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Kurbatfinski S, Woo J, Ntanda H, Giesbrecht G, Letourneau N. Perinatal Predictors and Mediators of Attachment Patterns in Preschool Children: Exploration of Children's Contributions in Interactions with Mothers. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1022. [PMID: 39201958 PMCID: PMC11352242 DOI: 10.3390/children11081022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/11/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024]
Abstract
Insecure and disorganized attachment patterns in children are linked to poor health outcomes over the lifespan. Attachment patterns may be predicted by variables that influence the quality of children's interactions with their primary caregivers/parents (usually mothers) such as prenatal and postnatal exposures and the children's own behaviours in interactions. The purposes of this exploratory study were to examine: (1) prenatal predictors of children's attachment patterns, and (2) postnatal mediators and moderators of associations between prenatal predictors and children's attachment patterns, with adjustment for relevant covariates. Mother-child dyads (n = 214) from the longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) cohort were studied using valid and reliable measures. Hayes' mediation analysis was employed to determine direct and indirect effects. Mothers' prenatal cortisol levels directly predicted disorganized (versus organized) child attachment in unadjusted models. Children's passivity (in adjusted models) and compulsivity (in unadjusted and adjusted models) in parent-child interactions mediated the pathway between mothers' prenatal cortisol levels and children's disorganized attachment patterns. Serial mediation analyses revealed that mothers' cortisol levels predicted their children's cortisol levels, which predicted children's compulsivity, and, ultimately, disorganized attachment in both unadjusted and adjusted models. No predictors were correlated with children's insecure (versus secure) attachment. This exploratory research suggests that prenatal exposure to mothers' cortisol levels and children's behavioural contributions to parent-child interaction quality should be considered in the genesis of children's attachment patterns, especially disorganization. Interventions focused on parent-child interactions could also focus on addressing children's behavioral contributions.
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Affiliation(s)
- Stefan Kurbatfinski
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (S.K.); (G.G.)
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
| | - Jennifer Woo
- Department of Psychiatry, University of Saskatchewan, Regina, SK S7N 0W8, Canada;
| | - Henry Ntanda
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
| | - Gerald Giesbrecht
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (S.K.); (G.G.)
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children’s Hospital Research Institute, Calgary, AB T2N 1N4, Canada;
- Owerko Centre, Faculty of Nursing and Cumming School of Medicine, Departments of Pediatrics, Psychiatry, and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
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Weiss S, Cooper B, Leung C. Exposure to prenatal stressors and infant autonomic nervous system regulation of stress. Stress 2024; 27:2327328. [PMID: 38497496 PMCID: PMC11144651 DOI: 10.1080/10253890.2024.2327328] [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] [Received: 09/11/2023] [Accepted: 03/02/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVES The purpose of this study was to determine the relationship between fetal exposure to maternal prenatal stressors and infant parasympathetic (PNS) and sympathetic (SNS) nervous function at 3 timepoints across the first year of life. BACKGROUND Autonomic nervous system impairments may mediate associations between gestational exposure to stressors and later infant health problems. Heart rate variability (HRV) provides a sensitive index of PNS and SNS function. However, no studies have assessed longitudinal associations between prenatal stressors and infant HRV measures of both PNS and SNS over the first year of life. METHODS During the third trimester of pregnancy, 233 women completed measures of life stressors and depression. At 1, 6 and 12 months of age, a stressor protocol was administered while infant electrocardiographic (ECG) data were collected from a baseline through a post-stressor period. HRV measures of PNS and SNS activity (HF, LF, LF/HF ratio) were generated from ECG data. We used multilevel regression to examine the aims, adjusting for maternal depression and neonatal morbidity. RESULTS There were no associations between prenatal stressors and any baseline or reactivity HRV metric over the infant's first year of life. However, exposure to more stressors was associated with lower post-stressor LF HRV at both 6 (β = -.44, p = .001) and 12 (β = -.37, p = .005) months of age. CONCLUSIONS Findings suggest potential alterations in development of the vagally mediated baroreflex function as a result of exposure to prenatal stressors, with implications for the infants' ability to generate a resilient recovery in response to stressors.
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Affiliation(s)
- Sandra Weiss
- Department of Community Health Systems, University of California, San Francisco, San Francisco, California, USA
| | - Bruce Cooper
- Department of Community Health Systems, University of California, San Francisco, San Francisco, California, USA
| | - Cherry Leung
- Department of Community Health Systems, University of California, San Francisco, San Francisco, California, USA
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Jones-Mason K, Coccia M, Alkon A, Melanie Thomas KCP, Laraia B, Adler N, Epel ES, Bush NR. Parental sensitivity modifies the associations between maternal prenatal stress exposure, autonomic nervous system functioning and infant temperament in a diverse, low-income sample. Attach Hum Dev 2023; 25:487-523. [PMID: 37749913 DOI: 10.1080/14616734.2023.2257669] [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: 08/02/2022] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
Evidence suggests that adversity experienced during fetal development may shape infant physiologic functioning and temperament. Parental sensitivity is associated with child stress regulation and may act as a buffer against risk for intergenerational health effects of pre- or postnatal adversity. Building upon prior evidence in a racially and ethnically diverse sample of infants (M infant age = 6.5 months) and women of low socioeconomic status, this study examined whether coded parenting sensitivity moderated the association between an objective measure of prenatal stress exposures (Stressful Life Events (SLE)) and infant parasympathetic (respiratory sinus arrhythmia; RSA) or sympathetic (pre-ejection period; PEP) nervous system functioning assessed during administration of the Still-Face-Paradigm (SFP) (n = 66), as well as maternal report of temperament (n = 154). Results showed that parental sensitivity moderated the associations between prenatal stress exposures and infant RSA reactivity, RSA recovery, PEP recovery, and temperamental negativity. Findings indicate that greater parental sensitivity is associated with lower infant autonomic nervous system reactivity and greater recovery from challenge. Results support the hypothesis that parental sensitivity buffers infants from the risk of prenatal stress exposure associations with offspring cross-system physiologic reactivity and regulation, potentially shaping trajectories of health and development and promoting resilience.
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Affiliation(s)
- Karen Jones-Mason
- Department of Psychiatry, University of California, San Francisco, USA
| | - Michael Coccia
- Department of Psychiatry, University of California, San Francisco, USA
| | - Abbey Alkon
- School of Nursing, University of California, San Francisco, USA
| | | | - Barbara Laraia
- School of Public Health, University of California, Berkeley, USA
| | - Nancy Adler
- Department of Psychiatry, University of California, San Francisco, USA
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, USA
| | - Nicole R Bush
- Department of Psychiatry, University of California, San Francisco, USA
- Department of Pediatrics, University of California, San Francisco, USA
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Letourneau N, Aghajafari F, Bell RC, Deane AJ, Dewey D, Field C, Giesbrecht G, Kaplan B, Leung B, Ntanda H. The Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal study: cohort profile and key findings from the first three years. BMJ Open 2022; 12:e047503. [PMID: 35131812 PMCID: PMC8823238 DOI: 10.1136/bmjopen-2020-047503] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The objectives of the ongoing Canadian longitudinal cohort called the Alberta Pregnancy Outcomes and Nutrition (APrON) study are to: (1) determine the relationship between maternal nutrient intake and status before, during, after pregnancy, and (a) maternal mental health, (b) pregnancy and birth outcomes, and (c) infant/child neurodevelopment and behavior; (2) identify maternal mental health and nutrient predictors of child behaviour; and (3) establish a DNA biobank to explore genomic predictors of children's neurodevelopment and behavior. The purpose of this paper is to describe the participants, measures, and key findings on maternal and paternal mental health, maternal nutrition, and child outcomes to when children are 3 years of age. PARTICIPANTS Participants included mothers and their children (n=2189) and mothers' partners (usually fathers; n=1325) from whom data were collected during the period from pregnancy to when children were 3 years of age, in Alberta, Canada. More than 88% of families have been retained to take part in completed data collection at 8 years of age. FINDINGS TO DATE Data comprise: questionnaires completed by pregnant women/mothers and their partners on mothers', fathers' and children's health; dietary interviews; clinical assessments; linkage to hospital obstetrical records; and biological samples such as DNA. Key findings on mental health, nutrition and child outcomes are presented. APrON women who consumed more selenium and omega-3 were less likely to develop symptoms of perinatal depression. Higher prenatal consumption of choline rich foods such as eggs and milk were recommended as was vitamin D supplementation for both mothers and children to meet guidelines. Couples in which both mothers and fathers were affected by perinatal depression reported lower incomes and higher maternal prenatal depressive symptoms and lower support from fathers postnatally and their children presented with the most behavioural problems. Maternal experiences of early adversity predicted increased likelihood of perinatal depression and anxiety and children's behavioural problems. FUTURE PLANS The APrON cohort offers a unique opportunity to advance understanding of the developmental origins of health and disease. There is a planned follow-up to collect data at 12 years of age.
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Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine (Departments of Paediatrics, Psychiatry & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Fariba Aghajafari
- Cumming School of Medicine (Family Medicine & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Rhonda C Bell
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Andrea J Deane
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Deborah Dewey
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Catherine Field
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Kaplan
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Brenda Leung
- Health Science - Public Health Program, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Henry Ntanda
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
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Nelson BW, Sheeber L, Pfeifer JH, Allen NB. Affective and Autonomic Reactivity During Parent-Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring. Res Child Adolesc Psychopathol 2021; 49:1513-1526. [PMID: 34142271 PMCID: PMC8483768 DOI: 10.1007/s10802-021-00840-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/28/2022]
Abstract
Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case-control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.
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Affiliation(s)
- Benjamin W Nelson
- Department of Psychology, University of Oregon, Eugene, OR, USA.
- Oregon Research Institute, Eugene, OR, USA.
- School of Medicine, University of Washington, Seattle, WA, USA.
- Department of Psychology, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.
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Cowell W, Khoury JE, Petty CR, Day HE, Benítez BE, Cunningham MK, Schulz SM, Ritz T, Wright RJ, Enlow MB. Integrated and diurnal indices of maternal pregnancy cortisol in relation to sex-specific parasympathetic responsivity to stress in infants. Dev Psychobiol 2021; 63:350-363. [PMID: 32658309 PMCID: PMC7855344 DOI: 10.1002/dev.22015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 01/21/2023]
Abstract
Maternal hypothalamic-pituitary-adrenal axis activity may prenatally program sex-specific stress-response pathways. We investigated associations between maternal cortisol during pregnancy and infant parasympathetic responsivity to stress among 204 mother-infant pairs. Cortisol indices included 3rd trimester hair cortisol, as well as diurnal slope and area under the curve, derived from saliva samples collected during pregnancy. Mother-infant dyads participated in the Repeated Still-Face Paradigm (SFP-R) at age 6 months. We calculated respiration-adjusted respiratory sinus arrhythmia (RSAc ), an indicator of parasympathetic activation, from infant respiration and cardiac activity measured during the SFP-R. We used multivariable linear mixed models to examine each cortisol index in relation to infant RSAc and investigated sex differences using cross-product terms. Diurnal cortisol indices were not associated with RSAc . There was no association between hair cortisol and baseline RSAc . However, hair cortisol was associated with sex-specific changes in RSAc over the SFP-R such that, among girls, parasympathetic withdrawal was reduced with increasing prenatal exposure to cortisol. Consistently higher levels of prenatal cortisol exposure may lead to dampened parasympathetic responsivity to stress during infancy, particularly among girls. Maternal hair cortisol may be particularly valuable for studying the effects of prenatal cortisol exposure on infant autonomic reactivity.
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Affiliation(s)
- Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jennifer E. Khoury
- Department of Psychiatry, Cambridge Hospital, Cambridge, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Helen E. Day
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA
| | - Brian E. Benítez
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA
| | | | - Stefan M. Schulz
- Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY,Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Harvard Medical School, Boston, MA,Department of Psychiatry, Boston Children’s Hospital, Boston, MA
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Sacrey LR, Raza S, Armstrong V, Brian JA, Kushki A, Smith IM, Zwaigenbaum L. Physiological measurement of emotion from infancy to preschool: A systematic review and meta-analysis. Brain Behav 2021; 11:e01989. [PMID: 33336555 PMCID: PMC7882167 DOI: 10.1002/brb3.1989] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Emotion regulation, the ability to regulate emotional responses to environmental stimuli, develops in the first years of life and plays an important role in the development of personality, social competence, and behavior. Substantial literature suggests a relationship between emotion regulation and cardiac physiology; specifically, heart rate changes in response to positive or negative emotion-eliciting stimuli. METHOD This systematic review and meta-analysis provide an in-depth examination of research that has measured physiological responding during emotional-evoking tasks in children from birth to 4 years of age. RESULTS The review had three main findings. First, meta-regressions resulted in an age-related decrease in baseline and task-related heart rate (HR) and increases in baseline and task-related respiratory sinus arrhythmia (RSA). Second, meta-analyses suggest task-related increases in HR and decreases in RSA and heart rate variability (HRV), regardless of emotional valence of the task. Third, associations between physiological responding and observed behavioral regulation are not consistently present in children aged 4 and younger. The review also provides a summary of the various methodology used to measure physiological reactions to emotional-evoking tasks, including number of sensors used and placement, various baseline and emotional-evoking tasks used, methods for extracting RSA, as well as percentage of loss and reasons for loss for each study. CONCLUSION Characterizing the physiological reactivity of typically developing children is important to understanding the role emotional regulation plays in typical and atypical development.
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Affiliation(s)
- Lori‐Ann R. Sacrey
- University of Alberta/Autism Research CentreGlenrose Rehabilitation HospitalEdmontonABCanada
| | - Sarah Raza
- University of Alberta/Autism Research CentreGlenrose Rehabilitation HospitalEdmontonABCanada
| | - Vickie Armstrong
- Dalhousie University/Autism Research CentreIWK Health CentreHalifaxNSCanada
| | - Jessica A. Brian
- University of Toronto/Autism Research CentreBloorview Research InstituteTorontoONCanada
| | - Azadeh Kushki
- University of Toronto/Autism Research CentreBloorview Research InstituteTorontoONCanada
| | - Isabel M. Smith
- Dalhousie University/Autism Research CentreIWK Health CentreHalifaxNSCanada
| | - Lonnie Zwaigenbaum
- University of Alberta/Autism Research CentreGlenrose Rehabilitation HospitalEdmontonABCanada
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Bush NR, Savitz J, Coccia M, Jones-Mason K, Adler N, Boyce WT, Laraia B, Epel E. Maternal Stress During Pregnancy Predicts Infant Infectious and Noninfectious Illness. J Pediatr 2021; 228:117-125.e2. [PMID: 32827529 PMCID: PMC7752845 DOI: 10.1016/j.jpeds.2020.08.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine the association between prenatal stress and infant physical health in the first year of life within an understudied, racially and ethnically diverse, highly stressed community sample. We expected that greater stress exposure would predict higher rates of infant illness. STUDY DESIGN Low-income, racially/ethnically diverse, overweight women with low medical risk pregnancies were recruited (2011-2014) during pregnancy. Pregnancy Stressful Life Events were assessed retrospectively (mean, 11.88 months postpartum). Perceived stress was assessed twice during pregnancy (at a mean of 17.4 weeks and again at a mean of 25.6 weeks) and at 6 months postpartum. Women with live births (n = 202) were invited; 162 consented to the offspring study. Medical records from pediatric clinics and emergency departments for 148 infants were abstracted for counts of total infectious illnesses, total noninfectious illness, and diversity of illnesses over the first year of life. RESULTS The final analytic sample included 109 women (mean age, 28.08 years) and their infants. In covariate-adjusted negative binomial models, maternal perceptions of stress across pregnancy were positively associated with infant illness. Each 1-point increase in average stress was associated with a 38% increase in incidence of infant infections (Incidence rate ratio, 1.38; 95% CI, 1.01-1.88; P < .05), a 73% increase in noninfectious illness (IRR, 1.73; 95% CI, 1.34-2.23; P < .05), and a 53% increase in illness diversity (IRR, 1.53; 95% CI, 1.25, 1.88; P < .01); effect sizes were larger for perceived stress later in pregnancy. Stressful life events count and postnatal stress were not uniquely associated with illness. CONCLUSIONS In line with recommendations from the American Academy of Pediatrics to screen for maternal perinatal depression, screening and support for stress reduction during pregnancy may benefit both maternal and child health.
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Affiliation(s)
- Nicole R. Bush
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry,Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco
| | - Jennifer Savitz
- Departments of Medicine and Clinical Pharmacy, University of California, San Francisco, CA,University of Washington and Seattle Children's Hospital, Seattle, WA
| | - Michael Coccia
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
| | - Karen Jones-Mason
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
| | - Nancy Adler
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
| | - W. Thomas Boyce
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry,Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco
| | - Barbara Laraia
- School of Public Health, University of California, Berkeley, CA
| | - Elissa Epel
- Weill Institute for Neurosciences, Center for Health and Community, Department of Psychiatry
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Leerkes EM, Buehler C, Calkins SD, Shriver LH, Wideman L. Protocol for iGrow (Infant Growth and Development Study): biopsychosocial predictors of childhood obesity risk at 2 years. BMC Public Health 2020; 20:1912. [PMID: 33317498 PMCID: PMC7734916 DOI: 10.1186/s12889-020-10003-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022] Open
Abstract
Background Childhood obesity remains a significant public health problem. To date, most research on the causes and correlates of obesity has focused on a small number of direct predictors of obesity rather than testing complex models that address the multifactorial nature of the origins of obesity in early development. We describe the rationale and methods of iGrow (Infant Growth and Development Study) which will test multiple pathways by which (a) prenatal maternal psychobiological risk predicts infant weight gain over the first 6 months of life, and (b) this early weight gain confers risk for obesity at age 2. Infant hormonal and psychobiological risk are proposed mediators from prenatal risk to early weight gain, though these are moderated by early maternal sensitivity and obesogenic feeding practices. In addition, higher maternal sensitivity and lower obesogenic feeding practices are proposed predictors of adaptive child self-regulation in the second year of life, and all three are proposed to buffer/reduce the association between high early infant weight gain and obesity risk at age 2. Methods iGrow is a prospective, longitudinal community-based study of 300 diverse mothers and infants to be followed across 5 data waves from pregnancy until children are age 2. Key measures include (a) maternal reports of demographics, stress, well-being, feeding practices and child characteristics and health; (b) direct observation of maternal and infant behavior during feeding, play, and distress-eliciting tasks during which infant heart rate is recorded to derive measures of vagal withdrawal; (c) anthropometric measures of mothers and infants; and (d) assays of maternal prenatal blood and infant saliva and urine. A host of demographic and other potential confounds will be considered as potential covariates in structural equation models that include tests of mediation and moderation. Efforts to mitigate the deleterious effects of COVID-19 on study success are detailed. Discussion This study has the potential to inform (1) basic science about early life processes casually related to childhood obesity and (2) development of targeted intervention and prevention approaches that consider mother, infant, and family risks and resources.
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Affiliation(s)
- Esther M Leerkes
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA.
| | - Cheryl Buehler
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA
| | - Susan D Calkins
- UNC Greensboro, Office of Research and Engagement, Greensboro, NC, 27402-6170, USA
| | - Lenka H Shriver
- UNC Greensboro, Department of Nutrition, Greensboro, NC, 27402-6170, USA
| | - Laurie Wideman
- UNC Greensboro, Department of Kinesiology, Greensboro, NC, 27402-6170, USA
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Ritz T, Schulz SM, Rosenfield D, Wright RJ, Bosquet Enlow M. Cardiac sympathetic activation and parasympathetic withdrawal during psychosocial stress exposure in 6-month-old infants. Psychophysiology 2020; 57:e13673. [PMID: 33048371 PMCID: PMC8548071 DOI: 10.1111/psyp.13673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/23/2020] [Accepted: 06/15/2020] [Indexed: 01/28/2023]
Abstract
Infant autonomic reactivity to stress is a potential predictor of later life health complications, but research has not sufficiently examined sympathetic activity, controlled for effects of physical activity and respiration, or studied associations among autonomic adjustments, cardiac activity, and affect in infants. We studied 278 infants during the repeated Still-Face Paradigm, a standardized stressor, while monitoring cardiac activity (ECG) and respiratory pattern (respiratory inductance plethysmography). Video ratings of physical activity and affect were also performed. Respiratory sinus arrhythmia (RSA) and T-wave amplitude (TWA) served as noninvasive indicators of cardiac parasympathetic and sympathetic activity, respectively. Responses were compared between infants who completed two still-face exposures and those who terminated after one exposure due to visible distress. Findings, controlled for physical activity, showed robust reductions in respiration-adjusted RSA and TWA, with more tonic attenuation of TWA. Infants completing only one still-face trial showed more pronounced autonomic changes and less recovery from stress. They also showed elevated minute ventilation, suggesting hyperventilation. Both reductions in adjusted RSA and TWA contributed equally to heart rate changes and were associated with higher negative and lower positive affect. These associations were more robust in the group of distressed infants unable to complete both still-face trials. Thus, cardiac sympathetic activation and parasympathetic withdrawal are part of the infant stress response, beyond associated physical activity and respiration changes. Their association with cardiac chronotropy and affect increases as infants' distress level increases. This excess reactivity to social stress should be examined as a predictor of future cardiovascular disease.
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Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, Texas, USA
| | - Stefan M. Schulz
- Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, Texas, USA
| | - Rosalind J. Wright
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michelle Bosquet Enlow
- Boston Children’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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11
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Nazzari S, Fearon P, Rice F, Ciceri F, Molteni M, Frigerio A. The biological underpinnings of perinatal depressive symptoms: A multi-systems approach. J Affect Disord 2020; 274:1004-1012. [PMID: 32663926 DOI: 10.1016/j.jad.2020.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/29/2020] [Accepted: 05/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Well-established evidence exists of an association between depressive symptoms and alterations in the stress and inflammatory response systems; however, the picture is far less coherent during the perinatal period. This study combines the assessment of multiple stress and inflammatory biomarkers in late pregnancy and after delivery in order to investigate cross-sectional and prospective associations with perinatal depressive symptoms. METHODS One-hundred-ten healthy women were assessed in late pregnancy (mean gestational age=34.76; SD=1.12) and 89 were re-evaluated after delivery (mean hours after delivery=52.36; SD=19.70) for depressive and anxiety symptoms through the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory. Serum Interleukin-6 (IL-6), C-Reactive Protein (CRP) and diurnal salivary cortisol levels were measured on both occasions, while diurnal salivary alpha amylase (sAA) levels were assessed in late pregnancy. RESULTS Using Hierarchical Linear Models, higher depressive symptoms were found to be associated with higher IL-6 levels, lower morning cortisol levels and a flatter cortisol diurnal slope during pregnancy, while adjusting for potential confounders. No significant associations were found after delivery or with change in biomarker levels from pre- to post-partum. Furthermore, preliminary evidence of a positive association between inflammation and stress markers in women with higher antenatal depressive symptoms was found. LIMITATIONS The sample was relatively small and highly selected, thus limiting generalizability of the findings. CONCLUSIONS Results emphasize the need for an integrated multi-systems approach to the understanding of the biological underpinnings of perinatal depression and suggest that the stress-immune interactions represent a promising avenue for future endeavor.
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Affiliation(s)
- S Nazzari
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy.
| | - P Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - F Rice
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, United Kingdom
| | - F Ciceri
- Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy
| | - M Molteni
- Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy
| | - A Frigerio
- Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy
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12
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Saboory E, Mohammadi S, Dindarian S, Mohammadi H. Prenatal stress and elevated seizure susceptibility: Molecular inheritable changes. Epilepsy Behav 2019; 96:122-131. [PMID: 31132613 DOI: 10.1016/j.yebeh.2019.04.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 01/08/2023]
Abstract
Stressful episodes are common during early-life and may have a wide range of negative effects on both physical and mental status of the offspring. In addition to various neurobehavioral complications induced by prenatal stress (PS), seizure is a common complication with no fully explained cause. In this study, the association between PS and seizure susceptibility was reviewed focusing on sex differences and various underlying mechanisms. The role of drugs in the initiation of seizure and the effects of PS on the nervous system that prone the brain for seizure, especially the hypothalamic-pituitary-adrenal (HPA) axis, are also discussed in detail by reviewing the papers studying the effect of PS on glutamatergic, gamma-aminobutyric acid (GABA)ergic, and adrenergic systems in the context of seizure and epilepsy. Finally, epigenetic changes in epilepsy are described, and the underlying mechanisms of this change are expanded. As the effects of PS may be life-lasting, it is possible to prevent future psychiatric and behavioral disorders including epilepsy by preventing avoidable PS risk factors.
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Affiliation(s)
- Ehsan Saboory
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran.
| | - Sedra Mohammadi
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
| | - Sina Dindarian
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
| | - Hozan Mohammadi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Maternal psychological distress during pregnancy and childhood health outcomes: a narrative review. J Dev Orig Health Dis 2018; 10:274-285. [PMID: 30378522 DOI: 10.1017/s2040174418000557] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Maternal psychological distress is common in pregnancy and may influence the risk of adverse outcomes in children. Psychological distress may cause a suboptimal intrauterine environment leading to growth and developmental adaptations of the fetus and child. In this narrative review, we examined the influence of maternal psychological distress during pregnancy on fetal outcomes and child cardiometabolic, respiratory, atopic and neurodevelopment-related health outcomes. We discussed these findings from an epidemiological and life course perspective and provided recommendations for future studies. The literature in the field of maternal psychological distress and child health outcomes is extensive and shows that exposure to stress during pregnancy is associated with multiple adverse child health outcomes. Because maternal psychological distress is an important and potential modifiable factor during pregnancy, it should be a target for prevention strategies in order to optimize fetal and child health. Future studies should use innovative designs and strategies in order to address the issue of causality.
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14
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Bleker LS, van Dammen L, Leeflang MMG, Limpens J, Roseboom TJ, de Rooij SR. Hypothalamic-pituitary-adrenal axis and autonomic nervous system reactivity in children prenatally exposed to maternal depression: A systematic review of prospective studies. Neurosci Biobehav Rev 2018; 117:243-252. [PMID: 30366609 DOI: 10.1016/j.neubiorev.2018.05.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 12/25/2022]
Abstract
Depression is a common condition affecting up to 20% of all pregnant women, and is associated with subsequent developmental and behavioral problems in children, such as conduct disorder and ADHD. One proposed mechanism underlying these associations is modification of the fetal hypothalamic pituitary adrenal (HPA)-axis and the autonomic nervous system (ANS), resulting in altered responses to stress. This review examined the evidence regarding altered HPA-axis and ANS reactivity in children prenatally exposed to high maternal depressive symptoms. A systematic search was conducted in the electronic databases MEDLINE, EMBASE and PsycINFO, for studies published till 25 July 2017. A total of 13 studies comprising 2271 mother-infant dyads were included. None of the studies were suitable for meta-analysis. Risk of bias assessment showed low risk for four studies. Only three studies described an independent association between exposure to high maternal prenatal depressive symptoms and altered stress reactivity in children. There is limited evidence of an independent association between prenatal exposure to maternal depression and altered HPA or ANS reactivity in children.
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Affiliation(s)
- Laura S Bleker
- Academic Medical Centre, Departments of Obstetrics and Gynaecology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Lotte van Dammen
- University of Groningen - University Medical Centre Groningen, Department of Obstetrics and Gynaecology, 9713 GZ, Groningen, The Netherlands; University of Groningen - University Medical Centre Groningen, Department of Epidemiology, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Mariska M G Leeflang
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Academic Medical Centre, Department of Research Support - Medical Library, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Academic Medical Centre, Departments of Obstetrics and Gynaecology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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15
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Abstract
PURPOSE OF REVIEW To evaluate the degree to which recent studies provide evidence that the effects of prenatal maternal stress (PNMS) on child health outcomes vary depending on the child's biological sex. In this review, we used a broad definition of stress, including negative life events, psychological stress, and established stress biomarkers. We identified 50 peer-reviewed articles (published January 2015-December 2017) meeting the inclusion criteria. RECENT FINDINGS Most articles (k = 35) found evidence of either sex-specific associations (significant in one sex but not the other) or significant PNMSxstress interactions for at least one child health outcome. Evidence for sex-dependent effects was strongest in the group of studies evaluating child neural/nervous system development and temperament as outcomes. There is sufficient evidence of sex-dependent associations to recommend that researchers always consider the potential role of child sex in PNMS programming studies and report descriptive statistics for study outcomes stratified by child biological sex.
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Affiliation(s)
- Susanna Sutherland
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Pl, Nashville, TN, 37203, USA
| | - Steven M Brunwasser
- Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, T-1218 Medical Center North, 1161 21st Avenue South, Nashville, TN, 37232-2650, USA.
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, 1161 21st Avenue, South, B-1118 MCN, Nashville, TN, 37232, USA.
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16
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Condon EM. Chronic Stress in Children and Adolescents: A Review of Biomarkers for Use in Pediatric Research. Biol Res Nurs 2018; 20:473-496. [PMID: 29865855 DOI: 10.1177/1099800418779214] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PROBLEM Incorporating biomarkers of chronic stress into pediatric research studies may help to explicate the links between exposure to adversity and lifelong health, but there are currently very few parameters to guide nurse researchers in choosing appropriate biomarkers of chronic stress for use in research with children and adolescents. METHODS Biomarkers of chronic stress are described, including primary mediators (glucocorticoids, catecholamines, and cytokines) and secondary outcomes (neurologic, immune, metabolic, cardiovascular, respiratory, and anthropometric) of the chronic stress response. RESULTS Evidence of the use of each biomarker in pediatric research studies is reviewed. Recommendations for pediatric researchers, including selection of appropriate biomarkers, measurement considerations, potential moderators, and future directions for research, are presented. DISCUSSION A wide range of biomarkers is available for use in research studies with children. While primary mediators of chronic stress have been frequently measured in studies of children, measurement of secondary outcomes, particularly immune and metabolic biomarkers, has been limited. With thoughtful and theoretically based approaches to selection and measurement, these biomarkers present an important opportunity to further explore the physiologic pathways linking exposure to chronic stress with later health and disease. CONCLUSION The incorporation of chronic stress biomarkers into pediatric research studies may provide valuable insight into the mechanisms through which stressful environments "get under the skin" and ultimately inform efforts to promote health and reduce inequities among children exposed to adversity.
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Affiliation(s)
- Eileen M Condon
- 1 Yale School of Nursing, West Campus Drive, Orange, CT, USA
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17
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Bush NR, Jones-Mason K, Coccia M, Caron Z, Alkon A, Thomas M, Coleman-Phox K, Wadhwa PD, Laraia BA, Adler NE, Epel ES. Effects of pre- and postnatal maternal stress on infant temperament and autonomic nervous system reactivity and regulation in a diverse, low-income population. Dev Psychopathol 2017; 29:1553-1571. [PMID: 29162167 PMCID: PMC5726291 DOI: 10.1017/s0954579417001237] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We examined the prospective associations of objective and subjective measures of stress during pregnancy with infant stress reactivity and regulation, an early-life predictor of psychopathology. In a racially and ethnically diverse low-income sample of 151 mother-infant dyads, maternal reports of stressful life events (SLE) and perceived stress (PS) were collected serially over gestation and the early postpartum period. Infant reactivity and regulation at 6 months of age was assessed via maternal report of temperament (negativity, surgency, and regulation) and infant parasympathetic nervous system physiology (respiratory sinus arrhythmia [RSA]) during the Still Face Paradigm. Regression models predicting infant temperament showed higher maternal prenatal PS predicted lower surgency and self-regulation but not negativity. Regression models predicting infant physiology showed higher numbers of SLE during gestation predicted greater RSA reactivity and weaker recovery. Tests of interactions revealed SLE predicted RSA reactivity only at moderate to high levels of PS. Thus, findings suggest objective and subjective measures of maternal prenatal stress uniquely predict infant behavior and physiology, adjusting for key pre- and postnatal covariates, and advance the limited evidence for such prenatal programming within high-risk populations. Assessing multiple levels of maternal stress and offspring stress reactivity and regulation provides a richer picture of intergenerational transmission of adversity.
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Affiliation(s)
- Nicole R. Bush
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
- Department of Pediatrics, University of California, San Francisco
| | - Karen Jones-Mason
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
| | - Michael Coccia
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
| | - Zoe Caron
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
| | - Abbey Alkon
- Department of Nursing, University of California, San Francisco
| | - Melanie Thomas
- Department of Psychiatry, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco
| | - Kim Coleman-Phox
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
| | - Pathik D. Wadhwa
- School of Medicine, Development, Health and Disease Research Program, University of California, Irvine
| | | | - Nancy E. Adler
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
| | - Elissa S. Epel
- Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco
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18
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Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model. Pain 2017; 157:2628-2639. [PMID: 27380502 DOI: 10.1097/j.pain.0000000000000637] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Offspring of parents with chronic pain are at increased risk for pain and adverse mental and physical health outcomes (Higgins et al, 2015). Although the association between chronic pain in parents and offspring has been established, few studies have addressed why or how this relation occurs. Identifying mechanisms for the transmission of risk that leads to the development of chronic pain in offspring is important for developing preventive interventions targeted to decrease risk for chronic pain and related outcomes (eg, disability and internalizing symptoms). This review presents a conceptual model for the intergenerational transmission of chronic pain from parents to offspring with the goal of setting an agenda for future research and the development of preventive interventions. Our proposed model highlights 5 potential mechanisms for the relation between parental chronic pain and pediatric chronic pain and related adverse outcomes: (1) genetics, (2) alterations in early neurobiological development, (3) pain-specific social learning, (4), general parenting and family health, and (5) exposure to stressful environment. In addition, the model presents 3 potential moderators for the relation between parent and child chronic pain: (1) the presence of chronic pain in a second parent, (2) timing, course, and location of parental chronic pain, and (3) offspring's characteristics (ie, sex, developmental stage, race or ethnicity, and temperament). Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family centered and include at-risk children.
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19
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Field T. Prenatal anxiety effects: A review. Infant Behav Dev 2017; 49:120-128. [PMID: 28886563 DOI: 10.1016/j.infbeh.2017.08.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 08/18/2017] [Accepted: 08/18/2017] [Indexed: 12/20/2022]
Abstract
This review is based on literature on prenatal anxiety effects that was found on Pubmed and PsycINFO for the years 2010-2016. Prenatal anxiety is thought to have distinct features, although it has been measured both by specific prenatal anxiety symptoms as well as by standardized anxiety scales. Its prevalence has ranged from 21 to 25% and it has been predicted by a number of pregnancy - related variables such as unintended pregnancy, demographic variables such as low acculturation and income and psychosocial factors including pessimism and partner tension. Prenatal anxiety effects on pregnancy include increased cortisol levels, pro-inflammatory cytokines, obstetric problems and cesarean section. Effects on the neonate include lower gestational age, prematurity, less insulin-like growth factor in cord blood, less exclusive breast-feeding and less self-regulation during the heelstick procedure. Prenatal anxiety effects continue into infancy and childhood both on physiological development and emotional/mental development. Among the physiological effects are lower vagal activity across the first two years, and lower immunity, more illnesses and reduced gray matter in childhood. Prenatal anxiety effects on emotional/mental development include greater negative emotionality and in infants, lower mental development scores and internalizing problems. Anxiety disorders occur during childhood and elevated cortisol and internalizing behaviors occur during adolescence. Interventions for prenatal anxiety are virtually nonexistent, although stroking (massaging) the infant has moderated the pregnancy - specific anxiety effects on internalizing behaviors in the offspring. The limitations of this literature include the homogeneity of samples, the frequent use of anxiety measures that are not specific to pregnancy, and the reliance on self-report. Nonetheless, the literature highlights the negative, long-term effects of prenatal anxiety and the need for screening and early interventions.
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Affiliation(s)
- Tiffany Field
- University of Miami/Miller School of Medicine, United States; Fielding Graduate University, United States.
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20
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Rash JA, Thomas JC, Campbell TS, Letourneau N, Granger DA, Giesbrecht GF. Developmental origins of infant stress reactivity profiles: A multi-system approach. Dev Psychobiol 2016; 58:578-99. [DOI: 10.1002/dev.21403] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/19/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Joshua A. Rash
- Department of Psychology; University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
| | - Jenna C. Thomas
- Department of Psychology; University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
| | - Tavis S. Campbell
- Department of Psychology; University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
| | - Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine (Pediatrics and Psychiatry); University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
- Alberta Children's Hospital Research Institute; University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
| | - Douglas A. Granger
- Institute for Interdisciplinary Saliva Bioscience Research; Arizona State University; Tempe AZ 85287
- Bloomberg School of Public Health and School of Medicine; The John Hopkins University School of Nursing; Baltimore MD 21205
| | - Gerald F. Giesbrecht
- Alberta Children's Hospital Research Institute; University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
- Department of Pediatrics, Cumming School of Medicine; University of Calgary; 2500 University Drive N.W. Calgary AB T2N 1N4 Canada
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