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Family Functioning and Mood and Anxiety Symptoms in Adolescents Born Extremely Preterm

Burnett, Alice C. PhD; Lee, Katherine J. PhD; Cheong, Jeanie L. Y. MD, FRACP; De Luca, Cinzia R. PhD; Roberts, Gehan MPH, PhD, FRACP; Wood, Stephen J. PhD; Doyle, Lex W. MD, FRACP; Anderson, Peter J. PhD

Journal of Developmental & Behavioral Pediatrics: January 2017 - Volume 38 - Issue 1 - p 39–48
doi: 10.1097/DBP.0000000000000368
Original Articles

Objective: To (1) compare adolescent- and parent-perceived family functioning between extremely preterm/extremely low birth weight (<28 wk/<1000 g, EP/ELBW) and normal birth weight (>2499 g, NBW) adolescents and (2) determine whether adolescents' or parents' ratings of family functioning were related to concurrent depression and anxiety symptoms in the adolescent and whether these relationships varied by birth group.

Methods: One hundred ninety-three EP/ELBW and 151 NBW adolescents (aged 15–20 yr) and their parents rated aspects of family functioning on the Family Environment Scale. Adolescents rated current depression and anxiety symptoms on the Center for Epidemiologic Studies Depression Scale-Revised and Beck Anxiety Inventory. Family functioning was compared across the groups using linear regression, and logistic regression was used to assess relationships between family functioning domains and elevated depression and anxiety scores.

Results: Compared with NBW controls, EP/ELBW adolescents reported similar levels of family Cohesiveness and Expressiveness, but less Conflict, and more Organization and Control. Parent ratings of family functioning were similar between groups except for higher Control scores in EP/ELBW group parents. Poorer family functioning as rated by adolescents, but not parents, was associated with increased depression/anxiety symptoms. These findings were generally consistent across both the EP/ELBW and control groups.

Conclusion: EP/ELBW adolescents report generally positive family functioning. While adolescents' perceptions of family functioning are associated with concurrent adolescent mental health, parental perceptions of family functioning may not be indicative of adolescents' mental health. Importantly, EP/ELBW adolescents do not appear to be more vulnerable to anxiety/depression in the context of poorly perceived family functioning than their NBW peers.

*Victorian Infant Brain Studies, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia;

Premature Infant Follow-up Programme, Newborn Research, Royal Women's Hospital, Melbourne, Australia;

Department of Paediatrics, University of Melbourne, Melbourne, Australia;

§Clinical Epidemiology and Biostatistics, Data Science, Murdoch Childrens Research Institute, Melbourne, Australia;

Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;

Psycho-Oncology Program, Royal Children's Hospital, Melbourne, Australia;

**Social and Mental Health Aspects of Serious Illness, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia;

††Clinical Services, Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia;

‡‡Population Health, Murdoch Childrens Research Institute, Melbourne, Australia;

§§School of Psychology, University of Birmingham, Birmingham, United Kingdom.

Address for reprints: Alice C. Burnett, PhD, Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, Victoria 3052, Australia; e-mail:

Supported by the National Health and Medical Research Council of Australia, through a Centre of Research Excellence Grant (ID 1060733), a Project Grant (ID 491246), and fellowship support (P.J.A.—ID 1081288; K.J.L.—ID 1053609; J.L.Y.C.—ID 1053787). The following were successful applicants for the Project Grant (ID 491246): L. W. Doyle, P. J. Anderson, S. J. Wood, Colin Robertson, Sarah Hope, Doug Hacking, and J. L. Y. Cheong. Support was also provided by the Victorian Government's Operational Infrastructure Support Program.

Disclosure: The authors declare no conflict of interest.

Received June , 2016

Accepted October , 2016

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