A Prospective Cohort Study of Influences on Externalizing Behaviors Across Childhood: Results From a Nurse Home Visiting Randomized Controlled Trial

TitleA Prospective Cohort Study of Influences on Externalizing Behaviors Across Childhood: Results From a Nurse Home Visiting Randomized Controlled Trial
Publication TypeJournal Article
AuthorsEnoch, M. A., H. Kitzman, J. A. Smith, E. Anson, C. A. Hodgkinson, D. Goldman, and D. L. Olds
OBJECTIVE: This study investigated genetic and environmental influences on behavior in a cohort of 600 children followed prenatally to 18 years. METHOD: A randomized controlled trial of prenatal/infancy nurse home visits (NHV) was conducted in 600 predominantly African American mothers and their firstborn children from Memphis, TN. Mothers were assessed in pregnancy for mental health (MH), self-efficacy, and mastery. Mothers reported longitudinally on smoking and alcohol/drug use. The functional polymorphisms SLC6A4 5-HTTLPR, FKBP5 rs1360780 and DRD2/ANKK1 rs1800497 were genotyped together with 186 ancestry informative markers. Composite externalizing disorders (ED) continuous total scores from the mother-report Achenbach Child Behavior Checklist were included as dependent variables in regression analyses for time points 2, 6, 12, and 18 years. RESULTS: Behaviors at younger ages strongly predicted later behaviors (p < .0001). Children whose mothers had high self-efficacy and had received NHV were better behaved at age 2 years. Poorer maternal MH adversely influenced ED up to 12 years, but at age 18 years, maternal mastery exerted a strong, positive effect (p = .0001). Maternal smoking was associated with worse ED at 6 and 18 years. Main and interactive effects of genetic polymorphisms varied across childhood: FKBP5 rs1360780 up to age 6, 5-HTTLPR from 6 to 12, and DRD2/ANKK1 rs1800497 from 2 to 18 years. CONCLUSION: Our study suggests that maternal MH and resilience measured in pregnancy have long-lasting effects on child behavior. Maternal smoking across childhood and genetic factors also play a role. NHV had a positive effect on early behavior. Our findings have implications for prevention of pathological behaviors in adulthood. Clinical trial registration information-Age-17 Follow-Up of Home Visiting Intervention; http://clinicaltrials.gov/; NCT00708695.
Title A Prospective Cohort Study of Influences on Externalizing Behaviors Across Childhood: Results From a Nurse Home Visiting Randomized Controlled Trial
Publication Title J Am Acad Child Adolesc Psychiatry
Publication Type Journal Article
Published Year 2016
Authors M.A. Enoch; H. Kitzman; J.A. Smith; E. Anson; C.A. Hodgkinson; D. Goldman; D.L. Olds
Edition 2016/04/30
Accession Number 27126851
Number 5
ISBN Number 0890-8567
Grant List
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