The Worldwide Burden of Infant Mental and Emotional Disorder: Report of the Task Force of the World Association for Infant Mental Health

Abstract

Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth -3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosingWe acknowledge the invaluable assistance of Mallika Rajamani in the preparation of this article. We have no conflicts of interest to declare. young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, 2015). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.Keywords: Infant mental health, infant mental disorders, prevalence of infant disorder, burden of disease, early intervention RESUMEN: Los niños en el mundo entero experimentan trastornos mentales y emocionales. Los trastornos mentales que ocurren en niños pequeños, especialmente infantes (entre el nacimiento y los 3 años de edad), a menudo pasan sin ser reconocidos. Las tasas de prevalencia son difíciles de determinar a causa de la falta de conocimiento y la dificultad de evaluar y diagnosticar niños pequeños. Sin embargo, la información existente sugiere que las tasas de trastornos en niños pequeños son comparables con aquellas de niños mayores y adolescentes. La falta de un amplio reconocimiento de los trastornos de infancia es particularmente preocupante debido a la posición clave que ocupa la infancia como pilar fundamental en el proceso de desarrollo. Tanto el cerebro como la conducta se encuentran en vulnerables etapas de desarrollo a lo largo de los tres primeros años de vida con la potencialidad de sufrir desviaciones que ocurren como respuesta al temprano trauma y a las privaciones. Los acercamientos de intervención para niños pequeños requieren una sensibilidad hacia sus necesidades de desarrollo dentro de sus familias. Se discuten la primacía de la infancia como una etapa de riesgos fundamentales para los trastornos, el impacto que el trauma y la violencia tienen sobre el desarrollo de los niños pequeños, el impacto que las rupturas familiares ...

The early biopsychosocial development of boys and the origins of violence in males

“…This issue of the Infant Mental Health Journal follows several lines of research finding that a significant part of the origins of violence lies in the environment of prenatal to toddlerhood periods of development (Tremblay, ; Tremblay & Côté, this issue). In many ways, this focus on the very early periods of life reflects other examples of problematic outcomes such as childhood psychopathologies and school failure, also often found to have a basis in the first years of life (Caspi et al., ; Fearon & Belsky, ; Fitzgerald & Eiden, ; Hatzinikolaou & Murray, ; Lyons‐Ruth et al., ; Raine, this issue; Schore, ; Sroufe, ; Sroufe, Egeland, Carlson, & Collins, ). In addition, the articles in this special issue focus on another important line of research, which involves gender differences, concerning predilections for problematic behaviors related to sex‐specific neurobiological development, especially prevalent when children are raised under conditions of compromised caregiving (Golding & Fitzgerald , ; Holden, ; Kigar & Auger, ; Martel, ; McGinnis, Bockneck, Beeghly, Rosenblum, & Muzik, ; Schore, ; Zahn‐Waxler, Shirtcliff, & Marceau.…”

Validation of the AMBIANCE‐brief: An observational screening instrument for disrupted caregiving

“…Instead, use of the AMBIANCE‐Brief in a multi‐method, multi‐informant assessment could provide useful information to identify points of vulnerability of caregiver–infant interactions, as well as potential targets for supportive interventions, within a nested, complex system of factors that influence infant development and mental health outcomes. Specifically, identifying difficulties within caregiver–infant interactions within the attachment relationship has been highlighted as one starting point for effective interventions for families at high risk (Bernard et al., ; Lyons‐Ruth et al., ; Tereno et al., ; Tryphonopoulos, Letourneau, & Ditommaso, ; Zeanah et al., ).…”

“…In addition, families with these risks are more likely to receive services in child welfare agencies (Jud, Fallon, & Trocmé, ). Paired with the rising call to mitigate infant mental health and socioemotional difficulties “within the caregiving relationship” (Lyons‐Ruth et al., , p. 698), a practical (i.e., cost‐ and time‐effective) measure of disrupted caregiving behavior is needed. However, a major challenge to implementing a measure of disrupted caregiving in a community agency is that observational coding of videotaped interactions requires considerable training and is time‐consuming to carry out, making it costly for use in community practice.…”

An illustrative case for addressing infant mental health referrals

“…Despite knowing the importance of the early detection of adverse experiences, mental health disorders beginning or occurring during infancy can be difficult to recognize (Lyons‐Ruth et al, ). To address this gap, this manuscript provides an illustrative case that describes the care of a parent–child dyad that includes the early detection of IMH in primary care with referral to a PMHNP, as well as highlight how integrative care with PMHNP can facilitate the use of the nursing process to promote optimal early childhood growth and development and prevent long‐term mental health problems.…”