title: Excessive infant crying doubles the risk of mood and behavioral problems at age 5: evidence for mediation by maternal characteristics.
abstract: The onset of behavioral problems starts in early life. This study examined whether excessive infant crying (maternal ratings) is a determinant of emotional and behavioral problems at age 5-6 years. In the Amsterdam Born Children and their Development (ABCD) study, a large prospective, observational, population-based multiethnic birth cohort, excessive infant crying (crying for three or more hours per 24 h day over the past week) during the 13th week after birth (range 11-25 weeks, SD 2 weeks), maternal burden of infant care and maternal aggressive behavior (either angry speaking, or physical aggression) was assessed using a questionnaire. Children's behavioral and emotional problems at the age of 5-6 were assessed by Goodman's Strengths and Difficulties Questionnaire (SDQ), by the subscale of generalized anxiety of the preschool anxiety scale (PAS), and by the Short Mood and Feelings Questionnaire (SMFQ). Inclusion criterion was singleton birth. Exclusion criteria were preterm born babies or congenital disorders. Among 3389 children, excessive infant crying (n = 102) was associated with a twofold increased risk of the overall problem behavior, conduct problems, hyperactivity, and mood problems at the age of 5-6 [ORs between 1.75 (95 % CI 1.09-2.81) and 2.12 (95 % CI 1.30-3.46)]. This association was mediated by maternal burden of infant care (change in odds' ratio 1-17 %) and maternal aggressive behavior (change in odds' ratio 4-10 %). There was no effect modification by the child's gender or maternal parity. Excessive infant crying was not associated with general anxiety problems. Excessive infant crying doubles the risk of behavioral, hyperactivity, and mood problems at the age of 5-6, as reported by their mother. Maternal burden of infant care partially mediates the association between excessive crying and behavioral and mood problems. Special care for mothers with a high burden of care for their excessive crying infant, notwithstanding their own good health, can be a feasible strategy for possible prevention of mood and behavioral problems in their children later in life.
authors.affiliation: Academic Center for Child and Adolescent Psychiatry de Bascule, Meibergdreef 5, 1105AZ, Amsterdam, The Netherlands. laetitiasmarius@online.nl.
authors.forename: Laetitia Joanna Clara Antonia
authors.initials: LJ
authors.lastname: Smarius
authors.affiliation: Academic Center for Child and Adolescent Psychiatry de Bascule, Meibergdreef 5, 1105AZ, Amsterdam, The Netherlands.
authors.forename: Thea G A
authors.initials: TG
authors.lastname: Strieder
authors.affiliation: Department of Epidemiology, Health Promotion and Health Care Innovation Public Health Service Amsterdam, Amsterdam, The Netherlands.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Loomans
authors.affiliation: Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Theo A H
authors.initials: TA
authors.lastname: Doreleijers
authors.affiliation: Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Tanja G M
authors.initials: TG
authors.lastname: Vrijkotte
authors.affiliation: Department of Pediatrics and EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, 1007 MB, The Netherlands.
authors.forename: Reinoud J
authors.initials: RJ
authors.lastname: Gemke
authors.affiliation: Department of Epidemiology, Health Promotion and Health Care Innovation Public Health Service Amsterdam, Amsterdam, The Netherlands.
authors.forename: Manon
authors.initials: M
authors.lastname: van Eijsden
mesh_terms: D000339:Affect; D001007:Anxiety / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology; D002675:Child, Preschool; D003448:Crying / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009034:Mother-Child Relations / Q000523:psychology*; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D000066553:Problem Behavior / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: Behavioral problems; Excessive infant crying; Maternal aggressive behavior; Maternal burden of infant care; Mood problems