Vollebergh, W.A.M.

Need for mental health care in adolescents and its determinants: The TRAILS Study (Article)

2013-04-01T00:00:00Z

Background: Although a great deal of evidence is available on the patterns and determinants of unmet health care needs among adolescents with mental health problems, little is known about the factors that influence the need for care. The aim of this study is to assess the occurrence of need for care for mental problems in adolescents and the determinants of this need. Methods: Data were obtained from three assessment waves of TRAILS (TRacking Adolescents' Individual Lives Survey) (N = 1406). Need for care was assessed at age 16/17 (parent report). Determinants concerned previous health care utilization, emotional and behavioral problems (child behavior checklist and youth self-report) and child and family characteristics. Results: Of the 1406 parents, 409 parents (29%) reported that their child needed help for mental problems. Of these adolescents, only 29% received specialized mental health treatment. The determinants of need for mental health care at age 16/17 were family break-up and parental internalizing problems (age 10/11), parent-reported internalizing and externalizing (age 10/11 and 13/14) and receiving specialized help (age 13/14). Conclusion: A substantial proportion of all adolescents need care for their mental problems, according to their parent. There is also a large group of adolescents with mental health problems according to their parents, but for whom no parental reported need for care is expressed. The findings stress the importance of early interventions focusing on raising parental and child awareness of mental health problems. © 2012 Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Early trauma and familial risk in the development of the extended psychosis phenotype in adolescence (Article)

2012-10-01T00:00:00Z

Objective: Both genetic and environmental factors are thought to play a role in the development of psychotic outcomes; however, their respective contributions over time, including possible developmental interactions, remain largely unknown. Method: The contribution of parental general and psychotic psychopathology as proxies of genetic risk to the development of subthreshold psychosis and its hypothesized interaction with childhood trauma were studied in a general population sample of 2230 adolescents, followed from age 10-16years. Outcome measures were: i) level of psychotic experiences at age 16years and ii) persistence of such experiences over the total follow-up period. Results: General parental psychopathology was associated with CAPE score (OR=1.08; P<0.043 for highest quintile) and suggestively predicted psychosis persistence (OR, 1.16; P<0.072). Psychotic parental psychopathology was suggestively associated with CAPE score (OR, 2.25; P<0.063 for highest quintile), predicted membership of the Persistent group (OR, 3.72; P<0.039) and suggestively predicted membership of the Decreasing group (OR 2.04; P<0.051). Childhood trauma was associated with CAPE score and with all developmental trajectories of subclinical psychosis. No evidence was found for an interaction between trauma and parental psychopathology. Conclusion: The development and persistence of subthreshold psychotic symptoms may be conditional on non-interacting proxy genetic and environmental influences.

Can the gateway hypothesis, the common liability model and/or, the route of administration model predict initiation of cannabis use during adolescence? A survival analysisthe TRAILS study (Article)

2011-01-01T00:00:00Z

Purpose There is substantial research linking tobacco and alcohol use to subsequent cannabis use, yet the specificity of this relationship is still under debate. The aim of this study was to examine which substance use modelthe gateway hypothesis, the common liability (CL) model and/or the route of administration modelbest explains the relationship between early onset of tobacco and alcohol use and subsequent cannabis use initiation. Methods We used data from 2,113 (51% female) Dutch adolescents who participated in three consecutive assessment waves (mean age: 11.09, 13.56, and 16.27 years, respectively) of the TRacking Adolescents' Individual Lives Survey study. (Pre)adolescent cannabis, tobacco and alcohol use was assessed using the Youth Self-Report and a TRacking Adolescents' Individual Lives Survey developed questionnaire. Results We found that, during adolescence, early onset of tobacco use does not pose a significantly higher risk of initiating cannabis use than early onset alcohol use. Therefore, we can rule out the route of administration model. Moreover, we found that adolescents who reported early onset comorbid use of both tobacco and alcohol have a higher likelihood to initiate cannabis use than adolescents who have tried either tobacco or alcohol. The gateway hypothesis is not broad enough to explain this finding. Therefore, the CL model best predicts our findings. Conclusion Future research on adolescent cannabis initiation should focus on testing the robustness of the CL model. Furthermore, identifying adolescents who use both tobacco and alcohol, before the age of 13, may help to curtail the onset of cannabis use.

Ethnic differences in mental health among incarcerated youths: Do Moroccan immigrant boys show less psychopathology than native Dutch boys? (Article)

2010-05-01T00:00:00Z

Psychiatric disorders are highly prevalent among incarcerated youth. However, whereas ethnic minority youths are overrepresented in the juvenile justice system, limited research is available on their mental health. In this study, differences in mental health problems between incarcerated adolescents of native Dutch and Moroccan origin, were examined. Child Behavior Checklist and Youth Self-Report scores were compared between incarcerated adolescents of native Dutch and Moroccan origin. Their scores were also compared to those of native Dutch and Moroccan immigrant youths in the general, non-incarcerated population. Native Dutch incarcerated adolescents showed higher levels of various mental health problems than incarcerated adolescents with a Moroccan background. Compared to the general population, incarcerated youths showed higher levels of mental health problems, but this deviation was much larger for native Dutch than for Moroccan immigrant youths. These ethnic differences in mental health problems could not be explained by ethnic differences in socio-economic background and social desirable answering tendencies. Incarcerated youths of Moroccan origin show less psychopathology than incarcerated native Dutch youths, which might be explained by disparities in sentencing procedures.

Predicting life-time and regular cannabis use during adolescence; The roles of temperament and peer substance use: The TRAILS study (Article)

2010-04-01T00:00:00Z

Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to life-time cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods Objectives were studied using data from 1300 participants of the Tracking Adolescents' Individual Lives Survey (TRAILS), a large, general population study of Dutch adolescents. We used parent-reports on the Early Adolescent Temperament Questionnaire to assess the dimensions of high-intensity pleasure, shyness, fearfulness, frustration and effortful control at age 10-12 years. By means of self-reports, life-time and regular cannabis use were determined at age 15-18 years, and proportion of substance-using peers was determined at ages 12-15 and 15-18 years. Models were adjusted for age, sex, intelligence and parental cannabis use. Results High-intensity pleasure odds ratio (OR) = 1.09, 95% confidence interval (CI) = 1.05-1.13 and effortful control (OR = 0.92, 95% CI = 0.89-0.96) affected the risk for life-time cannabis use through their influence on affiliation with cannabis-using peers. Shyness affected this risk independently from peer cannabis use. Only the pathway from effortful control was associated additionally with the development of regular cannabis use (OR = 0.93, 95% CI = 0.89-0.98). Conclusions Peer cannabis use and, to a lesser extent, certain temperamental characteristics affect an adolescent's risk of cannabis use, and should be considered in prevention programmes. We recommend future research to focus upon factors that potentially modify the association between temperament, affiliation with cannabis-using peers and cannabis use.

The role of temperament in the relationship between early onset of tobacco and cannabis use: The TRAILS study (Article)

2009-09-01T00:00:00Z

Background: While temperamental characteristics have been related to the onset of cannabis use, it is not clear at what point(s) along the trajectory from early onset of tobacco use (EOT) to early onset of cannabis use (EOC) these characteristics exert their impact. This study examined if (1) temperamental characteristics predispose to EOT that on its turn predisposes to EOC, and (2) temperament moderates the importance of EOT on the progression to EOC. Methods: Data from 1848 (83%) participants in the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective population study of Dutch adolescents, were analyzed. We used parent-reports on the Early Adolescent Temperament Questionnaire to assess the dimensions of high-intensity pleasure, frustration, effortful control, shyness and fearfulness at age 10-12. EOT and EOC were defined as use at least once before the ages of 12 and 13 years, respectively, assessed by means of self-reports. We performed mediation and moderation analyses in Mplus. Results: High levels of high-intensity pleasure predisposed to entrance in the trajectory from EOT to EOC. Once tobacco use had been initiated at early age, low levels of shyness and high levels of high-intensity pleasure increased the risk of progression to EOC. Conclusions: Besides a common liability for EOT and EOC based on temperament, the risk of transition from tobacco to cannabis use is modified by temperamental characteristics. Differences in interplay with other risk factors may explain the impact of temperament on distinct points along the substance use trajectory.

Problem behavior and acculturation in moroccan immigrant adolescents in the Netherlands: Effects of gender and parent-child conflict (Article)

2007-05-01T00:00:00Z

The gender specificity of the relation between acculturation and problem behavior in Moroccan immigrant adolescents in the Netherlands was examined. Three previously identified classes of adolescents with similar patterns of acculturation were used: an integrated, separated, and ambivalent class. Girls with an ambivalent acculturation pattern showed more problems than the other girls on parent- and adolescent-reported internalizing and externalizing behavior. For boys, no effects of acculturation on problem behavior were found. The high number of conflicts between parents and their ambivalently acculturated daughters partly explained the relation between acculturation and problem behavior. The findings emphasized that gender and parentchild conflict should be considered when attempting to understand the complex relation between acculturation and problem behavior.