Early Findings of Preventive Child Healthcare Professionals Predict Psychosocial Problems in Preadolescence: The TRAILS Study
Received 8 December 2009; accepted 11 February 2010. published online 12 April 2010.
Objective
To develop and validate a prediction model for psychosocial problems in preadolescence using data on early developmental factors from routine Preventive Child Healthcare (PCH).
Study design
The data come from the 1692 participants who take part in the TRacking Adolescents' Individual Lives Survey, a longitudinal study. Information on early developmental factors (ages 0 to 4 years) was collected from the PCH file. Parents complete the Child Behavior Checklist when their child is age 11. To examine the predictive value of PCH-registered developmental factors on preadolescent problems, several multiple logistic regression analysis were performed, in a derivation sample (n = 1058). The predictive performance of the models was then assessed with area under the curve (AUC) in a validation sample (n = 643) to evaluate the validity of these models.
Results
PCH-registered behavioral problems, attention/hyperactivity problems, enuresis, education level of the father, and being male were found to significantly predict externalizing problems (odds ratios [OR] between 1.4 and 3.7). Internalizing problems were predicted by maternal smoking during pregnancy, sleep problems, and being male (ORs between 1.7 and 3.0). The model for externalizing problems had a modest discriminatory power (AUC 0.66, 95% confidence interval 0.59-0.72). However, for internalizing problems the AUC was 0.54 (95% confidence interval 0.47-0.60), indicating poor discriminatory power.
Conclusions
Findings on early development as registered by PCH are modestly predictive for externalizing problems in preadolescents, but only slightly for internalizing problems.
aDepartment of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
bDepartment of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
cMunicipal Health Service Fryslân, Leeuwarden, The Netherlands
dDepartment of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
Reprint requests: M. Jaspers, MSc, University Medical Center Groningen, University of Groningen, Department of Health Sciences, PO Box 196, 9700 AD Groningen, The Netherlands.
ABSTRACT