Infant Reactivity Relates to Early Childhood Executive Function and Later Mental Health Diagnoses

• In Event: 3-088 - Infant Predictors of Social and Behavioral Impairments in Childhood and Adolescence

Integrative Statement

Introduction: Executive function (EF) impairments in children are associated with a range of psychopathological outcomes and cause problems in day-to-day functioning at home, school, and with peers (Nigg, 2017). It has been proposed that certain features of reactivity to both novelty and frustration in infancy can serve as early indicators of emerging EF impairments (Ursache et al., 2013, Rothbart et al., 2011), thus potentially serving as markers of risk for a range of social and emotional impairments. Here, we investigate the relation between infant reactivity, parent reports of EF profiles in early childhood, and lifetime presence of mental health diagnoses at ages 9 and 12.

Methods: 180 children (93 female) and their parents participated in a prospective longitudinal study focused on temperament in infancy and toddlerhood. Positive affect, negative affect, and motor behaviors were measured observationally at 4-months during presentation of novel stimuli. At age 5 years, those same children’s parents completed the Behavioral Rating Inventory of Executive Function (BRIEF; Gioia et al., 2000), from which seven subscales representing EF problems in daily life were drawn. Finally, children and their parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS; Kaufman et al., 1997), a semi-structured clinician-led interview used to assess childhood mental health disorders at ages 9 and 12 years. Here, children’s outcomes at 9 and 12 years were categorized as either 1) having met criteria for a mental health disorder at any point in their lifetime or 2) not having met criteria at any time. Categorical, lifetime presence of diagnoses included but was not limited to mood, anxiety, disruptive, neurodevelopmental, eating, and substance use disorders.

Results: Positive and negative affective response to novelty, but not motor reactivity at 4 months predicted different aspects of later childhood functioning and diagnosis. Specifically, positive affect at 4 months predicted problems with inhibition at age 5 years and lifetime rates of psychopathology at age 12 but not at age 9. This effect did not vary by gender, and remained significant after controlling for gender and SES. However, whereas negative affect at 4 months was associated with problems with inhibition as well as with planning and organization at 5 years, it was not significantly correlated with presence of psychopathology ages 9 or 12. At age 5, higher T-scores on all subscales of the BRIEF were associated with presence of psychopathology at age 12 (but not at age 9.) However, EF problems at age 5 neither accounted for nor mediated the relation between positive affect at 4 months and later psychopathology.

Conclusions: Infant reactivity to novelty was associated with lifetime presence of psychopathology as assessed at age 12, and there was no indication that this association was driven by parent-reported problems with EF at age 5. However, there were clear associations between both infant reactivity and EF and EF and later psychopathology. Implications for early identification and intervention, both in infancy and early childhood, are discussed, and future directions for research clarifying links between early temperament, EF, and psychopathology are described.

Authors

• Elizabeth G. Smith, University of Maryland
  Presenting Author

• Natalie Miller, University of Maryland, College Park
  Non-Presenting Author

• Nathan Fox, University of Maryland
  Non-Presenting Author

• Andrea Chronis-Tuscano, University of Maryland, College Park
  Non-Presenting Author