Internalizing symptoms in very low birth weight preschoolers: Symptom level and risk factors from four rating perspectives in a controlled multicenter study

Nadine Helle, Claus Barkmann, Stephan Ehrhardt, Axel von der Wense, Yvonne Nestoriuc, Carola Bindt

Research output: Contribution to journalArticle

Abstract

Background: Preterm births rates of infants with very low birth weight (VLBW < 1500 g) are increasing. Prematurity poses several risks for emotional child development, e.g., internalizing symptoms. Our understanding of this condition in young children is limited, for at preschool age, symptoms have mostly been assessed from the mother's perspective only. Methods: As part of the longitudinal HaFEn cohort-study in Hamburg, Germany, we measured the level of internalizing symptoms in VLBW and term preschoolers as well as predictors from four informants’ perspectives: mother, father, teacher, and child. A multilevel model was constructed to examine predictors of internalizing symptoms. n = 104 VLBW and n = 79 term children were included. Results: From both their parents’ perspective, children with VLBW had a significantly higher level of internalizing symptoms. From the teacher's and child's own perspectives, there were no significant mean group differences. In the multilevel analyses, the results were different regarding the four perspectives. VLBW did not predict internalizing symptoms. From mother's perspective, her own postpartum psychological distress, and from father's perspective, his postpartum and current psychological distress predicted a higher level of internalizing symptoms in their offspring. From teacher's perspective, socio-economic status predicted internalizing symptoms. Limitations: The sample size was relatively small. Exclusion criteria and drop out of families could have created some selection bias. Conclusions: Our findings point to the importance of early identification of parental postpartum psychological distress given the potential for later internalizing symptoms in their children or the perception of their offspring as vulnerable and symptomatic, which may also impact the child's development.

Original languageEnglish (US)
Pages (from-to)74-81
Number of pages8
JournalJournal of Affective Disorders
Volume246
DOIs
StatePublished - Mar 1 2019

Keywords

  • Internalizing symptoms
  • Parental psychological distress
  • Preschoolers
  • Preterm
  • Risk factors

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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