Skip to main content Accessibility help
Hostname: page-component-564cf476b6-wkm24 Total loading time: 0.257 Render date: 2021-06-23T00:33:21.212Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

Small for gestational age and poor fluid intelligence in childhood predict externalizing behaviors among young adults born at extremely low birth weight

Published online by Cambridge University Press:  14 July 2014

Ayelet Lahat
McMaster University
Ryan J. Van Lieshout
McMaster University
Saroj Saigal
McMaster University
Michael H. Boyle
McMaster University
Louis A. Schmidt
McMaster University
E-mail address:


Although infants born at extremely low birth weight (ELBW; birth weight < 1000 g) are at increased risk for developing later psychopathology, the mechanisms contributing to this association are largely unknown. In the present study, we examined a putative cognitive link to psychopathology in a cohort of ELBW survivors. These individuals were followed up prospectively at age 8 and again at ages 22–26. At 8 years, participants completed measures of fluid and general intelligence. As young adults, a subset of ELBW survivors free of major neurosensory impairments provided self-reports of personality characteristics related to psychopathology. Data from 66 participants indicated that, as predicted, the association between ELBW and externalizing behaviors was moderated by fluid intelligence. Specifically, ELBW individuals with poor fluid intelligence who were born small for gestational age (birth weight < 10th percentile for gestational age) showed the highest level of externalizing behaviors. These findings provide support for a cumulative risk model and suggest that fluid intelligence might be a cognitive mechanism contributing to the development of psychopathology among nonimpaired individuals who were born at ELBW and small for gestational age.

Special Section Articles
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below.


Aarnoudse-Moens, C. S. H., Weisglas-Kuperus, N., van Goudoever, J. B., & Oosterlaan, J. (2009). Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics, 124, 717728.CrossRefGoogle ScholarPubMed
Aiken, L. S., & West, G. M. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
Allin, M., Rooney, M., Cuddy, M., Wyatt, J., Walshe, M., Rifkin, L., et al. (2006). Personality in young adults who are born preterm. Pediatrics, 117, 309316.CrossRefGoogle ScholarPubMed
Anderson, P. J., & Doyle, L. W. (2004). Executive functioning in school-aged children who were born very preterm or with extremely low birth weight in the 1990s. Pediatrics, 114, 5057.CrossRefGoogle ScholarPubMed
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 6594.CrossRefGoogle ScholarPubMed
Baron, I. S., Kerns, K. A., Muller, U., Ahronovich, M. D., & Litman, F. R. (2012). Executive functions in extremely low birth weight and late-preterm preschoolers: Effects on working memory and response inhibition. Child Neuropsychology, 18, 586599.CrossRefGoogle ScholarPubMed
Belsky, J., & Pleuss, M. (2009). Beyond diathesis stress: Differential susceptibility to environmental influences. Psychological Bulletin, 135, 885908.CrossRefGoogle ScholarPubMed
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M., & Anand, K. S. (2002). Cognitive and behavioral outcomes of school-aged children who were born preterm: A meta-analysis. Journal of the American Medical Association, 288, 728737.CrossRefGoogle ScholarPubMed
Birney, D. P., Bowman, D. B., & Pallier, G. (2006). Prior to paradigm integration, the task is to resolve construct definitions of gF and WM. Behavioral and Brain Sciences, 29, 127129.CrossRefGoogle Scholar
Blair, C. (2006). How similar are fluid cognition and general intelligence? A developmental neuroscience perspective on fluid cognition as an aspect of human cognitive ability. Behavioral and Brain Sciences, 29, 109124.Google ScholarPubMed
Böhm, B., Smedler, A. C., & Forssberg, H. (2007). Impulse control, working memory and other executive functions in preterm children when starting school. Acta Paediatrica, 93, 13631371.CrossRefGoogle Scholar
Boyle, M. H., Miskovic, V., Van Lieshout, R. J., Duncan, L., Schmidt, L. A., Hoult, L., et al. (2011). Psychopathology in young adults born at extremely low birth weight. Psychological Medicine, 41, 17631774.CrossRefGoogle ScholarPubMed
Burchinal, M. R., Roberts, J. E., Zeisel, S. A., Hennon, E. A., & Hooper, S. (2006). Social risk and protective child, parenting, and child care factors in early elementary school years. Parenting: Science and Practice, 6, 79113.CrossRefGoogle Scholar
Burchinal, M. R., Roberts, J. E., Zeisel, S. A., & Rowley, S. J. (2008). Social risk and protective factors for African American children's academic achievement and adjustment during the transition to middle school. Developmental Psychology, 44, 286.CrossRefGoogle ScholarPubMed
Burgess, G. C., Braver, T. S., & Gray, J. R. (2006). Exactly how are fluid intelligence, working memory, and executive function related? Cognitive neuroscience approaches to investigating the mechanisms of fluid cognition. Behavioral and Brain Sciences, 29, 128129.CrossRefGoogle Scholar
Carlson, J. S., & Jensen, C. M. (1981). Reliability of the Raven Colored Progressive Matrices Test: Age and ethnic group comparisons. Journal of Consulting and Clinical Psychology, 49, 320.CrossRefGoogle Scholar
Cicchetti, D., & Rogosch, F. A. (1996). Equifinality and multifinality in developmental psychopathology. Development and Psychopathology, 8, 597600.CrossRefGoogle Scholar
Conwell, L. S., O'Callaghan, M. J., Andersen, M. J., Bor, W., Najman, J. M., & Williams, G. M. (2003). Early adolescent smoking and a web of personal and social disadvantage. Journal of Paediatrics and Child Health, 39, 580585.CrossRefGoogle Scholar
Edgin, J. O., Inder, T. E., Anderson, P. J., Hood, K. M., Clark, C. A., & Woodward, L. J. (2008). Executive functioning in preschool children born very preterm: Relationship with early white matter pathology. Journal of the International Neuropsychological Society, 14, 90101.CrossRefGoogle ScholarPubMed
Ellis, B. J., Boyce, W. T., Belsky, J., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2011). Differential susceptibility to the environment: An evolutionary neurodevelopmental theory. Development and Psychopathology, 23, 728.CrossRefGoogle ScholarPubMed
Embretson, S. E. (1995). The role of working memory capacity and general control processes in intelligence. Intelligence, 20, 169189.CrossRefGoogle Scholar
Engle, R. W., Tuholski, S. W., Laughlin, J. E., & Conway, A. R. A. (1999). Working memory, short-term memory, and general fluid intelligence: A latent-variable approach. Journal of Experimental Psychology: General, 128, 309331.CrossRefGoogle ScholarPubMed
Engle, W. A., Tomashek, K. M., & Wallman, C. (2007). “Late-preterm” infants: A population at risk. Pediatrics, 120, 13901401.CrossRefGoogle ScholarPubMed
Eysenck, S. B. G., Eysenck, H. J., & Barrett, P. (1985). A revised version of the psychoticism scale. Personality and Individual Differences, 6, 2129.CrossRefGoogle Scholar
Foulder-Hughes, L. A., & Cooke, R. W. (2003). Motor, cognitive, and behavioural disorders in children born very preterm. Developmental Medicine & Child Neurology, 45, 97103.CrossRefGoogle ScholarPubMed
Garlick, D., & Sejnowski, T. J. (2006). There is more to fluid intelligence than working memory capacity and executive function. Behavioral and Brain Sciences, 29, 134135.CrossRefGoogle Scholar
Heinonen, K., Raikkonen, K., Pesonen, A.-K., Andersson, S., Kajantie, E., Eriksson, J., et al. (2010). Behavioural symptoms of attention deficit/hyperactivity disorder in preterm and term children born small and appropriate for gestational age: A longitudinal study. BMC Pediatrics, 10, 91.CrossRefGoogle ScholarPubMed
Heitz, R. P., Redick, T. S., Hambrick, D. Z., Kane, M. J., Conway, A. R. A., & Engle, R. W. (2006). Working memory, executive function, and general fluid intelligence are not the same. Behavioral and Brain Sciences, 29, 135136.CrossRefGoogle Scholar
Huepe, D., Roca, M., Salas, N., Canales-Johnson, A., Rivera-Rei, A. A., Zamorano, L., et al. (2011). Fluid Intelligence and psychosocial outcome: From logical problem solving to social adaptation. PLOS ONE, 6, e24858.CrossRefGoogle ScholarPubMed
Johnson, S., & Marlow, N. (2011). Preterm birth and childhood psychiatric disorders. Pediatric Research, 69, 11R18R.CrossRefGoogle ScholarPubMed
Kane, M. J., & Engle, R. W. (2002). The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: An individual-differences perspective. Psychonomic Bulletin & Review, 9, 637671.CrossRefGoogle Scholar
Krain, A. L., & Castellanos, F. X. (2006). Brain development and ADHD. Clinical Psychology Review, 26, 433444.CrossRefGoogle ScholarPubMed
Kramer, M. S., Platt, R. W., Wen, S. W., Joseph, K. S., Allen, A., Abrahamowicz, M., et al. (2001). A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics, 108, E35.CrossRefGoogle ScholarPubMed
Lahat, A., Degnan, K. A., White, L. K., McDermott, J. M., Henderson, H. A., Lejuez, C., et al. (2012). Temperamental exuberance and executive function predict propensity for risk taking in childhood. Development and Psychopathology, 24, 847856.CrossRefGoogle ScholarPubMed
Levy-Shiff, R., Einat, G., Har-Even, D., Mogilner, M., Mogilner, S., Lerman, M., et al. (1994). Emotional and behavioral adjustment in children born prematurely. Journal of Clinical Child Psychology, 23, 323333.CrossRefGoogle Scholar
Luu, T. M., Ment, L., Allan, W., Schneider, K., & Vohr, B. R. (2011). Executive and memory function in adolescents born very preterm. Pediatrics, 127, e639e646.CrossRefGoogle ScholarPubMed
Martinussen, M., Fischl, B., Larsson, H. B., Skranes, J., Kulseng, S., Vangberg, T. R., et al. (2005). Cerebral cortex thickness in 15-year-old adolescents with low birth weight measured by an automated MRI-based method. Brain, 128(Pt 11), 25882596.CrossRefGoogle ScholarPubMed
McDermott, J. M., Perez-Edgar, K., Henderson, H. A., Chronis-Tuscano, A., Pine, D. S., & Fox, N. A. (2009). A history of childhood behavioral inhibition and enhanced response monitoring in adolescence are linked to clinical anxiety. Biological Psychiatry, 65, 445448.CrossRefGoogle ScholarPubMed
Nigg, J., Quamma, J., Greenberg, M., & Kusche, C. (1999). A two-year longitudinal study of neuropsychological and cognitive performance in relation to behavioral problems and competencies in elementary school children. Journal of Abnormal Child Psychology, 27, 5163.CrossRefGoogle ScholarPubMed
O'Keeffe, M. J., O'Callaghan, M., Williams, G. M., Najman, J. M., & Bor, W. (2003). Learning, cognitive, and attentional problems in adolescents born small for gestational age. Pediatrics, 112, 301307.CrossRefGoogle ScholarPubMed
Olson, S. L., Sameroff, A. J., Kerr, D. C., Lopez, N. L., & Wellman, H. M. (2005). Developmental foundations of externalizing problems in young children: The role of effortful control. Development and Psychopathology, 17, 2545.CrossRefGoogle ScholarPubMed
Paz, I., Gale, R., Laor, A., Danon, Y. L., Stevenson, D. K., & Seidman, D. S. (1995). The cognitive outcome of full-term small for gestational age infants at late adolescence. Obstetrics & Gynecology, 85, 452456.Google ScholarPubMed
Peterson, B. S., Anderson, A. W., Ehrenkranz, R., Staib, L. H., Tageldin, M., Colson, E., et al. (2003). Regional brain volumes and their later neurodevelopmental correlates in term and preterm infants. Pediatrics, 111, 939948.CrossRefGoogle ScholarPubMed
Peterson, B. S., Vohr, B., Staib, L. H., Cannistraci, C. J., Dolberg, A., Schneider, K. C., et al. (2000). Regional brain volume abnormalities and long-term cognitive outcome in preterm infants. Journal of the American Medical Association, 284, 19391947.CrossRefGoogle ScholarPubMed
Raikkonen, K., Pesonen, A.-K., Heinonen, K., Kajantie, E., Hovi, P., Jarvenpaa, A.-L., et al. (2008). Depression in young adults with very low birth weight: The Helsinki study of very low-birth-weight adults. Archives of General Psychiatry, 65, 290.CrossRefGoogle ScholarPubMed
Raven, J. (1983). Guide to using the coloured progressive matrices: Revised. London: HK Lewis.Google Scholar
Rickards, A. L., Kelly, E. A., Doyle, L. W., & Callanan, C. (2001). Cognition, academic progress, behavior and self-concept at 14 years of very low birth weight children. Journal of Developmental & Behavioral Pediatrics, 22, 1118.CrossRefGoogle ScholarPubMed
Saigal, S., Feeny, D., Rosenbaum, P., Furlong, W., Burrows, E., & Stoskopf, B. (1996). Self-perceived health status and health-related quality of life of extremely low-birth-weight infants at adolescence. Journal of the American Medical Association, 276, 453459.CrossRefGoogle ScholarPubMed
Saigal, S., Hoult, L. A., Streiner, D. L., Stoskopf, B. L., & Rosenbaum, P. L. (2000). School difficulties at adolescence in a regional cohort of children who were extremely low birth weight. Pediatrics, 105, 325331.CrossRefGoogle Scholar
Saigal, S., Rosenbaum, P. L., Szatmari, P., & Campbell, D. (1991). Learning disabilities and school problems in a regional cohort of extremely low birth weight (<1000 g) children: A comparison with term controls. Journal of Developmental and Behavioral Pediatrics, 12, 294300.Google Scholar
Saigal, S., Szatmari, P., Rosenbaum, P., Campbell, D., & King, S. (1990). Intellectual and functional status at school entry of children who weighed 1000 grams or less at birth: A regional perspective of births in the 1980s. Journal of Pediatrics, 116, 409416.CrossRefGoogle ScholarPubMed
Santesso, D. L., Segalowitz, S. J., & Schmidt, L. A. (2005). ERP correlates of error monitoring in 10-year olds are related to socialization. Biological Psychology, 70, 7987.CrossRefGoogle ScholarPubMed
Schmidt, L. A., Miskovic, V., Boyle, M. H., & Saigal, S. (2008). Shyness and timidity in young adults who were born at extremely low birth weight. Pediatrics, 122, e181e187.CrossRefGoogle ScholarPubMed
Schmidt, L. A., Miskovic, V., Boyle, M. H., & Saigal, S. (2010). Frontal electroencephalogram asymmetry, salivary cortisol, and internalizing behavior problems in young adults who were born at extremely low birth weight. Child Development, 81, 183199.CrossRefGoogle ScholarPubMed
Séguin, J. R., & Zelazo, P. D. (2005). Executive function in early physical aggression. In Tremblay, R. E., Hartup, W. W., & Archer, J. (Eds.), Developmental origins of aggression (pp. 307329). New York: Guilford Press.Google Scholar
Strang-Karlsson, S., Räikkönen, K., Pesonen, A.-K., Kajantie, E., Paavonen, E., Lahti, J., et al. (2008). Very low birth weight and behavioral symptoms of attention deficit hyperactivity disorder in young adulthood: The Helsinki study of very-low-birth-weight adults. American Journal of Psychiatry, 165, 13451353.CrossRefGoogle ScholarPubMed
Szatmari, P., Saigal, S., Rosenbaum, P., & Campbell, D. (1993). Psychopathology and adaptive functioning among extremely low birthweight children at eight years of age. Development and Psychopathology, 5, 345357.CrossRefGoogle Scholar
Szatmari, P., Saigal, S., Rosenbaum, P., Campbell, D., & King, S. (1990). Psychiatric disorders at five years among children with birthweights < 1000 g: A regional perspective. Developmental Medicine & Child Neurology, 32, 954962.CrossRefGoogle Scholar
Taylor, H. G., Klein, N., Minich, N., & Hack, M. (2000). Middle school-age outcomes in children with very low birth-weight. Child Development, 71, 14951511.CrossRefGoogle Scholar
Tolsa, C. B., Zimine, S., Warfield, S. K., Freschi, M., Sancho Rossignol, A., Lazeyras, F., et al. (2004). Early alteration of structural and functional brain development in premature infants born with intrauterine growth restriction. Pediatric Research, 56, 132138.CrossRefGoogle ScholarPubMed
van Baar, A. L., Vermaas, J., Knots, E., de Kleine, M. J. K., & Soons, P. (2009). Functioning at school age of moderately preterm children born at 32 to 36 weeks' gestational age. Pediatrics, 124, 251257.CrossRefGoogle ScholarPubMed
Waxman, J., Van Lieshout, R. J., Saigal, S., Boyle, M. H., & Schmidt, L. A. (2013). Still cautious: Personality characteristics of extremely low birth weight adults in their early 30s. Personality and Individual Differences, 55, 967971.CrossRefGoogle Scholar
Wechsler, D. (1974). Wechsler Intelligence Scale for Children—Revised. New York: Psychological Corp.Google Scholar
Weinberg, A., Olvet, D. M., & Hajcak, G. (2010). Increased error-related brain activity in generalized anxiety disorder. Biological Psychology, 85, 472480.CrossRefGoogle ScholarPubMed
White, L. K., McDermott, J. M., Degnan, K. A., Henderson, H. A., & Fox, N. A. (2011). Behavioral inhibition and anxiety: The moderating roles of inhibitory control and attention shifting. Journal of Abnormal Child Psychology, 39, 735747.CrossRefGoogle ScholarPubMed
Zelazo, P. D., Carlson, S. M., & Kesek, A. (2008). Development of executive function in childhood. In Nelson, C. A. & Luciana, M. (Eds.), Handbook of developmental cognitive neuroscience (2nd ed., pp. 553574). Cambridge, MA: MIT Press.Google Scholar
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Small for gestational age and poor fluid intelligence in childhood predict externalizing behaviors among young adults born at extremely low birth weight
Available formats

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Small for gestational age and poor fluid intelligence in childhood predict externalizing behaviors among young adults born at extremely low birth weight
Available formats

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Small for gestational age and poor fluid intelligence in childhood predict externalizing behaviors among young adults born at extremely low birth weight
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *