2026 ECNP Congress

PS04-4150

Linking early regulatory problems, cortical development and late-adolescent mental health

Matic Kadiš — S. Defina, R. Muetzel, S. Mulej Bratec · University of Maribor- Faculty of Arts, Department of Psychology, Maribor, Slovenia

2026 ECNP Congress

Introduction and Aims: Early regulatory problems (RPs), such as excessive crying beyond 3 months of age, or sleeping and feeding difficulties beyond 6 months, indicate early disruptions in developing capacity for self-regulation. These challenges elevate the risk for long-term behavioral issues by initiating a developmental cascade of dysregulation [1, 2]. While functional brain network alterations associated with RPs have been documented within socio-affective systems [3], longitudinal structural developmental correlates remain largely unexplored, as prior work has focused on single difficulties, such as crying or sleeping, and relied exclusively on cross-sectional assessments at specific ages [4, 5]. This study aimed to examine whether early RPs are associated with altered trajectories of cortical development, specifically cortical thickness, surface area, and gray-white matter contrast, and whether these trajectories mediate subsequent mental health outcomes in late adolescence.

Methods

We used prospective longitudinal data from the population-based Generation R birth cohort. Parent-reported RPs assessed at 6, 12, 18, and 36 months categorized participants into four groups: never, multiple, persistent, or multiple and persistent RPs. Structural MRI scans collected at ages 10, 14, and 18 years were processed to extract vertex-wise measures. Data were analyzed using linear mixed-effects models to identify main effects of RP group and group-by-age interactions, adjusting for key sociodemographic and clinical covariates. Mental health outcomes at age 18, including attention and externalizing problems, were evaluated using the Child Behavior Checklist. Regression-based mediation analyses tested whether observed developmental slopes of significant cortical clusters linked RPs to later psychosocial functioning.

Results

Early RPs were associated with distinct structural differences. Main effects were localized to the left hemisphere: multiple RPs were linked to lower surface area in a fusiform gyrus cluster, while multiple and persistent RPs were associated with lower cortical thickness in a caudal middle frontal cortex cluster. Significant group-by-age interactions revealed diverging developmental patterns of surface area in the right hemisphere: persistent RPs showed a steeper increase in a temporoparietal junction cluster, and multiple and persistent RPs exhibited a steeper linear increase within a precuneus cluster. Mediation analyses showed that the observed linear slope of cortical change within this right precuneus cluster (b = 0.03, SE = 0.01, p < .001) significantly mediated the relationship between multiple and persistent RPs and attention problems at age 18 (indirect effect = 0.35, 95% CI [0.00, 0.90]), indicating full mediation. No significant mediation was observed for other mental health outcomes.

Conclusions

Early RPs represent a vulnerability that initiates a cascade resulting in diverging patterns of structural cortical development. These localized structural differences point to specific vulnerabilities in early allostasis management and co regulation. In particular, the steeper developmental slope of the right precuneus cluster may represent a neurodevelopmental adaptation to early co regulatory instability that ultimately increases vulnerability to late adolescent attention problems. This prolonged maturation may act as a compensatory process that interferes with the capacity to balance internal and external focus, making it harder to filter distractions and sustain attention.

References

  1. Hemmi, M. H., Wolke, D., & Schneider, S. (2011). Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioural outcomes in childhood: A meta-analysis. Archives of Disease in Childhood, 96(7), 622–629. https://doi.org/10.1136/adc.2010.191312
  2. Winsper, C., Bilgin, A., & Wolke, D. (2020). Associations between infant and toddler regulatory problems, childhood co-developing internalising and externalising trajectories, and adolescent depression, psychotic and borderline personality disorder symptoms. Journal of Child Psychology and Psychiatry and Allied Disciplines, 61(2), 182–194. https://doi.org/10.1111/jcpp.13125
  3. Bäuml, J. G., Baumann, N., Avram, M., Mulej Bratec, S., Breeman, L., Berndt, M., Bilgin, A., Jaekel, J., Wolke, D., & Sorg, C. (2019). The Default Mode Network mediates the impact of infant regulatory problems on adult avoidant personality traits. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 4(4), 333–342. https://doi.org/10.1016/j.bpsc.2018.11.005
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