School of Psychology, Centre for Innovation in Mental Health, University of Southampton, University Road, Highfield Campus, Building 44, Southampton, SO17 1PS, UK.
Southampton Education School, University of Southampton, Southampton, SO17 1BJ, UK.
Eur Child Adolesc Psychiatry. 2024 Feb;33(2):411-420. doi: 10.1007/s00787-023-02175-y. Epub 2023 Feb 24.
Childhood head injuries and conduct problems increase the risk of aggression and criminality and are well-known correlates. However, the direction and timing of their association and the role of their demographic risk factors remain unclear. This study investigates the bidirectional links between both from 3 to 17 years while revealing common and unique demographic risks. A total of 8,603 participants (50.2% female; 83% White ethnicity) from the Millennium Cohort Study were analysed at 6 timepoints from age 3 to 17. Conduct problems were parent-reported for ages 3 to 17 using the Strengths and Difficulties Questionnaire (SDQ) and head injuries at ages 3 to 14. A cross-lagged path model estimated the longitudinal bidirectional effects between the two whilst salient demographic risks were modelled cumulatively at three ecological levels (child, mother, and household). Conduct problems at age 5 promoted head injuries between 5 and 7 (Z = 0.07; SE = 0.03; 95% CI, 0.02-0.13), and head injuries at ages 7 to 11 promoted conduct problems at age 14 (ß = .0.06; SE = .0.03; 95% CI, 0.01-0.12). Head injuries were associated with direct child-level risk at age 3, whereas conduct problems were associated with direct risks from all ecological levels until 17 years. The findings suggest a sensitive period at 5-11 years for the bidirectional relationship shared between head injuries and conduct problems. They suggest that demographic risks for increased head injuries play an earlier role than they do for conduct problems. Both findings have implications for intervention timing.
儿童期头部损伤和行为问题会增加攻击和犯罪的风险，这是众所周知的相关因素。然而，它们之间的关联方向和时间以及人口统计学风险因素的作用仍不清楚。本研究从 3 岁到 17 岁调查了两者之间的双向联系，同时揭示了共同和独特的人口统计学风险。总共 8603 名参与者（50.2%为女性；83%为白人）来自千禧年队列研究，在 3 到 17 岁期间的 6 个时间点进行了分析。3 到 17 岁时，使用《长处和困难问卷》（SDQ）对行为问题进行了父母报告，3 到 14 岁时对头部损伤进行了报告。交叉滞后路径模型估计了两者之间的纵向双向影响，同时在三个生态水平（儿童、母亲和家庭）上累积建模了显著的人口统计学风险。5 岁时的行为问题促进了 5 到 7 岁之间的头部损伤（Z=0.07；SE=0.03；95%CI，0.02-0.13），7 到 11 岁之间的头部损伤促进了 14 岁时的行为问题（β=0.06；SE=0.03；95%CI，0.01-0.12）。头部损伤与 3 岁时的直接儿童水平风险相关，而行为问题与所有生态水平的直接风险相关，直到 17 岁。这些发现表明，5 到 11 岁之间是头部损伤和行为问题之间双向关系的敏感时期。它们表明，增加头部损伤的人口统计学风险比行为问题更早发挥作用。这两个发现都对干预时机有影响。
