Neonatal Negative Emotionality Predicts Childhood Psychopathology Allison Momany, Beth Renee Troutman PhD Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa Introduction Previous research indicates maternal ratings of negative emotionality in young children correlate with ratings of emotional and behavioral problems during childhood (Grant, 2009; Stringaris, 2010). In these studies, initial ratings of temperament were conducted when children were 2 to 3 years of age. There has been debate about whether individual differences in neonatal temperament are indicative of difficulties with emotional regulation or transient. In the current study, we examine whether temperament ratings at one month predict later childhood psychopathology. Conclusions Results of this research are consistent with previous research indicating infant temperament is associated with childhood psychopathology. The unique contribution of this study is demonstrating temperament ratings during the neonatal period are associated with childhood psychopathology. In fact, the association between neonatal negative emotionality and childhood psychopathology in this study is more robust than the association in previous studies where temperament was assessed at a later age (Grant, 2009; Stringaris, 2010). Interpretation of current results is limited by the use of maternal ratings for both temperament and childhood psychopathology raising the possibility that the results are due to method variance. However, as noted by other researchers, primary caregivers have more opportunities to observe temperament and behavior across a range of situations (Grant, 2009). Methods 111 infants, identified through birth records, were evaluated in their home at 3 and 4 weeks. Infants were excluded if they were in the hospital for more than 10 days following birth or had a known genetic condition. Participants were contacted and recruited for participation in a follow-up study 8 to 11 years later (mean age = 9.3, SD = 1.0). 33 children (30%) participated in the follow-up. Neonatal negative emotionality The 6-item fussy-difficult scale of the Infant Characteristics Questionnaire (ICQ) (Bates, Freeland, & Lounsbury, 1979) was used to obtain maternal ratings of infant negative emotionality. A factor analysis of the ICQ indicates the 6-item fussy-difficult scale is the most “clear-cut and valid factor” of the ICQ with good internal consistency and has previously been used with 4- week-old infants (Cronbach’s alpha =.79 to.87) (Bates, et al., 1979; Van Egeren, 2004). Childhood psychopathology Mothers completed the Child Behavior Checklist (CBCL) when the children were 8 to 11 years of age. The internal consistency of the problem scales and DSM-oriented scales is supported by alpha coefficients ranging from.78 to.97 and.72 to.91 respectively (Achenbach, 2001). Criterion-related validity is supported by a significant difference between referred and non- referred children (Achenbach, 2001). Construct validity is supported by a significant association with other diagnostic instruments (Achenbach, 2001). Acknowledgments This research was supported by grants from the University of Iowa (International Travel Grant, College of Medicine Research Award, Iowa Center for Research by Undergraduates ), the Children’s Miracle Network, and NICHD (R03 HD ) to Beth Troutman and by contributions from the following individuals: Dymphna van den Boom, Ph.D. and Jude Cassidy, Ph.D. provided valuable consultation on designing and conducting this study. Christina Aliaga, Linsey Blair, Michelle Cardi, Leanne Florke, Altier Juarez, Erika Luttennegger, Susan Ryan, Lisa Tibey, Callie Berry, Jamie Bulleri, Christina Durham Weeks, Jennifer Gianone, Sarah Lowery, E. Imani Mitchell-Burrell, Donna Stewart, and Brooke van Horne assisted with data collection and data entry. to Demographic Characteristics Child gender: 44% male, 56% female Age of child at follow-up: 17.5% 8 yrs, 56% 9 yrs, 9% 10 yrs, 17.5% 11 yrs Infant ethnicity: 94% White, 3% Black, 3% Hispanic Family socioeconomic status: 88% professional class a a level IV or V per Hollingshead (1975) index Results Anxiety problems had the highest correlation (.67) and somatic problems had the lowest (.12). All of the scales except for conduct problems and somatic problems were significantly correlated with fussy-difficult temperament at four weeks. Clinical Implications From a public health perspective, these results suggest the possibility of screening infants for early regulatory difficulties that place them at risk for psychopathology, allowing for better prevention efforts. Infants who are identified as fussy-difficult could be monitored more closely for the development of behavioral problems and a professional consulted if the parent feels there is evidence of a behavioral problem. * p <.05, ** p <.01 CBCL Scales (8 to 11 years)ICQ Fussy Difficult Scale (4 weeks) Internalizing Problems.54** Externalizing Problems.35* Total Problems.52** Affective Problems.50** Anxiety Problems.67** Attention Deficit/hyperactivity Problems.44* Conduct Problems.18 Oppositional Defiant Problems.34* Somatic Problems.12 Table 2 Correlations between CBCL scales and ICQ Fussy Difficult Scale Frequency with Borderline Significant Problems During Childhood (t score ≥ 60) Total problems 6 (18%) Internalizing problems 9 (27%) Externalizing problems 3 (9%) AuthorYearInfant age at temperament ratingCBCL ScaleChild age at behavior ratingCorrelation Grant, et al yearsAnxiety 4-5 years 8-9 years Guerin, et al years Internalizing problems 4-6 years 7-9 years years Guerin, et al years Externalizing problems 4-6 years 7-9 years years Rhee, et al months Internalizing problems 4-12 years.24 (males).25 (females) Rhee, et al months Externalizing problems 4-12 years.17 (males).32 (females) Table 1 Previous Studies of Negative Emotionality and Childhood Psychopathology References Achenbach, T. a. R., L. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: ASEBA. Bates, J., Freeland, C., & Lounsbury, M. (1979). Measurement of infant difficultness. Child Development, 50, Grant, V., Bagnell, A., Chambers, C., Stewart, S. (2009). Early temperament prospectively predicts anxiety in later childhood. The Canadian Journal of Psychiatry, 54(5), Guerin, D., Gottfried, A., Thomas, C. (1997). Difficult temperament and behaviour problems: a longitudinal study from 1.5 to 12 years. International Journal of Behavioral Development, 21(1), Rhee, S., Cosgrove, V., Schmitz, S., Haberstick, B., Corley, R., Hewitt, J. (2006). Early childhood temperament and the covariation between internalizing and externalizing behavior in school-aged children. Twin Research and Human Genetics, 10(1), Stringaris, A., Maughan, B., and Goodman, R. (2010). What's in a disruptive disorder? Temperamental antecedents of oppositional defiant disorder: findings from the avon longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 49(5), Van Egeren, L. A. (2004). The development of the coparenting relationship over the transition to parenthood. Infant Mental Health Journal, 25(5), Sensitivity and Specificity : Temperament as a Screening Tool The cut-off for infant fussy-difficult temperament was one-half standard deviation above the mean For CBCL scales, the cut-off was borderline scores (t ≥ 60). Borderline scores were used rather than clinical scores because of the small number of individuals scoring in the clinical range. Sensitivity and specificity are as follows: total problems.83 and.71 internalizing problems.78 and.76 externalizing problems 1 and.68 Disclosure Statement: Neither author has any conflicts of interest to disclose