Browsing by Subject "ADOLESCENTS"

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  • Widlund, Anna; Tuominen, Heta; Korhonen, Johan (2018)
    It has been suggested that both performance and academic well-being play a role in adolescent students' educational attainment and school dropout. In this study, we therefore examined, first, what kinds of academic well-being (i.e., school burnout, schoolwork engagement, and mathematics self-concept) and mathematics performance profiles can be identified among lower secondary school students (N-grade (7) = 583, N-grade 9 = 497); second, how stable these profiles are across one school year during the seventh and ninth grades; and, third, how students with different academic well-being and mathematics performance profiles differ with respect to their educational aspirations. By means of latent profile analyses, three groups of students in seventh grade: thriving (34%), average (51%), and negative academic well-being (15%) and four groups of students in ninth grade: thriving (25%), average (50%), negative academic well-being (18%), and low-performing (7%) with distinct well-being and mathematics performance profiles were identified. Configural frequency analyses revealed that the profiles were relatively stable across one school year; 60% of the students displayed identical profiles over time. The thriving students reported the highest educational aspirations compared to the other groups. In addition, the low-performing students in the ninth grade had the lowest educational aspirations just before the transition to upper secondary school. Practical implications as well as directions for future research are discussed.
  • Dumuid, Dorothea; Stanford, Tyman E.; Pedisic, Zeljko; Maher, Carol; Lewis, Lucy K.; Martin-Fernandez, Josep-Antoni; Katzmarzyk, Peter T.; Chaput, Jean-Philippe; Fogelholm, Mikael; Standage, Martyn; Tremblay, Mark S.; Olds, Timothy (2018)
    Background: Daily activity data are by nature compositional data. Accordingly, they occupy a specific geometry with unique properties that is different to standard Euclidean geometry. This study aimed to estimate the difference in adiposity associated with isotemporal reallocation between daily activity behaviours, and to compare the findings from compositional isotemporal subsitution to those obtained from traditional isotemporal substitution. Methods: We estimated the differences in adiposity (body fat%) associated with reallocating fixed durations of time (isotemporal substitution) between accelerometer-measured daily activity behaviours (sleep, sedentary time and light and moderate-to-vigorous physical activity (MVPA)) among 1728 children aged 9-11 years from Australia, Canada, Finland and the UK (International Study of Childhood Obesity, Lifestyle and the Environment, 2011-2013).We generated estimates from compositional isotemporal substitution models and traditional non-compositional isotemporal substitution models. Results: Both compositional and traditional models estimated a positive (unfavourable) difference in body fat% when time was reallocated from MVPA to any other behaviour. Unlike traditional models, compositional models found the differences in estimated adiposity (1) were not necessarily symmetrical when an activity was being displaced, or displacing another (2) were not linearly related to the durations of time reallocated, and (3) varied depending on the starting composition. Conclusion: The compositional isotemporal model caters for the constrained and therefore relative nature of activity behaviour data and enables all daily behaviours to be included in a single statistical model. The traditional model treats data as real variables, thus the constrained nature of time is not accounted for, nor reflected in the findings. Findings from compositional isotemporal substitution support the importance of MVPA to children's health, and suggest that while interventions to increase MVPA may be of benefit, attention should be directed towards strategies to avoid decline in MVPA levels, particularly among already inactive children. Future applications of the compositional model can extend from pair-wise reallocations to other configurations of time-reallocation, for example, increasing MVPA at the expense of multiple other behaviours.
  • Harjutsalo, Valma; Maric-Bilkan, Christine; Forsblom, Carol; Groop, Per-Henrik; FinnDiane Study Grp (2016)
    Aims/hypothesis The aim of this study was to evaluate the relationship among age at onset of diabetes, age at onset of menarche and risk of diabetic nephropathy and laser-treated retinopathy in type 1 diabetes. Methods Data related to age at menarche were collected through questionnaires and were available for 1,304 women who participated in the Finnish Diabetic Nephropathy Study (FinnDiane). A possible association between age at menarche and diabetic nephropathy and retinopathy was investigated. Results There was an inverse relationship between the age at onset of diabetes and age at menarche: the younger the age at onset of diabetes, the higher the age at menarche (p <0.0001). A non-linear relationship between the age of menarche and risk of diabetic microvascular complications was found in patients with diabetes onset before menarche, but there was no such association in patients with diabetes onset after menarche. Women with delayed menarche (> mean age+ 2 years) had a 2.30 (95% CI 1.27, 4.17; p <0.006) times higher risk of nephropathy compared with the women who underwent menarche at the mean age +/- 2 years. Delayed menarche also increased the risk of retinopathy (OR 2.34 [95% CI 1.36, 4.01]). After excluding patients with nephropathy, the OR for retinopathy was 2.11 (95% CI 1.15, 3.90). Earlier menarche (<mean age-2 years) did not have any effect on this risk. Conclusions/interpretation Delayed menarche was associated with an increased risk of diabetic nephropathy and retinopathy, whereas early menarche was not. Delayed menarche may be used as a new tool to identify women at risk of diabetic microvascular complications.
  • Pereira, Renata C.; Valta, Helena; Tumber, Navdeep; Salusky, Isidro B.; Jalanko, Hannu; Makitie, Outi; Perry, Katherine Wesseling (2015)
    Background Bone fragility is common post solid organ transplantation but little is known about bone pathology on a tissue level. Abnormal osteocytic protein expression has been linked to compromised bone health in chronic kidney disease (CKD) and immunosuppressant medications may impact osteocyte function. Methods Transiliac bone biopsies were obtained from 22 pediatric solid organ allograft recipients (average age 15.6 years) an average of 6.3 +/- 1.2 years after transplantation and from 12 pediatric pre-dialysis CKD patients (average age 13.2 years). Histomorphometry and immunohistochemistry for FGF23, DMP1, sclerostin, and osteopontin were performed on all biopsies. Results FGF23 and sclerostin were increased in transplant recipients relative to non-transplant CKD, regardless of the type of allograft received and despite, in the case of liver and heart recipients, a higher GFR. Bone DMP1 expression was higher in liver or heart than in kidney recipients, concomitant with higher serum phosphate values. Osteopontin expression was higher in CKD than in transplant recipients (p Conclusions Solid-organ transplantation is associated with increased FGF23 and sclerostin expression. The contribution of these findings to compromised bone health post transplantation warrants further evaluation.
  • Dimitri, Paul; Fernandez-Luque, Luis; Banerjee, Indraneel; Bergada, Ignacio; Calliari, Luis Eduardo; Dahlgren, Jovanna; de Arriba, Antonio; Lapatto, Risto; Reinehr, Thomas; Senniappan, Senthil; Thomas-Teinturier, Cecile; Tsai, Meng-Che; Zaini, Azriyanti Anuar; Bagha, Merat; Koledova, Ekaterina (2021)
    Background: The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder. Objective: Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy. Methods: A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy. Results: A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed. Conclusions: The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.
  • Rank, Cecilie U.; Wolthers, Benjamin O.; Grell, Kathrine; Albertsen, Birgitte K.; Frandsen, Thomas L.; Overgaard, Ulrik M.; Toft, Nina; Nielsen, Ove J.; Wehner, Peder S.; Harila-Saari, Arja; Heyman, Mats M.; Malmros, Johan; Abrahamsson, Jonas; Noren-Nystrom, Ulrika; Tomaszewska-Toporska, Beata; Lund, Bendik; Jarvis, Kirsten B.; Quist-Paulsen, Petter; Vaitkeviciene, Goda E.; Griskevicius, Laimonas; Taskinen, Mervi; Wartiovaara-Kautto, Ulla; Lepik, Kristi; Punab, Mari; Jonsson, Olafur G.; Schmiegelow, Kjeld (2020)
    PURPOSE Asparaginase-associated pancreatitis (AAP) is common in patients with acute lymphoblastic leukemia (ALL), but risk differences across age groups both in relation to first-time AAP and after asparaginase re-exposure have not been explored. PATIENTS AND METHODS We prospectively registered AAP (n = 168) during treatment of 2,448 consecutive ALL patients aged 1.0-45.9 years diagnosed from July 2008 to October 2018 and treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol. RESULTS Compared with patients aged 1.0-9.9 years, adjusted AAP hazard ratios (HRa) were associated with higher age with almost identical HRa (1.6; 95% CI, 1.1 to 2.3; P = .02) for adolescents (10.0-17.9 years) and adults (18.0-45.9 years). The day 280 cumulative incidences of AAP were 7.0% for children (1.0-9.9 years: 95% CI, 5.4 to 8.6), 10.1% for adolescents (10.0 to 17.9 years: 95% CI, 7.0 to 13.3), and 11.0% for adults (18.0-45.9 years: 95% CI, 7.1 to 14.9; P = .03). Adolescents had increased odds of both acute (odds ratio [OR], 5.2; 95% CI, 2.1 to 13.2; P = .0005) and persisting complications (OR, 6.7; 95% CI, 2.4 to 18.4; P = .0002) compared with children (1.0-9.9 years), whereas adults had increased odds of only persisting complications (OR, 4.1; 95% CI, 1.4 to 11.8; P = .01). Fifteen of 34 asparaginase-rechallenged patients developed a second AAP. Asparaginase was truncated in 17/21 patients with AAP who subsequently developed leukemic relapse, but neither AAP nor the asparaginase truncation was associated with increased risk of relapse. CONCLUSION Older children and adults had similar AAP risk, whereas morbidity was most pronounced among adolescents. Asparaginase re-exposure should be considered only for patients with an anticipated high risk of leukemic relapse, because multiple studies strongly indicate that reduction of asparaginase treatment intensity increases the risk of relapse. (C) 2019 by American Society of Clinical Oncology
  • ISCOLE Res Grp; Zakrzewski-Fruer, Julia K.; Gillison, Fiona B.; Fogelholm, Mikael; Kivelä, Jemina; Räsänen, Sari; Roito, Sanna; Saloheimo, Taru; Valta, Leena (2019)
    BackgroundExisting research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites.MethodsThis multinational, cross-sectional study included 6228 children aged 9-11years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2days/week [rare], 3 to 5days/week [occasional] or 6 to 7days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200h) and afternoon (1200h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time.ResultsParticipants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated witha higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4min/day and 1.3%) than rare breakfast consumption (all p0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found.ConclusionsIn this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance.Trial registrationThe International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at(Identifier NCT01722500).
  • Finnish Diabet Nephropathy Study; Ahola, A. J.; Harjutsalo, V.; Forsblom, C.; Saraheimo, M.; Groop, P. -H. (2019)
    Aims To study the association between dietary intake and glycaemia in Type 1 diabetes. Methods Data on energy and nutrient intakes, and the mean and coefficient of variation of self-monitored blood glucose measurements were obtained from records completed by 1000 adults with Type 1 diabetes. Associations between these measures of glycaemia and dietary intake were investigated using generalized linear regression, with and without macronutrient substitution. Results In the first set of analyses, fibre intake was associated with lower mean self-monitored blood glucose values (beta = -0.428, 95% CI -0.624 to -0.231; P
  • Sullivan, Samaah M.; Broyles, Stephanie T.; Barreira, Tiago V.; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V.; Maher, Carol; Maia, Jose; Matsudo, Victor; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L.; Standage, Martyn; Tremblay, Mark S.; Tudor-Locke, Catrine; Zhao, Pei; Katzmarzyk, Peter T.; ISCOLE Res Grp (2017)
    We investigated whether associations of neighborhood social environment attributes and physical activity differed among 12 countries and levels of economic development using World Bank classification (low/lower-middle-, upper-middle- and high- income countries) among 9-11 year old children (N=6161) from the International Study of Childhood Obesity, Lifestyle, and the Environment (ISCOLE). Collective efficacy and perceived crime were obtained via parental/guardian report. Moderate-to-vigorous physical activity (MVPA) was assessed with waist-worn Actigraph accelerometers. Neighborhood environment by country interactions were tested using multi-level statistical models, adjusted for covariates. Effect estimates were reported by country and pooled estimates calculated across World Bank classifications for economic development using meta-analyses and forest plots. Associations between social environment attributes and MVPA varied among countries and levels of economic development. Associations were more consistent and in the hypothesized directions among countries with higher levels economic development, but less so among countries with lower levels of economic development.
  • Mardones, Francisco; Arnaiz, Pilar; Pacheco, Paz; Dominguez, Angelica; Villarroel, Luis; Eriksson, Johan G.; Barja, Salesa; Farias, Marcelo; Castillo, Oscar (2014)
  • Nislin, Mari; Pesonen, Henri (2019)
    In this article, we sought to determine the extent to which pre-service and in-service teachers' self-perceived competence is associated with sense of belonging and well-being during special education teacher studies, as well as determine whether there are differences among these factors between pre-service and in-service teachers. These are areas in which there is currently a shortage of research. Our data were collected using a survey with close-ended questions. The respondents consisted of 58 in-service and 29 pre-service teachers, aged 21-56 years. Data were analysed utilising quantitative methods. The findings revealed that the respondents demonstrated generally high levels of engagement and low to moderate levels of burnout. The results further indicated that the respondents reported themselves to be most competent when dealing with children of drug-related family abuse and less competent in working with children with severe disabilities. Although well-being and self-perceived competence were associated, we could not find any association between these factors and the sense of belonging. Given the theoretical and empirical evidence, a deeper understanding of the factors relating to teachers' ability to encounter diverse needs is unquestionably needed. The key findings are discussed in detail, and practical implications for teacher education are given.
  • Lindstrom, R.; Lepistö-Paisley, T.; Makkonen, T.; Reinvall, O.; Nieminen-von Wendt, T.; Alen, R.; Kujala, T. (2018)
    Objective: The present study explored the processing of emotional speech prosody in school-aged children with autism spectrum disorders (ASD) but without marked language impairments (children with ASD [no LI]). Methods: The mismatch negativity (MMN)/the late discriminative negativity (LDN), reflecting pre-attentive auditory discrimination processes, and the P3a, indexing involuntary orienting to attention-catching changes, were recorded to natural word stimuli uttered with different emotional connotations (neutral, sad, scornful and commanding). Perceptual prosody discrimination was addressed with a behavioral sound-discrimination test. Results: Overall, children with ASD (no LI) were slower in behaviorally discriminating prosodic features of speech stimuli than typically developed control children. Further, smaller standard-stimulus event related potentials (ERPs) and MMN/LDNs were found in children with ASD (no LI) than in controls. In addition, the amplitude of the P3a was diminished and differentially distributed on the scalp in children with ASD (no LI) than in control children. Conclusions: Processing of words and changes in emotional speech prosody is impaired at various levels of information processing in school-aged children with ASD (no LI). Significance: The results suggest that low-level speech sound discrimination and orienting deficits might contribute to emotional speech prosody processing impairments observed in ASD. (C) 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
  • Holm, Marja E.; Aunio, Pirjo; Björn, Piia M.; Klenberg, Liisa; Korhonen, Johan; Hannula, Markku S. (2018)
    This study investigates behavioral executive functions (EFs) in the mathematics classroom context among adolescents with different mathematics performance levels. The EF problems were assessed by teachers using a behavioral rating inventory. Using cutoff scores on a standardized mathematics assessment, groups with mathematics difficulties (MD; n = 124), low mathematics performance (LA; n = 140), and average or higher scores (AC; n = 355) were identified. Results showed that the MD group had more problems with distractibility, directing attention, shifting attention, initiative, execution of action, planning, and evaluation than the LA group, whereas the differences in hyperactivity, impulsivity, and sustaining attention were not significant. Compared to the AC group, the MD group showed more problems with all behavioral EFs except hyperactivity and impulsivity, while the LA group showed more problems only with shifting attention. Male adolescents showed more behavioral EF problems than female adolescents, but this gender difference was negligible within the MD group. The practical implications of the results are discussed.
  • Heinonen, Kati; Räikkönen, Katri; Pesonen, Anu-Katriina; Andersson, Sture; Kajantie, Eero; Eriksson, Johan; Wolke, Dieter; Lano, Aulikki (2010)
  • Esmaeilikia, Mahsa; Radun, Igor; Grzebieta, Raphael; Olivier, Jake (2019)
    A long-standing argument against bicycle helmet use is the risk compensation hypothesis, i.e., increased feelings of safety caused by wearing a helmet results in cyclists exhibiting more risky behaviour. However, past studies have found helmet wearing is not associated with risky behaviour, e.g., committing a traffic violation was positively associated with a lower frequency of helmet use. There is a lack of consensus in the research literature regarding bicycle helmet use and the risk compensation hypothesis, although this gap in knowledge was identified in the early 2000s. This is the first study to carry out a systematic review of the literature to assess whether helmet wearing is associated with risky behaviour. Two study authors systematically searched the peer-reviewed literature using five research databases (EMBASE, MEDLINE, COMPENDEX, SCOPUS, and WEB OF SCIENCE) and identified 141 unique articles and four articles from other sources. Twenty-three articles met inclusion criteria and their findings were summarised. Eighteen studies found no supportive evidence helmet use was positively associated with risky behaviour, while three studies provided mixed findings, i.e., results for and against the hypothesis. For many of these studies, bicycle helmet wearing was associated with safer cycling behaviour. Only two studies conducted from the same research lab provided evidence to support the risk compensation hypothesis. In sum, this systematic review found little to no support for the hypothesis bicycle helmet use is associated with engaging in risky behaviour. (C) 2018 The Authors. Published by Elsevier Ltd.
  • Vaara, Jani P.; Santtila, Matti; Vasankari, Tommi; Fogelholm, Mikael; Mäntysaari, Matti; Pihlainen, Kai; Vaara, Elina; Kyröläinen, Heikki (2020)
    Introduction Physical fitness is strongly related to health and may offer valuable information about public health. We investigated trends in physical fitness, leisure-time physical activity (LTPA), and anthropometry of young healthy adult Finnish men in representative population-based samples between 2003 and 2015. Methods Three independent cross-sectional samples of 18- to 35-year-old Finnish men were assessed in 2003 (n = 889), 2008 (n = 803), and 2015 (n = 690). Cardiorespiratory (VO(2)max) and muscular fitness (1-minute sit-ups and push-ups), body mass, and height were measured. Self-reported LTPA was assessed. Results After adjusting for age, education, and smoking, cardiorespiratory fitness was higher in 2003 (mean: 43.5, 95%CI: 42.9-44.1 mL/kg/min) compared to 2008 (41.3, 95%CI: 40.7-41.9 mL/kg/min) and 2015 (40.6, 95%CI: 40.0-41.2 mL/kg/min) (P <.001), whereas no difference was observed between 2008 and 2015. The lowest values in muscular fitness were observed in 2003, while no clear trends were further noticed. The adjusted BMI was higher in 2008 (25.1, 95%CI: 24.9-25.4) and 2015 (25.3, 95%CI: 25.3, 95%CI: 25.0-25.6) compared to 2003 (24.5, 95%CI: 24.3-24.8) (P <.005). In 2015, a higher proportion of individuals exercised at least four times per week compared to 2003 and 2008 (P <.05). Conclusion The decrease in cardiorespiratory fitness that took place between 2003 and 2008 plateaued after 2008. The plateau is in accordance with the previously observed trend of 5-10 years younger Finnish men. Moreover, muscular fitness was for the most part higher in 2008 and 2015 compared to 2003. Efforts directed to promote regular physical activity and improve physical fitness are needed.
  • Wolff, Lili-Ann; Vuorenpää, Sari; Sjöblom, Pia (2018)
    Social change requires new educational planning and sustainable teaching methods. Shaping an environment of care with animals as a part of the daily school life may produce such a change. In this article, we present a transdisciplinary study with the aim of exploring whether raising chickens in a classroom could promote learning, especially sustainability learning, and how. The study employs an ethnographic approach and we have analyzed the data according to interaction analysis. We collected the data in a culturally-diverse Finnish primary school class during May 2018. The data comprise field notes, videos and photographs from indoor and outdoor school activities; interviews and discussions with teachers and students; and, texts and artifacts that were made by students. The results show that having chickens in the classroom not only improved the students’ learning of biology, but also enhanced many other activities. The chicken project became part of a complex learning culture that met several of the aims of the curriculum and in many ways reached beyond the aim of merely learning science. The project became a natural part of sustainability education and promoted the acquisition of knowledge and skills in relation to the ecological and social dimensions of sustainability.
  • Bartels, Meike; Hendriks, Anne; Mauri, Matteo; Krapohl, Eva; Whipp, Alyce; Bolhuis, Koen; Conde, Lucia Colodro; Luningham, Justin; Ip, Hill Fung; Hagenbeek, Fiona; Roetman, Peter; Gatej, Raluca; Lamers, Audri; Nivard, Michel; van Dongen, Jenny; Lu, Yi; Middeldorp, Christel; van Beijsterveldt, Toos; Vermeiren, Robert; Hankemeijer, Thomas; Kluft, Cees; Medland, Sarah; Lundstrom, Sebastian; Rose, Richard; Pulkkinen, Lea; Vuoksimaa, Eero; Korhonen, Tellervo; Martin, Nicholas G.; Lubke, Gitta; Finkenauer, Catrin; Fanos, Vassilios; Tiemeier, Henning; Lichtenstein, Paul; Plomin, Robert; Kaprio, Jaakko; Boomsma, Dorret I. (2018)
    Childhood aggression and its resulting consequences inflict a huge burden on affected children, their relatives, teachers, peers and society as a whole. Aggression during childhood rarely occurs in isolation and is correlated with other symptoms of childhood psychopathology. In this paper, we aim to describe and improve the understanding of the co-occurrence of aggression with other forms of childhood psychopathology. We focus on the co-occurrence of aggression and other childhood behavioural and emotional problems, including other externalising problems, attention problems and anxiety-depression. The data were brought together within the EU-ACTION (Aggression in Children: unravelling gene-environment interplay to inform Treatment and InterventiON strategies) project. We analysed the co-occurrence of aggression and other childhood behavioural and emotional problems as a function of the child's age (ages 3 through 16years), gender, the person rating the behaviour (father, mother or self) and assessment instrument. The data came from six large population-based European cohort studies from the Netherlands (2x), the UK, Finland and Sweden (2x). Multiple assessment instruments, including the Child Behaviour Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ) and Multidimensional Peer Nomination Inventory (MPNI), were used. There was a good representation of boys and girls in each age category, with data for 30,523 3- to 4-year-olds (49.5% boys), 20,958 5- to 6-year-olds (49.6% boys), 18,291 7- to 8-year-olds (49.0% boys), 27,218 9- to 10-year-olds (49.4% boys), 18,543 12- to 13-year-olds (48.9% boys) and 10,088 15- to 16-year-olds (46.6% boys). We replicated the well-established gender differences in average aggression scores at most ages for parental ratings. The gender differences decreased with age and were not present for self-reports. Aggression co-occurred with the majority of other behavioural and social problems, from both externalising and internalising domains. At each age, the co-occurrence was particularly prevalent for aggression and oppositional and ADHD-related problems, with correlations of around 0.5 in general. Aggression also showed substantial associations with anxiety-depression and other internalizing symptoms (correlations around 0.4). Co-occurrence for self-reported problems was somewhat higher than for parental reports, but we found neither rater differences, nor differences across assessment instruments in co-occurrence patterns. There were large similarities in co-occurrence patterns across the different European countries. Finally, co-occurrence was generally stable across age and sex, and if any change was observed, it indicated stronger correlations when children grew older. We present an online tool to visualise these associations as a function of rater, gender, instrument and cohort. In addition, we present a description of the full EU-ACTION projects, its first results and the future perspectives.