Background: Mental disorders in childhood have a considerable health and societal impact but the associated\nnegative consequences may be ameliorated through early identification of risk and protective factors that can\nguide health promoting and preventive interventions. The objective of this study was to inform health policy and\npractice through identification of demographic, familial and environmental factors associated with emotional or\nbehavioural problems in middle childhood, and the predictors of resilience in the presence of identified risk factors.\nMethods: A cohort of 706 mothers followed from early pregnancy was surveyed at six to eight years post-partum\nby a mail-out questionnaire, which included questions on demographics, children�s health, development, activities,\nmedia and technology, family, friends, community, school life, and mother�s health.\nResults: Although most children do well in middle childhood, of 450 respondents (64% response rate), 29.5% and\n25.6% of children were found to have internalising and externalising behaviour problem scores in the lowest\nquintile on the NSCLY Child Behaviour Scales. Independent predictors for problem behaviours identified through\nmultivariable logistic regression modelling included being male, demographic risk, maternal mental health risk, poor\nparenting interactions, and low parenting morale. Among children at high risk for behaviour problems, protective\nfactors included high maternal and child self-esteem, good maternal emotional health, adequate social support,\ngood academic performance, and adequate quality parenting time.\nConclusions: These findings demonstrate that several individual and social resilience factors can counter the\ninfluence of early adversities on the likelihood of developing problem behaviours in middle childhood, thus\ninforming enhanced public health interventions for this understudied life course phase.
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