Early Findings of Preventive Child Healthcare Professionals Predict Psychosocial Problems in Preadolescence: The TRAILS Study

Jaspers, Merlijne; de Winter, Andrea F.; de Meer, Gea; Stewart, Roy E.; Verhulst, Frank C.; Ormel, Johan; Reijneveld, Sijmen A.

doi:10.1016/j.jpeds.2010.02.015

« Previous Next »The Journal of Pediatrics
Volume 157, Issue 2 , Pages 316-321.e2, August 2010

Early Findings of Preventive Child Healthcare Professionals Predict Psychosocial Problems in Preadolescence: The TRAILS Study

Merlijne Jaspers, MSc
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 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.
Andrea F. de Winter, PhD
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
Gea de Meer, MD, PhD
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
- Municipal Health Service Fryslân, Leeuwarden, The Netherlands
Roy E. Stewart, PhD
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
Frank C. Verhulst, MD, PhD
- Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
Johan Ormel, PhD
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
Sijmen A. Reijneveld, MD, PhD
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands

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.

AUC, Area under the curve, CBCL, Child Behavior Checklist, CI, Confidence interval, OR, Odds ratio, PCH, Preventive child healthcare, TRAILS, TRacking Adolescents' Individual Lives Survey