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However, existing studies used broad mental health outcomes and inconsistent outcome measures. They have also overlooked adolescence, which is a crucial and sensitive developmental period. Using harmonized RP classifications, measured from 6 to 36 months of age, and item-level harmonized mental health dimensions, we examined emotional, social, hyperactivity \/ inattention, and conduct problems at ages 10, 14, and 18 years in two population-based cohorts (ALSPAC, N\u2009=\u20093870; Generation R, N\u2009=\u20091798). Longitudinal mixed models showed RP-related differences across all mental health dimensions. Specifically, children with multiple (two or more at one timepoint) or multiple-persistent (two or more RPs present at three or more timepoints in the first 36 months) RPs had consistently higher emotional, social, attention, and conduct problems, compared with participants without RPs. These differences remained stable across adolescence, with no evidence of RP-by-assessment wave interactions and were comparable for both sexes. Our cross-cohort findings support early RPs as early indicators of later mental health vulnerability. They additionally show that these associations can be identified reliably using harmonized exposure and outcome constructs across cohorts. Screening for these behaviors in routine pediatric care offers a practical method to identify at-risk children and guide early preventive interventions.<\/jats:p>","DOI":"10.1007\/s00787-026-03190-5","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:22:12Z","timestamp":1788859332000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adolescent mental health outcomes following early regulatory problems"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8479-8045","authenticated-orcid":false,"given":"Matic","family":"Kadi\u0161","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7747-5803","authenticated-orcid":false,"given":"Pauline W.","family":"Jansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0788-8685","authenticated-orcid":false,"given":"Nicole","family":"Tsalacopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3620-7313","authenticated-orcid":false,"given":"Rianne","family":"Kok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-268X","authenticated-orcid":false,"given":"Dieter","family":"Wolke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2810-2095","authenticated-orcid":false,"given":"Satja","family":"Mulej Bratec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"3190_CR1","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/cdep.12420","volume":"15","author":"ML Filippetti","year":"2021","unstructured":"Filippetti ML (2021) Being in tune with your body: The emergence of interoceptive processing through caregiver\u2013infant feeding interactions. 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Ethical approval for the Avon Longitudinal Study of Parents and Children (ALSPAC) was obtained from the ALSPAC Ethics and Law Committee and the local research ethics committees.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants (or their parents\/legal guardians) included in the Generation R study. Informed consent for the use of all data collected was obtained from participants following the recommendations of the ALSPAC Ethics and Law Committee at the time. Participants can contact the study team at any time to retrospectively withdraw consent for their data to be used. Study participation is voluntary and during all data collection sweeps, information was provided on the intended use of data.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}