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Early childhood aetiology of mental health problems: a longitudinal population-based study
Abstract
Background: Mental health problems comprise an international public health issue affecting up to 20% of children and show considerable stability. We aimed to identify child, parenting, and family predictors from infancy in the development of externalising and internalising behaviour problems by age 3 years. Methods: Design Longitudinal, population‐based survey completed by primary caregivers when children were 7, 12, 18, 24 and 36 months old. Participants 733 children sequentially recruited at 6–7 months from routine well‐child appointments (August–September 2004) across six socio‐economically and culturally diverse government areas in Victoria, Australia; 589 (80%) retained at 3 years. Measures 7 months: sociodemographic characteristics, maternal mental health (Depression Anxiety Stress Scale (DASS)), substance misuse, home violence, social isolation, infant temperament; 12 months: partner relationship, parenting (Parent Behavior Checklist (PBC)); 18, 24 and 36 months: child behaviour (Child Behavior Checklist 1½–5 (CBCL)), PBC, DASS. Results: Sixty‐nine percent of all families attending well‐child clinics took part. The consistent and cumulative predictors of externalising behaviours were parent stress and harsh discipline. Predictors of internalising behaviours included small family size, parent distress, and parenting. Twenty‐five percent of variation in early externalising behaviour and 17% of variation in early internalising behaviour was explained. Conclusions: Effective and cost‐efficient population approaches to preventing mental health problems early in childhood are urgently needed. Programmes must support parents in reducing personal stress as well as negative parenting practices.
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“This is of significance as emotional and behavioural difficulties can manifest themselves because of severe discipline from the caregiver towards the child (Bayer et al. 2008).”
From The effects of paternal depression on child and adolescent outcomes: A systematic review (2016) · cites this paper as Bayer et al. 2008
In the citing paper
“This corresponds with evidence that the parenting a child or adolescent receives can significantly impact on emotional and behavioural development (Bayer et al. 2008;Stormshak et al. 2000).”
From The effects of paternal depression on child and adolescent outcomes: A systematic review (2016) · cites this paper as Bayer et al. 2008
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The effects of paternal depression on child and adolescent outcomes: A systematic review
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“This corresponds with evidence that the parenting a child or adolescent receives can significantly impact on emotional and behavioural development (Bayer et al. 2008; Stormshak et al. 2000).”
Burgdorf, V., Szabó, M., & Abbott, M. J. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01336 · Cited by 234
“Most studies investigated internalizing and externalizing symptoms, which are the most common psychological problems in youth (Bayer et al., 2008).”
BackgroundThe Co-Development of Parenting Stress and Childhood Internalizing and Externalizing Problems
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“Increasingly, longitudinal studies confirmed these findings (Ashford et al. 2008; Bayer et al. 2006, 2008; Mäntymaa et al. 2012).”
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Trajectories of maternal depressive symptoms predict child problem behaviour: The Generation R Study
Cents, R. A. M., Diamantopoulou, S., Hudziak, J. J., Jaddoe, V. W. V., Hofman, A., Verhulst, F. C., Lambregtse-van den Berg, M. P., & Tiemeier, H. (2013) · Psychological Medicine · doi:10.1017/s0033291712000657 · Cited by 158
“…research has shown that concurrent symptoms have a particularly adverse effect on child problem behaviour, possibly because they are the best indicator of ongoing depressive symptoms and interfere with mother–child interactions (Brennan et al. 2000 ; Trapolini et al. 2007 ; Bayer et al. 2008).”
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Self-citationParental Psychological Well-Being and Behavioral Outcome of Very Low Birth Weight Infants at 3 Years
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“In a longitudinal, population-based study of the etiology of internalizing and externalizing symptoms, Bayer et al. (2008) tested a comprehensive set of risk factors from infancy through early preschool and identified both child and environmental factors as important contributors, but did not…”
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“Although not verified in this study, single motherhood has been found to be associated with internalizing problems of the child [36, 58, 66].”
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“…1/1 studies Inappropriate developmental expectations increases IP in 1/1 studies Parental concern about mental health increases IEP in 1/1 studies Bayer et al. (2008), Gleason et al. (2011), Bayer et al. (2012) Child risk factors Child sex Being a boy increases EP in 3/3 studies, and IP in 1/1…”
BackgroundResultInfluentialEmotional and Behavioural Difficulties in Preschool
Poulou, M. S. (2013) · Journal of Child and Family Studies · doi:10.1007/s10826-013-9828-9 · Cited by 146
“Some studies revealed that maternal stress and harsh discipline parenting practices were consistent and cumulative predictors of externalizing problems over the first 3 years of life (Bayer et al. 2008; Brenner and Fox 1998).”
BackgroundDevelopment of children’s internalising and externalising problems from infancy to five years of age
Bayer, J. K., Ukoumunne, O. C., Mathers, M., Wake, M. A., Abdi, N., & Hiscock, H. (2012) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867412450076 · Cited by 98
“We first published longitudinal data in 2008 on socioemotional outcomes from infancy to early preschool age (3 years) (Bayer et al., 2008) from a wider population-based prevention trial that is published elsewhere (Hiscock et al. 2008).”
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“1 3 findings on maternal burden of care are in accordance with research findings on parenting as a determinant of internalizing behaviors at the age of 3 [37].”
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“Further, low parental warmth has been found to be a significant predictor of depressed mood among adolescent girls (Bayer et al., 2008; Belden and Luby, 2006; Ewell Foster et al., 2008; Hoffman et al., 2006; Reading, 2009).”
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Brandlistuen, R. E., Ystrøm, E., Eberhard‐Gran, M., Nulman, I., Koren, G., & Nordeng, H. (2015) · International Journal of Epidemiology · doi:10.1093/ije/dyv030 · Cited by 72
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“Together, these account for up to 45% of the variance in early childhood internalising symptoms [9,10,35].”
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Prevention of Mental Health Difficulties for Children Aged 0–3 Years: A Review
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“It is possible that continuously renting may correlate with other unmeasured markers of disadvantage associated with behaviour, for example, social isolation [33].”
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Achtergarde, S., Postert, C., Wessing, I., Romer, G., & Müller, J. M. (2014) · The Family Journal · doi:10.1177/1066480714564316 · Cited by 63
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“A report from Australia was based on a design more similar to the one used in the present study [17].”
MethodSocioeconomic Factors in Relation to Discrepancy in Parent versus Teacher Ratings of Child Behavior
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“Studies have shown that up to 14% of preschool-aged children have clinical levels of anxiety and depression (Bayer et al. 2008; Egger and Angold 2006).”
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“Nevertheless, generalisation of the findings to all community children could be limited, and replication with a population-level sample is required (Bayer et al, 2008; Pagani et al, 2008).”
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“Children raised in hostile parenting environments have been shown to report an increased risk for the emergence of emotional and behavioral problems both in childhood and later in adolescence (Bayer et al., 2008; Rutter, Giller, & Hagell, 1998; although note that an exception applies to studies conducted in high-risk…”
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“However, in Bayer’s study, the absence of older siblings was a key predictor of internalizing problems [18].”
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“…and preschoolers, designed to identify the early childhood aetiology of internalizing and externalizing behaviours found that up to 3 years of age, maternal stress and negative parenting consistently and cumulatively predicted both externalizing and internalizing problems (Bayer et al. 2008).”
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“There is now good evidence that a targeted programme addressing the issues most strongly related to early externalising and internalising symptoms (maternal stress and negative parenting practices)”
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“Other studies have examined the independent roles of temperament and parenting on children’s externalizing and internalizing behavior, as measured by the CBCL, but have not examined social outcomes specifically (Bayer et al. 2008).”
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“Furthermore, although general demographic child, parent and family characteristics, such as child male sex [3, 9, 48, 50, 51] and low birth weight [4, 51], relatively young and old parental age [17, 51], low parental educational level [4, 9, 17], single parenthood [3, 4, 9], number of siblings [4, 51] and day-care arr…”
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“…of positive parenting practices have been associated with lower social or behavioral dif fi culties (Gryczkowski et al., 2010; Hosokawa & Katsura, 2019; Stormshak et al., 2000), while negative parenting practices have been shown to consistently predict externalizing problems (Bayer et al., 2008).”
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Mother–Child Synchrony and Child Problem Behavior
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“Potential confounders of the relationships between paternal mental health, parenting, and child behaviour were identified a priori, on the basis of published literature (Bayer et al., 2008; Bayer et al., 2006; Bogels & Phares, 2008).”
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“, 2008), and a negative correlation in a second study (Bayer et al., 2008).”
BackgroundResultFinan, S. J., Warren, N., Priest, N., Mak, J. S., & Yap, M. B. H. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01627-x · Cited by 23
Conway, L. J., Levickis, P. A., Mensah, F. K., McKean, C., Smith, K. A., & Reilly, S. (2017) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.12320 · Cited by 29
“CBCL raw scores were used rather than T -scores because the wide age range of the norming sample (1–5 years) might reduce sensitivity to variation in yearly age bands (Bayer et al. 2008).”
MethodUrbanicity is Associated with Behavioral and Emotional Problems in Elementary School-Aged Children
Evans, B. E., Buil, J. M., Burk, W. J., Cillessen, A. H. N., & van Lier, P. A. C. (2018) · Journal of Child and Family Studies · doi:10.1007/s10826-018-1062-z · Cited by 21
“Parenting stress has been fairly robustly related to mental health problems (Ashford et al. 2008; Bayer et al. 2008), with recent evidence suggesting bidirectional effects (Stone et al. 2016).”
Sloan, S., Winter, K., Connolly, P., & Gildea, A. (2019) · Children and Youth Services Review · doi:10.1016/j.childyouth.2019.104619 · Cited by 21
“Re fl ecting changes in the dominant policy discourse, the constellation of issues is now more likely to be subsumed under the broader category of ‘ social, emotional and mental health ’ (SEMH) rather than social, emotional and behavioural di ffi culties (SEBD) (Bayer, Hiscock, Ukoumunne, Price, & Wake, 2008).”
BackgroundHiscock, H., Bayer, J. K., Lycett, K., Ukoumunne, O. C., Shaw, D. S., Gold, L. H., Gerner, B., Loughman, A., & Wake, M. A. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-420 · Cited by 20
“The Toddlers Without Tears program is one of the few truly universal mental health prevention programs [15,26,27].”
BackgroundSelf-citationCosta, C. D., Eikelboom, R. H., Jacques, A., Swanepoel, D. W., Whitehouse, A., Jamieson, S., & Brennan‐Jones, C. G. (2018) · Clinical Otolaryngology · doi:10.1111/coa.13094 · Cited by 19
“Nevertheless, it is thought that such dichotomous terms for behaviour are actually misleading as a single individual can display both types of behaviour concurrently.(23,24) Therefore, the association with behavioural deficits as a whole was considered for the purposes of this study, rather than a focus on specific be…”
BackgroundBailey, K. A., Webster, R. A., Baker, A., & Kavanagh, D. J. (2011) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2011.00401.x · Cited by 19
“It also appears that the impact of neglect (acts of omission) on adult psychiatric functioning is much longer lasting than what is currently researched (27, 29, 30).”
BackgroundThe reproduction of educational inequalities – do parenting and child behavioural problems matter?
Kaiser, T., Li, J., & Pollmann‐Schult, M. (2018) · Acta Sociologica · doi:10.1177/0001699318785690 · Cited by 18
“Additionally, our analysis was informed by a body of strong empirical evidence for the influence of parenting style on child behavioural problems and how they are related to parental SES (Bayer et al., 2008; Bøe et al., 2014).”
MethodMaternal stress, child behavior and the promotive role of older siblings
Amici, F., Röder, S. W., Kieß, W., Borte, M., Zenclussen, A. C., Widdig, A., & Herberth, G. (2022) · BMC Public Health · doi:10.1186/s12889-022-13261-2 · Cited by 24
“Children with siblings, for instance, are less likely to develop internalizing problems, even when controlling for maternal stress levels [75].”
BackgroundXie, E. B., Freeman, M., Penner‐Goeke, L., Reynolds, K., Lebel, C. A., Giesbrecht, G. F., Rioux, C., MacKinnon, A., Sauer-Zavala, S. E., Roos, L. E., et al. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01245-x · Cited by 25
Symeonides, C., Vuillermin, P., Sciberras, E., Senn, E., Thomson, S. M., Wardrop, N., Anderson, V. A., Pezic, A., Sly, P. D., & Ponsonby, A. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-041984 · Cited by 17
Eichner, M. (2020) · doi:10.1093/oso/9780190055479.001.0001 · Cited by 20
Rowe, S. L., Zimmer‐Gembeck, M. J., & Hood, M. (2016) · Journal of Adolescence · doi:10.1016/j.adolescence.2016.04.001 · Cited by 17
Lequertier, B., Simcock, G. P., Cobham, V. E., Kildea, S. V., & King, S. (2019) · Infancy · doi:10.1111/infa.12286 · Cited by 15
Factors influencing child mental health: A state‐wide survey of Victorian children
Goldfeld, S. R., & Hayes, L. (2012) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2012.02473.x · Cited by 15
Fenótipo comportamental de crianças e adolescentes com síndrome de Prader-Willi
de Mesquita, M. L. G., Brunoni, D., Neto, J. M. D. P., Kim, C. A., Melo, M. H. D. S., & Teixeira, M. C. T. V. (2010) · Revista Paulista de Pediatria · doi:10.1590/s0103-05822010000100011 · Cited by 15
Beatson, R. M., Bayer, J. K., Perry, A., Mathers, M., Hiscock, H., Wake, M. A., Beesley, K., & Rapee, R. M. (2014) · Infant and Child Development · doi:10.1002/icd.1863 · Cited by 15
Self-citationKovaniemi, S., Alakortes, J., Carter, A. S., Yliherva, A., Bloigu, R., Joskitt, L., Moilanen, I. K., & Ebeling, H. E. (2018) · Infant Behavior and Development · doi:10.1016/j.infbeh.2018.02.007 · Cited by 17
Buchanan-Pascall, S., Melvin, G. A., Gordon, M. S., & Gray, K. M. (2021) · Child Psychiatry & Human Development · doi:10.1007/s10578-021-01276-6 · Cited by 14
Holtz, C. A., Carrasco, J. M., Mattek, R. J., & Fox, R. A. (2009) · Child & Family Behavior Therapy · doi:10.1080/07317100903311018 · Cited by 14
Murdock, K. W., Pittman, L. D., & Fagundes, C. P. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0910-6 · Cited by 14
“Furthermore, greater harsh/negative parenting behavior is associated with higher child depressive symptoms (Baker and Hoerger 2012; Bayer et al. 2008).”
BackgroundPark, S., Oh, W., Kim, Y.-H., Kim, H. K., & Mastergeorge, A. M. (2022) · Social Development · doi:10.1111/sode.12661 · Cited by 13
Low, J., Bishop, A., & Pilkington, P. D. (2022) · Mental Health & Prevention · doi:10.1016/j.mhp.2022.200230 · Cited by 13
Father Locus of Control and Child Emotional and Behavioral Outcomes: A Prospective Study
Tone, E. B., Goodfellow, S., & Nowicki, S. (2012) · The Journal of Genetic Psychology · doi:10.1080/00221325.2011.571307 · Cited by 13
Preventing Preschool Mental Health Problems: Population-Based Cluster Randomized Controlled Trial
Hiscock, H., Gülenç, A., Ukoumunne, O. C., Gold, L. H., Bayer, J. K., Shaw, D. S., Le, H., & Wake, M. A. (2017) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000502 · Cited by 12
Self-citationLaletas, S., Goodyear, M. J., & Reupert, A. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0992-1 · Cited by 12
Bauer, J. A., Romano, M. E., Jackson, B. P., Bellinger, D. C., Korrick, S., & Karagas, M. R. (2023) · Exposure and Health · doi:10.1007/s12403-023-00543-2 · Cited by 13
“…domains are also important to quality of life; one in five children living in western societies experiences emotional and behavioral difficulties (Bayer et al. 2008; C. A. Boyle et al. 2011; M. H. Boyle et al. 2019) that relate to enhanced risk of future mental health disorders, substance use…”
Edwards, N. M. (2013) · Journal of Child and Family Studies · doi:10.1007/s10826-013-9712-7 · Cited by 11
“The literature increasingly acknowledges the importance of addressing mental health needs of young children and their families (Bayer et al. 2008; Powell et al. 2003) and empowering diverse parental caregivers to understand the importance of scaffolding, sensitivity and responsiveness in promoting young children’s eme…”
BackgroundArigayota, A., Duffek, B., Hou, C., & Eisingerich, A. B. (2025) · JMIR Serious Games · doi:10.2196/76522 · Cited by 11
“Moreover, young people often mirror the emotional climate of their household [18,19].”
Metadata
- Authors
- Bayer, J. K., Hiscock, H., Ukoumunne, O. C., Price, A., & Wake, M.
- Affiliations
- The University of Melbourne (AU)
- Royal Children's Hospital (AU)
- Murdoch Children's Research Institute (AU)
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2008-10-27
- Volume
- 49
- Issue
- 11
- Pages
- 1166-1174
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2131878256
- Cited by
- 193
- References
- 40
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 6 · 2023: 12 · 2022: 6 · 2021: 6 · 2020: 21 · 2019: 11 · 2018: 16 · 2017: 8 · 2016: 11 · 2015: 11 · 2014: 15 · 2013: 12 · 2012: 19
- FWCI
- 11.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Australian Rotary Health
- 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 › Psychology and Mental Health
- Keywords
- child mental health, early childhood, externalizing problems, parenting practices, harsh discipline, parental stress, maternal mental health, family size, infant temperament, domestic violence, child behavior problems, mental health prevention, well-child clinics
- MeSH terms
- Mental Disorders, Child, Preschool, Family, Family Relations, Female, Humans, Infant, Internal-External Control, Longitudinal Studies, Male, Mothers, Parent-Child Relations, Risk Factors, Socioeconomic Factors, Stress, Psychological, Temperament, Victoria, Parenting, Caregivers, Domestic Violence, Sex Distribution
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