Educational level, attention problems, and externalizing behaviour in adolescence and early adulthood: the role of social causation and health-related selection—the TRAILS study

Social causation and health-related selection may contribute to educational differences in adolescents’ attention problems and externalizing behaviour. The social causation hypothesis posits that the social environment influences adolescents’ mental health. Conversely, the health-related selection hypothesis proposes that poor mental health predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as attention problems and externalizing behaviour have the potential to interfere with educational attainment, but may also be affected by differences in the educational context. Furthermore, educational gradients in mental health may reflect the impact of ‘third variables’ already present in childhood, such as parental socioeconomic status (SES), and IQ. We investigated both hypotheses in relation to educational differences in externalizing behaviour and attention problems throughout adolescence and young adulthood. We used data from a Dutch cohort (TRAILS Study; n = 2229), including five measurements of educational level, externalizing behaviour, and attention problems from around age 14–26 years. First, we evaluated the directionality in longitudinal associations between education, externalizing behaviour, and attention problems with and without adjusting for individual differences using fixed effects. Second, we assessed the role of IQ and parental SES in relation to attention problems, externalizing behaviour, and educational level. Attention problems predicted decreases in education throughout all of adolescence and young adulthood. Differences in parental SES contributed to increases in externalizing behaviour amongst the lower educational tracks in mid-adolescence. Childhood IQ and parental SES strongly predicted education around age 14. Parental SES, but not IQ, also predicted early adolescent attention problems and externalizing behaviour. Our results provide support for the health-related selection hypothesis in relation to attention problems and educational attainment. Further, our results highlight the role of social causation from parental SES in determining adolescent educational level, attention problems, and externalizing behaviour.

1161Educational level, attention problems, and externalizing behaviour in adolescence – Social causation versus health-related selection

Background Social causation and health-related selection may contribute to educational gradients in adolescents’ attention problems (AP) and externalizing behaviour (EB). From past studies it is unclear which of these mechanisms predominates, as AP and EB have the potential to interfere with educational performance, but may also be affected by differences in the educational context. Furthermore, gradients in AP and EB may reflect confounding by stable background characteristics, which are often unmeasured (e.g. genetics). We investigated social causation and health-related selection in the development of educational differences in EB and AP. Methods We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level, EB, and AP at ages around 14, 16, 19, 22, and 26 years. We employed cross-lagged panel models with fixed effects. This novel method allowed to evaluate the directionality in longitudinal associations between education, EB, and AP, whilst simultaneously controlling for time-stable individual differences. Results AP, but not EB, consistently predicted decreases in subsequent educational level throughout all of adolescence and young adulthood. Regarding social causation, only lower education around age 14 predicted increases in AP around age 16, though this effect was not robust in sensitivity analyses. Conclusions AP interfere with educational performance and have the potential to negatively affect adolescents’ educational attainment throughout all phases of adolescence and young adulthood. Key messages Interventions to address the impact of AP on education are necessary in all age groups. Hereby, it is important to take developmental differences into account.

Children’s mental health in different contexts: Results from a multi-informant assessment of Estonian first-grade students

The current study sought to investigate the agreement between teachers and parents about the mental health of first-grade students, the factors that affected this agreement and the associations between measures completed by students, parents and teachers. The investigation used baseline data collected during the PAX Good Behavior Game (PAX GBG) effectiveness study in 42 Estonian schools (N = 708). Information was collected about externalizing and internalizing difficulties and prosocial behaviour, and about inhibitory control. Our research showed higher agreement between parents and teachers about externalizing behaviour and lower agreement regarding prosocial behavior and emotional problems. Inhibition was correlated with teacher-rated questionnaires, but not with parents’ responses. Sociodemographic factors influenced the agreement between teachers and parents somewhat differently. This study highlights the importance of a multi-informant approach in students’ mental health assessments, as some problems might be less observable in certain environments or by some respondents. The practical implications of these findings are discussed and suggestions are provided for the development of a school-based mental health screening system.

Identification of 370 loci for age at onset of sexual and reproductive behaviour, highlighting common aetiology with reproductive biology, externalizing behaviour and longevity

The timing of reproductive behaviour – age at first sexual intercourse (AFS) and age at first birth (AFB) – has implications for reproductive health, adolescent development and evolutionary fitness. In the largest genome-wide association study to date (AFS, N=387,338; AFB, N=542,901), we identify 370 independent signals, 11 which are sex-specific, with a 5-6% polygenic score prediction. Heritability shifted from 10% for those born in 1940 to 23% for the 1965 birth cohort. Using Genomic SEM, we show that signals are largely driven by the genetics of reproductive biology and externalizing behaviour. This is supported by extensive biological follow-up that isolates key genes related to follicle stimulating hormone (FSHB), implantation (ESR1), infertility (endometriosis, spontaneous abortion) and spermatid differentiation, morphogenesis and binding (KLF17, ZPBP). Later AFB is protective against later-life disease (type 2 diabetes, cardiovascular) and associated with longevity. Those from higher childhood socioeconomic circumstances and polygenic scores in the highest deciles (90%+) experience markedly later reproductive onset. Results are relevant for interventions in teenage sexual, reproductive and mental health, deepen our understanding of the drivers of later-life health and longevity, and fuel infertility and functional follow-up experiments.

Nurturing Family Environments for Children: Compassion-Focused Parenting as a Form of Parenting Intervention

The style of parenting a child receives has profound long-term impacts on that child’s life. Yet, the rates of child maltreatment globally are high (in both developing and developed countries), indicating that many children around the world are being raised in toxic environments. Evidence-based parenting programs (EBPPs) have been demonstrated to have positive impacts on improving parenting style, whilst reducing childhood social, emotional and behavioural problems. EBPPs originated out of a need to address externalizing behaviour problems and to address conduct problems, and compliance became a key target of these parenting models. Thus, many EBPPs were developed in an era where operant and social learning theory-based approaches to parenting were most prominent and these parenting models still prevail today. This paper has one major aim—to demonstrate how the next generation of EBPPs need to be grounded in evolved caring motivational systems and affiliative emotion processing, which requires an understanding of the evolved processes involved in parent-offspring caring. This new approach to parenting is called, ‘compassion-focused parenting’, and this new approach to parenting will be described.