Trajectories of dysregulation in preschool age

Abstract

Background: Dysregulation of emotions, behaviour and attention are involved in several areas of childhood psychopathology, but knowledge about early developmental trajectories remains scarce. This study aims to explore continuity and associations of dysregulation in preschool age.Methods: Dysregulation was measured at age 2½ years and again at 5 years in a community-based birth cohort of 1,099 children using the Child Behavior Checklist, preschool version (CBCL1½-5), answered by mothers. Based on the CBCL-DP/1½-5-Dysregulation Profile (CBCL-DP) score, we defined four trajectory groups, using the 75 th percentile from the Danish norm material as cut-off. Associations between the four CBCL-DP trajectory groups and potential covariates, including child, parental and family factors, were analysed using univariate and multiple multinomial logistic regression.Results: Nearly half (54%) of the children showed persistent low scores of CBCL-DP, 17% displayed continuing dysregulation problems, 13 % had problems that increased from 2½ years to 5 years, whereas 16 % of the children showed reduced problems across preschool age. Persistent dysregulation was associated with maternal postpartum depressive symptoms RRR = 2.20 (95% CI 1.29-3.75), low maternal educational level RRR = 1.69 (95% CI 1.08-2.66), and mothers' smoking during pregnancy RRR = 2.87 (95% CI 1.09-7.55).Conclusion: Persistent problems of emotional, behavioural and attention regulation in children aged 2½ years to 5 years is influenced by maternal educational level and post-partum depression symptoms. The study draws clinical attention to early symptoms of dysregulation and to the importance of addressing the specific needs of mentally vulnerable parents in intervention planning.

Assessment of Psychosocial and Neonatal Risk Factors for Trajectories of Behavioral Dysregulation Among Young Children From 18 to 72 Months of Age

“…In this study, CBCL-DP associations with prematurity are comparable to prior studies using similar measures related to behavioral problems at 6 to 19 years . Across GA groups, our results are also consistent with multinational findings regarding CBCL-DP trajectories associated with individual psychosocial adversities …”

“…Emotional and behavioral dysregulation among school-aged children has an average multinational prevalence of 9% (range, 2%-18%; n = 56 666) and is associated with subsequently severe behavioral, affective, and cognitive impairments through adulthood . Risk factors for children’s persisting emotional and behavioral dysregulation involve the cumulative burden of medical and socioeconomic adversities, as well as parental psychological and substance use challenges …”

“…[2][3][4] Risk factors for children's persisting emotional and behavioral dysregulation involve the cumulative burden of medical and socioeconomic adversities, as well as parental psychological and substance use challenges. [5][6][7][8][9][10][11] Children born preterm (<37 weeks' gestation), and children whose parents have co-occurring psychological and substance use challenges are at elevated risk for persisting dysregulation. [12][13][14][15][16] Moreover, prematurity, in combination with environmental adversity has been associated with childhood anxiety, attention, mood, and social-communicative disorders that persist into adulthood.…”

The Use of Lower or Higher Than Recommended Doses of Folic Acid Supplements during Pregnancy Is Associated with Child Attentional Dysfunction at 4–5 Years of Age in the INMA Project

“…In two birth cohorts in China, prevalences of 6.4% [41] and 12.3% [42] were reported for children 3 and 4 years old, respectively, although they evaluated the prevalence of Attention-Deficit-Hyperactivity Disorders (ADHD) while we evaluated only attentional function-just one of the ADHD symptoms. In another birth cohort study from Denmark, a prevalence of 30% was reported for children of 5 years [43]. Thus, it is difficult to make comparisons of inattention prevalence among studies since specific cut-off points or definitions for inattention are not used consistently yet.…”

A Longitudinal Approach to the Relationships Among Sleep, Behavioral Adjustment, and Maternal Depression in Preschoolers

“…The impact of MDS on children’s sleep and behavioral adjustment during the preschool period is not likely to be less important than during infancy and other developmental stages. Nevertheless, the vast majority of relevant studies has focused on the impact of postpartum depressive symptoms in the first few months to 3 years after childbirth (e.g., Ystrom et al, 2017 ; Parade et al, 2019 ; Cook et al, 2020 ; Asmussen et al, 2021 ). Given the importance of early childhood as a transition from infancy to middle childhood in both sleep and behavioral adjustment and the observed developmental changes during this period, understanding how these processes change over time in relation to MDS is crucial.…”