Developmental trajectories of toddler sleep problems: can a person-centered approach help identify children at risk?
Developmental trajectories of toddler sleep problems: can a person-centered approach help identify children at risk?
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幼儿睡眠问题的发展轨迹：以人为本的方法能否帮助识别处于危险中的儿童？
DOI：
10.1093/sleep/zsac142
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发表时间：
2022
期刊：
影响因子：
5.6
通讯作者：
Propper,CathiB
中科院分区：
文献类型：
--
作者：
Gustafsson,HannaC;Propper,CathiB
研究目标以前对幼儿睡眠问题的研究几乎完全依赖于以变量为中心的统计方法来分析这些数据，这些数据提供了关于普通儿童发展的有用信息。目前的研究考察了以人为中心的轨迹分析（一种可以识别在初始水平和/或睡眠问题轨迹上不同的儿童亚组的统计技术）是否有可能为我们了解幼儿睡眠问题及其发展提供信息。方法185个家庭在12、24、30、36月龄时进行评估。潜在类别增长分析用于测试24-36个月睡眠问题不同的亚组。亚组比较了36个月大的儿童外化、内化和总问题行为，以及12个月大的母亲心理健康、父母间冲突和母亲育儿行为。结果支持四类解决方案，包括“低、稳定”、“低、增加”、“高、增加”和“高、减少”类。睡眠问题持续存在或随着时间的推移而恶化的班级，其行为问题比症状有所改善或保持稳定的班级更严重。此外，12个月的母亲抑郁和整体症状严重程度、亲密伴侣暴力和母亲严厉侵入式的育儿行为在24个月睡眠障碍水平相似但随着时间的推移轨迹不同的班级之间有所区别。结论：这种统计方法似乎有可能增加对生命早期睡眠问题轨迹的理解。产妇心理健康、亲密伴侣暴力和父母行为可能是临床上有用的幼儿睡眠问题持续存在或发展的风险标志。
Study ObjectivesPrevious research examining toddler sleep problems has relied almost exclusively on variable-centered statistical approaches to analyze these data, which provide helpful information about the development of the average child. The current study examined whether person-centered trajectory analysis, a statistical technique that can identify subgroups of children who differ in their initial level and/or trajectory of sleep problems, has the potential to inform our understanding of toddler sleep problems and their development.MethodsFamilies (N= 185) were assessed at 12, 24, 30, and 36 months of child age. Latent class growth analysis was used to test for subgroups that differed in their 24–36 month sleep problems. Subgroups were compared on child 36-month externalizing, internalizing, and total problem behaviors, and on 12 month maternal mental health, inter-parental conflict, and maternal parenting behaviors.ResultsResults support a four-class solution, with “low, stable,” “low, increasing,” “high, increasing,” and “high decreasing” classes. The classes whose sleep problems persisted or worsened over time had worse behavioral problems than those whose symptoms improved or remained stably low. Additionally, 12 month maternal depression and global symptom severity, intimate partner violence, and maternal harsh-intrusive parenting behaviors discriminated between the classes that had similar levels of 24 month sleep disturbance but who had diverging trajectories over time.ConclusionsThis statistical approach appears to have the potential to increase understanding of sleep problem trajectories in the early years of life. Maternal mental health, intimate partner violence, and parenting behaviors may be clinically useful markers of risk for the persistence or development of toddler sleep problems.