title: Adverse life events as risk factors for behavioural and emotional problems in a 7-year follow-up of a population-based child cohort.
abstract: OBJECTIVE
  The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events.
  
  
  METHODS
  Data on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change.
  
  
  RESULTS
  Parental divorce significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers, decreasers, high persisters and low persisters), we found that children with a consistently high level of behavioural problems also had the highest number of adverse life events compared with any other group.
  
  
  CONCLUSIONS
  Family break-up was found to be a significant risk factor. This supports findings in previous studies. The fact that no other risk factor proved to be of significance might be due to lack of power in the study. Children experiencing high levels of adverse life events are at high risk of chronic problem behaviour. Thus these risk factors should be assessed in daily clinical practice.
authors.affiliation: Child and Adolescent Psychiatric Department, Mental Health Hospital and University Clinic, Region of Southern Denmark, University of Southern Denmark , Sdr. Boulevard 29, DK-5000 Odense C , Denmark.
authors.forename: Cathrine Skovmand
authors.initials: CS
authors.lastname: Rasmussen
authors.forename: Louise Gramstrup
authors.initials: LG
authors.lastname: Nielsen
authors.forename: Dorthe Janne
authors.initials: DJ
authors.lastname: Petersen
authors.forename: Erik
authors.initials: E
authors.lastname: Christiansen
authors.forename: Niels
authors.initials: N
authors.lastname: Bilenberg
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004243:Divorce / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D011159:Population Surveillance; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires