Bulletin - The measure of excellence : Canadian early childhood ...

SPECIAL FEATURE ON RESEARCH: BEHAVIOURBOYHOOD AGGRESSION: WHO IS AT RISK AND WHY?In the spring of 1984, an ambitiouslongitudinal study of physicalaggression in boys began. Thesubjects were 1,037 French-speakingkindergarten boys from lowsocio-economic areas in Montreal.They were assessed regularly fromthe age of six until they were fifteenyears old.Over the years,the researchersidentified four different kinds of aggressiveboys: chronic aggressors, high butdeclining aggressors (very aggressiveboys whose aggression diminished asthey matured) moderate but decliningaggressors(moderately aggressive boyswho tempered their aggression as theymatured), and low aggressors.The studyestablished that most boys reducedtheir level of physical aggression as theygrew older, while a small group (3%)maintained high levels of aggression.The researchers wondered if itwould be possible to identify boys atrisk of chronic physical aggressionfrom the time they entered school.Further study revealed that those whoremained physically aggressive untiladolescence tended to be hyperactive,highly oppositional and have low verbalIQs. Particularly worrisome was thecombination of hyperactivity and highopposition.Together,these two factorsincreased a boy's odds of becoming achronic aggressor eightfold.When researchers turned theirattention to the parents to determinewhat family characteristics (ifany) might predict the boys' aggressivetendencies, their findings weresomewhat surprising. A father'ssocio-economic and educational statusappeared to have no effect whatsoeveron a boy's risk of chronicaggression. It was the mother's agewhen she gave birth to her first childand her level of education that mattered.Thus, the son of a teenagedmother who had received limitedschooling was nine times more likelyto become a chronic aggressor.Sylvie Fortin, who heads up theFamily-Child-Youth program at theAssociation des CLSC et des CHSLDdu Québec notes that the study hasimportant implications for healthprofessionals. Helping young womenavoid unwanted pregnancies in theirteens is crucial, according to Fortin.But providing support to teen mothersis also essential. We must "helpyoung mothers provide a stable andsupportive environment for their children.Mothers should be helped todevelop long-term plans and a strongsocial network to break down isolationfrom peers," Fortin says.Given the strong link betweenhyperactivity and long-termaggression shown in the study,Fortin says that there is a vital needto identify hyperactive children at avery young age and provide themwith appropriate services. She notesthat this kind of program has beeninstituted in Quebec and targetsschool-aged children. Fortinexpects that the program will beextended to preschool-aged children,adding that we need "anapproach that brings together family,daycare services and schools forthese children."Ref.: D. S. Nagin and R. E. Tremblay."Parental and Early ChildhoodPredictors of Persistent PhysicalAggression in Boys from Kindergartento High School." Archives of GeneralPsychiatry.Vol. 58. April 2001.ARE CHILDHOOD TRAUMAS AND EATING DISORDERS RELATED?Do childhood traumas such asphysical or sexual abuse makewomen more likely to developbulimia nervosa later in life? Currentresearch suggests that childhoodabuse is associated with anomalousserotonin and cortisol functioningin the body. Studies of bulimicwomen also show this same anomaly.Reduced serotonin activity isassociated with mood disorderssuch as depression and reduced cortisol(the stress hormone) activity toprolonged intense stresses.A Quebec research team decidedto examine the activity of serotoninand cortisol in four groups: Abusedbulimic and non-abused bulimicwomen, and abused and non-abusednormal eaters. The researchers foundno systematic association betweenchildhood abuse and bulimia.However, they did find that bulimicwomen were much more likely to sufferfrom major depression. As well,symptoms of post-traumatic stressdisorder (PTSD) occurred significantlymore often in abused bulimic women.As in previous studies, the researchteam found reduced serotonin activityto be associated with both bulimia andchildhood abuse. However, lowercortisol activity was only associatedwith abuse, not with bulimia. Fromthese findings, the researchers speculatethat the same vulnerability thatmakes a woman more likely to developbulimia may make her more vulnerableto the detrimental effects of abuse.This vulnerability may be manifestedon the neurobiological level asreduced cortisol activity and at thebehavioural level as PTSD symptoms."There have been questions aboutwhether or not childhood abuse wasa causative factor in eating disorders,but research has failed to show causation,"noted Katherine Austin Leonard,Medical Director of the EatingDisorders Program at North YorkGeneral Hospital and a lecturer in theUniversity of Toronto's Division ofAdolescent Medicine. "These findingsare consistent with prior studies. It isan elegant study and the researchershave been very responsible with theirconclusions,” said Leonard.As a clinician working with eatingdisorder patients and their families,Leonard has seen many abusedbulimic women who also suffer fromPTSD and self-destructive behavior, afinding consistent with the results ofthis study. "This finding may be helpfulto patients in terms of understandingtheir symptoms," sheadded. Patients might also want toknow about the changes in serotoninactivity associated with bulimia."There were significant biologicalmarkers for eating disorders andabuse," Leonard said. "Understandingthe biological factors in eating disordershas become increasingly importantin terms of treatment.""Usually I'm very cautious about findingsfrom small studies such as this one,"said Leonard. "However, their findingswere striking, and they were very measuredand careful in their conclusions."Ref.: H. Steiger et al. "Association ofSerotonin and Cortisol Indices WithChildhood Abuse in Bulimia Nervosa."Archives of General Psychiatry. Vol. 58.September 2001.VOLUME 1, N O 3 - DECEMBER 2002 BULLETIN OF THE CENTRE OF EXCELLENCE FOR EARLY CHILDHOOD DEVELOPMENT - PAGE 11