Page 72 - Sample Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood

Chapter 7
complications at birth. This hypothesis is supported by evidence showing that early experiences of stressful events, such as being bullied or the loss of a family member, have a greater impact on the mental health of girls than of boys throughout childhood, adolescence, and adulthood.52, 53
Furthermore, cognitive perception of life adversities differs by gender. In boys and girls, cognitive errors, for example, overgeneralization and catastrophizing, influence emotion and behaviour in a different way. In boys, cognitive errors mediate the association between life adversity and hyperactivity while in girls they mediate the association between life adversity and peer and emotional problems.54 It is unclear, however, to what extent such mechanisms have an impact at pre- school age, considering the early stage of cognitive development.
Poor emotional functioning and the risk of coronary heart disease
Throughout life, indicators of poor emotional health have been associated with an increased risk of CHD and its metabolic precursors, including early life adversities,55 chronic psychological stress,56 mood disorders, and social isolation.57, 58 In Chapter 6, we provide evidence that the emotion regulation capacities of young people are not only associated with affective disorders, but also with CHD. This association was largely mediated through heavy smoking, poor cardiovascular fitness, and lower educational attainment in adulthood. Similarly, in prior research, lifestyle- associated factors were found to mediate the association between depression and CHD.59 Because of this link with lifestyle, improvement of emotion regulation skills may provide possibilities for the prevention of CHD, even in children. For example, 13-year-old teenagers with poor emotion regulation skills were more likely to consume junk food and to have sedentary lifestyles than peers with fair or good emotion regulation skills.60
In men with a parental history of CHD, we found an association between poor emotion regulation and CHD beyond effects of lifestyle and education. This was an unexpected finding, which generated some thoughts regarding possible explanations. First, the association could partly be explained by the impact of parental mortality due to CHD. Conscript data were linked to data on CHD mortality of the conscripts’ parents, i.e. parental mortality before the age of 60 years. This meant that the conscripts were relatively young when one of their parents died. Therefore, the impact of early parental death may have caused mental and physical dysregulation that could eventually predispose to CHD. However, additional analyses for all-cause mortality, not due to CHD, did not explain the
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