DZ) twins on ADHD symptoms in childhood (age 9/12; N\ =\ 15,549) and alcohol problems in late adolescence (age 18; N\ =\ 2,564). Consistent with prior longitudinal studies, the phenotypic association between hyperactive/impulsive ADHD symptoms and alcohol problems was small in magnitude, whereas the association for inattentive symptoms was even weaker. Additive genetic influences explained 99.8\% of the association between hyperactive/impulsive symptoms and alcohol problems. Furthermore, we found that the genetic risk specifically associated with hyperactive/impulsive symptoms was attenuated when estimated in the context of externalizing behavior liability during childhood, of which ADHD symptoms were specific expressions. In sensitivity analyses exploring hyperactivity in mid-adolescence, we found a similar pattern of genetic associations. These results are consistent with previous findings of genetically driven overlap in the etiology of ADHD and problematic alcohol use. At least some of this co-occurrence may result from a general predisposition to externalizing behaviors in youth. \© 2015 Wiley Periodicals, Inc.

}, keywords = {ADHD, behavioral genetics, externalizing, neurodevelopmental problems, substance misuse}, doi = {10.1002/ajmg.b.32412}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.b.32412}, author = {Quinn, Patrick D. and Erik Pettersson and Lundstr{\"o}m, Sebastian and Anckars{\"a}ter, Henrik and L{\r a}ngstr{\"o}m, Niklas and Gumpert, Clara Hellner and Henrik Larsson and Lichtenstein, Paul and D{\textquoteright}Onofrio, Brian M.} } @article {265, title = {Relative Immaturity in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms From Childhood to Early Adulthood: Exploring Genetic and Environmental Overlap Across Development}, journal = {Journal of the American Academy of Child \& Adolescent PsychiatryJournal of the American Academy of Child \& Adolescent Psychiatry}, volume = {55}, year = {2016}, month = {2016/10/01}, pages = {886 - 895}, abstract = {

ObjectiveAttention-deficit/hyperactivity disorder (ADHD) has been linked to immaturity relative to peers in childhood, yet it is unclear how such immaturity is associated with ADHD across development. This longitudinal twin study examined the genetic and environmental contributions to the association between parents? perception of their child?s immaturity relative to peers (RI) in childhood and ADHD symptoms across development.ObjectiveAttention-deficit/hyperactivity disorder (ADHD) has been linked to immaturity relative to peers in childhood, yet it is unclear how such immaturity is associated with ADHD across development. This longitudinal twin study examined the genetic and environmental contributions to the association between parents? perception of their child?s immaturity relative to peers (RI) in childhood and ADHD symptoms across development.

}, isbn = {0890-8567}, url = {https://doi.org/10.1016/j.jaac.2016.06.014}, author = {Brikell, Isabell and Kuja-Halkola, Ralf and Larsson, Jan-Olov and Benjamin B Lahey and Kuntsi, Jonna and Lichtenstein, Paul and Rydelius, Per-Anders and Henrik Larsson} } @article {80, title = {A Longitudinal Study of Resting Heart Rate and Violent Criminality in More Than 700 000 Men.}, journal = {JAMA Psychiatry}, volume = {72}, year = {2015}, month = {2015 Oct 1}, pages = {971-8}, abstract = {

IMPORTANCE: Low resting heart rate is a well-replicated physiological correlate of aggressive and antisocial behavior in children and adolescents, but whether low resting heart rate increases the risk of violence and other antisocial and risk-taking behaviors in adulthood has not been studied in representative samples.

OBJECTIVE: To study the predictive association of resting heart rate with violent and nonviolent criminality and with fatal and nonfatal injuries owing to assaults and unintentional injuries in the population.

DESIGN, SETTING, AND PARTICIPANTS: We conducted a study of data from several Swedish national registers on 710 264 Swedish men in the general population born from 1958 to 1991, with a follow-up of up to 35.7 years. Outcome data were available and analyzed from January 1, 1973, through December 31, 2009. Resting heart rate was measured together with blood pressure at mandatory military conscription testing at a mean (SD) age of 18.2 (0.5) years.

MAIN OUTCOMES AND MEASURES: Violent and nonviolent criminal convictions and medical treatments or deaths owing to assaults and unintentional injuries.

RESULTS: In models adjusted for physical, cardiovascular, psychiatric, cognitive, and socioeconomic covariates, compared with 139 511 men in the highest quintile of the distribution of resting heart rate (\≥83 beats/min), 132 595 men with the lowest quintile (heart rate, \≤60 beats/min) had a 39\% (95\% CI, 35\%-44\%) higher hazard of being convicted of violent crimes and a 25\% (95\% CI, 23\%-28\%) higher hazard of being convicted of nonviolent crimes. The corresponding hazard was 39\% higher for assault injuries (95\% CI, 33\%-46\%) and for unintentional injuries (95\% CI, 38\%-41\%). Further adjustment for cardiorespiratory fitness in a subset of 572 610 men with data from an exercise test did not reduce the associations. Similar associations were found between low systolic blood pressure and violent and nonviolent criminality and for assault injuries when systolic blood pressure was studied instead of resting heart rate in more than 1 million men.

CONCLUSIONS AND RELEVANCE: Among men, low resting heart rate in late adolescence was associated with an increased risk for violent criminality, nonviolent criminality, exposure to assault, and unintentional injury in adulthood. Most of these results were replicated with low systolic blood pressure. Resting heart rate and other autonomic measures merit further study in the development and prevention of violence and antisocial behavior.

}, issn = {2168-6238}, doi = {10.1001/jamapsychiatry.2015.1165}, author = {Latvala, Antti and Kuja-Halkola, Ralf and Almqvist, Catarina and Henrik Larsson and Paul Lichtenstein} }