Melbourne School of Psychological Sciences - Theses
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ItemAdult psychiatric outcomes of very low birth weight survivors: exploring mechanisms of risk and vulnerability( 2010)This study sought to determine the rate and nature of mental health problems in adults born very low birth weight (VLBW) and to explore whether developmental risk factors contribute to the development of these problems. Childhood studies have identified relationships between birth weight and a variety of behavioural and psychiatric outcomes, including attention deficit hyperactivity disorder (ADHD), mood and anxiety disorders and other negative psychological outcomes. However, the evidence is less clear as to whether these problems persist into adulthood. Previous research has also explored the biological basis for system impairment in VLBW individuals, hypothesised to affect stress-response systems (such as hypothalamic-pituitary-adrenocortex-axis functioning), and whether social/environment risk ‘triggers’ are required before biological alteration associated with VLBW is observed. However, few studies have prospectively followed VLBW survivors from birth, through childhood and adolescence and into adulthood, and even fewer have attempted to explore the nature and effects of possible biological system impairment in this population, in terms of whether biological, social and environmental adversity increases VLBW risk of psychopathology in adulthood. The current study addressed the limitations of previous research by using a prospective, longitudinal study design. A cohort of 117 VLBW and 32 NBW participants were followed from birth, at age two, five, eight, fourteen and eighteen years, and most recently, aged between mid to late twenties. Screening measures were combined with semi-structured clinical interviews for full diagnostic adult psychiatric assessment. The findings suggested that VLBW adults were more likely to be diagnosed with a psychiatric disorder than NBW peers. VLBW participants born less than1000 g also tended to have higher scores on measures of psychopathology compared with VLBW participants born 1000–1500 g. Further, adult adverse life event stress was found to be related to psychiatric outcomes for VLBW participants. In conclusion, VLBW adults were at greater risk of psychopathology than NBW peers, with those VLBW adults with lower birth weights and high adult adverse life event stress most vulnerable to experiencing psychiatric disorder.