Vivian Caroline Klein

Pain and distress reactivity and recovery as early predictors of temperament in toddlers born preterm

BACKGROUND Pain reactivity may reflect underlying mechanisms of constitutional aspects of temperament. AIM To examine whether the neonatal biobehavioral reactivity and recovery responses from pain and distress, as well as the gestational age, the illness severity and the amount of painful procedures undergone the Neonatal Intensive Care Unit (NICU) stay, predict temperament later in toddlerhood, in vulnerable children born preterm. STUDY DESIGN Prospective-longitudinal study. SUBJECTS Twenty-six preterm and very low birth weight infants followed from birth to toddlerhood. OUTCOME MEASURES Illness severity was assessed with the Clinical Risk Index for Babies (CRIB) score. The medical charts were reviewed prospectively for obtaining the amount of pain exposure in NICU. For assessing the behavioral and cardiac reactivity and recovery from pain and distress, the neonates were evaluated during routine blood collection in the NICU in the first 10 days of life. Pain and distress reactivity and recovery was measured using the Neonatal Facial Coding System score, the duration of crying, and the magnitude of average heart rate. At toddlerhood, mothers answered the Early Childhood Behavior Questionnaire. RESULTS Higher biobehavioral reactivity to pain and distress predicted higher temperamental Negative Affect, above and beyond gestational age, illness severity and amount of pain exposure in NICU. However, we did not find a predictive relation between gestational age, CRIB score and number of painful procedures undergone NICU and toddlers temperament. CONCLUSIONS The findings highlight the relevance of the neonatal individual characteristics of reactivity for identifying more vulnerable infants for future problems in biobehavioral regulation.

Prematuridade e interação mãe-criança: revisão sistemática da literatura

The aim of the present study was to analyse the scientific publications, from 1998 to 2004, about interaction between mothers and their pre-term born children and their development at pre-school and school age. A systematic bibliographical review about empirical studies indexed on MEDLINE, PsycINFO and LILACS data bases was done, using as key-words the terms: ‘preterm’ (very low birth weight, prematurity, premature birth) and ‘mother-child interaction’ (mother child dyads, mother child relationship, mother child relations, maternal mediation). Thirty-three articles were identified, 26 were selected and 22 were achieved. Most studies assessed mother-child interaction at the first four years of life, as well as its impact on children’s developmental outcome. The studies identified differences in the interaction between mother-pre term born child dyads and motherfull term born child dyads at pre-school and school age and at adolescence. Maternal interactive behaviors exerted a differential moderator effect on the developmental outcome of vulnerable children who presented previous biologic risk factors.

Effects of preterm birth and gender on temperament and behavior in children

The aim of the present study was to assess the direct and interactive effects of premature birth and gender on temperament and behavioral problems in 80 children aged 18-36 months. The sample was composed of children born preterm (PT; n=44) and children born full-term (FT; n=36). The childrens mothers completed temperament (ECBQ) and behavioral problem (CBCL 1.5-5) assessments. Analyses of variance (ANOVA 2×2) were performed. With regard to temperament, PT children exhibited significantly higher scores on high-intensity pleasure and perceptual sensitivity and lower scores on discomfort, cuddliness, and Attentional Focusing compared with FT children. Girls scored higher on fear and discomfort compared with boys. With concern to behavioral problems, PT children scored higher on attention problems compared with FT children. No interactive effect of premature birth and gender on temperament or behavioral problems was found.

Dor, autorregulação e temperamento em recém-nascidos pré-termo de alto risco

High risk preterm newborns are exposed to unavoidable painful experiences in Neonatal Intensive Care Units. In spite of their biological immaturity, they are able to perceive and react to pain stimuli. Repetitive exposure to pain has a negative impact on the development and may increase the infants vulnerability, affecting self-regulatory processes. Biobehavioral reactivity to pain is an indicator of self-regulation and it is associated to the childs temperament. Preterm infants need pharmacological and non-pharmacological strategies for pain relieving. Moreover, they need a context of synchronic interaction with their parents which must be adapted to their temperament characteristics. Health professionals may play an important role in supporting external regulation for those infants, promoting pain relief and preventing development problems.

Temperamento, comportamento e experiência dolorosa na trajetória de desenvolvimento da criança

O presente estudo teve por objetivo realizar uma revisao de estudos sobre as relacoes entre temperamento, comportamento e experiencias dolorosas iniciais nas trajetorias de desenvolvimento de criancas, especialmente nas nascidas prematuras. Os estudos empiricos foram obtidos por meio das bases de dados PsycINFO e Medline. Os resultados mostraram que o temperamento foi preditor de padroes individuais de reacao a dor e problemas de comportamento da crianca, em diferentes idades. Alem disso, as experiencias precoces de dor em criancas nascidas prematuras podem afetar a reatividade do bebe, que por sua vez mostrou associacao com dimensoes do temperamento nos primeiros anos de vida.El objetivo del presente estudio fue realizar una revision sobre las relaciones entre temperamento, comportamiento y experiencias dolorosas iniciales en la trayectoria del desarrollo de los ninos, especialmente en los nacidos prematuros. Los estudios empiricos fueron obtenidos por medio de la base de datos PsycINFO y Medline. Los resultados muestran que el temperamento fue el definidor de los patrones individuales de las reacciones al dolor y problemas del comportamiento de los ninos, en diferentes edades. Tambien las experiencias precoces de dolor en ninos nacidos prematuros pueden afectar la reactividad del recien nacido, que ademas mostro asociacion con dimensiones del temperamento en los primeros anos de vida.

Temperament and behavior problems in toddlers born preterm and very low birth weight.

The purpose of the present study was to examine the temperament and behavior problems of 32 toddlers born preterm and very low birth weight and 25 toddlers born full-term without medical problems. Mothers completed the Early Childhood Behavior Questionnaire and the Child Behavior Checklist-1.5-5 for assessing toddler`s temperament and behavior problems, respectively. The results showed that, regarding temperament, toddlers born preterm exhibited higher scores on the temperament dimensions Motor Activation, Perceptual Sensitivity, and High Intensity Pleasure, and lower scores on the temperament dimension Cuddliness than toddlers born full-term. In regard to behavior problems, toddlers born preterm showed higher attention problems scores than the comparison group. These findings indicated that children born preterm presented developmental vulnerabilities in temperament dimensions related to behavior problems at toddlerhood. Early intervention programs for preventing psychological problems in at-risk children, especially those born preterm, could focus on childrens temperament dispositions.

Temperamento e desenvolvimento da criança: revisão sistemática da literatura

Temperament is a personal variable which interacts with environmental variables and therefore may have an influence on child developmental pathways. The purpose of the present study was to review systematically the empirical studies published from 2001 to 2006 about temperament and its relationship to child development. Fifty empirical studies indexed in the data bases PsycInfo, MEDLINE and LILACS were selected through systematic bibliographic review. It was found that the most frequently used theoretical approach for studying temperament was the Rothbarts psychobiological approach. Temperament was assessed predominantly through questionnaires answered by mothers. The findings of the studies showed that children with temperament characterized by high levels of negative mood, fear, shyness and anger are vulnerable for exhibiting developmental problems. Temperament with high levels of effortful control, which indicates the ability to suppress behavioral and motivational trends guided by the affect and to reprogram the behavior in situations of conflict of interests, is associated to adaptive developmental outcomes.Temperament is a personal variable which interacts with environmental variables and therefore may have an influence on child developmental pathways. The purpose of the present study was to review systematically the empirical studies published from 2001 to 2006 about temperament and its relationship to child development. Fifty empirical studies indexed in the data bases PsycInfo, MEDLINE and LILACS were selected through systematic bibliographic review. It was found that the most frequently used theoretical approach for studying temperament was the Rothbart`s psychobiological approach. Temperament was assessed predominantly through questionnaires answered by mothers. The findings of the studies showed that children with temperament characterized by high levels of negative mood, fear, shyness and anger are vulnerable for exhibiting developmental problems. Temperament with high levels of effortful control, which indicates the ability to suppress behavioral and motivational trends guided by the affect and to reprogram the behavior in situations of conflict of interests, is associated to adaptive developmental outcomes.

Temperament and child development: systematic review of the literature

Temperament is a personal variable which interacts with environmental variables and therefore may have an influence on child developmental pathways. The purpose of the present study was to review systematically the empirical studies published from 2001 to 2006 about temperament and its relationship to child development. Fifty empirical studies indexed in the data bases PsycInfo, MEDLINE and LILACS were selected through systematic bibliographic review. It was found that the most frequently used theoretical approach for studying temperament was the Rothbarts psychobiological approach. Temperament was assessed predominantly through questionnaires answered by mothers. The findings of the studies showed that children with temperament characterized by high levels of negative mood, fear, shyness and anger are vulnerable for exhibiting developmental problems. Temperament with high levels of effortful control, which indicates the ability to suppress behavioral and motivational trends guided by the affect and to reprogram the behavior in situations of conflict of interests, is associated to adaptive developmental outcomes.Temperament is a personal variable which interacts with environmental variables and therefore may have an influence on child developmental pathways. The purpose of the present study was to review systematically the empirical studies published from 2001 to 2006 about temperament and its relationship to child development. Fifty empirical studies indexed in the data bases PsycInfo, MEDLINE and LILACS were selected through systematic bibliographic review. It was found that the most frequently used theoretical approach for studying temperament was the Rothbart`s psychobiological approach. Temperament was assessed predominantly through questionnaires answered by mothers. The findings of the studies showed that children with temperament characterized by high levels of negative mood, fear, shyness and anger are vulnerable for exhibiting developmental problems. Temperament with high levels of effortful control, which indicates the ability to suppress behavioral and motivational trends guided by the affect and to reprogram the behavior in situations of conflict of interests, is associated to adaptive developmental outcomes.

Temperamento y desarrollo infantil: revisión sistemática de la literatura

Temperament is a personal variable which interacts with environmental variables and therefore may have an influence on child developmental pathways. The purpose of the present study was to review systematically the empirical studies published from 2001 to 2006 about temperament and its relationship to child development. Fifty empirical studies indexed in the data bases PsycInfo, MEDLINE and LILACS were selected through systematic bibliographic review. It was found that the most frequently used theoretical approach for studying temperament was the Rothbarts psychobiological approach. Temperament was assessed predominantly through questionnaires answered by mothers. The findings of the studies showed that children with temperament characterized by high levels of negative mood, fear, shyness and anger are vulnerable for exhibiting developmental problems. Temperament with high levels of effortful control, which indicates the ability to suppress behavioral and motivational trends guided by the affect and to reprogram the behavior in situations of conflict of interests, is associated to adaptive developmental outcomes.Temperament is a personal variable which interacts with environmental variables and therefore may have an influence on child developmental pathways. The purpose of the present study was to review systematically the empirical studies published from 2001 to 2006 about temperament and its relationship to child development. Fifty empirical studies indexed in the data bases PsycInfo, MEDLINE and LILACS were selected through systematic bibliographic review. It was found that the most frequently used theoretical approach for studying temperament was the Rothbart`s psychobiological approach. Temperament was assessed predominantly through questionnaires answered by mothers. The findings of the studies showed that children with temperament characterized by high levels of negative mood, fear, shyness and anger are vulnerable for exhibiting developmental problems. Temperament with high levels of effortful control, which indicates the ability to suppress behavioral and motivational trends guided by the affect and to reprogram the behavior in situations of conflict of interests, is associated to adaptive developmental outcomes.

Temperamento, comportamiento y experiencia dolorosa en la trayectoria del desarrollo del niño

O presente estudo teve por objetivo realizar uma revisao de estudos sobre as relacoes entre temperamento, comportamento e experiencias dolorosas iniciais nas trajetorias de desenvolvimento de criancas, especialmente nas nascidas prematuras. Os estudos empiricos foram obtidos por meio das bases de dados PsycINFO e Medline. Os resultados mostraram que o temperamento foi preditor de padroes individuais de reacao a dor e problemas de comportamento da crianca, em diferentes idades. Alem disso, as experiencias precoces de dor em criancas nascidas prematuras podem afetar a reatividade do bebe, que por sua vez mostrou associacao com dimensoes do temperamento nos primeiros anos de vida.El objetivo del presente estudio fue realizar una revision sobre las relaciones entre temperamento, comportamiento y experiencias dolorosas iniciales en la trayectoria del desarrollo de los ninos, especialmente en los nacidos prematuros. Los estudios empiricos fueron obtenidos por medio de la base de datos PsycINFO y Medline. Los resultados muestran que el temperamento fue el definidor de los patrones individuales de las reacciones al dolor y problemas del comportamiento de los ninos, en diferentes edades. Tambien las experiencias precoces de dolor en ninos nacidos prematuros pueden afectar la reactividad del recien nacido, que ademas mostro asociacion con dimensiones del temperamento en los primeros anos de vida.