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Bertelsen TB, Haugland BSM, Wergeland GJ, Håland ÅT. Parental Early Life Maltreatment and Related Experiences in Treatment of Youth Anxiety Disorder. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01520-1. [PMID: 36939980 DOI: 10.1007/s10578-023-01520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/21/2023]
Abstract
The role of parents' early life maltreatment (ELM) (e.g. physical, sexual abuse) and related experiences, in relation to offspring anxiety is not well understood. The current study investigated the association between self-reported depression and ELM and related experiences in mothers (n = 79) and fathers (n = 50), and mother-, father-, and youth-reported symptoms of youth anxiety (n = 90). Outcomes were assessed at pre,- and posttreatment and 3-, 6-, and 12-months follow-up. Parental ELM were not associated with pre-treatment differences or differences in outcome of treatment. However ELM related experiences were associated with increased mother-, father-, and youth-rated youth anxiety at pretreatment. Fathers depressive symptoms were found to mediate the relationship between father ELM related experiences and father-rated youth anxiety symptoms. Future research is warranted on parental ELM and depression as factors affecting outcomes of treatment of youth anxiety. Trial registered at: helseforskning.etikkom.no (reg. nr. 2017/1367).
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Affiliation(s)
- Thomas B Bertelsen
- Department of Child and Adolescence Mental Health, Sørlandet Sykehus, Egsveien 100, 4630, Kristiansand, Norway. .,Department of Clinical Child and Adolescent Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | | | - Gro Janne Wergeland
- Division of Psychiatry, Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Åshild Tellefsen Håland
- Department of Child and Adolescence Mental Health, Sørlandet Sykehus, Egsveien 100, 4630, Kristiansand, Norway
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2
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Fransquet PD, Hjort L, Rushiti F, Wang S, Krasniqi SP, Çarkaxhiu SI, Arifaj D, Xhemaili VD, Salihu M, Leku NA, Ryan J. DNA methylation in blood cells is associated with cortisol levels in offspring of mothers who had prenatal post‐traumatic stress disorder. Stress Health 2022; 38:755-766. [PMID: 35119793 PMCID: PMC9790331 DOI: 10.1002/smi.3131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 12/30/2022]
Abstract
Maternal stress during pregnancy is associated with differential DNA methylation in offspring and disrupted cortisol secretion. This study aimed to determine methylation signatures of cortisol levels in children, and whether associations differ based on maternal post-traumatic stress disorder (PTSD). Blood epigenome-wide methylation and fasting cortisol levels were measured in 118 offspring of mothers recruited from the Kosovo Rehabilitation Centre for Torture Victims. Mothers underwent clinically administered assessment for PTSD using Diagnostic and Statistical Manual of Mental Disorders. Correlations between offspring methylation and cortisol levels were examined using epigenome-wide analysis, adjusting for covariates. Subsequent analysis focussed on a priori selected genes involved in the hypothalamic-pituitary-adrenal (HPA) axis stress signalling. Methylation at four sites were correlated with cortisol levels (cg15321696, r = -0.33, cg18105800, r = +0.33, cg00986889, r = -0.25, and cg15920527, r = -0.27). In adjusted multivariable regression, when stratifying based on prenatal PTSD status, significant associations were only found for children born to mothers with prenatal PTSD (p < 0.001). Several sites within HPA axis genes were also associated with cortisol levels in the maternal PTSD group specifically. There is evidence that methylation is associated with cortisol levels, particularly in offspring born to mothers with prenatal PTSD. However, larger studies need to be carried out to independently validate these findings.
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Affiliation(s)
- Peter Daniel Fransquet
- School of Public Health and Preventive MedicineBiological Neuropsychiatry and Dementia UnitMonash UniversityMelbourneVictoriaAustralia
| | - Line Hjort
- Department of ObstetricsCenter for Pregnant Women with DiabetesRigshospitaletCopenhagenDenmark,Novo Nordisk Foundation Center for Basic Metabolic ResearchMetabolic Epigenetics GroupFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Feride Rushiti
- Kosovo Rehabilitation Center for Torture VictimsPristinaAlbania
| | - Shr‐Jie Wang
- Danish Institute Against Torture (DIGNITY)CopenhagenDenmark
| | | | | | - Dafina Arifaj
- Kosovo Rehabilitation Center for Torture VictimsPristinaAlbania
| | | | - Mimoza Salihu
- Kosovo Rehabilitation Center for Torture VictimsPristinaAlbania
| | | | - Joanne Ryan
- School of Public Health and Preventive MedicineBiological Neuropsychiatry and Dementia UnitMonash UniversityMelbourneVictoriaAustralia
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Burenkova OV, Podturkin AA, Naumova OY, Hein S, Li N, Cicchetti D, Luthar SS, Grigorenko EL. Neuroendocrine and autonomic stress systems activity in young adults raised by mothers with mental health and substance abuse problems: A prospective cohort study. Dev Psychobiol 2021; 63:e22213. [PMID: 34813100 DOI: 10.1002/dev.22213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/27/2021] [Accepted: 10/26/2021] [Indexed: 11/07/2022]
Abstract
Among the well-known physiological consequences of early adverse environments is dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. A number of studies demonstrate that negative parenting and living with parents with a history of substance abuse and mental health problems may be associated with HPA axis dysregulation in children. In contrast, studies of more delayed effects in adult offspring, especially prospective, are still scarce. This study was a prospective longitudinal investigation of the association between maternal mental illnesses/substance abuse and maternal negative parenting/parental stress on one side and, on the other side, adult offspring outcomes 10 years later-specifically, we studied the activity of offspring's neuroendocrine (cortisol) and autonomic (heart rate) systems when exposed to a mild psychological stressor. Children of mothers with mental illnesses and/or substance abuse were exposed to more disadvantaged conditions (higher negative parenting and community violence). Despite this, maternal risk groups (having a mother with mental illnesses and/or substance abuse) were not associated with any of the indicators of stress systems activity. Regardless of the risk group, participants with dysregulated HPA axis activity experienced a higher level of negative parenting. Altogether, our study provides evidence that negative parenting may have long-lasting effects on stress-sensitive physiological mechanisms.
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Affiliation(s)
- Olga V Burenkova
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | | | - Oksana Yu Naumova
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation.,Human Genetics Laboratory, Vavilov Institute of General Genetics RAS, Moscow, Russian Federation
| | - Sascha Hein
- Department of Education and Psychology, Free University of Berlin, Berlin, Germany
| | - Nan Li
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Suniya S Luthar
- Authentic Connections, Tempe, Arizona, USA.,Teachers College, Columbia University, New York City, New York, USA
| | - Elena L Grigorenko
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation.,Baylor College of Medicine, Houston, Texas, USA
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Creech SK, Pulverman CS, Kroll-Desrosiers A, Kinney R, Dichter ME, Mattocks K. Intimate Partner Violence Among Pregnant Veterans: Prevalence, Associated Mental Health Conditions, and Health Care Utilization. J Gen Intern Med 2021; 36:2982-2988. [PMID: 33464464 PMCID: PMC8481457 DOI: 10.1007/s11606-020-06498-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent and serious health concern for women veterans, associated with mental and physical health symptoms. The adverse impacts of IPV are exacerbated during pregnancy, with added risks for pregnancy and postpartum outcomes. OBJECTIVE Identify the scope of IPV among pregnant veterans and associations with health outcomes. DESIGN Data were obtained from a national retrospective cohort study. PARTICIPANTS Study participants were 442 pregnant veterans using VHA maternity care benefits. MAIN MEASURES Mental health history was assessed via self-report measure and chart review; history of IPV and perinatal depression were assessed via brief validated self-report measures. KEY RESULTS Fourteen percent of the sample reported past-year IPV. Report of past-year IPV was associated with higher self-reported rates of lifetime mental health disorders including depression (p = 0.01), posttraumatic stress disorder (p = 0.02), anxiety disorders (p = 0.05), mood disorders (p = 0.01), bipolar disorder (p = 0.001), and eating disorders (p = 0.003); past-year IPV was also associated with the diagnosis of posttraumatic stress disorder during pregnancy (p = 0.002). Additionally, past-year IPV was associated with higher rates of military sexual trauma (MST; p = 0.03), pregnancy health risk behaviors (i.e., smoking, alcohol, and drug use; p = 0.004), greater number of VHA mental health visits during pregnancy (p = 0.04), and a lower likelihood of seeking social support from a spouse or partner (p < 0.0001). CONCLUSIONS Results indicate substantial rates of IPV among pregnant veterans, and high rates of mental health conditions which may be exacerbated by MST experience and lower likelihood of seeking social support. Clinicians treating pregnant veterans should screen for and address IPV and mental health treatment needs, and risks should be assessed among pregnant veterans experiencing IPV.
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Affiliation(s)
- Suzannah K Creech
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care System, Waco, USA.
- Department of Psychiatry, Dell Medical School of the University of Texas at Austin, Austin, USA.
| | - Carey S Pulverman
- VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care System, Waco, USA
- Department of Psychiatry, Dell Medical School of the University of Texas at Austin, Austin, USA
| | - Aimee Kroll-Desrosiers
- VHA Central Western Massachusetts Healthcare System, Leeds, USA
- VHA Center for Health Equity Research and Promotion, Crescenz VHA Medical Center, Philadelphia, USA
| | - Rebecca Kinney
- VHA Central Western Massachusetts Healthcare System, Leeds, USA
| | - Melissa E Dichter
- VHA Center for Health Equity Research and Promotion, Crescenz VHA Medical Center, Philadelphia, USA
- Temple University School of Social Work, Philadelphia, USA
| | - Kristin Mattocks
- VHA Central Western Massachusetts Healthcare System, Leeds, USA
- University of Massachusetts Medical School, Worcester, USA
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Sandoz V, Deforges C, Stuijfzand S, Epiney M, Vial Y, Sekarski N, Messerli-Bürgy N, Ehlert U, Bickle-Graz M, Morisod Harari M, Porcheret K, Schechter DS, Ayers S, Holmes EA, Horsch A. Improving mental health and physiological stress responses in mothers following traumatic childbirth and in their infants: study protocol for the Swiss TrAumatic biRth Trial (START). BMJ Open 2019; 9:e032469. [PMID: 31892657 PMCID: PMC6955544 DOI: 10.1136/bmjopen-2019-032469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Emergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother-infant interactions, but also on long-term infant development. The partner's mental health may also affect infant development. Evidence-based early interventions to prevent the development of postpartum PTSD in mothers are lacking. Immediately after a traumatic event, memory formation is vulnerable to interference. There is accumulating evidence that a brief behavioural intervention including a visuospatial task may result in a reduction in intrusive memories of the trauma. METHODS AND ANALYSIS This study protocol describes a double-blind multicentre randomised controlled phase III trial testing an early brief maternal intervention including the computer game 'Tetris' on intrusive memories of the ECS trauma (≤1 week) and PTSD symptoms (6 weeks, primary outcome) of 144 women following an ECS. The intervention group will carry out a brief behavioural procedure including playing Tetris. The attention-placebo control group will complete a brief written activity log. Both simple cognitive tasks will be completed within the first 6 hours following traumatic childbirth. The intervention is delivered by midwives/nurses in the maternity unit.The primary outcome will be differences in the presence and severity of maternal PTSD symptoms between the intervention and the attention-placebo control group at 6 weeks post partum. Secondary outcomes will be physiological stress and psychological vulnerability, mother-infant interaction and infant developmental outcomes. Other outcomes will be psychological vulnerability and physiological regulation of the partner and their bonding with the infant, as well as the number of intrusive memories of the event. ETHICS AND DISSEMINATION Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2017-02142). Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media. TRIAL REGISTRATION NUMBER NCT03576586.
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Affiliation(s)
- Vania Sandoz
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Manuella Epiney
- Department Woman-Child-Adolescent, Geneva University Hospital and University of Geneva, Geneva, GE, Switzerland
| | - Yvan Vial
- Obstetrics and Gynecology Service, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
| | - Nicole Sekarski
- Paediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
| | - Nadine Messerli-Bürgy
- Clinical Child Psychology & Biological Psychology, University of Fribourg, Fribourg, FR, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, ZH, Switzerland
| | - Myriam Bickle-Graz
- Neonatology Service, Woman-Mother-Child Department, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
| | - Mathilde Morisod Harari
- Service of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
| | - Kate Porcheret
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Daniel S Schechter
- Service of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, VD, Switzerland
- Department of Psychiatry, University of Geneva Faculty of Medicine, Geneve, GE, Switzerland
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City University of London, London, London, UK
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
- Neonatology Service, Woman-Mother-Child Department, University of Lausanne and Lausanne University Hospital, Lausanne, VD, Switzerland
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Koszycki D, Taljaard M, Bielajew C, Gow RM, Bradwejn J. Stress reactivity in healthy child offspring of parents with anxiety disorders. Psychiatry Res 2019; 272:756-764. [PMID: 30832196 DOI: 10.1016/j.psychres.2018.12.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/09/2018] [Accepted: 12/30/2018] [Indexed: 11/26/2022]
Abstract
Several studies suggest that anxiety disorders (AD) involve dysregulation of the autonomic nervous system (ANS) and hypothalamic-pituitary (HPA) axis. However, it is unknown if alterations in these biological systems are premorbid markers of AD risk or a state-dependent feature of anxiety. This study examined ANS and HPA-axis response to a laboratory stressor in healthy child offspring of parents with (n = 55) and without (n = 98) a history of AD. High frequency heart rate variability (HF-HRV) was assessed during sitting and standing baseline conditions and during a speech task where participants remained standing. Salivary cortisol was measured at baseline and at 15, 30, 45 and 60 min post-speech. Subjective anxiety was assessed with a visual analogue scale. Children of parents with AD displayed reduced HRV and a blunted cortisol response to the speech task compared to children of non-anxious parents. No risk group effect was found for anxiety ratings. These preliminary data suggest that healthy children of anxious parents exhibit altered stress reactivity to an acute laboratory stressor. Further research is needed to confirm findings and identify mechanisms that may account for altered self-regulation processes to a stressor in children at familial risk for AD.
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Affiliation(s)
- Diana Koszycki
- University of Ottawa, Ottawa, Ontario, Canada; Institut du savoir Montfort, Ottawa, Ontario, Canada; University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.
| | | | | | - Robert M Gow
- University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jacques Bradwejn
- University of Ottawa, Ottawa, Ontario, Canada; Institut du savoir Montfort, Ottawa, Ontario, Canada
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Homotypic and heterotypic continuity of internalizing and externalizing symptoms from ages 3 to 12: The moderating role of diurnal cortisol. Dev Psychopathol 2018; 31:789-798. [PMID: 30249313 DOI: 10.1017/s0954579418000573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Psychological symptoms that arise in early childhood can follow a multitude of patterns into adolescence, including homotypic continuity (i.e., similar symptoms over time) and heterotypic continuity (i.e., a shift in symptoms over time). However, we know very little about the factors that distinguish homotypic vs. heterotypic continuity of early internalizing and externalizing symptoms over development. In a separate line of research, diurnal cortisol has been shown to predict later internalizing and externalizing problems. In the current study, we tested whether diurnal cortisol patterns moderated the course of internalizing and externalizing symptoms from preschool to early adolescence. 554 children (54% male) and parents participated in a longitudinal study. Parents reported on their children's internalizing and externalizing symptoms at ages 3 and 12, and children collected diurnal saliva samples at age 9. Results showed that a steeper cortisol decline at age 9 combined with high internalizing or externalizing problems at age 3 predicted higher internalizing problems at age 12. A more blunted cortisol decline combined with early internalizing or externalizing problems predicted higher externalizing problems in early adolescence. These results illustrate the moderating role of stress system functioning in homotypic and heterotypic patterns of psychopathology from preschool to early adolescence.
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Schuler KL, Ruggero CJ, Goldstein BL, Perlman G, Klein DN, Kotov R. Diurnal Cortisol Interacts With Stressful Events to Prospectively Predict Depressive Symptoms in Adolescent Girls. J Adolesc Health 2017; 61:767-772. [PMID: 28935386 PMCID: PMC5701854 DOI: 10.1016/j.jadohealth.2017.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of present study was to test the diathesis-stress model of depression using baseline cortisol, prospective assessment of depression symptoms, and stressful life events. METHODS The sample consisted of 527 adolescent girls aged 13.5-15.5 years without major depressive disorder. At baseline, saliva samples were collected at waking, 30 minutes after waking, and 8 p.m. on 3 consecutive days. Diurnal cortisol was indexed by cortisol awakening response (CAR) and area under the curve with respect to ground (AUCg). Stressful events during the preceding interval and current depressive symptoms were assessed 18 months following baseline. RESULTS Stressful events and the interaction of CAR or AUCg with stressful events predicted depressive symptoms at 18 months, even after controlling for baseline depressive symptoms. Specifically, in the face of high levels of stress, baseline blunted CAR or smaller AUCg were associated with future depressive symptoms. This was more apparent for CAR than AUCg. The effect was reversed at low levels of stress, with heightened CAR associated with more severe depressive symptoms. CONCLUSIONS Blunted CAR and less daily cortisol output at baseline appear to accentuate the depressogenic effects of stressful events after 18 months, consistent with the diathesis-stress model of hypothalamic-pituitary-adrenal axis function in depression.
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Affiliation(s)
- Keke L. Schuler
- Department of Psychology, University of North Texas, Denton, TX 76203, United States of America,Correspondence concerning this article should be addressed to Keke Schuler, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203. Phone: +1-940-783-0244.
| | - Camilo J. Ruggero
- Department of Psychology, University of North Texas, Denton, TX 76203, United States of America
| | - Brandon L. Goldstein
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United Sates of America
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794, United States of America
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United Sates of America
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794, United States of America
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