Infant Regulatory Problems, Parenting, Maternal Mental Health Problems and Childhood Attention Problems

• In Event: 2-036 - Short-Term and Long-Term Outcomes After Infant Crying, Sleeping and Feeding Problems

Integrative Statement

Introduction. Infants with regulatory problems are thought to be hypersensitive to environmental stimuli (DeSantis, Coster, Bigsby, Lester, 2004) and previous research shows that outcomes are worse for children who also have poor parent-infant relationships and parental psychosocial stress (Hemmi, Wolke, Schneider, 2011).
Hypotheses. Aim of this study was to determine the combined impact of regulatory problems, parenting quality, including early parent-infant relationships, and maternal mental health on childhood attention problems. We hypothesize that multiple/persistent regulatory problems, suboptimal parenting and maternal mental health problems in infancy will all be related to higher attention problems in childhood. However, we deem it possible that these effects are not cumulative, i.e. additive, but alternatively, that these effects interact in a way that those infants with regulatory problems may be particularly vulnerable to poor parenting and maternal mental health problems and thus show a disproportionally increased risk for childhood attention problems.
Study population. The Bavarian Longitudinal Study is a prospective, population-based cohort study including 16 pediatric hospitals in Southern Bavaria (Germany) in which 1,459 infants were followed from birth to 8 years of age.
Methods. regulatory problems were assessed at 5 and 20 months using interviews by trained pediatricians. Parenting quality was assessed between birth and 5 months using parent interviews and nurses’ observations. Maternal mental health was assessed at birth and 5 months using standardized parents’ interviews. Childhood data on attention problems were collected at 8 years, using parent reports and expert behavior observation ratings.
Results. Of the 1,459 children, 82.9% (n=1,210) were classified as having no/single regulatory problems and 17.1% (n=249) were classified as having multiple/persistent regulatory problems. After correction for gestational age, sex, and socioeconomic status, early regulatory problems and low parenting quality predicted later attention problems. Their impact was additive, such that infants with both multiple/persistent regulatory problems and poor parenting quality showed the highest attention problems 8 years later. However, a significant interaction effect showed that regulatory problems were most strongly related to later attention problems for preterm born children. Maternal mental health was a significant moderator of the relationship between parenting quality and attention problems. With adequate maternal mental health, good parenting quality was related to lower attention problems, yet with mental health problems present, the effect of good parenting on attention problems diminished.
Conclusions. Our findings further support a cascade model of development whereby regulatory problems provide the trajectory’s starting point of dysregulated behavior across infancy and childhood in which parenting quality may represent an important factor explaining why infant regulatory problems persist. Guidance and support for parents of infants with regulatory problems may be essential to prevent the development of childhood attention problems, especially when maternal mental health problems are present.

Authors

• Linda Breeman, Utrecht University, Department of Youth and Family
  Presenting Author

• Julia Jaekel, The University of Tennessee Knoxville
  Non-Presenting Author

• Nicole Baumann, Department of Psychology, University of Warwick
  Non-Presenting Author

• Peter Bartmann, Department of Neonatology, University Hospital Bonn, Children's Hospital, Research Group Longitudinal Studies
  Non-Presenting Author

• Josef G. Bäuml, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München
  Non-Presenting Author

• Mihai Avram, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München
  Non-Presenting Author

• Christian Sorg, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München
  Non-Presenting Author

• Dieter Wolke, University of Warwick
  Non-Presenting Author