Behavioral sequelae of perinatal insults and early family adversity at 8 years of age

Objective: This prospective longitudinal study investigated the simultaneou s impact of early biological and psychosocial risk factors on behavioral ou tcome at school age. Method: A cohort of 362 children born between 1986 and 1988 with different biological (perinatal insults) and psychosocial risk f actors (family adversity) was followed from birth to school age. When their children were aged 8 years, parents of 89.0% of the initial sample complet ed the Child Behavior Checklist (CBCL). Results: More externalizing as well as internalizing problems were found in children born into adverse family backgrounds, whereas no differences at broad-band syndrome level were appar ent between groups with varying obstetric complications. Children with fami ly risk factors had higher scores on 5 of the 8 CBCL scales (including atte ntion, delinquent, and aggressive problems), whereas children with perinata l risk factors had more social and attention problems than children in the nonrisk groups. With one exception, no interactions between risk factors em erged, indicating that perinatal and family risk factors contributed indepe ndently to outcome. The differences between risk groups applied irrespectiv e of gender. Conclusions: The adverse impact of family adversity clearly ou tweighed the influence of obstetric complications in determining behavioral adjustment at school age.