Early Childhood Psychopathology Prospectively Predicts Social Functioning in Early Adolescence.

Psychopathology in school-age children predicts impairment later in development. However, the long-term psychosocial consequences of early childhood psychopathology are less well known. The current study is the first to prospectively examine how a range of diagnoses and symptoms in early childhood predict psychosocial functioning across specific domains during early adolescence 6-9 years later. A community sample (N = 595; 44.9% female; 88.7% White, 12.6% Hispanic) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. Diagnoses and dimensional scores for depressive, anxiety, attention-deficit/hyperactivity (ADHD), and oppositional defiant disorders (ODD) were examined. When children were 12 years old, children and parents completed the UCLA Life Stress Interview for Children, a semistructured interview assessing functioning in multiple domains (academic, behavior, close friends, broader peers, maternal relationship, paternal relationship). Having a diagnosis in early childhood predicted greater impairment in all domains in early adolescence, except paternal relationship. Externalizing disorders predicted impairment in more domains than internalizing disorders. Most of the associations between early childhood psychopathology and poorer functioning in adolescence persisted after taking into account adolescent psychopathology. Moreover, the majority of bivariate associations with depressive, ODD, and ADHD symptoms, but not anxiety symptoms, persisted in a subsample of children who did not meet criteria for a diagnosis in early childhood. Early childhood psychopathology has long-lasting deleterious effects on several domains of psychosocial functioning, often beyond the effects of continuing or recurring adolescent psychopathology. Findings thereby highlight the validity and clinical significance of early psychopathology.

Neural Biomarker and Early Temperament Predict Increased Internalizing Symptoms After a Natural Disaster.

OBJECTIVE: Although most people will experience a traumatic event at some point in their life, only some will develop significant psychological symptoms in the aftermath. In the current study, we use a preexisting longitudinal study located in Long Island to examine the impact of Hurricane Sandy on internalizing symptoms in a large sample of children. We focused on temperamental fear and a biomarker of risk for anxiety, the error-related negativity (ERN). The ERN is a negative deflection in the event-related potential (ERP) occurring when individuals make mistakes and is increased in anxious individuals. METHOD: The final sample consisted of 223 children who had undergone an observational assessment of fear at age 3 years and an electroencephalogram assessment of the ERN at age 6 years. At the age 9 year assessment, internalizing symptoms were assessed, and then again after the hurricane (∼65 weeks later). RESULTS: A significant three-way interaction among fearfulness, hurricane stressors, and the ERN in predicting posthurricane increases in internalizing symptoms suggested that children who were high in fear at age 3 years and experienced elevated hurricane stressors were characterized by subsequent increases in internalizing symptoms, but only when they were also characterized by an increased ERN at age 6 years. CONCLUSION: These findings support a diathesis-stress model, suggesting that early temperament and prestressor biological markers confer risk for increased psychological symptoms following environmental stressors.

Parents' behavioral inhibition moderates association of preschoolers' BI with risk for age 9 anxiety disorders.

BACKGROUND: Temperamental behavioral inhibition (BI) in children predicts later anxiety disorders. However, many children with BI do not develop anxiety disorders, suggesting the importance of identifying moderating factors. The current study examined whether parents' history of BI moderates the associations between preschoolers' BI and anxiety disorders at age 9. METHODS: The sample was 392 children and their parents from the community. Child BI was measured at age 3 using observational (Laboratory Temperament Assessment Battery; Lab-TAB) and parent report (Behavior Inhibition Questionnaire; BIQ) measures. In addition, both parents reported on their own history of childhood BI using the Retrospective Measure of Behavioral Inhibition (RMBI). When the children were 9 years old, a parent and the child were interviewed using the Kiddie Schedule for the Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). RESULTS: Parents' reports of their own BI moderated the associations of both observed and parent-reported child BI at age 3 with children's anxiety disorders at age 9. Among children whose parents reported having had higher childhood BI, those who exhibited high BI at age 3 were more likely to meet criteria for anxiety disorders at age 9. LIMITATIONS: The major limitation is the use of a retrospective measure of parental BI. CONCLUSIONS: These findings demonstrate that parents' histories of childhood BI moderate the association between their young children's BI and subsequent anxiety disorders. Thus, parental BI appears to identify a subgroup of BI children at particularly high risk for developing anxiety disorders by late childhood.

Negative emotionality and its facets moderate the effects of exposure to Hurricane Sandy on children's postdisaster depression and anxiety symptoms.

According to diathesis-stress models, temperament traits such as negative emotionality (NE) may moderate the effects of stressors on the development of symptoms of psychopathology, although little research has tested such models in children. Moreover, there are few data on whether specific facets of NE (sadness, fear, or anger) may specifically moderate the effects of stress on depression versus anxiety. Finally, there is a paucity of research examining whether childhood temperament moderates the effect of disaster exposure on depressive or anxiety symptoms. Hurricane Sandy, which affected many thousands of people in New York State and the surrounding regions in October 2012, offers a unique opportunity to address these gaps. Seven to eight years prior to Hurricane Sandy, 332 children 3 years old completed lab-based measures of NE and its facets. Six years later, when they were 9 years old, each mother rated her child's depressive and anxiety symptoms. Approximately 8 weeks post-Sandy (an average of 1 year after the age 9 assessment), mothers again rated their child's depressive and anxiety symptoms, as well as a measure of exposure to stress from Hurricane Sandy. Adjusting for symptom levels at age 9, higher levels of stress from Hurricane Sandy predicted elevated levels of depressive symptoms only in participants with high levels of temperamental sadness and predicted elevated levels of anxiety symptoms only in participants high in temperamental fearfulness. These findings support the role of early childhood temperament as a diathesis for psychopathology and highlight the importance of considering facets of temperament when examining their relationship to psychopathology. (PsycINFO Database Record

Loss of Temper and Irritability: The Relationship to Tantrums in a Community and Clinical Sample.

BACKGROUND: This study explores the relationship of irritability to tantrums and loss of temper in a community and clinical sample. METHODS: The community sample, recruited via commercial mailing lists, consisted of 462 6-year-olds whose parents completed the Child Behavior Checklist (CBCL), and Preschool Age Psychiatric Assessment (PAPA). Tantrums were assessed in the oppositional defiant disorder (ODD) section of the PAPA. Irritability was assessed in the depression section to identify persistently irritable and/or angry mood. The clinic sample, drawn from a child psychiatry clinic, included 229 consecutively referred 6-year-olds from 2005 through 2014 whose parents completed the CBCL and Child and Adolescent Symptom Inventory (CASI). Temper loss and irritability items came from the ODD and depression sections of the CASI, and tantrum description was taken from an irritability inventory. Children's Global Assessment Scale (CGAS) and the CBCL Dysregulation Profile were examined in both samples. Logistic and multiple regression were used to compare rates of diagnosis, CBCL subscales, CGAS, and tantrum quality between children with tantrums only and tantrums with irritability. RESULTS: Almost half (45.9%) of clinic children had severe tantrums; only 23.8% of those were said to be irritable. In the community, 11% of children had tantrums, but 78.4% of those were called irritable. However, irritability in the clinic, although less common, was associated with aggressive tantrums and substantial impairment. In contrast, irritability was associated with only a relatively small increase in impairment in the community sample. CONCLUSIONS: Irritability may have different implications in community versus clinic samples, and tantrums assessed in the community may be qualitatively different from those seen in clinics.

Neural Reactivity to Emotional Stimuli Prospectively Predicts the Impact of a Natural Disaster on Psychiatric Symptoms in Children.

BACKGROUND: Natural disasters expose entire communities to stress and trauma, leading to increased risk for psychiatric symptoms. Yet, the majority of exposed individuals are resilient, highlighting the importance of identifying underlying factors that contribute to outcomes. METHODS: The current study was part of a larger prospective study of children in Long Island, New York (n = 260). At age 9, children viewed unpleasant and pleasant images while the late positive potential (LPP), an event-related potential component that reflects sustained attention toward salient information, was measured. Following the event-related potential assessment, Hurricane Sandy, the second costliest hurricane in United States history, hit the region. Eight weeks after the hurricane, mothers reported on exposure to hurricane-related stress and children's internalizing and externalizing symptoms. Symptoms were reassessed 8 months after the hurricane. RESULTS: The LPP predicted both internalizing and externalizing symptoms after accounting for prehurricane symptomatology and interacted with stress to predict externalizing symptoms. Among children exposed to higher levels of hurricane-related stress, enhanced neural reactivity to unpleasant images predicted greater externalizing symptoms 8 weeks after the disaster, while greater neural reactivity to pleasant images predicted lower externalizing symptoms. Moreover, interactions between the LPP and stress continued to predict externalizing symptoms 8 months after the hurricane. CONCLUSIONS: Results indicate that heightened neural reactivity and attention toward unpleasant information, as measured by the LPP, predispose children to psychiatric symptoms when exposed to higher levels of stress related to natural disasters, while greater reactivity to and processing of pleasant information may be a protective factor.

Positive Parenting Interacts with Child Temperament and Negative Parenting to Predict Children's Socially Appropriate Behavior.

This study examined the effects of parents' positive and negative affect and behavior while interacting with their preschool child and the moderating role of child temperament in predicting children's subsequent difficulty with socially appropriate behavior around school-entry. Independent observational measures were used to assess child temperament (dysphoria; exuberance) and parenting at age 3, and multi-informant reports of child socially appropriate behavior were collected at age 6 (N = 219). Hierarchical multiple regression analyses revealed that children's temperamental dysphoria moderated the relationship between positive parenting and later socially appropriate behavior. High- and low-dysphoric children trended in opposite directions; highly dysphoric children experienced greater difficulty with socially appropriate behavior as levels of positive parenting increased, whereas low-dysphoric children experienced less difficulty with socially appropriate behavior with higher levels of positive parenting. There was also an interaction between positive and negative parenting, whereby the combination of elevated positive and negative parenting predicted children's later difficulty with socially appropriate behavior. The findings suggest that positive parenting interacts with early child temperament and negative parenting to impact the development of children's socially appropriate behavior.

Longitudinal associations between preschool psychopathology and school-age peer functioning.

The current study examined the effects of preschool psychopathology on peer functioning around school entry. Children (N = 211) were assessed at ages 3 and 6. A semi-structured diagnostic interview, the Preschool Age Psychiatric Assessment, was administered to a parent at both time points to assess psychopathology. The peer functioning constructs examined at age 6 included child popularity, socially inappropriate behavior, and conflicted shyness. Simultaneous multiple regressions revealed that age 3 anxiety disorder diagnosis was the only unique diagnostic predictor of age 6 socially inappropriate behavior and conflicted shyness, with age 3 anxiety dimensional scores uniquely predicting all three peer constructs. Age 3 anxiety disorder had direct effects on both socially inappropriate behavior and conflicted shyness, which were not mediated by concurrent anxiety disorder at age 6. Thus, preschool anxiety disorders may have enduring effects on child peer relationships in the early school-age years. Possible explanations and implications are explored.