Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 62
Filter
1.
Psychol Med ; 53(11): 5227-5234, 2023 08.
Article in English | MEDLINE | ID: mdl-35866360

ABSTRACT

BACKGROUND: For infants born in the contemporary era of neonatal care, little is known about adult mental health outcomes of extremely preterm birth (EP; <28 weeks' gestation) or extremely low birthweight (ELBW; <1000 g). This study aimed to compare attention deficit hyperactivity disorder (ADHD), anxiety, mood, and substance use disorder prevalence in young adults born EP/ELBW and normal birthweight (NBW; >2499 g) controls, and to compare change in prevalence of mental health symptoms and disorders from 18 to 25 years. METHODS: Participants were a prospective geographical cohort of 297 consecutive survivors born EP/ELBW during 1991-1992 and 260 NBW controls. At age 25 years, 174 EP/ELBW and 139 NBW participants completed the Adult ADHD Rating Scale, Structured Clinical Interview for DSM-IV Disorders, Beck Anxiety Inventory, and Center for Epidemiologic Studies Depression Scale-Revised. Data from follow-up at 18 years were also utilized. Multiple imputation was used to account for attrition. RESULTS: Mental health outcomes at 25 years were similar between groups: prevalence rates were ADHD 7% v. 5%; anxiety 32% v. 27%; mood 38% v. 35%; substance use 12% v. 14% in the EP/ELBW and NBW groups, respectively. In both groups, ADHD declined between 18 and 25 years [odds ratio (OR) per year = 0.87, 95% confidence interval (CI) 0.79-0.95], and generalized anxiety disorder and major depressive episode became more common (OR 1.22, 95% CI 1.10-1.35 per year; OR 1.20, 95% CI 1.10-1.30 respectively). CONCLUSIONS: This contemporary EP/ELBW cohort has comparable young adult mental health outcomes to controls, and similar patterns of change in mental health from late adolescence.


Subject(s)
Depressive Disorder, Major , Premature Birth , Infant , Female , Adolescent , Humans , Infant, Newborn , Young Adult , Adult , Infant, Extremely Low Birth Weight/psychology , Infant, Extremely Premature , Mental Health , Intensive Care, Neonatal , Prospective Studies
2.
Neurosci Lett ; 730: 135012, 2020 06 21.
Article in English | MEDLINE | ID: mdl-32360687

ABSTRACT

Exposure to early adversity is known to shape brain-behavior relations, which in turn can lead to hypersensitivity to threat and an increased risk of developing a range of psychopathologies. To date, much of the work in this area has considered exposure to negative post-natal events (e.g., maltreatment) in shaping these relations in humans. Here we examined the influence of prenatal adversity in the form of a suboptimal intra-uterine environment (i.e., being born at extremely low birth weight; [ELBW i.e., < 1000 g]). ELBW babies are the tiniest and most at-risk infants and are known to be at risk for internalizing problems (e.g., depression and anxiety) from childhood through early adulthood. However, we know relatively little about the mechanism(s) underlying this risk. Using the oldest known prospectively followed cohort of ELBW survivors, we examined associations among birth weight status, individual differences in frontal brain electrical activity (EEG) at rest (a marker of affective style) at age 22-26 years, and threat-related biases to angry faces (using the dot probe task) at 30-35 years of age. We found that among ELBW adults, those displaying greater relative right frontal EEG activity at rest exhibited greater vigilance to angry faces than those exhibiting greater relative left frontal EEG activity (n = 34, r = -0.40, p = .02). This pattern was not observed among normal birth weight (NBW) control participants (n = 47, r = .08, p > .05). As well, the relation between frontal EEG asymmetry and vigilance to angry faces was stronger for the ELBW group versus the NBW group (z = -2.21, p =  .03). These findings suggest that exposure to significant prenatal adversity may have long-term programming effects on biological and cognitive systems associated with emotion regulatory processes in the fourth decade of life. We speculate that these vulnerabilities may contribute to making some ELBW survivors susceptible to psychopathology.


Subject(s)
Anxiety Disorders/etiology , Bias , Brain/physiopathology , Infant, Extremely Low Birth Weight/psychology , Survivors/psychology , Adult , Case-Control Studies , Depression/etiology , Female , Humans , Infant, Newborn , Male , Pregnancy , Risk Factors , Young Adult
3.
J Dev Orig Health Dis ; 11(6): 632-639, 2020 12.
Article in English | MEDLINE | ID: mdl-31753052

ABSTRACT

The mental health of adult extremely low birth weight (ELBW) (<1000 g) survivors is poorer than their normal birth weight (NBW) peers. An understanding of the modifiable factors that affect this risk could provide targets for intervention. We set out to determine the extent to which a maternal history of mental health problems influenced mental health in ELBW and NBW offspring in adulthood. A total of 85 ELBW and 88 NBW individuals born between 1977 and 1982 in central west Ontario, Canada self-reported on internalizing (depression, anxiety) and externalizing (attention-deficit hyperactivity and antisocial) problems using the Diagnostic and Statistical Manual of Mental Disorders (DSM) scales of the Young Adult Self-Report at ages 22-26 and 30-35. They also reported on their mother's maternal mental health using the Family History Screen. An interaction was found between birth weight status and maternal history of an anxiety disorder such that ELBW survivors showed a greater increase in internalizing scores than NBW participants at 22-26 (ß = 10.27, p = 0.002) and at 30-35 years of age (ß = 12.65, p = 0.002). An interaction was also observed between birth weight and maternal history of mood disorder, with higher externalizing scores in ELBW survivors than NBW adults at 22-26 (ß = 7.21, p < 0.0001). ELBW adults appear to be more susceptible to the adverse mental health effects of exposure to maternal mood and anxiety disorders than those born at NBW. These links further highlight the importance of detecting and treating mental health problems in the parents of preterm survivors as a means of attempting to reduce the burden of psychopathology in this population.


Subject(s)
Anxiety/epidemiology , Attention Deficit Disorder with Hyperactivity/epidemiology , Depression/epidemiology , Mental Health/statistics & numerical data , Pregnancy Complications/psychology , Prenatal Exposure Delayed Effects/epidemiology , Adult , Anxiety/diagnosis , Anxiety/etiology , Anxiety/psychology , Attention Deficit Disorder with Hyperactivity/etiology , Attention Deficit Disorder with Hyperactivity/psychology , Depression/diagnosis , Depression/etiology , Depression/psychology , Female , Follow-Up Studies , Humans , Infant, Extremely Low Birth Weight/psychology , Infant, Newborn , Longitudinal Studies , Male , Ontario/epidemiology , Pregnancy , Pregnancy Complications/epidemiology , Prenatal Exposure Delayed Effects/diagnosis , Prenatal Exposure Delayed Effects/etiology , Prenatal Exposure Delayed Effects/psychology , Prevalence , Prospective Studies , Psychiatric Status Rating Scales , Risk Factors , Self Report/statistics & numerical data , Survivors/psychology , Survivors/statistics & numerical data , Young Adult
4.
J Perinatol ; 39(8): 1098-1104, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31235783

ABSTRACT

OBJECTIVE: To report cognitive outcomes of preterm infants evaluated in a single center between 1980 and 2015. STUDY DESIGN: Cognitive scores at a median age of 33 months were collected in preterm infants (birthweight ≤ 1000 g). Cognition was assessed using the Bayley Scales of Infant Development and the Stanford Binet Intelligence Scales. RESULTS: Six-hundred and two infants born between 1980 and 2015 were evaluated. Significant cognitive impairment for all infants decreased by 9.4% (p = 0.015) across the study period. For larger infants (birthweight ≥ 750 g), significant impairment decreased by 14.6% (p = 0.002). In smaller infants (birthweight < 750 g) no significant changes were observed in cognitive outcomes over the study period. CONCLUSIONS: Overall, long-term outcomes of ELBW infants in our cohort showed significant improvement since 1980. Significant impairment decreased in infants with BW ≥ 750 g; and, despite increased survival of smaller (BW < 750 g) and sicker infants, significant impairment in that subgroup did not worsen over time.


Subject(s)
Cognitive Dysfunction/epidemiology , Infant, Extremely Low Birth Weight/psychology , Infant, Extremely Premature/psychology , Child Development , Female , Humans , Infant, Newborn , Infant, Premature, Diseases , Infant, Small for Gestational Age/psychology , Intelligence Tests , Logistic Models , Male
5.
J Paediatr Child Health ; 55(12): 1481-1486, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31016801

ABSTRACT

AIM: Individuals born at extremely low birthweight (ELBW; <1000 g) are exposed to early adversities that increase the risk of mental health problems in later life. Caring parenting has been shown to offset the negative effects of early adversity in general population samples. However, the long-term impact of caring parenting on the mental health of preterm survivors in adulthood is not known. METHODS: Using data from the world's oldest longitudinally followed cohort of ELBW survivors (n = 179) and matched normal birthweight (NBW) control participants (n = 145), we examined if caring parenting moderated the link between preterm birth and mental health at 30-35 years of age. Participants reported on the parenting they received from their mothers using the parental bonding instrument. Self-esteem and internalising problems (i.e. depression, anxiety) were self-reported at 30-35 years of age using the Coopersmith Self-Esteem Inventory and Young Adult Self-Report questionnaire, respectively. RESULTS: A statistically significant interaction was found between birthweight status and caring maternal parenting on self-esteem and internalising psychopathology in adulthood. Stratified analyses demonstrated that caring parenting was associated with better self-esteem (P < 0.001) and lower levels of internalising symptoms (P = 0.001), but in NBW participants only. CONCLUSIONS: While the receipt of caring maternal parenting promoted mental health in adults born at NBW, it did not have the same protective effect on ELBW survivors. More research is needed to elucidate the aspects of parenting and the family environment that promote the long-term mental health of preterm survivors.


Subject(s)
Adult Survivors of Child Adverse Events/psychology , Infant, Extremely Low Birth Weight/psychology , Mental Health , Parenting , Survivors/psychology , Adult , Canada , Female , Humans , Male , Middle Aged , Self Concept , Self Report
6.
Neonatal Netw ; 37(5): 324-326, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30567815

ABSTRACT

Deb Discenza interviews Geoff, a preemie born almost 40 years ago, and gets unique insight into his birth, his NICU stay, and life afterward.


Subject(s)
Infant, Extremely Low Birth Weight/physiology , Infant, Extremely Low Birth Weight/psychology , Infant, Premature, Diseases/physiopathology , Infant, Premature, Diseases/psychology , Infant, Premature/physiology , Infant, Premature/psychology , Survivors/psychology , Adult , Humans , Incubators , Infant, Newborn , Male , Risk Factors
7.
J Child Psychol Psychiatry ; 59(11): 1192-1200, 2018 11.
Article in English | MEDLINE | ID: mdl-29667718

ABSTRACT

BACKGROUND: Individuals born extremely preterm are exposed to significant perinatal stresses that are associated with an increased risk of psychopathology. However, a paucity of longitudinal studies has prevented the empirical examination of long-term, dynamic effects of perinatal adversity on mental health. Here, internalizing and externalizing problems from adolescence through adulthood were compared in individuals born at extremely low birth weight (ELBW; <1,000 g) and normal birth weight (NBW; >2,500 g). METHODS: Internalizing and externalizing data were collected over 20 years in three waves, during adolescence, young adulthood, and adulthood. Growth models were used to compare longitudinal trajectories in a geographically based sample of 151 ELBW survivors and 137 NBW control participants born between 1977 and 1982 matched for age, sex, and socioeconomic status at age 8. RESULTS: After adjusting for sex, socioeconomic and immigrant status, and family functioning, ELBW survivors failed to show the normative, age-related decline in internalizing problems over time relative to their NBW peers (ß = .21; p < .01). Both groups exhibited small declines in externalizing problems over the same period. Self-esteem (but not physical health, IQ, or maternal mood) partially mediated the association between ELBW status and internalizing problems. CONCLUSIONS: Extremely low birth weight survivors experienced a blunting of the expected improvement in depression and anxiety from adolescence to adulthood. These findings suggest that altered physiological regulatory systems supporting emotional and cognitive processing may contribute to the maintenance of internalizing problems in this population.


Subject(s)
Infant, Extremely Low Birth Weight/psychology , Mental Disorders/etiology , Adolescent , Adult , Case-Control Studies , Dental Anxiety/etiology , Dental Anxiety/psychology , Depression/etiology , Depression/psychology , Female , Humans , Longitudinal Studies , Male , Mental Disorders/psychology , Psychological Tests , Psychopathology , Self Concept , Young Adult
8.
Child Care Health Dev ; 44(2): 227-233, 2018 03.
Article in English | MEDLINE | ID: mdl-28752669

ABSTRACT

BACKGROUND: Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5 years was explored. METHODS: Fifty 4-year-old children (born <28 weeks gestation or birth weight <1,000 g) with minimal/mild motor impairment were randomly allocated to intervention (n = 24) or standard care (n = 26). Intervention was 6 group-based physiotherapy weekly sessions and home programme. Standard care was best practice advice. The Child Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition. RESULTS: The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p = .004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p = .026), although still performed within the "normal" range. CBCL scores did not correlate with other scores. CONCLUSIONS: The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5 years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains.


Subject(s)
Child Behavior Disorders/rehabilitation , Infant, Extremely Low Birth Weight/psychology , Infant, Extremely Premature/psychology , Physical Therapy Modalities , Birth Weight , Child , Child Behavior Disorders/psychology , Child, Preschool , Follow-Up Studies , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Internal-External Control , Psychometrics , Sex Factors
9.
Child Care Health Dev ; 44(2): 234-239, 2018 03.
Article in English | MEDLINE | ID: mdl-28776722

ABSTRACT

BACKGROUND: Extremely low birth weight (ELBW; <1,000 g) infants are the most vulnerable babies and are at higher risk for experiencing overprotective (i.e., controlling and intrusive) parenting, which is hypothesized to contribute to the risk for mental disorders. Despite the increased risk for anxiety disorders and decreased risk for alcohol or substance use disorders seen in ELBW survivors, no research has examined the impact of parenting. This study investigated if overprotective parenting mediates links between ELBW birth status and psychiatric disorders in adulthood. STUDY DESIGN: Participants included ELBW survivors born in 1977-1982 and matched normal birth weight (≥2,500 g) control participants (ELBW n = 81; normal birth weight n = 87) prospectively followed in Ontario, Canada. These individuals retrospectively reported on whether either of their parents was overprotective using the Parental Bonding Instrument. Presence of a current anxiety disorder and of current alcohol or substance use disorders was assessed using the Mini International Neuropsychiatric Interview at age 29-36 years. RESULTS: Path analysis showed that overprotective parenting was a significant mediator of the association between ELBW status and risk for an anxiety disorder in adulthood and the risk for an alcohol or substance use disorder in adulthood in ELBW survivors. Overprotective parenting accounted for 53% of the association between ELBW status and the risk for an anxiety disorder in adulthood and 26% of the association between ELBW status and alcohol or substance use disorders. CONCLUSIONS: Overprotective parenting accounted for a substantial proportion of the increased risk for anxiety and alcohol or substance use disorders in adulthood in ELBW survivors. Despite their perceived vulnerabilities, it is important that the parents of ELBW survivors be supported in their attempts to facilitate their children's pursuit of independence during childhood and beyond.


Subject(s)
Anxiety Disorders/etiology , Infant, Extremely Low Birth Weight/psychology , Parenting , Adult , Anxiety Disorders/epidemiology , Birth Weight , Case-Control Studies , Female , Gestational Age , Humans , Infant, Newborn , Male , Ontario/epidemiology , Psychiatric Status Rating Scales , Risk Factors , Sex Factors , Substance-Related Disorders/epidemiology , Substance-Related Disorders/etiology , Survivors/psychology , Young Adult
10.
Pediatrics ; 141(1)2018 01.
Article in English | MEDLINE | ID: mdl-29196505

ABSTRACT

BACKGROUND AND OBJECTIVES: To determine if executive functioning outcomes at school age are different for extremely preterm (EP; <28 weeks' gestation) or extremely low birth weight (ELBW; <1000 g birth weight) children born in 1991 to 1992, 1997, and 2005 relative to their term-born peers. METHODS: Population-based cohorts of all EP/ELBW survivors born in the state of Victoria, Australia, in 1991 to 1992, 1997, and 2005, and contemporaneous controls (matched for expected date of birth, sex, mother's country of birth [English speaking or not], and health insurance status) were recruited at birth. At 7 to 8 years of age, parents of 613 children who were EP/ELBW and 564 children who were controls rated their children's executive functioning on the Behavior Rating Inventory of Executive Function (BRIEF). The proportion of children with elevated BRIEF scores (in the clinically significant range) in each birth group and era was compared by using logistic regression. Sensitivity analyses explored these associations after excluding children with intellectual impairment. RESULTS: Across the eras, EP/ELBW children had higher rates of elevated scores than controls in almost all BRIEF domains. The 2005 EP/ELBW cohort had increased executive dysfunction compared with earlier cohorts, particularly in working memory and planning and organization. This effect persisted after accounting for demographic factors and weakened slightly when those with intellectual impairment were excluded. CONCLUSIONS: These results indicate a concerning trend of increasing executive dysfunction for EP/ELBW children who were born more recently. This may have adverse implications for other functional domains, such as academic achievement and social-emotional well-being.


Subject(s)
Developmental Disabilities/diagnosis , Executive Function/physiology , Infant, Extremely Low Birth Weight/psychology , Infant, Extremely Premature/psychology , Age Factors , Child , Cohort Studies , Developmental Disabilities/epidemiology , Developmental Disabilities/etiology , Female , Forecasting , Gestational Age , Humans , Infant, Newborn , Male , Monitoring, Physiologic/methods , Neuropsychological Tests , Prognosis , Reference Values , Retrospective Studies , Risk Assessment , Sex Factors , Survivors , Term Birth , Victoria
11.
Pediatrics ; 140(5)2017 Nov.
Article in English | MEDLINE | ID: mdl-29030525

ABSTRACT

OBJECTIVES: We sought to evaluate the relationships between fetal growth restriction (FGR) (both severe and less severe) and assessments of cognitive, academic, and adaptive behavior brain function at age 10 years. METHODS: At age 10 years, the Extremely Low Gestational Age Newborns Cohort Study assessed the cognitive function, academic achievement, social-communicative function, psychiatric symptoms, and overall quality of life of 889 children born before 28 weeks' gestation. A pediatric epileptologist also interviewed parents as part of a seizure evaluation. The 52 children whose birth weight z scores were <-2 were classified as having severe FGR, and the 113 whose birth weight z scores were between -2 and -1 were considered to have less severe FGR. RESULTS: The more severe the growth restriction in utero, the lower the level of function on multiple cognitive and academic achievement assessments performed at age 10 years. Growth-restricted children were also more likely than their extremely preterm peers to have social awareness impairments, autistic mannerisms, autism spectrum diagnoses, difficulty with semantics and speech coherence, and diminished social and psychosocial functioning. They also more frequently had phobias, obsessions, and compulsions (according to teacher, but not parent, report). CONCLUSIONS: Among children born extremely preterm, those with severe FGR appear to be at increased risk of multiple cognitive and behavioral dysfunctions at age 10 years, raising the possibility that whatever adversely affected their intrauterine growth also adversely affected multiple domains of cognitive and neurobehavioral development.


Subject(s)
Child Development , Fetal Growth Retardation/diagnosis , Fetal Growth Retardation/psychology , Infant, Extremely Low Birth Weight/psychology , Neurodevelopmental Disorders/diagnosis , Neurodevelopmental Disorders/psychology , Child , Child Development/physiology , Female , Fetal Growth Retardation/epidemiology , Humans , Infant, Extremely Low Birth Weight/physiology , Infant, Newborn , Male , Neurodevelopmental Disorders/epidemiology , Neuropsychological Tests , Prospective Studies
12.
Psychol Bull ; 143(4): 347-383, 2017 04.
Article in English | MEDLINE | ID: mdl-28191983

ABSTRACT

Although individuals born at extremely low birth weight (ELBW; < 1,000 g) are the most vulnerable of all preterm survivors, their risk for mental health problems across the life span has not been systematically reviewed. The primary objective of this systematic review and meta-analysis was to ascertain whether the risk for mental health problems is greater for ELBW survivors than their normal birth weight (NBW) peers in childhood, adolescence, and adulthood. Forty-one studies assessing 2,712 ELBW children, adolescents, and adults and 11,127 NBW controls were reviewed. Group differences in mental health outcomes were assessed using random effects meta-analyses. The impacts of birthplace, birth era, and neurosensory impairment on mental health outcomes were assessed in subgroup analyses. Children born at ELBW were reported by parents and teachers to be at significantly greater risk than NBW controls for inattention and hyperactivity, internalizing, and externalizing symptoms. ELBW children were also at greater risk for conduct and oppositional disorders, autistic symptoms, and social difficulties. Risks for parent-reported inattention and hyperactivity, internalizing, and social problems were greater in adolescents born at ELBW. In contrast, ELBW teens self-reported lower inattention, hyperactivity, and oppositional behavior levels than their NBW peers. Depression, anxiety, and social difficulties were elevated in ELBW survivors in adulthood. Group differences were robust to region of birth, era of birth, and the presence of neurosensory impairments. The complex needs faced by children born at ELBW continue throughout development, with long-term consequences for psychological and social well-being. (PsycINFO Database Record


Subject(s)
Infant, Extremely Low Birth Weight/psychology , Infant, Extremely Premature/psychology , Mental Disorders/psychology , Mental Health , Survivors/psychology , Adolescent , Adult , Child , Child, Preschool , Humans , Infant, Newborn , Mental Disorders/epidemiology , Survivors/statistics & numerical data , Young Adult
13.
J Dev Behav Pediatr ; 38(1): 39-48, 2017 01.
Article in English | MEDLINE | ID: mdl-27984416

ABSTRACT

OBJECTIVE: To (1) compare adolescent- and parent-perceived family functioning between extremely preterm/extremely low birth weight (<28 wk/<1000 g, EP/ELBW) and normal birth weight (>2499 g, NBW) adolescents and (2) determine whether adolescents' or parents' ratings of family functioning were related to concurrent depression and anxiety symptoms in the adolescent and whether these relationships varied by birth group. METHODS: One hundred ninety-three EP/ELBW and 151 NBW adolescents (aged 15-20 yr) and their parents rated aspects of family functioning on the Family Environment Scale. Adolescents rated current depression and anxiety symptoms on the Center for Epidemiologic Studies Depression Scale-Revised and Beck Anxiety Inventory. Family functioning was compared across the groups using linear regression, and logistic regression was used to assess relationships between family functioning domains and elevated depression and anxiety scores. RESULTS: Compared with NBW controls, EP/ELBW adolescents reported similar levels of family Cohesiveness and Expressiveness, but less Conflict, and more Organization and Control. Parent ratings of family functioning were similar between groups except for higher Control scores in EP/ELBW group parents. Poorer family functioning as rated by adolescents, but not parents, was associated with increased depression/anxiety symptoms. These findings were generally consistent across both the EP/ELBW and control groups. CONCLUSION: EP/ELBW adolescents report generally positive family functioning. While adolescents' perceptions of family functioning are associated with concurrent adolescent mental health, parental perceptions of family functioning may not be indicative of adolescents' mental health. Importantly, EP/ELBW adolescents do not appear to be more vulnerable to anxiety/depression in the context of poorly perceived family functioning than their NBW peers.


Subject(s)
Anxiety/psychology , Depression/psychology , Family Relations/psychology , Infant, Extremely Low Birth Weight/psychology , Infant, Extremely Premature/psychology , Adolescent , Adult , Diagnostic Self Evaluation , Female , Humans , Infant, Newborn , Male , Parents , Self Report , Young Adult
14.
Br J Dev Psychol ; 35(3): 334-348, 2017 09.
Article in English | MEDLINE | ID: mdl-27943398

ABSTRACT

Exposure to early adversity is known to have deleterious effects on brain-behaviour relations across the lifespan and across a range of domains. Here, we tested a cumulative risk hypothesis of adult social functioning and health outcomes in the fourth decade of life, using the oldest known longitudinally followed cohort of survivors of extremely low birthweight (ELBW; <1,000 g). We investigated the additional impact of peer victimization in youth on social outcomes at age 29-36 years in ELBW survivors and matched normal birthweight (NBW; >2,500 g) participants. In the combined sample, peer victimization was associated with lower likelihood of having children and household income, poorer family functioning and self-esteem, more loneliness and chronic health conditions, less social support, and increased likelihood for contact with police. Moderation analyses indicated that among ELBW survivors, compared to their NBW counterparts, victimization was more strongly associated with being convicted of a crime and with having chronic health conditions. These findings highlight the negative long-term impact of peer victimization on all children and that some outcomes may be differentially affected by prenatal and early post-natal environments. Statement of contribution What is already known on this subject Exposure to early adversity has deleterious effects on brain-behaviour relations across the lifespan. Extremely premature children have higher rates of exposure to adversities, including peer victimization. Peer victimization is associated with adverse outcomes in adulthood in those born at term. What does this study add? Victimization negatively impacts the social outcomes of those born extremely premature and at term into adulthood. Associations appear to be affected by individual differences in prenatal and early post-natal environments. Intervention is crucial when peer victimization occurs in children at risk, as well as those typically developing.


Subject(s)
Crime Victims/psychology , Infant, Extremely Low Birth Weight/psychology , Loneliness/psychology , Peer Group , Self Concept , Social Adjustment , Social Support , Adult , Bullying , Child , Family/psychology , Female , Humans , Male , Young Adult
15.
Pediatrics ; 137(3): e20153383, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26908689

ABSTRACT

BACKGROUND: While children born at extremely low birth weight (ELBW; <1000 g) are at elevated risk for peer victimization, no research has examined its effects on mental health in adulthood. METHODS: ELBW survivors and matched normal birth weight (NBW; >2500 g) controls were part of a prospective, population-based study in Ontario, Canada. Peer victimization before age 16 was self-reported at age 22 to 26 years by using a 10-point measure. Presence of psychiatric disorders was examined at age 22 to 26 years (ELBW n = 142, NBW n = 133) and age 29 to 36 years (ELBW n = 84, NBW n = 90). RESULTS: After adjustment for confounding variables, for each 1-point increase in the peer victimization score, ELBW survivors had increased odds of current depressive (odds ratio [OR] = 1.67, 95% confidence interval [CI], 1.23-2.28), anxiety (OR = 1.36, 95% CI, 1.05-1.76), avoidant (OR = 1.39, 95% CI, 1.08-1.79), antisocial (OR = 1.92, 95% CI, 1.06-2.87), and attention-deficit/hyperactivity (OR = 1.39, 95% CI, 1.06-1.83) problems at age 22 to 26 years. At age 29 to 36 years, peer victimization score predicted increased odds of current panic disorder (OR = 1.69, 95% CI, 1.01-2.83) and obsessive-compulsive disorder (OR = 3.56, 95% CI, 1.25-10.09). For NBW controls, peer victimization predicted increased odds of antisocial problems at age 22 to 26 years. CONCLUSIONS: ELBW survivorsand NBW participants are vulnerable to the adverse psychiatric effects of childhood peer victimization in adulthood.


Subject(s)
Crime Victims/psychology , Family/psychology , Forecasting , Infant, Extremely Low Birth Weight/psychology , Mental Health , Peer Group , Adult , Female , Follow-Up Studies , Humans , Infant, Newborn , Male , Prospective Studies , Psychiatric Status Rating Scales , Psychological Tests , Socioeconomic Factors , Time Factors , Young Adult
16.
Child Neuropsychol ; 22(5): 587-99, 2016.
Article in English | MEDLINE | ID: mdl-25952145

ABSTRACT

The Test of Visuospatial Construction (TVSC), a measure of visuoconstruction that does not rely on upper extremity motor response or written production, was administered to extremely low birth weight (ELBW), late preterm (LPT), and term participants at preschool (n = 355) and kindergarten (n = 265) ages. TVSC showed statistically significant weak-to-moderate positive correlations (age 3: r = .118-.303; age 6: r = .138-.348) with Developmental VMI, Differential Ability Scales-II Copying, Matrices, and Pattern Construction subtests, Baron-Hopkins Board Test, and the Purdue Pegboard. One-way ANOVA indicated ELBW performed worse than Term (p = .044) on visuospatial construction at age 3 with a small-to-medium effect size (d = -0.43). No other statistically significant differences were found at age 3 on the TVSC (ELBW/LPT: p = .608, d = -0.17; LPT/Term: p = .116, d = -0.31). At age 6, ELBW participants performed worse than LPT participants (p = .027) and Term participants (p = .012); LPT participants did not differ from Term participants. Small effect sizes at age 3 (ELBW < LPT, d = -0.17; ELBW < Term, d = -0.43) were notably larger at age 6 (ELBW < LPT, d = -0.42; ELBW < Term, d = -0.53). Important practical differences showing LPT participants performed below Term participants (d = -0.31) at age 3 were no longer evident at age 6 (d = -0.097). These findings provide preliminary evidence of TVSC validity supporting its use to detect neuropsychological impairment and to recommend appropriate interventions in young preterm children.


Subject(s)
Developmental Disabilities/physiopathology , Infant, Extremely Low Birth Weight/physiology , Infant, Premature/physiology , Neuropsychological Tests/standards , Visual Perception/physiology , Analysis of Variance , Child , Child, Preschool , Female , Humans , Infant, Extremely Low Birth Weight/psychology , Infant, Newborn , Infant, Premature/psychology , Male , Psychomotor Performance/physiology , Reproducibility of Results , Schools
17.
J Pediatr Psychol ; 40(8): 825-33, 2015 Sep.
Article in English | MEDLINE | ID: mdl-25981895

ABSTRACT

OBJECTIVE: This study examined the measurement invariance of the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) DSM-oriented scales between extremely low birth weight (ELBW) and normal birth weight (NBW) youth. METHODS: The sample included 158 ELBW survivors and 145 matched, NBW controls at 8 and 12-16 years of age. RESULTS: Strict invariance was established at 8 years for parent-reported CBCL attention-deficit hyperactivity, conduct, and oppositional defiant scales, though invariance could not be established for affective problems at 8 or 12-16 years. Strict invariance was observed between 12-16-year-old ELBW and NBW groups on attention-deficit hyperactivity, anxiety, and oppositional defiant CBCL and YSR scales. Invariance could not be established for youth-reported conduct problems. CONCLUSIONS: While the majority of CBCL/YSR DSM-oriented subscales assess the same concepts in both ELBW and NBW children and adolescents across parent and youth reports, this may not be the case for affective and conduct problems.


Subject(s)
Birth Weight , Child Behavior/psychology , Infant, Extremely Low Birth Weight/psychology , Parents/psychology , Self Report , Survivors/psychology , Adolescent , Checklist , Child , Female , Humans , Male , Survivors/statistics & numerical data
18.
Qual Health Res ; 25(6): 763-74, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25854616

ABSTRACT

Extremely low gestational age infants (<28 weeks at birth) experience significant pain from repeated therapeutic procedures while hospitalized in the neonatal intensive care unit. As part of a program of research examining pain in preterm infants, we conducted a qualitatively driven mixed-methods design, supplemented with a qualitative and quantitative component, to understand how health care professionals (HCPs) assess and manage procedural pain for tiny and underdeveloped preterm infants. Fifty-nine HCPs from different disciplines across four tertiary-level neonatal units in Canada participated in individual or focus group interviews and completed a brief questionnaire. Four themes from the content analysis were (a) subtlety and unpredictability of pain indicators, (b) infant and caregiver attributes and contextual factors that influence pain response and practices, (c) the complex nature of pain assessment, and (d) uncertainty in the management of pain. The information gleaned from this study can assist in identifying gaps in knowledge and informing unit-based and organizational knowledge translation strategies for this vulnerable population.


Subject(s)
Attitude of Health Personnel , Evaluation Studies as Topic , Health Services Research/statistics & numerical data , Infant, Extremely Low Birth Weight/psychology , Intensive Care Units, Neonatal , Pain Measurement/nursing , Pain Measurement/psychology , Qualitative Research , Research Design , Canada , Evidence-Based Nursing/methods , Gestational Age , Humans , Infant, Newborn , Pain Management/methods , Pain Management/nursing , Tertiary Care Centers , Translational Research, Biomedical/statistics & numerical data
19.
Dev Psychobiol ; 57(4): 486-96, 2015 May.
Article in English | MEDLINE | ID: mdl-25873212

ABSTRACT

Young adult survivors of extremely low birth weight (ELBW; <1000 g) are known to be at elevated risk for internalizing problems, though little is known about the mechanisms that may lead to higher levels of psychopathology in this vulnerable group. We examined the moderating influence of neuroendocrine functioning on the link between being born at ELBW and internalizing behaviors at age 30-35. Salivary cortisol was collected 20 min after completion of a social stress task in 83 ELBW adult survivors and 89 normal birth weight (NBW; >2500 g) controls. Using a median split, participants were separated into two groups (high or low afternoon cortisol levels). ELBW survivors with "high" afternoon cortisol levels self-reported significantly higher levels of internalizing behaviors compared to those with "low" afternoon cortisol levels. This association between afternoon cortisol and internalizing symptoms did not exist among NBW controls. These results are suggestive of a differential susceptibility for internalizing behaviors among ELBW survivors, depending on their ability to regulate neuroendocrine responses.


Subject(s)
Infant, Extremely Low Birth Weight/metabolism , Infant, Extremely Low Birth Weight/psychology , Mental Disorders/physiopathology , Mental Disorders/psychology , Neurosecretory Systems/physiopathology , Survivors/psychology , Adult , Female , Humans , Hydrocortisone/metabolism , Longitudinal Studies , Male , Mental Disorders/metabolism , Neurosecretory Systems/metabolism , Psychological Tests , Saliva/metabolism , Stress, Psychological/metabolism , Stress, Psychological/physiopathology , Stress, Psychological/psychology , Survivors/statistics & numerical data
20.
J Dev Behav Pediatr ; 36(3): 178-87, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25741950

ABSTRACT

OBJECTIVE: To describe behavior problems in extremely low birth weight (ELBW, <1000 g) adolescents born 1992 through 1995 based on parent ratings and adolescent self-ratings at age 14 years and to examine changes in parent ratings from ages 8-14. METHOD: Parent ratings of behavior problems and adolescent self-ratings were obtained for 169 ELBW adolescents (mean birth weight 815 g, gestational age 26 wk) and 115 normal birth weight (NBW) controls at 14 years. Parent ratings of behavior at age 8 years were also available. Behavior outcomes were assessed using symptom severity scores and rates of scores above DSM-IV symptom cutoffs for clinical disorder. RESULTS: The ELBW group had higher symptom severity scores on parent ratings at age 14 years than NBW controls for inattentive attention-deficit hyperactivity disorder (ADHD), anxiety, and social problems (all p's < .01). Rates of parent ratings meeting DSM-IV symptom criteria for inattentive ADHD were also higher for the ELBW group (12% vs. 1%, p < .01). In contrast, the ELBW group had lower symptom severity scores on self-ratings than controls for several scales. Group differences in parent ratings decreased over time for ADHD, especially among females, but were stable for anxiety and social problems. CONCLUSIONS: Extremely low birth weight adolescents continue to have behavior problems similar to those evident at a younger age, but these problems are not evident in behavioral self-ratings. The findings suggest that parent ratings provide contrasting perspectives on behavior problems in ELBW youth and support the need to identify and treat these problems early in childhood.


Subject(s)
Infant, Extremely Low Birth Weight/psychology , Problem Behavior , Adolescent , Age Factors , Anxiety/etiology , Anxiety/psychology , Attention Deficit Disorder with Hyperactivity/etiology , Attention Deficit Disorder with Hyperactivity/psychology , Case-Control Studies , Child , Female , Humans , Male , Parents/psychology , Problem Behavior/psychology , Sex Factors
SELECTION OF CITATIONS
SEARCH DETAIL
...