Maternal depression and infant daytime cortisol

Resilience resources, coping, and health outcomes in college students during the Covid-19 pandemic

Background: Resilience resources are predispositions that promote individuals' abilities to cope with stress. Objective: The current cross-sectional study used path analysis with parallel multiple mediators to test whether coping behaviors mediated associations between resilience resources and somatic, depression, and anxiety symptoms during the Covid-19 pandemic. Method: Undergraduates at a small Northeastern college (n = 193) completed online surveys assessing resilience resources, coping, and symptoms. Results: Results support significant indirect effects from resilience resources to somatic symptoms through positive reinterpretation and growth, mental disengagement, and substance use. Total indirect effects for depressive symptoms were driven by mental disengagement and substance use, with a direct effect of resilience resources. The effect of resilience resources on anxiety symptoms was mediated by mental disengagement, and there was a direct effect of resilience resources. Conclusions: Findings demonstrate that some coping strategies link resilience resources to better outcomes, potentially informing interventions for adaptive coping during public health crises.

Maternal depression and child telomere length: The role of genetic sensitivity

BACKGROUND

The stress of a mother's depression may increasingly tax psychobiological systems that help children with self-regulation, increasing children's allostatic load over time. Some evidence supports children exposed to maternal depression tend to have shorter telomeres and tend to have more somatic and psychological problems. Children having one or more A1 alleles of dopamine receptor 2 (DRD2, rs1800497), tend to have greater sensitivity to maternal depression and could experience more adverse child outcomes that contribute to greater allostatic load.

METHODS

Using the Future Families and Child Wellbeing dataset, secondary-data analyses were used to test the effect of repeated exposure to maternal depression during early childhood on children's telomere length during middle childhood moderated by children's DRD2 genotype (N = 2884).

RESULTS

Greater maternal depression was not significantly associated with shorter child telomere length and this association was not moderated by DRD2 genotypes while controlling for factors associated with child telomere length.

IMPLICATIONS

The effect of maternal depression on children's TL may not be significant in populations from diverse racial-ethnic and family backgrounds during middle childhood. These findings could help further our current understanding psychobiological systems affected by maternal depression that result in adverse child outcomes.

LIMITATIONS

Even though this study used a relatively large and diverse sample, replication of DRD2 moderation in even larger samples is an important next step.

Under my skin: Parenting behavior and children's cortisol in the Los Angeles family and neighborhood survey

This study examined links between aspects of parenting behavior and children's cortisol and whether those links varied by child behavioral problems and ethnicity. Participants included children ages 9-15 (N = 159, 75% Latinx) and their primary caregivers from the Los Angeles Family and Neighborhood Survey (L.A.FANS; Wave 2). Children provided saliva upon waking, 30 min after waking, and at bedtime which was analyzed for cortisol. Analyses revealed associations between parenting behavior and cortisol were greater among children who had behavioral problems and these associations were stronger among non-Latinx White children compared to Latinx children. This study moves beyond the current literature by investigating these important associations in a predominately Latinx urban sample of children.

Psychiatric Symptoms, Posttraumatic Growth, and Life Satisfaction Among Parents of Seriously Ill Infants: A Prospective Case-Controlled Study

We evaluated psychiatric symptoms, posttraumatic growth, and life satisfaction among the parents (n = 34) of newborns (n = 17) requiring therapeutic hypothermia or urgent surgery (interest group). Our control group included 60 parents of healthy newborns (n = 30). The first surveys were completed soon after diagnosis or delivery and the follow-up surveys 1 year later (participation rate 88% in the interest group and 70% in the control group). General stress was common in both groups but was more prevalent in the interest group as were depressive symptoms, too. Anxiety was more common in the interest group, although it showed a decrease from the baseline in both groups. Life satisfaction had an inverse correlation with all measures of psychiatric symptoms, and it was lower in the interest group in the early stage, but similar at 12 months due to the slight decline in the control group. Mothers in the interest group had more anxiety and depressive symptoms than fathers in the early stage. Mothers had more traumatic distress than fathers at both time points. Half of the parents experienced substantial posttraumatic growth at 12 months. In conclusion, the serious illness of an infant substantially affects the well-being of the parents in the early stages of illness and one year after the illness.

Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders

One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.

Examining the role of socioeconomic status and temperament in the hair cortisol levels of infants

Socioeconomic status (SES) appears to be an important contextual factor in children's developmental outcomes, including their responses to stress. However, some children are more susceptible to its effects than others. Hair cortisol is a newer method of assessing the activity of the HPA axis, providing cumulative cortisol levels. The present article examined whether temperament (negative emotionality) moderates the association between an SES index and the hair cortisol concentration (HCC) of infants. Sixty infants from 6 to 15 months of age were recruited, of which 49 had sufficient hair for cortisol analysis. The SES index was calculated from the education levels of the mothers, family income, and a scale measuring the quality of the home environment. Negative emotionality was measured with the three sub-scales of the Infant Behavior Questionnaire (falling reactivity, distress to limitations, and fear). Among infants low in negative emotionality, there was no association between SES and cortisol. In contrast, among those high in negative emotionality, a significant association was obtained. These infants showed lower levels of HCC in lower-SES environments. The findings suggest that there are individual differences in reacting to the environment, and low levels of cortisol (not high) were found in susceptible infants in lower-SES families.

Maternal Symptoms of Anxiety and Depression and Child Nocturnal Awakenings at 6 and 18 Months

Objective

We aim to estimate the pathways between maternal symptoms of anxiety and depression and child nocturnal awakenings via structural equation modeling using a sibling design.

Methods

Structural equation modeling on data from 14,926 sibling dyads or triads from the Norwegian Mother and Child Cohort Study.

Results

At 6 months, we estimated the association between maternal symptoms of anxiety and child nocturnal awakenings to be owing to several nonsignificant pathways. Child nocturnal awakenings at 18 months, however, were influenced by concurrent maternal symptoms of anxiety (β = .10) and depression (β = .12). Neither maternal symptoms of anxiety (β = .04) nor depression (β = -.00) was influenced by concurrent child nocturnal awakenings.

Conclusions

Our findings suggest that maternal mental health influences child sleep behavior at 18 months after birth, and not vice versa. This is in support of hypotheses on maternal mental health influencing child sleep during toddlerhood.

The Prospective Association of the Diurnal Cortisol Rhythm With Sleep Duration and Perceived Sleeping Problems in Preschoolers: The Generation R Study

OBJECTIVE

Cortisol, the end product of the hypothalamic-pituitary-adrenal axis, plays an important role in modulating sleep. Yet, studies investigating the association between diurnal cortisol rhythm and sleep patterns in young children are scarce. We tested the hypothesis that the diurnal cortisol rhythm is associated with shorter sleep duration and more sleep problems across early childhood.

METHODS

This study was embedded in Generation R, a population-based cohort from fetal life onward. Parents collected saliva samples from their infant at five moments during day 1. In 322 infants aged 12 to 20 months, we determined the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Sleep duration and sleep behavior were repeatedly assessed across ages of 14 months to 5 years. Generalized estimating equation models were used to assess related cortisol measures to sleep duration and sleep behavior.

RESULTS

The diurnal cortisol slope and the CAR, but not the AUC, were associated with sleep duration across childhood. Children with flatter slopes and children with a more positive CAR were more likely to have shorter nighttime sleep duration (β per nmol/L/h slope = -0.12, 95% confidence interval = -0.19 to -0.05, p = .001; β per nmol/L CAR = -0.01, 95% confidence interval = -0.02 to 0.00, p = .04). Cortisol measures did not predict sleep problems.

CONCLUSIONS

The present study suggests that a flatter diurnal cortisol slope and a more marked morning rise, which can indicate stress (or hypothalamic-pituitary-adrenal dysregulation), have a long-term association with sleep regulation.

Stress Physiology in Infancy and Early Childhood: Cortisol Flexibility, Attunement and Coordination

Research on stress physiology in infancy has assumed increasing importance due to its lifelong implications. In this review, we focus on measurement of hypothalamic-pituitary-adrenal (HPA) function, in particular, and on complementary autonomic processes. We suggest that the measure of HPA function has been overly exclusive, focusing on individual reactivity to single, pragmatically selected laboratory challenges. We advocate use of multiple, strategically chosen challenges and within-subject designs. By administering one challenge that typically does not provoke reactivity and another that does, it is possible to represent allostatic load in terms of "flexibility," the capacity to titrate response to challenge. We also recommend assessing infant reactivity in the context of the primary caregiver's physiological function. Infant-mother "attunement" is central to developmental psychology, permeating diverse developmental domains with varied consequences. A review of adrenocortical attunement suggests that attunement is a reliable process, manifest across varied populations. However, attunement appears stronger in the context of more highly stressful circumstances, such that administration of multiple, selected challenges may help evaluate the degree to which individuals titrate attunement to challenge and determine the correlates of this differential attunement. Finally, we advocate studying the "coordination" of HPA function with other aspects of stress physiology and variation in the degree of this coordination. The use of multiple stressors is important here because each stress system is differentially sensitive to different types of challenge. Therefore, use of single stressors in between-subject designs impedes full recognition of the role played by each system. Overall, we recommend measure of flexibility, attunement, and coordination in the context of multiple challenges to capture allostasis in environmental and physiological context. The simultaneous use of such inclusive and integrative metrics may yield more reliable findings than has hitherto been the case. The interrelation of these metrics can be understood in the context of the adaptive calibration model..

Infant hair cortisol: associations with salivary cortisol and environmental context

Early chronic stress has enduring implications for physical and mental health outcomes. Hair cortisol concentration (HCC) has emerged as a marker of cumulative cortisol exposure, yet HCC in infants is not well understood. We examined how infant HCC relates to widely used basal salivary cortisol measures, maternal HCC, and environmental context in 111 infants assessed at 6 and 12 months of age. Maternal HCC at 6 and 12 months was correlated with infant HCC at 12 months. At 12 months, infant HCC was positively associated with waking salivary cortisol concentration (SCC), evening SCC, and area under the curve (AUC), but was independent of diurnal slope. Breastfeeding was associated with lower HCC, whereas increased sleep disruption was related to flatter slope. Reduced nighttime sleep duration was related both to higher HCC and to flatter slope. A person-focused analysis indicated that the combination of high HCC and flattened slope was associated with more environmental risks, highlighting the importance of investigating the interplay between HCC and diurnal cortisol slope. Results support the validity of HCC as a marker of cumulative cortisol exposure in infancy, while emphasizing the value of including multiple cortisol measures assessing distinct aspects of hypothalamic-pituitary-adrenal (HPA) function.

Associations between bedtime and nighttime parenting and infant cortisol in the first year

We examined how maternal care within the bedtime and nighttime contexts influences infant cortisol levels and patterning. Eighty-two mothers (M_age  = 29.4 years) and infants participated in a longitudinal study when infants were 3, 6, and 9 months old. At each time point, bedtime and nighttime parenting were recorded and infant cortisol at bedtime and the following morning was analyzed. Multilevel model analyses showed that infants had lower cortisol levels when mothers were more emotionally available at bedtime, and infants whose mothers responded more often to their non-distressed cues had lower cortisol levels on average. Less co-sleeping and more maternal responses to infant distress were linked to healthier cortisol patterning. By shedding light on parenting qualities and behaviors that influence infant cortisol, these results indicate avenues for intervention and suggest the utility of studying parenting in infant sleep contexts.

Postpartum depression: Etiology, treatment and consequences for maternal care

This article is part of a Special Issue "Parental Care". Pregnancy and postpartum are associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring.

DRD2 and SLC6A3 moderate impact of maternal depressive symptoms on infant cortisol

Both maternal depressive symptoms and infants' dopamine-related genetic characteristics have been linked to infants' hypothalamic-pituitary-adrenal (HPA) functioning. This study investigated the interactive influence of maternal depressive symptoms and infant DRD2 and SLC6A3 genotypes on infant cortisol reactivity; whether this interaction reflects diathesis-stress or differential susceptibility; and whether this interaction influences the flexibility of the infant cortisol response across challenges known to exert differential effects on infant cortisol reactivity. A community sample of 314 mother-infant dyads participated in toy frustration (age 16 months) and maternal separation (age 17 months) challenges, and salivary cortisol was collected at baseline, +20, and +40min. Maternal depressive symptoms were assessed with the Beck Depression Inventory-II at infant age 16 months. Infant buccal cells were collected at both time points for genotyping. DRD2 and SLC6A3 genotypes moderated the relation between maternal depressive symptomatology and infant cortisol reactivity in a diathesis-stress manner in the context of toy frustration, and in a differential susceptibility manner in the context of maternal separation. Higher levels of maternal depressive symptoms predicted reduced cortisol flexibility across challenges for infants with at least one A1 allele of DRD2 and infants with the 10/10 genotype of SLC6A3. Results suggest that maternal depressive symptomatology is related to infants' cortisol reactivity and to the flexibility of that reactivity across psychosocial challenges, but this relation is dependent on the infant's genetic characteristics.

Children's mental representations with respect to caregivers and post-traumatic symptomatology in Somatic Symptom Disorders and Disruptive Behavior Disorders

Introduction: In line with literature, the quality of adult–infant interactions and mental representations of the caregivers play an essential role in influencing the children’s well-being. Many studies focused the attention on the role of attachment for a better evaluation of child psychopathological outcomes. The flexibility of the child’s attachment model gives the opportunity to parents to be helped in modifying their own caregiving quality, encouraging the reflection on the children’s state of mind with respect to attachment. The aims of this study were to evaluate: (1) the attachment models in young patients diagnosed with Disruptive Behavior Disorders (DBDs) and Somatic Symptoms Disorders (SSDs); (2) the levels of post-traumatic symptomatology; (3) the association between the attachment models and post-traumatic symptomatology.

Methods: Forty Italian patients, aged from 8 to 15, recruited at Gaslini Paediatric Hospital of Genoa, previously diagnosed with SSD (N = 20) and DBD (N = 20) were assessed using the Child Attachment Interview (CAI), the Separation Anxiety Test (SAT), the Trauma Symptom Checklist for Children (TSCC-A). Socio-demographic data were collected.

Results: In both the clinical samples, the findings on the distribution of attachment models showed a significant presence of insecure attachment with respect to both parents in more than a half of the patients and high levels of disorganized attachment. No significant differences between DBD and SSD samples were found on post-traumatic symptomatology (Post-Traumatic Stress and Dissociation). Significant differences were found on Depression, Anxiety, and Fantasy subscales.

Discussion: This study can provide a detection of dysfunctional aspects in clinical populations. The findings suggest that the quality of the attachment to parents may be a fundamental element to better assess SSD and DBD in children and adolescents. Clinical implications of this study aimed at improving parental caregiving are highlighted.

The potential of infant fMRI research and the study of early life stress as a promising exemplar

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fMRI research with infants and toddlers has increased rapidly over the past decade.

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Infant fMRI has provided unique insight into early functional brain development.

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Complex methodological challenges associated with infant fMRI warrant careful consideration and ongoing research.

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Infant fMRI has potential to contribute to multiple fields of study.

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The study of early life stress is a prime example of a field that is ripe to benefit from this technique.

Functional magnetic resonance imaging (fMRI) research with infants and toddlers has increased rapidly over the past decade, and provided a unique window into early brain development. In the current report, we review the state of the literature, which has established the feasibility and utility of task-based fMRI and resting state functional connectivity MRI (rs-fcMRI) during early periods of brain maturation. These methodologies have been successfully applied beginning in the neonatal period to increase understanding of how the brain both responds to environmental stimuli, and becomes organized into large-scale functional systems that support complex behaviors. We discuss the methodological challenges posed by this promising area of research. We also highlight that despite these challenges, early work indicates a strong potential for these methods to influence multiple research domains. As an example, we focus on the study of early life stress and its influence on brain development and mental health outcomes. We illustrate the promise of these methodologies for building on, and making important contributions to, the existing literature in this field.

Maternal emotional availability at bedtime and infant cortisol at 1 and 3 months

BACKGROUND

Previous work has shown that early experience influences infant cortisol secretion. Few studies, however, have examined associations between parenting quality and cortisol levels and patterning in very young infants.

AIMS

This study examined linkages between maternal emotional availability (EA) during a routine caregiving task, bedtime, and infant cortisol in the first 3 months of life. Concurrent and longitudinal associations between maternal EA and infant cortisol were examined.

STUDY DESIGN

Families were visited when their infants were 1 and 3 months old. Video equipment was set up in order to record the infant's bedtime routine. Parents were provided with materials with which to take saliva samples from their infants at late afternoon, bedtime, and the following morning.

SUBJECTS

At 1 month, participants were 96 mothers and infants living in a rural U.S. state. Data were available for 88 mothers and infants at 3 months.

OUTCOME MEASURES

Maternal EA was scored from videotapes of bedtime at each age point. Infant cortisol was assessed from the saliva samples taken by parents.

RESULTS

Regression analyses indicated that at 1 and 3 months of age, infants of more emotionally available mothers showed lower levels of cortisol secretion across the night than infants of less emotionally available mothers. Additionally, multilevel model analyses indicated that infants of more emotionally available mothers showed greater evidence of a decline in their cortisol levels across the evening, followed by an increase across the nighttime into the morning in their cortisol at 3 months.

CONCLUSIONS

Findings suggest that maternal care in the context of a routine caregiving task is associated with lower stress reactivity and with earlier circadian patterning in very young infants.

Behavior problems in middle childhood: the predictive role of maternal distress, child attachment, and mother-child interactions

The objective of the study was to examine the longitudinal relation between early school-age measures of maternal psychosocial distress, quality of mother-child interactions, and child attachment behavior, and behavior problem profiles in middle childhood using a multi-informant design. Participants were 243 French-speaking mother-child dyads (122 girls) who were part of an ongoing longitudinal project. Maternal psychosocial distress was assessed when children were between 4 and 6 years of age. Mother-child interactive quality and attachment patterns were observed at age 6 during a laboratory visit. At age 8.5, externalizing and internalizing problems were assessed using mother and child reports. Results show that maternal psychosocial distress predicted later social adaptation reported by the child through the mediation of mother-child interactions. Analyses also revealed that higher maternal psychosocial distress and controlling attachment patterns, either of the punitive or caregiving type, significantly predicted membership in both child internalizing and externalizing clinical problem groups. Lower mother-child interactive quality, male gender, and child ambivalent attachment were also predictors of externalizing clinical problems.

Maternal PTSD associates with greater glucocorticoid sensitivity in offspring of Holocaust survivors

Intergenerational effects of trauma have been observed clinically in a wide range of populations, and parental PTSD has been associated with an increased risk for psychopathology in offspring. In studies of Holocaust survivor offspring, parental PTSD, and particularly maternal PTSD, has been associated with increased risk for PTSD, low basal urinary cortisol excretion and enhanced cortisol suppression in response to dexamethasone. Such findings implicate maternally derived glucocorticoid programming in the intergenerational transmission of trauma-related consequences, potentially resulting from in utero influences or early life experiences. This study investigated the relative influence of Holocaust exposure and PTSD in mothers and fathers on glucocorticoid sensitivity in offspring. Eighty Holocaust offspring and 15 offspring of non-exposed Jewish parents completed evaluations and provided blood and urine samples. Glucocorticoid sensitivity was evaluated using the lysozyme suppression test (LST), an in vitro measure of glucocorticoid receptor sensitivity in a peripheral tissue, the dexamethasone suppression test (DST), and 24-h urinary cortisol excretion. Maternal PTSD was associated with greater glucocorticoid sensitivity in offspring across all three measures of glucocorticoid function. An interaction of maternal and paternal PTSD on the DST and 24-h urinary cortisol showed an effect of decreased glucocorticoid sensitivity in offspring with paternal, but not maternal, PTSD. Although indirect, these findings are consistent with the hypothesis that epigenetic programming may be involved in the intergenerational transmission of trauma-related effects on glucocorticoid regulation.

Urinary paraben concentrations among pregnant women and their matching newborn infants of Korea, and the association with oxidative stress biomarkers

Parabens have been used in multiple products including personal care products, pharmaceuticals, and foods for more than 50 years but increasing numbers of studies have raised concerns on their safety. The present study was designed to determine urinary paraben levels among pregnant women and their matching newborn infants (<48 h after delivery), and the association between paraben levels and stress markers. Pregnant women (n=46) and their matching newborn infants were recruited from four university hospitals located in Seoul, Ansan and Jeju of Korea, 2011. Parabens including methyl paraben (MP), ethyl paraben (EP), n-propyl paraben (PP), and n-butyl paraben (BP) were measured in the urine using an automatic, high throughput online SPE-LC-MS/MS method. Urinary concentrations were normalized with specific gravity (SG). Free cortisol, malondealdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured in the urine as stress marker. Urinary MP was detected as the highest, and BP was detected as the lowest paraben in the urine samples of both pregnant women and their infants. Significant correlations between paraben concentrations of maternal and their newborn infant's urine were observed. The levels of urinary parabens among Korean pregnant women are comparable to those reported elsewhere, except for EP which were 4-9 folds higher than pregnant women of other countries. The ratios of infant to maternal urinary paraben concentrations varied between 0.5 and 0.6 for MP and PP, but approximately 10 fold lower for EP. Urinary MP or EP levels were associated with several oxidative stress related biomarkers such as urinary 8-OHdG and MDA, even after the adjustment of relevant covariates such as maternal age, mode of delivery, pre-pregnancy BMI, gestational age and parity. This is the first study that reported the levels of major parabens in the first urine of newborn infants. Further studies are warranted to understand the implications of paraben exposure among biologically susceptible human populations.