Early Regulatory Problems in Infancy and Psychopathological Symptoms at 24 Months: A Longitudinal Study in a High-risk Sample

Abstract

Background: This study investigates the association between regulatory disorders in infants at five months and the development of early childhood problems at 24 months. Methods: The sample was made up of 223 mother-child dyads from multi-problem families who participated in German family support research project “Nobody slips through the net”: These families faced psychosocial risks (e.g. poverty, excessive demands on the mother and mental health disorders of the mother, measured with the risk screening instrument Heidelberger Belastungsskala-HBS) and maternal stress, determined with the Parental Stress Index (PSI-SF). The children’s psychopathologic symptoms and possible early regulatory problems were evaluated by means of Child Behavior Checklist (CBCL 1 1/2-5) and a German questionnaire assessing problems of excessive crying, along with sleeping and feeding difficulties (SFS). Results: A statistically significant association between excessive crying, whining and sleeping problems of 5-month-old infants and both externalizing and internalizing problems of the same infants at age 2 (accounting for 17% and 15% of the variance, respectively) was found after controlling for maternal education, maternal status and infant sex. Feeding problems had no effect on the subsequent development of early childhood problems. Both externalizing and internalizing difficulties were associated with concurrent maternal distress (15% and 12% of the variance) and maternal assessment of the child as being a “difficult child” (14% and 5%, respectively), whereas concurrent maternal depressive symptoms contributed only marginally to the variance explanation (2% for both CBCL scales) at child’s age of 24 months. Conclusion: The results show that infants` regulatory problems contribute substantially to an increased risk of both externalized and internalized psychic problems in early childhood in the high-risk sample. Easily accessible support services provided by family health visitors (particularly to the so-called “at-risk families”) are strongly recommended to help prevent the broadening of children’s early regulatory problems into other areas of behavior.