Assessment, etiology and course of child and adolescent psychopathology
01 / 1988 - unknown
METIS Erasmus Universiteit Rotterdam
The main objective of this programme is to study the frequency, determinants, course and preventive internvention of child psychiatric disorders, such as anxiety, depression, somatoform disorders, aggressive and antisocial behaviours, hyperactivity, and developmental problems (autism, learning disorders, mental retardation). The program uses epidemiological methods to study psychopathology in general population, at risk, and clinical samples. These studies aim to develop assessment instruments and diagnostic procedures; assess the prevalence and incidence of child and adolescent disorders; study the onset and course of psychopathology from infancy to young adulthood using longitudinal and genetically sensitive research designs; assess the effectiveness of preventive and treatment approaches. General population studies The prevalence and course of child and adolescent psychiatric conditions has been studied in Dutch general population samples across the age range from 2 to 30 years. The influence of life events and personal and social-environmental determinants has been studied, and cross-cultural and secular trend analyses have been performed. These studies confirmed the high prevalence (7%) of serious psychiatric problems in Dutch children and adolescents as well as the cross-cultural similarity of child/adolescent psychopathology, and indicated that the use of mental health services at this age is mainly determined by severity of psychopathology, additional handicaps, and family burden. Longitudinal studies showed that earlier psychopathology is the strongest predictor of later psychopathology from childhood up to early adulthood, and is a strong predictor of later functional problems. Very few nonpsychopathological early predictors of later psychopathology can be demonstrated. Studies in general population samples also yielded improvements in the standardized assessment of psychopathology, ad well as contributions to the methodology of longitudinal studies (accelerated designs; developmental pathway analysis). Recently prevention studies have started, new large-scale longitudinal studies have been set up, and new data-analytic models are developed. At risk and clinical populations We have assessed the prevalence and longitudinal course of problem behaviours and quality of life in ethnic minority groups, adopted children, children and adolescents with mental retardation, children with psychiatric conditions, and adolescents with medical conditions (e.g. diabetes). Several studies on referred samples showed a very strong continuity of psychopathology up to 10 years after referral. Only few factors (learning problems, temperament, stress, family functioning) showed predictive power of later psychopathology over and above severity of earlier psychopathology. However, (chronic) physical problems appear to have considerable power in the prediction of later psychopathology (e.g. in mentally retarded children and adolescents). Studies on samples with chronic somatic disorders show the importance of cerebral involvement in child development, as well as the important role of psychological and personality factors in coping with these conditions. Intervention studies aiming anxiety disorders have started. Behavioural genetics In collaboration with the Free University Amsterdam, we have conducted (longitudinal) twin and adoption studies to determine genetic and environmental influences on problem behaviours in young children. Recent findings show changes in genetic influences on psychopathology from preschool- to school age, differential genetic and environmental influences on co morbid psychopathological problems as well as genetic influences on the stability of problem behaviours. Considerable contributions have been made to the development of estimation methods in quantitative behavioural genetics (e.g. rater bias models). The behavioural genetic studies continue the study of large genetically sensitive samples twins; adopted children) well into puberty using longitudinal designs and now include the detection of genetically sensitive syndromes of psychopathology (e.g. disruptive disorders).