Understanding individual variation in the continuity of youth mental health difficulties is critical for identifying the factors that promote recovery or chronicity. This study establishes the proportion of children showing psychopathology at 9 years, whose pathology had either remitted or persisted at 13. It describes the socio-demographic and clinical profiles of these groups, and examines the factors in 9-year-olds’ familial environments that predict longitudinal remission vs. persistence of psychopathology. The study utilised data from a prospective longitudinal study of 8568 Irish children. Child psychopathology was assessed using the Strengths and Difficulties Questionnaire (SDQ). Analysis established the rates of continuity of SDQ classifications between 9 and 13 years. Analysis also investigated the familial factors that predicted the remission vs. persistence of psychopathological symptoms, controlling for socio-demographic and child factors. Average SDQ scores improved between the ages of 9 and 13, F(1, 7292) = 276.52, p < 0.001, \(\eta _p^2\) = 0.04. Of children classified Abnormal aged 9, 41.1% remained so classified at 13, 21.4% were reclassified Borderline, and 37.6% Normal. Demographic and child risk factors for persistence of pathology were maleness (β = −1.00, p = 0.001, CI = 0.20–0.67), one-carer households (β = −0.71, p = 0.04, CI = 0.25–0.97), poor physical health (β = −0.64, p = 0.03, CI = 0.30–0.92), and low cognitive ability (β = 0.61, p = 0.002, CI = 1.26–2.70). Controlling for these factors, the only familial variable at 9 years that predicted subsequent pathological persistence was caregiver depression (β = −0.07, p = 0.03, CI = 0.87–0.99). The analysis highlights substantial rates of psychopathological discontinuity in a community sample and identifies the children most at risk of chronic mental health problems. These results will inform the targeting of early interventions and distribution of clinical resources.
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Fergusson DM, Lynskey MT, Horwood LJ (1997) Attentional difficulties in middle childhood and psychosocial outcomes in young adulthood. J Child Psychol Psychiatry 38:633–644. doi:10.1111/j.1469-7610.1997.tb01690.x
Goodwin RD, Fergusson DM, Horwood LJ (2004) Early anxious/withdrawn behaviours predict later internalising disorders. J Child Psychol Psychiatry 45:874–883. doi:10.1111/j.1469-7610.2004.00279.x
Jakobsen IS, Horwood LJ, Fergusson DM (2011) Childhood anxiety/withdrawal, adolescent parent-child attachment and later risk of depression and anxiety disorder. J Child Fam Stud 21:303–310. doi:10.1007/s10826-011-9476-x
Fergusson DM, Lynskey MT, Horwood LJ (1996) Factors associated with continuity and changes in disruptive behavior patterns between childhood and adolescence. J Abnorm Child Psychol 24:533–553. doi:10.1007/BF01670099
Bufferd SJ, Dougherty LR, Carlson GA et al (2012) Psychiatric disorders in preschoolers: continuity from ages 3–6. Am J Psychiatry 169:1157–1164. doi:10.1176/appi.ajp.2012.12020268
Costello E, Mustillo S, Erkanli A et al (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844. doi:10.1001/archpsyc.60.8.837
Visser JH, Ende J, Koot HM, Verhulst FC (2003) Predicting change in psychopathology in youth referred to mental health services in childhood or adolescence. J Child Psychol Psychiatry 44:509–519. doi:10.1111/1469-7610.00140
McGee R, Feehan M, Williams S, Anderson J (1992) DSM-III disorders from age 11–age 15 years. J Am Acad Child Adolesc Psychiatry 31:50–59. doi:10.1097/00004583-199201000-00009
Lavigne JV, Arend R, Rosenbaum D et al (1998) Psychiatric disorders with onset in the preschool years: I. stability of diagnoses. J Am Acad Child Adolesc Psychiatry 37:1246–1254. doi:10.1097/00004583-199812000-00007
Cantwell DP, Baker L (1989) Stability and natural history of DSM-III childhood diagnoses. J Am Acad Child Adolesc Psychiatry 28:691–700. doi:10.1097/00004583-198909000-00009
Kleinman JM, Ventola PE, Pandey J et al (2007) Diagnostic stability in very young children with autism spectrum disorders. J Autism Dev Disord 38:606–615. doi:10.1007/s10803-007-0427-8
Agnew-Blais JC, Polanczyk GV, Danese A et al (2016) Evaluation of the persistence, remission, and emergence of attention-deficit/hyperactivity disorder in young adulthood. JAMA Psychiatry 73:713–720. doi:10.1001/jamapsychiatry.2016.0465
Moffitt TE, Houts R, Asherson P et al (2015) Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. Am J Psychiatry. doi:10.1176/appi.ajp.2015.14101266
Sibley MH, Pelham WE, Gnagy EM et al (2012) When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol 80:1052–1061. doi:10.1037/a0029098
Sibley MH, Pelham WE, Molina BSG et al (2012) Diagnosing ADHD in adolescence. J Consult Clin Psychol 80:139–150. doi:10.1037/a0026577
Anselmi L, Barros FC, Teodoro MLM et al (2008) Continuity of behavioral and emotional problems from pre-school years to pre-adolescence in a developing country. J Child Psychol Psychiatry 49:499–507. doi:10.1111/j.1469-7610.2007.01865.x
Becker A, Rothenberger A, Sohn A, BELLA (2014) Six years ahead: a longitudinal analysis regarding course and predictive value of the Strengths and Difficulties Questionnaire (SDQ) in children and adolescents. Eur Child Adolesc Psychiatry 24:715–725. doi:10.1007/s00787-014-0640-x
Caye A, Rocha TB-M, Anselmi L et al (2016) Attention-deficit/hyperactivity disorder trajectories from childhood to young adulthood: evidence from a birth cohort supporting a late-onset syndrome. JAMA Psychiatry 73:705–712. doi:10.1001/jamapsychiatry.2016.0383
Beyer T, Postert C, Müller J, Furniss T (2012) Prognosis and continuity of child mental health problems from preschool to primary school: results of a 4-year longitudinal study. Child Psychiatry Hum Dev 43:533–543. doi:10.1007/s10578-012-0282-5
Ramtekkar UP, Reiersen AM, Todorov AA, Todd RD (2010) Sex and age differences in attention-deficit/hyperactivity disorder symptoms and diagnoses: implications for DSM-V and ICD-11. J Am Acad Child Adolesc Psychiatry 49(217–228):e3. doi:10.1016/j.jaac.2009.11.011
Feng X, Shaw DS, Silk JS (2008) Developmental trajectories of anxiety symptoms among boys across early and middle childhood. J Abnorm Psychol 117:32–47. doi:10.1037/0021-843X.117.1.32
Kerns KA, Siener S, Brumariu LE (2011) Mother–child relationships, family context, and child characteristics as predictors of anxiety symptoms in middle childhood. Dev Psychopathol 23:593–604. doi:10.1017/S0954579411000228
Midouhas E, Yogaratnam A, Flouri E, Charman T (2013) Psychopathology trajectories of children with autism spectrum disorder: the role of family poverty and parenting. J Am Acad Child Adolesc Psychiatry 52:1057–1065. doi:10.1016/j.jaac.2013.07.011
Barker ED, Copeland W, Maughan B et al (2012) Relative impact of maternal depression and associated risk factors on offspring psychopathology. Br J Psychiatry 200:124–129. doi:10.1192/bjp.bp.111.092346
Fergusson DM, Lynskey MT (1993) The effects of maternal depression on child conduct disorder and attention deficit behaviours. Soc Psychiatry Psychiatr Epidemiol 28:116–123. doi:10.1007/BF00801741
Charman T (2009) Editorial: the value of longitudinal studies for understanding continuity and variability in development. J Child Psychol Psychiatry 50:1439–1440. doi:10.1111/j.1469-7610.2009.02189.x
Watson D, Maitre B, Whelan CT, Williams J (2014) Dynamics of child economic vulnerability and socio-emotional development: an analysis of the first two waves of the growing up in Ireland study. Office of the Minister for Children, Dublin
Thornton M, Williams J, McCrory C et al (2016) Growing Up in Ireland National Longitudinal Study of Children: design, Instrumentation and Procedures for the Child Cohort at Wave Two (13 years). Department of Children and Youth Affairs, Dublin
Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586. doi:10.1111/j.1469-7610.1997.tb01545.x
Becker A, Woerner W, Hasselhorn M et al (2004) Validation of the parent and teacher SDQ in a clinical sample. Eur Child Adolesc Psychiatry 13:11–16. doi:10.1007/s00787-004-2003-5
Crone MR, Vogels AG, Hoekstra F et al (2008) A comparison of four scoring methods based on the parent-rated Strengths and Difficulties Questionnaire as used in the Dutch preventive child health care system. BMC Public Health 8:106. doi:10.1186/1471-2458-8-106
Vostanis P (2006) Strengths and difficulties questionnaire: research and clinical applications. Curr Opin Psychiatry 19:367–372. doi:10.1097/01.yco.0000228755.72366.05
Goodman R, Ford T, Simmons H et al (2003) Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Int Rev Psychiatry 15:166–172. doi:10.1080/0954026021000046128
Sareen J, Cox BJ, Stein MB et al (2007) Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. Psychosom Med 69:242–248. doi:10.1097/PSY.0b013e31803146d8
Webster-Stratton C (2016) The Incredible Years series: a developmental approach. In: Van Ryzin M, Kumpfer K, Fosco G, Greenberg M (eds) Family-based prevention programs for children and adolescents: theory, research, and large-scale dissemination. Psychology Press, New York, pp 42–67
Radloff LS (1977) The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401. doi:10.1177/014662167700100306
Pianta R (1992) Child-parent relationship scale. University of Virginia, Charlottesville, VA
Darling N, Toyokawa T (1997) Construction and validation of the Parenting Style Inventory II (PSI-II). http://www2.oberlin.edu/faculty/ndarling/lab/psiii.pdf. Accessed 31 Aug 2017
Nixon E (2012) How families matter for social and emotional outcomes of 9-year-old children: Growing Up in Ireland Report 4. Department of Children and Youth Affairs, Dublin
This research was funded by the Saint John of God Research Department (Grant ref 597).
The GUI study received ethical approval and monitoring from the Irish Health Research Board and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.
Conflict of interest
The authors declare that they have no conflict of interest.
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O’Connor, C., Reulbach, U., Gavin, B. et al. A prospective longitudinal investigation of the (dis)continuity of mental health difficulties between mid- to late-childhood and the predictive role of familial factors. Eur Child Adolesc Psychiatry 27, 289–300 (2018). https://doi.org/10.1007/s00787-017-1044-5
- Child psychopathology
- Strengths and Difficulties Questionnaire
- Parental depression