Tuesday, February 7, 2023

Excessive Crying, Irritability in Infancy Associated With Later Behavioral Problems

Infants who cry excessively (more than 3 hours at least 1 day/week) may be more likely to experience behavioral problems in childhood and adolescence than infants who cry less, suggests a report published yesterday in the Journal of the Academy of Child & Adolescent Psychiatry. Brain scans of these children at age 10 also revealed that the amygdala—a part of the brain involved with assessing threat and regulating emotional responses—was smaller in those who cried excessively and/or were irritable as infants.

“Most infants who cry excessively grow to be healthy, typically developing children, and it remains reasonable to remind parents of the good prognosis,” wrote Sara Sammallahti, Ph.D., of Erasmus MC Sophia Children’s Hospital in the Netherlands and colleagues. “Nonetheless, … our results suggest parent-reported excessive crying should not be simply shrugged off: it could reflect one of the earliest child markers of vulnerability to develop behavioral problems.”

The researchers analyzed data from the Generation R Study cohort, which included 4,751 children born in the Netherlands between 2002 and 2006. As part of the study, parents were asked to report if their three-month-old infants cried excessively by answering yes or no to the question “Has your child ever cried for more than 3 hours a day (24 hours) during the last week?” and/or if the baby was irritable, using the Mother and Baby Scales irritability scale. The parents were also asked to complete the Child Behavior Checklist (CBCL) when the children were 1.5, 3, 6, and 10 years. The CBCL measures internalizing problems (such as anxiety) and externalizing problems (such as aggression). At age 14, the youth completed the Youth Self-Report, which also measures internalizing and externalizing problems in adolescence. The children also underwent a structural brain MRI around the age of 10.

Children who cried excessively in infancy had higher parent-rated internalizing and externalizing problems throughout childhood compared with those who did not cry excessively in infancy; higher infant irritability was also associated with higher parent-rated internalizing and externalizing problems. Similarly, children who cried excessively and/or were more irritable as infants had smaller amygdala volume at 10 years.

“Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and be linked with neurobiological differences in the development of the amygdala,” Sammallahti and colleagues wrote.

They continued, “Neurobiological differences can manifest in crying behavior; however, behavior could also precede neurobiological differences: the experiences of irritable, excessively crying infants could impact structural amygdala development … [O]ur study suggests crying behavior and amygdala development are associated.”

For related information, see the Psychiatric News article “Irritability in Childhood May Point to Teens At High Risk for Suicide.”

(Image: iStock/Milan_Jovic)

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