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Children's personality traits are invaluable predictors of concurrent and later mental and physical health. Several validated longer inventories for assessing the widely recognized Five-Factor Model of personality in children are available, but short forms are scarce. This study aimed at constructing a 30-item form of the 144-item Hierarchical Personality Inventory for Children (HiPIC) (Mervielde & De Fruyt, ). Participants were 1543 children aged 6-12 years (sample 1) and 3895 children aged 8 years (sample 2). Sample 1 completed the full HiPIC, from which we constructed the HiPIC-30, and the Child Behaviour Checklist (Achenbach, ). Sample 2 completed the HiPIC-30. The HiPIC-30 personality domains correlated over r = .90 with the full HiPIC domains, had good Cronbach's alphas and correlated similarly with CBCL behaviour problems and gender as the full HiPIC. The factor structures of the HiPIC-30 were convergent across samples, but the imagination factor was not clear-cut. We conclude that the HiPIC-30 is a reliable and valid questionnaire for the Five-Factor personality traits in children. Copyright © 2016 John Wiley & Sons, Ltd.

Combining work and family responsibilities is challenging when children have special needs, and mothers commonly make employment-related adjustments. In this study, the authors examined associations between maternal work absence and child language impairment and behavior problems in preschool children. Questionnaire data at child age 3 years from 33,778 mothers participating in the prospective population-based Norwegian Mother and Child Cohort Study were linked to national register data on employment and long-term physician-certified sick leave at child age 3-5 years. Mothers who reported having a child with language impairment had a consistently higher risk of not being employed and were at increased risk of taking long-term sick leave at child age 5 years. Co-occurring problems were associated with excess risk. Language impairments in preschool children, in particular when they are co-occurring with behavior problems, are likely to have a range of negative short- and long-term consequences for the financial and overall health and well-being of mothers and their families.

Summary Background Personality may be an important yet understudied influence on childhood obesity. Objective We investigated the association between children's personality traits and weight status in a sample of 1533 6–12 year olds. Methods Mothers rated their child's personality using the Norwegian Hierarchical Personality Inventory for Children, and reported on their child's height and weight. Results Relative to their normal weight peers, overweight children were rated lower on energy, optimism, compliance, concentration, perseverance, and self-confidence, and higher on egocentricity, irritability, and anxiety. Conclusions These findings suggest possible mechanisms to investigate in future research relating personality to childhood obesity.

Objectives To investigate whether maternal negative affectivity, a tendency to frequent negative emotions and views, is associated with light alcohol use and binge drinking during pregnancy. Design Cohort. Setting Norway 1999–2008. Population The study includes complete information on 66 111 pregnant women and their partners. Methods We used data from the Norwegian Mother and Child Cohort study (MoBa) representing 39% of the pregnant population. Main outcome measures Light alcohol use (0.5–2 units one to four times per month) and binge drinking (an intake of 5 alcohol units or more) measured with the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). Results For each unit increase in maternal negative affectivity the odds for light alcohol use increased with 27% in the first trimester [95% confidence interval (CI) 1.19–1.36], and 28% in the second trimester (95% CI 1.18–1.39). With respect to binge drinking, each unit increase in maternal negative affectivity was associated with 55% higher odds in the first trimester (95% CI 1.44–1.67), and 114% higher odds in the second trimester (95% CI 1.70–2.69). Conclusions Negative affectivity is associated with both light alcohol use and binge drinking during pregnancy. The mechanisms mediating the relation between negative affectivity and alcohol use in pregnancy should be investigated further.

Background Many women temporarily reduce work hours or stop working when caring for small children. However, mothers of children with special health care needs may face particular challenges balancing childrearing responsibilities and employment demands. This study examines how the work participation among mothers of children with special health care needs compares with that of mothers in general during early motherhood, focusing in particular on the extent of the child's additional health care needs. Methods By linkage of the population-based Norwegian Mother and Child Cohort Study with national registers on employment, child health care needs, and social background factors, 41 255 mothers employed prior to childbirth were followed until child age 3 years to investigate associations between the child's care needs and mother's dropping out of employment. Results In total, 16.3% of the formerly employed mothers were no longer employed at child age 3 years. Mothers of children with mild care needs did not differ from mothers in general, whereas mothers of children with moderate [Risk Ratio (RR) 1.45; 95% confidence interval (CI) 1.17, 1.80] and severe care needs [RR 2.19; 95% CI 1.67, 2.87] were at substantial risk of not being employed at follow-up. The impact of the child's health care needs remained strong also after adjusting for several factors associated with employment in general. Conclusions Extensive childhood health care needs are associated with reduced short-term employment prospects and remain a substantial influence on mothers' work participation during early motherhood, irrespective of other important characteristics associated with maternal employment.

Aims To investigate associations between maternal stress and smoking prior to, during and 6 months after the pregnancy. Design A prospective population-based cohort study. Setting Norway. Participants A total of 71 757 women in the Norwegian Mother and Child Cohort Study (MoBa) participating twice during pregnancy and at 6 months postpartum. Measurements Respondents' estimates of anxiety and depression, relationship discord and negative life events were measured, along with self-reports of smoking behaviour and demographic variables. Smoking was assessed at gestation weeks 17 and 30 and at 6 months postpartum. Findings Of the 27.5% women who smoked at conception, 55.8% quit smoking during pregnancy. At 6 months postpartum, 28.9% of quitters had relapsed to smoking. In total, 12.9% of the sample reported smoking during the pregnancy. Adjusted for well-known risk factors, women reporting high levels of anxiety and depression had a decreased likelihood of quitting smoking during pregnancy [odds ratio (OR) 0.80, 95% confidence interval (CI): 0.73, 0.88) and an increased likelihood of relapsing after delivery (OR 1.26, 95% CI: 1.11, 1.44). Both relationship discord (OR 0.82, 95% CI: 0.75, 0.90) and exposure to negative life events (OR 0.93, 95%: CI 0.90, 0.96) had a negative influence on quitting smoking during pregnancy but had no influence on relapse to smoking postpartum. Conclusions Maternal stress and relationship discord may inhibit smoking cessation during pregnancy and promote resumption of smoking after pregnancy in women who have achieved abstinence.

Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study prospectively examined the presence of PTSS and PTSD and the mutual influence of child and parental PTSS in a large sample of pediatric patients with different medical conditions. Methods: A total of 287 children (aged 6.5-16 years) and their mothers (n = 239) and fathers (n = 221) were assessed at 5-6 weeks and 1 year after an accident or a new diagnosis of cancer or diabetes mellitus type 1 in the child. Results: At the first assessment 11.1% and at the second assessment 10.2% of the children had moderate to severe PTSS. At 5-6 weeks 29.3% of mothers and 18.6% of fathers met criteria for PTSD. At 1 year the rates were 14.6% for mothers and 7.9% for fathers. There were considerable differences of PTSS among different medical diagnostic groups in children and parents. Mothers were more vulnerable than fathers. Structural equation analysis revealed that initially high PTSS in mothers and fathers were longitudinally related to poorer recovery from PTSS in the child. Cross-lagged effects from the child to the parents and from one parent to the other were not significant. Conclusions: This study highlights the long-term influence of parental PTSS on the child's recovery after trauma and calls for a family systems approach and for early interventions in the treatment of traumatized pediatric patients. Language: en

Aim: To examine the association of the severity of congenital heart defects (CHDs) with internalizing problems in 18-month-olds and to explore the extent to which the internalizing problems are influenced by maternal distress and emotional reactivity in the child at age 6 months. Methods: We linked prospective data from the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health, with a nationwide CHD registry and identified 198 18-month-olds with CHDs in a cohort of 47 692 toddlers. Maternal reports on the children’s emotional reactivity at age 6 months, the children’s internalizing problems (anxiety, sleep problems, emotional reactivity) at age 18 months and maternal distress were assessed by questionnaires. Results: We found an association at age 18 months between the severity of the CHD and anxiety but not sleep problems or emotional reactivity. Children with severe but not with mild or moderate CHDs were twice as likely to experience the symptoms of anxiety compared with controls. These symptoms are not merely sequelae of earlier psychological reactions or concurrent maternal distress. Conclusion: Should these findings be replicated, future studies ought to investigate the mechanisms leading to elevated anxiety in toddlers with CHDs. In addition, clinical interventions should address the child’s anxiety as well as the interaction between the parents and the child.

Background With the advances in congenital cardiac surgery and medical management,mortality rates for congenital heart defects (CHD) have declined remarkably.As the number of CHD survivors have increased there is a growing focus on developmental morbidity.The objective of the current study is to compare symptoms of communication and social impairment in 18-month-old children with different severity of CHD with those of controls. Method We linked prospective data from the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health,with a nationwide medical CHD registry and identified 198 18-month-olds with CHD in a cohort of 47 692.Three groups of CHD were distinguished:mild/moderate (n = 122),severe (n = 54) and CHD with comorbidity (n = 22).Mothers reported on the child’s communication and social skills by completing items from the Ages and Stages Questionnaire as part of the Norwegian Mother and Child Cohort Study. Results Children aged 18 months old with CHD differed significantly from controls in levels of symptoms of communication impairment (P ! 0.0001) and social impairment (P ! 0.0001).The largest differences were found in children with CHD and comorbidity.Children with severe CHD also showed higher levels of both symptoms of communication and social impairment.Children with mild/moderate CHD showed a small difference only in symptoms of communication impairment. Conclusion Children with severe CHD and CHD with comorbidity show more symptoms of communication and social impairment compared with a large cohort at the age of 18 months.It is important to broaden the scope of inquiry to involve communication and social developmental domains.

The aims of the current study were to (1) identify dietary patterns in 3-year-old children; (2) investigate the extent to which negative affectivity, external parental locus of control and control-oriented child-feeding practices (pressure to eat and restriction) relate to these dietary patterns; and (3) to examine to what extent external parental locus of control and control-oriented child-feeding practices serve as mediators for these effects. This study was part of the Norwegian Mother and Child Cohort Study, comprising 14,122 mothers completing assessments at 6 months, 18 months and 3 years post-partum. Factor analysis of the children's diet identified two weakly correlated dietary patterns, labeled 'unhealthy' and 'wholesome'. Mothers high in negative affectivity perceived they had little control over their child's behaviour, which in turn was associated with both pressuring their child to eat and restricting the child's food intake and a less wholesome and a more unhealthy diet in the child. Pressuring the child to eat was independently associated with a less wholesome and a more unhealthy diet. Restricting the child's diet was associated with a more wholesome and a less unhealthy diet. These findings held after controlling for maternal smoking, education, age, body mass index, marital status, homemaker status and child gender.

Objective: To explore the prevalence of breast milk feeding (BMF) of infants with congenital heart defects (CHD) during first 6 months of life, as compared with general population. Design: The study is based on a subsample of the Norwegian Mother and Child Cohort Study conducted by Norwegian Institute of Public Health. A total of 60 600 mothers completed a questionnaire about infant feeding at 6 months postpartum. Infants with moderate/severe CHD (n = 131) were identified using nationwide CHD registry. A group of infants with CHD with comorbidity was also defined (n = 65). BMF was classified as predominant, continued, or no BMF. Month to month feeding status was analysed by means of Cox regression analyses. Results: Between child age 2–6 months, mothers of infants with CHD had a hazard ratio (HR) of 1.69 of weaning their child compared with mothers of controls. Mothers of infants with CHD with comorbidity weaned at an even faster rate (HR 3.54). At age 6 months, 9.9% of infants with CHD were fed with breast milk predominately, 64.1% continued to receive breast milk, and only 26% were fed no breast milk. For infants with CHD with comorbidity, corresponding percentages were 7.7%, 43.1% and 49.2%, respectively. Conclusions: Although CHD alone and particularly CHD with comorbidity increased risk that mothers wean earlier, a relatively high rate of continued breastfeeding was maintained. Future studies should investigate factors that support continued BMF even in the most severely affected children with CHD.

This study prospectively examined dyadic influences of parental personality on levels and change of family functioning in parents of a newly hospitalized child. A total of 183 couples whose child sought treatment for Type 1 diabetes, cancer, or an unintentional injury were assessed at 1 and 6 months posthospitalization with tests measuring personality, and family functioning. Analyses used structural equation modeling based on the actor–partner interdependence model. Family functioning in both parents showed substantial differential stability and interdependence. Mothers' Neuroticism and Agreeableness and fathers' Openness and Conscientiousness influenced their own family functioning. Fathers' Conscientiousness influenced their spouse's family functioning. Both parents' personalities influenced their family functioning over time, underlining that the parents' perspectives should be studied jointly.

Early dietary habits are formative for dietary habits later in life. Maternal personality might be an important factor in unhealthy feeding of children. The current study aims to assess the degree to which the personality trait of negative affectivity in mothers predicts their child's diet at age 18 months. This study is a part of the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health. A total of 27 763 mothers completed 3 repeated assessments of negative affectivity before and after childbirth and of the child's diet when the child was 18 months old. Exploratory factor analysis was used to identify the dietary patterns, and structural equation modeling was used to investigate the relationship with negative affectivity adjusted for socio-demographical variables. Exploratory factor analysis of a foods frequency questionnaire revealed two dietary patterns in the child, labeled unhealthy diet and wholesome diet. The unhealthy diet comprised foods rich in sugar and fat; the wholesome diet comprised foods rich in fibre, vitamins and minerals. Mothers high in negative affectivity were more inclined to feed their child an unhealthy diet. The results were adjusted for maternal age, years of education, relative income, marital status, number of children, having the child in daycare, maternal smoking, maternal body mass index, and child gender. This study shows that a maternal personality trait, negative affectivity, is related to feeding the child an unhealthy diet after controlling for key socio-demographic variables.

Aim Little is known about the influence of the personality of the child and the personalities of the child’s parents on glycaemic control in Type 1 diabetes. Our objective was to examine the extent to which glycaemic control is associated with the child’s and the parents’ stable personality traits, using the Big Five personality model as the basic framework. Methods Participants were 64 children (aged 6–16 years) with recent-onset Type 1 diabetes and their parents. Glycaemic control (HbA 1c ) was assessed at 6 months, 1 year and 2 years after diagnosis; personality was assessed at 4–6 weeks, 6 months and 1 year after diagnosis. Associations of personality with mean HbA 1c over 2 years were examined. Results Children with better glycaemic control had a personality pattern of high Agreeableness, high Conscientiousness and low Neuroticism. Mothers of children with better glycaemic control showed a similar personality pattern, whereas the personality of the father was only marginally related to glycaemic control. Children’s Conscientiousness and mothers’ Agreeableness together predicted 18% of the variability in mean HbA 1c . All associations were unchanged when we controlled for child’s age. Conclusions Glycaemic control in the child was associated with the same child and maternal personality characteristics that influence treatment adherence, health-promoting behaviours and general adjustment in adult populations. In future, studies are needed to examine attitudinal and behavioural mediators of this relationship. It is suggested that attention to the personalities of the child and the mother can help to tailor diabetes education to the individual child.

Aim: To assess the prevalence of specific coping strategies and predictors of coping strategy selection in 179 patients (mean age= 10.2 y). The children were investigated one month after the occurrence of an accident (n= 105), diagnosis of cancer (n= 26) or diagnosis of diabetes mellitus type I (n= 48). Results: Patients used a great variety of coping strategies. The most frequent strategies were cognitive avoidance, positive cognitive restructuring and avoidant actions. The strategies of seeking problem-focused support and emotion-focused support were rarely used. Diagnostic category, length of hospital stay, and gender were not associated with coping strategy use. Age, socioeconomic status and functional status of the patient were found to predict coping strategy selection. Younger children made less use of active coping, distraction and seeking support. Patients of lower socioeconomic status used religious coping strategies significantly more often, whereas patients with lower functional status used avoidance and support-seeking strategies more often. Conclusion: In this study it was found that paediatric patients used a wide variety of coping strategies, irrespective of diagnosis and gender. Age of the child and functional status were the most important predictors of coping strategy selection.

Background: Previous studies consistently found remarkable prevalence rates of posttraumatic stresssymptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents.Findings suggest a significant association between child and parent PTSS. The present study examined,in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSSand PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal andchild PTSS and PTSD were analyzed. Method: Two hundred and nine children (aged 6.5–14.5 years)were interviewed 5–6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 bymeans of the Child PTSD Reaction Index. Their mothers (n ¼ 180) and fathers (n ¼ 175) were as-sessed with the Posttraumatic Diagnostic Scale. Results: Children reported PTSS levels in the mildrange. Sixteen percent of the fathers and 23.9% of the mothers met full DSM-IV diagnostic criteria forcurrent PTSD. Type of trauma impacted differently on parents and children. In children, accident-related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer intheir child was associated with more symptoms. Functional status of the child was also found to be animportant predictor of PTSS in children and parents. PTSS scores of mothers and fathers were signi-ficantly correlated with each other. However, child PTSS were not significantly related to PTSS ofmothers and fathers. This was true for total scores as well as for DSM-IV symptom clusters. Conclu-sions: There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidentalinjuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, chil-dren, their mothers, and their fathers should be assessed separately, because a significant associationbetween child and parental PTSS may not exist. Keywords: Chronic illness, injury, pediatrics, parent–child relationships, posttraumatic stress disorder, trauma. Abbreviations: PTSS: Posttraumatic stresssymptoms; PTSD: Posttraumatic stress disorder; RI: Child PTSD Reaction Index; PDS: PosttraumaticDiagnostic Scale.Threats to a child’s health or life such as an accidentor the diagnosis of a severe chronic disease cancause traumatic reactions both in the child and inhis or her parents. Studies of pediatric patients andtheir parents consistently found remarkable preval-ence rates of posttraumatic stress symptoms (PTSS)and posttraumatic stress disorders (PTSD). Groupsstudied included children with a variety of acute andchronic physical conditions and their parents (DiGallo, Barton, & Parry-Jones, 1997; Kazak et al.,1997; Pelcovitz et al., 1998; Landolt, Boehler,Schwager, Schallberger, & Nuessli, 1998; Landoltet al., 2002; Stallard, Velleman, & Baldwin, 1998;Stuber, Christakis, Houskamp, & Kazak, 1996). Insum, the epidemiologic data are consistent with thetrauma literature regarding responses to moderate-magnitude traumatic exposure. Prevalence ratesdiffered depending on the measures and samplesused. Interestingly, parents tend to show higherrates of PTSS and PTSD than their children.Mediating factors in the development of PTSS andPTSD in children have been widely studied. Mostauthors acknowledge that, while every child will ex-periencepsychologicaldistressifthestressorissevereenough, the development of PTSS and PTSD ismultifactorial. Among othervariables, female sexhasoften been found to be a significant risk factor (Yule,1999). Clinical observations and empirical researchhave also suggested that the children’s and parentsPTSS and PTSD are associated. Several studies havedocumentedconcordantresponsesinparents(mostlymothers) and children that were exposed to the sametrauma (Barakat et al., 1997; De Vries et al., 1999;Greenetal.,1991;Laoretal.,1996;McFarlane,1987;Pelcovitz et al., 1998; Smith, Perrin, Yule, & Rabe-Hesketh,2001).However,otherresearchersfoundnorelationship between parental and child PTSS(Koplewicz et al., 2002; McDermott & Cvitanovich,2000; Parker, Watts, & Allsopp, 1995; Stuber et al.,1996). Some of the reasons contributing to theseinconsistent findings may be methodological. Sam-ples were not homogeneous with regard to age of thechild, the types of trauma the child was exposed to,and the time elapsed since occurrence of the trauma.Moreover, differences in assessment methods mayalso be important. Notably, all studies that failed tofind associations between parental and child PTSShaveusedchildrenasindependentinformantsoftheirown symptoms. Most studies that found significantassociationsbetweenparentalandchildPTSS,onthe

The associations of the MCMI-II symptom scales with dispositional coping strategies were studied among 239 psychiatric outpatients. A similar core-pattern of emotion-focused coping was associated with all symptom scales except the bipolar scale. High scores on the MCMI-II symptom scales were associated with low use of adaptive emotion-focused coping (e.g., seeking social support) and high use of maladaptive emotion-focused coping (e.g., disengagement). Thought disorder, drug dependence, and delusional disorder also were associated with reduced use of problem-focused coping. The findings support the theoretical distinction between adaptive and maladaptive emotion-focused coping. The potential negative impacts of this coping pattern in terms of mental health and life adaptation are discussed.

Forty German adolescent anorectic patients were assessed with regard to self-image components as measured by the Offer Self-Image Questionnaire (OSIQ). The profile of this group deviated negatively from the German standardization group of healthy subjects on measures of impulse control, emotional tone, body image, social relationships, sexual attitudes, and psychopathology. In addition, the OSIQ profile of this German sample was remarkably similar to the profiles of samples reported in two American studies. Finally, it was found that inpatient treatment served to improve the psychological condition of the patients with regard to certain but not all self-image components. Despite a trend of improvement, some of the scores did not fully normalize in this sample.

This paper presents findings derived from comparative studies using the Eating Attitude Test (EAT) and conducted in East and West Berlin during the 1980s when the two Germanies were still strictly segregated. On the whole, the findings support earlier observations that North American findings are not transferable or descriptive of Middle European populations. Lower EAT scores were found for both East and West Berlin samples when compared with North American samples, and deficient discriminant validity of the EAT is evidenced in the remarkably low mean score of the East Berlin patients with anorexia nervosa

Two semantic differentials for the assessment of body-image and the perception of personality are presented. In addition to the utility and economy of the two measures, discriminant validity was verified by showing that there was a highly significant difference in the profiles of anorectic patients and controls. Factor analyses showed very similar dimensions in both samples and resulted in four internally consistent scales. These scales were also sensitive to changes in body-image and the perception of personality during inpatient treatment of adolescent anorectic patients and were used to evaluate these changes.