{"title":"Fostering positive mental health outcomes in vulnerable children: Pathways to resilience after preterm birth.","authors":"E Sabrina Twilhaar,Dieter Wolke","doi":"10.1111/jcpp.70002","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nChildren born preterm (<37 weeks' gestation) are at increased risk of mental health problems, and their mental health outcomes have not improved in the past decades. This study aims to (1) determine the degree of mental health resilience in preterm-born children; (2) identify modifiable factors at individual, parent-child, family, peer group, and neighbourhood levels associated with resilience; (3) explore differential effects of factors based on sex and contextual adversity.\r\n\r\nMETHODS\r\nPreterm-born children from the Bavarian Longitudinal Study (BLS; n = 574) born in Germany (1985-1986) and Millennium Cohort Study (MCS; n = 985) born in the UK (2000-2002) were assessed prospectively at 7 (MCS) or 8 (BLS) years. Resilience was defined as better-than-expected mental health outcomes, using a residuals approach. Potential promotive factors included (1) individual: self-regulation, perceived competence, cognition; (2) parent-child relationships; (3) family: home environment, interparental relationship, social support, sibling relationships; (4) peers: bullying, friendships; and (5) neighbourhood characteristics. Associations between promotive factors and resilience were tested using regression-based methods, with sex and contextual adversity (adverse life events, psychosocial stress, socioeconomic deprivation) as moderators and mediators.\r\n\r\nRESULTS\r\nThe following factors were consistently (in both cohorts) associated with resilience: (1) individual: regulatory abilities, cognition; (2) parent-child: mother-child relationship; (3) family: authoritative and structured climate, interparental relationship; (4) peers: bullying. Regulatory abilities showed independent effect in both cohorts. Collectively, factors explained 30%-41% of the variance in resilience. Effects were similar across sex and contextual adversity, but promotive factors were less prevalent in boys and adverse contexts. Particularly in the UK, promotive resources were scarce amidst contextual adversity, which explained the lower resilience of children living in adversity.\r\n\r\nCONCLUSIONS\r\nThis study identified modifiable factors such as child self-regulation, interparental relationships, and bullying that - if improved - have a high potential for improving mental health outcomes in preterm-born children.","PeriodicalId":187,"journal":{"name":"Journal of Child Psychology and Psychiatry","volume":"109 1","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Child Psychology and Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jcpp.70002","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
BACKGROUND
Children born preterm (<37 weeks' gestation) are at increased risk of mental health problems, and their mental health outcomes have not improved in the past decades. This study aims to (1) determine the degree of mental health resilience in preterm-born children; (2) identify modifiable factors at individual, parent-child, family, peer group, and neighbourhood levels associated with resilience; (3) explore differential effects of factors based on sex and contextual adversity.
METHODS
Preterm-born children from the Bavarian Longitudinal Study (BLS; n = 574) born in Germany (1985-1986) and Millennium Cohort Study (MCS; n = 985) born in the UK (2000-2002) were assessed prospectively at 7 (MCS) or 8 (BLS) years. Resilience was defined as better-than-expected mental health outcomes, using a residuals approach. Potential promotive factors included (1) individual: self-regulation, perceived competence, cognition; (2) parent-child relationships; (3) family: home environment, interparental relationship, social support, sibling relationships; (4) peers: bullying, friendships; and (5) neighbourhood characteristics. Associations between promotive factors and resilience were tested using regression-based methods, with sex and contextual adversity (adverse life events, psychosocial stress, socioeconomic deprivation) as moderators and mediators.
RESULTS
The following factors were consistently (in both cohorts) associated with resilience: (1) individual: regulatory abilities, cognition; (2) parent-child: mother-child relationship; (3) family: authoritative and structured climate, interparental relationship; (4) peers: bullying. Regulatory abilities showed independent effect in both cohorts. Collectively, factors explained 30%-41% of the variance in resilience. Effects were similar across sex and contextual adversity, but promotive factors were less prevalent in boys and adverse contexts. Particularly in the UK, promotive resources were scarce amidst contextual adversity, which explained the lower resilience of children living in adversity.
CONCLUSIONS
This study identified modifiable factors such as child self-regulation, interparental relationships, and bullying that - if improved - have a high potential for improving mental health outcomes in preterm-born children.
期刊介绍:
The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including:
Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents.
Diagnosis: Research on the identification and classification of childhood disorders.
Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health.
Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders.
Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health.
Genetics: Genetic factors contributing to the development of childhood disorders.
JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health.
The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.