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A Prospective Cohort Study of Influences on Externalizing Behaviors Across Childhood: Results From a Nurse Home
Mary-Anne Enoch1, Harriet Kitzman2, Joyce A Smith2
1Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health (NIH), Bethesda, MD.
Insights
Maternal mental health and resilience in pregnancy significantly impact child behavior long-term. Nurse home visits aided early behavior, while genetics and maternal smoking also played roles.
Area of Science:
- Developmental psychology
- Behavioral genetics
- Public health interventions
Background:
- Child behavior is influenced by a complex interplay of genetic and environmental factors.
- Early life experiences and maternal characteristics can have lasting effects on behavioral development.
- Understanding these influences is crucial for developing effective prevention strategies.
Purpose of the Study:
- To investigate the long-term effects of genetic and environmental factors on child behavior from prenatal stages to 18 years.
- To evaluate the impact of prenatal/infancy nurse home visits (NHV) on child behavior.
- To examine the influence of maternal mental health, self-efficacy, mastery, and substance use on child externalizing disorders (ED).
Main Methods:
- A cohort of 600 predominantly African American mother-infant dyads participated in a randomized controlled trial of NHV.
- Maternal assessments included mental health, self-efficacy, and mastery during pregnancy.
- Genetic polymorphisms (SLC6A4 5-HTTLPR, FKBP5 rs1360780, DRD2/ANKK1 rs1800497) and maternal behaviors (smoking, alcohol/drug use) were longitudinally assessed.
- Child externalizing disorders were measured using the Achenbach Child Behavior Checklist at ages 2, 6, 12, and 18 years.
Main Results:
- Early childhood behaviors strongly predicted later behavioral outcomes (p < .0001).
- Maternal self-efficacy and NHV were associated with better child behavior at age 2.
- Maternal smoking was linked to increased ED at ages 6 and 18.
- Maternal mental health negatively impacted ED up to age 12, while maternal mastery positively influenced ED at age 18.
- Genetic polymorphisms showed varied effects across different childhood periods.
Conclusions:
- Maternal mental health and resilience during pregnancy have enduring positive effects on child behavioral development.
- Maternal smoking and specific genetic factors contribute to behavioral issues throughout childhood.
- Nurse home visits demonstrate a beneficial impact on early child behavior, highlighting their potential in prevention.
- These findings underscore the importance of early interventions and maternal support for preventing adult psychopathology.
Objective:
This study investigated genetic and environmental influences on behavior in a cohort of 600 children followed prenatally to 18 years.
Method:
A randomized controlled trial of prenatal/infancy nurse home visits (NHV) was conducted in 600 predominantly African American mothers and their firstborn children from Memphis, TN. Mothers were assessed in pregnancy for mental health (MH), self-efficacy, and mastery. Mothers reported longitudinally on smoking and alcohol/drug use. The functional polymorphisms SLC6A4 5-HTTLPR, FKBP5 rs1360780 and DRD2/ANKK1 rs1800497 were genotyped together with 186 ancestry informative markers. Composite externalizing disorders (ED) continuous total scores from the mother-report Achenbach Child Behavior Checklist were included as dependent variables in regression analyses for time points 2, 6, 12, and 18 years.
Results:
Behaviors at younger ages strongly predicted later behaviors (p < .0001). Children whose mothers had high self-efficacy and had received NHV were better behaved at age 2 years. Poorer maternal MH adversely influenced ED up to 12 years, but at age 18 years, maternal mastery exerted a strong, positive effect (p = .0001). Maternal smoking was associated with worse ED at 6 and 18 years. Main and interactive effects of genetic polymorphisms varied across childhood: FKBP5 rs1360780 up to age 6, 5-HTTLPR from 6 to 12, and DRD2/ANKK1 rs1800497 from 2 to 18 years.
Conclusion:
Our study suggests that maternal MH and resilience measured in pregnancy have long-lasting effects on child behavior. Maternal smoking across childhood and genetic factors also play a role. NHV had a positive effect on early behavior. Our findings have implications for prevention of pathological behaviors in adulthood. Clinical trial registration information-Age-17 Follow-Up of Home Visiting Intervention; http://clinicaltrials.gov/; NCT00708695.
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