The CHPs identify psychosocial problems in school-aged children frequently and undertake actions for most of them. Screening for psychosocial problems may be a promising option to reduce these problems, but accurate identification should be enhanced.

ObjectiveTo investigate fertility treatment, twin births, and unplanned pregnancies in pregnant women with eating disorders in a population-based sample.DesignA longitudinal population-based birth cohort (Generation R).SettingRotterdam, the Netherlands.SampleWomen from the Generation R study who reported a history of (recent or past) anorexia nervosa (n = 160), bulimia nervosa (n = 265), or both (n = 130), and a history of psychiatric disorders other than eating disorders (n = 1396) were compared with women without psychiatric disorders (n = 4367).MethodsWomen were compared on the studied outcomes using logistic regression. We performed crude and adjusted analyses (adjusting for relevant confounding factors).Main outcome measuresFertility treatment, twin births, unplanned pregnancies, and women's feelings towards unplanned pregnancies.ResultsRelative to women without psychiatric disorders, women with bulimia nervosa had increased odds (odds ratio, OR, 2.3; 95% confidence interval, 95% CI, 1.1–5.2) of having undergone fertility treatment. Women with all eating disorders had increased odds of twin births (anorexia nervosa, OR 2.7, 95% CI 1.0–7.7; bulimia nervosa, OR 2.7, 95% CI 1.1–6.6; anorexia and bulimia nervosa, OR 3.795% CI 1.3–10.7). Anorexia nervosa was associated with increased odds of unplanned pregnancies (OR 1.8, 95% CI 1.2–2.6) and mixed feelings about these pregnancies (adjusted OR 5.0, 95% CI 1.7–14.4). Pre-pregnancy body mass index did not explain the observed associations.ConclusionsEating disorders are associated with increased odds of receiving fertility treatment and twin births. Women with anorexia nervosa were more likely to have an unplanned pregnancy and have mixed feelings about the unplanned pregnancy. Fertility treatment specialists should be aware that both active and past eating disorders (both anorexia nervosa and bulimia nervosa) might underlie fertility problems.

We examined the cross-cultural equivalence of a widely used instrument that assesses perceived parental rearing, the EMBU-C, among native Dutch and immigrant adolescents living in The Netherlands. The results of a multigroup confirmatory factor analysis indicated that the factor structure of the EMBU-C, consisting of three latent factors (Warmth, Rejection, and Overprotection), and reliabilities of these scales are similar in both samples. These findings lend further support for the factorial and construct validity of this instrument. The comparison of perceived child rearing between native Dutch and immigrant adolescents showed cultural differences in only one of the assessed dimensions: Immigrant adolescents perceive their parents as more overprotective than do Dutch adolescents.

Different instruments can be used in the assessment of psychopathology in young children. In the present study the psychometric properties of a subset of items of the Devereux Child Behavior (DCB) rating scale were evaluated and the contribution of genetic and environmental influences to the variance of derived problem behavior scales was estimated. Maternal and paternal ratings were obtained in about 7600 5-year-old Dutch twin pairs. Six problem scales were derived from exploratory and confirmatory factor analysis and designated as emotional lability, aggressive behavior, attention problems, anxiety problems, physical coordination problems, and dependency. Univariate genetic analyses of the problem scales yielded large additive genetic effects. Heritability estimates ranged from 40% for aggressive behavior to 81% for attention problems. Shared environmental influences were found for aggressive behavior, anxiety problems, dependency, and emotional lability. Rater contrast and/or sibling interaction effects were found for attention problems and physical coordination.

For a quanti tati ve geneti c study of pr e-school pr obl em behavi our s, w e have col l ected data w i th the Child Behavior Checklist for 2 and 3-year-old children (CBCL 2/3). Questi onnai r es w er e compl eted by mother s of 3620 tw i n pai r s: 633 monozygoti c mal es, 581 di zygoti c mal es, 695 monozygoti c femal es, 519 di zygoti c femal es and 1192 di zygoti c opposi te sex tw i n pai r s. The geneti c and environmental influences on the Externalising and Internalising Problem scales were estimated, si mul taneousl y w i th sex di ffer ences and si bl i ng i nter acti on effects. Geneti c factor s expl ai ned most of the observed variance for both Externalising and Internalising Problems. Cooperative sibling i nter acti ons w er e found for Exter nal i si ng Pr obl ems, i ndi cati ng that tw i ns r ei nfor ce each other 's behavi our. Sex di ffer ences i n geneti c ar chi tectur e w er e found for Exter nal i si ng Pr obl ems. Geneti c factor s expl ai ned 75% of the var i ance i n girls and 50% i n boys. Shar ed envi r onmental i nfl uences w er e onl y of i mpor tance i n boys. For both pr obl em scal es, non-shar ed envi r onmental factor s accounted for 25 to 32% of the var i ance. The obser ved var i ances of I nter nal i si ng Pr obl ems coul d be adequatel y expl ai ned by geneti c and nonshar ed envi r onmental factor s, w i th geneti c factor s accounti ng for 68% of the var i ance.Keyw or ds: pre-school chi l dren, probl em behavi our, Chi l d Behavi or Checkl i st, tw i ns, behavi our geneti cs I ntr oducti on A number of studi es i ndi cate that roughl y 10 to 15% of pre-school chi l dren show probl em behavi ours.