Child Risk Factors: Impact on Early Childhood Mental Health

This chapter focuses on child factors that play a role in adaptation and maladaptation, specifically child temperament and attachment security. First, there is a review of the evidence showing that both the reactive, negative affect (NA) and regulatory components, effortful control (EC), of temperament, are risk factors for externalizing and internalizing disorders and have direct and indirect effects on both types of disorder. The indirect effects also reveal that NA and EC serve as mechanisms whereby factors from other domains (e.g., parenting) lead to child outcomes. This is followed by a review of the role of another aspect of temperament, sensory regulation (SR), as a risk factor. SR has been neglected in developmental psychopathology research, but there is some evidence that it is related to both types of disorders. Finally, there is a review of the role of attachment security as a risk factor. Previous research indicates that attachment security also has both direct and indirect effects, mediated by child EC, on psychopathology in young children. Finally, there is a description of the limitations of previous research and how the PACT study was designed to overcome some of these limitations.