Poster Title (Current Submission)

The Relative Influence of Postpartum Depression and Neonatal Fussiness on Childhood Psychopathology

Mentor Name

Beth Troutman

Other Mentor Department

psychiatry

Presentation Date

3-26-2011

Abstract

Our previous research found neonatal fussiness correlates with emotional and behavioral problems at ages 8 to 11. This research examines the relative influence of neonatal fussiness and postpartum maternal depression, a known risk factor.

Background Previous research indicates maternal ratings of fussiness in young children correlate with ratings of emotional and behavioral problems during childhood (Grant, 2009; Stringaris, 2010). Research also shows that postpartum maternal depression is a risk factor for childhood behavior problems and is correlated with maternal ratings of fussiness (Cutrona and Troutman, 1986). Our previous research found that neonatal fussiness at one month predicts later childhood psychopathology. The current study examines the relative influence of postpartum depression and maternal ratings of fussiness on later emotional and behavioral problems.

Methods Study methods were approved by the University of Iowa Institutional Review Board (IRB).

Subjects. 111 infants, identified through birth records, were evaluated in their home at 3 and 4 weeks. 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.

Assessments. 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).

Maternal depression. Symptoms of maternal depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS) (Cox, Holden, & Sagovsky, 1987) at 3 weeks postpartum and the Beck Depression Inventory (BDI) (Beck & Steer, 1993) at 4 weeks postpartum. The EPDS and BDI have been widely used in studies of postpartum depression. The EPDS and BDI were highly correlated (.59) so a postpartum depression score was created by standardizing EPDS and BDI scores and adding them.

Results Maternal postpartum depression and maternal ratings of neonatal fussiness are significantly correlated with a value of .38 (p>.005). Correlations between neonatal fussiness and childhood psychopathology with and without adjustment for postpartum maternal depression are presented in Table 1.

Conclusions Results of this research are consistent with previous research indicating infant temperament is associated with childhood psychopathology. Although maternal postpartum depression and maternal ratings of neonatal fussiness are significantly correlated, neonatal fussiness is a significant predictor of later emotional and behavioral problems after controlling for postpartum maternal depression.

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Mar 26th, 12:00 AM

The Relative Influence of Postpartum Depression and Neonatal Fussiness on Childhood Psychopathology

Our previous research found neonatal fussiness correlates with emotional and behavioral problems at ages 8 to 11. This research examines the relative influence of neonatal fussiness and postpartum maternal depression, a known risk factor.

Background Previous research indicates maternal ratings of fussiness in young children correlate with ratings of emotional and behavioral problems during childhood (Grant, 2009; Stringaris, 2010). Research also shows that postpartum maternal depression is a risk factor for childhood behavior problems and is correlated with maternal ratings of fussiness (Cutrona and Troutman, 1986). Our previous research found that neonatal fussiness at one month predicts later childhood psychopathology. The current study examines the relative influence of postpartum depression and maternal ratings of fussiness on later emotional and behavioral problems.

Methods Study methods were approved by the University of Iowa Institutional Review Board (IRB).

Subjects. 111 infants, identified through birth records, were evaluated in their home at 3 and 4 weeks. 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.

Assessments. 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).

Maternal depression. Symptoms of maternal depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS) (Cox, Holden, & Sagovsky, 1987) at 3 weeks postpartum and the Beck Depression Inventory (BDI) (Beck & Steer, 1993) at 4 weeks postpartum. The EPDS and BDI have been widely used in studies of postpartum depression. The EPDS and BDI were highly correlated (.59) so a postpartum depression score was created by standardizing EPDS and BDI scores and adding them.

Results Maternal postpartum depression and maternal ratings of neonatal fussiness are significantly correlated with a value of .38 (p>.005). Correlations between neonatal fussiness and childhood psychopathology with and without adjustment for postpartum maternal depression are presented in Table 1.

Conclusions Results of this research are consistent with previous research indicating infant temperament is associated with childhood psychopathology. Although maternal postpartum depression and maternal ratings of neonatal fussiness are significantly correlated, neonatal fussiness is a significant predictor of later emotional and behavioral problems after controlling for postpartum maternal depression.