Distinct trajectories of separation anxiety in the preschool years: persistence at school entry and early-life associated factors
Distinct trajectories of separation anxiety in the preschool years: persistence at school entry and early-life associated factors
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DOI：
10.1111/jcpp.12424
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发表时间：
2016-01-01
影响因子：
7.6
通讯作者：
Boivin, Michel
中科院分区：
文献类型：
--
作者：
Battaglia, Marco;Touchette, Evelyne;Boivin, Michel
背景：关于学龄前儿童分离焦虑（SA）症状的发生和演变，以及SA如何发展为分离焦虑障碍，人们知之甚少。在一个大的，有代表性的基于人群的样本中，我们调查了SA症状从婴儿期到入学的发展轨迹，它们的早期相关危险因素，以及它们与幼儿园教师SA评分的关系。方法对1933个年龄在1.5岁至6岁之间的家庭进行SA轨迹和危险因素的纵向评估。结果分析显示了一个最佳拟合的4轨迹解决方案，包括一个普遍的，未受影响的低持久性组（60.2%），以及三个不同发育过程的小组：高增加组（6.9%），高减少组（10.8%）和低增加组（22.1%）。高增长组在整个学前阶段都保持高水平，并且是预测6岁时教师评估SA的唯一轨迹。除了高增长外，所有的轨迹都显示到6岁时症状显著减少。高增长组和高下降组有几个共同的早期风险因素，但前者与母亲抑郁程度较高、母亲怀孕期间吸烟和父母失业有关。结论大多数在1.5岁时出现高SA的儿童有望在4-5岁时逐步康复。1.5岁时持续的高SA值得特别关注，可能预示着分离焦虑障碍。许多儿童围产期、父母和家庭环境风险因素与学龄前SA的发病和发展过程有关。
BackgroundLittle is known about how children differ in the onset and evolution of separation anxiety (SA) symptoms during the preschool years, and how SA develops into separation anxiety disorder. In a large, representative population-based sample, we investigated the developmental trajectories of SA symptoms from infancy to school entry, their early associated risk factors, and their associations with teachers' ratings of SA in kindergarten.MethodsLongitudinal assessment of SA trajectories and risk factors in a cohort of 1,933 families between the ages of 1.5 and 6years.ResultsAnalyses revealed a best-fitting, 4-trajectory solution, including a prevailing, unaffected Low-Persistent group (60.2%), and three smaller groups of distinct developmental course: a High-Increasing (6.9%), a High-Decreasing (10.8%), and a Low-Increasing group (22.1%). The High-Increasing group remained high throughout the preschool years and was the only trajectory to predict teacher-assessed SA at age 6years. Except for the High-Increasing, all trajectories showed substantial reduction in symptoms by age 6years. The High-Increasing and High-Decreasing groups shared several early risk factors, but the former was uniquely associated with higher maternal depression, maternal smoking during pregnancy, and parental unemployment.ConclusionsMost children with high SA profile at age 1.5years are expected to progressively recover by age 4-5. High SA at age 1.5 that persists over time deserves special attention, and may predict separation anxiety disorder. A host of child perinatal, parental and family-contextual risk factors were associated with the onset and developmental course of SA across the preschool years.