Scott Allie, Winchester Suzy Barcelos, Sullivan Mary C
University of Rhode Island, Department of Psychology, Kingston, Rhode Island.
University of Rhode Island, College of Nursing, Kingston, Rhode Island.
Int J Behav Dev. 2018 Mar;42(2):237-247. doi: 10.1177/0165025417692899. Epub 2017 Feb 22.
Premature infants have significant risk for later behavior problems. This study examined growth trajectories of three problem behaviors across five developmental age points from preschool to early adulthood in a well-characterized sample of premature infants. The effects of neonatal risk, gender, and socioeconomic context were modeled on these trajectories. The longitudinal sample was comprised of preterm infants (N = 160) with full variation of neonatal morbidity and birth weight (640-1950 grams). Trajectories of externalizing, internalizing and attention problem behaviors from 4 to 23 years, measured by the Child Behavior Checklist, were tested using latent growth curve modeling. The results indicate individual variation in the number of externalizing and internalizing problems over time. Externalizing problems were not significantly different for males and females, but male scores were consistently higher. Neonatal risk was significantly associated with higher internalizing problems at age 4, but was not predictive at school age and beyond. Attention problem scores increased from early preschool through adolescence for males, but females had little change over the same ages. SES was not predictive of any problem behavior trajectories and no significant two-way interactions were found. The results advance understanding of stability and change of three important problem behaviors through preschool, childhood and adolescence to young adulthood in prematurely born infants in order to inform clinicians about timely assessment and the refinement of effective interventions.
早产儿日后出现行为问题的风险很大。本研究在一个特征明确的早产儿样本中，考察了从学龄前到成年早期五个发育年龄点上三种问题行为的发展轨迹。对这些轨迹建立了新生儿风险、性别和社会经济背景的模型。纵向样本包括160名早产儿，他们的新生儿发病率和出生体重（640 - 1950克）具有全面的差异。使用潜在生长曲线模型对4至23岁儿童行为清单测量的外化、内化和注意力问题行为轨迹进行了测试。结果表明，随着时间推移，外化和内化问题的数量存在个体差异。外化问题在男性和女性之间没有显著差异，但男性得分始终较高。新生儿风险与4岁时较高的内化问题显著相关，但在学龄期及以后则没有预测作用。男性的注意力问题得分从学前早期到青春期有所增加，但女性在相同年龄段变化不大。社会经济地位不能预测任何问题行为轨迹，也未发现显著的双向交互作用。这些结果有助于加深对早产儿从学龄前、儿童期、青春期到成年早期三种重要问题行为的稳定性和变化的理解，以便为临床医生提供及时评估和完善有效干预措施的信息。
