Academic journal article Pre- and Peri-natal Psychology Journal

Classification Rates and Relative Risk Factors for Perinatal Events Predicting Emotional/Behavioral Disorders in Children

Academic journal article Pre- and Peri-natal Psychology Journal

Classification Rates and Relative Risk Factors for Perinatal Events Predicting Emotional/Behavioral Disorders in Children

Article excerpt

ABSTRACT: Perinatal factors were used to predict childhood emotional/behavioral disturbance using a discriminant analysis. A cross validation procedure was employed showing that 20 of 26 factors studied contributed to the separation between groups at clinical levels of accuracy. Frequencies, percentages, and relative risk factors were calculated for each perinatal factor and for the discriminant function. Results were used to argue to a multivariate approach in the examination of a relationship between perinatal events and development of emotional/behavioral disorders in children and adolescents.

Medical technology has greatly increased the survival rate for infants born at risk from perinatal complications. However, this has meant greater number of children with potential for development disorders. Indeed, research has suggested that such complications may play a role in the etiology of childhood emotional/behavioral disorders (e.g., Finegan & Quarrington, 1979; McGee, Silva & Willians, 1984; Torrey, Hersh & McCabe, (1975). Arguing from these data, a number of investigations stress that perinatal events should be considered in any attempt to understand the development of emotional/behavioral disorders.

Finegan and Quarrington (1979) compared the perinatal histories of 23 autistic children (65% were mentally retarded) and 15 normal siblings. The results of this investigation showed that when compared to the normal frequency of such complications, autistic children experienced a significatnly greater incidence of complicated deliveries, low birth weight, low APGAR scores, haemolytic disease, elevated serium bilirubin, and Respiratory Distress Syndrome (RDS). Moreover, autistic children presented with more complicated preganancies and neonatal risks as well as a significantly higher incidence of amniotic meconmium than their siblings. Using similar research methods, Torrey et al., (1975) showed maternal uterine bleeding was also associated with subsequent development of infantile autism.

Recently, McGee et al., (1984) studied factors involved in the development of behavior problems for a slightly disadvantaged group of children with behavior problems. When socio-economic, environmental and medical history variables were studied, "small for gestational age" was found to be the only salient perinatal event directly associated with the later onset of behavioral problems (McGee et al., 1984).

A similar line of research has shown that perinatal complications and genetic factors may interact to predispose a subject to psychopathology. In one study, McNeil and Kaij (1978) compared the perinatal histories of schizophrenic, borderline schizophrenic, and normal adults who were born to schizophrenic mothers. The results of this study showed that abnormal fetal position (e.g., breech presentation) occurred with significantly higher frequency in children that were subsequently diagnosed schizophrenic (Parnes, Schulsinger, Teasdale, Schulsinger, Feldman, & Mednick, 1982). Likewise, Parnas et al. (1982) reported a general trend of increased perinatal complications with schizophrenic subjects as compared to their borderline schizophrenic and normal cohorts. In this study, some 67% of the schizophrenics experienced some form of perinatal complication (Parnes et al., 1982). The investigators interpreted these results within Shield's diathesis stress model (e.g. see Wing, 1979), which asserts that the schizophrenic phenotype may be the result of an interplay between a stressful environment and genetic factors.

While much of the available evidence suggests a link between perinatal complications and development of emotional/behavioral disorders, few investigations have examined the interaction of perinatal events in the prediction of emotional/behavioral development. Although information regarding the long term effects of specific perinatal complications is of interest, it seems clear that perinatal events may interact to increase the risk of emotional/behavioral disturbance over a given factor in isolation. …

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