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Willford JA, Kaufman JM. Through a teratological lens: A narrative review of exposure to stress and drugs of abuse during pregnancy on neurodevelopment. Neurotoxicol Teratol 2024; 105:107384. [PMID: 39187031 DOI: 10.1016/j.ntt.2024.107384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 08/28/2024]
Abstract
Teratological research shows that both prenatal stress and prenatal substance exposure have a significant impact on neurodevelopmental outcomes in children. Using human research, the purpose of this narrative review is to explore the degree to which these exposures may represent complex prenatal and postnatal risks for the development of cognition and behavior in children. An understanding of the HPA axis and its function during pregnancy as well as the types and operationalization of prenatal stress provide a context for understanding the direct and indirect mechanisms by which prenatal stress affects brain and behavior development. In turn, prenatal substance exposure studies are evaluated for their importance in understanding variables that indicate a potential interaction with prenatal stress including reactivity to novelty, arousal, and stress reactivity during early childhood. The similarities and differences between prenatal stress exposure and prenatal substance exposure on neurodevelopmental outcomes including arousal and emotion regulation, cognition, behavior, stress reactivity, and risk for psychopathology are summarized. Further considerations for teratological studies of prenatal stress and/or substance exposure include identifying and addressing methodological challenges, embracing the complexity of pre-and postnatal environments in the research, and the importance of incorporating parenting and resilience into future studies.
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Affiliation(s)
- Jennifer A Willford
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Jesse M Kaufman
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America
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Shisler S, Lee JK, Schlienz NJ, Hawk LW, Thanos PK, Kong KL, Leising MC, Eiden RD. Prenatal tobacco and tobacco-cannabis co-exposure: Relationship with attention and memory in middle childhood. Neurotoxicol Teratol 2024; 104:107371. [PMID: 38971339 DOI: 10.1016/j.ntt.2024.107371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
We examined associations between prenatal tobacco exposure (with and without cannabis exposure) and children's performance on laboratory measures of sustained attention, attentional set shifting, and working memory in middle childhood (9-12 years of child age). Participants were recruited in the first trimester of pregnancy and oversampled for prenatal tobacco exposure; with a smaller sample (n = 133; n = 34 non-substance exposed, n = 37 exposed to tobacco only, n = 62 co-exposed) invited (oversampled for co-exposure) to participate in the middle-childhood assessment (M age = 10.6, SD = 0.77; 68% Black, 20% Hispanic). Results for sustained attention indicated lower attention (percent hits) at the first epoch for tobacco only exposed compared to non-exposed and co-exposed; a trend (p = .07) towards increases in impulsive responding across time (a total of 8 epochs) for tobacco exposed (with and without cannabis) compared to non-exposed children; and a significant association between higher number of cigarettes in the first trimester and greater increases in impulsive responding across epochs. However, children prenatally exposed to tobacco (with and without cannabis) demonstrated greater short-term memory compared to children not prenatally exposed, and this difference was driven by higher scores for children prenatally co-exposed to tobacco and cannabis compared to those who were non-exposed. Overall, results suggest that prenatal tobacco exposure, especially in the first trimester, may increase risk for impulsive responding on tasks requiring sustained attention, and that co-use of cannabis did not exacerbate these associations. The higher short-term memory scores among children who were co-exposed compared to non-exposed are perplexing and need replication, particularly in studies with larger sample sizes and samples exposed only to cannabis to examine this more closely.
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Affiliation(s)
- Shannon Shisler
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, United States of America.
| | - Jin-Kyung Lee
- Department of Psychology and the Social Science Research Institute, The Pennsylvania State University, University Park, PA, United States of America
| | - Nicolas J Schlienz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Larry W Hawk
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, United States of America
| | - Panayotis K Thanos
- Department of Pharmacology and Toxicology, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, USA; Department of Pediatrics, University of Missouri- Kansas City, Kansas City, MO, USA; Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - Meghan Casey Leising
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, United States of America
| | - Rina D Eiden
- Department of Psychology and the Social Science Research Institute, The Pennsylvania State University, University Park, PA, United States of America
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Goldstein E, Merrick JS, Edwards RC, Zhang Y, Sinche B, Raven J, Krislov S, Robledo D, Brown RL, Moskowitz JT, Tandon SD, Wakschlag LS. Personalized Mobile Health-Enhanced Cognitive Behavioral Intervention for Maternal Distress: Examining the Moderating Role of Adverse Childhood Experiences. Perm J 2024; 28:111-123. [PMID: 38263868 PMCID: PMC10940253 DOI: 10.7812/tpp/23.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Maternal history of trauma is a risk factor for distress during pregnancy. The purpose of this paper was to examine the theorized differential impact of a cognitive behavioral intervention (Mothers and Babies Personalized; MB-P) on maternal distress and emotional regulation for those with ≥ 1 adverse childhood experiences (ACEs; vs no ACEs) from pregnancy to 3 months postpartum. METHODS Between August 2019 and August 2021, eligible pregnant individuals aged ≥ 18 years, < 22 weeks' gestation, and English-speaking were recruited from 6 university-affiliated prenatal clinics. Participants (N = 100) were randomized to MB-P (n = 49) or control (n = 51). Analyzable data were collected for 95 participants. Analyses tested progression of change (slope) and at individual timepoints (panel analysis) for perinatal mental health outcomes. RESULTS The majority of participants (n = 68, 71%) reported experiencing > 1 ACE (median = 1, range: 0-11). Participants demonstrated significant differential effects for depressive symptoms in absence of ACEs (standardized mean differences [SMD] = 0.82; 95% confidence interval [CI] = [0.13-1.51]) vs in presence of ACEs (SMD = 0.39; 95% CI = [-0.20 to 0.97]) and perceived stress in absence of ACEs (SMD = 0.92; 95% CI = [0.23-1.62]) vs in presence of ACEs (SMD = -0.05; 95% CI = [-0.63 to 0.53]). A panel analysis showed significantly reduced depressive symptoms postintervention and increased negative mood regulation at 3 months postpartum for individuals with ACEs. CONCLUSIONS Findings support effectiveness of the MB-P intervention to reduce prenatal distress for all pregnant individuals. Preliminary exploration suggests the possibility that individuals with ACEs may benefit from enhanced trauma-informed content to optimize the effects of a perinatal intervention.
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Affiliation(s)
- Ellen Goldstein
- Department of Population Health Nursing Science, University of Illinois Chicago College of Nursing, Chicago, IL, USA
| | - Jillian S Merrick
- Department of Psychiatry and Behavioral Health, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Renee C Edwards
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yudong Zhang
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brianna Sinche
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julia Raven
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephanie Krislov
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniela Robledo
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roger L Brown
- University of Wisconsin Schools of Nursing, Medicine and Public Health, Madison, WI, USA
| | - Judith T Moskowitz
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Darius Tandon
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Sable C, Li JS, Tristani‐Firouzi M, Fagerlin A, Silver RM, Yandel M, Yost HJ, Beaton A, Dale J, Engel ME, Watkins D, Spurney C, Skinner AC, Armstrong SC, Shah SH, Allen N, Davis M, Hou L, Van Horn L, Labarthe D, Lloyd‐Jones D, Marino B. American Heart Association's Children's Strategically Focused Research Network Experience. J Am Heart Assoc 2023; 12:e028356. [PMID: 36974754 PMCID: PMC10122897 DOI: 10.1161/jaha.122.028356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
The American Heart Association's Strategically Focused Children's Research Network started in July 2017 with 4 unique programs at Children's National Hospital in Washington, DC; Duke University in Durham, North Carolina; University of Utah in Salt Lake City, Utah; and Lurie Children's Hospital/Northwestern University in Chicago, Illinois. The overarching goal of the Children's National center was to develop evidence-based strategies to strengthen the health system response to rheumatic heart disease through synergistic basic, clinical, and population science research. The overall goals of the Duke center were to determine risk factors for obesity and response to treatment including those that might work on a larger scale in communities across the country. The integrating theme of the Utah center focused on leveraging big data-science approaches to improve the quality of care and outcomes for children with congenital heart defects, within the context of the patient and their family. The overarching hypothesis of the Northwestern center is that the early course of change in cardiovascular health, from birth onward, reflects factors that result in either subsequent development of cardiovascular risk or preservation of lifetime favorable cardiovascular health. All 4 centers exceeded the original goals of research productivity, fellow training, and collaboration. This article describes details of these accomplishments and highlights challenges, especially around the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Norrina Allen
- Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Matthew Davis
- Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Lifang Hou
- Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Linda Van Horn
- Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Darwin Labarthe
- Northwestern University Feinberg School of MedicineChicagoILUSA
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MacNeill LA, Krogh‐Jespersen S, Zhang Y, Giase G, Edwards R, Petitclerc A, Mithal LB, Mestan K, Grobman WA, Norton ES, Alshurafa N, Moskowitz JT, Tandon SD, Wakschlag LS. Lability of prenatal stress during the COVID-19 pandemic links to negative affect in infancy. INFANCY 2022; 28:136-157. [PMID: 36070207 PMCID: PMC9538880 DOI: 10.1111/infa.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/01/2022] [Accepted: 07/30/2022] [Indexed: 01/19/2023]
Abstract
The association between prenatal stress and children's socioemotional development is well established. The COVID-19 pandemic has been a particularly stressful period, which may impact the gestational environment. However, most studies to-date have examined prenatal stress at a single time point, potentially masking the natural variation in stress that occurs over time, especially during a time as uncertain as the pandemic. This study leveraged dense ecological momentary assessments from a prenatal randomized control trial to examine patterns of prenatal stress over a 14-week period (up to four assessments/day) in a U.S. sample of 72 mothers and infants. We first examined whether varied features of stress exposure (lability, mean, and baseline stress) differed depending on whether mothers reported on their stress before or during the pandemic. We next examined which features of stress were associated with 3-month-old infants' negative affect. We did not find differences in stress patterns before and during the pandemic. However, greater stress lability, accounting for baseline and mean stress, was associated with higher infant negative affect. These findings suggest that pathways from prenatal stress exposure to infant socioemotional development are complex, and close attention to stress patterns over time will be important for explicating these pathways.
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Affiliation(s)
- Leigha A. MacNeill
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Sheila Krogh‐Jespersen
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Yudong Zhang
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Gina Giase
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Renee Edwards
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | | | - Leena B. Mithal
- Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Ann & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
| | - Karen Mestan
- Department of PediatricsNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Ann & Robert H. Lurie Children's Hospital of ChicagoChicagoIllinoisUSA
| | - William A. Grobman
- Department of Obstetrics and GynecologyThe Ohio State UniversityColumbusOhioUSA
| | - Elizabeth S. Norton
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA,Department of Communication Sciences and DisordersNorthwestern UniversityEvanstonIllinoisUSA
| | - Nabil Alshurafa
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA,Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Judith T. Moskowitz
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - S. Darius Tandon
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
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Knopik VS, Micalizzi L, Marceau K, Loviska AM, Yu L, Bien A, Rolan E, Evans AS, Palmer RHC, Heath AC. The roles of familial transmission and smoking during pregnancy on executive function skills: A sibling-comparison study. Dev Psychopathol 2022; 34:1-13. [PMID: 36039978 PMCID: PMC10710697 DOI: 10.1017/s095457942200075x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This research examines maternal smoking during pregnancy and risk for poorer executive function in siblings discordant for exposure. Data (N = 173 families) were drawn from the Missouri Mothers and Their Children study, a sample, identified using birth records (years 1998-2005), in which mothers changed smoking behavior between two pregnancies (Child 1 [older sibling]: M age = 12.99; Child 2 [younger sibling]: M age = 10.19). A sibling comparison approach was used, providing a robust test for the association between maternal smoking during pregnancy and different aspects of executive function in early-mid adolescence. Results suggested within-family (i.e., potentially causal) associations between maternal smoking during pregnancy and one working memory task (visual working memory) and one response inhibition task (color-word interference), with increased exposure associated with decreased performance. Maternal smoking during pregnancy was not associated with stop-signal reaction time, cognitive flexibility/set-shifting, or auditory working memory. Initial within-family associations between maternal smoking during pregnancy and visual working memory as well as color-word interference were fully attenuated in a model including child and familial covariates. These findings indicate that exposure to maternal smoking during pregnancy may be associated with poorer performance on some, but not all skills assessed; however, familial transmission of risk for low executive function appears more important.
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Affiliation(s)
- Valerie S Knopik
- Department of Human Development and Family Studies, Purdue University, 1202 West State St, West Lafayette, USA, IN, 47906
| | - Lauren Micalizzi
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5 Providence, RI, 02903, USA
- Department of Behavioral and Social Sciences, Box G-S121-5, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Kristine Marceau
- Department of Human Development and Family Studies, Purdue University, 1202 West State St, West Lafayette, USA, IN, 47906
| | - Amy M Loviska
- Department of Human Development and Family Studies, Purdue University, 1202 West State St, West Lafayette, USA, IN, 47906
| | - Li Yu
- Department of Human Development and Family Studies, Purdue University, 1202 West State St, West Lafayette, USA, IN, 47906
| | - Alexandra Bien
- Department of Human Development and Family Studies, Purdue University, 1202 West State St, West Lafayette, USA, IN, 47906
| | - Emily Rolan
- Department of Psychology, Michigan State University, 316 Physics Rd., East Lansing, MI, 48823, USA
| | - Allison S Evans
- Concord Comprehensive Neuropsychological Services, 86 Baker Avenue Extension #301, Concord, MA, 01742, USA
| | - Rohan H C Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - Andrew C Heath
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO, 63110, USA
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Massey SH, Estabrook R, Lapping-Carr L, Newmark RL, Decety J, Wisner KL, Wakschlag LS. Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention. Soc Sci Med 2022; 305:115071. [PMID: 35660692 DOI: 10.1016/j.socscimed.2022.115071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/19/2022] [Accepted: 05/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Spontaneous cessation and reduction in smoking by pregnant women suggest that concern about others, or empathy, could be a malleable target for intervention. We examined various empathy-related processes in relations to reported and biochemically assessed smoking during pregnancy. METHODS Participants were 154 pregnant women (M = 12.4 weeks gestation, SD = 4.6) who were smoking cigarettes immediately prior to pregnancy recognition (85 had quit and 69 were still smoking at enrollment). Empathy-related processes were measured with performance-based paradigms (affect sharing, empathic concern, and theory of mind) and a speech sample (expressed emotion). Smoking was assessed with timeline follow back interviews and urine cotinine assays. Using zero-inflated Poisson regression models, we tested direct and interactive effects of empathy-related processes with respect to biologically verified smoking cessation (zero portion); and mean cigarettes/day smoked after pregnancy recognition among persistent smokers (count portion). RESULTS Affect sharing was inversely related to post-recognition cigarettes/day (B(SE) = -0.17(0.07), 95%C.I. -0.30,-0.04, p = .011) and moderated the relationship between pre-recognition smoking and post-recognition smoking consistent with a buffering effect (B(SE) = -.17(0.05); 95%C.I. - 0.28,-0.06; p = .002). Other empathy related processes showed neither direct nor interactive effects on smoking outcomes. CONCLUSIONS Further research is recommended to clarify the role of empathy in pregnancy smoking.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, 19th Floor, Chicago, IL, 60611, USA.
| | - Ryne Estabrook
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison Street, 1018D, Chicago, IL, 60607, USA
| | - Leiszle Lapping-Carr
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Rebecca L Newmark
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA; University of California San Francisco School of Medicine, 513 Parnassus Ave, Suite S-224, San Francisco, CA, 94143, USA
| | - Jean Decety
- Department of Psychology, Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5848 South University Avenue, Chicago, IL, 60637, USA
| | - Katherine L Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, 19th Floor, Chicago, IL, 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan, Suite 2100, Chicago, IL, 60611, USA
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Rahman F, Coull BA, Carroll KN, Wilson A, Just AC, Kloog I, Zhang X, Wright RJ, Chiu YHM. Prenatal PM 2.5 exposure and infant temperament at age 6 months: Sensitive windows and sex-specific associations. ENVIRONMENTAL RESEARCH 2022; 206:112583. [PMID: 34922978 PMCID: PMC8810739 DOI: 10.1016/j.envres.2021.112583] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Prenatal exposure to fine particulate matter with a diameter of ≤2.5 μm (PM2.5) has been linked to adverse neurodevelopmental outcomes in later childhood, while research on early infant behavior remains sparse. OBJECTIVES We examined associations between prenatal PM2.5 exposure and infant negative affectivity, a stable temperamental trait associated with longer-term behavioral and mental health outcomes. We also examined sex-specific effects. METHODS Analyses included 559 mother-infant pairs enrolled in the PRogramming of Intergenerational Stress Mechanisms (PRISM) cohort. Daily PM2.5 exposure based on geocoded residential address during pregnancy was estimated using a satellite-based spatiotemporal model. Domains of negative affectivity (Sadness, Distress to Limitations, Fear, Falling Reactivity) were assessed using the Infant Behavior Questionnaire-Revised (IBQ-R) when infants were 6 months old. Subscale scores were calculated as the mean of item-specific responses; the global Negative Affectivity (NA) score was derived by averaging the mean of the four subscale scores. Bayesian distributed lag interaction models (BDLIMs) were used to identify sensitive windows for prenatal PM2.5 exposure on global NA and its subscales, and to examine effect modification by sex. RESULTS Mothers were primarily racial/ethnic minorities (38% Black, 37% Hispanic), 40% had ≤12 years of education; most did not smoke during pregnancy (87%). In the overall sample, BDLIMs revealed that increased PM2.5 at mid-pregnancy was associated with higher global NA, Sadness, and Fear scores, after adjusting for covariates (maternal age, education, race/ethnicity, sex). Among boys, increased PM2.5 at early pregnancy was associated with decreased Fear scores, while exposure during late pregnancy was associated with increased Fear scores (cumulative effect estimate = 0.57, 95% CI: 0.03-1.41). Among girls, increased PM2.5 during mid-pregnancy was associated with higher Fear scores (cumulative effect estimate = 0.82, 95% CI: 0.05-1.91). CONCLUSIONS Prenatal PM2.5 exposure was associated with negative affectivity at age 6 months, and the sensitive windows may vary by subdomains and infant sex.
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Affiliation(s)
- Fataha Rahman
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The City College of New York, New York, NY, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kecia N Carroll
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yueh-Hsiu Mathilda Chiu
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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9
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Ostlund BD, Pérez-Edgar KE, Shisler S, Terrell S, Godleski S, Schuetze P, Eiden RD. Prenatal substance exposure and maternal hostility from pregnancy to toddlerhood: Associations with temperament profiles at 16 months of age. Dev Psychopathol 2021; 33:1566-1583. [PMID: 35095214 PMCID: PMC8794013 DOI: 10.1017/s0954579421001000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We investigated whether infant temperament was predicted by level of and change in maternal hostility, a putative transdiagnostic vulnerability for psychopathology, substance use, and insensitive parenting. A sample of women (N = 247) who were primarily young, low-income, and had varying levels of substance use prenatally (69 nonsmokers, 81 tobacco-only smokers, and 97 tobacco and marijuana smokers) reported their hostility in the third trimester of pregnancy and at 2, 9, and 16 months postpartum, and their toddler's temperament and behavior problems at 16 months. Maternal hostility decreased from late pregnancy to 16 months postpartum. Relative to pregnant women who did not use substances, women who used both marijuana and tobacco prenatally reported higher levels of hostility while pregnant and exhibited less change in hostility over time. Toddlers who were exposed to higher levels of prenatal maternal hostility were more likely to be classified in temperament profiles that resemble either irritability or inhibition, identified via latent profile analysis. These two profiles were each associated with more behavior problems concurrently, though differed in their association with competence. Our results underscore the utility of transdiagnostic vulnerabilities in understanding the intergenerational transmission of psychopathology risk and are discussed in regards to the Research Domain Criteria (RDoC) framework.
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Affiliation(s)
- Brendan D. Ostlund
- Department of Psychology, The Pennsylvania State University, University Park, USA
| | | | - Shannon Shisler
- Research Institute on Addictions, University at Buffalo, State University of New York, Buffalo, USA
| | - Sarah Terrell
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, USA
| | - Stephanie Godleski
- Department of Psychology, Rochester Institute of Technology, Rochester, USA
| | - Pamela Schuetze
- Department of Psychology, State University of New York, Buffalo, USA
| | - Rina D. Eiden
- Department of Psychology, The Pennsylvania State University, University Park, USA
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10
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Kim S, Selya A, Wakschlag LS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. Estimating causal and time-varying effects of maternal smoking on youth smoking. Addict Behav 2021; 120:106982. [PMID: 34022755 PMCID: PMC8194413 DOI: 10.1016/j.addbeh.2021.106982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Maternal smoking is a well-known risk factor for youth smoking, yet whether this relationship is causal remains unresolved. This study utilizes propensity score methods for causal inference to robustly account for shared risk factors between maternal and offspring smoking. METHODS An 8-year longitudinal cohort of 900 adolescents in the Chicago area were followed starting from approximately age 15.6. The effects of maternal lifetime smoking (MLS) and prenatal tobacco exposure (PTE) (among participants reporting MLS) on offspring's past 30-day smoking, daily smoking status and smoking frequency were examined using logistic regression and Poisson regression after nearest-neighbor propensity matching. Age dependency of this relationship was then examined across the age range of 15-25 using time-varying effect modeling. RESULTS Propensity matching yielded 438 and 132 pairs for MLS and PTE study samples, respectively. MLS demonstrated significant associations with past 30-day smoking (RR 1.09; 95% CI 1.04-1.14), daily smoking (RR 1.08; 95% CI 1.05-1.12), and smoking frequency of offspring (RR 1.32; 95% CI 1.15-1.52), with stable effects across age. Among participants reporting MLS, having PTE showed significant additional effects on daily smoking (RR 1.09; 95% CI 1.02-1.17) and age-dependency that showed significance during young adulthood but not adolescence. CONCLUSION The relationship between maternal and offspring smoking was not fully accounted for by shared risk factors, suggesting possible causation with PTE having a delayed effect across age. Targeted prevention efforts should be made on maternal smoking-exposed adolescents to mitigate their risks of developing heavy smoking habits in adulthood.
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Affiliation(s)
- Sooyong Kim
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD, United States; PinneyAssociates, Inc., Pittsburgh, PA, United States
| | - Arielle Selya
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD, United States; PinneyAssociates, Inc., Pittsburgh, PA, United States; Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States.
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Innovations in Developmental Sciences, Northwestern University Chicago, IL, United States
| | - Lisa Dierker
- Department of Psychology, Wesleyan University, Middletown, CT, United States
| | - Jennifer S Rose
- Department of Psychology, Wesleyan University, Middletown, CT, United States
| | - Don Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States
| | - Robin J Mermelstein
- Institute for Health Research and Policy, University of Illinois-Chicago, Chicago, IL, United States
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11
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Finlay-Jones A, Ang JE, Bennett E, Downs J, Kendall S, Kottampally K, Krogh-Jespersen S, Lim YH, MacNeill LA, Mancini V, Marriott R, Milroy H, Robinson M, Smith JD, Wakschlag LS, Ohan JL. Caregiver-mediated interventions to support self-regulation among infants and young children (0-5 years): a protocol for a realist review. BMJ Open 2021; 11:e046078. [PMID: 34112642 PMCID: PMC8194327 DOI: 10.1136/bmjopen-2020-046078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Self-regulation is a modifiable protective factor for lifespan mental and physical health outcomes. Early caregiver-mediated interventions to promote infant and child regulatory outcomes prevent long-term developmental, emotional and behavioural difficulties and improve outcomes such as school readiness, educational achievement and economic success. To harness the population health promise of these programmes, there is a need for more nuanced understanding of the impact of these interventions. The aim of this realist review is to understand how, why, under which circumstances and for whom, early caregiver-mediated interventions improve infant and child self-regulation. The research questions guiding this review were based on consultation with families and community organisations that provide early childhood and family services. METHODS AND ANALYSIS Realist reviews take a theory-driven and iterative approach to evidence synthesis, structured around continuous refinement of a programme theory. Programme theories specify context-mechanism-outcome configurations to explain what works, for whom, under which circumstances and how. Our initial programme theory is based on prior work in this field and will be refined through the review process. A working group, comprising service users, community organisation representatives, representatives from specific populations, clinicians and review team members will guide the evidence synthesis and interpretation, as well as the development and dissemination of recommendations based on the findings of the review. The review will involve searching: (i) electronic databases, (ii) connected papers, articles and citations and (iii) grey literature. Decisions to include evidence will be guided by judgements about their contribution to the programme theory and will be made by the research team, with input from the working group. Evidence synthesis will be reported using the Realist and MEta-narrative Evidence Synthesis: Evolving Standards guidelines. ETHICS AND DISSEMINATION Ethical approval is not required as this is a review. Findings will be disseminated to our working group and through peer-reviewed publications and conference presentations. REVIEW REGISTRATION NUMBER The protocol is registered with Open Science Framework https://osf.io/5ce2z/registrations.
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Affiliation(s)
- Amy Finlay-Jones
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Jetro Emanel Ang
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Elaine Bennett
- School of Nursing & Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia
| | - Jenny Downs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Child Disability, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Keerthi Kottampally
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Yi Huey Lim
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Leigha A MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Vincent Mancini
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Rhonda Marriott
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia
| | - Helen Milroy
- Youth Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Department of Psychiatry, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Monique Robinson
- Youth Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Justin D Smith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- School of Medicine, The University of Utah, Salt Lake City, Utah, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Jeneva L Ohan
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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12
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Weber TL, Selya A, Wakschlag LS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. The effect of maternal smoking on offspring smoking is unrelated to heritable personality traits or initial subjective experiences. Nicotine Tob Res 2021; 23:1754-1762. [PMID: 33912956 DOI: 10.1093/ntr/ntab081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/23/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Maternal smoking is a risk factor for offspring smoking. Lifetime maternal smoking vs. prenatal tobacco exposure (PTE) appear to act through different mechanisms. This study tested the hypothesis that maternal smoking measures' effects on offspring smoking could be attributable to hereditary mechanisms: personality traits (novelty-seeking, impulsivity, neuroticism, self-esteem) and initial subjective smoking experiences (pleasurable, unpleasurable, dizziness). METHODS Data were drawn from the Social and Emotional Contexts of Adolescent Smoking Patterns (SECASP) study, an 8-year longitudinal study of 9 th or 10 th graders at baseline (≈age 15) who experiment with smoking (<100 lifetime cigarettes; N=594) at baseline. Young adult smoking frequency at the 8-year follow-up (≈age 23) was examined as a function of baseline characteristics (heritable trait, maternal smoking, PTE, sex) and baseline smoking frequency and nicotine dependence. Structural equation models determined whether inclusion of each heritable trait among offspring confounded the effects of maternal smoking (PTE or maternal smoking) on offspring smoking and nicotine dependence. RESULTS Impulsiveness was associated with intermediate adolescent smoking frequency (B=0.135, SD=0.043 p=0.002) and nicotine dependence (B=0.012, SD=0.003, p<0.001). Unpleasurable first experience (B=0.886, SD=0.374, p=0.018) and dizziness (B=0.629, SD=0.293, p=0.032) showed a trend with intermediate smoking frequency that was non-significant after correcting for multiple comparisons. These traits did not confound maternal smoking's effects. CONCLUSIONS None of the heritable traits examined in this model explained the effect of maternal smoking measures on adolescence or young adulthood offspring smoking. Further research is needed to elucidate the mechanism by which PTE and maternal smoking are linked to offspring smoking.
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Affiliation(s)
- Tess L Weber
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD
| | - Arielle Selya
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD.,Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD.,Pinney Associates, Inc., Pittsburgh, PA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Innovations in Developmental Sciences, Northwestern University Chicago, IL
| | - Lisa Dierker
- Department of Psychology, Wesleyan University, Middletown, CT
| | - Jennifer S Rose
- Department of Psychology, Wesleyan University, Middletown, CT
| | - Don Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | - Robin J Mermelstein
- Institute for Health Research and Policy, University of Illinois-Chicago, Chicago, IL
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13
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Wakschlag LS, Tandon D, Krogh-Jespersen S, Petitclerc A, Nielsen A, Ghaffari R, Mithal L, Bass M, Ward E, Berken J, Fareedi E, Cummings P, Mestan K, Norton ES, Grobman W, Rogers J, Moskowitz J, Alshurafa N. Moving the dial on prenatal stress mechanisms of neurodevelopmental vulnerability to mental health problems: A personalized prevention proof of concept. Dev Psychobiol 2020; 63:622-640. [PMID: 33225463 DOI: 10.1002/dev.22057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022]
Abstract
Prenatal stress exposure increases vulnerability to virtually all forms of psychopathology. Based on this robust evidence base, we propose a "Mental Health, Earlier" paradigm shift for prenatal stress research, which moves from the documentation of stress-related outcomes to their prevention, with a focus on infant neurodevelopmental indicators of vulnerability to subsequent mental health problems. Achieving this requires an expansive team science approach. As an exemplar, we introduce the Promoting Healthy Brain Project (PHBP), a randomized trial testing the impact of the Wellness-4-2 personalized prenatal stress-reduction intervention on stress-related alterations in infant neurodevelopmental trajectories in the first year of life. Wellness-4-2 utilizes bio-integrated stress monitoring for just-in-time adaptive intervention. We highlight unique challenges and opportunities this novel team science approach presents in synergizing expertise across predictive analytics, bioengineering, health information technology, prevention science, maternal-fetal medicine, neonatology, pediatrics, and neurodevelopmental science. We discuss how innovations across many areas of study facilitate this personalized preventive approach, using developmentally sensitive brain and behavioral methods to investigate whether altering children's adverse gestational exposures, i.e., maternal stress in the womb, can improve their mental health outlooks. In so doing, we seek to propel developmental SEED research towards preventive applications with the potential to reduce the pernicious effect of prenatal stress on neurodevelopment, mental health, and wellbeing.
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Affiliation(s)
- Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Darius Tandon
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Institute for Public Health & Medicine Center for Community Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Amelie Petitclerc
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Ashley Nielsen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Rhoozbeh Ghaffari
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Materials Science & Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Leena Mithal
- Department of Materials Science & Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA.,Department of Pediatrics (Infectious Diseases), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael Bass
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Erin Ward
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Institute for Public Health & Medicine Center for Community Health, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jonathan Berken
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Feinberg School of Medicine, Chicago, IL, USA
| | - Elveena Fareedi
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Peter Cummings
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Karen Mestan
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics (Neonatology), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elizabeth S Norton
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Communication Sciences & Disorders, School of Communication, Northwestern University, Chicago, IL, USA
| | - William Grobman
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Obstetrics & Gynecology (Maternal-Fetal Medicine), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - John Rogers
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Materials Science & Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Judith Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Nabil Alshurafa
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Computer Science, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
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14
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Morris AS, Wakschlag L, Krogh-Jespersen S, Fox N, Planalp B, Perlman SB, Shuffrey LC, Smith B, Lorenzo NE, Amso D, Coles CD, Johnson SP. Principles for Guiding the Selection of Early Childhood Neurodevelopmental Risk and Resilience Measures: HEALthy Brain and Child Development Study as an Exemplar. ADVERSITY AND RESILIENCE SCIENCE 2020; 1:247-267. [PMID: 33196052 PMCID: PMC7649097 DOI: 10.1007/s42844-020-00025-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
The vast individual differences in the developmental origins of risk and resilience pathways combined with sophisticated capabilities of big data science increasingly point to the imperative of large, neurodevelopmental consortia to capture population heterogeneity and key variations in developmental trajectories. At the same time, such large-scale population-based designs involving multiple independent sites also must weigh competing demands. For example, the need for efficient, scalable assessment strategies must be balanced with the need for nuanced, developmentally sensitive phenotyping optimized for linkage to neural mechanisms and specification of common and distinct exposure pathways. Standardized epidemiologic batteries designed for this purpose such as PhenX (consensus measures for Phenotypes and eXposures) and the National Institutes of Health (NIH) Toolbox provide excellent "off the shelf" assessment tools that are well-validated and enable cross-study comparability. However, these standardized toolkits can also constrain ability to leverage advances in neurodevelopmental measurement over time, at times disproportionately advantaging established measures. In addition, individual consortia often expend exhaustive effort "reinventing the wheel," which is inefficient and fails to fully maximize potential synergies with other like initiatives. To address these issues, this paper lays forth an early childhood neurodevelopmental assessment strategy, guided by a set of principles synthesizing developmental and pragmatic considerations generated by the Neurodevelopmental Workgroup of the HEALthy Brain and Child Development (HBCD) Planning Consortium. These principles emphasize characterization of both risk- and resilience-promoting processes. Specific measurement recommendations to HBCD are provided to illustrate application. However, principles are intended as a guiding framework to transcend any particular initiative as a broad neurodevelopmentally informed, early childhood assessment strategy for large-scale consortia science.
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Affiliation(s)
- Amanda Sheffield Morris
- Human Development and Family Science, Oklahoma State University, 700 North Greenwood Ave, Tulsa, OK 74106 USA
| | - Lauren Wakschlag
- Department of Medical and Social Sciences, & Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL USA
| | - Sheila Krogh-Jespersen
- Department of Medical and Social Sciences, & Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL USA
| | - Nathan Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD USA
| | - Beth Planalp
- Department of Psychology, University of Wisconsin, Madison, WI USA
| | - Susan B. Perlman
- Department of Psychiatry, Washington University- St. Louis, St. Louis, MO USA
| | - Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY USA
| | - Beth Smith
- Division of Research on Children, Youth, and Family, Children’s Hospital Los Angeles; Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Nicole E. Lorenzo
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD USA
| | - Dima Amso
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI USA
| | - Claire D. Coles
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Scott P. Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA USA
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15
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Massey SH, Clark CAC, Sun MY, Burns JL, Mroczek DK, Espy KA, Wakschlag LS. Dimension- and context-specific expression of preschoolers' disruptive behaviors associated with prenatal tobacco exposure. Neurotoxicol Teratol 2020; 81:106915. [PMID: 32693011 PMCID: PMC7484981 DOI: 10.1016/j.ntt.2020.106915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Precise phenotypic characterization of prenatal tobacco exposure (PTE)-related disruptive behavior (DB) that integrates nuanced measures of both exposures and outcomes is optimal for elucidating underlying mechanisms. Using this approach, our goals were to identify dimensions of DB most sensitive to PTE prior to school entry and assess contextual variation in these dimensions. METHODS A community obstetric sample of N = 369 women (79.2% lifetime smokers; 70.2% pregnancy smokers) from two Midwestern cities were assessed for PTE using cotinine-calibrated interview-based reports at 16, 28, and 40 weeks of gestation. A subset of n = 244 who completed observational assessments with their 5-year-old children in a subsequent preschool follow-up study constitute the analytic sample. Using two developmentally-meaningful dimensions previously associated with emergent clinical risk for DB-irritability and noncompliance-we assessed children with 2 parent-report scales: the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) and the Early Childhood Inventory (ECI). We also assessed children by direct observation across 3 interactional contexts with the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). We used generalized linear models to examine between-child variability across behavioral dimensions, and mixed effects models to examine directly observed within-child variability by interactional context. RESULTS Increasing PTE predicted increasing impairment in preschoolers' modulation of negative affect (irritability), but not negative behavior (noncompliance) across reported (MAP-DB) and observed (DB-DOS) dimensional measures. Moreover, children's PTE-related irritability was more pronounced when observed with parents than with the examiner. The ECI did not detect PTE-related irritability nor noncompliance. CONCLUSIONS Nuanced, dimension- and context-specific characterization of PTE-related DB described can optimize early identification of at-risk children.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA.
| | - Caron A C Clark
- Department of Educational Psychology, University of Nebraska at Lincoln, 241 Teacher College Hall, Lincoln, NE 68508, USA
| | - Michael Y Sun
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
| | - James L Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
| | - Kimberly A Espy
- Departments of Psychology and Biology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249-1644, USA; Department of Psychiatry & Behavioral Sciences, Long School of Medicine, University of Texas at San Antonio, 7703 Floyd Curl Drive, MC 7792 San Antonio, TX 78229, USA
| | - Lauren S Wakschlag
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
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16
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Bush NR, Wakschlag LS, LeWinn KZ, Hertz-Picciotto I, Nozadi SS, Pieper S, Lewis J, Biezonski D, Blair C, Deardorff J, Neiderhiser JM, Leve LD, Elliott AJ, Duarte CS, Lugo-Candelas C, O’Shea TM, Avalos LA, Page GP, Posner J. Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward. Front Psychiatry 2020; 11:547. [PMID: 32636769 PMCID: PMC7318113 DOI: 10.3389/fpsyt.2020.00547] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and functioning, and parental substance use) and discuss how these domains influence neurodevelopment, with particular emphasis on mental health outcomes. We also highlight a new initiative launched by the National Institutes of Health, the Environmental influences on Child Health Outcomes (ECHO) program. We discuss the role that ECHO will play in advancing our understanding of the impact of the family environment on children's risk for psychiatric outcomes. Lastly, we conclude with important unanswered questions and controversies in this area of research, highlighting how ECHO will contribute to resolving these gaps in our understanding, clarifying relationships between the family environment and children's mental health.
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Affiliation(s)
- Nicole R. Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Il, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sarah Pieper
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Johnnye Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Dominik Biezonski
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Clancy Blair
- Department of Population Health, New York University, New York, NY, United States
| | - Julianna Deardorff
- Community Health Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, Penn State University, University Park, PA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Amy J. Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, United States
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Claudia Lugo-Candelas
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Grier P. Page
- Department of Biostatistics and Epidemiology, RTI, Atlanta, GA, United States
| | - Jonathan Posner
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
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17
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Abstract
AbstractIt is well established that high-dose alcohol consumption during pregnancy increases the risk for a plethora of adverse offspring outcomes. These include neurodevelopmental, cognitive and social deficits, as well as psychiatric illnesses, such as depression and anxiety. However, much less evidence is available on the effects of low- and early-dose alcohol exposure on mental health outcomes, regardless of the accumulating evidence that mental health outcomes should be considered in the context of the Developmental Origins of Health and Disease hypothesis. This review will discuss the evidence that indicates low-dose and early prenatal alcohol exposure can increase the risk of mental illness in offspring and discuss the mechanistic pathways that may be involved.
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Clark CAC, Massey SH, Wiebe SA, Espy KA, Wakschlag LS. Does early maternal responsiveness buffer prenatal tobacco exposure effects on young children's behavioral disinhibition? Dev Psychopathol 2019; 31:1285-1298. [PMID: 30428950 PMCID: PMC6520205 DOI: 10.1017/s0954579418000706] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Children with prenatal tobacco exposure (PTE) exhibit early self-regulatory impairments, reflecting a life-course persistent propensity toward behavioral disinhibition. Previously, we demonstrated the protective role of parental responsiveness for reducing the risk of exposure-related disruptive behavior in adolescence. Here, we expanded this line of inquiry, examining whether responsiveness moderates the relation of PTE to a broader set of behavioral disinhibition features in early childhood and testing alternative diathesis-stress versus differential susceptibility explanatory models. PTE was assessed prospectively using interviews and bioassays in the Midwestern Infant Development Study (MIDS). Mother-child dyads (N = 276) were re-assessed at approximately 5 years of age in a preschool follow-up. We quantified maternal responsiveness and child behavioral disinhibition using a combination of directly observed activities in the lab and developmentally sensitive questionnaires. Results supported a diathesis-stress pattern. Children with PTE and less responsive mothers showed increased disruptive behavior and lower effortful control compared with children without PTE. In contrast, exposed children with more responsive mothers had self-regulatory profiles similar to their non-exposed peers. We did not observe sex differences. Findings provide greater specification of the protective role of maternal responsiveness for self-regulation in children with PTE and help clarify mechanisms that may underscore trajectories of exposure-related behavioral disinhibition.
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Affiliation(s)
- Caron A C Clark
- Department of Educational Psychology,University of Nebraska-Lincoln,Lincoln, NE,USA
| | - Suena H Massey
- Department of Psychiatry and Behavioral Sciences,Northwestern University Feinberg School of Medicine,Chicago, IL,USA
| | - Sandra A Wiebe
- Department of Psychology,University of Alberta,Edmonton,Alberta,Canada
| | - Kimberly Andrews Espy
- Office of the Provost,University of San Antonio at Texas, San Antonio, TX, USA;Developmental Cognitive Neuroscience Laboratory,University of Nebraska-Lincoln,Lincoln, NE, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University,Chicago,IL, USA
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King ZD, Moskowitz J, Egilmez B, Zhang S, Zhang L, Bass M, Rogers J, Ghaffari R, Wakschlag L, Alshurafa N. micro-Stress EMA: A Passive Sensing Framework for Detecting in-the-wild Stress in Pregnant Mothers. ACTA ACUST UNITED AC 2019; 3. [PMID: 32432212 DOI: 10.1145/3351249] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
High levels of stress during pregnancy increase the chances of having a premature or low-birthweight baby. Perceived self-reported stress does not often capture or align with the physiological and behavioral response. But what if there was a self-report measure that could better capture the physiological response? Current perceived stress self-report assessments require users to answer multi-item scales at different time points of the day. Reducing it to one question, using microinteraction-based ecological momentary assessment (micro-EMA, collecting a single in situ self-report to assess behaviors) allows us to identify smaller or more subtle changes in physiology. It also allows for more frequent responses to capture perceived stress while at the same time reducing burden on the participant. We propose a framework for selecting the optimal micro-EMA that combines unbiased feature selection and unsupervised Agglomerative clustering. We test our framework in 18 women performing 16 activities in-lab wearing a Biostamp, a NeuLog, and a Polar chest strap. We validated our results in 17 pregnant women in real-world settings. Our framework shows that the question "How worried were you?" results in the highest accuracy when using a physiological model. Our results provide further in-depth exposure to the challenges of evaluating stress models in real-world situations.
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Stroud LR, Papandonatos GD, McCallum M, Kehoe T, Salisbury AL, Huestis MA. Prenatal tobacco and marijuana co-use: Impact on newborn neurobehavior. Neurotoxicol Teratol 2018; 70:28-39. [PMID: 30266574 PMCID: PMC6239899 DOI: 10.1016/j.ntt.2018.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 12/17/2022]
Abstract
Tobacco and marijuana are some of the most common prenatal substance exposures worldwide. The social acceptability and political landscape of marijuana and its potency have changed dramatically in the last two decades leading to increased use by pregnant women. Despite evidence for increasing marijuana use and high rates of co-use of tobacco (TOB) and marijuana (MJ) during pregnancy, the impact of prenatal exposure to each substance is typically studied in isolation. We investigated the influence of co-exposure to TOB and MJ on infant neurobehavioral development over the first postnatal month. Participants were 111 mother-infant pairs from a low-income, diverse sample (Mean age = 25 ± 5; 54% minorities). TOB and MJ use were assessed by Timeline Followback interview with biochemical confirmation. Three groups were identified: (a) prenatal MJ + TOB, (b) prenatal TOB only, (c) controls. Newborn neurobehavior was assessed at seven time points over the first postnatal month using the NICU Network Neurobehavioral Scale. MJ + TOB-exposed infants showed decreased ability to self-soothe (Self-regulation) and attend to stimuli (Attention), and increased need for examiner soothing (Handling) and low motor activity (Lethargy) versus unexposed infants. Despite low levels of MJ use in MJ + TOB co-users, co-exposure was associated with nearly double the impact on infant self-soothing and need for examiner soothing versus TOB-exposure alone. Effects of MJ + TOB co-exposure appeared more pronounced for daughters than for sons. Although results are preliminary, they highlight additional risk from dual exposure to MJ + TOB vs. TOB exposure alone, particularly for daughters. Results also highlight the critical importance of investigating prenatal exposures in concert and the need for intervention efforts to address MJ co-use in pregnant TOB users.
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Affiliation(s)
- Laura R Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, United States; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States.
| | - George D Papandonatos
- Department of Biostatistics, School of Public Health, Brown University, 121 South Main Street, Room 703, Providence, RI 02903, United States.
| | - Meaghan McCallum
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States.
| | - Tessa Kehoe
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States.
| | - Amy L Salisbury
- Department of Pediatrics, Warren Alpert Medical School, Brown University, Box G-RIH, Hasbro 129, Providence, RI 02903, United States; Brown Center for the Study of Children at Risk, Women & Infants' Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905, United States.
| | - Marilyn A Huestis
- Institute for Emerging Health Professions, Thomas Jefferson University, 1020 Walnut Street, Philadelphia, PA 19107, United States.
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21
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Micalizzi L, Knopik VS. Maternal smoking during pregnancy and offspring executive function: What do we know and what are the next steps? Dev Psychopathol 2018; 30:1333-1354. [PMID: 29144227 PMCID: PMC6028309 DOI: 10.1017/s0954579417001687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Children exposed to maternal smoking during pregnancy (MSDP) exhibit difficulties in executive function (EF) from infancy through adolescence. Due to the developmental significance of EF as a predictor of adaptive functioning throughout the life span, the MSDP-EF relation has clear public health implications. In this paper, we provide a comprehensive review of the literature on the relationship between MSDP and offspring EF across development; consider brain-based assessments, animal models, and genetically informed studies in an effort to elucidate plausible pathways of effects; discuss implications for prevention and intervention; and make calls to action for future research.
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Affiliation(s)
- Lauren Micalizzi
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital
- Department of Psychiatry and Human Behavior, The Warren Alpert School of Medicine, Brown University
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University
| | - Valerie S. Knopik
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital
- Department of Psychiatry and Human Behavior, The Warren Alpert School of Medicine, Brown University
- Department of Human Development and Family Studies, Purdue University
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22
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Madigan S, Oatley H, Racine N, Fearon RMP, Schumacher L, Akbari E, Cooke JE, Tarabulsy GM. A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development. J Am Acad Child Adolesc Psychiatry 2018; 57:645-657.e8. [PMID: 30196868 DOI: 10.1016/j.jaac.2018.06.012] [Citation(s) in RCA: 247] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/23/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children. METHOD Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random-effects meta-analyses were used to derive mean effect sizes and test for potential moderators. RESULTS A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) = 1.66 (95% CI = 1.54-1.79). Effect sizes were stronger for depression (OR = 1.79; 95% CI = 1.61-1.99) compared to anxiety (OR = 1.50; 95% CI = 1.36-1.64). Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio-demographic risk was heightened. CONCLUSION Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.
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Affiliation(s)
| | - Hannah Oatley
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | - Emis Akbari
- George Brown College, Toronto, Ontario, Canada
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Stroud LR, McCallum M, Salisbury AL. Impact of maternal prenatal smoking on fetal to infant neurobehavioral development. Dev Psychopathol 2018; 30:1087-1105. [PMID: 30068428 PMCID: PMC6541397 DOI: 10.1017/s0954579418000676] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite recent emphasis on the profound importance of the fetal environment in "programming" postnatal development, measurement of offspring development typically begins after birth. Using a novel coding strategy combining direct fetal observation via ultrasound and actocardiography, we investigated the impact of maternal smoking during pregnancy (MSDP) on fetal neurobehavior; we also investigated links between fetal and infant neurobehavior. Participants were 90 pregnant mothers and their infants (52 MSDP-exposed; 51% minorities; ages 18-40). Fetal neurobehavior at baseline and in response to vibro-acoustic stimulus was assessed via ultrasound and actocardiography at M = 35 weeks gestation and coded via the Fetal Neurobehavioral Assessment System (FENS). After delivery, the NICU Network Neurobehavioral Scale was administered up to seven times over the first postnatal month. MSDP was associated with increased fetal activity and fetal limb movements. Fetal activity, complex body movements, and cardiac-somatic coupling were associated with infants' ability to attend to stimuli and to self-regulate over the first postnatal month. Furthermore, differential associations emerged by MSDP group between fetal activity, complex body movements, quality of movement, and coupling, and infant attention and self-regulation. The present study adds to a growing literature establishing the validity of fetal neurobehavioral measures in elucidating fetal programming pathways.
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Massey SH, Mroczek DK, Burns JL, Clark CAC, Espy KA, Wakschlag LS. Positive parenting behaviors in women who spontaneously quit smoking during pregnancy: Clues to putative targets for preventive interventions. Neurotoxicol Teratol 2018; 67:18-24. [PMID: 29501649 PMCID: PMC5970967 DOI: 10.1016/j.ntt.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 02/22/2018] [Accepted: 02/26/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND While the majority of pregnant smokers do not respond to intervention, little is known about how a subset of pregnant smokers known as spontaneous quitters achieve sustained biologically-confirmed abstinence through delivery in the absence of intervention. We explore a developmental framework to address this question by viewing spontaneous quitting as an adaptive parenting behavior, facilitated by abilities necessary for sensitive parenting, or responsiveness. Utilizing existing data, we examined responsiveness from parenting assessments in women who exhibited a variety of smoking patterns during pregnancy, including spontaneous quitting. METHODS Participants were N = 305 pregnant women assessed for smoking prospectively and biochemically at 16 weeks, 28 weeks, delivery, and 4 weeks postpartum, then reassessed with their children 5 years later with directly-observed home- and lab-based measures of parenting. We used linear regression analysis to compare spontaneous quitters with women who exhibited other prenatal smoking patterns on parenting responsiveness, controlling for potential confounders. RESULTS In home-based observations, spontaneous quitters (n = 22) exhibited greater responsiveness with their children relative to intermittent pregnancy smokers [n = 70; β = 0.258, p = .022]; persistent pregnancy smokers [n = 66; β = 0.228, p = .040]; former smokers (quit before pregnancy) [n = 78; β = 266, p = .028]; and never smokers [n = 69; β = 0.312, p = .009]. Hypothesized differences were not observed in lab-based and self-report measures. CONCLUSIONS Putative protective characteristics in spontaneous quitters were captured in mother-child interactions at home, but not in lab-based and maternal report measures of responsiveness. Specification of these characteristics using prospective designs that oversample for spontaneous quitters is recommended to enable translation to preventive interventions.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - James L Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Caron A C Clark
- Department of Educational Psychology, University of Nebraska - Lincoln, 241 Teachers College Hall, Lincoln, NE 68588-0308, USA.
| | - Kimberly A Espy
- Department of Psychology, University of Arizona, 1503 E University Blvd., P.O. Box 210068, Tucson, AZ 85721, USA; Department of Psychiatry, University of Arizona, 1503 E University Blvd., P.O. Box 210068, Tucson, AZ 85721, USA.
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
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25
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Blackwell CK, Wakschlag LS, Gershon RC, Cella D. Measurement framework for the Environmental influences on Child Health Outcomes research program. Curr Opin Pediatr 2018; 30:276-284. [PMID: 29406440 PMCID: PMC6029724 DOI: 10.1097/mop.0000000000000606] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF REVIEW Diverse methodological approaches pose significant challenges to assess environmental exposure effects on child health outcomes. Although transdisciplinary research efforts offer unique opportunities for understanding the complex and multidimensional facets of lifespan health and disease trajectories, a shared measurement strategy is necessary for ensuring cohesion and comprehensibility across disciplines and domains. RECENT FINDINGS Exposure science often focuses on one life stage, one primary outcome domain and/or one environmental context without regard for understanding the complexity of exposome pathways and outcomes across a developmental continuum. As part of the National Institutes of Health Environmental influences on Child Health Outcomes Program, the Person Reported Outcomes Core developed a unifying measurement framework that takes a lifespan development approach to assess physical, mental and social health outcomes within the complex matrix of environmental exposure pathways. SUMMARY The proposed framework offers a shared methodological approach to health outcome assessment, with a particular emphasis on person-reported outcomes. This framework will be instrumental for future large-scale consortia and transdisciplinary team science efforts by providing a common structure, measurement guidance and consistent terminology.
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Richard C. Gershon
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - the ECHO PRO Core
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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26
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Wakschlag LS, Perlman SB, Blair RJ, Leibenluft E, Briggs-Gowan MJ, Pine DS. The Neurodevelopmental Basis of Early Childhood Disruptive Behavior: Irritable and Callous Phenotypes as Exemplars. Am J Psychiatry 2018; 175:114-130. [PMID: 29145753 PMCID: PMC6075952 DOI: 10.1176/appi.ajp.2017.17010045] [Citation(s) in RCA: 128] [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] [Indexed: 12/24/2022]
Abstract
The arrival of the Journal's 175th anniversary occurs at a time of recent advances in research, providing an ideal opportunity to present a neurodevelopmental roadmap for understanding, preventing, and treating psychiatric disorders. Such a roadmap is particularly relevant for early-childhood-onset neurodevelopmental conditions, which emerge when experience-dependent neuroplasticity is at its peak. Employing a novel developmental specification approach, this review places recent neurodevelopmental research on early childhood disruptive behavior within the historical context of the Journal. The authors highlight irritability and callous behavior as two core exemplars of early disruptive behavior. Both phenotypes can be reliably differentiated from normative variation as early as the first years of life. Both link to discrete pathophysiology: irritability with disruptions in prefrontal regulation of emotion, and callous behavior with abnormal fear processing. Each phenotype also possesses clinical and predictive utility. Based on a nomologic net of evidence, the authors conclude that early disruptive behavior is neurodevelopmental in nature and should be reclassified as an early-childhood-onset neurodevelopmental condition in DSM-5. Rapid translation from neurodevelopmental discovery to clinical application has transformative potential for psychiatric approaches of the millennium. [AJP at 175: Remembering Our Past As We Envision Our Future November 1938: Electroencephalographic Analyses of Behavior Problem Children Herbert Jasper and colleagues found that brain abnormalities revealed by EEG are a potential causal factor in childhood behavioral disorders. (Am J Psychiatry 1938; 95:641-658 )].
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Affiliation(s)
- Lauren S Wakschlag
- From the Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and the Institute for Policy Research, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh, Pittsburgh; the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebr.; the Department of Psychiatry, University of Connecticut, Farmington, Conn.; and the National Institute of Mental Health, Bethesda, Md
| | - Susan B Perlman
- From the Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and the Institute for Policy Research, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh, Pittsburgh; the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebr.; the Department of Psychiatry, University of Connecticut, Farmington, Conn.; and the National Institute of Mental Health, Bethesda, Md
| | - R James Blair
- From the Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and the Institute for Policy Research, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh, Pittsburgh; the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebr.; the Department of Psychiatry, University of Connecticut, Farmington, Conn.; and the National Institute of Mental Health, Bethesda, Md
| | - Ellen Leibenluft
- From the Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and the Institute for Policy Research, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh, Pittsburgh; the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebr.; the Department of Psychiatry, University of Connecticut, Farmington, Conn.; and the National Institute of Mental Health, Bethesda, Md
| | - Margaret J Briggs-Gowan
- From the Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and the Institute for Policy Research, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh, Pittsburgh; the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebr.; the Department of Psychiatry, University of Connecticut, Farmington, Conn.; and the National Institute of Mental Health, Bethesda, Md
| | - Daniel S Pine
- From the Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and the Institute for Policy Research, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh, Pittsburgh; the Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebr.; the Department of Psychiatry, University of Connecticut, Farmington, Conn.; and the National Institute of Mental Health, Bethesda, Md
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27
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De Genna NM, Goldschmidt L, Day NL, Cornelius MD. Prenatal tobacco exposure, maternal postnatal nicotine dependence and adolescent risk for nicotine dependence: Birth cohort study. Neurotoxicol Teratol 2017; 61:128-132. [PMID: 28242457 PMCID: PMC5453833 DOI: 10.1016/j.ntt.2017.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 02/21/2017] [Accepted: 02/23/2017] [Indexed: 12/18/2022]
Abstract
AIMS The goals of this study are to determine if there is (a) a threshold effect for prenatal tobacco exposure (PTE) on adolescent risk for nicotine dependence, and (b) an additive effect of PTE and maternal postnatal nicotine dependence on adolescent risk for nicotine dependence. METHODS Pregnant women were recruited in their 4th or 5th gestational month and asked about cigarette use during the first trimester. Mothers reported on third trimester cigarette use at delivery. Sixteen years post-partum, mothers and offspring reported on current levels of cigarette use (N=784). Nicotine dependence was assessed in both using a modified Fagerström questionnaire. RESULTS Based on the results of a threshold analysis for PTE, four groups were created: threshold PTE only (10+ cigarettes per day), maternal nicotine postnatal dependence with no-low PTE (0-<10 cigarettes per day), threshold PTE+maternal postnatal nicotine dependence, and a referent group with no-low PTE and no maternal postnatal nicotine dependence. Adolescents in the PTE-only group and the PTE+maternal postnatal nicotine dependence group were significantly more likely to be at risk for nicotine dependence than the offspring from the referent group. However, there was no evidence for an additive effect of maternal postnatal nicotine dependence, and maternal nicotine dependence was not a significant predictor of adolescent risk for nicotine dependence in regression models including prenatal tobacco exposure. CONCLUSIONS Bivariate analysis revealed a threshold effect for PTE of 10 cigarettes per day. In multivariate analysis, PTE remained significantly related to risk for offspring nicotine dependence, after controlling for maternal postnatal nicotine dependence and other covariates associated with adolescent cigarette use.
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Affiliation(s)
- Natacha M De Genna
- Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, Graduate School of Public Health, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Lidush Goldschmidt
- University of Pittsburgh Medical Center, Program in Epidemiology, 817 Bellefield Tower, 100 North Bellefield Avenue, Pittsburgh, PA 15213, USA.
| | - Nancy L Day
- Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, Graduate School of Public Health, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Marie D Cornelius
- Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, Graduate School of Public Health, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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28
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Massey SH, Hatcher AE, Clark CAC, Burns JL, Pine DS, Skol AD, Mroczek DK, Espy KA, Goldman D, Cook E, Wakschlag LS. Does MAOA increase susceptibility to prenatal stress in young children? Neurotoxicol Teratol 2017; 61:82-91. [PMID: 28163169 PMCID: PMC5453809 DOI: 10.1016/j.ntt.2017.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/29/2016] [Accepted: 01/31/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND We previously demonstrated a gene-by-prenatal-environment interaction whereby the monoamine oxidase A gene (MAOA) modified the impact of prenatal tobacco exposure (PTE) on adolescent disruptive behavior (DB), with the MAOA risk genotype varying by sex. We extend this work by examining whether this mechanism is evident with another common adversity, prenatal stress exposure (PSE), and whether sex differences are present earlier in development in closer proximity to exposure. METHODS Participants were 281 mothers and their 285 children derived from a prenatal cohort with in-depth prospective measures of PSE and PTE. We assessed DB at age 5 via dimensional developmentally-sensitive measurement. Analyses were stratified by sex based on prior evidence for sex differences. RESULTS Concurrent stress exposure predicted DB in children (β=0.310, p=0.001), while main effects of prenatal exposures were seen only in boys. We found a three-way interaction of MAOA×PSE×sex on DB (β=0.813, p=0.022). Boys with MAOA-H had more DB as a function of PSE, controlling for PTE (β=0.774, p=0.015), and as a function of PTE, controlling for PSE (β=0.362, p=0.037). Boys with MAOA-L did not show this susceptibility. MAOA did not interact with PSE (β=-0.133, p=0.561) nor PTE (β=-0.144; p=0.505) in predicting DB in girls. Examination of gene-environment correlation (rGE) showed a correlation between paternal MAOA-L and daughters' concurrent stress exposure (r=-0.240, p=0.013). DISCUSSION Findings underscore complex mechanisms linking genetic susceptibility and early adverse exposures. Replication in larger cohorts followed from the pregnancy through adolescence is suggested to elucidate mechanisms that appear to have varying developmental expression.
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Affiliation(s)
- Suena H Massey
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19(th) Floor, Chicago, IL, 60611, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL, 60611, USA.
| | - Amalia E Hatcher
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Caron A C Clark
- Department of Psychology, University of Arizona, 1503 E University Blvd., P.O.Box 210068, Tucson, AZ 85721, USA.
| | - James L Burns
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL, 60611, USA.
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, NIMH Intramural Research Program, 15K North Drive, MSC-2670, Bethesda, MD 20892-2670, USA.
| | - Andrew D Skol
- Department of Medicine, University of Chicago, 900 E. 57th St, Chicago, IL 60637, USA.
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19(th) Floor, Chicago, IL, 60611, USA; Department of Psychology, Northwestern University, Swift Hall 102, 2029 Sheridan Road, Evanston, IL60208, USA.
| | - Kimberly A Espy
- Department of Psychology, University of Arizona, 1503 E University Blvd., P.O.Box 210068, Tucson, AZ 85721, USA; Department of Psychiatry, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ 85721, USA; Office for Research & Economic Development, University of Nebraska-Lincoln, USA.
| | - David Goldman
- Laboratory of Neurogenetics, NIAAA Intramural Research Program, National Institutes of Health, 5625 Fishers Lane, Room 3S-32:MSC 9412, Bethesda, MD 20892-9412, USA.
| | - Edwin Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
| | - Lauren S Wakschlag
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL, 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair, 19th Floor, Chicago, IL, 60611, USA.
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