Childhood temperament as a predictor of adolescent nonsuicidal self-injury.

Previous cross-sectional work has consistently found associations between neuroticism and impulsivity and nonsuicidal self-injury (NSSI). However, there are few longitudinal studies of personality risk factors for NSSI. In this study, we examined associations between individual differences in temperament at age 3 and NSSI from ages 9 to 15. At age 3, 559 preschool-aged children (54% male; Mage = 42.2 months [SD = 3.10]) completed laboratory assessments of temperament. Parents also completed questionnaires about their child's temperament. Children completed a diagnostic interview assessing NSSI engagement at ages 9, 12, and 15. By the age 15 assessment, 12.4% of adolescents reported engaging in NSSI. In univariate models, we found that higher levels of observed sadness and maternal-reported sadness and anger were associated with increased risk for NSSI. In multivariate models, female sex and maternal-reported anger were significantly associated with greater likelihood of NSSI. Laboratory observed sadness and impulsivity were associated with a higher likelihood of NSSI. This work extends the literature on personality risk factors associated with NSSI by finding longitudinal associations between early childhood negative affect and later NSSI engagement during adolescence.

A multimethod, multiinformant study of early childhood temperament and depression and anxiety symptoms in adolescence.

There is an extensive literature documenting associations between dimensions of temperament and depressive and anxiety disorders. However, much of the research in this area relies on cross-sectional and monomethod designs, uses samples of older youth and adults, and examines only the main effects of temperament. We examined longitudinal associations between temperamental positive emotionality (PE) and negative emotionality (NE) in early childhood and depressive and anxiety symptoms in adolescence. We assessed temperament using laboratory observations and parent reports, and symptoms using youth and parent report. We also examined potential moderators of these associations, including maternal and paternal history of depressive and anxiety disorders, youth experience of stressful life events, and parenting styles. Early childhood NE was associated with both adolescent depression and anxiety. Additionally, life events and psychological controlling and firm parenting moderated the associations between NE and depression symptoms, and maternal depression, paternal anxiety, and psychological controlling and firm parenting moderated the associations between NE and anxiety symptoms. Interaction effects were largely consistent with diathesis-stress interpretations. These findings show that temperamental NE, but not PE, is prospectively associated with risk for depressive and anxiety symptoms in adolescence, and that multiple additional factors potentiate these associations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Temperament and psychopathology in early childhood predict body dissatisfaction and eating disorder symptoms in adolescence.

Eating disorders (ED) are highly impairing and dangerous conditions that typically onset in adolescence. However, very few prospective studies have examined early childhood risk factors for ED pathology. Given well-established links between temperament and psychopathology, examination of these factors could inform prevention efforts. The current multi-method, multi-informant prospective longitudinal study tested whether laboratory-observed and parent-reported temperament and psychiatric disorders at ages 3 and 6 (N = 609) predict body dissatisfaction at ages 12 and 15 and dimensional symptoms of EDs (anorexia nervosa [AN] and bulimia nervosa [BN]) at age 15 (n = 458) in a community sample. Results indicated that early childhood temperament (positive and negative emotionality, perceptual sensitivity, impulsivity, less shyness) and childhood psychopathology (anxiety, oppositional defiant, attention deficit/hyperactivity, and depressive disorders), predicted body dissatisfaction in adolescence. In addition, childhood perceptual sensitivity and oppositional defiant and depressive disorders predicted AN symptoms. Demographic characteristics (female sex, lower levels of fathers' education, and parental marital status) in childhood predicted body dissatisfaction and AN symptoms. No temperament or psychopathology variables predicted BN symptoms. This study is an important first step toward continuing to identify areas of focus for future research on early childhood risk factors for ED symptoms and body dissatisfaction.

Examination of developmental pathways from preschool temperament to early adolescent ADHD symptoms through initial responsiveness to reward.

To identify sources of phenotypic heterogeneity in attention-deficit/hyperactivity disorder (ADHD) accounting for diversity in developmental/ pathogenic pathways, we examined, in a large sample of youth (N = 354), (a) associations between observed temperamental emotionality at age 3, an electrocortical index (i.e., reward positivity [RewP]) of initial responsiveness to reward at age 9, and ADHD symptoms at age 12, and (b) whether the association between emotionality and ADHD symptoms is mediated by initial responsiveness to reward. Bivariate analyses indicated greater positive emotionality (PE) was associated with enhanced RewP, lower age-9ADHD and lower age-12 inattention (IA). Negative emotionality (NE) was not associated with RewP or ADHD. Mediation analyses revealed the association between PE and hyperactivity/impulsivity (H/I) was mediated by RewP; enhanced RewP was associated with greater H/I. Greater PE was associated with enhanced RewP at a trend level. These effects held accounting for age-9 ADHD, age-12 IA and age-12 oppositional defiant and conduct disorder symptoms. As such, preschool emotionality is associated with adolescent ADHD-H/I symptoms through late childhood initial responsiveness to reward. These relations indicate that individual differences in emotionality and reward responsiveness may be informative for personalizing ADHD interventions.

The utility of parent-report screening tools in differentiating autism versus attention-deficit/hyperactivity disorder in school-age children.

LAY ABSTRACT: We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview - School-Age, the Social Responsiveness Scale - 2nd Edition, and the Social Communication Questionnaire - Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire - Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.

Life stress moderates the effects of preschool behavioral inhibition on anxiety in early adolescence.

BACKGROUND: Although a robust body of literature implicates temperamental behavioral inhibition (BI) as a prominent risk factor for anxiety disorders, many children with heightened BI do not develop anxiety. The current study examines the role of two forms of life stress (life events and natural disaster exposure) in moderating the relationship between BI in preschoolers and anxiety in early adolescence. METHOD: A community sample of 392 3-year-old children was administered a laboratory observational assessment of temperament. When children were a mean age 10, the region was struck by a devastating hurricane and exposure to disaster-related stress was assessed. In early adolescence, youth and a parent were administered the UCLA Life Stress Interview (LSI) to assess behaviorally independent and dependent negative life events during the prior year and youth completed the Screen for Child Anxiety Related Emotional Disorders (SCARED). RESULTS: The association between early childhood BI and anxiety symptoms in early adolescence was moderated by both independent life events and disaster-related stress. Children high in BI at age 3 reported greater anxiety symptoms at age 12 after exposure to higher levels of both forms of stress. CONCLUSIONS: Stress moderated the association between early BI and later anxiety. Importantly, this was evident for two different kinds of stressors that were independent of the child's behavior that increases confidence in the causal role of stress in the development of anxiety in high BI children.

Reactive and Regulatory Temperament: Longitudinal Associations with Internalizing and Externalizing Symptoms through Childhood.

Previous studies of the relationship between temperament and psychopathology have been limited by focusing on main effects of temperament on psychopathology, reliance solely on maternal reports of child temperament, and predominately using cross-sectional designs. This study extended this work by focusing on interactions between reactive (positive emotionality/PE; negative emotionality/NE) and regulatory (effortful control) dimensions of temperament, using laboratory observations of temperament, and focusing on longitudinal prediction of internalizing and externalizing behavior problems. 536 children (46.1% Female, 92.4% White) were followed in a prospective, longitudinal study of the relationship between temperament and psychopathology. Temperament was assessed using laboratory observations when children were at age 3. Mothers and fathers reported on internalizing and externalizing symptoms in their children at ages 3, 6, and 9. Multilevel modeling analyses examined associations between the interaction of temperament traits and patterns of change in internalizing and externalizing psychopathology. Interactions between reactive PE traits (Sociability, Exuberance), but not NE traits (Dysphoria, Fear), and regulatory temperament (Disinhibition) were associated with the slope of maternal-reported internalizing and paternal-reported externalizing symptoms such that youth low in PE traits and high in effortful control experienced a greater decline in symptoms over time. In conclusion, among children with lower levels of PE traits, strong regulatory abilities are associated with greater reductions in internalizing and externalizing symptoms over time. These models highlight the complex interaction between reactive and regulatory temperament and expand current understanding of temperamental risk for psychopathology.

Positive and Negative Emotionality at Age 3 Predicts Change in Frontal EEG Asymmetry across Early Childhood.

Depression is characterized by low positive emotionality (PE) and high negative emotionality (NE), as well as asymmetries in resting electroencephalography (EEG) alpha power. Moreover, frontal asymmetry has itself been linked to PE, NE, and related constructs. However, little is known about associations of temperamental PE and NE with resting EEG asymmetries in young children and whether this association changes as a function of development. In a longitudinal study of 254 three-year old children, we assessed PE and NE at age 3 using a standard laboratory observation procedure. Frontal EEG asymmetries were assessed at age 3 and three years later at age 6. We observed a significant three-way interaction of preschool PE and NE and age at assessment for asymmetry at F3-F4 electrode sites, such that children with both low PE and high NE developed a pattern of increasingly lower relative left-frontal cortical activity over time. In addition, F7-F8 asymmetry was predicted by a PE by time interaction, such that the frontal asymmetry in children with high PE virtually disappeared by age 6. Overall, these findings suggest that early temperament is associated with developmental changes in frontal asymmetry, and that the combination of low PE and high NE predicts the development of the pattern of frontal symmetry that is associated with depression.

Therapists' Adaptations to an Intervention to Reduce Challenging Behaviors in Children with Autism Spectrum Disorder in Publicly Funded Mental Health Services.

Publicly funded mental health services play an important role in serving children with autism spectrum disorder (ASD). Previous research indicates a high likelihood of adaptations when therapists deliver evidence based practices to non-ASD populations, though less is known about therapists' use of adaptations for children with ASD receiving mental health services. The current study uses a mixed quantitative and qualitative approach to characterize the types and reasons therapists adapted a clinical intervention [An Individualized Mental Health Intervention for Children with ASD (AIM HI)] for delivery with clinically complex children with ASD served in publicly funded mental health settings and identify therapist characteristics that predict use of adaptations. The most common adaptations were characterized as augmenting AIM HI and were done to individualize the intervention to fit with therapeutic style, increase caregiver participation, and address clients' and caregivers' needs and functioning. No therapist characteristics emerged as significant predictors of adaptations. Results suggest that therapists' adaptations were largely consistent with the AIM HI protocol while individualizing the model to address the complex needs of youth with ASD.

The BDNF gene val66met polymorphism and behavioral inhibition in early childhood.

Stably elevated behavioural inhibition (BI) is an established risk factor for internalizing disorders. This stability may be related to genetic factors, including a valine-to-methionine substitution on codon 66 (val66met) of the brain-derived neurotrophic factor (BDNF) gene. Past work on the BDNF met variant has inconsistently linked it to vulnerability to internalizing problems; some of this inconsistency may stem from the failure to consider gene-trait interactions in shaping the course of early BI. Toward elucidating early pathways to anxiety vulnerability, we examined gene-by-trait interactions in predicting the course of BI over time in 476 children, assessed for BI using standardized laboratory methods. We found that children with the met allele showed lower stability of BI between ages 3 and 6 than those without this allele. While the mechanisms that underlie this effect are unclear, our findings are consistent with the notion that the met variant, in the context of early BI, influences the stability of this trait in early development.

The Development of Latent Dimensions of Psychopathology across Early Childhood: Stability of Dimensions and Moderators of Change.

Recent research has described the structure of psychopathology as including one general and multiple specific factors, and this structure has been found in samples across development. However, little work has examined whether this structure is consistent across time, particularly in young children, within the same sample. Further, few studies have examined factors that influence the magnitude of the stability of latent dimensions of psychopathology. In the present study, we examine these issues in a community sample of 545 children assessed at ages 3 and 6. In addition, we explored child temperament, parental history of psychopathology, and parenting behaviors as potential moderators of the longitudinal stability of latent dimensions of psychopathology. We found that the same bifactor model structure identified at age 3 provided an adequate fit to the data at age 6. Further, our model revealed significant homotypic stability of the general, internalizing, and externalizing specific factors. We also found evidence of differentiation of psychopathology over time with the general factor at age 3 predicting the externalizing factor at age 6. However, we failed to identify moderators of the longitudinal associations between psychopathology latent factors. Overall, our results bolster support for the bifactor structure of psychopathology, particularly in early childhood.

Early temperamental fearfulness and the developmental trajectory of error-related brain activity.

The error-related negativity (ERN) is a negative deflection in the event-related potential waveform that occurs when an individual makes a mistake, and an increased ERN has been proposed as a biomarker for anxiety. However, previous work suggests that fearful children are characterized by a smaller ERN. We have proposed that this may reflect the changing phenomenology of anxiety across development. In the current study, we investigate this possibility using a longitudinal within-subject design. In 271 children, we completed observational measures of fear when the children were 3 years old, and then measured the ERN when the children were 6 and 9 years old. Fearful children were characterized by a decreased ERN when they were 6-year-old; by age 9, the same children who were fearful at age 3 had increased ERNs-a pattern that closely resembles that of anxious adolescents and adults.

Developmental Origins of Rumination in Middle Childhood: The Roles of Early Temperament and Positive Parenting.

Rumination, a thinking style characterized by a repetitive inward focus on negative cognitions, has been linked to internalizing disorders, particularly depression. Moreover, research suggests that rumination may be a cognitive vulnerability that predisposes individuals to psychopathology. Surprisingly little is known, however, about the etiology and development of rumination. The present study examined the role of specific components of child temperamental negative emotionality (sadness, fear, anger) and effortful control (inhibition), as well as parenting behaviors during early childhood on the development of rumination in middle childhood. Early childhood (age 3) temperament and parenting behaviors were assessed observationally and rumination was self-reported in middle childhood (age 9) in a large community sample (N = 425; 47.1% female). Two significant interactions emerged. First, temperamental anger interacted with inhibitory control (IC) such that high anger and low IC predicted higher levels of rumination, whereas low anger and low IC predicted lower levels of rumination. Second, IC interacted with parenting such that children with low IC and positive parenting had lower levels of rumination. In contrast, children with high IC reported similar levels of rumination regardless of parenting quality. Overall, these findings highlight the interplay of early IC with temperamental anger and positive parenting in the development of ruminative tendencies in middle childhood.

Temperament Distinguishes Persistent/Recurrent from Remitting Anxiety Disorders Across Early Childhood.

Up to 20% of preschool-age children meet criteria for anxiety disorders and, for a large subset, anxiety appears to persist throughout early childhood. However, little is known about which factors predict persistence/recurrence of anxiety in young children. Temperament, including behavioral inhibition (BI), negative emotionality (NE), and positive emotionality (PE), predict the onset of anxiety disorders, but to our knowledge no study has examined whether temperament predicts the course of anxiety in young children. From a community sample of 3-year-olds, we identified 89 children (79.8% White, non-Hispanic; 41.6% female) who met criteria for an anxiety disorder and examined whether observed and parent-reported BI, NE, and PE at age 3 distinguished children who continued to meet criteria for an anxiety disorder from those who remitted by age 6. Higher levels of BI and lower levels of PE assessed in the laboratory and higher parent-reported BI and shyness and lower surgency at age 3 significantly predicted persistence/recurrence of anxiety disorders from age 3 to 6. These data are the first to demonstrate the influence of temperament on the course of anxiety disorders in young children. These findings can enhance assessment and treatment of anxiety by focusing intervention efforts on children who are at risk for persistent or recurring anxiety rather than children who are displaying transient, and possibly developmentally normative, anxiety.

Associations between observed temperament in preschoolers and parent psychopathology.

Parent history of psychopathology is an established marker of children's own risk for later disorder and can therefore be used as a means of validating other risks, such as child temperament. While associations between children's temperament and parent psychopathology have been reported, few studies have used observational measures of child temperament or examined trait interactions, particularly between children's affective and regulatory traits such as effortful control (EC). In this bottom-up family study of 968 three-year-olds and their parents, we examined interactions between preschoolers' observed positive and negative affectivity (NA) and EC as predictors of a known marker of psychopathology risk: parent history of disorder. Children with lower positive affectivity had an increased probability of paternal depression history in the context of higher child NA. In addition, children with lower EC and higher NA had an increased probability of maternal anxiety. Findings shed new light on the main effects and interactions that account for associations between child temperament and parent history of disorder, one of the best-established markers of an individual's own risk for future disorder, implicating reactive and regulatory traits that merit special consideration in future longitudinal work. Copyright © 2017 John Wiley & Sons, Ltd.

The stability of temperament from early childhood to early adolescence: A multi-method, multi-informant examination.

Temperament is a core aspect of children's psychological functioning and is assumed to be at least somewhat stable across childhood. However, little research has assessed the stability of temperament from early childhood to early adolescence. Moreover, few studies have examined the influence of measurement and analytic methods on the stability of early temperament over periods of more than a few years. We obtained laboratory observations and mother and father reports of temperamental negative and positive emotionality and effortful control from 559 three-year olds. Approximately 9 years later, children and both parents completed questionnaire measures of similar temperament constructs. Zero-order correlations revealed greater within- than cross-informant stability. In addition, compared to parent reports, early childhood laboratory measures showed greater convergent and divergent validity with child, mother, and father reports at age 12. Finally, latent temperament variables at age 3 composed of laboratory and parent-report measures and latent variables at age 12 composed of parent and child reports showed moderate stability. There was also a weak but significant association of early effortful control with later negative and positive emotionality. Results have implications for assessing temperament and knowledge of the stability of temperament across childhood.

Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview.

Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4-14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non-autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen's kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06-0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.

Parents' behavioral inhibition moderates association of preschoolers' BI with risk for age 9 anxiety disorders.

BACKGROUND: Temperamental behavioral inhibition (BI) in children predicts later anxiety disorders. However, many children with BI do not develop anxiety disorders, suggesting the importance of identifying moderating factors. The current study examined whether parents' history of BI moderates the associations between preschoolers' BI and anxiety disorders at age 9. METHODS: The sample was 392 children and their parents from the community. Child BI was measured at age 3 using observational (Laboratory Temperament Assessment Battery; Lab-TAB) and parent report (Behavior Inhibition Questionnaire; BIQ) measures. In addition, both parents reported on their own history of childhood BI using the Retrospective Measure of Behavioral Inhibition (RMBI). When the children were 9 years old, a parent and the child were interviewed using the Kiddie Schedule for the Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). RESULTS: Parents' reports of their own BI moderated the associations of both observed and parent-reported child BI at age 3 with children's anxiety disorders at age 9. Among children whose parents reported having had higher childhood BI, those who exhibited high BI at age 3 were more likely to meet criteria for anxiety disorders at age 9. LIMITATIONS: The major limitation is the use of a retrospective measure of parental BI. CONCLUSIONS: These findings demonstrate that parents' histories of childhood BI moderate the association between their young children's BI and subsequent anxiety disorders. Thus, parental BI appears to identify a subgroup of BI children at particularly high risk for developing anxiety disorders by late childhood.

Behavioral observations of positive and negative valence systems in early childhood predict physiological measures of emotional processing three years later.

BACKGROUND: The Research Domain Criteria (RDoC) constructs of Positive Valence Systems (PVS) and Negative Valence Systems (NVS) are presumed to manifest behaviorally through early-emerging temperamental negative affectivity (NA) and positive affectivity (PA). The late positive potential (LPP) is a physiological measure of attention towards both negative and positive emotional stimuli; however, its associations with behavioral aspects of PVS and NVS have yet to be examined. METHODS: In a community sample of children (N = 340), we examined longitudinal relationships between observational measures of temperamental PA and NA assessed at age 6, and the LPP to both pleasant and unpleasant images assessed at age 9. RESULTS: Lower PA at age 6 predicted reduced LPP amplitudes to pleasant, but not unpleasant, images. NA as a composite measure was not related to the LPP, but specific associations were observed with facets of NA: greater fear predicted an enhanced LPP to unpleasant images, whereas greater sadness predicted a reduced LPP to unpleasant images. LIMITATIONS: We were unable to evaluate concurrent associations between behavioral observations of temperament and the LPP, and effect sizes were modest. CONCLUSIONS: Results support correspondence between behavioral and physiological measures of emotional processing across development, and provide evidence of discriminant validity in that PA was specifically related to the LPP to pleasant images, while facets of NA were specifically linked to the LPP to unpleasant images. Distinct associations of temperamental sadness and fear with the LPP highlight the importance of further evaluating subconstructs of NVS.

A Longitudinal Investigation of Predictors of the Association Between Age 3 and Age 6 Behavioural Inhibition.

Children who exhibit elevated levels of the temperament trait behavioural inhibition (BI) across time may be at greatest risk for anxiety. However, little research has investigated the influence of other temperamental traits, particularly positive emotionality (PE), on the continuity of BI in childhood, nor whether parental overprotection influences associations between early and later child BI. To explore whether PE and overprotection shape associations between early and later BI, this longitudinal study of three-year-olds (N = 446) followed up at age 6 included tasks tapping child temperament, and parental overprotection was assessed via interview ratings and parent-report. Lower levels of child PE and higher levels of caregiver overprotection at baseline predicted stronger associations between laboratory-assessed BI at ages 3 and 6. Findings elucidate influences shaping the developmental continuity of BI.