TY - JOUR
T1 - Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years
T2 - stress in pregnancy study
AU - Nomura, Yoko
AU - Newcorn, Jeffrey H.
AU - Ginalis, Christine
AU - Heitz, Catherine
AU - Zaki, Jeenia
AU - Khan, Farzana
AU - Nasrin, Mardia
AU - Sie, Kathryn
AU - DeIngeniis, Donato
AU - Hurd, Yasmin L.
N1 - Funding Information:
The authors would like to thank the children and parents who consented to participate in this study. The authors thank Jacob Ham, Ph.D., Katie Dana, Ph.D., Lexi Pritchett, Ph.D., and Patricia Pehme, Ph.D. for clinical interviews; and former research staff and assistants at Queens College, CUNY for their contributions to this study. This research work was supported by the grant R01MH102729 from the National Institute of Mental Health, and PSC‐CUNY, Queens College Research Enhancement Grant (to Y.N.). J.H.N. reports the following disclosures (all unrelated to this work): consultant/advisory board for Adlon Therapeutics, Arbor, Cingulate Therapeutics, Corium, Lumos, Lundbeck, Medice, Myriad, NLS, OnDosis, Rhodes, and Supernus; research support from Adlon, Otsuka, Shire, Supernus; honoraria for disease state lectures from Otsuka and Takeda, and served as a consultant for the US. The remaining authors have declared that they have no competing or potential conflicts of interest. Key points
Funding Information:
The authors would like to thank the children and parents who consented to participate in this study. The authors thank Jacob Ham, Ph.D., Katie Dana, Ph.D., Lexi Pritchett, Ph.D., and Patricia Pehme, Ph.D. for clinical interviews; and former research staff and assistants at Queens College, CUNY for their contributions to this study. This research work was supported by the grant R01MH102729 from the National Institute of Mental Health, and PSC-CUNY, Queens College Research Enhancement Grant (to Y.N.). J.H.N. reports the following disclosures (all unrelated to this work): consultant/advisory board for Adlon Therapeutics, Arbor, Cingulate Therapeutics, Corium, Lumos, Lundbeck, Medice, Myriad, NLS, OnDosis, Rhodes, and Supernus; research support from Adlon, Otsuka, Shire, Supernus; honoraria for disease state lectures from Otsuka and Takeda, and served as a consultant for the US. The remaining authors have declared that they have no competing or potential conflicts of interest.Key points Prenatal stress, in the form of a natural disaster, increased the risk for preschool children's psychopathology, especially anxiety, depressive, and attention deficit/disruptive behavior disorders. Male children had a substantially greater risk for attention deficit/disruptive behavior disorders, whereas females had greater risk for anxiety disorders. Emerging psychopathology following exposure to a natural disaster in utero can be identified as early as the preschool years. It is presumed that this increased risk for psychiatric disorders is mediated through a variety of parent, child, and environmental factors, including possible gene x environment interactions. Further research is required to elucidate these mechanisms. The frequency of natural disasters is increasing. Parents, educators, and pediatricians should be aware that young children exposed to such events are at increased risk for the development of psychiatric disorders – even when those events occur in utero – and monitor for the possible emergence of psychiatric disorders. Policy makers, obstetricians, and pediatricians need to create an infrastructure to assist pregnant women and their families when confronting a natural disaster, to mitigate risks to their children in utero, support healthy development after birth, and reduce subsequent psychiatric disorders. Prenatal stress, in the form of a natural disaster, increased the risk for preschool children's psychopathology, especially anxiety, depressive, and attention deficit/disruptive behavior disorders. Male children had a substantially greater risk for attention deficit/disruptive behavior disorders, whereas females had greater risk for anxiety disorders. Emerging psychopathology following exposure to a natural disaster in utero can be identified as early as the preschool years. It is presumed that this increased risk for psychiatric disorders is mediated through a variety of parent, child, and environmental factors, including possible gene x environment interactions. Further research is required to elucidate these mechanisms. The frequency of natural disasters is increasing. Parents, educators, and pediatricians should be aware that young children exposed to such events are at increased risk for the development of psychiatric disorders – even when those events occur in utero – and monitor for the possible emergence of psychiatric disorders. Policy makers, obstetricians, and pediatricians need to create an infrastructure to assist pregnant women and their families when confronting a natural disaster, to mitigate risks to their children in utero, support healthy development after birth, and reduce subsequent psychiatric disorders.
Publisher Copyright:
© 2022 Association for Child and Adolescent Mental Health.
PY - 2023/7
Y1 - 2023/7
N2 - Background: Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children. Methods: Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2–5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent-report structured diagnostic interview developed for preschool-age children. Sixty-six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS-related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age, race, SES, maternal substance use, and normative prenatal stress. Results: Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p =.030), anxiety disorders (HR = 5.1, p <.0001), and attention-deficit/disruptive behavioral disorders (HR = 3.4, p =.02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p =.004), attention-deficit/hyperactivity disorder (ADHD; HR = 5.5, p =.01), oppositional-defiant disorder (ODD; HR = 3.8, p =.05), and separation-anxiety disorder (SAD; HR = 3.5, p =.001). Males had distinctively elevated risks for attention-deficit/disruptive behavioral disorders (HR = 7.8, p =.02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p <.0001), phobia (HR = 2.8, p =.02) and depressive disorders (HR = 30.0, p =.03), including SAD, GAD, and dysthymia. Conclusions: The findings demonstrate that in utero exposure to a major weather-related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.
AB - Background: Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children. Methods: Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2–5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent-report structured diagnostic interview developed for preschool-age children. Sixty-six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS-related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age, race, SES, maternal substance use, and normative prenatal stress. Results: Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p =.030), anxiety disorders (HR = 5.1, p <.0001), and attention-deficit/disruptive behavioral disorders (HR = 3.4, p =.02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p =.004), attention-deficit/hyperactivity disorder (ADHD; HR = 5.5, p =.01), oppositional-defiant disorder (ODD; HR = 3.8, p =.05), and separation-anxiety disorder (SAD; HR = 3.5, p =.001). Males had distinctively elevated risks for attention-deficit/disruptive behavioral disorders (HR = 7.8, p =.02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p <.0001), phobia (HR = 2.8, p =.02) and depressive disorders (HR = 30.0, p =.03), including SAD, GAD, and dysthymia. Conclusions: The findings demonstrate that in utero exposure to a major weather-related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.
KW - Natural disasters
KW - anxiety
KW - developmental psychopathology
KW - disruptive behavior
KW - sex differences
UR - http://www.scopus.com/inward/record.url?scp=85138425331&partnerID=8YFLogxK
U2 - 10.1111/jcpp.13698
DO - 10.1111/jcpp.13698
M3 - Article
AN - SCOPUS:85138425331
SN - 0021-9630
VL - 64
SP - 1080
EP - 1091
JO - Journal of Child Psychology and Psychiatry and Allied Disciplines
JF - Journal of Child Psychology and Psychiatry and Allied Disciplines
IS - 7
ER -