Department of Psychology, CUNY Queens College, Flushing, NY, USA.
Department of Psychology, CUNY Graduate Center, New York, NY, USA.
J Child Psychol Psychiatry. 2023 Jul;64(7):1080-1091. doi: 10.1111/jcpp.13698. Epub 2022 Sep 21.
Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children.
Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2-5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent-report structured diagnostic interview developed for preschool-age children. Sixty-six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS-related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age, race, SES, maternal substance use, and normative prenatal stress.
Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p = .030), anxiety disorders (HR = 5.1, p < .0001), and attention-deficit/disruptive behavioral disorders (HR = 3.4, p = .02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p = .004), attention-deficit/hyperactivity disorder (ADHD; HR = 5.5, p = .01), oppositional-defiant disorder (ODD; HR = 3.8, p = .05), and separation-anxiety disorder (SAD; HR = 3.5, p = .001). Males had distinctively elevated risks for attention-deficit/disruptive behavioral disorders (HR = 7.8, p = .02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p < .0001), phobia (HR = 2.8, p = .02) and depressive disorders (HR = 30.0, p = .03), including SAD, GAD, and dysthymia.
The findings demonstrate that in utero exposure to a major weather-related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.
越来越多的证据表明，胎儿期暴露于自然灾害与儿童行为问题之间存在关联，但我们对学龄前儿童特定精神病理学的发展仍知之甚少。
对 163 名学龄前儿童（平均年龄 3.19 岁，85.5%为种族和民族少数群体）及其父母（n=151）进行了每年一次的评估，在 2-5 岁时使用学龄前儿童精神病理学评估（PAPA）评估精神病理学的出现，这是一种为学龄前儿童开发的父母报告结构诊断访谈。66 名（40.5%）儿童在子宫内暴露于桑迪风暴（SS），97 名（59.5%）未暴露。生存分析评估了暴露和未暴露儿童的发病模式，并估计了特定精神病理学的累积风险，包括总发病率和性别发病率。分析控制了与 SS 相关的客观和主观压力、同期家庭压力以及人口统计学和心理社会混杂因素的严重程度，如母亲年龄、种族、SES、母亲物质使用和正常产前压力。
胎儿期暴露于 SS 与抑郁障碍（危险比（HR）=16.9，p=0.030）、焦虑障碍（HR=5.1，p<0.0001）和注意力缺陷/多动障碍（ADHD；HR=3.4，p=0.02）显著增加有关。广泛性焦虑障碍（GAD；HR=8.5，p=0.004）、注意缺陷/多动障碍（ADHD；HR=5.5，p=0.01）、对立违抗性障碍（ODD；HR=3.8，p=0.05）和分离焦虑障碍（SAD；HR=3.5，p=0.001）的诊断率也升高。男性对注意力缺陷/多动障碍的风险明显升高（HR=7.8，p=0.02），包括 ADHD、CD 和 ODD，而女性患焦虑障碍的风险增加（HR=10.0，p<0.0001）、恐惧症（HR=2.8，p=0.02）和抑郁障碍（HR=30.0，p=0.03），包括 SAD、GAD 和心境恶劣。
研究结果表明，胎儿期暴露于重大与天气相关的灾害（SS）与儿童精神病理学风险增加有关，并提供了性别影响下特定精神病理学结果的证据。需要更多关注来了解导致这种风险增加的特定父母、儿童和环境因素，并制定减轻策略。
