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Regulatory problems and developmental psychopathology within the first 2 years of living-a nested in cohort
Janni Ammitzbøll1,2, Anne Lise Olsen3, Susanne Landorph2
1National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark.
Insights
Infancy regulatory problems (RP) in sleep, feeding, and emotional regulation are linked to a higher risk of childhood mental health disorders. Early identification and intervention are crucial for vulnerable infants to prevent long-term psychopathology.
Area of Science:
- Child Psychology
- Developmental Psychiatry
- Infant Mental Health
Background:
- Regulatory problems (RP) in infancy, including sleep, feeding, and excessive crying, are suspected contributors to childhood psychopathology.
- Limited understanding exists regarding the early developmental trajectories of these regulatory issues.
Purpose of the Study:
- To investigate regulatory problems (RP) in infants aged 8-11 months.
- To examine the association between infant RP and mental health problems at 1.5 years of age.
- To assess the influence of maternal mental health and relationship problems on these associations.
Main Methods:
- A nested sample of 416 infants was drawn from a community-based cohort of 2,973.
- Infants were screened for RP by community health nurses.
- Diagnostic assessments at 1.5 years used ICD-10 and DC:0-3R criteria, with logistic regression and mediation analyses.
Main Results:
- Infant sleep RP correlated with a 2-fold increased risk of sleep disorders (OR 9.3) and behavioral/emotional disorders (OR 2.9).
- Feeding/eating RP were linked to higher risks of overall mental disorder (OR 1.4) and feeding disorders (OR 6.0).
- Emotional regulation RP showed associations with increased risks for behavioral/emotional disorders (OR 2.2) and relationship disorders (OR 1.8). Maternal factors mediated 0-48% of these effects.
Conclusions:
- Regulatory problems in infancy (8-11 months) predict an increased risk for ICD-10 and DC:0-3R disorders by 1.5 years.
- These findings identify a vulnerable infant population requiring early preventive interventions to mitigate psychopathology development.
Background:
Infancy regulatory problems (RP) of sleep, feeding and eating, and excessive crying are thought to play a key role in the development of psychopathology in childhood, but knowledge of the early trajectories is limited.
Objective:
To explore RP at ages 8-11 months and the associations with mental health problems at 1½ years, and assess the influences of maternal mental health problems and relationship problems.
Methods:
RP was explored in a nested in-cohort sample (N = 416) drawn from a community-based cohort (N = 2,973). Cohort children were examined by community health nurses, using a mental health screening, which included seven items of RP. Follow-up at 1½ years included diagnostic assessment according to the International Classification of Diseases, ICD-10, and the Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood: Revised edition, DC:0-3R. Data analyses included logistic regression models and analyses of the mediation effect of maternal mental health and relationship problems.
Results:
RP of sleep were associated with a 2-fold increased risk of child mental disorder specifically sleep disorders, adjusted odds ratio (OR) 9.3 [95% confidence interval (CI): 2.0-42.9], disorders of behavior and emotions, adjusted OR 2.9 (95% CI: 1.0-8.4), and DC:0-3R regulatory disorders, adjusted OR 2.7 (95% CI: 1.0-7.5). Children with RP of feeding and eating showed an increased risk of overall mental disorder, adjusted OR 1.4 (95% CI: 0.7-2.4), and specifically, feeding and eating disorders, adjusted OR 6.0 (95% CI: 1.6-21.7), disorders of behavior and emotions, adjusted OR 2.2 (95% CI: 0.9-5.8), as well as DC:0-3R regulatory disorders, adjusted OR 1.6 (1.0-7.5). RP of emotional regulation were associated with increased risk of any mental disorder, adjusted OR 1.5 (1.0-2.4), and specifically behavioral and emotional disorders, adjusted OR 2.2 (95% CI: 0.9-5.9) and DC:0-3R relationship disorders, adjusted OR 1.8 (95% CI: 0.9-3.8). The mediation effect of maternal mental health problems and relationship problems ranged between 0% and 48%.
Conclusion:
RP at ages 8-11 months is associated with increased risk of ICD-10 and DC:0-3R disorders at 1½ years. Study findings highlight a group of vulnerable infants in need of preventive intervention to break the early trajectories of psychopathology.
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