Dysregulated Infant – Dysregulated Child?

It is well known that babies get upset, but are infants who get REALLY upset and are very difficult to manage more likely to have behavioral problems later in life?  The data so far has been somewhat inconclusive and long-term follow-up is lacking.

A new study from the journal Pediatrics may add some insight into the question. This Australian study examined approximately 6000 infants.  Dysregulated infants were assessed using a questionnaire that asked about colic, sleeplessness, feeding problems, and overactivity with the top 10% classified as dysregulated. The children were followed-up at age 5, 14, and 21 using our very own Achenbach rating scales such as the Child Behavior Checklist which in the early waves of the study were “modified” and shortened.  About half of the original patients were assessed at age 21.  DSM Diagnoses were also obtained using a structured interview.  Logistic regressions were used for the analysis and to caclulate odds ratios.

The results showed that infant dysregulation assessed at 6 months was indeed associated with parent-reported behavioral problems at age 5 and 14 but not self-reported behavioral problems at 14 or 21.  For example, 9.7% of the nondysregulated infants versus 19.4% of the dysregulated infants were classified as having clinical levels of externalizing problems at age 5 (odds ratio 2.23). When maternal levels of anxiety and depression were taken into account, the associations between infant dysregulation and later behavioral problems were diminished  but generally still statistically significant.  There were no significantly elevated rates of DSM disorders assessed by self-report at age 21.

There were some problems with the paper.   The authors reported that maternal anxiety/depression were MEDIATORS of the infant dysregulation-child behavior problems link (meaning that they believe the results worked through this mechanism), but from my reading it looks more like a confound variable (i.e another variable that could account for the association), which in other areas of the paper they acknowledge.  For example, increased maternal anxiety and depression could have resulted in the perception of a more difficult to manage infant.  It is also worth pointing out, as is easily missed in studies that report odds ratios, that the vast majority of dysregulated infants did not manifest clinical behavior problems even at age 5 let alone later in life.


Hyde et al., Long-term Outcomes of Infant Behavioral Dysregulation.  Pediatrics 2012; 130:5 e1243-e1251


Comments are closed.