Preschool Psychopathology: Continuity and Outcomes at Age 6

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DESCRIPTION (provided by applicant): Little is known about psychopathology in preschoolers, and there are particularly few studies on internalizing problems in this population. In addition, there are few longitudinal studies that examine the continuity of early childhood disorders and symptoms. Longitudinal studies are needed to elucidate the clinical significance and future implications of psychopathology in young children. Existing studies tend to focus on externalizing problems and include symptom checklist measures that provide few details about the nature and clinical significance of symptoms. Further, studies of psychopathology in preschoolers have typically used clinical samples, which are subject to a variety of biases. The proposed research project is a prospective longitudinal study designed to examine the stability of psychopathology in young children using a comprehensive diagnostic interview in a large community sample. Specific emotional and behavioral disorders and symptoms will be assessed at ages 3 and 6 to compare rates of disorders, levels of symptoms, and concurrent comorbidity. Homotypic and heterotypic continuity of disorders and symptoms will be analyzed. In addition, predictors of change in symptoms in 3 domains will be examined: child (functional impairment, temperament), family (maternal psychopathology, parenting behavior), and life stress. A preliminary model positing that age 3 child and family variables have direct effects on change in children's symptoms between ages 3 and 6, as well as indirect effects on symptoms as mediated by life stress prior to the age 6 assessment will be tested. Finally, a subset of the sample will be re-interviewed 3 months later to explore the value of extending the length of the primary period of the diagnostic interview. The stability of symptoms and diagnoses from ages 3 to 6 would support the validity of psychopathology in preschoolers and encourage the development of prevention and early intervention effort targeting both emotional and behavioral problems and their developmental sequelae. Public Health Relevance: is study has the potential to improve our understanding of the course and significance of psychopathology in preschoolers, and to identify predictors of change in psychiatric symptoms that can be used to guide decision-making regarding early intervention and need for services. In addition, this study can help to refine the assessment of psychopathology in young children.