The role of child adrenocortical functioning in pathways between interparental conflict and child maladjustment

Children's cognitive performance and selective attention following recent community violence

Research has shown robust relationships between community violence and psychopathology, yet relatively little is known about the ways in which community violence may affect cognitive performance and attention. The present study estimates the effects of police-reported community violence on 359 urban children's performance on a computerized neuropsychological task using a quasi-experimental fixed-effects design. Living in close proximity to a recent violent crime predicted faster but marginally less accurate task performance for the full sample, evolutionarily adaptive patterns of "vigilant" attention (i.e., less attention toward positive stimuli, more attention toward negative stimuli) for children reporting low trait anxiety, and potentially maladaptive patterns of "avoidant" attention for highly anxious children. These results suggest that community violence can directly affect children's cognitive performance while also having different (and potentially orthogonal) impacts on attention deployment depending on children's levels of biobehavioral risk. Implications for mental health and sociological research are discussed.

Resilience as Regulation of Developmental and Family Processes

Resilience can be defined as establishing equilibrium subsequent to disturbances to a system caused by significant adversity. When families experience adversity or transitions, multiple regulatory processes may be involved in establishing equilibrium, including adaptability, regulation of negative affect, and effective problem-solving skills. The authors' resilience-as-regulation perspective integrates insights about the regulation of individual development with processes that regulate family systems. This middle-range theory of family resilience focuses on regulatory processes across levels that are involved in adaptation: whole-family systems such as routines and sense of coherence; coregulation of dyads involving emotion regulation, structuring, and reciprocal influences between social partners; and individual self-regulation. Insights about resilience-as-regulation are then applied to family-strengthening interventions that are designed to promote adaptation to adversity. Unresolved issues are discussed in relation to resilience-as-regulation in families, in particular how risk exposure is assessed, interrelations among family regulatory mechanisms, and how families scaffold the development of children's resilience.

Cortisol reactivity to social stress as a mediator of early adversity on risk and adaptive outcomes

Children chronically exposed to stress early in life are at increased risk for maladaptive outcomes, though the physiological mechanisms driving these effects are unknown. Cortisol reactivity was tested as a mediator of the relation between prenatal substance exposure and/or early adversity on adaptive and maladaptive outcomes. Data were drawn from a prospective longitudinal study of prenatal substance exposure (N = 860). Cortisol reactivity was assessed at age 11. Among African Americans, prenatal substance exposure exerted an indirect effect through early adversity and cortisol reactivity to predict externalizing behavior, delinquency, and a positive student-teacher relationship at age 11. Decreased cortisol reactivity was related to maladaptive outcomes, and increased cortisol reactivity predicted better executive functioning and a more positive student-teacher relationship.

A typology of interpartner conflict and maternal parenting practices in high-risk families: Examining spillover and compensatory models and implications for child adjustment

The present study incorporates a person-based approach to identify spillover and compartmentalization patterns of interpartner conflict and maternal parenting practices in an ethnically diverse sample of 192 2-year-old children and their mothers who had experienced higher levels of socioeconomic risk. In addition, we tested whether sociocontextual variables were differentially predictive of theses profiles and examined how interpartner-parenting profiles were associated with children's physiological and psychological adjustment over time. As expected, latent class analyses extracted three primary profiles of functioning: adequate functioning, spillover, and compartmentalizing families. Furthermore, interpartner-parenting profiles were differentially associated with both sociocontextual predictors and children's adjustment trajectories. The findings highlight the developmental utility of incorporating person-based approaches to models of interpartner conflict and maternal parenting practices.

Family systems and ecological perspectives on the impact of deployment on military families

The scope of sustained military operations in Iraq and Afghanistan has placed great demands on the Armed Forces of the United States, and accordingly, military families have been faced with deployments in more rapid succession than ever before. When military parents fulfill occupational duties during wartime, military children and families face multiple challenges, including extended separations, disruptions in family routines, and potentially compromised parenting related to traumatic exposure and subsequent mental health problems. Such challenges can begin to exert a significant toll on the well-being of both individuals and relationships (e.g., marital, parent-child) within military families. In order to respond more effectively to the needs of military families, it is essential that mental health clinicians and researchers have a better understanding of the challenges faced by military families throughout the entire deployment experience and the ways in which these challenges may have a cumulative impact over multiple deployments. Moreover, the mental health field must become better prepared to support service members and families across a rapidly evolving landscape of military operations around the world, including those who are making the transition from active duty to Veteran status and navigating a return to civilian life and those families in which parents will continue to actively serve and deploy in combat zones. In this article, we utilize family systems and ecological perspectives to advance our understanding of how military families negotiate repeated deployment experiences and how such experiences impact the well-being and adjustment of families at the individual, dyadic, and whole family level.

Stress system development from age 4.5 to 6: family environment predictors and adjustment implications of HPA activity stability versus change

This study addressed early calibration of stress systems by testing links between adversity exposures, developmental stability of hypothalamic-pituitary-adrenal (HPA) axis activity, and behavior problems in a sample of adopted children. Families (n=200) were assessed when the child was 9, 18, and 27 months, 4.5 and 6 years to collect adversity information-parent psychopathology, stress, financial need, and home chaos. Morning and evening cortisol samples at the final two assessments indexed child HPA activity, and parent-reported internalizing and externalizing at the final assessment represented child behavior outcomes. Increases in cumulative adversity from 4.5 to 6 related to higher child morning cortisol, whereas age six cumulative adversities related to lower, unstable child evening cortisol. Examination of specific adversity dimensions revealed associations between (1) increasing home chaos and stable morning cortisol, which in turn related to internalizing problems; and (2) high parental stress and psychopathology and lower, unstable evening cortisol, which in turn related to externalizing problems.

Interventions to improve cortisol regulation in children: a systematic review

Childhood adversity is associated with physiologic dysregulation across multiple biological systems; however, relatively little is known about whether these changes are reversible with intervention. The objective of this review was to examine evidence for the effectiveness of interventions to promote healthy cortisol regulation in children. We selected articles from English-language publications in PubMed and EBSCO databases through 2012. Two independent reviewers assessed articles against eligibility criteria. Eligible studies were randomized controlled or quasi-experimental studies designed to improve relationships, environments, or psychosocial functioning in children and examined cortisol as an outcome. We identified 19 articles. There was substantial heterogeneity across studies with regard to age, selection criteria, intervention design, cortisol assessment, and follow-up duration. Eighteen of the 19 articles reported at least 1 difference in baseline cortisol, diurnal cortisol, or cortisol responsivity between intervention and control participants. Importantly, however, there was remarkable inconsistency with regard to how the interventions influenced cortisol. Therefore, studies that included a low-risk comparison group (n = 8) provided critical insight, and each found some evidence that postintervention cortisol levels in the intervention group approximated the low-risk comparison group and differed from children receiving usual care. In conclusion, existing studies show that cortisol activity can be altered by psychosocial interventions. These findings are promising, not only because they indicate physiologic plasticity that can be leveraged by interventions but also because they suggest it may be possible to repair regulatory systems after childhood adversity, which could inform strategies for reducing health disparities and promoting lasting improvements in health.

Asymmetry in children's salivary cortisol and alpha-amylase in the context of marital conflict: links to children's emotional security and adjustment

Recent research supports the promise of examining interactive models of physiological processes on children's adjustment. The present study investigates interactions between children's autonomic nervous system activity and adrenocortical functioning in the context of marital discord; specifically, testing models of concurrent responses proposed by Bauer et al. ([2002] Developmental and Behavioral Pediatrics 23:102-113) in the prediction of children's behavioral responses to conflict and adjustment. Asymmetry and symmetry in children's salivary alpha-amylase and cortisol were examined in 195 children (M age = 8 years) in response to viewing conflict vignettes. Results were partially consistent with an interactive model in the context of high marital discord; asymmetry among higher alpha-amylase and lower cortisol related to higher emotional insecurity and concurrent and subsequent maladjustment. In contrast, patterns of symmetrical responses were related to greater maladjustment for children exposed to lower levels of marital discord, supporting an additive model. Findings support the importance of a multisystem approach to investigating the adaptiveness of children's physiological stress responses, while also highlighting the value of considering physiological responses in the context of family risk.

Gender and the development of oppositional defiant disorder: contributions of physical abuse and early family environment

Research is needed to understand the role of gender in the stability, course and etiology of antisocial behavior. Family environment, given its proximal association with children's behavior, holds great promise in understanding risk for antisocial behavior. The present study examined the role of parental acceptance and emotional responsivity as assessed using the HOME, caregiver report of intimate partner violence (IPV), and levels of physical abuse as assessed using the Conflict Tactics Scales, on subsequent symptoms of Oppositional Defiant Disorder (ODD), a childhood disorder characterized by antisocial behavior. Data were drawn from Waves 1-3, cohorts 3 and 6 of the Project for Human Development in Chicago Neighborhoods. Results suggest only minor gender differences in levels of ODD symptoms, with equal rates of stability from Wave 2 to 3 in symptom levels. For boys and girls, IPV was associated with an increased risk of ODD symptoms, and higher acceptance was associated with reduced risk of ODD symptoms. However, gender differences emerged in the impact of physical abuse and emotional responsiveness, in that the former was a significant predictor for girls only, and the latter was significant for boys only. Potential implications for these findings, including the role of gender socialization are discussed.

Constructive and Destructive Marital Conflict, Parenting, and Children's School and Social Adjustment

This study addresses the links between destructive and constructive marital conflict and mothers' and fathers' parenting to understand associations with children's social and school adjustment. Multi-method, longitudinal assessments of 235 mothers, fathers, and children (129 girls) were collected across kindergarten, first, and second grades (ages 5-7 at Time 1; ages 7-9 at Time 3). Whereas constructive marital conflict was related to both mothers' and fathers' warm parenting, destructive marital conflict was only linked to fathers' use of inconsistent discipline. In turn, both mothers' and fathers' use of psychological control was related to children's school adjustment, and mothers' warmth was related to children's social adjustment. Reciprocal links between constructs were also explored, supporting associations between destructive marital conflict and mothers' and fathers' inconsistent discipline. The merit of examining marital conflict and parenting as multidimensional constructs is discussed in relation to understanding the processes and pathways within families that affect children's functioning.

Spouses' cortisol associations and moderators: testing physiological synchrony and connectedness in everyday life

In this study, associations were examined between cortisol levels of wives and husbands in 47 heterosexual married couples. Both partners' salivary cortisol levels were measured at the same moments seven times a day on 2 typical weekdays. After accounting for the effects of the diurnal rhythm of cortisol and relevant control variables, dyadic hierarchical linear modeling indicated significant positive linkages between partners' cortisol levels, consistent with the hypothesized within-couple physiological synchrony. Variables reflecting more (spousal presence) or less connectedness (loneliness, being alone) were also collected at the time of each cortisol sample. Results indicated that husbands' cortisol levels were higher at moments they reported feeling lonelier and lower at moments they were in the presence of their spouse. Wives' cortisol levels were higher at moments they were alone. In addition, wife-husband cortisol synchrony was stronger for husbands who spent relatively more time with their spouse across the study period-even after accounting for time spent with others in general. These findings suggest that marital partners evidence positive within-couple cortisol associations, and that connectedness (particularly physical closeness) may underpin spouses' physiological synchrony.

What sleeping babies hear: a functional MRI study of interparental conflict and infants' emotion processing

Experiences of adversity in the early years of life alter the developing brain. However, evidence documenting this relationship often focuses on severe stressors and relies on peripheral measures of neurobiological functioning during infancy. In the present study, we employed functional MRI during natural sleep to examine associations between a more moderate environmental stressor (nonphysical interparental conflict) and 6- to 12-month-old infants' neural processing of emotional tone of voice. The primary question was whether interparental conflict experienced by infants is associated with neural responses to emotional tone of voice, particularly very angry speech. Results indicated that maternal report of higher interparental conflict was associated with infants' greater neural responses to very angry relative to neutral speech across several brain regions implicated in emotion and stress reactivity and regulation (including rostral anterior cingulate cortex, caudate, thalamus, and hypothalamus). These findings suggest that even moderate environmental stress may be associated with brain functioning during infancy.

Pathways from harsh parenting to adolescent antisocial behavior: a multidomain test of gender moderation

We tested for gender moderation within a multidomain model of antisocial behavior (ASB) among community youth, drawn from the Project on Human Development in Chicago Neighborhoods study. Youths (N = 1,639) were 9 to 12 years old at baseline and were followed for two additional waves, spaced approximately 2.5 years apart. We hypothesized that harsh and physically coercive parenting, a familial level risk factor, would impact individual level risk factors for ASB, such as childhood temperament ratings of emotionality and inhibitory control, and preadolescent externalizing and internalizing symptoms, as well as involvement with antisocial peers. We further hypothesized that this process and its impact on ASB would be moderated by gender. We used both multiple indicator multiple causes and multiple group analyses to test for gender moderation and a structural equation modeling multiple mediation framework to evaluate the strength of indirect effects. We tested the role of family, individual, and peer level influences on ASB, after accounting for the role of known contextual factors, including poverty, race, and neighborhood. Our overall model fit the data well for males and females, indicating harsh parenting, disinhibition, emotionality, and peers exert a strong influence on risk for ASB. Gender moderated the pathway from harsh parenting to externalizing behavior, such that this was a significant pathway for girls, but not boys. We discussed the importance of these findings with regard to intervention planning for youth at risk for ASB and future gender-informed models of ASB.

Pathways and processes of risk in associations among maternal antisocial personality symptoms, interparental aggression, and preschooler's psychopathology

Two studies examined the nature and processes underlying the joint role of interparental aggression and maternal antisocial personality as predictors of children's disruptive behavior problems. Participants for both studies included a high-risk sample of 201 mothers and their 2-year-old children in a longitudinal, multimethod design. Addressing the form of the interplay between interparental aggression and maternal antisocial personality as risk factors for concurrent and prospective levels of child disruptive problems, the Study 1 findings indicated that maternal antisocial personality was a predictor of the initial levels of preschooler's disruptive problems independent of the effects of interparental violence, comorbid forms of maternal psychopathology, and socioeconomic factors. In attesting to the salience of interparental aggression in the lives of young children, latent difference score analyses further revealed that interparental aggression mediated the link between maternal antisocial personality and subsequent changes in child disruptive problems over a 1-year period. To identify the family mechanisms that account for the two forms of intergenerational transmission of disruptive problems identified in Study 1, Study 2 explored the role of children's difficult temperament, emotional reactivity to interparental conflict, adrenocortical reactivity in a challenging parent-child task, and experiences with maternal parenting as mediating processes. Analyses identified child emotional reactivity to conflict and maternal unresponsiveness as mediators in pathways between interparental aggression and preschooler's disruptive problems. The findings further supported the role of blunted adrenocortical reactivity as an allostatic mediator of the associations between parental unresponsiveness and child disruptive problems.

Interparental aggression and infant patterns of adrenocortical and behavioral stress responses

Drawing on emotional security theory, this study examined linkages between interparental aggression, infant self-regulatory behaviors, and patterns of physiological and behavioral stress responses in a diverse sample of 735 infants residing in predominately low-income, non-metropolitan communities. Latent profile analysis revealed four classes of adrenocortical and behavioral stress-response patterns at 7 months of age, using assessments of behavioral and cortisol reactivity to an emotion eliciting challenge, as well as global ratings of the child's negative affect and basal cortisol levels. The addition of covariates within the latent profile model suggested that children with more violence in the home and children who used less caregiver-oriented regulation strategies were more likely to exhibit a pattern of high cortisol reactivity with moderate signs of distress rather than the average stress response, suggesting possible patterns of adaptation in violent households.

Caregiver Protective Behavior, Toddler Fear and Sadness, and Toddler Cortisol Reactivity in Novel Contexts

Previous research has shown that caregiver protective behavior may exacerbate toddler distress in specific contexts. The current study sought to extend this work to examine associations between these variables and toddler cortisol reactivity. Ninety-three 24-month-old toddlers were observed across six novel contexts designed to elicit distress. Toddlers were asked to give saliva samples at the beginning and end of the laboratory procedure. Toddler sadness, toddler fear, and caregiver protective behavior were coded. Results indicate that caregiver protective behavior accounted for the association between toddler sadness and cortisol reactivity where higher levels of protective behavior were associated with higher cortisol reactivity. The current study showed that caregiver protective behavior, which functions to prevent a child from interacting with a novel stimulus, is an important mechanism to consider when understanding toddler stress responses during novel contexts.

Stress and puberty-related hormone reactivity, negative emotionality, and parent--adolescent relationships

Hormone reactivity to stressors and hormones that rapidly change at puberty are hypothesized to influence moods, which may in turn affect parent-child relationship quality. The present study investigated whether reactivity of testosterone, DHEA, and cortisol in a clinic setting (venipuncture paradigm) predicted negative emotionality and family problems at Time 1 (0 months), Time 2 (6 months), and Time 3 (12 months) in a sample of 56 boys (M = 12.72, SD = 1.32 years) and 52 girls (M = 11.99, SD = 1.55 years). Reactivity of each hormone, negative emotionality, and family problems were measured at each of three laboratory visits. Testosterone reactivity at the first assessment predicted family problems one year later. DHEA stress reactivity was related to concurrent negative emotionality at six and 12 months. Cortisol reactivity did not predict negative emotionality or family problems. Reactivity of different hormones that change at puberty may play an important role in adolescent moods and family processes during puberty.

Sex differences in the programming effects of prenatal stress on psychopathology and stress responses: an evolutionary perspective

There is strong evidence from animal studies that prenatal stress has different effects on male and female offspring. In general, although not always, prenatal stress increases anxiety, depression and stress responses, both hypothalamic-pituitary-adrenal and cardiovascular, in female offspring rather than in male. Males are more likely to show learning and memory deficits. There have been few studies so far in humans which differentiate effects of prenatal stress on male and female psychopathology. Some studies support the animal models, but the evidence is inconsistent. The mediating mechanisms for any sex specific effects are little understood, but there is evidence that placental function can differ depending on the sex of the fetus. We suggest that there may be an evolutionary reason for any sex differences in the long term effects of prenatal stress. In a stressful environment it may be adaptive for females, who are more likely to stay in one place and look after children, to be more vigilant, alert to danger and thus show more stress responsiveness. This can give rise to a more anxious or depressed phenotype. With males it may be more adaptive to go out and explore new environments, compete with other males, and be more aggressive. For this it may help to be less responsive to external stressors. More research is needed into sex differences in the effects of prenatal stress in humans, to test these ideas.

Patterns of children's adrenocortical reactivity to interparental conflict and associations with child adjustment: a growth mixture modeling approach

Examining children's physiological functioning is an important direction for understanding the links between interparental conflict and child adjustment. Utilizing growth mixture modeling, the present study examined children's cortisol reactivity patterns in response to a marital dispute. Analyses revealed three different patterns of cortisol responses, consistent with both a sensitization and an attenuation hypothesis. Child-rearing disagreements and perceived threat were associated with children exhibiting a rising cortisol pattern, whereas destructive conflict was related to children displaying a flat pattern. Physiologically rising patterns were also linked with emotional insecurity and internalizing and externalizing behaviors. Results supported a sensitization pattern of responses as maladaptive for children in response to marital conflict, with evidence also linking an attenuation pattern with increased family risk. The findings of the present study support children's adrenocortical functioning as one mechanism through which interparental conflict is related to children's coping responses and psychological adjustment.

Does dampened physiological reactivity protect youth in aggressive family environments?

Is an attenuated physiological response to family conflict, seen in some youth exposed to early adversity, protective or problematic? A longitudinal study including 54 youth (average age 15.2 years) found that those with higher cumulative family aggression exposure showed lower cortisol output during a laboratory-based conflict discussion with their parents, and were less likely to show the normative pattern of increased cortisol reactivity to a discussion they rated as more conflictual. Family aggression interacted with cortisol reactivity in predicting youth adjustment: Adolescents from more aggressive homes who were also more reactive to the discussion reported more posttraumatic stress symptoms and more antisocial behavior. These results suggest that attenuated reactivity may protect youth from the negative consequences associated with aggressive family environments.

Focus on methodology: salivary bioscience and research on adolescence: an integrated perspective

The characterization of the salivary proteome and advances in biotechnology create an opportunity for developmental scientists to measure multi-level components of biological systems in oral fluids and identify relationships with developmental processes and behavioral and social forces. The implications for developmental science are profound because from a single oral fluid specimen, information can be obtained about a broad array of biological systems and the genetic polymorphisms related to their function. The purpose of this review is to provide a conceptual and tactical roadmap for investigators interested in integrating these measurement tools into research on adolescent health and development.

Allostatic and environmental load in toddlers predicts anxiety in preschool and kindergarten

Psychobiological models of allostatic load have delineated the effects of multiple processes that contribute to risk for psychopathology. This approach has been fruitful, but the interactive contributions of allostatic and environmental load remain understudied in early childhood. Because this developmental period encompasses the emergence of internalizing problems and biological sensitivity to early experiences, this is an important time to examine this process. In two studies, we examined allostatic and environmental load and links to subsequent internalizing and externalizing problems. Study 1 examined relations between load indices and maladjustment, concurrently and at multiple times between age 2 and kindergarten; Study 2 added more comprehensive risk indices in a sample following a group of highly fearful toddlers from 2 to 3 years of age. Results from both studies showed that increased allostatic load related to internalizing problems as environmental risk also increased. Study 2, in addition, showed that fearfulness interacted with allostatic and environmental load indices to predict greater anxiety among the fearful children who had high levels of allostatic and environmental load. Taken together, the findings support a model of risk for internalizing characterized by the interaction of biological and environmental stressors, and demonstrate the importance of considering individual differences and environmental context in applying models of allostatic load to developmental change in early childhood.

Impact of Parental Conflict and Emotional Abuse on Children and Families

The goal of this review is to summarize empirical research conducted over the past several decades examining the impact of parental conflict and emotional abuse on children and families. Toward this goal, four different subtopics are categorized and reviewed. These include the impact of mutual couple conflict, verbal, and emotional abuse/control on children; the impact of father-perpetrated verbal and emotional abuse/control on children; the impact of mother-perpetrated verbal and emotional abuse/control on children; and the impact of partner abuse on the family system including consideration of family stress, boundaries, alliances, and family structure. A review of the literature revealed 105 empirical papers, which are referenced in tables. Overarching theoretical and conceptual frameworks proposed within the field of interparental conflict and child development are used to organize and distill the broad findings evident across these studies. Recommendations for future avenues of research are presented.

Interparental aggression and children's adrenocortical reactivity: testing an evolutionary model of allostatic load

Guided by an evolutionary model of allostatic load, this study examined the hypothesis that the association between interparental aggression and subsequent changes in children's cortisol reactivity to interparental conflict is moderated by their temperamental dispositions. Participants of the multimethod, longitudinal study included 201 2-year-old toddlers and their mothers. These children experienced elevated levels of aggression between parents. Consistent with the theory, the results indicated that interparental aggression predicted greater cortisol reactivity over a 1-year period for children who exhibited high levels of temperamental inhibition and vigilance. Conversely, for children with bold, aggressive temperamental characteristics, interparental aggression was marginally associated with diminished cortisol reactivity. Further underscoring its implications for allostatic load, increasing cortisol reactivity over the one year span was related to concomitant increases in internalizing symptoms but decreases in attention and hyperactivity difficulties. In supporting the evolutionary conceptualization, these results further supported the relative developmental advantages and costs associated with escalating and dampened cortisol reactivity to interparental conflict.

Blunted cortisol responses to stress signal social and behavioral problems among maltreated/bullied 12-year-old children

BACKGROUND

Evidence from animal and human studies suggests that early-life stress such as physical maltreatment has long-lasting effects on the hypothalamic-pituitary-adrenal (HPA) axis and is associated with blunted HPA axis reactivity in adulthood. Few studies have investigated whether blunted HPA axis reactivity observed in children exposed to early-life stress signals social, emotional, and behavioral problems.

METHODS

Participants were 190 12-year-old children (50.5% males) recruited from the Environmental Risk Longitudinal Twin Study, a nationally representative 1994 to 1995 cohort of families with twins. Cortisol responses to psychosocial stress were measured in maltreated/bullied (n = 64) and comparison children (n = 126). We ascertained maltreatment and bullying victimization using mothers' reports and assessed children's social, emotional, and behavioral problems at ages 5 and 12 using mothers' and teachers' reports.

RESULTS

Piecewise multilevel growth curve analyses indicated that maltreated/bullied and comparison children showed distinct cortisol responses to stress. Specifically, maltreated/bullied children had lower cortisol responses than comparison children who exhibited a significant increase. Lower cortisol responses were, in turn, associated with more social and behavioral problems among maltreated/bullied children.

CONCLUSIONS

These findings provide support for the influence of childhood harm on blunted HPA axis reactivity and its potential impact on children's functioning. Our findings emphasize the need to integrate stress biomarkers in guiding prevention efforts for young victims.

Influence of early life stress on later hypothalamic-pituitary-adrenal axis functioning and its covariation with mental health symptoms: a study of the allostatic process from childhood into adolescence

The hypothalamic-pituitary-adrenal (HPA) axis is a primary mechanism in the allostatic process through which early life stress (ELS) contributes to disease. Studies of the influence of ELS on children's HPA axis functioning have yielded inconsistent findings. To address this issue, the present study considers multiple types of ELS (maternal depression, paternal depression, and family expressed anger), mental health symptoms, and two components of HPA functioning (traitlike and epoch-specific activity) in a long-term prospective community study of 357 children. ELS was assessed during the infancy and preschool periods; mental health symptoms and cortisol were assessed at child ages 9, 11, 13, and 15 years. A three-level hierarchical linear model addressed questions regarding the influences of ELS on HPA functioning and its covariation with mental health symptoms. ELS influenced traitlike cortisol level and slope, with both hyper- and hypoarousal evident depending on type of ELS. Further, type(s) of ELS influenced covariation of epoch-specific HPA functioning and mental health symptoms, with a tighter coupling of HPA alterations with symptom severity among children exposed previously to ELS. Results highlight the importance of examining multiple types of ELS and dynamic HPA functioning in order to capture the allostatic process unfolding across the transition into adolescence.

Interparental violence, maternal emotional unavailability and children's cortisol functioning in family contexts

Our goal in the present study was to examine the specificity of pathways among interparental violence, maternal emotional unavailability, and children's cortisol reactivity to emotional stressors within interparental and parent-child relationships. The study also tested whether detrimental family contexts were associated, on average, with hypocortisolism or hypercortisolism responses to stressful family interactions in young children. Participants included 201 toddlers and their mothers who were from impoverished backgrounds and who experienced disproportionate levels of family violence. Assessments of interparental violence were derived from maternal surveys and interviews, whereas maternal emotional unavailability was assessed through maternal reports and observer ratings of caregiving. Salivary cortisol levels were sampled at 3 time points before and after laboratory paradigms designed to elicit children's reactivity to stressful interparental and parent-child contexts. Results indicated that interparental violence and the mother's emotional unavailability were differentially associated with children's adrenocorticol stress reactivity. Furthermore, these family risk contexts predicted lower cortisol change in response to distress. The results are interpreted in the context of risky family and emotional security theory conceptualizations that underscore how family contexts differentially impact children's physiological regulatory capacities.

Family relationships and children's stress responses

In this chapter, the theoretical and empirical associations between family relationships and children's responses to stressors are reviewed. Family relationships explored are primarily dyadic, representing the emphasis of past empirical research; these include parent-parent, parent-child, and sibling relationships. However, in recognition of the more complicated and interconnected nature of family relationships, also reviewed are associations between the broader family context and children's stress responses. Multiple measures of stress responses are considered, including both physiological and emotional responses to and recovery from stressful experiences. Overall, the studies reviewed suggest that poor-quality family environments, including those characterized by low emotional support or high conflict, are associated with dysregulated stress responses throughout childhood and adolescence. In contrast, children and adolescents in families with high emotional support or low conflict seem to be protected from developing stress regulatory problems. Limitations in this body of research as well as directions for future research are discussed.

Longitudinal associations among child maltreatment, social functioning, and cortisol regulation

Child maltreatment increases the risk for impaired social functioning and cortisol regulation. However, the longitudinal interplay among these factors is still unclear. This study aimed to shed light on the effect of maltreatment on social functioning and cortisol regulation over time. The sample consisted of 236 children (mean age 7.64 years, SD = 1.36; 125 maltreated children and 111 nonmaltreated children, 128 boys and 108 girls) who attended a week-long summer camp for 2 consecutive years. Saliva was collected during 5 days at 9:00 a.m. and 4:00 p.m. Means of morning and afternoon cortisol levels and cortisol change (difference between morning and afternoon levels, controlled for morning levels) were used to group the children into low-, medium-, and high-cortisol groups. Prosocial, disruptive/aggressive, and withdrawn behaviors were assessed using information from peers and counselors. Maltreated children showed less prosocial and more disruptive/aggressive and withdrawn behavior. Results of structural equation modeling analyses indicated that there were indirect effects of maltreatment on Year 2 morning cortisol via prosocial and disruptive/aggressive behavior: Lower levels of prosocial behavior and higher levels of disruptive/aggressive behavior were related to lower morning cortisol levels 1 year later. Withdrawn behavior was related to higher afternoon cortisol values 1 year later. Results of this study suggest that maltreated children are more likely to experience difficulties in social functioning, which in turn is related to cortisol regulation 1 year later. This altered hypothalamic-pituitary-adrenocortical (HPA) axis functioning may put children at risk for later psychopathology.

Understanding children's emotional processes and behavioral strategies in the context of marital conflict

Marital conflict is a distressing context in which children must regulate their emotion and behavior; however, the associations between the multidimensionality of conflict and children's regulatory processes need to be examined. The current study examined differences in children's (N = 207, mean age = 8.02 years) emotions (mad, sad, scared, and happy) and behavioral strategies to regulate conflict exposure during resolved, unresolved, escalating, and child-rearing marital conflict vignettes. Children's cortisol levels were assessed in relation to child-rearing and resolved conflict vignettes. Anger and sadness were associated with escalating and child-rearing conflicts, fearfulness was related to escalating and unresolved conflicts, and happiness was associated with resolution. Anger was associated with children's strategies to stop conflict, whereas sadness was associated with monitoring and avoidant strategies. Cortisol recovery moderated the link between fearfulness and behavioral regulation. These results highlight the importance of children's emotions and regulatory processes in understanding the impact of marital conflict.

Allostatic processes in the family

The concepts of allostatic load and allostatic processes can help psychologists understand how health trajectories are influenced by stressful childhood experiences in the family. This paper describes psychological pathways and two key allostatic mediators, the hypothalamic–pituitary–adrenal axis and the immune system, through which stressful early rearing conditions may influence adult mental and physical health. The action of meshed gears is introduced as a metaphor to illustrate how responses occurring within a brief time frame, for example, immediate reactions to stressors, can influence developmental and health processes unfolding over much longer spans of time. We identify early-developing psychological and biological response patterns that could link chronic stressors in childhood to later health outcomes. Some of these “precursor outcomes” (e.g., heightened vigilance and preparedness for threats; enhanced inflammatory and humoral responses to infectious microorganisms) appear to be aimed at protection from immediate dangers; they may reflect “adaptive trade-offs” that balance short-term survival advantages under harsh rearing conditions against disadvantages manifested later in development. Our analysis also suggests mechanisms that underlie resilience in risky family environments.

Longitudinal pathways between political violence and child adjustment: the role of emotional security about the community in Northern Ireland

Links between political violence and children's adjustment problems are well-documented. However, the mechanisms by which political tension and sectarian violence relate to children's well-being and development are little understood. This study longitudinally examined children's emotional security about community violence as a possible regulatory process in relations between community discord and children's adjustment problems. Families were selected from 18 working class neighborhoods in Belfast, Northern Ireland. Participants (695 mothers and children, M = 12.17, SD = 1.82) were interviewed in their homes over three consecutive years. Findings supported the notion that politically-motivated community violence has distinctive effects on children's externalizing and internalizing problems through the mechanism of increasing children's emotional insecurity about community. Implications are considered for understanding relations between political violence and child adjustment from a social ecological perspective.

Longitudinal associations between marital instability and child sleep problems across infancy and toddlerhood in adoptive families

This study examined the longitudinal association between marital instability and child sleep problems at ages 9 and 18 months in 357 families with a genetically unrelated infant adopted at birth. This design eliminates shared genes as an explanation for similarities between parent and child. Structural equation modeling indicated that T1 marital instability predicted T2 child sleep problems, but T1 child sleep problems did not predict T2 marital instability. This result was replicated when models were estimated separately for mothers and fathers. Thus, even after controlling for stability in sleep problems and marital instability and eliminating shared genetic influences on associations using a longitudinal adoption design, marital instability prospectively predicts early childhood sleep patterns.

Maternal sensitivity buffers the adrenocortical implications of intimate partner violence exposure during early childhood

This study prospectively examined the effect of intimate partner violence (IPV) on adrenocortical reactivity and recovery during early childhood. The sample (n = 1102 mother–infant dyads; 49.2% male) was racially diverse and from predominantly low-income, rural communities. To measure IPV exposure mothers completed the Conflicts Tactics Scale, and her caretaking behaviors were observed when her child was approximately 7, 15, and 24 months of age. Children's saliva samples, later assayed for cortisol, were collected around challenge tasks designed to elicit emotional reactivity. IPV was related to a trajectory of increased cortisol reactivity from infancy to toddlerhood. By contrast, the trajectory for non-IPV-exposed children decreased in cortisol reactivity across 7 to 24 months of age. At the 24-month assessment, on average, toddlers did not exhibit a cortisol reaction; however, those exposed to high levels of violence continued to have reactivity. Accumulative levels of IPV across the first 2 years of life predicted cortisol reactivity at 24 months of age. Early (7-month) sensitive maternal behavior moderated this relationship, so that only children exposed to both early insensitivity and high accumulated IPV exhibited increased reactivity at the 24-month assessment. Findings are discussed in relation to the risky family framework.

Positive parenting during childhood moderates the impact of recent negative events on cortisol activity in parentally bereaved youth

RATIONALE

Early parental loss has been associated with neuroendocrine dysregulation in youth; however, the form of cortisol dysregulation varies widely. Identifying risk and protective factors that influence physiological regulation has important implications for understanding the development of mental health problems in parentally bereaved youth.

OBJECTIVES

The current study investigated the prospective effects of positive parenting on the relation between recent negative life events and cortisol activity in adolescents/young adults several years after bereavement.

METHODS

Positive parenting was assessed an average of 18.5 months following parental death. Six years later, adolescents/young adults (N = 55) reported on exposure to recent negative life events, and salivary cortisol was assessed before and after a conflict discussion task with their caregiver. The interaction between positive parenting and exposure to recent negative events was used to predict total cortisol output and response to the task.

RESULTS

Multilevel modeling and the probing of the interaction effect demonstrated that total cortisol output increased with greater exposure to recent negative events among those with lower levels of past positive parenting. These relations were significant over and above current internalizing and externalizing symptoms.

CONCLUSIONS

The current results highlight the need to consider the interactive influence of proximal and distal factors on neuroendocrine functioning for youth exposed to early parental loss.

Interparental relationship dynamics and cardiac vagal functioning in infancy

This study examined associations between interparental relationship dynamics and vagus system functioning in infancy. The functioning of the vagus system, part of the parasympathetic nervous system, indexes emotional reactivity and regulation. Interparental avoidance and dyadic adjustment constitute the focus of this study in order to bring attention to relationship dynamics not subsumed under overt conflict. Infants' baseline vagal tone and change in vagal tone in response to a novel toy were assessed at 5 months in a sample of high-risk mother-infant dyads (n=77). Maternal report of interparental avoidance demonstrated an association with infants' baseline vagal tone, while interparental dyadic adjustment was associated with change in infants' vagal tone from baseline to the novel toy. Infant gender moderated these associations. Maternal sensitivity did not mediate interparental relationship dynamics and infants' vagal functioning. Results are discussed in the context of emotional security theory.

Mother-adolescent physiological synchrony in naturalistic settings: within-family cortisol associations and moderators

In this study, the authors examined parent-adolescent cortisol associations in 45 families with adolescent children (24 girls; M age = 15.78 years, SD = 1.44 years). Family members' salivary cortisol levels were measured seven times a day on 2 typical weekdays. Family members provided reports of demographic and health variables, and adolescents rated parent-child relationship characteristics. After accounting for the effects of time of day and relevant demographic and health control variables on cortisol levels, hierarchical linear models indicated the presence of significant covariation over time in mother-adolescent cortisol (i.e., physiological synchrony). Furthermore, moderating tests revealed that mother-adolescent cortisol synchrony was strengthened among dyads characterized by mothers and adolescents spending more time together, and in families rated higher on levels of parent-youth shared activities and parental monitoring or supervision. Analysis of momentary characteristics indicated that maternal presence at the time of cortisol sampling lowered adolescent cortisol levels but did not account for mother-adolescent cortisol synchrony. Within-family physiological synchrony was amplified in momentary contexts of elevated maternal negative affect and elevated adolescent negative affect.

Medication effects on salivary cortisol: tactics and strategy to minimize impact in behavioral and developmental science

The non-invasive measurement of cortisol in saliva has enabled behavioral scientists to explore the correlates and concomitants of the interaction between the activity of the hypothalamic-pituitary-adrenal (HPA) axis, intrinsic factors, and social forces as they occur naturally in everyday life. The widespread integration of salivary cortisol into behavioral science has also revealed that omnipresent features of everyday life such as, over-the-counter and prescription medications, have the capacity to influence measurement validity. We identify several pathways by which pharmacologic agents could influence salivary cortisol, including (a) direct agonistic and antagonistic effects on the HPA axis, (b) indirect effects on physiological systems networked with the HPA axis, (c) moderation or mediation effects on cortisol secretion via pharmacologically induced change in subjective experience, (d) iatrogenic effects on the availability or composition of saliva, or the diffusion of serum constituents into oral fluid, and (e) cross-reactivities with antibodies used to detect cortisol by immunoassay. Specific medications with the capacity to influence salivary cortisol via these pathways are documented in an effort to procedurally and statistically minimize this potential source of error variance in the next generation of studies.

Childhood parental divorce and cortisol in young adulthood: evidence for mediation by family income

Childhood parental divorce has been linked with negative physical and psychological health in adulthood, potentially due to alterations in adrenocortical activity resulting from chronic stress. The current study evaluated cortisol in 94 young adults (mean age 19.9) from families characterized by parental divorce (n=43) or intact parental marriages (n=51). Salivary cortisol was assessed prior to and at 3 time points after a challenging speech task. Participants from divorced families had significantly lower cortisol across the experimental period than those from intact families, even after controlling for family conflict and current depression and anxiety. Lower family income was also associated with lower cortisol, and partially mediated the relationship between parental divorce and cortisol. Findings suggest that childhood parental divorce is associated with attenuated cortisol in young adulthood, which may be explained by lower income in divorced families.

Adaptive coping under conditions of extreme stress: Multilevel influences on the determinants of resilience in maltreated children

The study of resilience in maltreated children reveals the possibility of coping processes and resources on multiple levels of analysis as children strive to adapt under conditions of severe stress. In a maltreating context, aspects of self-organization, including self-esteem, self-reliance, emotion regulation, and adaptable yet reserved personalities, appear particularly important for more competent coping. Moreover, individual differences in biological processes ranging from gene by environment interactions to the hypothalamic-pituitary-adrenal axis to brain organization related to emotion also are shown to influence the resilience in maltreated youth, highlighting the multifaceted contributions to successful coping.

Children's context inappropriate anger and salivary cortisol

Some children show emotion that is not consistent with normative appraisal of the context and can therefore be defined as context inappropriate (CI). The authors used individual growth curve modeling and hierarchical multiple regression analyses to examine whether CI anger predicts differences in hypothalamic-pituitary-adrenal axis activity, as manifest in salivary cortisol measures. About 23% of the 360 children (ages 6-10 years, primarily 7-8) showed at least 1 expression of CI anger in situations designed to elicit positive affect. Expression of anger across 2 positive assessments was less common (around 4%). CI anger predicted the hypothesized lower levels of cortisol beyond that attributed to context appropriate anger. Boys' CI anger predicted lower morning cortisol and flatter slopes. Results suggest that this novel approach to studying children's emotion across varying contexts can provide insight into affective style.

Stressor paradigms in developmental studies: what does and does not work to produce mean increases in salivary cortisol

The stress response system is comprised of an intricate interconnected network that includes the hypothalamic-pituitary-adrenocortical (HPA) axis. The HPA axis maintains the organism's capacity to respond to acute and prolonged stressors and is a focus of research on the sequelae of stress. Human studies of the HPA system have been facilitated enormously by the development of salivary assays which measure cortisol, the steroid end-product of the HPA axis. The use of salivary cortisol is prevalent in child development stress research. However, in order to measure children's acute cortisol reactivity to circumscribed stressors, researchers must put children in stressful situations which produce elevated levels of cortisol. Unfortunately, many studies on the cortisol stress response in children use paradigms that fail to produce mean elevations in cortisol. This paper reviews stressor paradigms used with infants, children, and adolescents to guide researchers in selecting effective stressor tasks. A number of different types of stressor paradigms were examined, including: public speaking, negative emotion, relationship disruption/threatening, novelty, handling, and mild pain paradigms. With development, marked changes are evident in the effectiveness of the same stressor paradigm to provoke elevations in cortisol. Several factors appear to be critical in determining whether a stressor paradigm is successful, including the availability of coping resources and the extent to which, in older children, the task threatens the social self. A consideration of these issues is needed to promote the implementation of more effective stressor paradigms in human developmental psychoendocrine research.

Marital conflict and children's externalizing behavior: interactions between parasympathetic and sympathetic nervous system activity

Toward greater specificity in the prediction of externalizing problems in the context of interparental conflict, interactions between children's parasympathetic and sympathetic nervous system (PNS and SNS) activity were examined as moderators. PNS activity was indexed by respiratory sinus arrhythmia (RSA) and RSA reactivity (RSA-R) to lab challenges. SNS activity was indexed by skin conductance level (SCL) and SCL reactivity (SCL-R) to lab challenges. Moderation hypotheses were examined in 3 multi-informant studies with children ranging in age between 7 and 9 in Studies 1 and 2 and between 6 and 12 in Study 3. Findings are robust across studies and provide the first reported evidence of interactions between PNS and SNS activity as moderators of the association between children's exposure to marital conflict and externalizing behaviors. More specifically, opposing action of the PNS and SNS (i.e., coactivation and coinhibition) operated as a vulnerability factor for externalizing behavior in the context of marital conflict. Conversely, coordinated action of the PNS and SNS (i.e., reciprocal PNS or SNS activation) operated as a protective factor. Results are supportive of the authors' proposed biopsychosocial framework in which individual differences in the coordination of the activity of the PNS and SNS can function as vulnerability or protective factors in the context of family risk. Findings extend current theory indicating the importance of multisystem investigations for clarifying inconsistencies and discrepancies in the literature linking environmental stress, physiological responses, and child adjustment.