Social, emotional & biological processes in emergent conduct disorders: Wirral Child Health & Development Study 1-4 yrs

Lead Research Organisation: University of Manchester
Department Name: Medical and Human Sciences


This study aims to find out why some children develop behaviour problems from an early age and what factors lead to them persisting. If these difficulties are not understood and families are not helped by informed therapeutic interventions, these problems commonly develop into serious aggression or violence during adolescence and adulthood. These young people develop additional mental health and relationship problems and may then have marked difficulties parenting their own children safely. If identified early, some childhood behaviour can be helped by supporting parents in using optimal parenting strategies. However, once problematic behaviour has become entrenched it can become harder to change. We need to be able identify and understand these vulnerable children early in their lives, so chronic problems can be prevented.

Children become aggressive for different reasons and we need to know more about these. Some infants may be temperamentally more easily triggered into angry outbursts, and may become angrier in response to experiencing angry behaviour towards them or around them. Other babies may be born less emotional than average, and become less emotionally responsive to the feelings of other people as they grow up. Other children, able to feel emotions when very young, may find ways of dampening down their emotions if they are frightened over time and do not experience parental comfort. Thus different ways of responding emotionally during early life may lead to later aggression. Many factors including the genetic make-up of the child, stress during pregnancy or in early life, and parents? availability or ability to respond to their baby?s emotions probably affect how they develop.

We are currently following1286 first time mothers, partners and babies during pregnancy until the babies? first birthdays. Many infants will develop without behavioural difficulties and it is important to study them too. A sub-group of 300 mothers reporting differing levels of stress have agreed to tell us about their lives in more detail, and let us observe their children?s emotions, mother-child relationships, their child?s physiology and problem solving at 4 weeks, and 6 and 12 months of age. We aim now to follow the parents and children up to 4 years of age by which time some families will have given us detailed information at 10 time points in their lives. The study design, quality and frequency of assessments will enormously improve our understanding of the developmental pathways to aggression, improving chances of developing targeted interventions.

Technical Summary

The study will seek to identify factors and mechanisms that contribute to aggression and emergence of conduct problems at age 4 years. The broad range of factors examined will enable competing, complementary and interacting hypotheses to be examined. These include genes, maternal personality, exposure to violence and family circumstance. A particular focus will be on vulnerability marked by emotional and physiological reactivity in infancy. By following more than 1200 parents and children currently being studied from pregnancy, we will seek to examine the mechanisms by which risk factors may influence early development of emotion and physiological regulation, either through direct effects on the foetus or via early parenting, and how these then may lead onto conduct problems.

We hypothesise three pathways, high fearlessness leading to aggression with callous-unemotional traits, anger proneness together with intrusive or harsh parenting leading to aggression witout callous unemotional traits, and initial low fearlessness (fearfulness) together with exposure to frightening experiences, leading to fearlessness and aggression. In the proposed study we will follow children and their parents to 48 months, who currently are being assessed up to age 12 months. The sample was identified during pregnancy by approaching all first time mothers booking into the only antenatal service on the Wirral, Merseyside. This generated an ?extensive? sample of 1286 mothers and 1042 partners who provided questionnaire and interview data at 20 weeks gestation. By April 2009 we expect to have recruited an ?intensive? sample of 305 mothers stratified by the presence of psychosocial risk, and assessed first at 34 weeks gestation, with subsequent repeated measurement of maternal mental health, parenting, and infant emotional and physiological regulation, at 4 weeks, and 6 and 12 months This proposal is to follow both extensive and intensive samples from 12 months to 48 months of age with study children being observed and mothers interviewed when the children are aged 24 and 36 months. Assessments cover maternal mental health and relationships, parenting quality, threatening events, child fear and anger expression and aggression, cortisol and autonomic reactivity. Parent reports of child emotional and behavioural problems will be assessed at ages 12, 18, 24, 30, 36 and 48 months. DNA will be obtained from the intensive and extensive samples. Data analyses will examine whether hypothesised behavioural and physiological trajectories leading to aggression can be identified, and whether they are predicted by prenatal, genetic and postnatal risks.


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Braithwaite EC (2020) Sex differences in foetal origins of child emotional symptoms: a test of evolutionary hypotheses in a large, general population cohort. in Journal of child psychology and psychiatry, and allied disciplines

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Vidal-Ribas P (2017) Sex differences in the associations between vagal reactivity and oppositional defiant disorder symptoms. in Journal of child psychology and psychiatry, and allied disciplines