Dissertation

Early Neurodevelopmental and Temperamental Characteristics in Childhood Onset Depression

Kapornai, Krisztina

2009

Overview

Introduction: Identification of early risks for childhood onset major depression (COD) can play a significant role in the intervention and prevention to reduce the severity, duration and long-term consequences of major depressive disorder (MDD). Although some investigators have studied the role of perinatal problems and developmental delay in the development of different psychiatric disorders in children and in depressed adults, the number of available studies investigating the effects of these early risk factors in relation to early onset internalizing psychopathology (COD and anxiety disorders) is limited. From other atypical childhood characteristics, early difficult temperament has been well documented as risk for psychopathology later in life. Hypothesis: 1.a) Perinatal problems, developmental delay, and difficult temperament are more frequent in children with COD than in community control kids and 1.b) in their unaffected siblings. 2.a) Early atypical childhood characteristics would render children vulnerable to earlier onset and more severe first episode of major depressive disorder in children. 2.b) A stable, intact, two-parent family early on will act as a protective factor and attenuate the negative impact of atypical childhood characteristics on the onset of COD. 3) Early atypical childhood characteristics would render children vulnerable to earlier onset of first internalizing disorder (i.e., the age at which the first episode of MDD or comorbid dysthymia or anxiety disorder began). Method: Participants were children (ages 7– 14) with MDD, their unaffected (up to 18 years of age) siblings and community control kids from elementary schools. Diagnoses (via DSM-IV criteria) and onset dates of disorders were finalized “best estimate” psychiatrists, and based on multiple information sources. Mothers provided developmental data in a face-to face structured interview (COD kids and unaffected siblings) and via self-rated version of the same interview about controls. Depressive symptoms were measured by CDI (community controls). Results:Early neurodevelopmental characteristics (perinatal problems, delayed motor development, difficult temperament) elevated the risk for COD. Difficult temperament predicted earlier onset of MDD and first internalizing disorder, but its effect was ameliorated if the family was intact during early childhood. Further, the importance of difficult temperament decreased as a function of time. Perinatal problems and developmental delay did not impact onset ages of disorders, and none of the early childhood characteristics associated with MDD episode severity.Conclusions:Children with MDD may have added disadvantage of earlier onset if they had a difficult temperament in infancy. Early caregiver stability may attenuate some adverse effects of difficult infant temperament. Thus improving the support for mothers dealing with infants after perinatal/neurodevelopmental problems and/or with difficult early temperament could have positive effect in the prevention of emotional disorders later in childhood.

• Publisher: ProQuest Dissertations & Theses
• Subject: Child development / Clinical psychology / Comorbidity / Developmental psychology / Individual & family studies / Mental depression / Mental health / Parents & parenting / Psychology / Teenagers
• ISBN: 9798381039832