Ross Hannah Mercedes Araminta, Girard Lisa-Christine
Lancaster University, Lancaster, UK.
University of Oslo, Oslo, Norway.
Child Psychiatry Hum Dev. 2023 Nov 1. doi: 10.1007/s10578-023-01614-w.
This study investigated joint trajectories of conduct problems and hyperactivity/inattention from age three to nine in a cohort of 7,507 children in Ireland (50.3% males; 84.9% Irish). The parent-reported Strengths and Difficulties Questionnaire was used to collect information on conduct problems (CP) and hyperactivity/inattention (HI). Information regarding risk markers was collected when participants were nine-months-old via parent report and standardised assessments. Using a person-centred approach (i.e., group-based multi trajectory modelling), six trajectories were identified: no CP/low HI, low-stable CP/HI, low-declining CP/stable HI, desisting co-occurring CP/HI, pure-increasing HI, and high chronic co-occurring CP/HI. Specific risk markers for group membership included: male sex; birth complications; perceived difficult temperament; lower primary caregiver age and education level, and higher stress level; prenatal exposure to smoking, and indicators of lower socioeconomic status. Primary caregiver-child bonding and having siblings were protective markers against membership in elevated groups. Results suggest support for both 'pure' HI and co-occurring trajectories of CP and HI emerging in toddlerhood. However, no support was found for a 'pure' CP trajectory, which may support the suggestion that children on a persistent CP trajectory will have coexisting HI. Intervention efforts may benefit from starting early in life and targeting multiple risk markers in families with fewer resources.
本研究调查了爱尔兰7507名儿童(50.3%为男性;84.9%为爱尔兰人)从三岁到九岁期间行为问题和多动/注意力不集中的联合轨迹。采用家长报告的优势与困难问卷收集行为问题(CP)和多动/注意力不集中(HI)的信息。通过家长报告和标准化评估,在参与者九个月大时收集有关风险标志物的信息。采用以人为本的方法(即基于群体的多轨迹建模),确定了六种轨迹:无CP/低HI、低稳定CP/HI、低下降CP/稳定HI、停止共现CP/HI、单纯增加HI以及高慢性共现CP/HI。组成不同组别的特定风险标志物包括:男性;出生并发症;难养型气质;主要照顾者年龄和教育水平较低以及压力水平较高;产前接触吸烟,以及社会经济地位较低的指标。主要照顾者与孩子的亲密关系以及有兄弟姐妹是防止归入高风险组别的保护标志物。结果表明,支持幼儿期出现的“单纯”HI以及CP和HI的共现轨迹。然而,未发现支持“单纯”CP轨迹的证据,这可能支持了这样的观点,即持续处于CP轨迹的儿童会同时存在HI。干预措施可能从生命早期开始,并针对资源较少家庭中的多种风险标志物,这样可能会更有成效。