AN ITALIAN LONGITUDINAL STUDY OF INFANTILE MALNUTRITION FROM INFANCY TO PRE-PUBERTY

The long-term outcome of infantile malnutrition is still poorly understood. We aimed to expand longitudinal research by exploring the interplay among the child characteristics (affect regulation, eating self-regulation), maternal attachment and psychopathology. 278 children were diagnosed at two years with malnutrition and “apparent lack of interest in eating or food” (based on: DC:03R, DC:0-5, ARFID/DSM-5). At the Diagnostic Assessment, children’s emotional functioning, maternal attachments and psychopathology were also evaluated. 113 children (58 boys, 55 girls) and their mothers of the original sample, who received limited psychosocial treatment, were followed-up at five, seven, and eleven years; children’s growth and level of malnutrition, mothers’ psychopathological symptoms and eating attitudes, as well as their children’s emotional functioning were evaluated over time. At the Diagnostic Assessment, children exhibited different degrees of acute and/or chronic malnutrition; their mothers showed anxiety, depression and dysfunctional eating attitudes; insecure and unresolved maternal attachments with respect to Loss/Trauma were found a significant predictor of the severity of children’s malnutrition. Longitudinal trends showed an improvement in the severity of malnutrition, but 73% of children still had ongoing mild to moderate to severe malnutrition at 11 years. The children showed increasing emotional problems, and their mothers’ psychopathological and eating symptoms worsened as well. At 11 years of age, the girls’ emotional problems and their mothers’ psychopathology and disturbed eating attitudes were more severe than that of the boys and their mothers. At the last follow-up, a significant effect of the mothers’ psychopathology, as well as the severity of the children’s malnutrition on their emotional problems emerged. This study points out that the course of children, who received limited psychosocial treatment, is characterized by an enduring risk of malnutrition and increasing psychopathological risk factors in both, the children and their mothers, up to the sensitive period of pre-puberty