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

作者：Enoch Mary Anne^*; Kitzman Harriet; Smith Joyce A; Anson Elizabeth; Hodgkinson Colin A; Goldman David; Olds David L

来源：Journal of the American Academy of Child and Adolescent Psychiatry, 2016, 55(5): 376-382.

DOI：10.1016/j.jaac.2016.02.007

• Achenbach Child Behavior Checklist
• nurse home visiting
• 5-HTTLPR
• FKBP5
• DRD2/ANKK1

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.

• 出版日期2016-5