401
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Lebel CA, McMorris CA, Kar P, Ritter C, Andre Q, Tortorelli C, Gibbard WB. Characterizing adverse prenatal and postnatal experiences in children. Birth Defects Res 2019; 111:848-858. [PMID: 30690931 DOI: 10.1002/bdr2.1464] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/24/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prenatal and postnatal adversities, including prenatal alcohol exposure (PAE), prenatal exposure to other substances, toxic stress, lack of adequate resources, and postnatal abuse or neglect, often co-occur. These exposures can have cumulative effects, or interact with each other, leading to worse outcomes than single exposures. However, given their complexity and heterogeneity, exposures can be difficult to characterize. Clinical services and research often overlook additional exposures and attribute outcomes solely to one factor. METHODS We propose a framework for characterizing adverse prenatal and postnatal exposures and apply it to a cohort of 77 children. Our approach considers type, timing, and frequency to quantify PAE, other prenatal substance exposure, prenatal toxic stress, postnatal threat (harm or threat of harm), and postnatal deprivation (failure to meet basic needs) using a 4-point Likert-type scale. Postnatal deprivation and harm were separated into early (<24 months of age) and late (≥24 months) time periods, giving seven exposure variables. Exposures were ascertained via health records, child welfare records, interviews with birth parents, caregivers, and/or close family/friends. RESULTS Nearly all children had co-occurring prenatal exposures, and two-thirds had both prenatal and postnatal adversities. Children with high PAE were more likely to experience late postnatal adversities, and children with other prenatal substance exposure were more likely to have early postnatal deprivation. Postnatal adversities were more likely to co-occur. CONCLUSION This framework provides a comprehensive picture of a child's adverse exposures, which can inform assessment and intervention approaches and policy and will be useful for future research.
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Affiliation(s)
- Catherine A Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carly A McMorris
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Preeti Kar
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Chantel Ritter
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Quinn Andre
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | | | - W Ben Gibbard
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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402
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Morrill MI, Schulz MS, Nevarez MD, Preacher KJ, Waldinger RJ. Assessing within- and between-family variations in an expanded measure of childhood adversity. Psychol Assess 2019; 31:660-673. [PMID: 30628820 DOI: 10.1037/pas0000691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Previous measures of childhood adversity have enabled the identification of powerful links with later-life wellbeing. The challenge for the next generation of childhood adversity assessment is to better characterize those links through comprehensive, fine-grained measurement strategies. The expanded, retrospective measure of childhood adversity presented here leveraged analytic and theoretical advances to examine multiple domains of childhood adversity at both the microlevel of siblings and the macrolevel of families. Despite the fact that childhood adversity most often occurs in the context of families, there is a dearth of studies that have validated childhood adversity measures on multiple members of the same families. Multilevel psychometric analyses of this childhood adversity measure administered to 1,194 siblings in 500 families indicated that the additional categories of childhood adversity were widely endorsed, and increased understanding of the sources and sequalae of childhood adversity when partitioned into within- and between-family levels. For example, multilevel confirmatory factor analyses (MCFAs) indicated that financial stress, unsafe neighborhood, and parental unemployment were often experienced similarly by siblings in the same families and stemmed primarily from family wide (between-family) sources. On the other hand, being bullied and school stressors were often experienced differently by siblings and derived primarily from individual (within-family) processes. Multilevel structural equation modeling (MSEM) further illuminated differential criterion validity correlations between these categories of childhood adversity with midlife psychological, social, and physical health. Expanded, multidomain, and multilevel measures of childhood adversity appear to hold promise for identifying layered causes and consequences of adverse childhood experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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403
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Brumley LD, Brumley BP, Jaffee SR. Comparing cumulative index and factor analytic approaches to measuring maltreatment in the National Longitudinal Study of Adolescent to Adult Health. CHILD ABUSE & NEGLECT 2019; 87:65-76. [PMID: 30146090 DOI: 10.1016/j.chiabu.2018.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 07/29/2018] [Accepted: 08/19/2018] [Indexed: 06/08/2023]
Abstract
Child maltreatment is a complex and multifaceted construct in need of advanced statistical techniques to improve its measurement. The current study compared the predictive utility of a cumulative index to a factor analytic approach for constructing a measure of maltreatment. Data were from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health (Wave III: n = 14,800; Wave IV: n = 12,288). As adults, participants retrospectively reported on their childhood experiences of physical abuse, sexual abuse, emotional abuse, physical neglect, supervisory neglect, and social services investigations. Both the cumulative index and a two-factor solution showed evidence of convergent validity, predicting lifetime incidence of homelessness, being paid for sex, and various measures of running away or living apart from biological parents, and prospectively predicting depression, substance use, and criminal behavior. The latent variables, derived from a factor analytic approach, had greater explanatory power for many outcomes compared to the cumulative index, even when controlling for sociodemographic variables. Results suggest that factor analysis is a better methodology than a cumulative index for measuring maltreatment in large datasets when explanatory power for external outcomes is of greatest concern.
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Affiliation(s)
- Lauren D Brumley
- Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA 19104, USA.
| | - Benjamin P Brumley
- Graduate School of Education, University of Pennsylvania, 3700 Walnut Street, Philadelphia, PA 19104, USA.
| | - Sara R Jaffee
- Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA 19104, USA.
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404
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Barzilay R, Calkins ME, Moore TM, Wolf DH, Satterthwaite TD, Cobb Scott J, Jones JD, Benton TD, Gur RC, Gur RE. Association between traumatic stress load, psychopathology, and cognition in the Philadelphia Neurodevelopmental Cohort. Psychol Med 2019; 49:325-334. [PMID: 29655375 DOI: 10.1017/s0033291718000880] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Traumatic stressors during childhood and adolescence are associated with psychopathology, mostly studied in the context of post-traumatic stress disorder (PTSD) and depression. We investigated broader associations of traumatic stress exposure with psychopathology and cognition in a youth community sample. METHODS The Philadelphia Neurodevelopmental Cohort (N = 9498) is an investigation of clinical and neurobehavioral phenotypes in a diverse (56% Caucasian, 33% African American, 11% other) US youth community population (aged 8-21). Participants were ascertained through children's hospital pediatric (not psychiatric) healthcare network in 2009-2011. Structured psychiatric evaluation included screening for lifetime exposure to traumatic stressors, and a neurocognitive battery was administered. RESULTS Exposure rate to traumatic stressful events was high (none, N = 5204; one, N = 2182; two, N = 1092; three or more, N = 830). Higher stress load was associated with increased psychopathology across all clinical domains evaluated: mood/anxiety (standardized β = .378); psychosis spectrum (β = .360); externalizing behaviors (β = .311); and fear (β = .256) (controlling for covariates, all p < 0.001). Associations remained significant controlling for lifetime PTSD and depression. Exposure to high-stress load was robustly associated with suicidal ideation and cannabis use (odds ratio compared with non-exposed 5.3 and 3.2, respectively, both p < 0.001). Among youths who experienced traumatic stress (N = 4104), history of assaultive trauma was associated with greater psychopathology and, in males, vulnerability to psychosis and externalizing symptoms. Stress load was negatively associated with performance on executive functioning, complex reasoning, and social cognition. CONCLUSIONS Traumatic stress exposure in community non-psychiatric help-seeking youth is substantial, and is associated with more severe psychopathology and neurocognitive deficits across domains, beyond PTSD and depression.
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Affiliation(s)
- Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - Monica E Calkins
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - Tyler M Moore
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - Daniel H Wolf
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - Theodore D Satterthwaite
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - J Cobb Scott
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - Jason D Jones
- Department of Psychiatry, Neuropsychiatry Section,Perelman School of Medicine,University of Pennsylvania,Philadelphia, PA,USA
| | - Tami D Benton
- Department of Psychiatry, Neuropsychiatry Section,Perelman School of Medicine,University of Pennsylvania,Philadelphia, PA,USA
| | - Ruben C Gur
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
| | - Raquel E Gur
- Department of Child and Adolescent Psychiatry and Behavioral Sciences,Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine;CHOP,Philadelphia, PA,USA
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405
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Miller AB, Sheridan MA, Hanson JL, McLaughlin KA, Bates JE, Lansford JE, Pettit GS, Dodge KA. Dimensions of deprivation and threat, psychopathology, and potential mediators: A multi-year longitudinal analysis. JOURNAL OF ABNORMAL PSYCHOLOGY 2018. [PMID: 29528670 DOI: 10.1037/abn0000331] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Prior research demonstrates a link between exposure to childhood adversity and psychopathology later in development. However, work on mechanisms linking adversity to psychopathology fails to account for specificity in these pathways across different types of adversity. Here, we test a conceptual model that distinguishes deprivation and threat as distinct forms of childhood adversity with different pathways to psychopathology. Deprivation involves an absence of inputs from the environment, such as cognitive and social stimulation, that influence psychopathology by altering cognitive development, such as verbal abilities. Threat includes experiences involving harm or threat of harm that increase risk for psychopathology through disruptions in social-emotional processing. We test the prediction that deprivation, but not threat, increases risk for psychopathology through altered verbal abilities. Data were drawn from the Child Development Project (N = 585), which followed children for over a decade. We analyze data from assessment points at age 5, 6, 14, and 17 years. Mothers completed interviews at age 5 and 6 on exposure to threat and deprivation experiences. Youth verbal abilities were assessed at age 14. At age 17, mothers reported on child psychopathology. A path analysis model tested longitudinal paths to internalizing and externalizing problems from experiences of deprivation and threat. Consistent with predictions, deprivation was associated with risk for externalizing problems via effects on verbal abilities at age 14. Threat was associated longitudinally with both internalizing and externalizing problems, but these effects were not mediated by verbal abilities. Results suggest that unique developmental mechanisms link different forms of adversity with psychopathology. (PsycINFO Database Record
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - John E Bates
- Department of Psychological and Brain Sciences, Indiana University
| | | | - Gregory S Pettit
- Department of Human Development and Family Studies, Auburn University
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406
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Dunn EC. Childhood Adversity as a Plasticity Factor That Modifies the Association Between Subsequent Life Experience and Psychopathology. JAMA Netw Open 2018; 1:e185358. [PMID: 30646389 DOI: 10.1001/jamanetworkopen.2018.5358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Erin C Dunn
- Center for Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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407
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Dunn EC, Soare TW, Raffeld MR, Busso DS, Crawford KM, Davis KA, Fisher VA, Slopen N, Smith ADAC, Tiemeier H, Susser ES. What life course theoretical models best explain the relationship between exposure to childhood adversity and psychopathology symptoms: recency, accumulation, or sensitive periods? Psychol Med 2018; 48:2562-2572. [PMID: 29478418 PMCID: PMC6109629 DOI: 10.1017/s0033291718000181] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although childhood adversity is a potent determinant of psychopathology, relatively little is known about how the characteristics of adversity exposure, including its developmental timing or duration, influence subsequent mental health outcomes. This study compared three models from life course theory (recency, accumulation, sensitive period) to determine which one(s) best explained this relationship. METHODS Prospective data came from the Avon Longitudinal Study of Parents and Children (n = 7476). Four adversities commonly linked to psychopathology (caregiver physical/emotional abuse; sexual/physical abuse; financial stress; parent legal problems) were measured repeatedly from birth to age 8. Using a statistical modeling approach grounded in least angle regression, we determined the theoretical model(s) explaining the most variability (r2) in psychopathology symptoms measured at age 8 using the Strengths and Difficulties Questionnaire and evaluated the magnitude of each association. RESULTS Recency was the best fitting theoretical model for the effect of physical/sexual abuse (girls r2 = 2.35%; boys r2 = 1.68%). Both recency (girls r2 = 1.55%) and accumulation (boys r2 = 1.71%) were the best fitting models for caregiver physical/emotional abuse. Sensitive period models were chosen alone (parent legal problems in boys r2 = 0.29%) and with accumulation (financial stress in girls r2 = 3.08%) more rarely. Substantial effect sizes were observed (standardized mean differences = 0.22-1.18). CONCLUSIONS Child psychopathology symptoms are primarily explained by recency and accumulation models. Evidence for sensitive periods did not emerge strongly in these data. These findings underscore the need to measure the characteristics of adversity, which can aid in understanding disease mechanisms and determining how best to reduce the consequences of exposure to adversity.
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Affiliation(s)
- Erin C Dunn
- Center for Genomic Medicine, Massachusetts General Hospital,Boston, MA,USA
| | - Thomas W Soare
- Center for Genomic Medicine, Massachusetts General Hospital,Boston, MA,USA
| | - Miriam R Raffeld
- Center for Genomic Medicine, Massachusetts General Hospital,Boston, MA,USA
| | - Daniel S Busso
- Center for Genomic Medicine, Massachusetts General Hospital,Boston, MA,USA
| | | | - Kathryn A Davis
- Center for Genomic Medicine, Massachusetts General Hospital,Boston, MA,USA
| | - Virginia A Fisher
- Center for Genomic Medicine, Massachusetts General Hospital,Boston, MA,USA
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics,School of Public Health, University of Maryland,College Park, MD,USA
| | | | | | - Ezra S Susser
- Department of Epidemiology,Mailman School of Public Health, Columbia University,New York, NY,USA
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408
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Raffaelli M, Santana JP, de Morais NA, Nieto CJ, Koller SH. Adverse childhood experiences and adjustment: A longitudinal study of street-involved youth in Brazil. CHILD ABUSE & NEGLECT 2018; 85:91-100. [PMID: 30170923 DOI: 10.1016/j.chiabu.2018.07.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/17/2018] [Accepted: 07/29/2018] [Indexed: 06/08/2023]
Abstract
Most research on adverse childhood experiences (ACEs) has been conducted in high-income countries in the global North. The current longitudinal study examined the prevalence, overlap, and impact of ACEs in a sample of Brazilian children and adolescents who use city streets as spaces for socialization and survival (i.e., street-involved youth). Participants (N = 113; M age = 14.18 years) were recruited in three cities following standardized procedures. Most youth were male (80.5%) and non-White (91%). Lifetime exposure to ACEs was assessed at the first study time point; six indicators of psychological, behavioral, and physical adjustment were assessed 6 months later. Analyses addressed three research goals. First, the prevalence of seven ACEs was examined. Youth reported an average of 4.8 ACEs (SD = 1.25); no significant age or gender differences were found in ACEs exposure (all ps > .05). Second, the overlap between different ACEs was explored. Family dysfunction was correlated with family disruption and physical abuse; poverty and physical abuse were related (ps < .05). Third, prospective associations between ACEs and adjustment were tested. Total number of ACEs was not significantly correlated with any outcome, but several associations emerged for specific ACEs. For example, death of a close friend or family member was prospectively associated with negative affect; sexual abuse was associated with illicit drug use and physical health symptoms (ps < .05). Findings highlight the prevalence of ACEs in this vulnerable population and underscore the value of extending research on ACEs into novel populations and contexts.
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Affiliation(s)
- Marcela Raffaelli
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 904 W. Nevada Street, Urbana, IL, 61801, USA.
| | - Juliana Prates Santana
- Institute of Psychology, Federal University of Bahia, Rua Aristides Novis, 197, Estrada de São Lázaro, Salvador, BA, CEP: 40210-730, Brazil.
| | - Normanda Araujo de Morais
- Graduate Psychology Program, University of Fortaleza, Av. Washington Soares, 1321, Edson Queiroz, Fortaleza, CE, CEP: 60811-905, Brazil.
| | - Carlos J Nieto
- Universidad del Rosario, Carrera 24 #63C-69, Bogotá, DC, Colombia.
| | - Silvia H Koller
- Universidad del Rosario, Carrera 24 #63C-69, Bogotá, DC, Colombia; North-West University, Vanderbijlpark, South Africa.
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409
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Amso D, Salhi C, Badre D. The relationship between cognitive enrichment and cognitive control: A systematic investigation of environmental influences on development through socioeconomic status. Dev Psychobiol 2018; 61:159-178. [PMID: 30375651 DOI: 10.1002/dev.21794] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/22/2022]
Abstract
We measured the impact of socioeconomic status (SES) on cognitive processes. We examined cognitive control, specifically working memory (WM), in a sample of N = 141 7- to 17-year-olds using rule-guided behavior tasks. Our hypothesis is based on computational modeling data that suggest that the development of flexible cognitive control requires variable experiences in which to implement rule-guided action. We found that not all experiences that correlated with SES in our sample impacted task performance, and not all experiential variables that impacted performance were associated with SES. Of the experiential variables associated with task performance, only cognitive enrichment opportunities worked indirectly through SES to affect WM as tested with rule-guided behavior tasks. We discuss the data in the context of necessary precision in SES research.
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Affiliation(s)
- Dima Amso
- Brown University, Providence, Rhode Island
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410
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Swales DA, Stout-Oswald SA, Glynn LM, Sandman C, Wing DA, Davis EP. Exposure to traumatic events in childhood predicts cortisol production among high risk pregnant women. Biol Psychol 2018; 139:186-192. [PMID: 30359722 DOI: 10.1016/j.biopsycho.2018.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 09/10/2018] [Accepted: 10/05/2018] [Indexed: 12/14/2022]
Abstract
Childhood exposure to traumatic events has a profound and disruptive impact on mental and physical health, including stress physiology. In the current study, we evaluate 90 pregnant women at risk for preterm delivery and assess the association between history of exposure to traumatic events and hair cortisol concentrations, an integrated measure of cortisol production. Exposure to more traumatic events in childhood and in adulthood independently predicted elevated hair cortisol concentrations in pregnancy. Notably, the impact of childhood exposure to traumatic events remained after accounting for more proximal traumatic events in adulthood. Further, there was a significant interaction between childhood and adult exposures. Traumatic experiences in adulthood were more strongly associated with hair cortisol concentrations among mothers with a history of greater childhood trauma. Findings suggest that not only do proximal adult exposures impact HPA-axis functioning during pregnancy, but that childhood traumatic experiences have persisting consequences for HPA-axis functioning during pregnancy. Maternal HPA-axis dysregulation in pregnancy has consequences for both maternal health and for fetal development. Therefore, we consider prenatal maternal HPA-axis functioning as a potential biological pathway underlying intergenerational consequences of childhood trauma.
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Affiliation(s)
| | | | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA, USA; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Curt Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Deborah A Wing
- Obstetrics and Gynecology, University of California, Irvine, Irvine, CA, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver CO, USA; Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
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411
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Goodman GS, Quas JA, Goldfarb D, Gonzalves L, Gonzalez A. Trauma and Long‐Term Memory for Childhood Events: Impact Matters. CHILD DEVELOPMENT PERSPECTIVES 2018. [DOI: 10.1111/cdep.12307] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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412
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Spinazzola J, van der Kolk B, Ford JD. When Nowhere Is Safe: Interpersonal Trauma and Attachment Adversity as Antecedents of Posttraumatic Stress Disorder and Developmental Trauma Disorder. J Trauma Stress 2018; 31:631-642. [PMID: 30338544 PMCID: PMC6221128 DOI: 10.1002/jts.22320] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 02/06/2023]
Abstract
Developmental trauma disorder (DTD) has been proposed as clinical framework for the sequelae of complex trauma exposure in children. In this study, we investigated whether DTD is associated with different traumatic antecedents than posttraumatic stress disorder (PTSD). In a multisite sample of 236 children referred from pediatric or mental health treatment, DTD was assessed using the DTD Structured Interview. Trauma history was assessed using the Traumatic Events Screening Instrument (TESI). On an unadjusted basis, both DTD, odds ratios (ORs) = 2.0-3.8, 95% CI [1.17, 7.19]; and PTSD, ORs = 1.8-3.0, 95% CI [1.04, 6.27], were associated with past physical assault and/or abuse, family violence, emotional abuse, neglect, and impaired caregivers; and DTD was associated community violence, OR = 2.7, 95% CI [1.35, 5.43]. On a multivariate basis after controlling for the effects of PTSD, DTD was associated with family and community violence and impaired caregivers, ORs = 2.0-2.5, 95% CI [1.09, 5.97], whereas PTSD was only associated with physical assault and/or abuse after controlling for the effects of DTD, OR = 2.4, 95% CI [1.07, 4.99]. Exposure to both interpersonal trauma and attachment adversity was associated with the highest DTD symptom count, controlling for the PTSD symptom count. Although childhood PTSD and DTD share several traumatic antecedents, DTD may be uniquely associated with pervasive exposure to violent environments and impaired caregiving. Therefore, DTD warrants further investigation as a framework for the assessment and treatment of children with histories of interpersonal victimization and attachment adversity.
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Affiliation(s)
| | - Bessel van der Kolk
- The Trauma CenterBrooklineMassachusetts,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Julian D. Ford
- Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonConnecticutUSA
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413
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Duffy KA, McLaughlin KA, Green PA. Early life adversity and health-risk behaviors: proposed psychological and neural mechanisms. Ann N Y Acad Sci 2018; 1428:151-169. [PMID: 30011075 PMCID: PMC6158062 DOI: 10.1111/nyas.13928] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/06/2018] [Accepted: 06/18/2018] [Indexed: 12/18/2022]
Abstract
Early life adversity (ELA) is associated with poorer health in adulthood, an association explained, at least in part, by increased engagement in health-risk behaviors (HRBs). In this review, we make the case that ELA influences brain development in ways that increase the likelihood of engaging in HRBs. We argue that ELA alters neural circuitry underpinning cognitive control as well as emotional processing, including networks involved in processing threat and reward. These neural changes are associated psychologically and behaviorally with heightened emotional reactivity, blunted reward responsivity, poorer emotion regulation, and greater delay discounting. We then demonstrate that these adaptations to ELA are associated with an increased risk of smoking cigarettes, drinking alcohol, and eating high-fat, high-sugar foods. Furthermore, we explore how HRBs affect the brain in ways that reinforce addiction and further explain clustering of HRBs.
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Affiliation(s)
- Korrina A. Duffy
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Paige A. Green
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
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414
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Platt JM, McLaughlin KA, Luedtke AR, Ahern J, Kaufman AS, Keyes KM. Targeted Estimation of the Relationship Between Childhood Adversity and Fluid Intelligence in a US Population Sample of Adolescents. Am J Epidemiol 2018; 187:1456-1466. [PMID: 29982374 DOI: 10.1093/aje/kwy006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 01/03/2018] [Indexed: 12/27/2022] Open
Abstract
Many studies have shown inverse associations between childhood adversity and intelligence, although most are based on small clinical samples and fail to account for the effects of multiple co-occurring adversities. Using data from the 2001-2004 National Comorbidity Survey Adolescent Supplement, a cross-sectional US population study of adolescents aged 13-18 years (n = 10,073), we examined the associations between 11 childhood adversities and intelligence, using targeted maximum likelihood estimation. Targeted maximum likelihood estimation incorporates machine learning to identify the relationships between exposures and outcomes without overfitting, including interactions and nonlinearity. The nonverbal score from the Kaufman Brief Intelligence Test was used as a standardized measure of fluid reasoning. Childhood adversities were grouped into deprivation and threat types based on recent conceptual models. Adjusted marginal mean differences compared the mean intelligence score if all adolescents experienced each adversity to the mean in the absence of the adversity. The largest associations were observed for deprivation-type experiences, including poverty and low parental education, which were related to reduced intelligence. Although lower in magnitude, threat events related to intelligence included physical abuse and witnessing domestic violence. Violence prevention and poverty-reduction measures would likely improve childhood cognitive outcomes.
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415
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Saxbe D, Khoddam H, Piero LD, Stoycos SA, Gimbel SI, Margolin G, Kaplan JT. Community violence exposure in early adolescence: Longitudinal associations with hippocampal and amygdala volume and resting state connectivity. Dev Sci 2018; 21:e12686. [PMID: 29890029 DOI: 10.1111/desc.12686] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/01/2018] [Indexed: 11/29/2022]
Abstract
Community violence exposure is a common stressor, known to compromise youth cognitive and emotional development. In a diverse, urban sample of 22 adolescents, participants reported on community violence exposure (witnessing a beating or illegal drug use, hearing gun shots, or other forms of community violence) in early adolescence (average age 12.99), and underwent a neuroimaging scan 3-5 years later (average age 16.92). Community violence exposure in early adolescence predicted smaller manually traced left and right hippocampal and amygdala volumes in a model controlling for age, gender, and concurrent community violence exposure, measured in late adolescence. Community violence continued to predict hippocampus (but not amygdala) volumes after we also controlled for family aggression exposure in early adolescence. Community violence exposure was also associated with stronger resting state connectivity between the right hippocampus (using the manually traced structure as a seed region) and bilateral frontotemporal regions including the superior temporal gyrus and insula. These resting state connectivity results held after controlling for concurrent community violence exposure, SES, and family aggression. Although this is the first study focusing on community violence in conjunction with brain structure and function, these results dovetail with other research linking childhood adversity with smaller subcortical volumes in adolescence and adulthood, and with altered frontolimbic resting state connectivity. Our findings suggest that even community-level exposure to neighborhood violence can have detectable neural correlates in adolescents.
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Affiliation(s)
- Darby Saxbe
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Hannah Khoddam
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | | | - Sarah A Stoycos
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Sarah I Gimbel
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
| | - Gayla Margolin
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jonas T Kaplan
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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416
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The association between early life stress and prefrontal cortex activation during implicit emotion regulation is moderated by sex in early adolescence. Dev Psychopathol 2018; 29:1851-1864. [PMID: 29162186 DOI: 10.1017/s0954579417001444] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Early life stress (ELS) is a significant risk factor for the emergence of internalizing problems in adolescence. Beginning in adolescence, females are twice as likely as males to experience internalizing disorders. The present study was designed to examine sex differences in the association between ELS and internalizing problems in early pubertal adolescents, and whether and how corticolimbic function and connectivity may underlie these associations. Fifty-nine early pubertal males and 78 early pubertal females, ages 9-13 years (all Tanner Stage 3 or below) underwent functional magnetic resonance imaging as they performed an emotion label task that robustly interrogates corticolimbic function. Participants were also interviewed about their experience of ELS. Females exhibited a positive association between ELS and internalizing problems, whereas males exhibited no such association. Whole-brain and amygdala region of interest analyses indicated that whereas females exhibited a positive association between ELS and the ventrolateral prefrontal cortex during implicit emotion regulation, males showed no such association. Activation in these regions was positively associated with internalizing problems in females but not males; however, activation in these regions did not mediate the association between ELS and internalizing problems. Finally, both boys and girls exhibited an association between ELS and increased negative connectivity between the right ventrolateral prefrontal cortex and bilateral amygdala. Using a carefully characterized sample of early pubertal adolescents, the current study highlights important sex differences in the development of corticolimbic circuitry during a critical period of brain development. These sex differences may play a significant role in subsequent risk for internalizing problems.
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417
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Westermair AL, Stoll AM, Greggersen W, Kahl KG, Hüppe M, Schweiger U. All Unhappy Childhoods Are Unhappy in Their Own Way-Differential Impact of Dimensions of Adverse Childhood Experiences on Adult Mental Health and Health Behavior. Front Psychiatry 2018; 9:198. [PMID: 29875707 PMCID: PMC5974933 DOI: 10.3389/fpsyt.2018.00198] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 04/30/2018] [Indexed: 12/16/2022] Open
Abstract
Adverse childhood experiences have consistently been linked with poor mental and somatic health in adulthood. However, due to methodological restraints of the main lines of research using cumulative or selective models, little is known about the differential impact of different dimensions of adverse childhood experiences. Therefore, we gathered data from 396 psychiatric in-patients on the Adverse Childhood Experiences (ACE) questionnaire, extracted dimensions using factor analysis and compared this dimensional model of adverse childhood experiences to cumulative and selective models. Household Dysfunction (violence against the mother, parental divorce, substance abuse or incarceration of a household member) was associated with poor health behaviors (smoking, alcohol dependency and obesity as proxy marker for an imbalance between energy intake and physical activity) and with poorer socio-economic achievement (lower education and income) in adulthood. The previously reported associations of maltreatment and sexual abuse with these outcome criteria could not be corroborated. Both Maltreatment (emotional and physical neglect and abuse) and Sexual Abuse predicted BPD, PTSD and suicidal behavior. However, the two ACE dimensions showed sufficiently divergent validity to warrant separate consideration in future studies: Maltreatment was associated with affective and anxiety disorders such as social phobia, panic disorder and major depressive disorder, whereas Sexual Abuse was associated with dysregulation of bodily sensations such as pain intensity and hunger/satiation. Also, we found both quantitative and qualitative evidence for the superiority of the dimensional approach to exploring the consequences of adverse childhood experiences in comparison to the cumulative and selective approaches.
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Affiliation(s)
- Anna L. Westermair
- Department of Psychiatry and Psychotherapy, University of LübeckLübeck, Germany
| | - Anne M. Stoll
- Department of Internal Medicine I, University of LübeckLübeck, Germany
| | - Wiebke Greggersen
- Department of Psychiatry and Psychotherapy, University of LübeckLübeck, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Michael Hüppe
- Department of Anesthesiology and Intensive Care, University of LübeckLübeck, Germany
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, University of LübeckLübeck, Germany
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418
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Ford JD, Charak R, Modrowski CA, Kerig PK. PTSD and dissociation symptoms as mediators of the relationship between polyvictimization and psychosocial and behavioral problems among justice-involved adolescents. J Trauma Dissociation 2018; 19:325-346. [PMID: 29547076 DOI: 10.1080/15299732.2018.1441354] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Polyvictimization (PV) has been shown to be associated with psychosocial and behavioral impairment in community and high risk populations, including youth involved in juvenile justice. However, the mechanisms accounting for these adverse outcomes have not been empirically delineated. Symptoms of posttraumatic stress disorder (PTSD) and dissociation are documented sequelae of PV and are associated with a wide range of behavioral/emotional problems. This study used a cross-sectional research design and bootstrapped multiple mediation analyses with self-report measures completed by a large sample of justice-involved youth (N = 809, ages 12-19 years old, 27% female, 46.5% youth of color) to test the hypothesis that PTSD and dissociation symptoms mediate the relationship between PV and problems with anger, depression/anxiety, alcohol/drug use, and somatic complaints after controlling for the effects of exposure to violence and adversities related to juvenile justice involvement. As hypothesized, PTSD symptoms mediated the relationship of PV with all outcomes except alcohol/drug use problems (which had an unmediated direct association with PV). Partially supporting study hypotheses, dissociation symptoms mediated the relationship between PV and internalizing problems (i.e., depression anxiety; suicide ideation). Implications are discussed for prospective research demarcating the mechanisms linking PV and adverse outcomes in juvenile justice and other high risk populations.
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Affiliation(s)
- Julian D Ford
- a Department of Psychiatry , University of Connecticut Health Center , Farmington , CT , USA
| | - Ruby Charak
- b Department of Psychological Science , University of Texas Rio Grande Valley , Edinburg , TX , USA
| | - Crosby A Modrowski
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Patricia K Kerig
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
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419
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Ford JD, Delker BC. Polyvictimization in childhood and its adverse impacts across the lifespan: Introduction to the special issue. J Trauma Dissociation 2018; 19:275-288. [PMID: 29547074 DOI: 10.1080/15299732.2018.1440479] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although much empirical work has focused on the adverse impact of specific types of childhood victimization (e.g., sexual, physical, or emotional abuse), researchers and clinicians increasingly are recognizing the prevalence of polyvictimization, or exposure to multiple types of victimization. Polyvictimization during formative developmental periods may have detrimental and potentially lifelong biopsychosocial impacts over and above the effects of exposure to specific types of adversity. In this guest editorial, we summarize the key questions and findings for six empirical studies on polyvictimization included in this Special Issue of the Journal of Trauma & Dissociation. These empirical studies further our understanding of the nature, consequences, and assessment of polyvictimization. We conclude with recommendations for continued scientific research and clinical inquiry on polyvictimization.
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Affiliation(s)
- Julian D Ford
- a Department of Psychiatry, University of Connecticut Schools of Medicine and Law, Farmington, Connecticut, USA
| | - Brianna C Delker
- b Department of Psychology, Western Washington University, Bellingham, Washington, USA
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420
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Poor mental health among low-income women in the U.S.: The roles of adverse childhood and adult experiences. Soc Sci Med 2018; 206:14-21. [PMID: 29679816 DOI: 10.1016/j.socscimed.2018.03.043] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 02/26/2018] [Accepted: 03/11/2018] [Indexed: 01/20/2023]
Abstract
RATIONALE It is well established that exposure to a greater number of adverse childhood experiences (ACEs) increases the risk of poor physical and mental health outcomes. Given the predictive validity of ACE scores and other cumulative risk metrics, a similar measurement approach may advance the study of risk in adulthood. OBJECTIVE We examined the prevalence and interrelations of 10 adverse adult experiences, including household events such as intimate partner violence and extrafamilial events such as crime victimization. We also tested the relation between cumulative adult adversity and later mental health problems, and we examined whether adult adversity mediates the link between childhood adversity and mental health. METHODS Data were collected from 501 women in the Families and Children Thriving Study, a longitudinal investigation of low-income families that received home visiting services in Wisconsin. We conducted correlation analyses to assess interrelations among study measures along with multivariate analyses to test the effects of childhood and adult adversity on three outcomes: depression, anxiety, and posttraumatic stress disorder (PTSD). We then fit a structural equation model to test whether the effects of childhood adversity on mental health are mediated by adult adversity. RESULTS Over 80% of participants endorsed at least one adverse adult experience. Adult adversities correlated with each other and with the mental health outcomes. Controlling for ACEs and model covariates, adult adversity scores were positively associated with depression, anxiety, and PTSD scores. Path analyses revealed that the ACE-mental health connection was mediated by adult adversity. CONCLUSION Our findings indicate that mental health problems may be better understood by accounting for processes through which early adversity leads to later adversity. Pending replication, this line of research has the potential to improve the identification of populations that are at risk of poor health outcomes.
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421
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Koss KJ, Gunnar MR. Annual Research Review: Early adversity, the hypothalamic-pituitary-adrenocortical axis, and child psychopathology. J Child Psychol Psychiatry 2018; 59:327-346. [PMID: 28714126 PMCID: PMC5771995 DOI: 10.1111/jcpp.12784] [Citation(s) in RCA: 253] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Research on early adversity, stress biology, and child development has grown exponentially in recent years. FINDINGS We review the current evidence for the hypothalamic-pituitary-adrenocortical (HPA) axis as a stress-mediating mechanism between various forms of childhood adversity and psychopathology. We begin with a review of the neurobiology of the axis and evidence for relations between early adversity-HPA axis activity and HPA axis activity-psychopathology, as well as discuss the role of regulatory mechanisms and sensitive periods in development. CONCLUSIONS We call attention to critical gaps in the literature to highlight next steps in this research including focus on developmental timing, sex differences, stress buffering, and epigenetic regulation. A better understanding of individual differences in the adversity-HPA axis-psychopathology associations will require continued work addressing how multiple biological and behavioral systems work in concert to shape development.
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Affiliation(s)
- Kalsea J. Koss
- Center for Research on Child Wellbeing, Office of Population Research, Department of Molecular Biology, Princeton, Princeton University, NJ, USA
| | - Megan R. Gunnar
- Center for Research on Child Wellbeing, Office of Population Research, Department of Molecular Biology, Princeton, Princeton University, NJ, USA
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422
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Danese A. Commentary: Biological embedding of childhood adversity: where do we go from here? A reflection on Koss and Gunnar (2018). J Child Psychol Psychiatry 2018; 59:347-349. [PMID: 29574732 DOI: 10.1111/jcpp.12891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2018] [Indexed: 12/30/2022]
Abstract
The review by Koss & Gunna provides a scholarly overview of the role of the hypothalamic-pituitary-adrenal (HPA) axis in mediating the association between childhood adversity and psychopathology. Through their insightful observations, the authors craft a rich framework to critically appraise the current evidence and inform future research in this area. Overall, the review calls for a new generation of studies testing biological embedding hypotheses with greater attention to design, measurement, statistical models, and translational approaches. These new studies are much needed. By uncovering the causal pathways underlying the biological embedding of childhood adversity, we can gain important new tools to prevent the most impairing forms of psychopathology among the most vulnerable individuals in society.
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Affiliation(s)
- Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,National and Specialist CAMHS Trauma and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London, UK
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423
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Brodbeck J, Fassbinder E, Schweiger U, Fehr A, Späth C, Klein JP. Differential associations between patterns of child maltreatment and comorbidity in adult depressed patients. J Affect Disord 2018; 230:34-41. [PMID: 29407536 DOI: 10.1016/j.jad.2017.12.077] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/09/2017] [Accepted: 12/31/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Types of maltreatment often co-occur and it is unclear how maltreatment patterns impact on comorbidity in depressed patients. METHODS We analysed associations of maltreatment patterns with a broad range of comorbidities assessed with diagnostic interviews in 311 treatment-seeking depressed outpatients. RESULTS Latent class analyses identified a "no maltreatment class" (39%), a "mild to moderate abuse and neglect class" (34%), a "severe abuse and neglect class" (14%) and a "severe neglect class" (13%). We found a dose-response association for the first three classes with comorbid disorders, a general psychopathology factor and an interpersonal insecurity factor. Patients in the "severe abuse and neglect" class had increased odds ratios (OR) of suffering from an anxiety disorder (OR 3.58), PTSD (OR 7.09), Borderline personality disorder (OR 7.97) and suicidality (OR 10.04) compared to those without child maltreatment. Patients in the "severe neglect" class did not have a higher risk for comorbidity than those in the "no maltreatment" class. LIMITATIONS Class sizes in the "severe abuse and neglect" and the "severe neglect" classes were small and findings should be replicated with other clinical and population samples. CONCLUSIONS A higher severity rather than the constellation of types of child abuse and neglect was associated with more comorbid disorders. An exception were patients reporting solely severe emotional and physical neglect who had a similar risk for comorbidity as patients without a history of child maltreatment. This may be associated with distinct learning experiences and may inform treatment decisions.
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Affiliation(s)
- Jeannette Brodbeck
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Eva Fassbinder
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Ulrich Schweiger
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Antje Fehr
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Christina Späth
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Jan Philipp Klein
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany.
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424
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Barch DM, Belden AC, Tillman R, Whalen D, Luby JL. Early Childhood Adverse Experiences, Inferior Frontal Gyrus Connectivity, and the Trajectory of Externalizing Psychopathology. J Am Acad Child Adolesc Psychiatry 2018; 57:183-190. [PMID: 29496127 PMCID: PMC5836492 DOI: 10.1016/j.jaac.2017.12.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 12/04/2017] [Accepted: 12/22/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Early adverse childhood experiences (ACEs) have been linked to the development of both internalizing and externalizing psychopathology. In our prior work, we found that ACEs predicted reductions in the volume of the inferior frontal gyrus (IFG), a brain region important for impulse control and emotion regulation. Here we tested the hypothesis that ACEs might influence child behavioral outcomes through an impact on IFG functional connectivity, which may influence impulsive or risk-taking behavior. METHOD We examined the effects of prospectively assessed ACEs on IFG connectivity in childhood, and their relationship to the trajectory of subsequent psychopathology from late school age and early adolescence, using data from an 11-year longitudinal study of children starting in preschool that included 3 waves of resting state functional connectivity across childhood and early adolescence. RESULTS ACEs predicted functional connectivity of both left and right IFG. Multi-level modeling of symptoms across 3 waves of assessments indicated that more ACEs predicted both internalizing and externalizing symptoms. However, altered IFG connectivity specifically predicted greater externalizing symptoms over time in middle childhood and early adolescence, as compared to internalizing symptoms. Longitudinal modeling indicating that the relationships between externalizing and functional connectivity were maintained across 3 waves of functional connectivity assessment. CONCLUSION These findings underscore the relationship of ACEs to later psychopathology, and suggest that connectivity of the IFG, a region known to play an important role in impulse control and emotion regulation, may play a key role in the risk trajectory of ACEs to externalizing problems. However, further work is needed to understand whether these relationships reflect a direct effect of ACEs or whether ACEs are a marker for other environmental or genetic factors that may also influence brain development and behavior.
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425
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Rosen ML, Sheridan MA, Sambrook KA, Meltzoff AN, McLaughlin KA. Socioeconomic disparities in academic achievement: A multi-modal investigation of neural mechanisms in children and adolescents. Neuroimage 2018; 173:298-310. [PMID: 29486324 DOI: 10.1016/j.neuroimage.2018.02.043] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/14/2018] [Accepted: 02/21/2018] [Indexed: 12/17/2022] Open
Abstract
Growing evidence suggests that childhood socioeconomic status (SES) influences neural development, which may contribute to the well-documented SES-related disparities in academic achievement. However, the particular aspects of SES that impact neural structure and function are not well understood. Here, we investigate associations of childhood SES and a potential mechanism-degree of cognitive stimulation in the home environment-with cortical structure, white matter microstructure, and neural function during a working memory (WM) task across development. Analyses included 53 youths (age 6-19 years). Higher SES as reflected in the income-to-needs ratio was associated with higher parent-reported achievement, WM performance, and cognitive stimulation in the home environment. Although SES was not significantly associated with cortical thickness, children raised in more cognitively stimulating environments had thicker cortex in the frontoparietal network and cognitive stimulation mediated the assocation between SES and cortical thickness in the frontoparietal network. Higher family SES was associated with white matter microstructure and neural activation in the frontoparietal network during a WM task, including greater fractional anisotropy (FA) in the right and left superior longitudinal fasciculi (SLF), and greater BOLD activation in multiple regions of the prefrontal cortex during WM encoding and maintenance. Greater FA and activation in these regions was associated higher parent-reported achievement. Together, cognitive stimulation, WM performance, FA in the SLF, and prefrontal activation during WM encoding and maintenance significantly mediated the association between SES and parent-reported achievement. These findings highlight potential neural, cognitive, and environmental mechanisms linking SES with academic achievement and suggest that enhancing cognitive stimulation in the home environment might be one effective strategy for reducing SES-related disparities in academic outcomes.
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Affiliation(s)
- Maya L Rosen
- Department of Psychology, University of Washington, United States.
| | - Margaret A Sheridan
- Department of Psychology, University of North Carolina, Chapel Hill, United States
| | - Kelly A Sambrook
- Department of Radiology, University of Washington, United States
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426
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Abstract
Anxiety disorders are among the most prevalent psychiatric disorders in youth; however, progress in treatment for childhood anxiety has stalled over the past decade. The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project represents a shift toward a dimensional and interdisciplinary approach to psychiatric disorders; this shift can reframe developmental psychopathology for childhood anxiety and facilitate novel advances in its classification and treatment. Here we highlight constructs in the Systems for Social Processes and the Negative Valence System domains of RDoC, as they relate to childhood anxiety disorders. Childhood anxiety relates to both RDoC domains. In terms of social processes, through natural reliance on parents to reduce children's fear, attachment represents one particular social process, which plays a central role in anxiety among youth. In terms of negative valence, considerable research links threat conditioning to pediatric anxiety. Finally, fronto-amygdala circuitry relates to all three entities, as it has been shown to underly both attachment processes and threat learning, while it also has been consistently implicated in anxiety disorders across development. Through integrative and translational approaches, RDoC provides unique opportunities and simultaneous challenges for advancing the understanding and treatment of childhood anxiety disorders.
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427
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Buchmüller T, Lembcke H, Busch J, Kumsta R, Leyendecker B. Exploring Mental Health Status and Syndrome Patterns Among Young Refugee Children in Germany. Front Psychiatry 2018; 9:212. [PMID: 29887810 PMCID: PMC5981028 DOI: 10.3389/fpsyt.2018.00212] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/04/2018] [Indexed: 11/24/2022] Open
Abstract
Refugee children share a large number of pre-, peri-, and post-migration risk factors, which make them vulnerable for developing mental health concerns. Within the last few years, a large number of families with young children have sought refuge in Germany. However, children's mental health status in Germany is mostly unclear. A central aim of developmental psychopathology is to understand how risk factors lead to the emergence of mental health concerns. One approach to investigating this association is the study of specificity, which describes the idea that specific risk factors are related to specific psychological outcomes. The aim of our study was to assess the mental health status of young refugee children in Germany, and to explore a potential refugee-specific mental health pattern. In two studies, we assessed mental health outcomes of 93 children from Syria or Iraq, aged 1.5-5 years, who recently arrived in Germany. The results were compared to U.S. norm data of typically developing children, and to norm data of a clinical sample in order to explore mental health patterns. In the first study (n = 35), we used standardized screening tools for parents (CBCL 1.5-5). In the second study (n = 58), mental health states of refugee children were assessed by caretakers (CTRF 1.5-5). In comparison to U.S. norm data of normally developing children, refugee parents reported more mental health concerns for their children, especially on syndrome scales of internalizing difficulties. A comparison to U.S. clinical reference data showed a specific mental health pattern, characterized by increased levels of anxiety/depression, attention problems, and withdrawal behavior. Caretakers, too, reported more mental health problems compared to typically developing children, albeit to a smaller extent. However, a comparison to clinically-referred children only led to partial confirmation of a specific mental health pattern. Our studies offer important insights into the mental health status and pattern of young refugee children, which is essential for preventing the onset of psychopathology and for offering tailored interventions.
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Affiliation(s)
- Thimo Buchmüller
- Department of Developmental Psychology, Faculty of Psychology, Ruhr-University Bochum Bochum, Germany
| | - Hanna Lembcke
- Department of Developmental Psychology, Faculty of Psychology, Ruhr-University Bochum Bochum, Germany
| | - Julian Busch
- Department of Developmental Psychology, Faculty of Psychology, Ruhr-University Bochum Bochum, Germany
| | - Robert Kumsta
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum Bochum, Germany
| | - Birgit Leyendecker
- Department of Developmental Psychology, Faculty of Psychology, Ruhr-University Bochum Bochum, Germany
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428
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Dennison MJ, Rosen ML, Sambrook KA, Jenness JL, Sheridan MA, McLaughlin KA. Differential Associations of Distinct Forms of Childhood Adversity With Neurobehavioral Measures of Reward Processing: A Developmental Pathway to Depression. Child Dev 2017; 90:e96-e113. [PMID: 29266223 DOI: 10.1111/cdev.13011] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Childhood adversity is associated with altered reward processing, but little is known about whether this varies across distinct types of adversity. In a sample of 94 children (6-19 years), we investigated whether experiences of material deprivation, emotional deprivation, and trauma have differential associations with reward-related behavior and white matter microstructure in tracts involved in reward processing. Material deprivation (food insecurity), but not emotional deprivation or trauma, was associated with poor reward performance. Adversity-related influences on the integrity of white matter microstructure in frontostriatal tracts varied across childhood adversity types, and reductions in frontostriatal white matter integrity mediated the association of food insecurity with depressive symptoms. These findings document distinct behavioral and neurodevelopmental consequences of specific forms of adversity that have implications for psychopathology risk.
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429
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Nooner KB, Hooper SR, De Bellis MD. An examination of sex differences on neurocognitive functioning and behavior problems in maltreated youth. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2017; 10:435-443. [PMID: 29199840 DOI: 10.1037/tra0000356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE In the developmental traumatology model, the biological construct of sex is considered a moderator that may negatively influence child maltreatment sequelae including those pertaining to neurocognitive function. METHOD This study examined sex-differences in neurocognitive function and behavior problems in maltreated boys (n = 42), maltreated girls (n = 56) versus nonmaltreated boys (n = 45) and girls (n = 59). Maltreated boys were hypothesized to have poorer neurocognitive functioning than maltreated girls, and nonmaltreated boys and girls, in all neurocognitive domains, particularly pertaining to executive function and attention. We also examined correlations between cognitive function and parent report of child behavior problems for maltreated and nonmaltreated children. RESULTS Maltreated boys performed more poorly on measures of intelligence, attention, language, memory, executive function, and academic achievement in both reading and math than nonmaltreated boys. Maltreated boys did not perform more poorly on these cognitive measures or behavioral measures than maltreated girls, except for one memory measure. Maltreated girls performed more poorly on measures of intelligence, language, memory, executive function, and academic achievement than nonmaltreated girls. Maltreated girls with better visual-spatial skills had more internalizing and externalizing problems. Effect sizes for these sex differences ranged from small to large. CONCLUSIONS Both maltreated boys and girls showed poorer cognitive function than their nonmaltreated sex-matched controls. Maltreated girls had subtle sparing of attention and short-term memory (STM). Understanding sex differences in neurocognitive functioning may have implications for designing large population studies of maltreated youth. (PsycINFO Database Record
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Affiliation(s)
- Kate B Nooner
- Department of Psychology, University of North Carolina, Wilmington
| | - Stephen R Hooper
- Department of Allied Health Sciences, University of North Carolina School of Medicine
| | - Michael D De Bellis
- Duke Healthy Childhood Brain Development Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
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430
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Sheridan MA, Peverill M, Finn AS, McLaughlin KA. Dimensions of childhood adversity have distinct associations with neural systems underlying executive functioning. Dev Psychopathol 2017; 29:1777-1794. [PMID: 29162183 PMCID: PMC5733141 DOI: 10.1017/s0954579417001390] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Childhood adversity is associated with increased risk for psychopathology. Neurodevelopmental pathways underlying this risk remain poorly understood. A recent conceptual model posits that childhood adversity can be deconstructed into at least two underlying dimensions, deprivation and threat, that are associated with distinct neurocognitive consequences. This model argues that deprivation (i.e., a lack of cognitive stimulation and learning opportunities) is associated with poor executive function (EF), whereas threat is not. We examine this hypothesis in two studies measuring EF at multiple levels: performance on EF tasks, neural recruitment during EF, and problems with EF in daily life. In Study 1, deprivation (low parental education and child neglect) was associated with greater parent-reported problems with EF in adolescents (N = 169; 13-17 years) after adjustment for levels of threat (community violence and abuse), which were unrelated to EF. In Study 2, low parental education was associated with poor working memory (WM) performance and inefficient neural recruitment in the parietal and prefrontal cortex during high WM load among adolescents (N = 51, 13-20 years) after adjusting for abuse, which was unrelated to WM task performance and neural recruitment during WM. These findings constitute strong preliminary evidence for a novel model of the neurodevelopmental consequences of childhood adversity.
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431
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Miu AC, Bîlc MI, Bunea I, Szentágotai-Tătar A. Childhood trauma and sensitivity to reward and punishment: Implications for depressive and anxiety symptoms. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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432
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Parra GR, Smith GL, Mason WA, Savolainen J, Chmelka MB, Miettunen J, Järvelin MR. Tests of linear and nonlinear relations between cumulative contextual risk at birth and psychosocial problems during adolescence. J Adolesc 2017; 60:64-73. [PMID: 28755649 PMCID: PMC5601021 DOI: 10.1016/j.adolescence.2017.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
This study tested whether there are linear or nonlinear relations between prenatal/birth cumulative risk and psychosocial outcomes during adolescence. Participants (n = 6963) were taken from the Northern Finland Birth Cohort Study 1986. The majority of participants did not experience any contextual risk factors around the time of the target child's birth (58.1%). Even in this low-risk sample, cumulative contextual risk assessed around the time of birth was related to seven different psychosocial outcomes 16 years later. There was some evidence for nonlinear effects, but only for substance-related outcomes; however, the form of the association depended on how the cumulative risk index was calculated. Gender did not moderate the relation between cumulative risk and any of the adolescent psychosocial outcomes. Results highlight the potential value of using the cumulative risk framework for identifying children at birth who are at risk for a range of poor psychosocial outcomes during adolescence.
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Affiliation(s)
- Gilbert R Parra
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 135 Mabel Lee Hall, Lincoln, NE 68588, United States.
| | - Gail L Smith
- Boys Town National Research Institute for Child and Family Studies, 14100 Crawford Street, Boys Town, NE 68010, United States
| | - W Alex Mason
- Boys Town National Research Institute for Child and Family Studies, 14100 Crawford Street, Boys Town, NE 68010, United States
| | - Jukka Savolainen
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, United States
| | - Mary B Chmelka
- Boys Town National Research Institute for Child and Family Studies, 14100 Crawford Street, Boys Town, NE 68010, United States
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC PHE Centre for Environment and Health, School of Public Health, Imperial College London, UK; Center for Life Course Epidemiology, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Biocenter Oulu, University of Oulu, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland
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433
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McLaughlin KA, Sheridan MA, Nelson CA. Neglect as a Violation of Species-Expectant Experience: Neurodevelopmental Consequences. Biol Psychiatry 2017; 82:462-471. [PMID: 28392082 PMCID: PMC5572554 DOI: 10.1016/j.biopsych.2017.02.1096] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/03/2017] [Accepted: 02/20/2017] [Indexed: 12/25/2022]
Abstract
The human brain requires a wide variety of experiences and environmental inputs in order to develop normally. Children who are neglected by caregivers or raised in institutional environments are deprived of numerous types of species-expectant environmental experiences. In this review, we articulate a model of how the absence of cognitive stimulation and sensory, motor, linguistic, and social experiences common among children raised in deprived early environments constrains early forms of learning, producing long-term deficits in complex cognitive function and associative learning. Building on evidence from animal models, we propose that deprivation accelerates the neurodevelopmental process of synaptic pruning and limits myelination, resulting in age-specific reductions in cortical thickness and white matter integrity among children raised in deprived early environments. We review evidence linking early experiences of psychosocial deprivation to reductions in cognitive ability, associative and implicit learning, language skills, and executive functions as well as atypical patterns of cortical and white matter development-domains that should be profoundly influenced by deprivation through the learning and neural mechanisms we propose. These patterns of atypical development are difficult to explain with existing models that emphasize stress pathways and accelerated limbic system development. A learning account of how deprived early environments influence cognitive and neural development provides a complementary perspective to stress models and highlights novel pathways through which deprivation might confer risk for internalizing and externalizing psychopathology. We end by reviewing evidence for plasticity in cognitive and neural development among children raised in deprived environments following interventions that improve caregiving quality.
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Affiliation(s)
- Katie A McLaughlin
- Department of Psychology, University of Washington, Seattle, Washington.
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Charles A Nelson
- Division of Developmental Medicine and Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston; Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts
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434
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Gard AM, Waller R, Shaw DS, Forbes EE, Hariri AR, Hyde LW. The long reach of early adversity: Parenting, stress, and neural pathways to antisocial behavior in adulthood. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:582-590. [PMID: 29170760 PMCID: PMC5695704 DOI: 10.1016/j.bpsc.2017.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early life adversities including harsh parenting, maternal depression, neighborhood deprivation, and low family economic resources are more prevalent in low-income urban environments and are potent predictors of psychopathology, including, for boys, antisocial behavior (AB). However, little research has examined how these stressful experiences alter later neural function. Moreover, identifying genetic markers of greater susceptibility to adversity is critical to understanding biopsychosocial pathways from early adversity to later psychopathology. METHODS Within a sample of 310 low-income boys followed from age 1.5 to 20, multimethod assessments of adversities were examined at age 2 and age 12. At age 20, amygdala reactivity to emotional facial expressions was assessed using fMRI, and symptoms of Antisocial Personality Disorder were assessed via structured clinical interview. Genetic variability in cortisol signaling (CRHR1) was examined as a moderator of pathways to amygdala reactivity. RESULTS Observed parenting and neighborhood deprivation at age 2 each uniquely predicted amygdala reactivity to emotional faces at age 20 over and above other adversities measured at multiple developmental periods. Harsher parenting and greater neighborhood deprivation in toddlerhood predicted clinically-significant symptoms of AB via less amygdala reactivity to fearful facial expressions and this pathway was moderated by genetic variation in CRHR1. CONCLUSIONS These results elucidate a pathway linking early adversity to less amygdala reactivity to social signals of interpersonal distress 18 years later, which in turn increased risk for serious AB. Moreover, these findings suggest a genetic marker of youth more susceptible to adversity.
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Affiliation(s)
- Arianna M Gard
- Department of Psychology, University of Michigan, Ann Arbor, MI
| | - Rebecca Waller
- Department of Psychology, University of Michigan, Ann Arbor, MI
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA
| | - Erika E Forbes
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, NC
| | - Luke W Hyde
- Department of Psychology, University of Michigan, Ann Arbor, MI
- Center for Human Growth and Development & Institute for Social Research, University of Michigan, Ann Arbor, MI
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435
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Bush NR, Lane RD, McLaughlin KA. Mechanisms Underlying the Association Between Early-Life Adversity and Physical Health: Charting a Course for the Future. Psychosom Med 2017; 78:1114-1119. [PMID: 27763991 PMCID: PMC5111624 DOI: 10.1097/psy.0000000000000421] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Early-life adversities (ELA) are associated with subsequent pervasive alterations across a wide range of neurobiological systems and psychosocial factors that contribute to accelerated onset of health problems and diseases. In this article, we provide an integrated perspective on recent developments in research on ELA, based on the articles published in this Special Issue of Psychosomatic Medicine. We focus on the following: 1) the distinction between specific versus general aspects of ELA with regard to the nature of exposure (e.g., physical and sexual abuse, emotional abuse or neglect, relative socioeconomic deprivation), biological and behavioral correlates of ELA, and differences across diseases; 2) the importance of timing in the critical phases of exposure to ELA; and 3) adaptive versus dysfunctional responses to ELA and their consequences for biological and behavioral risk factors for adverse health outcomes. This article concludes with outlining important new targets for research in this area, including the neurobiology of affect as a mechanism linking ELA to adverse health outcomes, and the need for large-scale longitudinal investigations of multisystem processes relevant to ELA in diverse samples, starting prenatally, continuing to late adolescence, and with long-term follow-up assessments that enable evaluation of incident disease outcomes.
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Affiliation(s)
- Nicole R Bush
- From the Departments of Psychiatry and Pediatrics, University of California San Francisco, Division of Developmental Medicine, Center for Health and Community (Bush), San Francisco, California; Departments of Psychiatry, Psychology and Neuroscience (Lane), University of Arizona, Tucson, Arizona; Department of Psychology (McLaughlin), University of Washington, Seattle, Washington
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436
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Hostinar CE, Nusslock R, Miller GE. Future Directions in the Study of Early-Life Stress and Physical and Emotional Health: Implications of the Neuroimmune Network Hypothesis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 47:142-156. [PMID: 28107039 DOI: 10.1080/15374416.2016.1266647] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Early-life stress is associated with increased vulnerability to physical and emotional health problems across the lifespan. The recently developed neuroimmune network hypothesis proposes that one of the underlying mechanisms for these associations is that early-life stress amplifies bidirectional crosstalk between the brain and the immune system, contributing to several mental and physical health conditions that have inflammatory underpinnings, such as depression and coronary heart disease. Neuroimmune crosstalk is thought to perpetuate inflammation and neural alterations linked to early-life stress exposure, and also foster behaviors that can further compromise health, such as smoking, drug abuse and consumption of high-fat diets. The goal of the present review is to briefly summarize the neuroimmune network hypothesis and use it as a starting point for generating new questions about the role of early-life stress in establishing a dysregulated relationship between neural and immune signaling, with consequences for lifespan physical and emotional health. Specifically, we aim to discuss implications and future directions for theory and empirical research on early-life stress, as well as for interventions that may improve the health and well-being of children and adolescents living in adverse conditions.
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