Socio-Emotional Development Following Very Preterm Birth: Pathways to Psychopathology

Abstract

Very preterm birth (VPT; < 32 weeks of gestation) has been associated with an increased risk to develop cognitive and socio-emotional problems, as well as with increased vulnerability to psychiatric disorder, both with childhood and adult onset. Socio-emotional impairments that have been described in VPT individuals include diminished social competence and self-esteem, emotional dysregulation, shyness and timidity. However, the etiology of socio-emotional problems in VPT samples and their underlying mechanisms are far from understood. To date, research has focused on the investigation of both biological and environmental risk factors associated with socio-emotional problems, including structural and functional alterations in brain areas involved in processing emotions and social stimuli, perinatal stress and pain and parenting strategies. Considering the complex interplay of the aforementioned variables, the review attempts to elucidate the mechanisms underlying the association between very preterm birth, socio-emotional vulnerability and psychopathology. After a comprehensive overview of the socio-emotional impairments associated with VPT birth, three main models of socio-emotional development are presented and discussed. These focus on biological vulnerability, early life adversities and parenting, respectively. To conclude, a developmental framework is used to consider different pathways linking VPT birth to psychopathology, taking into account the interaction between medical, biological, and psychosocial factors.

Autonomic Nervous System Function After a Skin-to-Skin Contact Intervention in Infants With Congenital Heart Disease

“…These mothers’ recognition of the importance of physical contact and relationship has been validated in numerous studies of the association between positive mother-infant interactions and subsequent neurodevelopment in healthy and in premature infants. 49,50 Schore’s Regulation theory delineates many of the critical neurobiological processes that occur during mother-infant interaction, 13,51 including changes in patterns of ANS activity. In newborn infants, this stimulation of regulatory pathways occurs primarily through the day-to-day repetition of holding and feeding.…”

Training of parental scaffolding in high‐socio‐economic status families: How do parents of full‐ and preterm‐born toddlers benefit?

“…Developmental trajectories after preterm birth are very heterogeneous (Yaari et al ., ). Although strong everyday functioning is reported even among VPT preschoolers (Andersson, Martin, Strand Brodd, & Almqvist, ), detrimental long‐term sequelae following extremely or very preterm birth are well documented and evidenced by a substantially heightened prevalence of attention deficit disorders, learning difficulties, and behavioural and socio‐emotional problems (Aarnoudse‐Moens et al ., ; Arpi & Ferrari, ; Eryigit‐Madzwamuse, Baumann, Jaekel, Bartmann, & Wolke, ; Johnson & Marlow, ; Johnson et al ., ; Lemola, ; Montagna & Nosarti, ). Even among MLPT children, evidence for disadvantageous long‐term consequences expands: a prolonged school career due to late school enrolment and class repetition and demand for therapeutic interventions in low‐risk preterm children (Reuner, Hassenpflug, Pietz, & Philippi, ), and less advanced cognitive functioning, more school and behaviour problems, and higher prevalence of psychiatric disorders for MLPT children and adults compared with full‐term peers (de Jong, Verhoeven, & van Baar, ; Quigley et al ., ; Vohr, ).…”

Developmental cascades of social inhibition and friendships in preterm and full‐term children

“…Although preterm children's more frequent functional differences (e.g., motor problems) and cognitive deficits (e.g., lower IQ) predicted their peer relationship difficulties in middle childhood in one study (Heuser et al, ), lower cognitive abilities do not explain a withdrawn personality factor found in adults born preterm (Eryigit‐Madzwamuse et al, ). Thus, the mechanisms underlying the link between preterm birth and social problems are still poorly understood (Montagna & Nosarti, ; Zmyj, Witt, Weitkämper, Neumann, & Lücke, ).…”