The Association between Stressful Life Events and Emotional and Behavioral Problems in Children 0–7 Years Old: The CIKEO Study

Yuan Fang, Hein Raat*, Dafna A. Windhorst, Irene N. Fierloos, Harrie Jonkman, Clemens M.H. Hosman, Matty R. Crone, Wilma Jansen, Amy van Grieken

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Stressful life events (SLEs) are recognized risk factors for emotional and behavioral problems, but the association is understudied among young children. Our aim was to examine the association between exposure to SLEs and emotional and behavioral problems in young children up to 7 years old. Methods: We analyzed baseline data from 959 children (mean age = 3.3 years; SD = 1.9; 47.5% girls) in the CIKEO study, a community-based longitudinal study in the Netherlands. Linear regression was used to assess the associations between the total as well as the individual exposure to SLEs experienced in the past 12 months, and emotional and behavioral problems assessed by CBCL 1.5-5. Interactions of SLEs and child age, sex, ethnic background, and socioeconomic status were explored. Results: Higher total exposure to SLEs, as indicated by the number of SLEs, was significantly associated with higher CBCL total, internalizing and externalizing problem scores (p for trend < 0.05). The results did not differ by child age, sex, ethnic background, or family SES. Six out of the 12 SLEs explored were independently associated with greater CBCL total/externalizing/internalizing scores (p < 0.05). Conclusions: Exposure to SLEs is associated with higher levels of emotional and behavioral problems in young children, and the impact of SLEs may vary depending on the types of events. Stressful life events might be a useful target for interventions to improve emotional and behavioral well-being among young children.

Original languageEnglish
Article number1650
JournalInternational Journal of Environmental Research and Public Health
Issue number3
Publication statusPublished - 31 Jan 2022

Bibliographical note

Funding Information:
Funding: The CIKEO study was funded by the Netherlands Organization for Health Research and Development (ZonMw, Grant Number:729300015). Yuan Fang received support from the China Scholarship Council (CSC) PhD Fellowship for her PhD study in Erasmus MC, Rotterdam, the Netherlands (Fellowship: 201806100213). ZonMw and CSC have no role in any part of the research, writing and reviewing of the manuscript. The authors declare no conflicts of interest.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (


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