Individual and Socio-familial Risk and Protective Factors in Two Generations of the

Mauritius Joint Child Health Project

S. E. Luczak, C. Dalais, A. Raine,

P. H. Venables, F. Schulsinger, & S. A. Mednick

Funded by WHO, Danish State Department, DANIDA, Medical Research

Council (UK), Leverhulme Trust, Wellcome Trust, Ford Foundation, Scottish

Rite, US National Institutes of Health (K02MH01114, K08AA14265,

R01AA10206,, R01AA18179, R01HD42259, R01RR13642) & Mauritian

Ministries of Health and Education

Overview

Mauritius background

Joint Child Health Project

– Childhood precursors (birth records, ages 3, 8, 11, 17 y/o)

– Adult outcomes (intervention, aggression/criminality, schizotypy, substance use)

– Multigenerational transmission (current study)

– Future directions (additional outcomes, co-morbidity)

Mauritius

Mauritius

Mauritius

Mauritius

Mauritius

Human Development Index

Language

Economy

Government

Medical

Education

Disease

Joint Child Health Project

Birth cohort (100%) from two towns

N = 1,795

Followed since 1972 when 3 years of age

Religioethnic diversity matches population

– 52% Hindu

– 26% Creole

– 19% Muslim

– 4% Chinese, French, other

Joint Child Health Project: Age 3 Years

Assessment (N = 1,795)

– Psychophysiology, cognitive ability, temperament/behavior

– Parent-child interaction, home visit

– Medical evaluation, pregnancy & birth records

Intervention (n = 200)

– Preschool as usual vs. enriched (nutrition, stimulation)

– Selected by psychophysiological reactivity (hyper-, hypo-respond)

– Followed at ages 4, 5, 6, and 8 years (behavior, psychophysiology)

Joint Child Health Project: Childhood Phases Age 8 (n = 1,173)

– Teacher behavior ratings

– School medical evaluation

Age 11 (n = 1,264)

– Psychophysiology, cognitive ability, behavior problems

– Home visit for family environment, medical

Age 17 (n = 615)

– Behavior problems (e.g., schizotypy, hyperactivity)

– Neuropsychology

Joint Child Health Project: Adult Phases

Ages 23-30 (n = 1,023-1,795)

– Crime (self-report and official records)

– Mental health diagnoses (depression, schizotypy, alcohol)

Age 35-40 (n = 932-1,208)

– Alcohol, smoking, gambling

– Depression, anxiety, deviance

– Parenting, family environment

– Positive outcomes (satisfaction, happiness)

JCHP Findings: Intervention Effects Intervention was associated with:

conduct disorder, hyperactivity, schizotypal behavior at 17

criminal behavior (self-report & official) by 23

Better effects in malnourished children

JCHP Findings: Childhood Outcomes

Aggression:

– Age 3 low heart rate, fearlessness, stimulation-seeking predict age 11 aggression

– Birth complications & age 3 malnutrition predict externalizing at age 11 (and 17)

Cognition:

– Age 3 low stimulation seeking (after psychosocial adversity) predict lower age 11 IQ

– Age 11 low verbal IQ and executive functioning predict lifetime alcohol problems

JCHP Findings: Schizotypal Behavior

Schizotypy:

– Prenatal influenza exposure associated with age 17 schizotypy

– Age 3 adversity predicts age 23 schizotypy, which is partially mediated by performance IQ

– Impaired habituation to aversive stimuli at ages 3 & 11 predict schizotypal behavior at age 23, particularly cognitive-perceptual features

JCHP Findings: AUD in Total & Drinkers

0

5

10

15

20

25

30

35

AUD (total sample) AUD (lifetime drinkers only)

a a/b c b a a b

Hindi Tamil Muslim Catholic Hindi Tamil Muslim Catholic

JCHP Findings: Alcohol Problems 4 latent classes

Non-problematic (66%)

Hazardous (11%)

Moderate (16%)

Severe (6%)

Severe

Externalizing

Academic achievement

Psychosocial adversity

Hazardous

IQ total score

Psychosocial adversity

JCHP Offspring

Prior testing on offspring 3-5 y/o and 8-13 y/o

- Psychophysiology

- Cognitive ability

- Temperament/behavior

- Parent-child interaction

- Home/family environment

Intervention: Omega-3

200 children (10-13 y/o)

SmartFish juice with omega-3 for 6 months

Assessment (psychophysiology, cognitive, behavioral)

Current Phase: Intergenerational Transmission

Substance use & misuse (alcohol, smoking, illicit)

Behavior problems (internalizing, externalizing)

Medical history (conditions, hospitalizations, head injury)

Health (nutrition, activities, medications)

Genes (5-HTTLPR, DRD2, GABRA2, ALDH & ADH)

Personality (5 Factor)

Family/peers (bonding/monitoring, support, conflict tactics)

Ethnicity/religion/culture (behavior, individual/collectivistic)

JCHP Future Directions

Drinking & smoking

Onset & progression

Differences across cohorts, gender, religion

Diabetes

Childhood (pregnancy, malnutrition)

Adult (obesity, nutrition, activity)

Cognitive abilities

Developmental pattern

Verbal abilities

US Acknowledgements

Jo Ann Farver, John Horn, Jack McArdle, Carol Prescott (co-Is, mentors)

Sandy Brown, Marc Schuckit, Ken Sher, Bob Zucker (Consultants)

Howard Edenberg, Tiebing Liang (Collaborators)

Elizabeth Chernei, Rubin Khoddam, Marsha Sargeant, Jackie Tilley, Lisa Yarnell; Omar Arid, Kelsey Bradshaw, Nicole Chow, Anna Schwartz (Research lab)

Mauritius Acknowledgements

Ministry of Health

JCHP participants

JCHP staff (Tashneem Mahoomed, Shameem Oomur)

Joint Child Health Project Staff (K08)

Joint Child Health Project Staff (R01)