Differences in behavioral and emotional problems among children aged 1-4 years from two independent cohorts in Montevideo, Uruguay: the 2013 and 2018 ENDIS studies.

OBJECTIVE

To examine differences in behavioral and emotional problems among children aged 1-4 years using baseline data from two independent Uruguayan cohort studies (2013 and 2018), and to investigate whether differences were explained by socioeconomic, maternal, and child characteristics.

METHODS

Data from two independent Montevideo cohorts (2013: n=790; 2018: n=743) were analyzed. Behavioral and emotional problems were assessed through maternal report using the Child Behavior Checklist for Ages 1½-5 (CBCL 1½-5). Between-cohort differences were examined using ANCOVA with sequential adjustment for socioeconomic, maternal, and child characteristics.

RESULTS

The 2018 cohort showed higher CBCL scores for total problems (mean difference=1.87, Cohen's d=0.10, 95%CI:0.00-0.20, p=0.049) and internalizing problems (mean difference=1.01, d=0.17, 95%CI:0.07-0.27, p=0.001). Externalizing scores showed a non-significant trend (mean difference=0.57, d=0.07, 95%CI:-0.02-0.17, p=0.140). After adjustment, emotionally reactive, anxious/depressed, withdrawn, and aggressive behavior scores remained significantly higher in 2018. Differences were largest among low-income families (CBCL total: adjusted mean difference=5.94, p=0.001; internalizing=2.63, p<0.001), with virtually no difference in the highest income tercile.

CONCLUSIONS

Effect sizes were small overall, yet higher scores in the 2018 cohort were concentrated in lower-income families, suggesting socioeconomic patterning of behavioral and emotional problems across cohorts.