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1.	Butwicka, Agnieszka, et al. (author) Hypospadias and increased risk for neurodevelopmental disorders 2014 In: Journal of Child Psychology and Psychiatry. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0021-9630 .- 1469-7610. Journal article (peer-reviewed)abstract BACKGROUND: Hypospadias (aberrant opening of the urethra on the underside of the penis) occurs in 1 per 300 newborn boys. It has been previously unknown whether this common malformation is associated with increased psychiatric morbidity later in life. Studies of individuals with hypospadias also provide an opportunity to examine whether difference in androgen signaling is related to neurodevelopmental disorders. To elucidate the mechanisms behind a possible association, we also studied psychiatric outcomes among brothers of the hypospadias patients. METHODS: Registry study within a national cohort of all 9,262 males with hypospadias and their 4,936 healthy brothers born in Sweden between 1973 and 2009. Patients with hypospadias and their brothers were matched with controls by year of birth and county. The following outcomes were evaluated (1) any psychiatric (2) psychotic, (3) mood, (4) anxiety, (5) eating, and (6) personality disorders, (7) substance misuse, (8) attention-deficit hyperactivity disorder (ADHD), (9) autism spectrum disorders (ASD), (10) intellectual disability, and (11) other behavioral/emotional disorders with onset in childhood. RESULTS: Patients with hypospadias were more likely to be diagnosed with intellectual disability (OR 3.2; 95% CI 2.8-3.8), ASD (1.4; 1.2-1.7), ADHD (1.5; 1.3-1.9), and behavioral/emotional disorders (1.4; 1.2-1.6) compared with the controls. Brothers of patients with hypospadias had an increased risk of ASD (1.6; 1.3-2.1) and other behavioral/emotional disorders with onset in childhood (1.2; 0.9-1.5) in comparison to siblings of healthy individuals. A slightly higher, although not statistically significant, risk was found for intellectual disability (1.3; 1.0-1.9). No relation between other psychiatric diagnosis and hypospadias was found. CONCLUSIONS: This is the first study to identify an increased risk for neurodevelopmental disorders in patients with hypospadias, as well as an increased risk for ASD in their brothers, suggesting a common familial (genetic and/or environmental) liability.
2.	Chen, Qi, et al. (author) Shared familial risk factors between attention-deficit/hyperactivity disorder and overweight/obesity : a population-based familial coaggregation study in Sweden 2017 In: Journal of Child Psychology and Psychiatry. - Stockholm : Wiley-Blackwell Publishing Inc.. - 0021-9630 .- 1469-7610. ; 58:6, s. 711-718 Journal article (peer-reviewed)abstract Background: Despite meta-analytic evidence for the association between attention-deficit/hyperactivity disorder (ADHD) and overweight/obesity, the mechanisms underlying the association are yet to be fully understood.Methods By linking multiple Swedish national and regional registers, we identified 472,735 index males born during 1973-1992, with information on body weight and height directly measured before they were conscripted for military service. We further identified 523,237 full siblings born during 1973-2002 for the index males. All individuals were followed up from their third birthday to December 31, 2009 for ADHD diagnosis. Logistic regression models were used to estimate the association between overweight/obesity in index males and ADHD in their full siblings.Results: Siblings of index males with overweight/obesity had increased risk for ADHD (overweight: OR = 1.14, 95% CI = 1.05-1.24; obesity: OR = 1.42, 95% CI = 1.24-1.63), compared with siblings of index males with normal weight. The results were adjusted for birth year of the index male and sex of the sibling. After further adjustment for ADHD status of the index male, the familial coaggregation remained significant (overweight: OR = 1.13, 95% CI = 1.04-1.22; obesity: OR = 1.38, 95% CI = 1.21-1.57). The results were similar across sex of the siblings.Conclusions: Attention-deficit/hyperactivity disorder and overweight/obesity share familial risk factors, which are not limited to those causing overweight/obesity through the mediation of ADHD. Future research aiming at identifying family-wide environmental risk factors as well as common pleiotropic genetic variants contributing to both traits is warranted.
3.	Dinkler, Lisa, et al. (author) Maltreatment-associated neurodevelopmental disorders : a co-twin control analysis 2017 In: Journal of Child Psychology and Psychiatry. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0021-9630 .- 1469-7610. Journal article (peer-reviewed)abstract BACKGROUND: Childhood maltreatment (CM) is strongly associated with psychiatric disorders in childhood and adulthood. Previous findings suggest that the association between CM and psychiatric disorders is partly causal and partly due to familial confounding, but few studies have investigated the mechanisms behind the association between CM and neurodevelopmental disorders (NDDs). Our objective was to determine whether maltreated children have an elevated number of NDDs and whether CM is a risk factor for an increased NDD 'load' and increased NDD symptoms when controlling for familial effects. METHODS: We used a cross-sectional sample from a population-representative Swedish twin study, comprising 8,192 nine-year-old twins born in Sweden between 1997 and 2005. CM was defined as parent-reported exposure to emotional abuse/neglect, physical neglect, physical abuse, and/or sexual abuse. Four NDDs were measured with the Autism-Tics, AD/HD, and other comorbidities inventory. RESULTS: Maltreated children had a greater mean number of NDDs than nonmaltreated children. In a co-twin control design, CM-discordant monozygotic twins did not differ significantly for their number of NDDs, suggesting that CM is not associated with an increased load of NDDs when genetic and shared environmental factors are taken into account. However, CM was associated with a small increase in symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder in CM-discordant MZ twins, although most of the covariance of CM with NDD symptoms was explained by common genetic effects. CONCLUSIONS: Maltreated children are at higher risk of having multiple NDDs. Our findings are, however, not consistent with the notion that CM causes the increased NDD load in maltreated children. Maltreated children should receive a full neurodevelopmental assessment, and clinicians should be aware that children with multiple NDDs are at higher risk of maltreatment.
4.	Halldner, Linda, et al. (author) Relative immaturity and ADHD : findings from nationwide registers, parent- and self-reports 2014 In: Journal of Child Psychology and Psychiatry. - Stockholm : Wiley-Blackwell. - 0021-9630 .- 1469-7610. ; 55:8, s. 897-904 Journal article (peer-reviewed)abstract BACKGROUND: We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment.METHODS: We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case-control designs to study 6-69 year-old individuals in Sweden from July 2005 to December 2009 (Cohort 1). Cohort 1 included 56,263 individuals diagnosed with ADHD or ever used prescribed ADHD-specific medication. Complementary population-representative cohorts provided DSM-IV ADHD symptom ratings; parent-reported for 10,760 9-year-old twins born 1995-2000 from the CATSS study (Cohort 2) and self-reported for 6,970 adult twins age 20-47 years born 1959-1970 from the STAGE study (Cohort 3). We calculated odds ratios (OR:s) for ADHD across age for individuals born in November/December compared to January/February (Cohort 1). ADHD symptoms in Cohorts 2 and 3 were studied as a function of calendar birth month.RESULTS: ADHD diagnoses and medication treatment were both significantly more common in individuals born in November/December versus January/February; peaking at ages 6 (OR: 1.8; 95% CI: 1.5-2.2) and 7 years (OR: 1.6; 95% CI: 1.3-1.8) in the Patient and Prescribed Drug Registers, respectively. We found no corresponding differences in parent- or self-reported ADHD symptoms by calendar birth month.CONCLUSION: Relative immaturity compared to class mates might contribute to ADHD diagnosis and pharmacotherapy despite absence of parallel findings in reported ADHD symptom loads by relative immaturity. Increased clinical awareness of this phenomenon may be warranted to decrease risk for imprecise diagnostics and treatment. We speculate that flexibility regarding age at school start according to individual maturity could reduce developmentally inappropriate demands on children and improve the precision of ADHD diagnostic practice and pharmacological treatment.
5.	Hedman, Anna, et al. (author) Bidirectional relationship between eating disorders and autoimmune diseases 2019 In: Journal of Child Psychology and Psychiatry. - Stockholm : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 60:7, s. 803-812 Journal article (peer-reviewed)abstract BACKGROUND: Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases.METHODS: In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs.RESULTS: We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal-related autoimmune diseases such as, celiac disease and Crohn's disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED.CONCLUSIONS: The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.
6.	Kuja-Halkola, Ralf, et al. (author) Codevelopment of ADHD and externalizing behavior from childhood to adulthood 2015 In: Journal of Child Psychology and Psychiatry. - Stockholm : Wiley-Blackwell. - 0021-9630 .- 1469-7610. ; 56:6, s. 640-647 Journal article (peer-reviewed)abstract BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) frequently co-occurs with externalizing disorders, but a clear understanding of the etiologic underpinnings is hampered by the limited understanding of the codevelopment of the traits from childhood into early adulthood.METHODS: Using a birth cohort of 2600 twins, the Swedish Twin study of Child and Adolescent Development study, assessed at ages 8-9, 13-14, 16-17, and 19-20, we investigated the codevelopment of ADHD and externalizing behavior from childhood to adulthood. The analyses examined ADHD-like and externalizing traits, as rated by twins and their parents using the Attention Problems scale and Externalizing scale of the Child Behavior Checklist, and estimated cross-lagged effects (one trait at one time-point predicting the other at the next). The covariation between the traits were decomposed into stable (effects carried over from the prior time-points) and innovative (new effects for each time-point) sources; each source was further decomposed into additive genetics, shared and nonshared environment.RESULTS: The analysis suggested that externalizing traits in middle childhood (age 8-9) predicted ADHD-like traits in early adolescence (age 13-14), whereas the reverse association was nonsignificant. In contrast, ADHD-like traits in lateadolescence (age 16-17) predicted externalizing traits in early adulthood (age 19-20). The correlation between ADHD-like and externalizing traits increased over time. At all time-points, innovative sources contributed substantially to maintained comorbidity. Genetic effects explained 67% of the covariation at each time-point; importantly, nearly 50% of these effects were innovative.CONCLUSIONS: This study challenges the belief that ADHD generally precedes externalizing behaviors; rather, change in the etiologic factors across the development is the rule. The effects were due to both new genetic and environmental factors emerging up to young adulthood. Clinicians and researchers needs to consider complex etiologic and developmental models for the comorbidity between ADHD and externalizing behaviors.
7.	Lundström, Sebastian, et al. (author) Autism spectrum disorders and coexisting disorders in a nationwide Swedish twin study 2015 In: Journal of Child Psychology and Psychiatry and Allied Disciplines. - Stockholm : Wiley. - 0021-9630 .- 1469-7610. ; 56:6, s. 702-710 Journal article (peer-reviewed)abstract Background: Evidence from twin and molecular genetic studies is accumulating that Autism Spectrum Disorder (ASD) shares substantial etiological factors with other disorders. This is mirrored in clinical practice where ASD without coexisting disorders is rare. The present study aims to examine the range of coexisting disorders in ASD in a genetically informative cohort. Methods: Parents of all Swedish 9-year-old twins born between 1992 and 2001 (n = 19,130) underwent a telephone interview designed to screen for child psychiatric disorders, including ASD. To ensure full coverage of child psychiatric disorders, data were also retrieved from population-based health registers. We investigated the coexistence of eight psychiatric disorders known to coexist with ASDs in probands and their co-twins. Results: Half of the individuals with ASDs (50.3%) had four or more coexisting disorders and only 4% did not have any concomitant disorder. The ‘healthy co-twin’ in ASD discordant monozygotic twin pairs was very often (79% of boys and 50% of girls) affected by at least one non-ASD disorder. The corresponding figures for ASD discordant dizygotic twin pairs were significantly lower (46% of males and 30% of females). Conclusions: Detailed phenotypic descriptions including symptoms of problems associated with a wide range of child psychiatric disorders may aid in unraveling the genetic architecture of ASD and should guide the development of intervention strategies addressing each problem type specifically.
8.	Pettersson, Erik, et al. (author) Birth weight as an independent predictor of ADHD symptoms : a within-twin pair analysis 2015 In: Journal of Child Psychology and Psychiatry. - Hoboken, USA : Wiley-Blackwell. - 0021-9630 .- 1469-7610. ; 56:4, s. 453-459 Journal article (peer-reviewed)abstract Background Studies have found an association between low birth weight and ADHD, but the nature of this relation is unclear. First, it is uncertain whether birth weight is associated with both of the ADHD dimensions, inattentiveness and hyperactivity-impulsivity. Second, it remains uncertain whether the association between birth weight and ADHD symptom severity is confounded by familial factors.Method: Parents of all Swedish 9- and 12-year-old twins born between 1992 and 2000 were interviewed for DSM-IV inattentive and hyperactive-impulsive ADHD symptoms by the Autism - Tics, AD/HD and other Comorbidities (A-TAC) inventory (N = 21,775 twins). Birth weight was collected prospectively through the Medical Birth Registry. We used a within-twin pair design to control for genetic and shared environmental factors.Results: Reduced birth weight was significantly associated with a mean increase in total ADHD (β = -.42; 95% CI: -.53, -.30), inattentive (β = -.26; 95% CI: -.33, -.19), and hyperactive-impulsive (β = -.16; 95% CI: -.22, -.10) symptom severity. These results imply that a change of one kilogram of birth weight corresponded to parents rating their child nearly one unit higher (going from "no" to "yes, to some extent" on a given symptom) on the total ADHD scale. These associations remained within pairs of MZ and DZ twins, and were also present when restricting the analyses to full term births.Conclusions: There is an independent association between low birth weight and all forms of ADHD symptoms, even after controlling for all environmental and genetic confounds shared within twin pairs. These results indicate that fetal growth restriction (as reflected in birth weight differences within twin pairs) and/or the environmental factors which influence it is in the casual pathway leading to ADHD.
9.	Rydell, Mina, et al. (author) Has the attention deficit hyperactivity disorder phenotype become more common in children between 2004 and 2014? : Trends over 10 years from a Swedish general population sample 2018 In: Journal of Child Psychology and Psychiatry. - Stockholm : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 59:8, s. 863-871 Journal article (peer-reviewed)abstract BACKGROUND: Studies have reported increases in clinically diagnosed and treated attention deficit hyperactivity disorder (ADHD) during the last decade, but it is unclear if this reflects an increase in the underlying ADHD phenotype. We aimed to clarify if there has been an increase in the prevalence of ADHD-like traits in the general population from 2004 to 2014.METHOD: Data were collected from 9-year-old twins (19,271), participating in the population-based Child and Adolescent Twin Study in Sweden between 2004 and 2014. We assessed lifetime ADHD symptoms using the Autism-Tics, ADHD and other Comorbidities inventory. Research proxies for diagnostic-level ADHD and subthreshold ADHD were derived from this scale. We modeled the lifetime prevalence of diagnostic-level and subthreshold ADHD with logistic regression, and assessed mean ADHD scores each year with linear regression. Lifetime prevalence of clinically diagnosed ADHD was retrieved from the National Patient Register and modeled with logistic regression.RESULTS: The prevalence of diagnostic-level ADHD based on parent ratings did not differ significantly over time from 2004 to 2014 (OR 1.37; 95% CI: 0.77-2.45; p-value .233). Both subthreshold ADHD and mean ADHD scores increased significantly over time (both p-values <.001). Clinically diagnosed ADHD increased more than fivefold from 2004 to 2014 (OR 5.27, 95% CI: 1.85-14.96).CONCLUSIONS: We found no evidence of an increase in ADHD-like traits at the extreme end of the distribution from 2004 to 2014, but small increases in normal and subthreshold variations of ADHD-like traits were observed. This suggests that the increased rates of clinically diagnosed ADHD might reflect changes in diagnostic and treatment practices of ADHD, administrative changes in reporting diagnoses, greater awareness of ADHD, better access to healthcare, or current overdiagnosis, rather than an increase in the ADHD phenotype.
10.	Skoglund, Charlotte, et al. (author) Familial confounding of the association between maternal smoking during pregnancy and ADHD in offspring 2014 In: Journal of Child Psychology and Psychiatry. - Stockholm : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 55:1, s. 61-8 Journal article (peer-reviewed)abstract BACKGROUND: Maternal Smoking During Pregnancy (SDP) has consistently been associated with increased risk of attention-deficit/hyperactivity disorder (ADHD) in offspring, but recent studies indicate that this association might be due to unmeasured familial confounding.METHODS: A total of 813,030 individuals born in Sweden between 1992 and 2000 were included in this nationwide population-based cohort study. Data on maternal SDP and ADHD diagnosis were obtained from national registers and patients were followed up from the age of 3 to the end of 2009. Hazard Ratios (HRs) were estimated using stratified Cox regression models. Cousin and sibling data were used to control for unmeasured familial confounding.RESULTS: At the population level maternal SDP predicted ADHD in offspring (HR(ModerateSDP) = 1.89; HR(HighSDP)= 2.50). This estimate gradually attenuated toward the null when adjusting for measured confounders (HR(ModerateSDP)= 1.62; HR(HighSDP)= 2.04), unmeasured confounders shared within the extended family (i.e., cousin comparison) (HR(ModerateSDP)= 1.45; HR(HighSDP)= 1.69), and unmeasured confounders within the nuclear family (i.e., sibling comparison) (HR(ModerateSDP)= 0.88; HR(HighSDP)= 0.84).CONCLUSIONS: Our results suggest that the association between maternal SDP and offspring ADHD are due to unmeasured familial confounding.
11.	Cantor-Graae, Elizabeth, et al. (author) Risk for schizophrenia in intercountry adoptees: a Danish population-based cohort study 2007 In: Journal of Child Psychology and Psychiatry and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:11, s. 1053-1060 Journal article (peer-reviewed)abstract Background: Increasing numbers of intercountry adoptees are reaching adulthood, the age of onset for most serious mental disorders. Little is known about the development of schizophrenia in intercountry adoptees, a group with potentially increased vulnerability. The aim of this study was to investigate the risk of developing schizophrenia in adoptees and in non-adoptees. Methods: Utilising data from the Danish Civil Registration System, we established a population-based cohort of 1.06 million persons resident in Denmark before the age of 15, whose legal mother lived in Denmark at the child's birth. Intercountry adoptees were identified as children born abroad. Record linkage provided information on psychiatric admissions. Results: Intercountry adoptees had an increased relative risk (RR) (RR = 2.90, 95% CI 2.41-3.50) of developing schizophrenia compared to native Danes. The increased risk was independent of age at onset and age at, or region of, adoption, and was not attributable to mental illness in a foster parent, the foster parent's age, or to urbanisation. The foster mother's own biological offspring had also an increased risk of developing schizophrenia (1.92, 95% Cl 1.23-3.02). Conclusions: Young adult intercountry adoptees are at increased risk for schizophrenia. Although the underlying cause is unknown, a complex interplay of factors presumably may be involved, including heredity, adversity prior to adoption, and post-adoption adjustment difficulties during upbringing.
12.	Göran, Söderlund, et al. (author) Listen to the Noise: Noise is Beneficial for Cognitive Performance in ADHD 2007 In: Journal of Child Psychology and Psychiatry and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:8, s. 840-847 Journal article (peer-reviewed)abstract Background: Noise is typically conceived of as being detrimental to cognitive performance. However, given the mechanism of stochastic resonance, a certain amount of noise can benefit performance. We investigate cognitive performance in noisy environments in relation to a neurocomputational model of attention deficit hyperactivity disorder (ADHD) and dopamine. The Moderate Brain Arousal model (MBA; Sikstro¨m & So¨derlund, 2007) suggests that dopamine levels modulate how much noise is required for optimal cognitive performance. We experimentally examine how ADHD and control children respond to different encoding conditions, providing different levels of environmental stimulation. Methods: Participants carried out self-performed mini tasks (SPT), as a high memory performance task, and a verbal task (VT), as a low memory task. These tasks were performed in the presence, or absence, of auditory white noise. Results: Noise exerted a positive effect on cognitive performance for the ADHD group and deteriorated performance for the control group, indicating that ADHD subjects need more noise than controls for optimal cognitive performance. Conclusions: The positive effect of white noise is explained by the phenomenon of stochastic resonance (SR), i.e., the phenomenon that moderate noise facilitates cognitive performance. The MBA model suggests that noise in the environment, introduces internal noise into the neural system through the perceptual system. This noise induces SR in the neurotransmitter systems and makes this noise beneficial for cognitive performance. In particular, the peak of the SR curve depends on the dopamine level, so that participants with low dopamine levels (ADHD) require more noise for optimal cognitive performance compared to controls. Keywords: ADHD, stochastic resonance, dopamine, episodic memory, SPT, noise. Abbreviations: MBA: moderate brain arousal; SR: stochastic resonance; SPT: subject-performed task; VT: verbal task (VT).
13.	Larsson, Henrik, 1975-, et al. (author) Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8,500 twin pairs. 2012 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 53:1, s. 73-80 Journal article (peer-reviewed)abstract Although the clinical utility of categorically defined attention-deficit hyperactivity disorder (ADHD) is well established, there is also strong evidence supporting the notion of ADHD as an extreme of a continuous trait. Nevertheless, the question of whether the etiology is the same for different levels of DSM-IV ADHD symptoms remains to be investigated. The aim of this study was to assess genetic links between the extreme and the subthreshold range of ADHD symptoms.
14.	Lundström, Sebastian, et al. (author) Trajectories leading to autism spectrum disorders are affected by paternal age: findings from two nationally representative twin studies. 2010 In: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 51:7, s. 850-856 Journal article (peer-reviewed)abstract Background: Despite extensive efforts, the causes of autism remain unknown. Advancing paternal age has been associated with various neurodevelopmental disorders. We aim to investigate three unresolved questions: (a) What is the association between paternal age and autism spectrum disorders (ASD)?; (b) Does paternal age moderate the genetic and environmental etiological factors for ASD? (c) Does paternal age affect normal variation in autistic-like traits? Methods: Two nationally representative twin studies from Sweden (n = 11, 122, assessed at age 9 or 12) and the UK (n = 13, 524, assessed at age 9) were used. Categorical and continuous measures of ASD, autistic-like traits and autistic similarity were calculated and compared over paternal age categories. Results: Both cohorts showed a strong association between paternal age and the risk for ASD. A U-shaped risk association could be discerned since the offspring of both the youngest and oldest fathers showed an elevation in the risk for ASD. Autistic similarity increased with advancing paternal age in both monozygotic and dizygotic twins. Both cohorts showed significantly higher autistic-like traits in the offspring of the youngest and oldest fathers. Conclusions: Phenomena associated with paternal age are clearly involved in the trajectories leading to autistic-like traits and ASD. Mechanisms influencing the trajectories might differ between older and younger fathers. Molecular genetic studies are now needed in order to further understand the association between paternal age and ASD, as well as normal variation in social, language, and repetitive behaviors in the general population.
15.	Cederblad, M, et al. (author) Mental health in international adoptees as teenagers and young adults. An epidemiological study 1999 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 40:8, s. 1239-1248 Journal article (peer-reviewed)
16.	Green, Dido, et al. (author) The severity and nature of motor impairment in Asperger's syndrome : A comparison with Specific Developmental Disorder of Motor Function 2002 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 43:5, s. 655-668 Journal article (peer-reviewed)abstract Background:The aims of this study were to measure objectively the extent and severity of motor impairment in children with Asperger's syndrome and to determine whether the motor difficulties experienced by such children differed in any way from those classified as having a Specific Developmental Disorder of Motor Function (SDD-MF). Criteria derived from ICD 10-R were used to identify 11 children with Asperger's syndrome and a matched group of 9 children with a Specific Developmental Disorder of Motor Function. Children in both groups were required to have a verbal IQ of 80 or greater on the WISC IIIR.Method:The Autism Diagnostic Interview (Revised; Lord, Rutter, & LeCouteur, 1994) was used to identify features of AS in the first group and to exclude them in the latter. The Movement Assessment Battery for Children (Henderson & Sugden, 1992) provided a standardised test of motor impairment. A Gesture Test based on that by Cermak, Coster, and Drake (1980) was used to assess the child's ability to mime the use of familiar tools and to imitate meaningless sequences of movements.Results:All the children with Asperger's syndrome turned out to meet our criterion for a diagnosis of motor impairment, five of the six most severely motor impaired children in the whole study being from this group. Performance of the Asperger group was also slightly poorer on the Gesture Test. The profile of performance on each test was examined in detail but no evidence of group differences in the pattern of impairment was found.Conclusions:This study is consistent with others suggesting a high prevalence of clumsiness in Asperger's syndrome. Our findings also attest to the widespread prevalence of motor impairment in developmental disorders and the problems such co-morbidity poses for attempts to posit discrete and functionally coherent impairments underlying distinct syndromes.
17.	Pagani, Linda, et al. (author) The impact of family transition on the development of delinquency in adolescent boys : a 9-year longitudinal study 1998 In: Journal of Child Psychology and Psychiatry. - Oxford : Wiley. - 0021-9630 .- 1469-7610. ; 39:4, s. 489-499 Journal article (peer-reviewed)abstract Examined prospectively the impact of family transition on deviant development in a sample of 427 French-Canadian boys participating in a longitudinal study from kindergarten onwards. During the course of the study some boys experienced family transition. The boys were grouped by developmental period and number of marital transitions they experienced: divorced between ages 6-11; divorced between ages 12-15; remarried between ages 6-11; and remarried between ages 12-15. From ages 11-15 the author's assessed boys' delinquency and their family processes (parental supervision, punishment, and communication) annually. The results suggest that boys who experienced remarriage between ages 12-15 are at greater risk for delinquency. In particular, they showed evidence of comparatively more theft and fighting at earlier ages than their peers from families that had remained intact. At similar points in development, they perceived less expressive parent-child relationships. Finally, these boys also perceived less monitoring by their parents, both overall and at different points in adolescence.
18.	Billstedt, Eva, 1961, et al. (author) Autism in adults: symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. 2007 In: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:11, s. 1102-1110 Journal article (peer-reviewed)abstract BACKGROUND: Few studies have looked at the very long-term outcome of individuals with autism who were diagnosed in childhood. METHODS: A longitudinal, prospective, community-based follow-up study of adults who had received the diagnosis of autism (classic and atypical) in childhood (n = 105) was conducted. A structured interview (the Diagnostic Interview for Social and COmmunication disorders--the DISCO) was used in order to evaluate symptoms and symptom patterns 13-22 years after original diagnosis. Childhood measures, including IQ-level at time of childhood diagnosis and communicative speech registered before age 5 years, were studied in relation to the presence of autism symptoms at follow-up. RESULTS: The classical and atypical autism groups were fairly homogeneously impaired in terms of symptoms in the social interaction category whereas other common childhood autism symptoms, including maladaptive and stereotyped behaviours, were more variable in the study group at follow-up. Odd responses to sensory stimuli were still extremely common. Speech before 5 years of age, IQ, gender, diagnosed medical disorder and onset of epilepsy before 5 years were variables that correlated to outcome on the DISCO algorithm for autistic spectrum disorders (Wing & Gould, 1979) concerning style and quality of social interaction, communication style and pattern of self-chosen activities. CONCLUSIONS: Social interaction problems were still present in the vast majority of adults with autism/atypical autism, but behavioural impairments were much more variable in adulthood. Almost all cases were reported to show persistent perceptual problems. Certain childhood measures were found to prospectively predict adult social interaction style, communication type, and pattern of self-chosen activities, which still met diagnostic criteria for autism/atypical autism in adulthood.
19.	Brocki, Karin C., et al. (author) Early concurrent and longitudinal symptoms of ADHD and ODD : Relations to different types of inhibitory control and working memory 2007 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:10, s. 1033-1041 Journal article (peer-reviewed)abstract Background: The aim of the present study was to investigate how three different types of inhibitory control - interference control within task, interference control outside task, and prepotent response inhibition - and two types of working memory - verbal and spatial - would relate to early symptoms of attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), both concurrently and longitudinally. Methods: Seventy-two preschoolers, 1/3 who had been identified as being at risk for developing ADHD and/or ODD, completed neuropsychological tasks designed to measure inhibitory control and working memory. Behavioral symptoms were measured through parental and teacher ratings of the DSM-IV criteria for ADHD and ODD. Results: Our results suggest distinct types of inhibitory control as being good predictors of concurrent and longitudinal symptoms of ADHD, rather than ODD. However, no associations were obtained between working memory and ADHD or ODD symptoms either concurrently or longitudinally. Conclusions: This study emphasizes the need to isolate complex executive processes and break them down into components in order to properly understand the neuropsychological roots involved in ADHD and ODD.
20.	Forsman, Mats, et al. (author) A longitudinal twin study of the direction of effects between psychopathic personality and antisocial behaviour 2010 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 51:1, s. 39-47 Journal article (peer-reviewed)abstract Background: Antisocial behaviour may partly develop as a consequence of psychopathic personality. However, neither the direction of effects nor the aetiology of the association has previously been clarified. The aim in this study was to investigate the direction of effects between psychopathic personality and antisocial behaviour, and to investigate the genetic and environmental contribution to this association. Method: Twins (n = 2,255) in the Swedish Twin Study of Child and Adolescent Development were prospectively followed from adolescence to adulthood. We used a longitudinal cross-lagged twin model to study the associations between psychopathic personality and antisocial behaviour. Results: Psychopathic personality in mid-adolescence predicted antisocial behaviour in adulthood (p < .001), but not the other way around. However, bidirectional effects were found when a measure of persistent antisocial behaviour (from age 8-9 to age 16-17) was used. Psychopathic personality predicted both rule-breaking behaviour (p < .001) and aggressive behaviour (p < .01). Genetic factors were of importance in mediating the longitudinal associations between psychopathic personality and antisocial behaviour. Conclusions: This study provides evidence that genetically influenced psychopathic personality is a robust predictor of adult antisocial behaviour, but also that persistent antisocial behaviour has an impact on adult psychopathic personality via genetic effects.
21.	Gillberg, Christopher, 1950, et al. (author) Autism Under Age 3 Years: A Clinical Study of 28 Cases Referred for Autistic Symptoms in Infancy 1990 In: Journal of Child Psychology and Psychiatry and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 31:6, s. 921-934 Journal article (peer-reviewed)abstract Twenty-eight children referred with a preliminary diagnosis of autistic disorder under age 3 yrs were extensively examined from the neuropsychiatric point of view and followed up for several months to several years. A diagnosis of autistic disorder was confirmed in 75% of the cases. A variety of associated medical conditions was identified. It was concluded that autism can be diagnosed in a substantial proportion of cases before age 3 yrs and that the neurobiological background is similar to that seen in older autistic children.
22.	Hysing, Mari, et al. (author) Chronic physical illness and mental health in children. Results from a large-scale population study. 2007 In: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:8, s. 785-792 Journal article (peer-reviewed)abstract BACKGROUND: The aim of the present study was to evaluate the sensitivity and specificity of the Strengths and Difficulties Questionnaire (SDQ) in detecting emotional and behavioural problems among children with chronic illness (CI). METHODS: Parents and teachers of a population of primary school children in Norway (n = 9430) completed a questionnaire including the SDQ, and a question about chronic illness. A total of 74% (n = 7007) of the parents participated. A sub-sample (n = 1040) was given a psychiatric diagnostic evaluation according to the Development and Well-Being Assessment (DAWBA). RESULTS: According to parent reports, 537 (8%) children had a CI. The SDQ revealed an increased risk of emotional and behavioural problems in children with CI as compared with non-CI peers, both among boys (OR = 2.10 CI 95% 1.56-2.83) and girls (OR = 2.11 CI 95% 1.49-2.99). Children with CI also showed an increased risk of psychiatric disorder as assessed by the DAWBA (OR = 1.70 CI 95% 1.04-2.85). Both the sensitivity and specificity of the SDQ in predicting a psychiatric diagnosis were high, even when only information from parents was included. CONCLUSION: Children with CI in the general population are at increased risk of behavioural and emotional problems and psychiatric disorders. Given its high sensitivity and specificity the SDQ might work well as a screening instrument for behaviour/emotional problems and psychiatric disorder in children with CI.
23.	Kerr, Margaret, et al. (author) Psychopathic traits moderate peer influence on adolescent delinquency 2012 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 53:8, s. 826-835 Journal article (peer-reviewed)abstract Background: Peer influence on adolescent delinquency is well established, but little is known about moderators of peer influence. In this study, we examined adolescents (targets) and their peers psychopathic personality traits as moderators of peer influence on delinquency in peer networks. We used three separate dimensions of the psychopathic personality: grandiose-manipulative traits, callous-unemotional traits, and impulsive-irresponsible traits. Methods: We used a peer network approach with five waves of longitudinal data from 847 adolescents in one community. Peer nominations were not limited to the school context, thus allowing us to capture all potentially important peers. In addition, peers reported on their own delinquency, thus allowing us to avoid problems of false consensus or projection that arise when individuals report on their peers delinquency. We used simulation investigation for empirical network analyses (SIENA), which is the only program currently available that can be used to study peer influence effects in peer networks of multiple relationships while controlling for selection effects. Results: Targets and peers callous-unemotional and grandiose-manipulative traits uniquely moderated peer influence on delinquency. Relative to those with low levels, targets who were high on these traits were less influenced by peers delinquency, and peers who were high on these traits were more influential on targets delinquency. Selection effects were found for impulsive-irresponsible traits, but these traits did not moderate peer influence on delinquency. Conclusions: As the first study to look at moderating effects of psychopathic traits on peer influence, this study advances knowledge about peer influence on delinquency and about psychopathic traits in adolescents. In addition, the study contributes to the literature by looking at unique effects of the three dimensions of psychopathy and taking a peer network approach, in which network effects, self-selection, and other selection effects are controlled when examining influence and moderators of influence.
24.	Larsson, Henrik, 1975- (author) Commentary : Psychopathic traits enhance adolescents' influence on others and make them less easily influenced by others?--reflections on Kerr et al. (2012) 2012 In: Journal of Child Psychology and Psychiatry. - : Wiley-Blackwell. - 0021-9630 .- 1469-7610. ; 53:8, s. 836-837 Journal article (peer-reviewed)
25.	Larsson, Henrik, 1975-, et al. (author) Developmental trajectories of DSM-IV symptoms of attention-deficit/hyperactivity disorder : genetic effects, family risk and associated psychopathology 2011 In: Journal of Child Psychology and Psychiatry. - : Wiley-Blackwell. - 0021-9630 .- 1469-7610. ; 52:9, s. 954-963 Journal article (peer-reviewed)abstract BACKGROUND: DSM-IV specifies three ADHD subtypes; the combined, the hyperactive-impulsive and the inattentive. Little is known about the developmental relationships underlying these subtypes. The objective of this study was to describe the development of parent-reported hyperactivity-impulsivity and inattention symptoms from childhood to adolescence and to study their associations with genetic factors, family risk, and later adjustment problems in early adulthood.METHOD: Data in this study comes from 1,450 twin pairs participating in a population-based, longitudinal twin study. Developmental trajectories were defined using parent-ratings of hyperactivity-impulsivity and inattention symptoms at age 8-9, 13-14, and 16-17. Twin methods were used to explore genetic influences on trajectories. Family risk measures included low socioeconomic status, large family size and divorce. Self-ratings of externalizing and internalizing problems in early adulthood were used to examine adjustment problems related to the different trajectory combinations.RESULTS: We found two hyperactivity-impulsivity trajectories (low, high/decreasing) and two inattention trajectories (low, high/increasing). Twin modeling revealed a substantial genetic component underlying both the hyperactivity-impulsivity and the inattention trajectory. Joint trajectory analyses identified four groups of adolescents with distinct developmental patterns of hyperactivity-impulsivity and inattention: a low/low group, a primarily hyperactive, a primarily inattentive and a combined (high/high) trajectory type. These trajectory combinations showed discriminant relations to adjustment problems in early adulthood. The hyperactive, inattentive and combined trajectory subtypes were associated with higher rates of family risk environments compared to the low/low group.CONCLUSION: Study results showed that for those on a high trajectory, hyperactivity decreased whereas inattention increased. The combinations of these trajectories lend developmental insight into how children shift from (i) a combined to inattentive subtype, and (ii) a hyperactive-impulsive to a combined subtype. This study suggests that ADHD subtypes cannot be viewed as discrete and stable categories.
26.	Lothmann, Claudia, et al. (author) Cognitive bias modification training in adolescents : effects on interpretation biases and mood 2011 In: Journal of Child Psychology and Psychiatry. - : WILEY. - 0021-9630 .- 1469-7610. ; 52:1, s. 24-32 Journal article (peer-reviewed)abstract Background: Negative biases in the interpretation of ambiguous material have been linked to anxiety and mood problems. Accumulating data from adults show that positive and negative interpretation styles can be induced through cognitive bias modification (CBM) paradigms with accompanying changes in mood. Despite the therapeutic potential of positive training effects, training paradigms have not yet been explored in adolescents. Methods: Eighty-two healthy adolescents (aged 13-17 years) were randomly allocated to either positive or negative CBM training. To assess training effects on interpretation bias, participants read ambiguous situations followed by test sentences with positive or negative interpretations of the situation. Participants rated the similarity of these sentences to the previously viewed ambiguous situations. Training effects on negative and positive affect were assessed using visual analogue scales before and after training. Results: After training, adolescents in the negative condition drew more negative and fewer positive interpretations of new ambiguous situations than adolescents in the positive condition. Within the positive condition, adolescents endorsed more positive than negative interpretations. In terms of mood changes, positive training resulted in a significant decrease in negative affect across participants, while the negative condition led to a significant decrease in positive affect among male participants only. Conclusion: This is the first study to demonstrate the plasticity of interpretation bias in adolescents. The immediate training effects on mood suggest that it may be possible to train a more positive interpretation style in youth, potentially helping to protect against anxiety and depressive symptoms.
27.	Munoz, Luna C., et al. (author) Verbal ability and delinquency : testing the moderating role of psychopathic traits 2008 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 49:4, s. 414-421 Journal article (peer-reviewed)abstract Background Impaired verbal abilities are one of the most consistent risk factors for serious antisocial and delinquent behavior. However, individuals with psychopathic traits often show serious antisocial behavior, despite showing no impairment in their verbal abilities. Thus, the aim of the current study was to examine whether psychopathy moderates the relationship between verbal abilities and delinquent behavior in a sample of detained youth. Methods The sample included 100 detained adolescent boys who were assessed on self-reported delinquent acts and psychopathic traits, as well as their age at first offense based on official records. Participants also completed a competitive computer task involving two levels of provocation, during which skin conductance was measured. A standard measure of receptive vocabulary was individually administered. Results As predicted, there was a significant interaction between callous-unemotional (CU) traits (a critical dimension of psychopathy) and verbal ability when predicting violent delinquency. Individuals who were high on CU traits with higher scores on the measure of verbal abilities reported the greatest violent delinquency. These individuals also showed the lowest level of skin conductance reactivity during the provocation task. Conclusions The results suggest CU traits are an important moderator of the relation between verbal abilities and violent delinquency.
28.	Parkes, Jackie, et al. (author) Psychological problems in children with cerebral palsy: a cross-sectional European study. 2008 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 49:4, s. 405-13 Journal article (peer-reviewed)abstract OBJECTIVES: To describe psychological symptoms in 8-12-year-old children with cerebral palsy; to investigate predictors of these symptoms and their impact on the child and family. DESIGN: A cross-sectional multi-centre survey. PARTICIPANTS: Eight hundred and eighteen children with cerebral palsy, aged 8-12 years, identified from population-based registers of cerebral palsy in eight European regions and from multiple sources in one further region. MAIN OUTCOME MEASURES: The Strengths and Difficulties Questionnaire (SDQ)(P4-16) and the Total Difficulties Score (TDS) dichotomised into normal/borderline (TDS < or = 16) versus abnormal (TDS > 16). STATISTICAL ANALYSIS: Multilevel, multivariable logistic regression to relate the presence of psychological symptoms to child and family characteristics. RESULTS: About a quarter of the children had TDS > 16 indicating significant psychological symptoms, most commonly in the domain Peer Problems. Better gross motor function, poorer intellect, more pain, having a disabled or ill sibling and living in a town were independently associated with TDS > 16. The risk of TDS > 16 was odds ratio (OR) = .2 (95% CI: .1 to .3) comparing children with the most and least severe functional limitations; OR = 3.2 (95%CI: 2.1 to 4.8) comparing children with IQ < 70 and others; OR = 2.7 (95% CI: 1.5 to 4.6) comparing children in severe pain and others; OR = 2.7 (95% CI:1.6 to 4.6) comparing children with another disabled sibling or OR = 1.8 (95%CI: 1.2 to 2.8) no siblings and others; OR = 1.8 (95% CI: 1.1 to 2.8) comparing children resident in a town and others. Among parents who reported their child to have psychological problems, 95% said they had lasted over a year, 37% said they distressed their child and 42% said they burdened the family at least 'quite a lot'. CONCLUSIONS: A significant proportion of children with cerebral palsy have psychological symptoms or social impairment sufficiently severe to warrant referral to specialist services. Care must be taken in the assessment and management of children with cerebral palsy to ensure psychological problems are not overlooked and potentially preventable risk factors like pain are treated effectively. The validity of the SDQ for children with severe disability warrants further assessment.
29.	Posserud, Maj-Britt, et al. (author) Autistic features in a total population of 7-9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). 2006 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 47:2, s. 167-75 Journal article (peer-reviewed)abstract BACKGROUND: The prevalence of autism is reported to be on the rise worldwide. Change of diagnostic criteria and a broadening of the concept of autism have been mentioned as contributing factors. Further studies of general populations are needed. The present study assessed the distribution of autistic features in a total population of children 7-9 years of age, and explored the impact of age, gender, informant, and participation bias on symptom report. METHODS: Teacher and parent forms of the Autism Spectrum Screening Questionnaire (ASSQ) were used in the "Bergen Child Study", a total population study of 9430 children aged 7-9 years. Completed teacher forms were returned for 97% and parent forms for 71% of the children. High-scorers were defined according to the ASSQ validation study by Ehlers, Gillberg, and Wing (1999). RESULTS: The distribution of ASSQ scores was found to be almost continuous. Of the children with both a teacher and a parent form, 2.1% were defined as high-scorers. Children without parent informed consent (i.e., anonymous children) obtained significantly higher teacher scores than those who had questionnaires completed by both parent and teacher. Adjusting prevalence for the anonymous children, the prevalence of high-scorers was 2.7% of the total population. Age did not affect symptom scores. Boys scored higher and parents reported more symptoms, particularly in girls. Agreement between informants was low to moderate. CONCLUSIONS: Autism symptoms are not uncommon in the general population of children. Our findings are consistent with the concept of autism as a spectrum. Non-responders had a higher load of autism symptoms than identified children, indicating that reports on the prevalence of autism in a responder group underestimate true prevalence. Large differences across informants suggested the need to gather information both from families and from schools when screening for autism spectrum disorders.
30.	Rodriguez, A, et al. (author) Fetal origins of child non-right-handedness and mental health 2008 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 49:9, s. 967-976 Journal article (peer-reviewed)
31.	Rodriguez, Alina, et al. (author) Fetal origins of non-right-handedness and child mental health 2008 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 49:9, s. 967-976 Journal article (peer-reviewed)abstract Background: Environmental risk during fetal development for non-right-handedness, an index of brain asymmetry, and its relevance for child mental health is not fully understood. Methods: A Swedish population-based prospective pregnancy-offspring cohort was followed-up when children were five years old (N = 1714). Prenatal environmental risk exposures were the number of ultrasound examinations and maternal distress during pregnancy. Child mental health, including symptoms of attention deficit hyperactivity disorder (ADHD), language difficulties, and care-seeking for child behavior problems, was assessed via maternal and/or kindergarten teacher's ratings. Results: Prenatal exposure to maternal depressive symptoms and critical life events were associated with increased risk of child non-right-handedness and mixed handedness, after adjustment for parity, maternal age, birth outcomes, infant sex, and parental handedness. No association was found between handedness and number of ultrasound examinations. Non-right and mixed-handedness, rather than left-handedness, were associated with increased risk of language difficulties and particularly with ADHD symptoms, after adjustment for current parental ADHD symptoms, current maternal depressive symptoms, birth outcomes, smoking during pregnancy, depressive symptoms and critical life events. Problems were significant enough to prompt mothers to seek care for children's behavioral problems, and parents were more likely to have received advice from the children's kindergarten teachers to seek care. Conclusions: This study suggests that mixed-handedness, i.e., reflecting atypical brain laterality, can be a marker of both severity of prenatal exposure to maternal distress and of increased risk of ADHD symptoms in childhood. Our results support the idea that the fetal environment plays a role in subsequent child mental health.
32.	Rodriguez, Alina, et al. (author) Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? : Disentangling the effects of social adversity 2009 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 50:9, s. 1073-1083 Journal article (peer-reviewed)abstract Background: Studies concerning whether exposure to low levels of maternal alcohol consumption during fetal development is related to child inattention and hyperactivity symptoms have shown conflicting results. We examine the contribution of covariates related to social adversity to resolve some inconsistencies in the extant research by conducting parallel analyses of three cohorts with varying alcohol consumption and attitudes towards alcohol use.Methods: We compare three population-based pregnancy2013offspring cohorts within the Nordic Network on ADHD from Denmark and Finland. Prenatal data were gathered via self-report during pregnancy and birth outcomes were abstracted from medical charts. A total of 21,678 reports concerning inattention and hyperactivity symptoms in children were available from the Strengths and Difficulties Questionnaire or the Rutter Scale completed by parents and/or teachers.Results: Drinking patterns differed cross-nationally. Women who had at least some social adversity (young, low education, or being single) were more likely to drink than those better off in the Finnish cohort, but the opposite was true for the Danish cohorts. Prenatal alcohol exposure was not related to risk for a high inattention-hyperactivity symptom score in children across cohorts after adjustment for covariates. In contrast, maternal smoking and social adversity during pregnancy were independently and consistently associated with an increase in risk of child symptoms.Conclusions: Low doses of alcohol consumption during pregnancy were not related to child inattention/hyperactivity symptoms once social adversity and smoking were taken into account.
33.	Rodriguez, Alina (author) Maternal pre-pregnancy obesity and risk for inattention and negative emotionality in children 2010 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 51:2, s. 134-143 Journal article (peer-reviewed)abstract Objective:This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children.Methods:A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714). Mothers and kindergarten teachers rated children's ADHD symptoms, presence and duration of problems, and emotionality. Dichotomized outcomes examined difficulties of clinical relevance (top 15% of the distribution). Analyses adjusted for pregnancy (maternal smoking, depressive symptoms, life events, education, age, family structure), birth outcomes (birth weight, gestational age, infant sex) and concurrent variables (family structure, maternal depressive symptoms, parental ADHD symptoms, and child overweight) in an attempt to rule out confounding.Results:Maternal pre-pregnancy overweight and obesity predicted high inattention symptom scores and obesity was associated with a two-fold increase in risk of difficulties with emotion intensity and emotion regulation according to teacher reports. Means of maternal ratings were unrelated to pre-pregnancy body mass index (BMI). Presence and duration of problems were associated with both maternal over and underweight according to teachers.Conclusions:Despite discrepancies between maternal and teacher reports, these results provide further evidence that maternal pre-pregnancy overweight and obesity are associated with child inattention symptoms and extend previous work by establishing a link between obesity and emotional difficulties. Maternal adiposity at the time of conception may be instrumental in programming child mental health, as prenatal brain development depends on maternal energy supply. Possible mechanisms include disturbed maternal metabolic function. If maternal pre-pregnancy obesity is a causal risk factor, the potential for prevention is great.
34.	Rydelius, PA (author) Annotation: are children of alcoholics a clinical concern for child and adolescent psychiatrists of today? 1997 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 38:6, s. 615-624 Journal article (peer-reviewed)
35.	Silberg, JL, et al. (author) The developmental association between eating disorders symptoms and symptoms of depression and anxiety in juvenile twin girls 2005 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 46:12, s. 1317-1326 Journal article (peer-reviewed)
36.	Sjöberg, Rickard L. (author) Child testimonies during an outbreak of witch hysteria : Sweden 1670-1671 1995 In: Journal of Child Psychology and Psychiatry. - : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 36:6, s. 1039-1051 Journal article (peer-reviewed)abstract Eight hundred and nine testimonies given by children between the ages of 1 and 16 to the priests of the parish of Rättvik, and to the Royal commission of inquiry, during an outbreak of witch hysteria in 1670-71 are examined. The result implies that the capacity to separate reality from fantasy as well as the tendency to give stereotyped testimonies are related to age, social influence from other children and sex. The results also suggest that the testimonies were influenced by the person investigating the child.
37.	Thorell, Lisa B. (author) Do delay aversion and executive function deficits make distinct contributions to the functional impact of ADHD symptoms? : A study of early academic skill deficits 2007 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:11, s. 1061-1070 Journal article (peer-reviewed)abstract Background: The present study examined the distinct properties of executive functioning in relation to ADHD symptoms, as well as functional outcomes associated with ADHD. In line with the dual-pathway model of ADHD, executive functioning and delay aversion were expected to show independent effects on ADHD symptoms. Furthermore, relations to early academic skills were examined, and it was hypothesized that the two processes of the dual-pathway model can be differentiated in terms of their effect on academic skill deficits, such that EF deficits, but not delay aversion, mediate the link between ADHD and academic functioning. Results: As hypothesized, both EF deficits and delay aversion were independently related to ADHD symptoms. However, when conducting separate analyses for the two ADHD symptom domains, only the effect of EF deficits was independently related to symptoms of inattention, whereas only the effect of delay aversion was independently related to symptoms of hyperactivity/ impulsivity. The mediation analysis showed that EF deficits, but not delay aversion, act as a mediator in the relation between symptoms of inattention and both mathematics and language skills. In addition, there was also a significant direct effect of inattention on early academic skills. Conclusions: The findings of the present study are of importance for current models of heterogeneity in ADHD as they 1) provide further support for the notion that EF deficits and delay aversion are two possible pathways to ADHD, 2) add new interesting knowledge by showing that EF deficits and delay aversion can be differentiated in terms of their relations to the two ADHD symptom domains, and 3) indicate that the two processes of the dual-pathway model can also be differentiated in terms of their effect on functional impairments associated with ADHD.
38.	Tuvblad, Catherine, 1968-, et al. (author) Heritability for adolescent antisocial behavior differs with socioeconomic status : gene–environment interaction 2006 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 47:7, s. 734-743 Journal article (peer-reviewed)abstract Background: Socioeconomic status is often assumed to be of importance for the development of antisocial behavior, yet it explains only a fraction of the variance. One explanation for this paradox could be that socioeconomic status moderates the influence of genetic and environmental effects on antisocial behavior.Method: TCHAD is a Swedis h longitudinal population-based twin study that contains 1,480 twin pairs born 1985-1986. The present study included 1,133 twin pairs, aged 16-17 years. Antisocial behavior was measured through self-report. Family socioeconomic status was assessed by parentalreported education and occupational status. Neighborhood socioeconomic conditions were assessed using five aggregated level variables: ethnic diversity, basic educational level, unemployment level, buying power, and crime-rate. We used structural equation modeling to test whether socioeconomic status interacted with latent genetic and environmental effects for antisocial behavior.Results: Gen etic influences on antisocial behavior were more important in adolescents in socioeconomically more advantaged environments, whereas the shared environment was higher in adolescents in socioeconomically less advantaged environments. Heritability for antisocial behavior was higher in girls than in boys, irrespective of socioeconomic background.Conclusions: Our results suggest that differe nt intervention policies should be considered in different socioeconomic areas. In socioeconomically advantaged areas, it might be more fruitful to focus on individually based preventions and treatments. In socioeconomically disadvantaged areas, intervention and prevention policies might be more effective on a community level, to account for shared environmental risk factors.
39.	Vinnerljung, Bo, et al. (author) Suicide attempts and severe psychiatric morbidity among former child welfare clients--a national cohort study. 2006 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 47:7, s. 723-33 Journal article (peer-reviewed)
40.	Ahlberg, Richard, et al. (author) Shared familial risk factors between autism spectrum disorder and obesity : a register‐based familial coaggregation cohort study 2022 In: Journal of Child Psychology and Psychiatry. - : John Wiley & Sons. - 0021-9630 .- 1469-7610. ; 63:8, s. 890-899 Journal article (peer-reviewed)abstract Background: Meta-analyses suggest an association between autism spectrum disorder (ASD) and obesity, but the factors underlying this association remain unclear. This study investigated the association between ASD and obesity stratified on intellectual disability (ID). In addition, in order to gain insight into possible shared etiological factors, the potential role of shared familial liability was examined.Method: We studied a cohort of 3,141,696 individuals by linking several Swedish nationwide registers. We identified 35,461 individuals with ASD and 61,784 individuals with obesity. Logistic regression models were used to estimate the association between ASD and obesity separately by ID and sex and by adjusting for parental education, psychiatric comorbidity, and psychotropic medication. Potential shared familial etiologic factors were examined by comparing the risk of obesity in full siblings, maternal and paternal half-siblings, and full- and half-cousins of individuals with ASD to the risk of obesity in relatives of individuals without ASD.Results: Individuals with ASD + ID (OR = 3.76 [95% CI, 3.38-4.19]) and ASD-ID (OR = 3.40 [95% CI, 3.23-3.58]) had an increased risk for obesity compared with individuals without ASD. The associations remained statistically significant when adjusting for parental education, psychiatric comorbidity, and medication. Sex-stratified analyses indicated a higher relative risk for males compared with females, with statistically significant interaction effects for ASD-ID, but not for ASD+ID in the fully adjusted model. First-degree relatives of individuals with ASD+ID and ASD-ID had an increased risk of obesity compared with first-degree relatives of individuals without ASD. The obesity risk was similar in second-degree relatives of individuals with ASD+ID but was lower for and ASD-ID. Full cousins of individuals with ASD+ID had a higher risk compared with half-cousins of individuals with ASD+ID). A similar difference in the obesity risk between full cousins and half-cousins was observed for ASD-ID.Conclusions: Individuals with ASD and their relatives are at increased risk for obesity. The risk might be somewhat higher for males than females. This warrants further studies examining potential common pleiotropic genetic factors and shared family-wide environmental factors for ASD and obesity. Such research might aid in identifying specific risks and underlying mechanisms in common between ASD and obesity.
41.	Ahmadzadeh, YI, et al. (author) Parental criticism and adolescent internalising symptoms: using a Children-of-Twins design with power calculations to account for genetic influence 2022 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 63:5, s. 599-607 Journal article (peer-reviewed)
42.	Andersson, Anneli, 1992-, et al. (author) Research Review : The strength of the genetic overlap between ADHD and other psychiatric symptoms - a systematic review and meta-analysis 2020 In: Journal of Child Psychology and Psychiatry. - : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 61:11, s. 1173-1183 Research review (peer-reviewed)abstract Background: Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with other psychiatric disorders. Twin studies have established that these co-occurrences are in part due to shared genetic risks. However, the strength of these genetic overlaps and the potential heterogeneity accounted for by type of psychiatric symptoms, age, and methods of assessment remain unclear. We conducted a systematic review to fill this gap.Methods: We searched PubMed, PsycINFO, Embase, and Web of Science until March 07, 2019. Genetic correlations (r(g)) were used as effect size measures.Results: A total of 31 independent studies fulfilled the inclusion criteria. The pooled estimates showed that the associations between ADHD and other psychiatric symptoms were partly explained by shared genetic factors, with a pooled genetic correlation of 0.50, 95% confidence interval: 0.46-0.60. The genetic correlations (r(g)) between ADHD and externalizing (r(g) = .49 [0.37-0.61]), internalizing (r(g) = .50 [0.39-0.69]), and neurodevelopmental (r(g) = .56 [0.47-0.66]) symptoms were similar in magnitude. The genetic correlations in childhood and adulthood werer(g) = .53 (0.43-0.63) andr(g) = .51 (0.44-0.56), respectively. For methods of assessment, the genetic correlations were also similar in strength, self-reportsr(g) = .52 (0.47-0.58), other informantsr(g) = .55 (0.41-0.69), and combined ratersr(g) = .50 (0.33-0.65).Conclusions: These findings indicate that the co-occurrence of externalizing, internalizing, and neurodevelopmental disorder symptoms in individuals with ADHD symptoms in part is due to a shared genetic risk.
43.	Arvidsson, Olof, et al. (author) Secular changes in the symptom level of clinically diagnosed autism. 2018 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 59:7, s. 744-751 Journal article (peer-reviewed)abstract The prevalence of autism has been reported to have increased worldwide. A decrease over time in the number of autism symptoms required for a clinical autism diagnosis would partly help explain this increase. This study aimed to determine whether the symptom level of clinically diagnosed autism cases below age 13 had changed over time.Parents of Swedish 9-year old twins (n=28,118) participated in a telephone survey, in which symptoms and dysfunction/suffering related to neurodevelopmental disorders [including autism, but also attention-deficit/hyperactivity disorder (ADHD), Developmental Coordination Disorder (DCD), and Learning Disabilities (LD)] in their children were assessed over a 10-year period. Survey data was merged with the National Patient Register containing clinically registered autism diagnoses (n=271).In individuals who had been clinically diagnosed with autism before the age of 13, the symptom score for autism decreased on average 30% over more than a decade in birth cohorts 1992-2002. There was an average decrease of 50% in the autism symptom score from 2004 to 2014 in individuals who were diagnosed with autism at ages 7-12, but there was no decrease in those diagnosed at ages 0-6.Over time, considerably fewer autism symptoms seemed to be required for a clinical diagnosis of autism, at least for those diagnosed after the preschool years. The findings add support for the notion that the observed increase in autism diagnoses is, at least partly, the by-product of changes in clinical practice, and flag up the need for working in agreement with best practice guidelines.
44.	Balazs, J, et al. (author) Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk 2013 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 54:6, s. 670-677 Journal article (peer-reviewed)
45.	Barenbaum, Joshua, et al. (author) The psychosocial aspects of children exposed to war : practice and policy initiatives. 2004 In: Journal of Child Psychology and Psychiatry. - 0021-9630 .- 1469-7610. ; 45:1, s. 41-62 Journal article (peer-reviewed)abstract The atrocities of war have detrimental effects on the development and mental health of children that have been documented since World War II. To date, a considerable amount of knowledge about various aspects of this problem has been accumulated, including the ways in which trauma impacts child mental health and development, as well as intervention techniques, and prevention methods. Considering the large populations of civilians that experience the trauma of war, it is timely to review existing literature, summarize approaches for helping war-affected children, and suggest future directions for research and policy.
46.	Barzilay, S, et al. (author) A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents 2019 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 60:10, s. 1104-1111 Journal article (peer-reviewed)
47.	Beckman, K., et al. (author) Method of self-harm in adolescents and young adults and risk of subsequent suicide 2018 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 59:9, s. 948-956 Journal article (peer-reviewed)abstract Background: Self-harm is common in youth and an important risk factor for suicide. Certain self-harm methods might indicate a higher risk of suicide. The main aim of this study was to determine whether some methods of self-harm in adolescents (10-17 years) and young adults (18-24 years) are associated with a particularly high risk of suicide. A secondary aim was to ascertain how different self-harm methods might affect the probability of psychiatric follow up. Method: Five Swedish registers were linked in a national population-based cohort study. All nonfatal self-harm events recorded in specialist health care, excluding psychiatry and primary care services, among 10-24 year olds between 2000 and 2009 were included. Methods were classified as poisoning, cutting/piercing, violent method (gassing, hanging, strangulation/suffocation, drowning, jumping and firearms), other and multiple methods. Hazard Ratios (HR) for suicide were calculated in Cox regression models for each method with poisoning as the reference. Odds Ratios (OR) for psychiatric inpatient care were determined in logistic regression models. Analyses were adjusted for important covariates and stratified by age group and treatment setting (inpatient/outpatient). Results: Among adolescents with initial medical hospitalisation, use of a violent method was associated with a near eightfold increase in HR for suicide compared to self-poisoning in the adjusted analysis [HR 7.8; 95% confidence interval (CI) 3.2-19.0]. Among hospitalised young adult women, adjusted HRs were elevated fourfold for both cutting [4.0 (1.9-8.8)] and violent methods [3.9 (1.5-10.6)]. Method of self-harm did not affect suicide risk in young adult men. Adolescents using violent methods had an increased probability of psychiatric inpatient care following initial treatment for self harm. Conclusions: Violent self-harm requiring medical hospitalisation may signal particularly high risk of future suicide in adolescents (both sexes) and in young adult women. For the latter group this is the case for cutting requiring hospitalisation as well.
48.	Berg, Lisa, et al. (author) Parental death during childhood and depression in young adults – a national cohort study 2016 In: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 57:9, s. 1092-1098 Journal article (peer-reviewed)abstract BackgroundThere are few prospective, population-based studies on childhood parental death and psychiatric disorders in adulthood, and previous findings are inconclusive. This study investigated the association between parental death from natural and external (suicides, accidents or homicides) causes before 18 years and the risk of clinical depression in young adults, in relation to age at loss and gender of both child and parent.MethodsIn this register-based study, a national cohort born in Sweden during 1973–1982 (n = 862,554) was followed with regard to hospital admissions and outpatient care for depression during 2006–2013. Multivariate Cox proportional hazards models were used to estimate the impact of parental death, taking sociodemographic and parental psychosocial covariates into account.ResultsMaternal death from natural causes was associated with a hazard ratio (HR) of outpatient care for depression of 1.19 [95% confidence interval (CI), 1.02–1.40] in men and 1.15 (1.01–1.31) in women, after adjustment for sociodemographic confounders, with similar effect sizes for paternal natural death. Death from external causes consistently had higher effect size compared with natural deaths, in particular in relation to risk of hospital admissions for depression where they were as high as HR 3.23 (2.38–4.38) for men, and 1.79 (1.30–2.47) for women after a loss of a mother. Losing a parent in preschool age, compared with losing a parent as a teenager, was associated with higher risks of both hospitalization (p = .006) and outpatient care (p = .001) for depression.ConclusionsThis study indicates that parental loss to death from natural causes during childhood is associated with a small increased risk of long-term consequences for psychological health. Children who lose their parents to death from external causes, that is suicides, accidents or homicides, and children losing a parent in young ages are, however, at particular risk and should be given priority in preventive interventions after parental loss.
49.	Bjureberg, Johan, et al. (author) Adolescent self-harm with and without suicidality : cross-sectional and longitudinal analyses of a Swedish regional register 2019 In: Journal of Child Psychology and Psychiatry. - : John Wiley & Sons. - 0021-9630 .- 1469-7610. ; 60:3, s. 295-304 Journal article (peer-reviewed)abstract Background: Self-harm is common and there is a need for studies that investigate the relevance of this behavior in clinical samples to inform risk assessment and treatment. The objectives in the current studies were to compare clinical and psychosocial correlates and subsequent adverse outcomes in youth who present to child and adolescent mental health services (CAMHS) with self-harm only (SH), self-harm with suicidality (SH+SU), with those without any indication of SH or SH+SU.Methods: We conducted a case-control study and a longitudinal cohort study using data from a regional clinical care register, and Swedish national registers. The case-control study included all patients (5-17 years) between 2011 and 2015 (N = 25,161). SH and SH+SU cases were compared with controls (patients without SH) regarding a range of correlates. The longitudinal study included former CAMHS patients (N = 6,120) who were followed for a median time of 2.8 years after termination of CAMHS contact regarding outcomes such as clinical care consumption, social welfare recipiency, and crime conviction.Results: In the case-control study, both the SH and SH+SU groups received more clinical care, had lower global functioning, and higher odds of having mental disorders compared to controls. In most comparisons, the SH+SU group had more problems than the SH group. In the longitudinal study, the same pattern emerged for most outcomes; for example, the adjusted hazard ratio for recurrent care due to self-harm was 23.1 (95% confidence interval [CI], 17.0-31.4) in the SH+SU group compared to 3.9 (95% CI, 2.3-6.7) in the SH group.Conclusions: Adolescent patients presenting with self-harm have higher risks for adverse outcomes than patients without self-harm. Suicidality in addition to self-harm is associated with more severe outcomes, importantly recurrent episodes of care for self-harm.
50.	Bjureberg, J, et al. (author) Adverse clinical outcomes among youths with nonsuicidal self-injury and suicide attempts: a longitudinal cohort study 2022 In: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 63:8, s. 921-928 Journal article (peer-reviewed)

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