Suchergebnisse

Most of the available data on the dimensional structure underlying the EMBU - an originally Swedish measure designed to assess one's recollections concerning one's parents' rearing behaviour - has been obtained with adults or adolescents. In the present study, using exploratory factor analysis, an attempt was made to determine the EMBU factorial structure in a Spanish sample of children aged 7-12 years (N=205). Four factors explaining only 24% and 25% of the total variance in the ratings of the fathers and those of the mothers, respectively, and being invariant across parental sex, were interpreted: Emotional Warmth, Rejection, Control Attempts, and Favouring Subject. Results with respect to the internal consistency reliability of the corresponding scales were satisfactory, as were homogeneity figures pertaining to each set of theoretically-related items. Higher-order analyses of the first-order dimensions (mothers and fathers jointly) revealed three factors explaining 85% of the total variance: Control Attempts, Care (Rejection vs. Emotional Warmth), and Favouring Subject. The factorially-derived (first-order) scales were uncorrelated with sex of the recipient. All scales (except Rejection) correlated sizeably, negatively, with age (medium effect size) pointing, as outlined, to the need to take into account the relevant normative, design and research implications in further investigation. Some similarities and differences with findings yielded previously with adults and adolescents are briefly pinpointed.

OBJECTIVES: New legislation on youth care in the Netherlands led to the implementation of community-based support teams, providing integrated primary youth care. Important aims of the new Youth Act were more integrated, timely care and less use of intensive forms of care. Our aim was to study changes in youth care use in time and the role of newly introduced community-based support teams herein. SETTING: Register data (2015-2018) on youth of a large city were linked and combined with administrative and aggregated data on team characteristics. PARTICIPANTS: Data on 126 095 youth (0-18 years) were available for analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary, specialised and residential youth care use were the primary outcomes. RESULTS: Generalised estimating equations analyses adjusted for individual characteristics demonstrated that over 4 years, use of primary youth care increased from 2.2% to 8.5% (OR 1.70; 99% CI 1.67 to 1.73), specialised youth care decreased from 7.2% to 6.4% (OR 0.98; 99% CI 0.97 to 1.00) and residential youth care increased slightly (OR 1.04; 99% CI 1.01 to 1.06). Gender, age, family status, migrant background and educational level were all associated with the types of youth care use and also with some trends in time. Likelihood to receive care increased in time for preschool and younger children but did not improve for migrant children.Case load, team size, team turnover, team performance and transformational leadership showed significant associations with different types of youth care use but hardly with trends in time. CONCLUSION: Patterns of youth care use changed towards more locally provided primary youth care, slightly less specialised and slightly more residential youth care. Furthermore, youth care use among younger children increased in time. These trends are partly in line with the trends intended by the Youth Act. Little evidence was found for the role of specific team characteristics on changes in youth care use in time.

OBJECTIVES: New legislation on youth care in the Netherlands led to the implementation of community-based support teams, providing integrated primary youth care. Important aims of the new Youth Act were more integrated, timely care and less use of intensive forms of care. Our aim was to study changes in youth care use in time and the role of newly introduced community-based support teams herein. SETTING: Register data (2015–2018) on youth of a large city were linked and combined with administrative and aggregated data on team characteristics. PARTICIPANTS: Data on 126 095 youth (0–18 years) were available for analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary, specialised and residential youth care use were the primary outcomes. RESULTS: Generalised estimating equations analyses adjusted for individual characteristics demonstrated that over 4 years, use of primary youth care increased from 2.2% to 8.5% (OR 1.70; 99% CI 1.67 to 1.73), specialised youth care decreased from 7.2% to 6.4% (OR 0.98; 99% CI 0.97 to 1.00) and residential youth care increased slightly (OR 1.04; 99% CI 1.01 to 1.06). Gender, age, family status, migrant background and educational level were all associated with the types of youth care use and also with some trends in time. Likelihood to receive care increased in time for preschool and younger children but did not improve for migrant children. Case load, team size, team turnover, team performance and transformational leadership showed significant associations with different types of youth care use but hardly with trends in time. CONCLUSION: Patterns of youth care use changed towards more locally provided primary youth care, slightly less specialised and slightly more residential youth care. Furthermore, youth care use among younger children increased in time. These trends are partly in line with the trends intended by the Youth Act. Little evidence was found for the role of specific team characteristics on changes in youth care use in time.

We examined the mental health problems of Dutch young adult domestic adoptees ( N = 75) relative to Dutch non-adopted peers and Dutch international adoptees. We found small differences in favor of the non-adopted peers ( N = 2021), while a minority of male domestic adoptees were at risk of anxiety/depression problems. Domestic adoptees showed somewhat less problems behavior than international adoptees ( N = 1331). Domestic and international adoptees differed in search status (non-searcher, searcher, reunited), although this could not explain any differences in mental health problems. Social workers and clinicians should support (male) adult adoptees in coping with possible feelings of anxiety and depression. Future studies should pay attention to gender differences in adoptees.

Purpose of the studyIdiopathic non‐cirrhotic portal hypertension (INCPH) has been reported increasingly in patients with chronic HIV infection. However, several aspects of this disorder remain to be elucidated. The aim of our study was to evaluate the prevalence and risk factors of HIV associated INCPH.MethodsAll adult HIV patients attending the outpatient clinic between February and September 2011 underwent sonographical spleen size determination and assessment of portosystemic collaterals. Patients with splenomegaly underwent an extensive ultrasound examination. Gastroscopy was performed when additional signs of portal hypertension or collaterals were observed. All children with HIV infection underwent extensive ultrasound examination. INCPH was diagnosed according to the general definition. Differences between INCPH cases (group 1) and HIV patients treated with didanosine (ddI) without portal hypertension (group 2) were assessed at HIV diagnosis, start of ddI and INCPH diagnosis.Summary of resultsFour out of 1010 screened adult HIV patients were diagnosed with INCPH (prevalence of 4‰). Hundred of the 1010 screened patients were treated with ddI. All INCPH patients were treated with ddI, representing an INCPH prevalence of 4% in patients exposed to ddI. In The Netherlands, 7000 patients were treated with ddI and only 17 are diagnosed with INCPH, suggesting underdiagnosis in 260 patients. No differences in clinical characteristics predictive for the development of INCPH could be demonstrated between group 1 and group 2 at HIV infection or start of ddI treatment. INCPH patients were treated longer with ddI [86 vs. 51 months, p<0.01] and concomitant treatment with ddI and stavudine [21 vs. 4 months, p<0.01]. Corrected for age and duration of follow‐up of HIV, active protein c [0.64 vs. 1.13, p<0.01] and active protein s [0.67 vs. 1.01, p<0.01] levels were lower in the INCPH group. None of the 38 children with HIV infection were diagnosed with INCPH. None of these children were ever treated with ddI.ConclusionsIn our study HIV‐associated INCPH only occurred in patients exposed to ddI. Awareness for this disorder is warranted considering the suggested underdiagnosis based on these study results. Risk factors are long term treatment with ddI and concomitant treatment with stavudine and screening for signs of portal hypertension in this subgroup may be recommended. A possible pathophysiological role for thrombophilia remains to be elucidated.
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Study background and aims: Ethnic disparities in mental health in adolescence may play a role in the development of ethnic disparities in educational attainment. The aim of this study was to assess the contribution of ethnic disparities in mental health problems in adolescence to ethnic disparities in educational attainment in adulthood. Methods: We followed two community samples of respectively 486 Dutch native and 168 Turkish migrant adolescents (11—15 years old) into adulthood (21—25 years old). Mental health was measured in adolescence, and educational attainment was assessed in adulthood. The contribution of mental health disparities to educational disparities was estimated by the degree of attenuation of the odds ratio (OR) for low education after adjustment for mental health problems. Results: Adult Turkish men more often had attained lower education than Dutch men (OR 1.81 (1.01—3.25)). Additional adjustment for mental health problems during adolescence did not change the OR. In Turkish women, however, the OR was 1.94 (1.04—3.62), and adjustment for mental health problems lowered it by 96% to 1.04 (0.51—2.14). The contribution was mostly due to ethnic disparities in internalizing problems. Conclusion: In women, but not in men, ethnic disparities in mental health, especially internalizing problems, were a strong predictor for the development of ethnic disparities in educational attainment. Prevention or treatment of internalizing problems among Turkish girls will probably contribute to the prevention of educational disparities.

The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent–child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self‐report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent–child dyads) compared to adolescents from the general population (GP; 70 parent–child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.

School-aged children with an ethnic minority background are relatively often involved in bullying and victimization, but the role of ethnic composition of schools in this context remains unclear. This study examined the relation between ethnic minority background, ethnic school composition, and bullying behaviour around primary school entry in the Netherlands. The study was based on a 2008/2009 school survey in Rotterdam, a Dutch city where about 50 % of children have a non-Dutch background. For 8523 children, teacher reports of bullying behaviour at age 5–6 years were available. Children with a non-Dutch background had higher odds of being a victim (adjusted OR 1.41, 95 % CI 1.11, 1.80), bully (OR 1.38, 95 % CI 1.20, 1.58) or bully-victim (OR 1.38, 95 % CI 1.19, 1.62) than children of Dutch national origin. Ethnic diversity in schools increased children's risk of bullying behaviour (e.g. ORvictim per 0.1 increase in 0–1 diversity range = 1.06, 95 % CI 1.00, 1.13), with children of both Dutch and non-Dutch national origin relatively more often involved in bullying in ethnically diverse schools. The proportion of same-ethnic peers in school reduced the risk of bullying among children of Dutch national origin (e.g. ORvictim per 10 % more same-ethnic children = 0.90, 95 % CI 0.83, 0.98), but not among non-Dutch children. In conclusion, ethnic minority background and ethnic diversity within schools are risk factors for bullying among 5–6 year olds. Plausibly, reductions in absolute numbers of bullying events may be obtained with tailor-made interventions in ethnically diverse schools. Such interventions should preferably be offered early in the school curriculum.

Psychiatric disorders are highly prevalent among incarcerated youth. However, whereas ethnic minority youths are overrepresented in the juvenile justice system, limited research is available on their mental health. In this study, differences in mental health problems between incarcerated adolescents of native Dutch and Moroccan origin, were examined. Child Behavior Checklist and Youth Self-Report scores were compared between incarcerated adolescents of native Dutch and Moroccan origin. Their scores were also compared to those of native Dutch and Moroccan immigrant youths in the general, non-incarcerated population. Native Dutch incarcerated adolescents showed higher levels of various mental health problems than incarcerated adolescents with a Moroccan background. Compared to the general population, incarcerated youths showed higher levels of mental health problems, but this deviation was much larger for native Dutch than for Moroccan immigrant youths. These ethnic differences in mental health problems could not be explained by ethnic differences in socio-economic background and social desirable answering tendencies. Incarcerated youths of Moroccan origin show less psychopathology than incarcerated native Dutch youths, which might be explained by disparities in sentencing procedures.

AbstractResearch on twin-singleton differences in externalizing and internalizing problems in childhood is largely cross-sectional and yields contrasting results. The goal of this study was to compare developmental trajectories of externalizing and internalizing problems in 6- to 12-year-old twins and singletons. Child Behavior Checklist (CBCL) maternal reports of externalizing and internalizing problems were obtained for a sample of 9651 twins from the Netherlands Twin Register and for a representative general population sample of 1351 singletons. Latent growth modeling was applied to estimate growth curves for twins and singletons. Twin-singleton differences in the intercepts and slopes of the growth curves were examined. The developmental trajectories of externalizing problems showed a linear decrease over time, and were not significantly different for twins and singletons. Internalizing problems seem to develop similarly for twins and singletons up to age 9. After this age twins' internalizing symptoms start to decrease in comparison to those of singletons, resulting in less internalizing problems than singletons by the age of 12 years. Our findings confirm the generalizability of twin studies to singleton populations with regard to externalizing problems in middle and late childhood. The generalizability of studies on internalizing problems in early adolescence in twin samples should be addressed with care. Twinship may be a protective factor in the development of internalizing problems during early adolescence.

AbstractTo obtain a better understanding of how genetic and environmental processes are involved in the stability and change in problem behavior from early adolescence into adulthood, studies with genetically informative samples are important. The present study used parent-reported data on internalizing and externalizing problem behavior of adoptees at mean ages 12.4, 15.5 and 26.3. In this adoption study adopted biologically related sibling pairs shared on average 50% of their genes and were brought up in the same family environment, whereas adopted biologically unrelated sibling pairs only shared their family environment. The resemblance between these adopted biologically related (N = 106) and unrelated sibling pairs (N = 230) was compared and examined over time. We aimed to investigate (1) to what extent are internalizing and externalizing problem behavior stable from early adolescence into adulthood, and (2) whether the same or different genetic and environmental factors affect these problem behaviors at the 3 assessments. Our results show that both internalizing (rs ranging from .34 to .58) and externalizing behavior (rs ranging from .47 to .69) were rather stable over time. For internalizing and externalizing problem behavior it was found that both genetic and shared environmental influences could be modeled by an underlying common factor, which explained variance in problem behavior from early adolescence into adulthood and accounted for stability over time. The nonshared environmental influences were best modeled by a Cholesky decomposition for internalizing behavior, whereas a time-specific influence of the nonshared environment was included in the final model of externalizing behavior.