External Publications Using GUI Data

Introduction
Despite a growing body of research on associations between adolescent digital use and well-being, few studies have investigated these associations a) longitudinally and b) across socioeconomic status. The present study uses high-quality longitudinal data to examine how digital engagement shapes socioemotional and educational outcomes from early to late adolescence across socioeconomic status (SES).

Methods
Participants are 7685 individuals (49.0% female) from the 1998 birth cohort of the longitudinal Growing Up In Ireland (GUI) survey. The survey was administered to Irish parents and children between 2007 and 2016 (at ages 9, 13, and 17/18). Fixed-effects regression modeling was used to establish associations between digital engagement and socioemotional and educational outcomes. Further Fixed-Effects models were analyzed separately by SES, to assess how associations between digital use and adolescent outcomes differ by socioeconomic groups.

Results
Results show that digital screen time increases markedly from early to late adolescence, but to a higher extent among low-SES versus high-SES groups. Heavy levels of digital screen time (i.e., 3+ hours daily) are associated with declines in well-being, particularly for external and prosocial functioning, while engagement in learning-oriented digital activities and gaming is associated with better adolescent outcomes. Yet, low-SES adolescents are globally more harmed than high-SES adolescents by their digital engagement, and high-SES adolescents benefit more from moderate levels of digital use and from engaging in learning-oriented digital activities.

Conclusions
This study suggests that digital engagement is associated with socioeconomic inequalities in adolescents’ socioemotional well-being and, to a lesser extent, educational outcomes.

Background
Self-harm is a major public health concern in young people and is governed by a complex interaction of different risk factors. While many studies have identified these risk factors, less is known about how they tend to co-occur together.

Methods
A latent class analysis was conducted using risk factors for self-harm from two waves at ages 13 and 17 from the Growing Up in Ireland (GUI) study their associations with self-harm were examined longitudinally at ages 17 and 20, respectively.

Results
At age 13, there was a ‘peer problems’ group with higher probabilities of bullying, being unpopular and internalising problems and a ‘school and substance use problems’ group with higher probabilities of substance use, truancy or excessive absence from school and violence. Both of these two groups had over a two-fold risk of self-harm at age 17 in comparison to the low risk factor group. At age 17, there was a group with depression that was diagnosed by a medical professional with the highest relative risk (RR:13.9 (95 % CI 10.2–19.0)) of self-harm at age 20. Two other groups with undiagnosed depression had high probabilities of being bullied, and either high or low probabilities of substance use that had a 9.4 (95 % CI 6.8–13.1) and 7.4 (95 % CI 5.5–10.0) relative risk of self-harm at age 20, respectively.

Conclusions
Identifying hidden sub-groups using risk factors for self-harm in young people can inform potential public health interventions by clinicians and other professionals who work with young people.

Although children’s relationships with their parents and teachers contribute to their school adjustment and achievement, few studies have examined interactions between these relationships, particularly for father-child relationships. Using the Growing Up in Ireland birth cohort (N = 7507, 50.3% male), we examined child-adult relationship quality – rated by parents at age 3 and by teachers at age 5 – as predictors of teacher-rated behavioural adjustment and academic achievement at age 9 (indexed by self-reported academic self-concepts and performance on formal reading assessments). Controlling for prior levels of problem behaviours, verbal ability, and family SES, our results indicated that children’s relationships with parents and teachers showed small and comparable independent effects on school adjustment and achievement. For mothers and teachers, moderation analyses showed a cumulative risk pattern for conflictual relationships and a compensatory pattern for close relationships. Children are likely to benefit from improving closeness and reducing conflict in adult-child relationships as well as interventions that involve mothers, fathers, and teachers.

There is now fairly substantial evidence of a socioeconomic gradient in low birth weight for developed countries. The standard summary statistic for this gradient is the concentration index. Using data from the recently published Growing Up in Ireland survey, this paper calculates this index for low birth weight arising from preterm and intrauterine growth retardation. It also carries out a decomposition of this index for the different sources of low birth weight and finds that income inequality appears to be less important for the case of preterm births, while father’s education and local environmental conditions appear to be more relevant for intrauterine growth retardation. The application of the standard Blinder–Oaxaca decomposition also indicates that the socioeconomic gradient for low birth weight appears to arise owing to different characteristics between rich and poor, and not because the impact of any given characteristic on low birth weight differs between rich and poor.

The quality of the interparental relationship bears important implications for children’s socioemotional development. Given evidence that relationship satisfaction among parents tends to decline over time this study examined how change in parents’ relationship satisfaction from nine-months-old until nine-years-old related to children’s socioemotional difficulties at nine-years-old. Participants were 2074 mothers, fathers, and their child (55.1% male) recruited through random sampling of the Child Benefit Registrar by Growing Up in Ireland cohort study. Mothers ranged in age from 18 to 40 years (M = 31.06, SD = 4.70) and fathers ranged in age from 18 to 60 years (M = 33.50, SD = 5.54). Mothers and fathers completed the Dyadic Adjustment Scale at nine-months-old and at nine-years-old whereas child socioemotional development was assessed via teacher report on the Strengths and Difficulties Questionnaire at nine-years-old. Residualised change analysis indicated that both parents experienced declines in relationship satisfaction from nine-months-old until nine- years-old. However, in families where initial levels of relationship satisfaction were high, there was no significant association between decline in satisfaction and child socioemotional difficulties. Conversely, in couples where initial levels of satisfaction were low, mothers, but not fathers, who experienced further declines had female, but not male, children with more socioemotional difficulties at nine years (β = −0.22, p = 0.01; R2 = 0.15, F = 2.31, p = 0.02). These findings highlight the need for carefully tailored interventions aimed at promoting couple relationship satisfaction during transition to parenthood such that the negative impact on children of any decline experienced over time can be mitigated.

Background
Psychotic experiences (PEs) are commonly reported in adolescence and are associated with a range of negative outcomes. Few targets for intervention for PEs have been identified. One potential target is self-concept: an individual’s beliefs about his/her personal attributes. Improvements in self-concept have been shown to reduce psychotic symptoms in patients with schizophrenia but no study has investigated the relationship between changes in self-concept and risk of PEs in the general population.

We aimed to investigate: (a) the relationship between child and adolescent self-concept and adolescent PEs; and (b) whether changes in self-concept between childhood and adolescence were associated with risk of adolescent PEs.

Method
Using data from age 9 and age 13 (n = 7,423) of the child cohort (Cohort’98) from the Growing Up in Ireland study we investigated the relationship between self-concept at age 9 and age 13 and PEs at age 13. PEs were measured using the Adolescent Psychotic Symptoms Screener and self-concept was measured using the Piers Harris-II. Using a stratified analysis, we investigated the relationship between change in self-concept between age 9 and age 13 and the risk of PEs at age 13. Additionally we investigated changes across the six self-concept subscales.

Results
Psychotic experiences were reported by 13% of participants at age 13. ‘Very low’ self-concept at age 9 was associated with an increased risk of PEs at age 13 (Adjusted-OR: 2.74, CI: 1.80–4.19), and ‘High’ self-concept at age 9 was associated with a decreased risk of PEs at age 13 (Adjusted-OR: 0.77, CI: 0.60–0.97). The stratified analysis indicated that improvements in self-concept reduced the odds of adolescent PEs and decline in self-concept increased the odds of adolescent PEs. This effect was noted across the majority of the self-concept subscales.

Conclusions
There is a strong relationship between self-concept and PEs. The antecedents of low self-concept may be a useful target for preventative psychiatry. Broad-spectrum interventions targeting self-concept in childhood may help to reduce the incidence of PEs in adolescence

Children live in a technology-mediated world, and most young people use a variety of technologies in their daily lives. However, despite intense public discourse, we have little empirical evidence on how technology use impacts on children’s development across a number of psycho-social domains. Research that has been conducted tends to be largely small-scale or cross-sectional in nature and most often focused on (young) adults rather than children. Using longitudinal data on one-in-eight Irish children, we use econometric methods to test for associations between early mobile phone ownership and two measures of children’s psycho-social development between 9 and 13 years of age. We examine the Piers Harris Self-Concept Scale, reported by children, and the Strengths and Difficulties (SDQ) score, completed by the primary caregiver. We find no generalised associations between early mobile phone ownership and psycho-social outcomes. However, there is evidence that associations differ by gender and across psycho-social sub-domains. We find no robust associations affecting boys, but girls who receive phones earlier fare less well in terms of their behavioural adjustment and academic self-concept scores at 13 years of age, all else being equal. Further research is needed to identify causal mechanisms and explore possible mediating effects of family/social context.

KEYWORDS: Mobile phone ownership; psychological adjustment; self-concept; gender; longitudinal data; Piers Harris; SDQ

Objective
Childhood chronic illness can have a high impact on the child’s quality of life. The foundations of health are established in early life, and are shaped by biological, psychosocial, spiritual and environmental processes and influences. The objectives of this presentation are twofold: firstly to describe the prevalence of chronic illness in 9-year-olds in Ireland, secondly to illustrate how chronic illness influences the psychological and social development of the children.

Methods
Analysis was based on data of 8570 9-year old children, and their families who participated in Growing Up in Ireland—the National Longitudinal Study of Children. The sample was generated through the primary school system. A representative sample of 910 schools participated; the sample of children and their families was randomly selected from within the schools. Questionnaires were administered in schools; and after completion of this phase, the project interviewers visited the families of the 9-year olds in their homes and administered core questionnaires to the Study Child and his/her carers who provided either home-based or centre-based care on a regular basis.

Results
The overall prevalence of chronic illness reported by mothers among the 9-year old cohort was 11% (gender-specific prevalence for boys: 13%, and significantly lower for girls: 10%). Respiratory illnesses accounted for almost half (46%) of all chronic illnesses, followed by mental and behavioural conditions with 19% (high gender dysbalance: reported for boys in 24%, for girls in 12%). Children with a reported chronic illness had significantly more emotional, conduct, hyperactivity, peer-based and prosocial difficulties when compared with children without a reported chronic illness. Abnormal scores, based on the Strengths and Difficulties Questionnaire were found in 20% in children with a chronic disease, and in 5.5% in children without a chronic disease. Socio-economic Status was associated with poorer health outcomes. Furthermore, primary care givers’ views and perceptions regarding the chronic illness of the child were found to be a significant factor on child strengths and difficulties in a multivariate model.

Conclusions
The majority of 9-year old children can be assessed as healthy. The most common chronic illness in this large cohort was respiratory disease and overall, chronic conditions were found to have a negative impact on the child’s emotional and social state.

Background
Globally, childhood obesity is a significant public health problem associated with adverse health and economic consequences. To tackle the problem, we need a comprehensive understanding on how the environment in which we live may influence obesity related behaviours and weight status. Thus, we explore if distance to and number of food outlets ([1] supermarkets and [2] convenience stores) in the local area impact on either dietary quality or body mass index (BMI) in 9-year-old children whilst controlling for socio-economic characteristics of the family.

Methods
Cross sectional analysis of the Growing Up in Ireland (GUI) Study, a two-stage clustered sample of 8568 nine year old children from the Republic of Ireland. Children were recruited from schools (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Height and weight measurements were used to calculate BMI. Diet was assessed using a short food frequency questionnaire and a dietary quality score was generated based on Irish healthy eating guidelines. Socio-economic status was measured using parent reported household class, household net equivalised income and highest level of maternal education. Food access was measured as network distance to (in quintiles) and number of (within 1000km) convenience stores and supermarkets to each participant’s household within the local area. Separate fixed effects regression models were used to assess the impact of local area food access on (1) dietary quality and (2) BMI, stratified by gender.

Results
After controlling for socio-economic characteristics of the household, distance to the nearest supermarket was not associated with dietary quality in boys (Q5 v Q1; B = 0.84, 95% CI, –0.49 to 2.18) or girls (Q5 v Q1; B = –0.41, 95% CI, –1.60 to 0.77). Distance to the nearest convenience store was associated with dietary quality in boys (Q5 v Q1; B = 1.01, 95% CI, 0.13 to 1.89) but not in girls (Q5 v Q1; B = 0.04, 95% CI, –0.71 to 0.80). The number of convenience stores or supermarkets within 1000m of the household did not impact on dietary quality. Access to food outlets was not associated with BMI in girls or boys.

Conclusion
There was little evidence to suggest that access to food stores impact dietary quality or BMI in children. From a population health perspective, strategies tackling environmental factors associated with making poor lifestyle choices are needed. Thus, further research on the association between food access and obesity risk is needed.

Background
Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood.

Objective
To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and mother indicators of physical health and psychopathology in Ireland.

Methods
We used a nationally representative, prospective cohort (Growing Up in Ireland–Infant Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9 months, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression).

Results
Of 11 134 participants, 4 trajectories were identified: never in poverty (43.1%), material/subjective>monetary poverty (16.1%), monetary>material poverty (25.6%) and persistent poverty (15.2%). Children in persistent poverty compared with those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (aOR) 1.70, 95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51, 95% CI 1.20, 1.91), and psychopathology (aOR 2.06, 95% CI 1.42, 2.99). The outcomes for primary parents (99.7% were mothers) were as follows: having higher odds of being overweight (aOR 1.49, 95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13, 95% CI 1.63, 2.79), and depression (aOR 3.54, 95% CI 2.54, 4.94).

Conclusions
Any poverty trajectory was associated with poorer psychopathology and physical well-being in late childhood for children and their mothers in Ireland.

Background
Historically, breastfeeding rates in Ireland have been low compared with international averages. It has been suggested that maternal ethnicity and citizenship may influence breastfeeding rates, with ethnic minorities thought more likely to breast feed.

Aim
The aim of this study is to investigate the association among maternal citizenship, ethnicity, birthplace and breast feeding. It is hypothesised that Irish mothers (identified through Irish citizenship, self-identified Irish ethnicity or Irish birthplace) are less likely to breast feed than non-Irish mothers.

Methods
The study population of Growing Up in Ireland: the National Longitudinal Study of Children was used for this study. Analysis was restricted to 11 092 biological mother and infant pairs with a complete breastfeeding history. Logistic regression analysis was used to estimate ORs and 95% CIs for breast feeding relative to maternal citizenship and ethnicity, controlling for the confounding effects of other maternal variables.

Results
Results indicated that 55.9% (6202 of 11 092) of mothers had initiated breast feeding, with only 7.9% (874 of 11 092) of mothers currently breast feeding their infant (at 9 months of age). Irish citizens (4693 of 9368, 50.0%) were significantly less likely to have initiated breast feeding compared with non-Irish citizens (1503 of 1695, 88.7%). Irish born mothers (4179 of 8627, 48.8%) were also significantly less likely to have initiated breast feeding than mothers born elsewhere (2023 of 2462, 82.2%).

Conclusions
Maternal citizenship and ethnicity appear to be the strongest influencing factors on breastfeeding initiation and duration. However, this raises a possibility that the increase in breastfeeding rates seen recently may be the result of increased immigration into Ireland, rather than the success of policy and research efforts.

The aim of this study was to examine the role of different types of home learning activities, such as reading, singing, painting, playing games, and letters and numbers (ABCs and 123 s), in the development of nonverbal reasoning skills in young children. Although much previous research has focused on the role of the home learning environment in the development of language and numeracy skills, few studies have explored other aspects of cognitive development such as nonverbal reasoning. The data were drawn from the Growing Up in Ireland study, a nationally representative longitudinal birth cohort study. We examined whether learning activities were associated with scores on standardized nonverbal reasoning and vocabulary tests of the British Ability Scales in a sample of 9793 3-year-old children. The regression models also controlled for other factors that potentially influence cognitive development such as the parent–child relationship and maternal education. The findings indicate that activities such as reading, games, and painting/drawing have a small but statistically significant association with nonverbal reasoning scores, as well as with vocabulary scores, even after controlling for other factors in the model. Teaching the alphabet or numbers did not make significant contributions to the model. The findings of the study highlight the importance of considering the role of different types of home learning activities, as well as other environmental factors, in different aspects of cognitive development. We consider the implications of the findings for theories of cognitive development and for supporting cognitive development in young children.

Previous research has tended to classify stepfamilies based on self-report of their familial relationships. However, some stepfamily members do not identify as being part of a stepfamily, leading to the exclusion of certain stepfamilies from stepfamily research. Using data from the first national cohort study of children in Ireland, the aim of this study was to compare the characteristics of self-identifying stepfamilies with those of non-self-identifying stepfamilies, a group about which little is known. The analysis revealed that in approximately 10% of stepfamilies, neither parent declared their stepfamily status (n = 34, N = 288 stepfamilies). No differences emerged between self-identifying and non-self-identifying stepfamilies in the quality of the parent–child or spousal relationships. Non-self-identifying stepfamilies were less likely to be complex, and were more likely to be stepmother and simple stepfamilies than self-identifying stepfamilies. These findings suggest that non-self-identifying stepfamilies constitute a significant minority of stepfamilies who may exhibit unique structural characteristics.

Keywords: stepfamily; family  relationships; identity; stepchildren; stepparents; membership status

Background
Health disparities for children with intellectual disabilities can be challenging to measure due to many other factors that can impact health and healthcare use. The aim of the current study was to use longitudinal cohort data to compare children with intellectual disability (ID) in Ireland between 2006 and 2014 on healthcare utilisation and unmet need, at ages 9 and 13, using a propensity score matching (PSM) approach.

Methods
Using data from the Growing up in Ireland study, PSM was used to identify an appropriate control sample to compare with a sample of children with ID (n = 124). Participants were matched on variables that are known to influence healthcare utilisation to reduce the impact of confounding variables between groups so that differences between the groups can be estimated. Logistic regression was used to estimate effects at ages 9 and 13.

Results
Children with ID were no more likely to have visited a general practitioner or emergency department in the past 12 months than children without ID. They did have a greater likelihood of visiting a doctor in a hospital in the past 12 months and of having an overnight stay in hospital by age 9. Primary caregivers of children with ID were more likely to report unmet health needs at ages 9 and 13.

Conclusions
This approach is a novel means of comparing healthcare use in this population by balancing the impact of other factors that may result in inequities, to which children with ID may be more vulnerable.

Aim
To explore the association between weight and bullying; considering victims and perpetrators as two aspects of bullying, and subjective perception and objective measurement as two aspects of weight.

Methods
This study is based on the first wave of data collection from Growing Up in Ireland – the National Longitudinal Study of Children. The two-stage sample design included a sample of 910 primary schools in Ireland, from which a sample of 8568 nine-year-old children and their families was randomly selected. Analysis is based on statistically reweighted data to ensure that it is representative of all 9-year-olds in Ireland.

Results
Significantly (P < 0.001) more girls were overweight or obese (33.1%: 23.1% overweight and 10% obese) than boys (25.2%: 18.3% and 6.9%). Children who were body mass index (BMI) classified as overweight or obese were significantly (P < 0.001) more likely to be victimised when compared with children whose BMI was not classified as overweight or obese. BMI-classified thinness was not significantly associated with victimisation; however, the body image of being skinny or very skinny was significantly (P = 0.015) associated with being victimised. Bullying perpetration was not associated with BMI-derived weight classification but was significantly (P < 0.001) associated with the child’s own self-description of weight.

Conclusions
Overall body image was found to have a stronger association with victimisation and bullying perpetration than objective BMI-derived weight classification. Further research investigating the mediating role of body image in the relationship between weight, victimisation and bullying is necessary to better understand this association.

Background
The aim of this study was to use a social-ecological approach to examine the influence of individual, social, and environmental factors on moderate-to-vigorous physical activity (MVPA) and screen-time in a sample of 9-year-old children in Ireland.

Methods
The sample was 1509 boys and girls from the Growing Up in Ireland (GUI) national study. MVPA, screen time, and individual, social, and environmental variables were assessed via questionnaires completed by children, their parents, and their teachers. Multiple regression was used to identify factors that correlated with children’s MVPA and screen-time levels.

Results
For boys, factors such as activity with friends (P < .0001) and popularity (P < .01) were associated with MVPA, while factors such as BMI (P < .01) and MVPA (P < .01) were associated with screen time. Similarly for girls, factors such as activity with friends (P < .0001) and sociability were associated with MVPA, however factors such as BMI (P < .05), and access to play space (P < .05) were more closely associated with screen time.

Conclusion
Social factors were more closely associated with MVPA, while individual factors were significantly correlated with screen time for both boys and girls. Correlates differed for boys and girls, suggesting that interventions should consider both the target population as well as the activity behavior.

Background
Independent associations between screen time (ST)/physical activity (PA) and overweight (OW)/obesity have been demonstrated but little research exists on the role of ST among sufficiently active children.

Purpose
To examine the combined influence of ST and PA on risk of OW/obesity in a nationally representative sample of 9-year-old Irish children.

Methods
The sample in this cross sectional analysis contained 8568 children. Self-report parent data were used to group children into ST and PA categories and related to OW/obesity using forced entry logistic regression.

Results
High ST (> 3 hours/day), bedroom TV and mobile phone ownership increased risk of OW/obesity in high and low active children (P < .05). Low PA (<9 bouts fortnightly) was also associated with OW/obesity. In combined analyses, OW/obesity was lowest in the reference low ST/high PA group with ORs of 1.38, 1.63, and 2.07, respectively, in the low ST/low PA, high ST/high PA, and high ST/low PA groups. Access to electronic media, low socioeconomic status, parental obesity, and not engaging in sports were all related to high ST (P < .05).

Conclusion
This study supports findings that ST is associated with OW/Obesity demonstrating this separately in high and low active children.

Introduction
The aim of this paper was to examine the role of perinatal, obstetric and post partum factors on maternal and paternal stress. It will present the first examination of the role of prenatal, obstetric, post-partum, and demographic variables in parenting stress for mothers and fathers at 9 months.

Methods
Data from 6821 parental dyads of 9-month-old infants were extracted from the Growing Up in Ireland National Longitudinal Study of Children. Participants completed the Parental Stress Scale, the Dyadic Adjustment Scale, the Quality of Attachment Sub-scale from the Maternal and Paternal Postnatal Attachment Scales, and a single item health status question from the Short Form 12 Health Survey. Information on prenatal care, pregnancy complications, obstetric outcomes, infant health, and participant demographics were also collected. Separate hierarchical linear regressions were conducted for mothers and fathers

Results
Mothers reported higher levels of parenting stress than fathers (p < 0.001). Maternal parenting stress was predicted by attachment, own health status, average sleep, occupation, household income, and having a very rapid labor. Paternal parenting stress was predicted by attachment and own health status.

Discussion
A range of perinatal factors was associated with an increased risk of higher parenting stress at 9 months post-partum and the roles of these factors differ between mothers and fathers. These findings are important for predicting and reducing risk of parenting stress in both genders.

Keywords
Attachment, obstetric outcomes, parenting stress, prenatal, well-being

Background
Energy poverty, typified by cold homes and/or an inability to afford energy bills, presents risks to the mental health of occupants. Parents of young children may be especially susceptible to a mental health toll from energy poverty since they have a significant care obligation and spend much of their day at home.

Methods
Data from the Growing Up in Ireland study inform this longitudinal analysis.

Results
A 1.64 greater odds of maternal depression were estimated for households containing young children characterized by energy poverty [P = 0.000; 95% confidence interval (CI): 1.31–2.05]. For energy poor households with older children (9 years and above), the odds of maternal depression were also higher [odds ratio (OR) 1.74, P = 0.001; 95% CI: 1.27–2.39]. Fathers of young children had greater odds of depression in energy poor households (OR 1.59, P = 0.002; 95% CI: 1.19–2.12), though the deleterious effect on mental health was not statistically significant for fathers of older children.

Conclusions
Energy poverty increases the likelihood of depression in parents. These findings merit policy attention since a mental health burden is in itself important, and more widely, parental well-being can influence child development and outcomes.