Psychomotor and mental development during infancy. Relation to psychosocial conditions and health. Part IV of a longitudinal study of children in a new Stockholm suburb

Symptoms of depression and internalizing problems in early adulthood - associated factors from birth to adolescence

PURPOSE

Even though the mechanisms behind the development of depression and internalizing problems remains unknown, many different factors have been shown to increase the risk. Longitudinal studies enable the investigation of exposure during different developmental periods during childhood. This study aims to examine factors associated with depressive and internalizing problems at age 20 in terms of sociodemographic factors, previous mental health problems and stressful life events during childhood, adolescence, and early adulthood.

METHODS

A birth cohort of 1723 children were followed to age 20. At the 20-year follow-up, n = 731 (44%) participated. Standardized instruments were filled out at baseline and the 3-,12- and 20-year follow-ups.

RESULTS

Depressive problems at age 20 were associated with female gender, experience of interpersonal life events reported at age 20, bullying victimization and reports on paternal mental health problems. Participants with depressive problems were also less likely to have experienced adolescence as happy and to report that their father had been a good father. Internalizing problems at age 20 were, in addition, associated with internalizing problems at age 12 and reports on maternal mental health problems. Internalizing problems were associated with a lower likelihood of experiencing adolescence as happy in the final model.

CONCLUSION

Recent events (i.e. interpersonal life events and bullying) seemed to be the most influential factors on the development of internalizing and depressive problems. Internalizing problems during childhood increased the risk for internalizing problems in early adulthood, emphasizing the importance of early intervention. Fewer factors were found to increase the risk for depressive problems compared to internalizing problems.

Mental health and experience of being bullied in 12-year-old children with overweight and obesity

AIM

The aim was to study the association between weight, mental health and experience of being bullied in 12-year-old children. Additional aim was to investigate the impact of childhood psychosocial risk factors for overweight and obesity at age 12.

METHODS

Study participants were members of a Swedish prospective cohort study. A total of 573 children were followed from pregnancy to age 12. IOTF-BMI at 12 years of age was used to categorise normal weight, overweight and obesity. Mothers, children and teachers filled out questionnaires on child mental health and experience of being bullied at age 12.

RESULTS

In bivariate analysis, girls with obesity reported significantly more behavioural problems than normal weight and overweight peers; however, no significant differences in mental health was noted between different weight categories when controlling for gender, experience of life events and socio-economic factors. Overweight and obesity were associated with experience of being bullied after controlling for gender, experience of life events and socio-economic factors (OR = 2.05, 95% CI = 1.08-3.91).

CONCLUSION

Children with overweight and obesity are at increased risk of being bullied compared with normal weight peers. No significant differences in mental health were noted between children with obesity, overweight and normal weight in multivariate analysis.

A Biopsychosocial Approach to Risk and Resilience on Behavior in Children Followed from Birth to Age 12

An increasing prevalence of mental health problems calls for more knowledge into factors associated with resilience. The present study used multiple statistical methodologies to examine a biopsychosocial model of risk and resilience on preadolescence behavior. Data from 889 children and mothers from a birth cohort were used. An adversity score was created by combining maternal symptoms of depression, psychosocial risk and children's experiences of life events. The proposed resilience factors investigated were candidate genetic polymorphisms, child temperament, social functioning, and maternal sense of coherence. The l/l genotype of the serotonin transporter linked polymorphic region was associated with lower internalizing scores, but not mainly related to the level of adversity. An easy temperament was associated with resilience for children exposed to high adversity. Social functioning was found to be promotive independent of the risk level. The results support a multiple-level model of resilience indicating effects, though small, of both biological and psychosocial factors.

Early predictors of behavioural problems in pre-schoolers - a longitudinal study of constitutional and environmental main and interaction effects

Background

The early environment is important for child development and wellbeing. Gene-by-environment studies investigating the impact of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the Brain Derived Neurotrophic Factor (BDNF) Val66Met polymorphisms by life events on mental health and behaviour problems have been inconclusive. Methodological differences regarding sample sizes, study population, definitions of adversities and measures of mental health problems obstacle their comparability. Furthermore, very few studies included children. The aim of this study was to examine the associations between a broad range of risk factors covering pregnancy and birth, genetic polymorphism, experience of multiple life events and psychosocial environment, and child behaviour at age 3, using a comparably large, representative, population-based sample.

Methods

A total of 1,106 children, and their mothers, were followed from pregnancy to age 3. Information on pregnancy and birth-related factors was retrieved from the Medical Birth Register. Questionnaires on depressive symptoms, child behaviour and child experiences of life events were filled in by the mothers. Child saliva samples were used for genotyping the 5-HTTLPR and BDNF Val66Met polymorphisms. Multiple logistic regression was used to investigate the association between psychological scales and genetic polymorphisms.

Results

Symptoms of postpartum depression increased the risk of both internalizing and externalizing problems. Experience of multiple life events was also a predictor of behavioural problems across the scales. No gene-by-environment or gene-by-gene-by-environment interactions were found. Children of immigrants had an increased risk of internalizing problems and parental unemployment was significantly associated with both internalizing and externalizing type of problems.

Conclusion

This study shows the importance of the psychosocial environment for psychosocial health in preschool children, and adds to the literature of null-findings of gene-by-environment effects of 5-HTTLPR and BDNF in children.

Electronic supplementary material

The online version of this article (doi:10.1186/s12887-016-0614-x) contains supplementary material, which is available to authorized users.

Effect of gene, environment and maternal depressive symptoms on pre-adolescence behavior problems - a longitudinal study

BACKGROUND

Depression is a common and disabling condition with a high relapse frequency. Maternal mental health problems and experience of traumatic life events are known to increase the risk of behavior problems in children. Recently, genetic factors, in particular gene-by-environment interaction models, have been implicated to explain depressive etiology. However, results are inconclusive.

METHODS

Study participants were members of the SESBiC-study. A total of 889 mothers and their children were followed during the child's age of 3 months to 12 years. Information on maternal depressive symptoms was gathered postpartum and at a 12 year follow-up. Mothers reported on child behavior and traumatic life events experienced by the child at age 12. Saliva samples were obtained from children for analysis of 5-HTTLPR and BDNF Val66Met polymorphisms.

RESULTS

Multivariate analysis showed a significant association between maternal symptoms of depression and anxiety, and internalizing problems in 12-year-old children (OR 5.72, 95% CI 3.30-9.91). Furthermore, carriers of two short alleles (s/s) of the 5-HTTLPR showed a more than 4-fold increased risk of internalizing problems at age 12 compared to l/l carriers (OR 4.73, 95% CI 2.14-10.48). No gene-by-environment interaction was found and neither depressive symptoms postpartum or traumatic experiences during childhood stayed significant in the final model.

CONCLUSIONS

Concurrent maternal symptoms of depression and anxiety are significant risk factors for behavior problems in children, which need to be taken into account in clinical practice. Furthermore, we found a main effect of 5-HTTLPR on internalizing symptoms in 12-year-old children, a finding that needs to be confirmed in future studies.

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study

BACKGROUND

This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months.

METHODS

Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36-Item Short Form Health Survey (SF-36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self-report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling.

RESULTS

This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months.

CONCLUSIONS

This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self-report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow-up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.

Screening for psychosocial development among infants in an urban slum of Delhi

OBJECTIVE

Psychosocial developmental screening of the infants in an urban slum of Delhi and studying the factors influencing the development.

METHODS

In this cross-sectional study 202 infants and their mothers were included. Psychosocial Development Screening Test developed by Indian Council of Medical Research was used to asses the development status of infants, and the mothers were interviewed for socio-demographic details

RESULTS

Infants who achieved milestones in time were 92.5% for personal skills, 91.8% for hearing language and concept development and 90.6% for gross motor milestones, respectively. These percentages were lower for Vision and fine motor (88.6) and social skills (81.4). Sex of the infant and socioeconomic status of their families significantly influences the few domains of development. Other factors like age of the infant, literacy of their mothers were not significantly influencing the development of infants.

CONCLUSION

The objective evaluation and screening for psychosocial development of infants living tin urban slums is necessary for early detection and intervention.

Breastfeeding duration, milk fat composition and developmental indices at 1 year of life among breastfed infants

The associations of breastfeeding duration and milk fat composition with the developmental outcome at 1 year of age were measured within 44 infants exclusively breastfed for 3 months, out of 95 recruited at birth. Pooled breast milk (hindmilk) of the mothers was analysed at colostrum, 1, 3, 6, 9, and 12 months for total fat and fatty acid content. Infants were examined at 12 months by means of the Bayley test. There was a progressive reduction of the number of breastfed babies after the introduction of solids to 29 (6 months), 17 (9 months) and 10 (12 months). After adjusting for major confounders, infants breastfed for 6 months or longer showed a trend to have an advantage at the Bayley psychomotor developmental index compared to those breastfed >3 and <6 months (95% CI for difference: - 0.6, 13.8; P= 0.07) while the Bayley mental developmental index (MDI) was just 2.1 points higher. Among the milk fat components considered for each time-point, the total fat content at 6 months showed the strongest association with the MDI at 12 months (r=0.59, P=0.001). Prolonging breastfeeding during the weaning process may result in a better developmental performance at 12 months, possibly due to the supply of fats affecting brain composition.

Home visiting the newborn baby as a basis for developmental surveillance at child welfare centres

Home visiting is a part of the Swedish child health surveillance programme. In the present study, part of a longitudinal prospective project, the predictive power of observations at home visits to 338 newborn babies was evaluated. The regular home visit was made by the nurse at a Child Welfare Centre also using a check-list developed for this project. Her check-list assessments seemed valid in identifying families with stressful psychosocial conditions. When the general home situation was judged as "poor" or "dubious", the boys showed signs of a delayed mental development at 4-5 years of age. Assessments of "feeding problems" among boys were associated with behavioural problems at 4-5 years of age. The results underline the importance of an early home visit as a base for the developmental surveillance at Child Welfare Centres. However, the results of the home visit observations were not followed by any extra interventions at CWC. It seems the nurse should feel confident in her check-list judgement and initiate interventions where appropriate.

Screening for minimal brain dysfunction (MBD/DAMP) at six years of age: results of motor test in relation to perinatal conditions, development and family situation

The aim of this study was to investigate if children aged 6 years of age, classified as having minimal brain dysfunction (MBD) or deficit in attention, motor control and perception (DAMP), exhibit special medical problems, specific developmental features or if special psychosocial conditions exist in the family. The screening program, using the psychoneurological part of the method developed by Gillberg et al., included 234 children who were followed-up prospectively from pregnancy and birth. The results were related to the physical and mental development of the children, to the psychosocial and socioeconomic conditions of the families, to pre- and postnatal conditions and to "reduced optimality score", as defined by Prechtl. Mental development was assessed by the use of Griffiths' test at 10-14 months and at 4-5 years of age. At the second Griffiths' test, the mother was also interviewed about the presence of aggressiveness and other symptoms of childhood psychopathology in her child, as defined by the DSM-III criteria, and a psychological observation was also made. In addition to screening for MBD/DAMP, at 6 years of age the parents were asked to complete a questionnaire aimed at identifying attention deficit disorder (ADD). No medical or psychological intervention was made before this stage. Fourteen children (9M, 5F) (6%) were identified as having a positive MBD/DAMP screening result. The results of the screening procedure showed a weak correlation with those obtained using the questionnaire based on the DSM-III criteria for ADD.(ABSTRACT TRUNCATED AT 250 WORDS)

Development and survival: a study of children at risk living in adverse psychosocial milieu

The aim of this study is to describe the situation of children at risk in psychosocially disadvantageous milieus, how these children cope with their situation, and which survival strategies they do develop. A summary of longitudinal research in child development and epidemiology shows that the reasons for psychopathology are complex and multidimensional. What is not known is the very process in which the child forms his or her experiences and resources into a constructive or less constructive strategy for handling the forces that build up a stressful milieu. To penetrate and learn something from such a process a longitudinal study concerning 12 preschool children during a 4-year period, was designed. Methods used were Griffith's psychomotorical test, a behavior inquiry, case sheet notes, and interviews with children, their families and the staff involved. The result showed three girls developing mainly constructive (moderating) strategies, the other children demonstrated more or less destructive, outerdirected, or innerdirected patterns. All boys in the study demonstrate less constructive strategies.

Early child health in Lahore, Pakistan: XII. Milestones

Psychomotor development was assessed in 1476 infants from four different levels of urbanization in and around Lahore, Pakistan. Development was assessed monthly at birth to 24 months of age by using a set of 10 milestones selected from the Denver Developmental Screening Test and the Developmental Screening Inventory. The psychomotor development of children in the upper middle (Um) class was consistent with reference population groups in Europe and North America, hence this group was used as control. There was significant delay in the psychomotor development of infants belonging to the poorer areas compared to the Um class. There was no sex difference in the development of the milestones in any study area, except for girls in the Um class who were earlier for about one month than boys in talking. Infants in the poorer areas were, on average about 3 months, delayed in their walking and fine motor activity (building a tower of 3 cubes) in comparison with the Um class. Observed disturbance in psychomotor development at an early age may affect the abilities and achievements in later life.

Mental development in late infancy after prenatal exposure to benzodiazepines--a prospective study

Seventeen infants born to mothers who used benzodiazepines (BZD) throughout pregnancy were followed prospectively and compared with 29 infants born to mothers who had not used psychoactive substances. On the Griffiths' Developmental Scale, the BZD-exposed infants demonstrated consistently lower mean GQs and DQs for all subscales at 5, 10 and 18 months of age. The differences in GQ reached statistical significance at 10 and 18 months. The DQs differed significantly for all subscales at 10 months and for the personal-social behaviour and hearing and speech subscales at 18 months of age. We suggest that prenatal exposure to BZD may cause a general delay in mental development up to 18 months of age.

Children of alcoholic parents: health, growth, mental development and psychopathology until school age. Results from a prospective longitudinal study of children from the general population

Of 640 women who paid their first visit to the two maternal welfare centres in a new Stockholm suburb during one prospective year, 532 (85%) were interviewed with regard to 41 stress factors forming a "life stress score" (LSS). The interviews were supplemented with data from hospital, social welfare and police records concerning the expectant mother and the father. The 532 mothers were divided into three groups according to the degree of psychosocial stress (group 1 (n = 194) without psychosocial stress; group 2 (n = 171) with severe psychosocial stress; and group 3 (n = 167) in an intermediate group). In group 2, there were 23 mothers and 51 fathers in 64 families known to suffer from alcoholism/heavy drinking at the time of the first interview and these comprised our study group. The pregnancies and deliveries in the families were investigated with prospective methods. There were 497 liveborn children of whom 54 were born into families known for alcoholism/heavy drinking. The physical health and development of the children was followed by prospective data from the child welfare centers. Data concerning psychological development and psychiatric health of the child were obtained by interviewing the mother and evaluating the child during visits at home at one and four years of age. At one year of age, 452 of the children (226 boys, 226 girls) and at four to five years of age, 412 of the children (202 boys, 210 girls), were evaluated using the Griffiths' Development Scales. Findings from these evaluations form the basis for comparison of development of children from alcoholic/heavy drinking parents with all other children. For 388 children, data were available from all examinations up to the end of the fourth year, including 38 children (12 boys, 26 girls) in the study group and 350 other children (183 boys, 167 girls). The present findings indicate that children of alcoholic parents in the general population who were followed from pregnancy up to the end of their fourth year have a higher risk of pre- and postnatal death, and have poorer mental development and more symptoms of a psychopathological child psychiatric nature (DSM-III) than other children. Differences related to physical development during infant years disappeared during the observation time. With regard to mental development over a longer period, it appears that factors related to the parent's addictions and the child's sex (i.e. male child) are more important than pediatric risk factors in the form of a score of reduced optimality.

Extremely low-birth-weight infants less than 901 g. Growth and development after one year of life

In a long-term prospective control study, 20 extremely low-birth-weight infants with birth weights between 500 and 900 g (mean 755 +/- 109 g) and gestational ages between 24 and 30 weeks (mean 26.2 +/- 1.8 weeks) were compared with 20 full-term infants, after the first year of life for growth, development and continuing morbidity after discharge from the intensive care unit. The total rate of neurological abnormalities was 17%; the rate of infantile post-hemorrhagic hydrocephalus requiring shunt operations was 8.7%, while 13% had retinopathy of prematurity with vision deficit, but none was blind. The hospital readmission rate was 70%, but for most infants only one or a few readmissions were needed whereas three infants with chronic lung disorders required frequent hospital readmissions, mainly for respiratory infections. Apart from 4 infants with major cerebral neonatal complications, 16 of 20 extremely low-birth-weight infants (80%) showed development within the normal range at one year of age, although with delay in some areas in comparison with full-term control infants. Follow-up into preschool and school age is in progress. We cautiously suggest that the results at the one year follow-up do indicate a possible favourable long-term outcome for many of these extremely low-birth-weight infants with normal cognitive development and with no major neurological sequelae.

Psychomotor and mental development from birth to age of four years; sex differences and their relation to home environment. Children in a new Stockholm suburb. Results from a longitudinal prospective study starting at the beginning of pregnancy

Five hundred and thirty-two pregnant women were interviewed about their psychosocial health at the beginning of pregnancy. According to various factors including alcoholism, mental disease and criminality among the women and their husbands the families were divided in three groups of different degrees according to psychosocial stress. The pregnancies, deliveries and the 497 live-born children in these families have been investigated with prospective methods. Data concerning the psychological development and psychiatric health of the child were attained by interviewing the mother and evaluating the child during visits to home (age 1 and 4). The physical health and development of the children has been followed by prospective data achieved from the child welfare centers. At one year of age 452 of the children (226 boys, 226 girls) and at four-five years of age 412 of the children (202 boys, 210 girls) were evaluated by the Griffith's Development Scales. Findings from these evaluations can now be related to a number of factors concerning the psychosocial situation, pediatric riskfactors etc. With the prospective, longitudinal methods used in this project interesting results concerning sex differences related to the mental development have been found. At one year of age girls had higher scores than boys on the Griffiths-subscale measuring hearing-and-speech abilities. At four years of age several significant differences between the sexes were found. Girls had more "even" Griffiths-profiles and scored higher than boys in several Griffiths-subscales. The greatest differences at four years of age were found concerning personal-social function and eye-hand-coordination. Boys seem to be specially vulnerable to the psychosocial situation in their homes as the Griffiths-results at four years of age are lower among boys from homes with psychosocial stress compared to other boys. It should be very interesting to follow and study what these sex differences mean concerning future development, the occurrence of psychopathology school difficulties.

Psychological development at 7 years of age in children with congenital hypothyroidism. Timing and dosage of initial treatment

Sixty of 68 consecutive patients detected during the first two years of the Swedish screening programme for congenital hypothyroidism were Griffiths tested at the age 6.5-7.5 years. The test quotients of the patients could not be distinguished from those of a reference population. Replacement therapy with 8.7 +/- 2.8 micrograms of L-thyroxine (mean +/- SD)/kg/d had been started at 15.0 +/- 7.1 days of life. Furthermore, normal results on Griffiths tests were also found in 13 patients with delayed normalization of serum TSH, i.e. greater than 19 mU/l at the age of six weeks, as well as in patients with retarded skeletal maturity and/or very low neonatal serum levels of thyroxine, i.e. less than 18 nmol/l and tri-iodothyronine, i.e. less than 0.92 nmol/l. Our findings indicate that a replacement dose of 6-11 micrograms L-thyroxine/kg/d is adequate and allows normal psychological development if treatment is started early.