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Sustained social withdrawal behavior and ‘difficult’ temperament among infants, in relation to maternal affectivity in a low-income area of Kinshasa, Democratic Republic of Congo

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Abstract

Little is known about the relationship between maternal affectivity, social withdrawal and temperament in infants in low-income countries. The goal of the study was to assess the prevalence of social withdrawal behavior in infants aged 8 ± 2.3 months and to explore associations between maternal affectivity during pregnancy and postpartum, infant social withdrawal (as a sign of stress) and ‘difficult’ temperament as assessed by the mothers. 458 mother–infant dyads were recruited in the city’s public mother and child health-care centers. The eight items of the Alarm Distress Baby scale (8-ADBB) and the five-item M (modified) ADBB (M-ADBB) were used to assess sustained withdrawal behavior (ISSWB). The Goldberg Depression and Anxiety Scales were used to assess maternal affectivity and mental well-being. A specially designed questionnaire was used to identify stressful events faced by the mother during pregnancy. The ELDEQ-QCB was used to assess the degree of difficulty in managing the baby. Using the M-ADBB, we found a striking figure of 69.2% for ISSWB with 8-ABB (range 0–29) and 72.7% with the M-ADBB (range 0–10). ISSWB was linked to negative maternal affectivity and to high incidence of stressful events for the mothers, and to the child being viewed as ‘difficult’ by the mother. Positive prenatal affectivity was a protective factor of ISSWB (OR 0.46). Results are compared with previous studies in Africa. Early screening for ISSWB and identification of factors affecting maternal mental well-being could help in early intervention and increase the chances of better child development.

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Acknowledgements

We would like to thank to Professor Didier Journois, Paris University for valuable methodological and statistical advice. We would like to express our special appreciation and thanks to the following people from the management teams of the Medical Centers and Hospitals of Kinshasa, as they allowed and supported the conduct of this study along with providing the infrastructure and additional survey staff for the principal investigator. The same applies for the trained data collectors: Batumbula Mbilaseme, Kamanga Mbuyi Bijoux, Kilungu Meskia, Lokangu Ilonga, Mesongolo Guy, Ngoy Mutongole, Nkoso Bandula, Ntumba Tshala Monique and Yembe Mayemba James. We are also deeply grateful to all mothers who agreed to inclusion in this study along with their babies: their situation triggered the idea of conducting this study. We thank Professor Michael Boivin from Michigan State University, USA, for his valuable advice on producing quality scientific writing. Finally, we thank the management team of the « Fondation pour la promotion et la protection de la santé mentale de l’enfant

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Authors and Affiliations

  1. Unités de Neurologie Pédiatrique et de Neuropsychologie, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, B.P.825, Kinshasa, Democratic Republic of the Congo

    Daniel Okitundu-Luwa

  2. Service de Psychiatrie Femme et Enfants, Département de psychiatrie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo

    Brigitte Imbula Essam & Ally Ndjukendi Omba

  3. Unité de Neuropsychologie, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo

    Marie-Thérèse Sombo Ayanne

  4. Médecin Chargé de la Recherche et la Documentation Scientifique à la Fondation pour la Promotion et la Protection de la sante mentale de l’enfant «FOPPROSAME Asbl», Kinshasa, Democratic Republic of the Congo

    Franck Otete Djamba

  5. Service de Neurodiagnostic, Département de Neurologie, Centre Neuro Psycho Pathologique du Mont-Amba, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo

    Tharcisse Kayembe Kalula

  6. Département de Psychologie Clinique, Faculté de Psychologie et Sciences de l’Education Département et, Consultant au Département de Neurologie, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo

    Timothée Kamanga Mbuyi

  7. Service de Psychiatrie de l’enfant et de l’adolescent, Hôpital Bichat, APHP, Paris et Université de Paris, Paris, France

    Antoine Guedeney

  8. Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway

    Espérance Kashala-Abotnes

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  1. Daniel Okitundu-Luwa
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  2. Brigitte Imbula Essam
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  3. Marie-Thérèse Sombo Ayanne
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  4. Ally Ndjukendi Omba
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  5. Franck Otete Djamba
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  6. Tharcisse Kayembe Kalula
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  7. Timothée Kamanga Mbuyi
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  8. Antoine Guedeney
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  9. Espérance Kashala-Abotnes
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Contributions

O-LE-AD, I-EB, S-AM-T, N-OA, K-KT, and K-MT covered the study design; they furthermore contributed with data analysis and article drafting. AG contributed to the study design, the data interpretation and the manuscript. O-DF and K-AE contributed to data analysis and the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Daniel Okitundu-Luwa.

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The author declares that they have no conflict of interest.

Ethical considerations

Ethics approval was granted by the Theses and Dissertations Committee of the Faculty of Medicine, University of Kinshasa/Democratic Republic of Congo. Only children whose parents gave informed consent were included in the study.

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The original online version of this article was revised due to incorrect author name.

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Okitundu-Luwa, D., Imbula Essam, B., Sombo Ayanne, MT. et al. Sustained social withdrawal behavior and ‘difficult’ temperament among infants, in relation to maternal affectivity in a low-income area of Kinshasa, Democratic Republic of Congo. Eur Child Adolesc Psychiatry 32, 427–437 (2023). https://doi.org/10.1007/s00787-021-01873-9

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