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Cited by 233Child and Adolescent Psychosocial and Emotional DevelopmentMaternal Mental Health During Pregnancy and PostpartumChild Abuse and Trauma

Exploring Risk Factors for the Emergence of Children's Mental Health Problems

Essex, Marilyn J., Kraemer, Helena C., Armstrong, Jeffrey M., Boyce, W. Thomas, Goldsmith, H. Hill, Klein, Marjorie H., Woodward, Hermi, Kupfer, David J.·2006·Archives of General Psychiatry
DOI 10.1001/archpsyc.63.11.1246
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Abstract

CONTEXT: Exploratory studies that generate testable models of how risk factors for childhood mental health problems work together over time are critical for developing effective prevention and treatment strategies. OBJECTIVE: To build models addressing the following 2 questions: (1) How early can we identify children at risk for mental health problems in third grade? (2) How do the risk factors work together over time? DESIGN AND PARTICIPANTS: We assessed a Wisconsin community sample 8 times, beginning during pregnancy. Three hundred seventy-nine families completed multi-informant reports (mothers, teachers, and children) of children's mental health symptoms in third grade. MAIN OUTCOME MEASURES: Symptom severity and directionality (externalizing vs internalizing). RESULTS: The hypothesis was generated that family socioeconomic status (SES) defined different pathways to symptom severity. In low/middle SES families, children were at risk if their mothers were distressed during the infancy period, which was then associated with more generalized maternal and child distress and dysregulation during the preschool period. In high SES families, the picture was more complex, beginning with parental histories of depression and family psychopathology, which then led to greater family stress in the infancy period and maternal and child distress and dysregulation during the preschool period. For all children, social and academic impairment during the school transition was an important mediator. Two pathways to later symptom directionality consisted of one beginning with child sex and the other with child temperament. CONCLUSIONS: Most risk factors predicted symptom severity and not directionality. The risk factors for internalizing and externalizing problems may be much the same, and the same preventive interventions might be effective for both classes of problems. Furthermore, at-risk children from high SES families might be identifiable as early as infancy, whereas those from lower SES families may be identifiable only as preschoolers.

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Authors
Essex, M. J., Kraemer, H. C., Armstrong, J. M., Boyce, W. T., Goldsmith, H. H., Klein, M. H., Woodward, H., & Kupfer, D. J.
Affiliations
University of Wisconsin–Madison (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2006-11-01
Volume
63
Issue
11
Pages
1246
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.63.11.1246
OpenAlex
W2092874746
Cited by
233
References
72
Citations by year
2026: 5 · 2025: 4 · 2024: 6 · 2023: 14 · 2022: 9 · 2021: 10 · 2020: 7 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 11 · 2015: 12 · 2014: 14 · 2013: 14 · 2012: 19
FWCI
15.92
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (P50-MH53524, R01MH044340)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
child psychopathology, risk factors, socioeconomic status, maternal distress, child distress, emotional dysregulation, family psychopathology, parental depression, family stress, internalizing problems, externalizing problems, symptom severity, transition to school, social dysfunction, academic impairment, child temperament, sex differences, early detection
MeSH terms
Adult, Age Factors, Mental Disorders, Child, Child Behavior, Child Behavior Disorders, Depressive Disorder, Family Health, Female, Health Status, Humans, Infant, Newborn, Longitudinal Studies, Mothers, Pregnancy, Pregnancy Complications, Surveys and Questionnaires, Risk Factors, Severity of Illness Index, Social Class, Stress, Psychological, Temperament, Wisconsin, Child of Impaired Parents

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