Infant malnutrition predicts conduct problems in adolescents

Abstract

Objectives The purpose of this study was to compare the prevalence of conduct problems in a well-documented sample of Barbadian adolescents malnourished as infants and a demographic comparison group and to determine the extent to which cognitive impairment and environmental factors account for this association. Methods Behavioral symptoms were assessed using a 76-item self-report scale in 56 Barbadian youth (11–17 years of age) with histories of protein–energy malnutrition (PEM) limited to the first year of life and 60 healthy classmates. Group comparisons were carried out by longitudinal and cross-sectional multiple regression analyses at 3 time points in childhood and adolescence. Results Self-reported conduct problems were more prevalent among previously malnourished youth (P < 0.01). Childhood IQ and home environmental circumstances partially mediated the association with malnutrition. Teacher-reported classroom behaviors at earlier ages were significantly correlated with youth conduct problems, confirming the continuity of conduct problems through childhood and adolescence. Discussion Self-reported conduct problems are elevated in children and adolescents with histories of early childhood malnutrition. Later vulnerability to increased conduct problems appears to be mediated by the more proximal neurobehavioral effects of the malnutrition on cognitive function and by adverse conditions in the early home environment.

Relationship between infant malnutrition and childhood maltreatment in a Barbados lifespan cohort

“…Finally, as with all longitudinal studies, there was attrition. There were not, however, significant differences between BNS participants and non-participants on key demographic variables (Galler et al, 2012). Given that this is a 45+ year longitudinal study, the ability to locate and enroll this number of the original cohort can be considered a strength.…”

“…Household standard of living was assessed at three time points during childhood and adolescence (in 1977 at 5–11 yrs , 1982 at 9–15 yrs and 1984 at 11–17 yr s) using the 50-item Barbados Ecology Questionnaire (Galler et al, 1985; 2012). This questionnaire included items related to living conditions in the home, and the income, educational and occupational backgrounds of the parents.…”

“…Each of these early exposures can have lasting effects on physical and mental health, including altered stress response (Puetz et al, 2016; Rosen et al, 2004); increased inflammatory factors (Bourke, Berkley, & Prendergast, 2016; Coelho et al, 2014), and increased risk for cognitive and mental health problems (Galler et al, 2012; 2013; Young & Widom, 2014). In addition, they likely share some of the same risk factors, such as strained family economic resources (Brown et al, 1998; Walker et al, 2007).…”

Social deprivation and the HPA axis in early development

“…It is possible, of course, that nutrition might be involved as it is certainly likely that the non-adopted children had a more nutritious diet than either the PI or PFC children. Indeed, research shows that malnutrition during the first years of life is associated with internalizing and externalizing symptoms during later childhood and adolescence (Galler et al, 2010; 2012). Until we understand the biological pathway to altered patterning of cortisol production in children coming from high-risk early life circumstances, we should think broadly about the conditions that might affect the development of the HPA axis.…”

Early malnutrition predicts parent reports of externalizing behaviors at ages 9–17

“…Self-reports by these same youth, however, did document an elevated prevalence of aggressive behaviors in the index group at the third time point. 30 Thus, parent and youth perceptions regarding aggressive behaviors appears to diverge at ages 11–17 years. Different perceptions by parents and adolescents have generally been recognized.…”