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Eriksson A, Kimmel MC, Furmark T, Wikman A, Grueschow M, Skalkidou A, Frick A, Fransson E. Investigating heart rate variability measures during pregnancy as predictors of postpartum depression and anxiety: an exploratory study. Transl Psychiatry 2024; 14:203. [PMID: 38744808 PMCID: PMC11094065 DOI: 10.1038/s41398-024-02909-9] [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: 05/19/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
Perinatal affective disorders are common, but standard screening measures reliant on subjective self-reports might not be sufficient to identify pregnant women at-risk for developing postpartum depression and anxiety. Lower heart rate variability (HRV) has been shown to be associated with affective disorders. The current exploratory study aimed to evaluate the predictive utility of late pregnancy HRV measurements of postpartum affective symptoms. A subset of participants from the BASIC study (Uppsala, Sweden) took part in a sub-study at pregnancy week 38 where HRV was measured before and after a mild stressor (n = 122). Outcome measures were 6-week postpartum depression and anxiety symptoms as quantified by the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Anxiety Inventory (BAI). In total, 112 women were included in a depression outcome analysis and 106 women were included in an anxiety outcome analysis. Group comparisons indicated that lower pregnancy HRV was associated with depressive or anxious symptomatology at 6 weeks postpartum. Elastic net logistic regression analyses indicated that HRV indices alone were not predictive of postpartum depression or anxiety outcomes, but HRV indices were selected as predictors in a combined model with background and pregnancy variables. ROC curves for the combined models gave an area under the curve (AUC) of 0.93 for the depression outcome and an AUC of 0.83 for the anxiety outcome. HRV indices predictive of postpartum depression generally differed from those predictive of postpartum anxiety. HRV indices did not significantly improve prediction models comprised of psychological measures only in women with pregnancy depression or anxiety.
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Affiliation(s)
- Allison Eriksson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Women's Mental Health during the Reproductive Lifespan - WOMHER, Uppsala University, Uppsala, Sweden.
| | - Mary Claire Kimmel
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Anna Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marcus Grueschow
- Zurich Center for Neuroeconomics (ZNE), Department of Economics, University of Zurich, Zurich, Switzerland
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Andreas Frick
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
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2
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Rose DK, Bentley L, Maity A, Maguire RL, Planchart A, Spasojevic I, Liu AJ, Thorp J, Hoyo C. Association between F2-isoprostanes and self-reported stressors in pregnant americans of African and European ancestry. Heliyon 2024; 10:e25578. [PMID: 38356491 PMCID: PMC10865309 DOI: 10.1016/j.heliyon.2024.e25578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
Background Poor birth outcomes such as preterm birth/delivery disproportionately affect African Americans compared to White individuals. Reasons for this disparity are likely multifactorial, and include prenatal psychosocial stressors, and attendant increased lipid peroxidation; however, empirical data linking psychosocial stressors during pregnancy to oxidative status are limited. Methods We used established scales to measure five psychosocial stressors. Maternal adverse childhood experiences, financial stress, social support, anxiety, and depression were measured among 50 African American and White pregnant women enrolled in the Stress and Health in Pregnancy cohort. Liquid chromatography-tandem mass spectrometry was used to measure biomarkers of oxidative stress (four urinary F2-isoprostane isomers), to estimate oxidative status. Linear regression models were used to evaluate associations between psychosocial stressors, prenatal oxidative status and preterm birth. Results After adjusting for maternal obesity, gestational diabetes, and cigarette smoking, African American women with higher oxidative status were more likely to report higher maternal adverse childhood experience scores (β = 0.16, se = 1.07, p-value = 0.024) and depression scores (β = 0.05, se = 0.02, p = 0.014). Higher oxidative status was also associated with lower gestational age at birth (β = -0.13, se = 0.06, p = 0.04) in this population. These associations were not apparent in Whites. However, none of the cross-product terms for race/ethnicity and social stressors reached statistical significance (p > 0.05). Conclusion While the small sample size limits inference, our novel data suggest that psychosocial stressors may contribute significantly to oxidative stress during pregnancy, and preterm birth or delivery African Americans. If replicated in larger studies, these findings would support oxidative stress reduction using established dietary or pharmacological approaches present a potential avenue to mitigate adverse effects of psychosocial stressors on birth outcomes.
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Affiliation(s)
- Deborah K. Rose
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Loren Bentley
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Arnab Maity
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - Rachel L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Antonio Planchart
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Ivan Spasojevic
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, PK/PD Core Laboratory, Durham, NC, USA
| | - Andy J. Liu
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | - John Thorp
- Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
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3
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Filetti C, Kane-Grade F, Gunnar M. The Development of Stress Reactivity and Regulation in Children and Adolescents. Curr Neuropharmacol 2024; 22:395-419. [PMID: 37559538 PMCID: PMC10845082 DOI: 10.2174/1570159x21666230808120504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 08/11/2023] Open
Abstract
Adversity experienced in early life can have detrimental effects on physical and mental health. One pathway in which these effects occur is through the hypothalamic-pituitary-adrenal (HPA) axis, a key physiological stress-mediating system. In this review, we discuss the theoretical perspectives that guide stress reactivity and regulation research, the anatomy and physiology of the axis, developmental changes in the axis and its regulation, brain systems regulating stress, the role of genetic and epigenetics variation in axis development, sensitive periods in stress system calibration, the social regulation of stress (i.e., social buffering), and emerging research areas in the study of stress physiology and development. Understanding the development of stress reactivity and regulation is crucial for uncovering how early adverse experiences influence mental and physical health.
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Affiliation(s)
- Clarissa Filetti
- Institute of Child Development, University of Minnesota, Minneapolis, USA
| | - Finola Kane-Grade
- Institute of Child Development, University of Minnesota, Minneapolis, USA
| | - Megan Gunnar
- Institute of Child Development, University of Minnesota, Minneapolis, USA
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Weingarten SJ, Osborne LM. Review of the Assessment and Management of Perinatal Mood and Anxiety Disorders. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:16-24. [PMID: 38694149 PMCID: PMC11058917 DOI: 10.1176/appi.focus.20230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Perinatal mood and anxiety disorders (PMADs) are the most common complication of childbirth. When poorly controlled, they are associated with worse obstetric outcomes, such as higher rates of preterm birth and unplanned cesarean delivery. They are also associated with suicide, a leading cause of perinatal maternal death. This article provides an overview of evidence-based recommendations for screening, assessment, and management of PMADs, including suicide risk assessment and management and pharmacological and nonpharmacological treatment options compatible with pregnancy and lactation. Although specialized reproductive psychiatrists can provide expert guidance for the management of PMADs, their scarcity means that most patients will not have access to this expert care and instead will seek guidance from general psychiatrists. This article provides a clinical guide for generalists that is based on the best current evidence, including recently released treatment guidelines.
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Affiliation(s)
- Sarah J Weingarten
- Department of Obstetrics and Gynecology (Weingarten, Osborne) and Department of Psychiatry (Osborne), Weill Cornell Medicine at NewYork-Presbyterian Hospital, New York, NY
| | - Lauren M Osborne
- Department of Obstetrics and Gynecology (Weingarten, Osborne) and Department of Psychiatry (Osborne), Weill Cornell Medicine at NewYork-Presbyterian Hospital, New York, NY
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5
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Schwartz JA, Calvi JL, Allen SL, Granger DA. Adrenocortical Responses to Daily Stressors Are Calibrated by Early Life Adversity: An Investigation of the Adaptive Calibration Model. EVOLUTIONARY PSYCHOLOGY 2023; 21:14747049231212357. [PMID: 37964553 PMCID: PMC10647968 DOI: 10.1177/14747049231212357] [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: 01/03/2023] [Accepted: 10/20/2023] [Indexed: 11/16/2023] Open
Abstract
Studies examining the impact of early adversity on physiological responsivity to environmental challenges in later life yield a complex pattern of findings and ambiguity regarding the direction of effect, with some studies reporting heightened responses and others reporting dampened responses. One potential reason for these mixed findings is an oversimplified theoretical model surrounding the connection between early life stressor exposure and subsequent stress responsivity. The adaptive calibration model offersa contemporary set of assumptions aimed at providing a better understanding of the ways that early life experiences shape the stress response system to better align with current and future environments. The current study utilized a large subsample from the National Study of Daily Experiences (N = 1,605) to examine the extent to which the association between daily stressor exposure and cortisol levels varies across levels of early life adversity. Results revealed that those individuals who experienced extremely low levels of early life adversity displayed the greatest increase in cortisol levels across the day as daily stressor exposure increased. Alternatively, those individuals who experienced extremely high levels of early life adversity displayed almost no change in diurnal production of cortisol as daily stressor exposure increased. The results are discussed within the evolutionary-developmental context of the adaptive calibration model along with suggestions for future research.
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Affiliation(s)
- Joseph A. Schwartz
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, FL, USA
| | - Jessica L. Calvi
- Nebraska Athletic Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Samantha L. Allen
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, FL, USA
| | - Douglas A. Granger
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
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6
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Simon L, Admon R. From childhood adversity to latent stress vulnerability in adulthood: the mediating roles of sleep disturbances and HPA axis dysfunction. Neuropsychopharmacology 2023; 48:1425-1435. [PMID: 37391592 PMCID: PMC10425434 DOI: 10.1038/s41386-023-01638-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/29/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
Childhood adversity is a prominent predisposing risk factor for latent stress vulnerability, expressed as an elevated likelihood of developing stress-related psychopathology upon subsequent exposure to trauma in adulthood. Sleep disturbances have emerged as one of the most pronounced maladaptive behavioral outcomes of childhood adversity and are also a highly prevalent core feature of stress-related psychopathology, including post-traumatic stress disorder (PTSD). After reviewing the extensive literature supporting these claims, the current review addresses the notion that childhood adversity-induced sleep disturbances may play a causal role in elevating individuals' stress vulnerability in adulthood. Corroborating this, sleep disturbances that predate adult trauma exposure have been associated with an increased likelihood of developing stress-related psychopathology post-exposure. Furthermore, novel empirical evidence suggests that sleep disturbances, including irregularity of the sleep-wake cycle, mediate the link between childhood adversity and stress vulnerability in adulthood. We also discuss cognitive and behavioral mechanisms through which such a cascade may evolve, highlighting the putative role of impaired memory consolidation and fear extinction. Next, we present evidence to support the contribution of the hypothalamic-pituitary-adrenal (HPA) axis to these associations, stemming from its critical role in stress and sleep regulatory pathways. Childhood adversity may yield bi-directional effects within the HPA stress and sleep axes in which sleep disturbances and HPA axis dysfunction reinforce each other, leading to elevated stress vulnerability. To conclude, we postulate a conceptual path model from childhood adversity to latent stress vulnerability in adulthood and discuss the potential clinical implications of these notions, while highlighting directions for future research.
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Affiliation(s)
- Lisa Simon
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel.
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
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7
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Cantave CY, Brendgen M, Paquin S, Lupien S, Dionne G, Vitaro F, Boivin M, Ouellet-Morin I. The phenotypic associations and gene-environment underpinnings of socioeconomic status and diurnal cortisol secretion in adolescence. Dev Psychopathol 2023; 35:1119-1129. [PMID: 34698624 DOI: 10.1017/s0954579421001048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
While converging evidence suggests that both environmental and genetic factors underlie variations in diurnal cortisol, the extent to which these sources of influence vary according to socioeconomic status (SES) has seldom been investigated, particularly in adolescence. To investigate whether a distinct genetic and environmental contribution to youth's diurnal cortisol secretion emerges according to family SES and whether the timing of these experiences matters. Participants were 592 twin pairs, who mostly came from middle-income and intact families and for whom SES was measured in childhood and adolescence. Diurnal cortisol was assessed at age 14 at awakening, 30 min later, in the afternoon and evening over four nonconsecutive days. SES-cortisol phenotypic associations were specific to the adolescence period. Specifically, higher awakening cortisol levels were detected in wealthier backgrounds, whereas higher cortisol awakening response (CAR) and diurnal changes were present at both ends of the SES continuum. Moreover, smaller genetic contributions emerged for awakening cortisol in youth from poorer compared to wealthier backgrounds. The results suggest that the relative contribution of inherited factors to awakening cortisol secretion may be enhanced or suppressed depending on the socio-family context, which may help to decipher the mechanisms underlying later adjustment.
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Affiliation(s)
| | - Mara Brendgen
- Department of Psychology, University of Quebec at Montreal, Canada
| | - Stéphane Paquin
- School of Criminology, University of Montreal, Montreal, Canada
| | - Sonia Lupien
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
- Centre for Studies on Human Stress, Department of Psychiatry, University of Montreal, Montreal, Canada
| | - Ginette Dionne
- School of Psychology, Laval University, Quebec City, Canada
| | - Frank Vitaro
- School of Psychoeducation, University of Montreal, Montreal, Canada
- Sainte-Justine Hospital Research Center, Montreal, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Quebec City, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada
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8
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Corrigan M, O'Rourke A, Moran B, Fletcher J, Harkin A. Inflammation in the pathogenesis of depression: a disorder of neuroimmune origin. Neuronal Signal 2023; 7:NS20220054. [PMID: 37457896 PMCID: PMC10345431 DOI: 10.1042/ns20220054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
There are several hypotheses concerning the underlying pathophysiological mechanisms of major depression, which centre largely around adaptive changes in neuronal transmission and plasticity, neurogenesis, and circuit and regional connectivity. The immune and endocrine systems are commonly implicated in driving these changes. An intricate interaction of stress hormones, innate immune cells and the actions of soluble mediators of immunity within the nervous system is described as being associated with the symptoms of depression. Bridging endocrine and immune processes to neurotransmission and signalling within key cortical and limbic brain circuits are critical to understanding depression as a disorder of neuroimmune origins. Emergent areas of research include a growing recognition of the adaptive immune system, advances in neuroimaging techniques and mechanistic insights gained from transgenic animals. Elucidation of glial-neuronal interactions is providing additional avenues into promising areas of research, the development of clinically relevant disease models and the discovery of novel therapies. This narrative review focuses on molecular and cellular mechanisms that are influenced by inflammation and stress. The aim of this review is to provide an overview of our current understanding of depression as a disorder of neuroimmune origin, focusing on neuroendocrine and neuroimmune dysregulation in depression pathophysiology. Advances in current understanding lie in pursuit of relevant biomarkers, as the potential of biomarker signatures to improve clinical outcomes is yet to be fully realised. Further investigations to expand biomarker panels including integration with neuroimaging, utilising individual symptoms to stratify patients into more homogenous subpopulations and targeting the immune system for new treatment approaches will help to address current unmet clinical need.
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Affiliation(s)
- Myles Corrigan
- Neuropsychopharmacology Research Group, School of Pharmacy and Pharmaceutical Sciences and Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- Transpharmation Ireland, Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Aoife M. O'Rourke
- School of Biochemistry and Immunology, Trinity Biosciences Institute, Trinity College, Dublin, Ireland
| | - Barry Moran
- School of Biochemistry and Immunology, Trinity Biosciences Institute, Trinity College, Dublin, Ireland
| | - Jean M. Fletcher
- School of Biochemistry and Immunology, Trinity Biosciences Institute, Trinity College, Dublin, Ireland
| | - Andrew Harkin
- Neuropsychopharmacology Research Group, School of Pharmacy and Pharmaceutical Sciences and Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
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9
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Rådmark L, Osika W, Wallén MB, Nissen E, Lönnberg G, Bränström R, Henje E, Gardner R, Fransson E, Karlsson H, Niemi M. Autonomic function and inflammation in pregnant women participating in a randomized controlled study of Mindfulness Based Childbirth and Parenting. BMC Pregnancy Childbirth 2023; 23:237. [PMID: 37038176 PMCID: PMC10084615 DOI: 10.1186/s12884-023-05528-2] [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] [Received: 06/07/2022] [Accepted: 03/16/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Pregnancy and childbirth are significant events in many women's lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, stress and depression are associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group. METHODS This study is a sub-study of a larger RCT, where significant intervention effects were found on perinatal depression (PND) and perceived stress. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. In this sub-study, we included altogether 80 women with increased risk for PND, and blood samples and HRV measures were available from 60 of the participants (26 in the intervention and 34 in the control group). RESULTS Participants who received MBCP reported a significantly larger reduction in perceived stress and a significantly larger increase in mindfulness, compared to participants who received the active control treatment. However, in this sub-study, the intervention had no significant effect on PND, inflammatory serum markers or measures of HRV. CONCLUSIONS No significant differences were found regarding changes in HRV measures and biomarkers of inflammation, larger studies may be needed in the future. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02441595 . Registered 12 May 2015 - Retrospectively registered.
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Affiliation(s)
- Lina Rådmark
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, CSS, Center for Social Sustainability, Karolinska Institutet, Alfred Nobels allé 23, 141 83, Huddinge, Sweden
| | - Walter Osika
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, CSS, Center for Social Sustainability, Karolinska Institutet, Alfred Nobels allé 23, 141 83, Huddinge, Sweden
- Northern Stockholm Psychiatry, Stockholm Health Care Services, Vårdvägen 1, 112 81, Stockholm, Sweden
| | | | - Eva Nissen
- Karolinska Institutet, Department Women's and Children's Health, Stockholm, Sweden
| | - Gunilla Lönnberg
- Karolinska Institutet, Department Women's and Children's Health, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, 752 37, Uppsala, Sweden
| | - Richard Bränström
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Eva Henje
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, 901 85, Umeå, Sweden
| | - Renee Gardner
- Department of Global Public Health, Karolinska Institutet, Solnavägen 1 E, 10431, Stockholm, Sweden
| | - Emma Fransson
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, 171 65, Stockholm, Sweden
- Department of Women´s and Children´s Health, Uppsala University, Akademiska sjukhuset, 751 85, Uppsala, Sweden
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria Niemi
- Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, CSS, Center for Social Sustainability, Karolinska Institutet, Alfred Nobels allé 23, 141 83, Huddinge, Sweden.
- Department of Global Public Health, Karolinska Institutet, Solnavägen 1 E, 10431, Stockholm, Sweden.
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Wyns A, Hendrix J, Lahousse A, De Bruyne E, Nijs J, Godderis L, Polli A. The Biology of Stress Intolerance in Patients with Chronic Pain—State of the Art and Future Directions. J Clin Med 2023; 12:jcm12062245. [PMID: 36983246 PMCID: PMC10057496 DOI: 10.3390/jcm12062245] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Stress has been consistently linked to negative impacts on physical and mental health. More specifically, patients with chronic pain experience stress intolerance, which is an exacerbation or occurrence of symptoms in response to any type of stress. The pathophysiological mechanisms underlying this phenomenon remain unsolved. In this state-of-the-art paper, we summarised the role of the autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis, the two major stress response systems in stress intolerance. We provided insights into such mechanisms based on evidence from clinical studies in both patients with chronic pain, showing dysregulated stress systems, and healthy controls supported by preclinical studies, highlighting the link between these systems and symptoms of stress intolerance. Furthermore, we explored the possible regulating role for (epi)genetic mechanisms influencing the ANS and HPA axis. The link between stress and chronic pain has become an important area of research as it has the potential to inform the development of interventions to improve the quality of life for individuals living with chronic pain. As stress has become a prevalent concern in modern society, understanding the connection between stress, HPA axis, ANS, and chronic health conditions such as chronic pain is crucial to improve public health and well-being.
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Affiliation(s)
- Arne Wyns
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
| | - Jolien Hendrix
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium;
- Flanders Research Foundation-FWO, 1090 Brussels, Belgium
- Correspondence:
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Flanders Research Foundation-FWO, 1090 Brussels, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Elke De Bruyne
- Department of Hematology and Immunology-Myeloma Center Brussels, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussels, Belgium
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Lode Godderis
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium;
- External Service for Prevention and Protection at Work, IDEWE, 3001 Heverlee, Belgium
| | - Andrea Polli
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (A.W.); (A.L.); (J.N.); (A.P.)
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium;
- Flanders Research Foundation-FWO, 1090 Brussels, Belgium
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11
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Cortisol reactivity and negative affect among preterm infants at 12 months during a mother-infant interaction task. Infant Behav Dev 2023; 70:101784. [PMID: 36401957 DOI: 10.1016/j.infbeh.2022.101784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/26/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate correlates of preterm (PT) infant's cortisol reactivity and the association to infant negative affect, during a mother-infant interaction procedure. Participants included 48 infants born prematurely (gestational age < 37 weeks) and their mothers, assessed when infants were 12 months old corrected for prematurity. The examined variables comprised both neonatal and environmental dimensions including maternal interactive behavior. Infant negative affect and maternal interactive behavior were assessed with a standardized mother-infant interaction task. A baseline infant saliva sample was collected before the interaction began, and a second sample after the interaction episodes ended. Results revealed that decrease of infant's cortisol concentration was significantly associated with the exposure to more sensitive, and less intrusive maternal behaviors. However, once controlled for neonatal risk, family SES and maternal psychological distress, the associations were rendered non-significant. Although the association between cortisol reactivity and negative affect trended toward significance, maternal intrusiveness was the only significant predictor of observed infant negative affect. Findings suggest the importance of primary relational experiences on PT infants' early regulatory competencies.
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12
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Bezanson S, Nichols ES, Duerden EG. Postnatal maternal distress, infant subcortical brain macrostructure and emotional regulation. Psychiatry Res Neuroimaging 2023; 328:111577. [PMID: 36512951 DOI: 10.1016/j.pscychresns.2022.111577] [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: 07/18/2022] [Revised: 09/16/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Maternal distress is associated with an increased risk for adverse emotional development in infants, including difficulties with emotion regulation. Prenatal maternal distress has been associated with alterations in infant brain development. However, less is known about these associations with postnatal maternal distress, despite this being an important modifiable risk factor that can promote healthy brain development and emotional outcomes in infants. METHODS & RESULTS Infants underwent magnetic resonance imaging (MRI) and mothers completed standardized questionnaires concerning their levels of perceived distress 2-5 months postpartum. Infant emotion regulation was assessed at 8-11 months via maternal report. When examining the associations between maternal distress and infant macrostructure, maternal anxiety was associated with infant right pallidum volumes. Increased display of negative emotions at 8-11 months of age was associated with smaller hippocampal volumes and this association was stronger in girls than boys. CONCLUSION Findings suggest that postnatal maternal distress may be associated with early infant brain development and emphasize the importance of maternal mental health, supporting previous work. Furthermore, macrostructural properties of infant subcortical structures may be further investigated as potential biomarkers to identify infants at risk of adverse emotional outcomes.
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Affiliation(s)
- Samantha Bezanson
- Neuroscience Program, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Emily S Nichols
- Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada; Western Institute for Neuroscience, Western University, London, Ontario, Canada
| | - Emma G Duerden
- Neuroscience Program, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada; Western Institute for Neuroscience, Western University, London, Ontario, Canada; Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Children's Health Research Institute, Western University, London, Ontario, Canada.
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13
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Mlili NE, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:71-83. [PMID: 35297354 DOI: 10.2174/1871527321666220316122605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy is a sensitive period when women experience major hormonal and psychological changes. A high prevalence of the symptoms of depression and manifested major depression rates have been reported during this period, leading to negative outcomes both for mothers and the offspring. Despite its prevalence, the aetiology of depression is not yet fully understood. Nonetheless, alterations in cortisol levels have been proposed as a reliable biomarker to identify pregnant women at risk of perinatal depression. Hair cortisol has recently been extensively used in bio-psychological studies as a suitable non-invasive biomarker for several neuropsychiatric disorders. Various studies have published evidence regarding the relationship between cortisol fluctuations during the perinatal period, measured both in hair and in other substrates, and the onset of perinatal symptoms of depression. This current review provides an overview of cortisol level changes measured in women's hair during pregnancy or the postpartum period and its association with perinatal symptoms of depression. Further studies, including repetitive measurement of both hair cortisol and depression throughout the prenatal period, must be performed to clarify the relationship between cortisol levels and perinatal symptoms of depression.
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Affiliation(s)
- Nisrin El Mlili
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Hanan Ahabrach
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia 46010, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia 46010, Spain
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14
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Karl M, Huth V, Schälicke S, Müller-Stark C, Weise V, Mack JT, Kirschbaum C, Weidner K, Garthus-Niegel S, Steudte-Schmiedgen S. The association between maternal symptoms of depression and hair glucocorticoids in infants across the perinatal period. Psychoneuroendocrinology 2023; 147:105952. [PMID: 36370678 DOI: 10.1016/j.psyneuen.2022.105952] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Maternal symptoms of depression constitute an early adversity for infants that is considered to exert its effects via the maternal-placental-fetal neuroendocrine axis. Previous research implicates associations between maternal prenatal symptoms of depression and infants' glucocorticoid (GC) levels shortly after birth. To date, associations have not been investigated in the early postnatal period. The current study aimed to investigate the influence of maternal perinatal symptoms of depression on infants' neonatal and postnatal hair GCs providing a retrospective reflection of integrated cortisol secretion in the intrauterine and early postnatal period, respectively. METHODS As part of a prospective cohort study, hair samples of infants were taken up to two weeks after delivery (N = 152) and again eight weeks after delivery (N = 165). Liquid chromatography-tandem mass spectrometry was used to determine hair cortisol and cortisone in scalp-near 2-cm hair segments. Maternal symptoms of depression were assessed during pregnancy and eight weeks postnatally based on the Edinburgh Postnatal Depression Scale. RESULTS Higher maternal prenatal symptoms of depression showed a significant association with higher infants' neonatal hair cortisol, when controlling for confounding variables (i.e., gestational age, mode of delivery, parity, storage time, pregnancy complications). A non-significant trend for this effect was found for the hair cortisol-to-cortisone ratio while no effect occurred for hair cortisone. No association of maternal postnatal symptoms of depression with infants' postnatal hair GCs was observed. Further exploratory analyses revealed no relationship between a change of maternal prenatal to postnatal symptoms of depression with the change from infants' neonatal to postnatal hair GC levels or postnatal hair GCs. CONCLUSION Our results suggest that maternal prenatal symptoms of depression are associated with dysregulated infants' hair cortisol levels mainly incorporated in the intrauterine period which, in turn, might contribute to increased susceptibility for later diseases. However, no relationship was observed in infants' hair samples additionally reflecting hair GCs of the early postnatal period. Future studies should consider research on associations between maternal symptoms of depression and infants' hair GCs also later in life and take into account additional risk factors with potential impacts on GC secretion during early infancy.
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Affiliation(s)
- Marlene Karl
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Vanessa Huth
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sarah Schälicke
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Corinna Müller-Stark
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Victoria Weise
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Judith T Mack
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Institute for Systems Medicine (ISM), Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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15
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Alcala CS, Orozco Scott P, Tamayo‐Ortiz M, Hernández Chávez MDC, Schnaas L, Carroll KN, Niedzwiecki MM, Wright RO, Téllez‐Rojo MM, Wright RJ, Hsu HL, Rosa MJ. Longitudinal assessment of maternal depression and early childhood asthma and wheeze: Effect modification by child sex. Pediatr Pulmonol 2023; 58:98-106. [PMID: 36128727 PMCID: PMC9771993 DOI: 10.1002/ppul.26164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Studies report associations between maternal mental health and adverse respiratory outcomes in children; however, the impact of timing and duration of maternal distress remains understudied. We sought to longitudinally examine associations between maternal depression and childhood asthma and wheeze, and explore sex differences. METHODS Maternal depression (n = 601) was assessed using the Edinburgh Depression Scale questionnaire, dichotomized at a clinically relevant cutoff (>12) (a) during pregnancy, (b) postpartum, and (c) postpartum and subsequent time points postnatally (recurrent depression). Report of wheeze in the past 12 months (current wheeze) and asthma were obtained using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire at 48 and 72 months. Associations were analyzed using a modified Poisson regression adjusted for covariates, and in interaction models. RESULTS Both postpartum and recurrent depression were associated with higher risk of current wheeze (relative risk [RR]: 1.87, 95% confidence interval [CI]: 1.21, 2.90; RR: 2.41, 95% CI: 1.53, 3.79) and asthma at 48 months (RR: 2.42, 95% CI: 1.01, 5.84; RR: 2.45, 95% CI: 1.02, 5.84). In interaction analyses, associations were stronger in females. Recurrent depression was associated with a higher risk of current wheeze at 48 months in females (RR: 4.34, 95% CI: 2.02, 9.32) when compared to males (RR: 1.89, 95% CI: 1.05, 3.39). CONCLUSIONS Postpartum and recurrent depression were associated with a higher risk of wheeze and asthma in children. Understanding the temporal- and sex-specific effects of maternal depression may better inform prevention strategies.
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Affiliation(s)
- Cecilia S. Alcala
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Paloma Orozco Scott
- Department of MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Marcela Tamayo‐Ortiz
- Occupational Health Research UnitMexican Social Security InstituteMexico CityMexico
| | | | - Lourdes Schnaas
- Department of Developmental NeurobiologyNational Institute of PerinatologyMexico CityMexico
| | - Kecia N. Carroll
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Pediatrics, Icahn School of Medicine at Mount SinaiKravis Children's HospitalNew YorkNew YorkUSA
| | - Megan M. Niedzwiecki
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robert O. Wright
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Institute for Exposomic ResearchIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Martha Maria Téllez‐Rojo
- Center for Nutrition and Health ResearchNational Institute of Public HealthCuernavaca, MorelosMexico
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Pediatrics, Icahn School of Medicine at Mount SinaiKravis Children's HospitalNew YorkNew YorkUSA
- Institute for Exposomic ResearchIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Hsiao‐Hsien Leon Hsu
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Maria José Rosa
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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16
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Ambeskovic M, Laplante DP, Kenney T, Elgbeili G, Beaumier P, Azat N, Simcock G, Kildea S, King S, Metz GAS. Elemental analysis of hair provides biomarkers of maternal hardship linked to adverse behavioural outcomes in 4-year-old children: The QF2011 Queensland Flood Study. J Trace Elem Med Biol 2022; 73:127036. [PMID: 35841837 DOI: 10.1016/j.jtemb.2022.127036] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 06/07/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Exposure to adverse experiences during pregnancy, such as a natural disaster, can modify development of the child with potential long-term consequences. Elemental hair analysis may provide useful indicators of cellular homeostasis and child health. The present study investigated (1) if flood-induced prenatal maternal stress is associated with altered hair elemental profiles in 4-year-old children, and (2) if hair elemental profiles are associated with behavioural outcomes in children. METHODS Participants were 75 children (39 boys; 36 girls) whose mothers were exposed to varying levels of stress due to a natural disaster (2011 Queensland Flood, Australia) during pregnancy. At 4 years of age, language development, attention and internalizing and externalizing problems were assessed and scalp hair was collected. Hair was analyzed by inductively coupled plasma mass spectrometry (ICP-MS) for 28 chemical elements. RESULTS A significant curvilinear association was found between maternal objective hardship and copper levels in boys, as low and high maternal objective hardship levels were associated with the highest hair copper levels. Mediation analysis revealed that low levels of maternal objective hardship and high levels of copper were associated with lower vocabulary scores. Higher levels of maternal objective hardship were associated with higher magnesium levels, which in turn were associated with attention problems and aggression in boys. In girls, high and low maternal objective hardship levels were associated with high calcium/potassium ratios. CONCLUSION Elemental hair analysis may provide a sensitive biomonitoring tool for early identification of health risks in vulnerable children.
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Affiliation(s)
- Mirela Ambeskovic
- Canadian Centre for Behavioural Neuroscience, Department of Neuroscience, University of Lethbridge, Lethbridge, AL, Canada.
| | - David P Laplante
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Thomas Kenney
- Canadian Centre for Behavioural Neuroscience, Department of Neuroscience, University of Lethbridge, Lethbridge, AL, Canada
| | - Guillaume Elgbeili
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
| | | | - Nagy Azat
- CanAlt Health Laboratories, Concord, ON, Canada
| | - Gabrielle Simcock
- Thompson Institute, University of the Sunshine Coast, QL, Australia; Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Suzanne King
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada; Department of Psychology, McGill University, Montreal, QC, Canada.
| | - Gerlinde A S Metz
- Canadian Centre for Behavioural Neuroscience, Department of Neuroscience, University of Lethbridge, Lethbridge, AL, Canada; Southern Alberta Genome Sciences Centre, University of Lethbridge, Lethbridge, AL, Canada.
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17
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Wagner RE, Jonson-Reid M, Drake B, Kohl PL, Pons L, Zhang Y, Fitzgerald RT, Laudenslager ML, Constantino JN. Parameterizing Toxic Stress in Early Childhood: Maternal Depression, Maltreatment, and HPA-Axis Variation in a Pilot Intervention Study. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022:10.1007/s11121-022-01366-4. [PMID: 35606570 DOI: 10.1007/s11121-022-01366-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 12/22/2022]
Abstract
Adverse experiences superseding a child's capacity to sustain regulation of emotion and adaptive function are theorized to constitute "toxic stressors" when they induce a deleterious biological response within an individual. We ascertained presumptive parameters of toxic stress among 164 low-income infants and toddlers (ages 4-48 months) from 132 families enrolled in Early Head Start (EHS). We randomized a subset of these families into a pilot intervention arm of parenting education (the Incredible Years, TIY), which supplemented the EHS curriculum. Official report child abuse and neglect (CAN) and child behavior were serially ascertained over the course of the study. We observed relatively low associations among maternal depression, CAN, caregiver-child relationship quality, hair cortisol, and adverse child behavioral outcomes. Moreover, despite poverty and the high prevalence (51%) of CAN in this sample, the frequency of clinical-level internalizing and externalizing behavior among the children did not exceed that of the general population, by their parents' report. The pilot supplementation of EHS with TIY improved attendance in group meetings but did not significantly reduce adverse behavioral outcomes or CAN. This study revealed marked independence of standard indices of toxic stress (child maltreatment, maternal depression, caregiver emotional unavailability) which have been presumed to be risk factors for the development of psychopathology. That they were weakly inter-correlated, and only modestly predictive of child behavioral outcomes in this EHS sample, caution against presumptions about the toxicity of individual stressors, highlight the importance of ascertaining risk (and compensatory influences) comprehensively, suggest buffering effects of programs like EHS, and demonstrate the need for greater understanding of what parameterizes resilience in early childhood.
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Affiliation(s)
- Rachael E Wagner
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Melissa Jonson-Reid
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Brett Drake
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Patricia L Kohl
- School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura Pons
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Yi Zhang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Robert T Fitzgerald
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - John N Constantino
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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18
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Effenberger PS, Send TS, Gilles M, Wolf IAC, Frank J, Bongard S, Kumsta R, Witt SH, Rietschel M, Deuschle M, Streit F. Urbanicity, behavior problems and HPA axis regulation in preschoolers. Psychoneuroendocrinology 2022; 137:105660. [PMID: 35033927 DOI: 10.1016/j.psyneuen.2022.105660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/05/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022]
Abstract
Growing up in cities is associated with increased risk for developing mental health problems. Stress exposure and altered stress regulation have been proposed as mechanisms linking urbanicity and psychopathology, with most research conducted in adult populations. Here, we focus on early childhood, and investigate urbanicity, behavior problems and the regulation of the hypothalamus-pituitary-adrenal (HPA) axis, a central circuit of the stress system, in a sample of N = 399 preschoolers aged 45 months. Urbanicity was coded dichotomously distinguishing between residences with more or less than 100,000 inhabitants. Behavior problems were measured using the Child Behavior Checklist (CBCL) 1½ - 5. Cortisol stress reactivity was assessed using an age-appropriated game-like stress task, and cortisol in the first morning urine was measured to assess nocturnal HPA axis activity. Urbanicity was not associated with behavior problems, urinary cortisol or the cortisol stress response. Neither urinary cortisol nor salivary cortisol response after stress exposure were identified as mediators of the relationship between urbanicity and behavior problems. The findings suggest no strong association of urbanicity with behavior problems and HPA axis regulation in preschool age. To our knowledge, this is the youngest sample to date studying the relationship between urbanicity and behavior problems as well as HPA axis regulation. Future research should examine at which age associations can first be identified and which mechanisms contribute to these relationships.
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Affiliation(s)
- Pauline S Effenberger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany; Department of Psychology, Goethe-University Frankfurt, Theodor-W.-Adorno-Platz 6, 60323 Frankfurt am Main, Germany
| | - Tabea S Send
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Isabell A C Wolf
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Stephan Bongard
- Department of Psychology, Goethe-University Frankfurt, Theodor-W.-Adorno-Platz 6, 60323 Frankfurt am Main, Germany
| | - Robert Kumsta
- Department of Genetic Psychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany.
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19
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Sabol TJ, Kessler CL, Rogers LO, Petitclerc A, Silver J, Briggs-Gowan M, Wakschlag LS. A window into racial and socioeconomic status disparities in preschool disciplinary action using developmental methodology. Ann N Y Acad Sci 2022; 1508:123-136. [PMID: 34554578 PMCID: PMC10127520 DOI: 10.1111/nyas.14687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022]
Abstract
There are large differences in expulsions and suspensions on the basis of race starting in preschool and divergent explanations for their cause. The current study explores how developmental methodology can shed light on this vexing issue. We leverage two measures: (1) childcare provider complaints about children's behavior and their recommended disciplinary action (measured by parent report); and (2) observed disruptive behavior measured by a laboratory-based standardized observation tool, the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS), among a large, sociodemographically diverse sample of children (n = $\text{=}$ 430; mean age = $\text{=}$ 4.79 years). We identified three latent class profiles on the basis of race/socioeconomic status (SES) and found disparities in childcare provider complaints based on profile membership. More specifically, children classified in the Black/Hispanic, poor and Black, nonpoor profiles both had significantly higher childcare provider complaints compared with children in the White/Hispanic, nonpoor profile. By contrast, there were no differences in observed disruptive behavior based on race/SES profiles. Finally, childcare provider complaints in preschool were associated with lower cognitive performance in elementary school, above and beyond observed disruptive behavior in preschool and race/SES profiles. Implications for classroom practice and contributions to the national debate on school disciplinary policies are discussed.
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Affiliation(s)
- Terri J. Sabol
- The School of Education and Social Policy, Northwestern University, Evanston, Illinois
- Institute for Policy Research and Institute for Innovations in Developmental Sciences, Evanston, Illinois
| | - Courtenay L. Kessler
- The School of Education and Social Policy, Northwestern University, Evanston, Illinois
- Institute for Policy Research and Institute for Innovations in Developmental Sciences, Evanston, Illinois
| | - Leoandra Onnie Rogers
- Institute for Policy Research and Institute for Innovations in Developmental Sciences, Evanston, Illinois
- Department of Psychology, Northwestern University, Evanston, Illinois
| | | | - Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | | | - Lauren S. Wakschlag
- Institute for Policy Research and Institute for Innovations in Developmental Sciences, Evanston, Illinois
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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20
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Klimes-Dougan B, Papke V, Carosella KA, Wiglesworth A, Mirza SA, Espensen-Sturges TD, Meester C. Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders. Neurosci Biobehav Rev 2022; 135:104528. [PMID: 35031342 DOI: 10.1016/j.neubiorev.2022.104528] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/19/2022]
Abstract
One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.
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Affiliation(s)
- Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA.
| | - Victoria Papke
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Katherine A Carosella
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Salahudeen A Mirza
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Tori D Espensen-Sturges
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Christina Meester
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
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21
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Burenkova OV, Podturkin AA, Naumova OY, Hein S, Li N, Cicchetti D, Luthar SS, Grigorenko EL. Neuroendocrine and autonomic stress systems activity in young adults raised by mothers with mental health and substance abuse problems: A prospective cohort study. Dev Psychobiol 2021; 63:e22213. [PMID: 34813100 DOI: 10.1002/dev.22213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/27/2021] [Accepted: 10/26/2021] [Indexed: 11/07/2022]
Abstract
Among the well-known physiological consequences of early adverse environments is dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. A number of studies demonstrate that negative parenting and living with parents with a history of substance abuse and mental health problems may be associated with HPA axis dysregulation in children. In contrast, studies of more delayed effects in adult offspring, especially prospective, are still scarce. This study was a prospective longitudinal investigation of the association between maternal mental illnesses/substance abuse and maternal negative parenting/parental stress on one side and, on the other side, adult offspring outcomes 10 years later-specifically, we studied the activity of offspring's neuroendocrine (cortisol) and autonomic (heart rate) systems when exposed to a mild psychological stressor. Children of mothers with mental illnesses and/or substance abuse were exposed to more disadvantaged conditions (higher negative parenting and community violence). Despite this, maternal risk groups (having a mother with mental illnesses and/or substance abuse) were not associated with any of the indicators of stress systems activity. Regardless of the risk group, participants with dysregulated HPA axis activity experienced a higher level of negative parenting. Altogether, our study provides evidence that negative parenting may have long-lasting effects on stress-sensitive physiological mechanisms.
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Affiliation(s)
- Olga V Burenkova
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation
| | | | - Oksana Yu Naumova
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation.,Human Genetics Laboratory, Vavilov Institute of General Genetics RAS, Moscow, Russian Federation
| | - Sascha Hein
- Department of Education and Psychology, Free University of Berlin, Berlin, Germany
| | - Nan Li
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Dante Cicchetti
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Suniya S Luthar
- Authentic Connections, Tempe, Arizona, USA.,Teachers College, Columbia University, New York City, New York, USA
| | - Elena L Grigorenko
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Psychology, Saint-Petersburg State University, Saint Petersburg, Russian Federation.,Baylor College of Medicine, Houston, Texas, USA
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22
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Mueller I, Snidman N, DiCorcia JA, Tronick E. Acute Maternal Stress Disrupts Infant Regulation of the Autonomic Nervous System and Behavior: A CASP Study. Front Psychiatry 2021; 12:714664. [PMID: 34867513 PMCID: PMC8635696 DOI: 10.3389/fpsyt.2021.714664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
Exposure to maternal stress is assumed to influence infant health and development across the lifespan. The autonomic nervous system (ANS) is especially sensitive to the effects of the early caregiving environment and linked to predictors of later mental health. Understanding how exposure to maternal stress adversely affects the developing ANS could inform prevention. However, there is no agreed upon definition of maternal stress making its study difficult. Here we use the Caretaker Acute Stress Paradigm (CASP) to study the effects of maternal stress in an experimentally controlled laboratory setting. The CASP has 5 episodes, a natural play, followed by a caretaker stressor (or control) condition, another play, a classic still face episode, followed by another play. A total of 104 4-months-old infants and their mothers were randomly assigned to either the caretaker-stress or caretaker-control condition. Changes in behavior, heart rate (HR), and respiratory sinus arrhythmia (RSA) before and after the introduction of the stressor (or control condition) were recorded and compared. Infants in the maternal stress condition showed significantly more behavioral distress [X 2 = (1, N = 104) = 4.662, p = 0.031]. Moreover, infants whose mothers were in the stress condition showed an significant increase in heart rate after the caretaker condition [F (1, 102) = 9.81, p = 0.002]. Finally we observed a trend to faster RSA recovery in infants of the control condition [F (1, 75) = 3.539, p = 0.064]. Results indicate that exposure to acute maternal stress affects infant regulation of the autonomic nervous system and behavior.
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Affiliation(s)
- Isabelle Mueller
- Department of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Nancy Snidman
- Child Development Unit, Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Jennifer A. DiCorcia
- Child Development Unit, Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Ed Tronick
- Child Development Unit, Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
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23
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Bedtime Routines of Young Children, Parenting Stress, and Bedtime Resistance: Mediation Models. Child Psychiatry Hum Dev 2021; 54:683-691. [PMID: 34731402 DOI: 10.1007/s10578-021-01275-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
This study examined if inconsistent bedtime routines are a mechanism through which high levels of parenting stress are related to bedtime resistant behaviors. Bedtime resistant behavior is a common problem in young children. Although previous studies have linked parenting stress to problematic behaviors at bedtime, understanding how and why that may be has been subject to limited empirical investigation. Caregivers (N = 118) of a child age 2-5 were recruited on Amazon's mechanical turk. There was a significant indirect effect of parenting stress on bedtime resistance through bedtime routines as well as a significant indirect effect of bedtime routines on bedtime resistant behavior through parenting stress. These findings suggest that there is a bidirectional relationship between inconsistent routines and parenting stress. Clinically, these results suggest that implementing a consistent routine at bedtime may improve both parent (less stress) and child (less bedtime resistance) functioning.
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24
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Toledo G, Côté HCF, Adler C, Thorne C, Goetghebuer T. Neurological development of children who are HIV-exposed and uninfected. Dev Med Child Neurol 2021; 63:1161-1170. [PMID: 33987826 DOI: 10.1111/dmcn.14921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2021] [Indexed: 12/20/2022]
Abstract
Widespread use of antiretroviral drugs for pregnant/breastfeeding females with human immunodeficiency virus (HIV) has led to declining vertical transmission. Despite being HIV-uninfected, the increasing number of children who are HIV-exposed and uninfected (CHEU) often present with developmental alterations. We review seminal and recent evidence on the neurological development of CHEU and associations with early life HIV/antiretroviral exposure. Our conceptual model highlights the numerous exposures and universal risk factors for CHEU developmental disorders. Early studies suggest a significant association between HIV exposure and neurological abnormalities, varying according to the burden of HIV-specific exposures and other risk factors. More recent observations from the modern era are inconsistent, although some studies suggest specific antiretrovirals may adversely affect neurological development of CHEU. As the CHEU population continues to grow, alongside simultaneous increases in types and combinations of antiretrovirals used in pregnancy, long-term monitoring of CHEU is necessary for understanding the effects of HIV/antiretroviral exposure on CHEU developmental outcomes. What this paper adds Evidence on the neurological development of children who are human immunodeficiency virus (HIV)-exposed and uninfected (CHEU) is synthesized. Comparisons are made to children who are HIV-unexposed, across treatment eras and settings, and by antiretroviral drug regimens and drug classes. CHEU exposures are complex and include HIV-specific and universal risk factors which may affect development during the early years of life.
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Affiliation(s)
- Gabriela Toledo
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Hélène C F Côté
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada
| | - Catherine Adler
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Claire Thorne
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Tessa Goetghebuer
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
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25
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Rudd KL, Bush NR, Alkon A, Roubinov DS. Identifying profiles of multisystem physiological activity across early childhood: Examining developmental shifts and associations with stress and internalizing problems. Psychoneuroendocrinology 2021; 128:105196. [PMID: 33765640 PMCID: PMC8188642 DOI: 10.1016/j.psyneuen.2021.105196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
Physiological regulation is an important predictor of health across the lifespan. Regulation occurs across multiple collaborative systems, yet few empirical studies explore multisystem activity and how this collaborative regulation develops early in life. The current study used latent profile analysis to evaluate multisystem regulation in the autonomic nervous system and hypothalamic pituitary adrenal (HPA) axis in 150 racially/ethnically diverse, low-income children at 18- and 36-months. At both timepoints, profiles of generally moderate activity (Moderate Arousal) and heightened baseline activity (Anticipatory Arousal) emerged. A profile of typically adaptive patterns across all systems (Active Copers) emerged at 18-months and a profile of heightened HPA Axis activity (HPA-axis Responders) emerged at 36-months. Persistent membership in the Anticipatory Arousal profile across time was associated with exposure to greater maternal stress at 18-months and child internalizing problems at 36-months. These findings highlight early multisystem profile development and suggest associations with stress and later behavior problems.
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Affiliation(s)
- Kristen L. Rudd
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA
| | - Nicole R. Bush
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA,University of California, San Francisco; Department of Pediatrics; San Francisco, CA,University of California, San Francisco; Weill Institute for Neurosciences; San Francisco, CA
| | - Abbey Alkon
- University of California, San Francisco; School of Nursing; San Francisco, CA
| | - Danielle S. Roubinov
- University of California, San Francisco; Department of Psychiatry and Behavioral Sciences; San Francisco, CA,University of California, San Francisco; Weill Institute for Neurosciences; San Francisco, CA
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26
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Rio-Aige K, Azagra-Boronat I, Castell M, Selma-Royo M, Collado MC, Rodríguez-Lagunas MJ, Pérez-Cano FJ. The Breast Milk Immunoglobulinome. Nutrients 2021; 13:nu13061810. [PMID: 34073540 PMCID: PMC8230140 DOI: 10.3390/nu13061810] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 12/24/2022] Open
Abstract
Breast milk components contribute to the infant’s immune development and protection, and among other immune factors, immunoglobulins (Igs) are the most studied. The presence of IgA in milk has been known for a long time; however, less information is available about the presence of other Igs such as IgM, IgG, and their subtypes (IgG1, IgG2, IgG3, and IgG4) or even IgE or IgD. The total Ig concentration and profile will change during the course of lactation; however, there is a great variability among studies due to several variables that limit establishing a clear pattern. In this context, the aim of this review was firstly to shed light on the Ig concentration in breast milk based on scientific evidence and secondly to study the main factors contributing to such variability. A search strategy provided only 75 studies with the prespecified eligibility criteria. The concentrations and proportions found have been established based on the intrinsic factors of the study—such as the sampling time and quantification technique—as well as participant-dependent factors, such as lifestyle and environment. All these factors contribute to the variability of the immunoglobulinome described in the literature and should be carefully addressed for further well-designed studies and data interpretation.
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Affiliation(s)
- Karla Rio-Aige
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Ignasi Azagra-Boronat
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Margarida Castell
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Marta Selma-Royo
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), 46890 Paterna, Valencia, Spain; (M.S.-R.); (M.C.C.)
| | - María Carmen Collado
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), 46890 Paterna, Valencia, Spain; (M.S.-R.); (M.C.C.)
| | - María J. Rodríguez-Lagunas
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Francisco J. Pérez-Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
- Correspondence: ; Tel.: +34-934-024-505
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27
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Jahnke JR, Roach J, Azcarate-Peril MA, Thompson AL. Maternal precarity and HPA axis functioning shape infant gut microbiota and HPA axis development in humans. PLoS One 2021; 16:e0251782. [PMID: 34015045 PMCID: PMC8136730 DOI: 10.1371/journal.pone.0251782] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 05/03/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Early life exposure to adverse environments, and maternal stress in particular, has been shown to increase risk for metabolic diseases and neurobehavioral disorders. While many studies have examined the hypothalamic-pituitary-adrenal axis (HPA axis) as the primary mechanism behind these relationships, emerging research on the brain-gut axis suggests that the microbiome may play a role. In this study, we tested the relationships among maternal precarity and HPA axis dysregulation during the peripartum period, infant gut microbiome composition, and infant HPA axis functioning. METHODS Data come from 25 mother-infant dyads in the Galápagos, Ecuador. Women completed surveys on precarity measures (food insecurity, low social support, depression, and stress) and gave salivary cortisol samples during and after pregnancy. Infant salivary cortisol and stool were collected in the postpartum. Statistical significance of differences in microbial diversity and relative abundance were assessed with respect to adjusted linear regression models. RESULTS Maternal precarity was associated with lower diversity and higher relative abundance of Enterobacteriaceae and Streptococcaceae and a lower relative abundance of Bifidobacterium and Lachnospiraceae. These patterns of colonization for Enterobacteriaceae and Bifidobacterium mirrored those found in infants with HPA axis dysregulation. Maternal HPA axis dysregulation during pregnancy was also associated with a greater relative abundance of Veillonella. CONCLUSIONS Overall, exposures to precarity and HPA axis dysregulation were associated with an increase in groups that include potentially pathogenic bacteria, including Enterobacteriaceae, Streptococcaceae, and Veillonella, and a decrease in potentially protective bacteria, including Bifidobacterium and Lachnospiraceae, as well as a decrease in overall diversity.
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Affiliation(s)
- Johanna R. Jahnke
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jeffrey Roach
- Research Computing Center, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America
- UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Andrea Azcarate-Peril
- UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Amanda L. Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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28
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Burstein O, Simon N, Simchon-Tenenbaum Y, Rehavi M, Franko M, Shamir A, Doron R. Moderation of the transgenerational transference of antenatal stress-induced anxiety. Transl Psychiatry 2021; 11:268. [PMID: 33947833 PMCID: PMC8094124 DOI: 10.1038/s41398-021-01383-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/10/2021] [Accepted: 03/29/2021] [Indexed: 01/08/2023] Open
Abstract
Maternal stress has debilitating implications for both mother and child, including increased risk for anxiety. The current COVID-19 pandemic escalates these phenomena, thus, urging the need to further explore and validate feasible therapeutic options. Unlike the protracted nature of clinical studies, animal models could offer swift evidence. Prominent candidates for treatment are selective serotonin reuptake inhibitors (SSRIs) to the mother, that putatively accommodate maternal functioning, and, thereby, also protect the child. However, SSRIs might have deleterious effects. It is important to assess whether SSRIs and other pharmacotherapies can moderate the transference of anxiety by soothing maternal anxiety and to examine the extent of offspring's exposure to the drugs via lactation. To our knowledge, the possibility that antenatal stress exacerbates lactation-driven exposure to SSRIs has not been tested yet. Thirty ICR-outbred female mice were exposed to stress during gestation and subsequently administered with either the SSRI, escitalopram, or the novel herbal candidate, shan-zha, during lactation. Upon weaning, both dams' and pups' anxiety-like behavior and serum escitalopram levels were assessed. The major findings of the current study show that both agents moderated the antenatal stress-induced transgenerational transference of anxiety by ameliorating dams' anxiety. Interestingly though, pups' exposure to escitalopram via lactation was exacerbated by antenatal stress. The latter finding provides a significant insight into the mechanism of lactation-driven exposure to xenobiotics and calls for a further consideration vis-à-vis the administration of other drugs during breastfeeding.
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Affiliation(s)
- Or Burstein
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Noam Simon
- School of Behavioral Science, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Yaarit Simchon-Tenenbaum
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Dr. Miriam and Sheldon G. Adelson Center for the Biology of Addictive Diseases, Tel-Aviv University, Tel-Aviv, Israel
| | - Moshe Rehavi
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Dr. Miriam and Sheldon G. Adelson Center for the Biology of Addictive Diseases, Tel-Aviv University, Tel-Aviv, Israel
| | - Motty Franko
- Department of Psychology, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- Department of Education and Psychology, The Open University of Israel, Raanana, Israel
| | - Alon Shamir
- Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Mazor Mental Health Center, Akko, Israel
| | - Ravid Doron
- Department of Education and Psychology, The Open University of Israel, Raanana, Israel.
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29
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Galbally M, Watson SJ, Lappas M, de Kloet ER, van Rossum E, Wyrwoll C, Mark P, Lewis AJ. Fetal programming pathway from maternal mental health to infant cortisol functioning: The role of placental 11β-HSD2 mRNA expression. Psychoneuroendocrinology 2021; 127:105197. [PMID: 33743501 DOI: 10.1016/j.psyneuen.2021.105197] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 02/06/2023]
Abstract
Placental 11β-HSD2 has been a focus of research for understanding potential fetal programming associated with maternal emotional disorders. This study examined the pathway from antenatal mental health via placental 11β-HSD2 mRNA to cortisol regulation in the infant offspring. This study reports on data obtained from 236 participants in the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). At term, placental tissue was collected within 30 min of birth from 52 participants meeting current criteria for a depressive disorder, and 184 control participants. Depressive disorders were diagnosed using the SCID-IV. In addition, antidepressant use, depressive and anxiety symptoms were measured in early and late pregnancy. Placental 11β-HSD2 mRNA expression was measured using qRT-PCR. Infant salivary cortisol samples were taken at 12 months of age. Women on antidepressant medication and with higher trait anxiety had higher placental 11β-HSD2 expression compared to women not taking medication. Furthermore, the offspring of women taking an antidepressant and who also had a current depressive disorder and high trait anxiety had high cortisol reactivity at 12 months of age and this was mediated through 11β-HSD2 mRNA expression. In contrast, offspring of women not taking antidepressant medication with depressive disorder and high anxiety there was low cortisol reactivity observed. Our findings suggest that the relationship between maternal antenatal depression and anxiety and infant cortisol reactivity is mediated through placental 11β-HSD2 mRNA expression. Furthermore, the direction differed for women taking antidepressants, where infant cortisol reactivity was high whereas when compared to those with unmedicated depression and anxiety, where infant cortisol reactivity was low.
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Affiliation(s)
- Megan Galbally
- Psychology, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia; King Edward Memorial Hospital, Subiaco, Australia.
| | - Stuart J Watson
- Psychology, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia
| | - Martha Lappas
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - E Ron de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisabeth van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Caitlin Wyrwoll
- School of Human Sciences, The University of Western Australia, Australia
| | - Peter Mark
- School of Human Sciences, The University of Western Australia, Australia
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30
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Tommerup K, Lacey RE. Maternal and Paternal Distress in Early Childhood and Child Adiposity Trajectories: Evidence from the Millennium Cohort Study. Obesity (Silver Spring) 2021; 29:888-899. [PMID: 33899340 DOI: 10.1002/oby.23150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study investigated associations between mothers' and fathers' distress reported in early childhood (at ages 9 months and 3 years) and childhood adiposity trajectories from ages 5 to 14 years. METHODS Linear mixed-effects models were undertaken in the Millennium Cohort Study. Self-reported maternal and paternal distress was measured at ages 9 months and 3 years. BMI and fat mass index (FMI) were modeled from ages 5 to 14 years, adjusting for socioeconomic and child characteristics and stratifying by child sex. RESULTS Maternal distress reported at 9 months was associated with steeper increases in BMI and FMI trajectories for girls (BMI: β = 0.06; 95% CI: 0.01 to 0.11; FMI: β = 0.04; 95% CI: 0.00 to 0.08). Paternal distress reported at 9 months was associated with steeper increases in BMI and FMI for both girls (BMI: β = 0.06; 95% CI: 0.00 to 0.12, FMI: β = 0.05; 95% CI: -0.02 to 0.10) and boys (BMI: β = 0.09; 95% CI: 0.03 to 0.15, FMI: β = 0.06; 95% CI: 0.01 to 0.10). Maternal "moderate" distress at 3 years was associated with steeper BMI and FMI trajectories for girls only (BMI: β = 0.08; 95% CI: 0.03 to 0.12, FMI; β = 0.06; 95% CI: 0.02 to 0.10). CONCLUSIONS Maternal and paternal distress experienced in early childhood, particularly during infancy, was associated with steeper adiposity trajectories for children from ages 5 to 14 years.
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Affiliation(s)
- Kristiane Tommerup
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Rebecca E Lacey
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
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31
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Shirtcliff E, Hanson J, Phan J, Ruttle P, Pollak S. Hyper- and hypo-cortisol functioning in post-institutionalized adolescents: The role of severity of neglect and context. Psychoneuroendocrinology 2021; 124:105067. [PMID: 33302238 PMCID: PMC8757590 DOI: 10.1016/j.psyneuen.2020.105067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 09/27/2020] [Accepted: 11/12/2020] [Indexed: 01/30/2023]
Abstract
Understanding the developmental timing of stress exposure may help inform mechanisms underlying how stress "gets under the skin" and influences the stress response system, including the HPA axis and its end-product cortisol. Early adversity may be particularly detrimental; however, it is difficult to disentangle the timing of adversity from its cumulative burden because there is typically high continuity between early and later adversity. Moreover, context and the different stressors inherent in various contexts may interact with stress exposure to influence psychophysiological functioning. To address this issue, we examined adolescents who had been reared in institutions and suffered neglect or social deprivation ranging from approximately six months to several years of life prior to adoption into U.S. homes. We focused on the stress hormone cortisol because it can reflect continued regulatory problems in youth, even years after youth transition to typical homes. We examined cortisol morning levels and diurnal rhythms across multiple contexts (home, school, lab) on 5 separate days in 41 post-institutionalized youth and 78 comparison youth. Employing hierarchical linear modeling, we found that when assessed in the lab, post-institutionalized (PI) youth displayed lower morning cortisol levels and flatter diurnal slopes than the control youth. Yet at home, PI youth displayed higher morning cortisol levels than the control youth. In addition to group effects, we also examined severity of early adversity and found that PI kids who had endured the most severe early adversity displayed lower home cortisol levels than controls. No significant predictors of diurnal cortisol on school days were identified. These data fit with the notion that the HPA axis is impacted by early adversity, even years after adoption, and with emerging theories that postulate that stress physiology calibrates within youth to help them adapt to their context. In the case of severe early adversity, the cost of such adaptation may not be desirable. It also highlights the important role of context when assessing HPA axis activity, particularly in post-institutionalized youth.
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Goulter N, Roubinov DS, McMahon RJ, Boyce WT, Bush NR. Externalizing and Internalizing Problems: Associations with Family Adversity and Young Children's Adrenocortical and Autonomic Functioning. Res Child Adolesc Psychopathol 2021; 49:629-642. [PMID: 33442783 DOI: 10.1007/s10802-020-00762-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 01/15/2023]
Abstract
The development of child mental health problems has been associated with experiences of adversity and dysregulation of stress response systems; however, past research has largely focused on externalizing or internalizing problems (rather than their co-occurrence) and single physiological systems in high-risk adolescent samples. The present study examined whether cumulative family adversity, functioning in the hypothalamic-pituitary-adrenal axis (i.e., cortisol) and the parasympathetic nervous system (i.e., respiratory sinus arrhythmia [RSA]), and their interactions, predicted trajectories of co-occurring externalizing and internalizing problems among young children. Participants included 338 socioeconomically and racially diverse children (M age = 5.32 years, SD = .32; male = 51.8%) from a community sample. Family adversity (assessed with six measures) and child daily cortisol output and resting RSA were assessed in kindergarten. Parents, teachers, and children reported on children's externalizing and internalizing psychopathology up to three times from kindergarten to grade 1. Latent class growth analyses identified stable trajectories of externalizing and internalizing psychopathology. Trajectories were combined to create groups: co-occurring externalizing and internalizing (13.1%), externalizing-only (14.0%), internalizing-only (11.3%), and low problems (61.3%). Family adversity and resting RSA significantly positively predicted co-occurring group membership. Tests for interactions showed adversity did not significantly interact with physiological indicators to predict group membership. However, the two physiological systems interacted, such that higher and lower daily cortisol predicted internalizing group membership for children with lower and higher resting RSA, respectively. Findings support the importance of considering family context and multiple physiological systems to inform understanding of the development of mental health problems, and their co-occurrence, in early childhood.
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Affiliation(s)
- Natalie Goulter
- Simon Fraser University, Burnaby; BC Children's Hospital Research Institute, Vancouver, BC, Canada.
| | | | - Robert J McMahon
- Simon Fraser University, Burnaby; BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - W Thomas Boyce
- University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- University of California San Francisco, San Francisco, CA, USA
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Ungar M, Theron L, Murphy K, Jefferies P. Researching Multisystemic Resilience: A Sample Methodology. Front Psychol 2021; 11:607994. [PMID: 33510683 PMCID: PMC7835509 DOI: 10.3389/fpsyg.2020.607994] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Abstract
In contexts of exposure to atypical stress or adversity, individual and collective resilience refers to the process of sustaining wellbeing by leveraging biological, psychological, social and environmental protective and promotive factors and processes (PPFPs). This multisystemic understanding of resilience is generating significant interest but has been difficult to operationalize in psychological research where studies tend to address only one or two systems at a time, often with a primary focus on individual coping strategies. We show how multiple systems implicated in human resilience can be researched in the same study using a longitudinal, six-phase transformative sequential mixed methods study of 14- to 24-year-olds and their elders in two communities dependent on oil and gas industries (Drayton Valley, Canada, and Secunda/eMbalenhle, South Africa). Data collection occurred over a 5-year period, and included: (1) community engagement and the identification of youth health and well-being priorities; (2) participatory youth-centric qualitative research using one-on-one semi-structured interviews and arts-based methods; (3) survey of 500 youth at three time points to assess psychosocial health indicators and outcomes; (4) collection of hair samples to assess stress biomarkers (cortisol and dehydroepiandrosterone-DHEA) over time; (5) youth-led ecological data collection and assessment of historical socio-economic development data; and (6) community resource mapping with community elders. Analyzing data from these multiple systems will allow us to understand the interrelationship and impact of PPFPs within and across systems. To date, we have undertaken thematic and narrative qualitative analyses, and descriptive analyses of the preliminary ecological and survey data. As we proceed, we will combine these and grounded theory approaches with innovative techniques such as latent transition analysis and network analysis, as well as modeling of economic conditions and spatial analysis of human geographies to understand patterns of PPFPs and their inter-relationships. By analyzing the complexity of data collected across systems (including cultural contexts) we are demonstrating the possibility of conducting multisystemic resilience research which expands the way psychological research accounts for positive development under stress in different contexts. This comprehensive examination of resilience may offer an example of how the study of resilience can inform socially and contextually relevant interventions and policies.
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Affiliation(s)
- Michael Ungar
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Linda Theron
- Department of Educational Psychology, Faculty of Education, University of Pretoria, Pretoria, South Africa
| | - Kathleen Murphy
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Philip Jefferies
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada
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Stigma associated with parental depression or cancer: Impact on spouse and offspring's cortisol levels and socioemotional functioning. Dev Psychopathol 2021; 32:1822-1837. [DOI: 10.1017/s0954579420001431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractStress associated with caring for a mentally ill spouse can adversely affect the health status of caregivers and their children. Adding to the stress of caregiving is the stigma often placed against spouses and children of people with mental illness. Contrary to mental illness, many physical disorders such as cancer may be less stigmatized (expect pulmonary cancer). In this study, we measured externalized and internalized stigma, as well as psychological (depressive symptoms and stressful life events) and physiological (basal salivary cortisol levels) markers of stress in 115 spouses and 154 children of parents suffering from major depressive disorder, cancer, or no illness (control group). The results show that spouses and children from families with parental depression present significantly more externalized stigma than spouses and children from families with parental cancer or no illness, although we find no group differences on internalized stigma. The analysis did not show a significant group difference either for spouses or their children on depressive symptomatology, although spouses from the parental depression group reported greater work/family stress. Finally, we found that although for both spouses children the awakening cortisol response was greater on weekdays than on weekend days, salivary cortisol levels did not differ between groups. Bayes factor calculated on the null result for cortisol levels was greater than 100, providing strong evidence for the null hypothesis H0. Altogether, these results suggest an impact of stigma toward mental health disorder on psychological markers of stress but no impact of stigma on physiological markers of stress. We suggest that these results may be due to the characteristics of the families who participated in the present study.
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Biological sensitivity to context: A test of the hypothesized U-shaped relation between early adversity and stress responsivity. Dev Psychopathol 2020; 32:641-660. [PMID: 31347484 DOI: 10.1017/s0954579419000518] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We conducted signal detection analyses to test for curvilinear, U-shaped relations between early experiences of adversity and heightened physiological responses to challenge, as proposed by biological sensitivity to context theory. Based on analysis of an ethnically diverse sample of 338 kindergarten children (4-6 years old) and their families, we identified levels and types of adversity that, singly and interactively, predicted high (top 25%) and low (bottom 25%) rates of stress reactivity. The results offered support for the hypothesized U-shaped curve and conceptually replicated and extended the work of Ellis, Essex, and Boyce (2005). Across both sympathetic and adrenocortical systems, a disproportionate number of children growing up under conditions characterized by either low or high adversity (as indexed by restrictive parenting, family stress, and family economic condition) displayed heightened stress reactivity, compared with peers growing up under conditions of moderate adversity. Finally, as hypothesized by the adaptive calibration model, a disproportionate number of children who experienced exceptionally stressful family conditions displayed blunted cortisol reactivity to stress.
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Hagaman AK, Baranov V, Chung E, LeMasters K, Andrabi N, Bates LM, Rahman A, Sikander S, Turner E, Maselko J. Association of maternal depression and home adversities with infant hypothalamic-pituitary-adrenal (HPA) axis biomarkers in rural Pakistan. J Affect Disord 2020; 276:592-599. [PMID: 32871690 PMCID: PMC7792907 DOI: 10.1016/j.jad.2020.07.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 05/29/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Each year, almost 35% of children are exposed to maternal depression and more grow up in persistent poverty, increasing the risk for stress-related disease and other socio-developmental deficits later in life. These impacts are likely related to chronic stress via the hypothalamic-pituitary-adrenal (HPA) axis. However, there is little evidence relating early windows of child HPA axis activity to multiple exposures. METHODS We investigated chronic measures of hair-derived HPA axis hormones (cortisol and dehydroepiandrosterone (DHEA)) in 104 one-year old infants from rural Pakistan and longitudinal measures of maternal depression, intimate partner violence (IPV), socio-economic status (SES), and the home environment. RESULTS Estimates from adjusted linear mixed effects models did not reveal consistent significant associations between infant cortisol and maternal depression or home adversities. By contrast, infants exposed to maternal depression during pregnancy had lower DHEA levels (ß= -0.18 95% confidence interval [CI]: -0.34, -0.02) as did those whose mothers experienced multiple types of IPV (ß=-4.14 95% CI: -7.42, -0.79) within one year postpartum. Higher SES had a significant positive association with infant DHEA levels (ß= 0.77 95% CI: 0.08, 1.47). Depression severity and chronicity at one year postpartum had near significant associations with infant DHEA. Measures of home environment had no observable impacts on infant HPA axis activity. LIMITATIONS Limitations include the modest sample size and aggregation of hair samples for analysis. CONCLUSION Results point to possible early HPA axis dysregulation driven by changes in DHEA activity, but not cortisol at one year of age. Findings contribute to growing research examining intergenerational transmissions of maternal depression, IPV, and household environment on infant stress-response systems.
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Affiliation(s)
- Ashley K Hagaman
- Department of Social and Behavioral Science, Yale School of Public Health, Yale University, New Havern, CT, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Victoria Baranov
- Department of Economics, University of Melbourne, Melbourne, Australia
| | - Esther Chung
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nafeesa Andrabi
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa M Bates
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Atif Rahman
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK; Human Development Research Foundation, Islamabad, Pakistan
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan; Health Services Academy, Islamabad, Pakistan
| | - Elizabeth Turner
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Father absence, age at menarche, and genetic confounding: A replication and extension using a polygenic score. Dev Psychopathol 2020; 34:355-366. [PMID: 33107423 DOI: 10.1017/s0954579420000929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Father absence has a small but robust association with earlier age at menarche (AAM), likely reflecting both genetic confounding and an environmental influence on life history strategy development. Studies that have attempted to disambiguate genetic versus environmental contributions to this association have shown conflicting findings, though genomic-based studies have begun to establish the role of gene-environment interplay in the father absence/AAM literature. The purpose of this study was to replicate and extend prior genomic work using the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective longitudinal cohort study (N = 2,685), by (a) testing if an AAM polygenic score (PGS) could account for the father absence/AAM association, (b) replicating G×E research on lin-28 homolog B (LIN28B) variation and father absence, and (c) testing the G×E hypothesis using the PGS. Results showed that the PGS could not explain the father absence/AAM association and there was no interaction between father absence and the PGS. Findings using LIN28B largely replicated prior work that showed LIN28B variants predicted later AAM in father-present girls, but this AAM-delaying effect was absent or reversed in father-absent girls. Findings are discussed in terms genetic confounding, the unique biological role of LIN28B, and using PGSs for G×E tests.
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DeCandia CJ, Volk KT, Unick GJ, Donegan LRW. Developing a Screening Tool for Young Children Using an Ecological Framework. INFANTS AND YOUNG CHILDREN 2020; 33:237-258. [PMID: 34211253 PMCID: PMC8240794 DOI: 10.1097/iyc.0000000000000173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Young children from impoverished backgrounds experience high levels of family and environmental stress, adversely impacting developmental functioning. Early identification provides a pathway to solutions, but many children are never assessed. In addition, the child-serving workforce lacks resources and expertise to use traditional measures. Furthermore, existing measures do not account for the substantial influence of a child's ecology. To bridge these gaps, we developed the Neurodevelopmental Ecological Screening Tool (NEST) and conducted a pilot study (n=60) to test its feasibility for use with caregivers of children ages 3-5 in low-resource settings. We developed an item pool across three domains (child, caregiver, environment), vetted it with experts, and conducted cognitive interviewing with parents (n=15) and case managers (n-10). Simultaneously, we built an online, user-friendly delivery platform. We used a one parameter Item Response Model and a Rasch-based Rating Scale Model (RSM) and fit confirmatory factor analytic (CFA) models to test for unidimensional and construct validity. The results support the feasibility of screening children from low SES populations within low-resource settings using an ecological perspective and supports the work of child-serving paraprofessionals in identifying and addressing risks in the lives of young children.
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Affiliation(s)
| | | | - George J Unick
- University of Maryland, School of Social Work, Baltimore, MD, USA
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Zava F, Sette S, Baumgartner E, Coplan RJ. Shyness and empathy in early childhood: Examining links between feelings of empathy and empathetic behaviours. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020; 39:54-77. [PMID: 32918304 DOI: 10.1111/bjdp.12347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 08/04/2020] [Indexed: 12/24/2022]
Abstract
Although shy children have been described as less empathetic than their more sociable peers, this may be due to a performance rather than a competence deficit. The aim of this study was to explore the moderating role of shyness in the association between empathic feelings and empathic-related reactions. Participants were 212 preschoolers (Mage = 58.32 months, SD = 10.72). Children provided self-reports of empathetic feelings, parents rated child shyness and empathic behaviours (e.g., reparative behaviours), and teachers assessed indices of socio-emotional functioning (e.g., prosocial behaviours). Results revealed interaction effects between empathic feelings and shyness in the prediction of outcome variables. Among children with lower levels of shyness, empathy rated by children was positively related to empathetic and reparative behaviours (rated by parents) and prosocial behaviours (rated by teachers). At higher levels of shyness, these relations were attenuated. These results can be interpreted to suggest that although shy children may not differ from their more sociable counterparts in experiencing empathy, they seem to be less likely to act empathically.
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Affiliation(s)
- Federica Zava
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Stefania Sette
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Emma Baumgartner
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Robert J Coplan
- Department of Psychology, Carleton University, Ottawa, Ottawa, Canada
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Sechi C, Vismara L, Rollè L, Prino LE, Lucarelli L. First-Time Mothers' and Fathers' Developmental Changes in the Perception of Their Daughters' and Sons' Temperament: Its Association With Parents' Mental Health. Front Psychol 2020; 11:2066. [PMID: 32973623 PMCID: PMC7468484 DOI: 10.3389/fpsyg.2020.02066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/27/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Most studies investigating the role of parenting behaviors on a child's development are directed to mothers. However, recent analyses show that mothers and fathers have a different influence on a child's functioning, specifically her/his temperament. The present study explored the developmental change of parents' perception of their daughters' and sons' temperament and its association with parental mental health problems. METHODS The sample included 188 parents (94 couples) and their at-term 94 babies (55.3% boys, 44.7% girls). Assessments by self-reports were conducted at 3 (Time 1) and 12 (Time 2) months after the children's birth; at Time 1, mothers and fathers independently answered: the State-Trait Anxiety Inventory (STAI), the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Behavior Questionnaire (IBQ-R). At Time 2, EPDS, STAI, and IBQ-R were again administered to mothers and fathers. RESULTS In general, mothers and fathers would give similar descriptions of their child's temperament throughout the first year of life; however, infant temperament showed developmental changes as well as gender differences. Mother and father anxiety and depression symptoms are associated with the infants' negative affectivity. Also, mothers with high anxiety and depression levels perceive their infants with a minor tendency to approach novelty, to seek environmental stimulation, and to express/experience positive emotions. CONCLUSION The results highlight the need to screen for infants' temperament vulnerabilities in the context of maternal and paternal depression in order to protect the child from behavioral, cognitive, and emotional difficulties and to create specific programs aimed at preventing dysfunctional parent-infant relationships.
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Affiliation(s)
- Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Luca Rollè
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Loredana Lucarelli
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
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Caregiver depression is associated with hair cortisol in a low-income sample of preschool-aged children. Psychoneuroendocrinology 2020; 117:104675. [PMID: 32402926 PMCID: PMC7798357 DOI: 10.1016/j.psyneuen.2020.104675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Caregiver depression and child temperamental characteristics such as effortful control have been associated with child dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Hair cortisol concentrations (HCC) has been increasingly adopted as an integrated marker of HPA axis activity. This study examined the associations between caregiver depressive symptoms, caregiver social support, child effortful control, and child HCC in a sample of a high-risk, low-income preschool-aged children. METHODS 154 caregivers comprised mostly of mothers and their children (2-to-5 years) who were enrolled in a birth cohort study conducted in poor urban neighborhoods of São Paulo, Brazil. Through personal interviews at their homes, caregivers provided ratings of their psychosocial experiences and of their child's behavior. Hair was sampled from children with at least a 3-cm hair length. RESULTS In a multivariable regression analysis, an unadjusted model showed child age to be negatively associated with HCC (β = -0.32, p < .001). The adjusted model, which accounted for child age and sex, showed a positive relationship between caregiver depressive symptoms and HCC (β = 0.22, p < .01). Caregiver social support and child effortful control were not associated with HCC. CONCLUSIONS The elevated HCC among children with caregivers reporting greater depression risk is consistent with prior findings showing elevated HCC among children exposed to persistent stress. Stabilization of child HCC may be occurring within preschool children given the negative association between HCC and age. Greater research is needed to determine whether the effects of caregiver social support and effortful control can be captured through HCC.
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Hillmann K, Neukel C, Zimmermann J, Fuchs A, Zietlow AL, Möhler E, Herpertz SC, Kaess M, Bertsch K. Maternal early life maltreatment and psychopathology affect the next generation: Alterations in post-awakening cortisol levels of primary school-aged children. Dev Psychobiol 2020; 63:98-107. [PMID: 32497280 DOI: 10.1002/dev.21996] [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: 05/20/2019] [Revised: 02/26/2020] [Accepted: 05/08/2020] [Indexed: 11/07/2022]
Abstract
Early life maltreatment (ELM) has severe and lasting effects on the individual, which might also impact the next generation. On an endocrine level, the hypothalamus-pituitary-adrenal axis has been suggested to play an important role in the interplay between ELM and the development of mental disorders. Several studies have revealed that maternal post-awakening cortisol concentration, maternal sensitivity, maternal ELM and psychopathology are associated with children's cortisol levels. We investigated the post-awakening cortisol concentrations in 6- to 11-year-old children (N = 53) whose mothers either had experienced ELM and had developed a lifetime mental disorder (N = 15 ELM and disorder group), had experienced ELM without developing a mental disorder (N = 12 ELM-only group), or had neither experienced ELM nor developed a mental disorder (N = 26 HC-group). Furthermore, we assessed maternal post-awakening cortisol concentrations, maternal psychopathology, and sensitivity. Multilevel analysis revealed higher cortisol at awakening (S1) levels in children of mothers with ELM and disorder. Maternal cortisol at awakening (S1) also predicted the child's cortisol at awakening (S1), and no effect of maternal sensitivity could be found. The current results replicate an attunement of cortisol levels (S1) between mothers and children and suggest an association between the children's endocrine stress system and maternal factors such as ELM and psychopathology.
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Affiliation(s)
- Karen Hillmann
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | | | - Anna Fuchs
- Department of Child and Adolescent Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Anna-Lena Zietlow
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Heidelberg University, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katja Bertsch
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
- Department of Psychology, Ludwig-Maximilians-University, München, Germany
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O’Connor TG, Willoughby MT, Moynihan JA, Messing S, Vallejo Sefair A, Carnahan J, Yin X, Caserta MT. Early childhood risk exposures and inflammation in early adolescence. Brain Behav Immun 2020; 86:22-29. [PMID: 31059804 PMCID: PMC6825880 DOI: 10.1016/j.bbi.2019.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/26/2019] [Accepted: 05/02/2019] [Indexed: 02/06/2023] Open
Abstract
There is now reliable evidence that early psychosocial stress exposures are associated with behavioral health in children; the degree to which these same kinds of stress exposures predict physical health outcomes is not yet clear. We investigated the links between economic adversity, family and caregiving stress in early childhood and several markers of immune function in early adolescence. The sample is derived from the Family Life Project, a prospective longitudinal study of at-risk families. Socio-demographic and psychosocial risks have been assessed at regular intervals since the children were first assessed at 2 months of age. When the children were early adolescents, we conducted an in-depth health assessment of a subsample of families; blood samples were collected from venipuncture for interleukin(IL)-6, Tumor Necrosis Factor (TNF)-alpha, and C-reactive protein (CRP), as well as glucocorticoid resistance. Results indicated limited but reliable evidence of an association between early risk exposure and inflammation in adolescence. Specifically, caregiver depressive symptoms in early childhood predicted elevated CRP almost a decade later, and the prediction was significant after accounting for multiple covariates such as socio-economic adversity, health behaviors and body mass index. Our findings provide strong but limited evidence that early stress exposures may be associated with inflammation, suggesting one mechanism linking early stress exposure to compromised behavioral and somatic health.
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Affiliation(s)
| | | | - Jan A Moynihan
- Department of Psychiatry, University of Rochester Medical Center
| | - Susan Messing
- Department of Statistics and Bioinformatics, University of Rochester Medical Center
| | | | | | - Xiajuan Yin
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester Medical Center
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Ponzi D, Flinn MV, Muehlenbein MP, Nepomnaschy PA. Hormones and human developmental plasticity. Mol Cell Endocrinol 2020; 505:110721. [PMID: 32004677 DOI: 10.1016/j.mce.2020.110721] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 11/11/2019] [Accepted: 01/16/2020] [Indexed: 12/15/2022]
Abstract
Natural selection favors the evolution of mechanisms that optimize the allocation of resources and time among competing traits. Hormones mediate developmental plasticity, the changes in the phenotype that occur during ontogeny. Despite their highly conserved functions, the flexibilities of human hormonal systems suggest a strong history of adaptation to variable environments. Physiological research on developmental plasticity has focused on the early programming effects of stress, the hypothalamus-pituitary-adrenal axis (HPAA) and the hypothalamus-pituitary-gonadal axis (HPGA) during critical periods, when the hormones produced have the strongest influence on the developing brain. Often this research emphasizes the maladaptive effects of early stressful experiences. Here we posit that the HPAA and HPAG systems in human developmental plasticity have evolved to be responsive to complex and dynamic problems associated with human sociality. The lengthy period of human offspring dependency, and its associated brain development and risks, is linked to the uniquely human combination of stable breeding bonds, extensive paternal effort in a multi-male group, extended bilateral kin recognition, grandparenting, and controlled exchange of mates among kin groups. We evaluate an evolutionary framework that integrates proximate physiological explanations with ontogeny, phylogeny, adaptive function, and comparative life history data.
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Affiliation(s)
- Davide Ponzi
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Italy.
| | - Mark V Flinn
- Department of Anthropology, Baylor University, Waco, TX, USA
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van der Leek AP, Bahreinian S, Chartier M, Dahl ME, Azad MB, Brownell MD, Kozyrskyj AL. Maternal Distress During Pregnancy and Recurrence in Early Childhood Predicts Atopic Dermatitis and Asthma in Childhood. Chest 2020; 158:57-67. [PMID: 32173490 DOI: 10.1016/j.chest.2020.01.052] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 01/20/2020] [Accepted: 01/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early-life stress is becoming an important determinant of immune system programming. Maternal prenatal distress is found to be associated with atopic disease in offspring but the separate effects of postnatal distress are not well-studied. RESEARCH QUESTION Does the likelihood of asthma and atopic dermatitis in children increase when they are exposed to maternal distress pre- and postnatally in a sex-specific manner? STUDY DESIGN AND METHODS Using data from a provincial newborn screen and health-care database for 12,587 children born in 2004, maternal distress (depression or anxiety) was defined as prenatal, self-limiting, recurrent, or late-onset postpartum. Atopic dermatitis (AD) and asthma at ages 5 years and 7 years of age were diagnosed by using hospitalization, physician visit, or prescription records. Associations between maternal distress and childhood asthma and AD were determined by using multiple logistic regression. RESULTS After adjusting for risk factors, a significant association between maternal prenatal (OR, 1.27; 95% CI, 1.11-1.46), recurrent postpartum (OR, 1.28; 95% CI, 1.11-1.48), and late-onset postpartum (OR, 1.19, 95% CI, 1.06-1.34) distress was found with AD at age 5 years. Asthma at age 7 years was also associated with maternal prenatal distress (OR, 1.57; 95% CI, 1.29-1.91) and late-onset postnatal distress (OR, 1.22; 95% CI, 1.01-1.46). Self-limiting postnatal distress was not found to be a risk factor for either atopic condition. Associations with AD or asthma were of a similar magnitude in boys and girls; the exception was recurrent postnatal distress, which increased risk for asthma in boys only. INTERPRETATION This population-based study provides evidence for sex-specific associations between maternal prenatal and postnatal distress, as well as the development of AD and asthma. The findings support recommendations for greater psychosocial support of mothers during pregnancy and early childhood to prevent childhood atopic disease.
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Affiliation(s)
| | - Salma Bahreinian
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Mariette Chartier
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew E Dahl
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Meghan B Azad
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Marni D Brownell
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Lee BC, Modrek S, White JS, Batra A, Collin DF, Hamad R. The effect of California's paid family leave policy on parent health: A quasi-experimental study. Soc Sci Med 2020; 251:112915. [PMID: 32179364 DOI: 10.1016/j.socscimed.2020.112915] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 11/27/2022]
Abstract
The U.S. is the only high-income country without a national paid family leave (PFL) policy. While a handful of U.S. states have implemented PFL policies in recent years, there are few studies that examine the effects of these policies on health. In this study, we tested the hypothesis that California's PFL policy-implemented in 2004-improved parent health outcomes. Data were drawn from the 1993-2017 waves of the Panel Study of Income Dynamics, a large diverse national cohort study of U.S. families (N = 6,690). We used detailed longitudinal sociodemographic information about study participants and a quasi-experimental difference-in-differences analytic technique to examine the effects of California's PFL policy on families who were likely eligible for the paid leave, while accounting for underlying trends in these outcomes among states that did not implement PFL policies in this period. Outcomes included self-rated health, psychological distress, overweight and obesity, and alcohol use. We found improvements in self-rated health and psychological distress, as well as decreased likelihood of being overweight and reduced alcohol consumption. Improvements in health status and psychological distress were greater for mothers, and reductions in alcohol use were greater for fathers. Results were robust to alternative specifications. These findings suggest that California's PFL policy had positive impacts on several health outcomes, providing timely evidence to inform ongoing policy discussions at the federal and state levels. Future studies should examine the effects of more recently implemented state and local PFL policies to determine whether variation in policy implementation and generosity affects outcomes.
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Affiliation(s)
- Bethany C Lee
- University of Pennsylvania Law School, Philadelphia, PA, USA
| | - Sepideh Modrek
- Health Equity Institute, San Francisco State University, San Francisco, CA, USA
| | - Justin S White
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Akansha Batra
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Daniel F Collin
- Department of Family & Community Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA; Department of Family & Community Medicine, University of California San Francisco, San Francisco, CA, USA.
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Cox EQ, Killenberg S, Frische R, McClure R, Hill M, Jenson J, Pearson B, Meltzer-Brody SE. Repetitive transcranial magnetic stimulation for the treatment of postpartum depression. J Affect Disord 2020; 264:193-200. [PMID: 32056750 DOI: 10.1016/j.jad.2019.11.069] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/10/2019] [Accepted: 11/12/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is a common and gravely disabling health concern. Repetitive transcranial magnetic stimulation (rTMS) is an FDA approved treatment for major depression and may be a valuable tool in the treatment of PPD. The treatment effect of rTMS is rapid, generally well tolerated, without systemic effects, and without medication exposure to a fetus and/or breastfed infant. METHODS Six women with PPD received 20 sessions of 10 Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC) over a 4 week period. Psychiatric rating scales (BDI, EPDS, STATI), cognitive assessments (MMSE, Trails B, List Generation) and breastfeeding practices were surveyed at baseline and post rTMS treatment. BDI and EPDS were obtained weekly, as well as 3 months and 6 months post study conclusion. RESULTS Average BDI, EPDS, and STAI scores declined over the 4-week duration of rTMS treatment. Of the six patients, four achieved remission as assessed by EPDS and one achieved remission and two responded as assessed by BDI. Mean BDI and EPDS scores at 3 and 6 months follow-up remained below levels at study entry. No evidence of cognitive changes or breastfeeding disruptions. LIMITATIONS This was an exploratory study with small sample size with no sham control arm. Daily administration of rTMS provides potential for confounding of behavioral activation in the otherwise often isolative postpartum period. CONCLUSIONS rTMS was safe and well tolerated among participants with evidence of sustained improvements in depression and anxiety scores. This study supports rTMS as a promising non-pharmacologic treatment modality for perinatal depression.
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Affiliation(s)
- E Q Cox
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - S Killenberg
- Disability Determination Services, 40 Fountain Street, Providence, RI 02903, United States.
| | - R Frische
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - R McClure
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - M Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - J Jenson
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - B Pearson
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - S E Meltzer-Brody
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
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Childhood maltreatment affects adolescent sensitivity to parenting and close friendships in predicting growth in externalizing behavior. Dev Psychopathol 2020; 31:1237-1253. [PMID: 30249308 DOI: 10.1017/s0954579418000585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Childhood maltreatment robustly predicts adolescent externalizing behaviors (EB; e.g., violence, delinquency, substance use) and may crystalize patterns of EB by influencing sensitivity to the social environment (e.g., parenting, friendships). In a nationally representative sample of 9,421 adolescents, we modeled latent growth curves of EB from age 13 to 32 years. Next, we explored whether maltreated youth differed from nonmaltreated youth in their sensitivity to parental closeness, friendship involvement, and polymorphisms from dopamine genes linked to EB (dopamine receptors D2 and D4, dopamine transporter). Overall, maltreated youth had significantly higher levels of EB across adolescence and adulthood; however, maltreated and nonmaltreated youth showed similar patterns of EB change over time: violent behavior decreased in adolescence before stabilizing in adulthood, whereas nonviolent delinquency and substance use increased in adolescence before decreasing in the transition to adulthood. Maltreatment reduced sensitivity to parental closeness and friendship involvement, although patterns varied based on type of EB outcome. Finally, none of the environmental effects on EB were significantly moderated by the dopamine polygenic risk score after accounting for multiple testing. These findings underline the enduring effects of early maltreatment and implicate that maltreatment may contribute to long-term risk for EB by influencing children's sensitivity to social relationship factors in adolescence.
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Clemens V, Bürgin D, Eckert A, Kind N, Dölitzsch C, Fegert JM, Schmid M. Hypothalamic-pituitary-adrenal axis activation in a high-risk sample of children, adolescents and young adults in residential youth care - Associations with adverse childhood experiences and mental health problems. Psychiatry Res 2020; 284:112778. [PMID: 32004894 DOI: 10.1016/j.psychres.2020.112778] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 12/28/2022]
Abstract
Adverse childhood experiences (ACEs) lead to devastating long-term health consequences that are associated with a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children and adolescents living in institutional care have an increased risk to experience ACEs, particularly linked to missing continuity of care, and a higher risk for consequences of ACEs such as mental disorders. In order to improve the overall quality of care, it is important to better understand the stress-physiology of this high-risk sample and to identify specific stressors linked to adverse outcomes. Therefore, we assessed ACEs due to missing continuity of care and their association with hair cortisol and DHEA levels in children, adolescents and young adults in institutional care. Results show that ACEs resulting from the family of origin, in detail maternal mental illness, and ACEs due to out-of-home placement, namely frequent change of caregivers, are associated with HPA axis over-activation. HPA axis activation is associated with enhanced mental health problems. These results point towards an association between continuity of care and the stress system of children and adolescents in this high-risk sample. Care concepts that focus on continuity of care might help to reduce these physiological alterations and devastating long-term consequences following ACEs.
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Affiliation(s)
- Vera Clemens
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5 89073 Ulm Germany.
| | - David Bürgin
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Switzerland
| | - Anne Eckert
- Neurobiology Lab for Brain Aging and Mental Health, Transfaculty Research Platform Molecular and Cognitive Neuroscience, University of Basel, Switzerland
| | - Nina Kind
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Switzerland
| | - Claudia Dölitzsch
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5 89073 Ulm Germany
| | - Jörg M Fegert
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5 89073 Ulm Germany
| | - Marc Schmid
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Switzerland
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