A presentation by Susan Luczak as part of the Childhood Risk and Resilience panel discussion at the International Symposium on Cohort and Longitudinal Studies in Developing Contexts, UNICEF Office of Research - Innocenti, Florence, Italy 13-15 October 2014

1. 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

2. 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)

3. Mauritius

4. Mauritius

5. Mauritius

6. Mauritius

7. Mauritius
Human Development Index
Language
Economy
Government
Medical
Education
Disease

8. 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

9. 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)

10. 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

11. 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)

12. 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

13. 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

14. 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

15. JCHP Findings: AUD in Total & Drinkers
35
30
25
20
15
10
5
0
a a/b c b a a b
Hindi Tamil Muslim Catholic Hindi Tamil Muslim Catholic
AUD (total sample) AUD (lifetime drinkers only)

16. 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

17. 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)

18. 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)

19. 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

20. 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)

21. Mauritius Acknowledgements
 Ministry of Health
 JCHP participants
 JCHP staff (Tashneem Mahoomed, Shameem Oomur)

22. Joint Child Health Project Staff (K08)

23. Joint Child Health Project Staff (R01)