Cognitive functioning in children with internalising, externalising and dysregulation problems: a population-based study

L.M.E. Blanken, T. White, S.E. Mous, M. Basten, R.L. Muetzel, V.W.V. Jaddoe, M. Wals, J. van der Ende, F.C. Verhulst, H. Tiemeier

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2016, The Author(s).Psychiatric symptoms in childhood are closely related to neurocognitive deficits. However, it is unclear whether internalising and externalising symptoms are associated with general or distinct cognitive problems. We examined the relation between different types of psychiatric symptoms and neurocognitive functioning in a population-based sample of 1177 school-aged children. Internalising and externalising behaviour was studied both continuously and categorically. For continuous, variable-centred analyses, broadband scores of internalising and externalising symptoms were used. However, these measures are strongly correlated, which may prevent identification of distinct cognitive patterns. To distinguish groups of children with relatively homogeneous symptom patterns, a latent profile analysis of symptoms at age 6 yielded four exclusive groups of children: a class of children with predominantly internalising symptoms, a class with externalising symptoms, a class with co-occurring internalising and externalising symptoms, that resembles the CBCL dysregulation profile and a class with no problems. Five domains of neurocognitive ability were tested: attention/executive functioning, language, memory and learning, sensorimotor functioning, and visuospatial processing. Consistently, these two different modelling approaches demonstrated that children with internalising and externalising symptoms show distinct cognitive profiles. Children with more externalising symptoms performed lower in the attention/executive functioning domain, while children with more internalising symptoms showed impairment in verbal fluency and memory. In the most severely affected class of children with internalising and externalising symptoms, we found specific impairment in the sensorimotor domain. This study illustrates the specific interrelation of internalising and externalising symptoms and cognition in young children.
Original languageEnglish
Pages (from-to)445-456
JournalEuropean Child and Adolescent Psychiatry
Volume26
Issue number4
DOIs
Publication statusPublished - 1 Apr 2017
Externally publishedYes

Funding

This study was supported by the Netherlands Organization for Health Research and Development (ZonMw) TOP project number 91211021 and Sophia Children’s Hospital Research Foundation (SSWO) Project 639. The Generation R Study is conducted by the Erasmus Medical Centre in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR-MDC), Rotterdam. We gratefully acknowledge the contribution of children and parents, general practitioners, hospitals, midwives and pharmacies in Rotterdam. We thank Andrea Wildeboer, Hanan El Marroun, Ilse Nijs, Marcus Schmidt, Nikita Schoemaker and Sandra Thijssen for their efforts in study coordination, data collection and technical support. The general design of Generation R Study is made possible by financial support from the Erasmus Medical Centre, Rotterdam, the Erasmus University Rotterdam, ZonMw, the Netherlands Organisation for Scientific Research (NWO), and the Ministry of Health, Welfare and Sport.

FundersFunder number
Netherlands Organization for Health Research and Development
SSWO639
Sophia Children’s Hospital Research Foundation
ZonMw91211021
Erasmus Universiteit Rotterdam
Ministerie van Volksgezondheid, Welzijn en Sport
Erasmus Medisch Centrum
Nederlandse Organisatie voor Wetenschappelijk Onderzoek

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