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Trajectories of internalising and externalising symptoms and inflammation in the general child population
Eirini Flouri1, Glyn Lewis2, Marta Francesconi1
1Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
Insights
Increasing internalizing symptoms in children are linked to higher inflammation markers like C-reactive protein (CRP) and interleukin-6 (IL-6). This suggests emotional and social difficulties may impact physical health in children.
Area of Science:
- Child Psychology
- Developmental Pediatrics
- Immunology
Background:
- Inflammatory markers may precede or follow child behavioral problems.
- Previous research lacked adjustment for confounders like psychosocial stressors and prenatal exposures.
- The trajectory of these problems in childhood was not fully explored.
Purpose of the Study:
- To investigate the childhood association between the growth of internalizing and externalizing symptoms and inflammatory markers.
- To account for potential confounders in this association.
- To explore the link between symptom trajectories and inflammation levels.
Main Methods:
- Utilized data from the Avon Longitudinal Study of Parents and Children (ALSPAC).
- Analyzed trajectories of internalizing (emotional, social) and externalizing (hyperactivity, conduct) problems from ages 4 to 9 years.
- Assessed C-reactive protein (CRP) and interleukin-6 (IL-6) levels at age 9 using latent growth curve modeling and linear regression on 4525 participants.
Main Results:
- Increasing internalizing symptoms over childhood correlated with higher CRP and IL-6 levels at age 9, even after confounder adjustment.
- A 1-unit annual increase in internalizing symptoms predicted a 12% rise in CRP and an 8% rise in IL-6.
- No significant association was found between externalizing symptoms and either inflammatory marker.
Conclusions:
- Identified a potential pathway from increasing emotional and social difficulties to elevated inflammation in healthy children.
- The association, if causal, implies that interventions for emotional and social problems may yield physical health benefits.
- This study is a foundational step in understanding the link between child behavioral trajectories and inflammation.
Background:
Elevations in inflammatory marker levels have been shown to precede internalising and externalising problems in the general child population. One study has found the reverse, that elevations in inflammatory marker levels in childhood follow internalising and externalising problems. However, the authors did not explore the role of the course of these problems in childhood or adjust for a number of potential confounders including psychosocial stressors and prenatal and perinatal exposures.
Aims:
To investigate the association in childhood between the growth of internalising and externalising symptoms and levels of inflammatory markers, while accounting for potential confounders.
Methods:
Using data from the Avon Longitudinal Study of Parents and Children, we tested the association between the trajectories of internalising (emotional and social) and externalising (hyperactivity and conduct) problems, at ages 4, 6, 8 and 9 years, and levels of C-reactive protein (CRP) and interleukin 6 (IL-6) at age 9 years. We analysed data (n = 4525) using latent growth curve modelling and linear regression.
Results:
Children who had increasing levels of internalising symptoms over childhood were more likely to have higher levels of CRP and IL-6 at 9 years of age, even after adjustment for confounders. A one-unit increase in the rate of annual change of internalising symptoms was related to an increase of 12% and 8% in the level of CRP and IL-6, respectively. However, there was no evidence for an association between externalising symptoms and either inflammatory marker.
Conclusions:
This study is the first step towards identifying a robust pathway, via increases in emotional and social difficulties, to elevated inflammation in healthy children. This association, if causal, suggests that effective interventions for children experiencing chronic emotional and social difficulties could also have physical health benefits.
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