Abstract

BackgroundThis study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors.MethodsA validated screen for temperamental inhibition was distributed to parents of young children attending preschools in six government regions of Melbourne, Australia. Screening identified 11% of children as inhibited (703 of 6347 screened) and eligible for a prevention study. Participants were 545 parents of inhibited preschoolers (78% uptake), of whom 84% were followed into mid childhood (age 7–10 years: wave 1, n = 446; wave 2, n = 427; wave 3, n = 426). Parents and children then completed questionnaires for child internalizing (anxious and depressive) symptoms, and parents received a diagnostic interview for child anxiety disorder. In mid-childhood parents also completed questionnaires annually to describe recent life-stressors experienced by their child, and any potentially traumatic events in the first four years of life.ResultsOnly one in 14 temperamentally inhibited children had experienced a potentially traumatic event in early childhood. In mid childhood 56% experienced recent life-stressors. Inhibited children who had early life trauma experienced slightly more anxiety disorder and symptoms in mid childhood. Those children with more recent life-stressors in mid childhood also had slightly more symptoms of anxiety and depression. In contrast to stress sensitization, inhibited children with early trauma plus recent stressors did not show especially high mid-childhood internalizing difficulties.ConclusionsEarly life trauma and recent life-stressors each convey a small risk for children with an inhibited temperament to develop internalizing problems. Nevertheless, early life stress may not always result in negative sensitization for children in the general population.

Highlights

  • This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors

  • The types of potentially traumatic events experienced by inhibited preschoolers in the general population were - child hospitalization (41%, n = 12), death of a loved one (38%, n = 11), parent life threatening illness (14%, n = 4), natural disaster (7%, n = 2), parent abandoned child (3%, n = 1), parent

  • Consistent with other international studies, we found that more mid-childhood life-stressors was associated with more child internalizing problems [28,29,30,31,32,33,34,35, 37]

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Summary

Introduction

This study explored whether temperamentally inhibited children who experience early trauma are vulnerable to developing internalizing problems in the face of later life-stressors. When internalizing problems develop in childhood they are associated with academic, social, and family dysfunction [5]. They can persist into adolescence and adulthood to become long term disorders, with substantial negative life impacts in social, educational, employment and health domains [3, 6, 7]. In pediatric healthcare, understanding the development of internalizing problems in children is important, to inform discussions with families and facilitate early intervention

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