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Baldwin S, Insan N, Beauchamp H, Gilroy V, Morton A, Barlow J. Feasibility and acceptability of using the Alarm Distress BaBy (ADBB) scale within universal health visiting practice in England: a mixed-methods study protocol. BMJ Open 2023; 13:e078579. [PMID: 38030252 PMCID: PMC10689357 DOI: 10.1136/bmjopen-2023-078579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION The Alarm Distress BaBy (ADBB) scale developed by Guedeney and Fermanian in 2001, is a validated screening tool designed for use by healthcare practitioners to identify infant social withdrawal. This study will explore the acceptability and feasibility of the use of the full ADBB scale and a modified ADBB (m-ADBB) scale as part of routine health visiting visits in England. METHODS AND ANALYSIS A mixed methods sequential exploratory design will be used. Five health visitors will be trained in using the ADBB scale and 20 in the m-ADBB scale, from two National Health Service sites in England. Qualitative semi-structured interviews will be carried out with health visitors after they receive the training and again 2 months after using the scales in routine family health visits. Quantitative data will also be collected from the same participants for a range of items during the study period. The theoretical framework of Normalisation Process Theory will underpin the study, to provide in-depth explanations of the implementation process. Qualitative data will be analysed using thematic analysis. Quantitative data will be analysed using descriptive analysis. ETHICS AND DISSEMINATION Ethical approval was granted by the University of Oxford Departmental Research Ethics Committee. Dissemination of results will be via organisational websites, social media platforms, newsletters, professional networks, conferences and journal articles.
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Affiliation(s)
- Sharin Baldwin
- Research Department, Institute of Health Visiting, London, UK
- School of Nursing and Midwifery, Western Sydney University, Penrith, Western Australia, Australia
| | | | - Hilda Beauchamp
- Perinatal Mental Health Team, Institute of Health Visiting, London, UK
| | - Vicky Gilroy
- Research Department, Institute of Health Visiting, London, UK
| | | | - Jane Barlow
- Department of Social Policy, University of Oxford, Oxford, UK
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Okitundu-Luwa D, Imbula Essam B, Sombo Ayanne MT, Ndjukendi Omba A, Otete Djamba F, Kayembe Kalula T, Kamanga Mbuyi T, Guedeney A, Kashala-Abotnes E. Sustained social withdrawal behavior and 'difficult' temperament among infants, in relation to maternal affectivity in a low-income area of Kinshasa, Democratic Republic of Congo. Eur Child Adolesc Psychiatry 2023; 32:427-437. [PMID: 34536147 DOI: 10.1007/s00787-021-01873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
Little is known about the relationship between maternal affectivity, social withdrawal and temperament in infants in low-income countries. The goal of the study was to assess the prevalence of social withdrawal behavior in infants aged 8 ± 2.3 months and to explore associations between maternal affectivity during pregnancy and postpartum, infant social withdrawal (as a sign of stress) and 'difficult' temperament as assessed by the mothers. 458 mother-infant dyads were recruited in the city's public mother and child health-care centers. The eight items of the Alarm Distress Baby scale (8-ADBB) and the five-item M (modified) ADBB (M-ADBB) were used to assess sustained withdrawal behavior (ISSWB). The Goldberg Depression and Anxiety Scales were used to assess maternal affectivity and mental well-being. A specially designed questionnaire was used to identify stressful events faced by the mother during pregnancy. The ELDEQ-QCB was used to assess the degree of difficulty in managing the baby. Using the M-ADBB, we found a striking figure of 69.2% for ISSWB with 8-ABB (range 0-29) and 72.7% with the M-ADBB (range 0-10). ISSWB was linked to negative maternal affectivity and to high incidence of stressful events for the mothers, and to the child being viewed as 'difficult' by the mother. Positive prenatal affectivity was a protective factor of ISSWB (OR 0.46). Results are compared with previous studies in Africa. Early screening for ISSWB and identification of factors affecting maternal mental well-being could help in early intervention and increase the chances of better child development.
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Affiliation(s)
- Daniel Okitundu-Luwa
- Unités de Neurologie Pédiatrique et de Neuropsychologie, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, B.P.825, Kinshasa, Democratic Republic of the Congo.
| | - Brigitte Imbula Essam
- Service de Psychiatrie Femme et Enfants, Département de psychiatrie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marie-Thérèse Sombo Ayanne
- Unité de Neuropsychologie, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ally Ndjukendi Omba
- Service de Psychiatrie Femme et Enfants, Département de psychiatrie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Franck Otete Djamba
- Médecin Chargé de la Recherche et la Documentation Scientifique à la Fondation pour la Promotion et la Protection de la sante mentale de l'enfant «FOPPROSAME Asbl», Kinshasa, Democratic Republic of the Congo
| | - Tharcisse Kayembe Kalula
- Service de Neurodiagnostic, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Timothée Kamanga Mbuyi
- Département de Psychologie Clinique, Faculté de Psychologie et Sciences de l'Education Département et, Consultant au Département de Neurologie, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antoine Guedeney
- Service de Psychiatrie de l'enfant et de l'adolescent, Hôpital Bichat, APHP, Paris et Université de Paris, Paris, France
| | - Espérance Kashala-Abotnes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
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Burtchen N, Alvarez-Segura M, Urben S, Giovanelli C, Mendelsohn AL, Guedeney A, Schechter DS. Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum. Attach Hum Dev 2022; 24:1-27. [PMID: 36371796 DOI: 10.1080/14616734.2022.2142894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022]
Abstract
Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. METHODS One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. RESULTS Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. CONCLUSIONS At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.
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Affiliation(s)
- Nina Burtchen
- Clinic for Psychosomatic Medicine and Psychotherapy, Freiburg University Medical Center, Freiburg, Germany
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Mar Alvarez-Segura
- Child and Adolescent Psychiatry Service, Department of Psychiatry, Abat Oliba CEU University, Barcelona, Spain
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Sébastien Urben
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Alan L Mendelsohn
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Antoine Guedeney
- Child & Adolescent Psychiatry Service, Hôpital Bichat-Claude
- Bernard Faculty of Medicine, University of Paris Diderot, Paris, France
| | - Daniel S Schechter
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and Faculty of Biology and Medicine, Lausanne, Switzerland
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Væver MS, Krogh MT, Stuart AC, Madsen EB, Haase TW, Egmose I. Understanding Your Baby: protocol for a controlled parallel group study of a universal home-based educational program for first time parents. BMC Psychol 2022; 10:223. [PMID: 36138482 PMCID: PMC9502638 DOI: 10.1186/s40359-022-00924-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Infant mental health represents a significant public health issue. The transition to parenthood provides optimal opportunities for supporting parenting competence. Especially parental mentalization, i.e. the caregiver’s ability to notice and interpret the child’s behavior in terms of mental states, is important in infancy where the caregiver-infant communication is based solely on the infant’s behavioral cues.
Methods This study evaluates the efficacy of the intervention Understanding Your Baby (UYB) compared to Care As Usual (CAU) in 10 Danish municipalities. UYB aims at promoting parental competence in new parents by supporting them in noticing their infants’ behavioral cues and interpreting them in terms of mental states. Participants will be approximately 1,130 singletons and their parents. Inclusion criteria are first-time parents, minimum 18 years old, living in one of the 10 municipalities, and registered in the Danish Civil Registration Register (CPR). Around 230 health visitors deliver the UYB as part of their routine observation of infant social withdrawal in the Danish home visiting program. During an interaction between the health visitor and the infant, the health visitor articulates specific infant behaviors and helps the caregivers interpret these behaviors to mental states. The study is a controlled parallel group study with data obtained at four time points in two phases: First in the control group receiving the publicly available postnatal care (CAU), secondly in the intervention group after UYB implementation into the existing postnatal services. The primary outcome is maternal competence. Secondary measures include paternal competence, parental stress, parental mentalizing, and infant socioemotional development. Analysis will employ survey data and data from the health visitors’ register.
Discussion Results will provide evidence regarding the efficacy of UYB in promoting parenting competences. If proved effective, the study will represent a notable advance to initiating the UYB intervention as part of a better infant mental health strategy in Denmark. Conversely, if UYB is inferior to CAU, this is also important knowledge in regard to promoting parenting competence and infant mental health in a general population.
Trial registrationhttps://ClinicalTrials.gov with ID no. NCT03991416. Registered at 19 June 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03991416 Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00924-3.
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Affiliation(s)
- Mette Skovgaard Væver
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Building 03-2-216, 1353, Copenhagen K, Denmark.
| | - Marianne Thode Krogh
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Building 03-2-216, 1353, Copenhagen K, Denmark
| | - Anne Christine Stuart
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Building 03-2-216, 1353, Copenhagen K, Denmark
| | - Eva Back Madsen
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Building 03-2-216, 1353, Copenhagen K, Denmark
| | - Tina Wahl Haase
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Building 03-2-216, 1353, Copenhagen K, Denmark
| | - Ida Egmose
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Building 03-2-216, 1353, Copenhagen K, Denmark
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Clark SE, Locke RL, Baxendale SL, Seifer R. Withdrawn Behavior in Preschool: Implications for Emotion Knowledge and Broader Emotional Competence. Front Psychol 2022; 13:895557. [PMID: 35846605 PMCID: PMC9281896 DOI: 10.3389/fpsyg.2022.895557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
The present study investigated the respective roles of withdrawal, language, and context-inappropriate (CI) anger in the development of emotion knowledge (EK) among a subsample of 4 and 5 year-old preschoolers (n = 74). Measures included parent-reported withdrawn behavior, externalizing behavior, and CI anger, as well as child assessments of receptive language and EK. Ultimately, findings demonstrated that receptive language mediated the relationship between withdrawn behavior and situational EK. However, CI anger significantly interacted with receptive language, and, when incorporated into a second-stage moderated mediation analysis, moderate levels of CI anger rendered the indirect effect of withdrawn behavior on situational EK via receptive language insignificant. Cumulatively, these findings demonstrate a mechanism by which withdrawal may impact EK. They also indicate that such an effect may be attenuated in children with moderate levels of CI anger. Implications of these findings are discussed.
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Affiliation(s)
- Samantha E. Clark
- Department of Psychology, University of Massachusetts Dartmouth, Dartmouth, MA, United States
| | - Robin L. Locke
- Department of Psychology, University of Massachusetts Dartmouth, Dartmouth, MA, United States
| | - Sophia L. Baxendale
- Department of Psychology, University of Massachusetts Dartmouth, Dartmouth, MA, United States
| | - Ronald Seifer
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, East Providence, RI, United States
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Toseeb U, Oginni OA, Dale PS. Developmental Language Disorder and Psychopathology: Disentangling Shared Genetic and Environmental Influences. JOURNAL OF LEARNING DISABILITIES 2022; 55:185-199. [PMID: 34112015 PMCID: PMC8996291 DOI: 10.1177/00222194211019961] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
There is considerable variability in the extent to which young people with developmental language disorder (DLD) experience mental health difficulties. What drives these individual differences remains unclear. In the current article, data from the Twin Early Development Study were used to investigate the genetic and environmental influences on psychopathology in children and adolescents with DLD (n = 325) and those without DLD (n = 865). Trivariate models were fitted to investigate etiological influences on DLD and psychopathology, and bivariate heterogeneity and homogeneity models were fitted and compared to investigate quantitative differences in etiological influences on psychopathology between those with and without DLD. The genetic correlation between DLD and internalizing problems in childhood was significant, suggesting that their co-occurrence is due to common genetic influences. Similar, but nonsignificant effects were observed for externalizing problems. In addition, genetic influences on internalizing problems, but not externalizing problems, appeared to be higher in young people with DLD than those without DLD, suggesting that the presence of DLD may exacerbate genetic risk for internalizing problems. These findings indicate that genetic influences on internalizing problems may also confer susceptibility to DLD (or vice versa) and that DLD serves as an additional risk factor for those with a genetic predisposition for internalizing problems.
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Affiliation(s)
- Umar Toseeb
- University of York, UK
- Umar Toseeb, PhD, Department of Education,
University of York, Heslington Lane, York, YO10 5DD, UK.
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Pérez Martínez C, Grollemund B, Gavelle P, Viaux-Savelon S, Guedeney A. The Prevalence of Social Withdrawal in Infants With Cleft Lip and Palate: The Feasibility of the Full and the Modified Versions of the Alarm Distress Baby Scale. Front Pediatr 2022; 10:804802. [PMID: 35874558 PMCID: PMC9301039 DOI: 10.3389/fped.2022.804802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social withdrawal is a risk indicator for infant development with both organic and non-organic causes. Cleft lip and palate (CLP) impose a higher risk of physical and emotional distress in infants and alters parent-infant relationships. The ADBB scale is a screening tool to identify social withdrawal as a sign of distress in infants. The aim of this study is to evaluate the prevalence of social withdrawal behavior in infants with CLP using the full 8-item ADBB scale and the modified 5-item ADBB scale, and to examine the feasibility of both scales. METHODS 145 infants with Cleft Lip and Palate were enrolled and video recorded during a pediatric consultation. All infants were scored by two expert raters trained in ADBB scale, and subsequently scored with the m-ADBB by an independent expert. We measured the interrater agreement for the full ADBB scale and psychometric properties of both scales. RESULTS The full ADBB scale identified 15.9% of infants as having social withdrawal behavior (score above cutoff ≥5). Among the infants evaluated with the m-ADBB scale, 44.9% had a score above the suggested cutoff (≥2). For both scales, the item "vocalization" showed the higher scores. We found a good internal consistency for the full ADBB (Cronbach's alpha = 0.82) and an acceptable internal consistency for the modified ADBB (Cronbach's alpha = 0.71). The interrater agreement for the full ADBB scale was excellent (kappa = 0.837). The Spearman correlation coefficient between the total scores of the two versions was 0.88 (P < 0.001). CONCLUSION Our results indicate a relatively high prevalence of social withdrawal in infants with Cleft Lip and Palate, especially evaluated with the modified 5-item ADBB scale. We found that the full ADBB and the modified ADBB scales are feasible to use as screening tools of social withdrawal in this population. CLINICAL TRIAL REGISTRATION This trial is registered on ClinicalTrials.gov, identifier: NCT00993993. The data is the property of Assistance Publique, Hôpitaux de Paris.
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Affiliation(s)
| | - Bruno Grollemund
- Department of Dental-Facial Orthopedia, Pole of Bucco Dentaries' Medicine and Surgery, Cleft Competence Center, Strasbourg University Hospital, Strasbourg, France
| | - Pascale Gavelle
- Department of Maxillofacial Surgery and Plastic Hôpital Necker Enfants Malades, Paris, France
| | - Sylvie Viaux-Savelon
- Department of Neonatology an Obstetric, University Lyon 1 and University Hospital Croix Rousse, Hospices Civils de Lyon (HCL), Lyon, France
| | - Antoine Guedeney
- Department of Child and Adolescent Psychiatry, Université de Paris and Bichat Claude Bernard Assistance Publique - Hôpitaux de Paris (APHP) Hôpital, Paris, France
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Nöthling J, Laughton B, Seedat S. Maternal depression and infant social withdrawal as predictors of behaviour and development in vertically HIV-infected children at 3.5 years. Paediatr Int Child Health 2021; 41:268-277. [PMID: 35235497 DOI: 10.1080/20469047.2021.2023436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In low- and middle-income countries, there is a high prevalence of post-partum depression and it is often associated with HIV status. Maternal depression negatively affects mothering and can lead to social withdrawal in infants. Maternal depression and infant social withdrawal can have deleterious long-term effects on children's behaviour and neurodevelopmental trajectories. AIM To investigate whether maternal depression and infant social withdrawal at 10-12 months post-partum were significant predictors of child behaviour and development at 42 months. METHOD Seventy-four mother-infant dyads living with HIV were followed in a prospective, longitudinal design. Mothers were assessed for depression using the Center for Epidemiologic Studies Depression scale (CES-D). Infant social withdrawal was assessed by the modified Alarm Distress Baby Scale (m-ADBB), and development and behaviour were evaluated by the Griffiths Mental Development Scales (GMDS) and the Child Behavior Checklist (CBCL), respectively. RESULTS Maternal depression explained 4.8% of the variance in child behaviour (β = 0.98, t = 2.05, p < 0.05) and 10.3% of the variance in development (β = -0.30, t = -2.66, p < 0.05). Infant social withdrawal was not a significant predictor of behaviour (β = 3.27, t = 1.36, p = 0.18), but it did uniquely explain 7% of the variance in development (β = -1.32, t = -2.48, p < 0.05). CONCLUSION In the context of HIV, screening for maternal depression and the quality of mother-infant interactions are important (especially in the 1st year post-partum), given the significant long-term impact they have on behaviour and neurodevelopment. ABBREVIATIONS ANOVA: analysis of variance; ART: antiretroviral therapy; CBCL: Child Behavioral Checklist; CES-D: Center for Epidemiologic Studies Depression Scale; CHEI: children HIV-exposed and infected; CHER: Children with HIV Early Antiretroviral Treatment Trial; CHEU: children HIV-exposed and uninfected; CHUU: children HIV-unexposed and -uninfected; GMDS: Griffiths Mental Development Scales; HIV: human immunodeficiency virus; LMIC: low- and middle-income countries; m-ADBB: modified Alarm Distress Baby Scale; NRF: National Research Foundation; SAMRC: South African Medical Research Council; WHO: World Health Organization.
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Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Barbara Laughton
- Department of Paediatrics and Child Health, The Family Centre for Research with Ubuntu, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Egmose I, Smith-Nielsen J, Lange T, Stougaard M, Stuart AC, Guedeney A, Væver MS. How to screen for social withdrawal in primary care: An evaluation of the alarm distress baby scale using item response theory. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021. [DOI: 10.1016/j.ijnsa.2021.100038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ntow KO, Krzeczkowski JE, Amani B, Savoy CD, Schmidt LA, Van Lieshout RJ. Maternal and Infant Performance on the Face-to-Face Still-Face Task following Maternal Cognitive Behavioral Therapy for Postpartum Depression. J Affect Disord 2021; 278:583-591. [PMID: 33032029 DOI: 10.1016/j.jad.2020.09.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study examined the impact of treating postpartum depression (PPD) with cognitive-behavioral therapy (CBT) on mother and infant behavior on the face-to-face still-face (FFSF) paradigm. METHODS Data from 68 mothers and their infants, 35 women with PPD within 12 months of delivery, and 33 healthy control dyads matched on infant age, sex and familial socioeconomic status were examined. Women with PPD received nine weeks of group CBT and were compared with healthy control dyads with at three timepoints on changes in mother-infant performance on the FFSF. RESULTS A significant group x FFSF phase x visit interaction was observed for infant withdrawn behavior at the three months post-treatment (p=0.006). Infants of mothers with PPD displayed significantly less withdrawn behavior after treatment, normalizing to levels of control infants. LIMITATIONS A relatively small sample consisting predominantly of Caucasian mother-infant dyads and the presence of comorbid anxiety in the PPD group. CONCLUSION Three months after group CBT for PPD, infants' withdrawn behavior appears to normalize to levels seen in the infants of healthy controls. Future studies should investigate whether treatments focused on the mother-infant dyad have distinctive effects on mothers and their infants' behaviors.
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Affiliation(s)
- Kwadjo O Ntow
- Global Health Graduate Program, McMaster University, Ontario, Canada.
| | | | - Bahar Amani
- Neuroscience Graduate Program, McMaster University, Ontario, Canada
| | - Calan D Savoy
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Ontario Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience & Behavior, McMaster University, Ontario Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Ontario Canada
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Lachman A, Burger M, Jordaan ER, Leppanen J, Puura K, Niehaus DJH. Maternal Shared Pleasure, Infant Withdrawal, and Developmental Outcomes in a High Risk Setting in South Africa. Front Psychiatry 2021; 12:668009. [PMID: 34354608 PMCID: PMC8329093 DOI: 10.3389/fpsyt.2021.668009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Infants in lower middle income countries are often exposed to early adversities which may lead to suboptimal caregiving environments and place them at risk of not achieving their developmental potential. Synchrony and positive engagement in the mother-infant relationship plays a critical role in buffering the impact of early adversity. Shared Pleasure (SP) is considered a marker of high intensity positive interaction and may hold a promise of improving developmental outcomes. Methods: This study was part of a prospective observational study of mothers with and without mental illness in South Africa. Dyadic videos were assessed for SP and infant withdrawal (using the Alarm Distress Baby Scale) at 6 months. Infant developmental outcomes were assessed using the Bayley's Scales for Infant and Toddler Development, third edition at 18 months. Results: Ninety-one dyads were assessed for SP. The occurrence of SP was low (20%). There was no significant association with an EPDS measure of maternal depression (p = 0.571) and SP moments. Infant withdrawal was high (72%) and associated with male infant gender (p = 0.025). There was a significant association between the occurrence of SP and a lower score of infant withdrawal (estimate = -1.29; SE = 0.4; p = 0.0002). The number of SP moments at 6 months was significantly associated with motor (estimate = 2.4; SE = 0.9; p = 0.007) and marginally significant with cognitive scores (estimate = 1.9; SE = 1.0; p = 0.052) at 18 months. Regression modelling differential outcomes showed a greater improvement in cognitive scores at 18 months in infants with an SP moment compared to those without an SP moment [SP average difference (AD) = 7.4 (2.4), no SP AD = 10.4 (1.2); p = 0.012]. Infants without an SP moment experienced a larger decrease in motor scores at 18 months compared to those with an SP moment [SP AD = -3 (3.0); no SP AD = -10.6 (1.5), p = 0.027]. Conclusion: While the occurrence of SP in this sample was low and the rates of infant withdrawal were high, there were promising results suggesting early positive SP interactions may contribute to improvements in subsequent developmental outcomes.
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Affiliation(s)
- Anusha Lachman
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Marlette Burger
- Physiotherapy Division, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Esmè R Jordaan
- Biostatistics Unit, South African Medical Research Council, Durban, South Africa.,Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - Jukka Leppanen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Kaija Puura
- Department of Child Psychiatry, Tampere University, Tampere, Finland
| | - Dana J H Niehaus
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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Zhou F, Huang P, Wei X, Guo Y, Lu J, Feng L, Lu M, Liu X, Tu S, Deprez A, Guedeney A, Shen S, Qiu X. Prevalence and Characteristics of Social Withdrawal Tendency Among 3-24 Months in China: A Pilot Study. Front Psychiatry 2021; 12:537411. [PMID: 34220558 PMCID: PMC8242944 DOI: 10.3389/fpsyt.2021.537411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/24/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Sustained withdrawal behavior is an obstacle for child development. The present study aimed to preliminarily evaluate the prevalence of social withdrawal tendency in young Chinese children using the Alarm Distress Baby Scale (ADBB) and describe the characteristics of socially withdrawn children. Method: This was a cross-sectional analysis as part of a prospective cohort study. A total of 114 children aged 3-24 months were included. The following instruments were administered: the Chinese version of ADBB, the Ages and Stages Questionnaire (ASQ-3), the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE), and the Infant Temperamental Questionnaire. The tendency of social withdrawal in children was assessed using the ADBB. Social withdrawal was defined as an ADBB score of 5 or above. Student's t-test, χ2 test, and Fisher's exact test were performed to identify the differences in maternal and child characteristics between the children with and without social withdrawal. Age-specific indicators of development in these two groups were also presented. Results: About 16.7% of the children were socially withdrawn. Compared with those without social withdrawal, children with social withdrawal were older and had higher proportions of boys (68.4 vs. 42.1%) and social-emotional development delay (63.2 vs. 0%). In age-specific analyses, social-emotional development was poorer in children with social withdrawal across all age groups from 3 to 24 months. Conclusion: Assessed by the ADBB, the prevalence of social withdrawal tendency in young Chinese children was similar to that reported in the European population; children with social withdrawal tended to have poorer social-emotional development. Further research with larger sample sizes is needed to validate the scale and confirm these findings.
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Affiliation(s)
- Fengjuan Zhou
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xueling Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yixin Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lanlan Feng
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xian Liu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Si Tu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Alexandra Deprez
- Laboratory of Psychopathology and Health Processes, Institute of Psychology, University of Paris Descartes, Paris, France
| | - Antoine Guedeney
- Department of Child and Adolescent Psychiatry, Bichat Claude Bernard Hospital, Paris University, Paris, France
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Obstetrics and Gynecology, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, China
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13
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Ulak M, Ranjitkar S, Shrestha M, Braarud HC, Chandyo RK, Shrestha L, Guedeney A, Strand TA, Kvestad I. The Feasibility of the Full and Modified Versions of the Alarm Distress Baby Scale (ADBB) and the Prevalence of Social Withdrawal in Infants in Nepal. Front Psychol 2020; 11:2025. [PMID: 32982842 PMCID: PMC7479187 DOI: 10.3389/fpsyg.2020.02025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background Sustained social withdrawal in infancy may have organic and nonorganic causes and could hinder normal development. The Alarm Distress Baby (ADBB) scale is a widely validated screening tool of social withdrawal in children 2–24 months. The aim of the current study was to evaluate the full and modified ADBB in Nepalese infants in a community-based study. Methods We enrolled 600 infants who were video recorded during a pediatric examination. The 36 infants first enrolled were scored by an expert rater, and the subsequent 64 infants were scored by two trained staff with the full ADBB scale. Of the 600 enrolled infants, 597 videos (including the 100 infants scored with the full ADBB) were scored with the modified ADBB (m-ADBB) scale by the trained staff, with 7% double scoring. We measured the interrater agreement and psychometric properties of both scales. Results In the 64 infants scored with the full ADBB by two raters, the concordance correlation coefficients (CCCs) indicated poor interrater agreement. For the m-ADBB, the CCCs were better indicating acceptable agreement between raters. The greatest lower bound (GLB) for reliability coefficient for the full ADBB scored by an expert rater indicated good internal consistency, whereas the GLB coefficient for the m-ADBB indicated poorer internal consistency. The Spearman correlation coefficient between the total scores of the two versions was 0.82 (P < 0.001). Among the infants scored with the full ADBB, 25% had a score above cutoff (≥5). Scored with the m-ADBB in the full sample, 11.4% of the infants had a score above the suggested cutoff (≥2). In both versions, children achieved high scores on vocalization. Conclusion Our findings suggest that the m-ADBB is an acceptable approach to achieve adequate interrater agreement in a large community-based study in Nepal. Results indicate high prevalence of social withdrawal in this population. There are, however, uncertainties on the internal consistency of the scales in this setting, and the validity of the scales needs to be investigated further. More effective training strategies for administration and additional cultural-specific instructions could be important measures to explore before implementing the scale further in this setting.
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Affiliation(s)
- Manjeswori Ulak
- Child Health Research Project, Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Suman Ranjitkar
- Child Health Research Project, Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Merina Shrestha
- Child Health Research Project, Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Hanne C Braarud
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Laxman Shrestha
- Child Health Research Project, Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Antoine Guedeney
- Department of Child and Adolescent Psychiatry, Hospital Bichat-Claude Bernard, Université de Paris, Paris, France
| | - Tor A Strand
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
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14
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Bustamante Loyola J, Perez Retamal M, Morgues Nudman MI, Maturana A, Salinas Gonzalez R, Cox H, González Mas JM, Muñoz L, Lopez L, Mendiburo-Seguel A, Simó S, Palau Subiela P, Guedeney A. Interactive Guidance Intervention to Address Sustained Social Withdrawal in Preterm Infants in Chile: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e17943. [PMID: 32589156 PMCID: PMC7394375 DOI: 10.2196/17943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 11/29/2022] Open
Abstract
Background Preterm newborns can be exposed early to significant perinatal stress, and this stress can increase the risk of altered socioemotional development. Sustained social withdrawal in infants is an early indicator of emotional distress which is expressed by low reactivity to the environment, and if persistent, is frequently associated with altered psychological development. Infants born prematurely have a higher probability of developing sustained social withdrawal (adjusted odds ratio 1.84, 95% CI 1.04-3.26) than infants born full term, and there is a correlation between weight at birth and sustained social withdrawal at 12 months of age. Objective The aims of this study are to compare the effect of the interactive guidance intervention to that of routine pediatric care on sustained social withdrawal in infants born moderately or late preterm and to explore the relationship between sustained social withdrawal in these infants and factors such as neonatal intensive care unit hospitalization variables, parental depression, and posttraumatic stress symptoms. Methods This study is designed as a multicenter randomized controlled trial. Moderate and late preterm newborns and their parents were recruited and randomized (1:1 allocation ratio) to control and experimental groups. During neonatal intensive care unit hospitalization, daily duration of skin-to-skin contact, breastfeeding, and parental visits were recorded. Also, a daily score for neonatal pain and painful invasive procedures were recorded. After discharge from neonatal intensive care, for the duration of the study, both groups will attend follow-up consultations with neonatologists at 2, 6, and 12 months of age (corrected for gestational age) and will receive routine pediatric care. Every consultation will be recorded and assessed with the Alarm Distress Baby Scale to detect sustained social withdrawal (indicated by a score of 5 or higher). The neonatologists will perform an interactive guidance intervention if an infant in the intervention group exhibits sustained social withdrawal. In each follow-up consultation, parents will fill out the Edinburgh Postnatal Depression Scale, the modified Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale–revised. Results Recruitment for this trial started in September 2017. As of May 2020, we have completed enrollment (N=110 infants born moderately or late preterm). We aim to publish the results by mid-2021. Conclusions This is the first randomized controlled trial with a sample of infants born moderately or late preterm infants who will attend pediatric follow-up consultations during their first year (corrected for gestational age at birth) with neonatologists trained in the Alarm Distress Baby Scale and who will receive this interactive guidance intervention. If successful, this early intervention will show significant potential to be implemented in both public and private health care, given its low cost of training staff and that the intervention takes place during routine pediatric follow-up. Trial Registration ClinicalTrials.gov NCT03212547; https://clinicaltrials.gov/ct2/show/NCT03212547. International Registered Report Identifier (IRRID) DERR1-10.2196/17943
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Affiliation(s)
- Jorge Bustamante Loyola
- Neonatology Unit, Clinica Alemana de Santiago, Santiago, Chile.,Doctoral Programme in Clinical and Health Psychology, Universitat de Valencia, Valencia, Spain.,Spain Association for Infant Mental Health Since Gestation, Valencia, Spain.,Neonatology Unit, Hospital San Jose, Santiago, Chile
| | | | | | - Andres Maturana
- Neonatology Unit, Clinica Alemana de Santiago, Santiago, Chile.,Faculty Development Office, Universidad del Desarrollo, Santiago, Chile
| | | | - Horacio Cox
- Neonatology Unit, Clinica Alemana de Santiago, Santiago, Chile
| | | | - Lucia Muñoz
- Neonatology Unit, Hospital San Jose, Santiago, Chile
| | - Lilian Lopez
- Neonatology Unit, Hospital San Jose, Santiago, Chile
| | | | - Sandra Simó
- Faculty of Psychology, Universitat de Valencia, Valencia, Spain
| | | | - Antoine Guedeney
- Hospital Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Paris 7, Paris, France
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15
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Abstract
This chapter focuses on new concepts and new paradigms shedding light on the complex issue of socioenvironmental factors that affect the psychologic development of the child. Longitudinal controlled studies have sorted out "what leads to what under which circumstances," adding to the heuristic value of the addition of risks and of the Bronfenbrenner's ecologic model of development and disentangling the socioeconomic status (SES) from poverty. We emphasize the importance of taking attachment styles and attachment disorganization into account for a better understanding of both normal development and early psychopathology. Intervention studies demonstrate the real life effect of the gene-environment interaction with or without epigenetic processes. Thus, this chapter deals with paradigmatic situations as ADS, Prader-Willi, or prematurity as they allow us to learn more about early development and epigenetic influences.
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Léger J, Forhan A, Dos Santos S, Larroque B, Ecosse E, Charles MA, Heude B. Developmental milestones at one year for the offspring of mothers with congenital hypothyroidism: a population-based study. Eur J Endocrinol 2018; 178:471-480. [PMID: 29500308 DOI: 10.1530/eje-17-0855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/01/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Maternal thyroid dysfunction during pregnancy is associated with neurodevelopmental impairment in the offspring. No data are currently available for the offspring of patients treated early for congenital hypothyroidism (CH). The aim of this study was to investigate motor and language milestones at one year of age in a population-based registry of children born to young women with CH. DESIGN AND METHODS We assessed 110 children born to mothers with CH, and 1367 children from the EDEN French population-based birth cohort study prospectively, at the age of one year, with identical questionnaires. Outcomes were assessed in terms of scores for childhood developmental milestones relating to mobility, motor coordination, communication, motricity and language skills. RESULTS After adjustment for confounding factors, children born to mothers with CH were found to have a higher risk of poor motor coordination than those of the EDEN cohort (OR: 4.18, 95% CI: 2.52-6.93). No differences were identified for the other four domains investigated. Children born to mothers with gestational diabetes have a higher risk of low motor coordination score than their peers (OR: 2.10, 95% CI: 1.21-3.66). Children born to mothers with TSH ≥ 10 IU/L during the first six months of pregnancy were more likely to have low motricity or communication skills scores than those born to mothers with lower TSH concentrations (56% vs 21% for each score, P < 0.04). CONCLUSIONS Maternal CH may have slight adverse effects on some developmental milestones in the child at one year of age, particularly for children born to mothers with uncontrolled hypothyroidism. However, it remains unclear whether these adverse effects modify subsequent neurodevelopment.
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Affiliation(s)
- Juliane Léger
- Paediatric Endocrinology Diabetology Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Reference Center for Growth and Development Endocrine Diseases, Paris, France
- Paris Diderot University, Sorbonne Paris Cité, Paris, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, DHU Protect, Paris, France
| | - Anne Forhan
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origin of Child Health and Development Team (ORCHAD), Paris, France
- Paris Descartes University, Paris, France
| | - Sophie Dos Santos
- Paediatric Endocrinology Diabetology Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Béatrice Larroque
- Epidemiology and Clinical Research Unit, Beaujon Hospital, Clichy, France
| | - Emmanuel Ecosse
- Paediatric Endocrinology Diabetology Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Reference Center for Growth and Development Endocrine Diseases, Paris, France
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origin of Child Health and Development Team (ORCHAD), Paris, France
- Paris Descartes University, Paris, France
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center, Early Origin of Child Health and Development Team (ORCHAD), Paris, France
- Paris Descartes University, Paris, France
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17
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Guedeney A, Doukhan S, Forhan A, Heude B, Peyre H. To which extent social withdrawal at the age of 1 year is associated with IQ at 5-6 years old? Results of the EDEN mother-child cohort. Eur Child Adolesc Psychiatry 2017; 26:1343-1350. [PMID: 28417256 DOI: 10.1007/s00787-017-0988-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 04/09/2017] [Indexed: 10/19/2022]
Abstract
The present study aims to determine to which extent social withdrawal at 1 year is associated with the child's IQ at the end of the preschool period. Children (N = 1045) from the EDEN mother-child cohort were assessed for social withdrawal behaviours at 1 year by trained midwives using the Alarm Distress BaBy (ADBB) scale. Midwives also examined infants' language and motor development at 1 year. At the age 5-6 years, IQ scores were based on the WPPSI-III. Linear regression models were used to determine the association between IQ and ADBB, adjusted for a broad range of pre- and postnatal environmental factors and for language and motor skills scores at 1 year. After adjusting for environmental factors, children with social withdrawal at 1 years (ADBB ≥5; N = 195) had significantly lower IQ scores at 5-6 years (-2.81 IQ points; p value 0.007) compared to children without social withdrawal (ADBB <5; N = 847). When motor and language skills at 1 year were included in the previous model, no association between social withdrawal and IQ at 5-6 years was found. Being socially withdrawn at 1 year is associated with lower IQ scores at 5-6 years. The potential influence of these developmental aspects on each other (withdrawal behaviour and language/motor skills) may occur early in development. Our results improve our understanding of the outcomes of early social withdrawal behaviour and call for early detection of delay in acquisition of language/motor skills among socially withdrawn young children.
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Affiliation(s)
- Antoine Guedeney
- Department of Child and Adolescent Psychiatry Hospital Bichat Claude Bernard, GHPVS, University Denis Diderot Paris, Cité & INSERM UMRS 1178, 94807, Villejuif, France
| | - Sarah Doukhan
- Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | - Anne Forhan
- INSERM UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Developmental Origins of Health and Disease (ORCHAD) Team, 94807, Villejuif, France.,Paris Descartes University, Paris, France
| | - Barbara Heude
- INSERM UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Developmental Origins of Health and Disease (ORCHAD) Team, 94807, Villejuif, France.,Paris Descartes University, Paris, France
| | - Hugo Peyre
- Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France. .,Laboratoire de Sciences Cognitives et Psycholinguistique (ENS, EHESS, CNRS), Ecole Normale Supérieure, PSL Research University, Paris, France.
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