1
|
Mustonen P, Kortesluoma S, Scheinin NM, Perasto L, Kataja EL, Tervahartiala K, Tuulari JJ, Coimbra B, Carter AS, Rodrigues AJ, Sousa N, Paavonen EJ, Korja R, Karlsson H, Karlsson L. Negative associations between maternal prenatal hair cortisol and child socioemotional problems. Psychoneuroendocrinology 2024; 162:106955. [PMID: 38232530 DOI: 10.1016/j.psyneuen.2023.106955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/19/2023] [Accepted: 12/30/2023] [Indexed: 01/19/2024]
Abstract
Maternal prenatal distress can participate in the programming of offspring development, in which exposure to altered maternal long-term cortisol levels as measured by hair cortisol concentrations (HCC) may contribute. Yet, studies investigating whether and how maternal prenatal HCC associates with problems in child socioemotional development are scarce. Furthermore, questions remain regarding the timing and potential sex-specificity of fetal exposure to altered cortisol levels and whether there are interactions with maternal prenatal distress, such as depressive symptoms. The subjects were drawn from those FinnBrain Birth Cohort families that had maternal reports of child socioemotional problems (the Brief Infant-Toddler Social and Emotional Assessment [BITSEA] at 2 years and/or the Strengths and Difficulties Questionnaire [SDQ] at 5 years) as follows: HCC1 population: maternal mid-pregnancy HCC measured at gestational week 24 with 5 cm segments to depict cortisol levels from the previous five months (n = 321); and HCC2 population: end-of-pregnancy HCC measured 1-3 days after childbirth (5 cm segment; n = 121). Stepwise regression models were utilized in the main analyses and a sensitivity analysis was performed to detect potential biases. Negative associations were observed between maternal HCC2 and child BITSEA Total Problems at 2 years but not with SDQ Total difficulties at 5 years, and neither problem score was associated with HCC1. In descriptive analyses, HCC2 was negatively associated with Internalizing problems at 2 years and SDQ Emotional problems at 5 years. A negative association was observed among 5-year-old girls between maternal HCC1 and SDQ Total Difficulties and the subscales of Conduct and Hyperactivity/inattentive problems. When interactions were also considered, inverse associations between HCC2 and BITSEA Internalizing and Dysregulation Problems were observed in subjects with elevated prenatal depressive symptoms. It was somewhat surprising that only negative associations were observed between maternal HCC and child socioemotional problems. However, there are previous observations of elevated end-of-pregnancy cortisol levels associating with better developmental outcomes. The magnitudes of the observed associations were, as expected, mainly modest. Future studies with a focus on the individual changes of maternal cortisol levels throughout pregnancy as well as studies assessing both maternal and child HPA axis functioning together with child socioemotional development are indicated.
Collapse
Affiliation(s)
- Paula Mustonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
| | - Susanna Kortesluoma
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychiatry, University of Turku and Satakunta Wellbeing Services County, Sairaalantie 3, 28500 Pori, Finland
| | - Laura Perasto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychology, University of Turku and Turku University Hospital, Assistentinkatu 7, 20014 Turku, Finland
| | - Katja Tervahartiala
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychology and Speech-Language Pathology, University of Turku, Assistentinkatu 7, 20014 Turku, Finland; Department of Psychology, University of Jyväskylä, Seminaarinkatu 15, 40014 Jyväskylä, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, 20520 Turku, Finland
| | - Bárbara Coimbra
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, R. da Universidade, 4710-057 Braga, Portugal
| | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA 02125, USA
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, R. da Universidade, 4710-057 Braga, Portugal; Clinical Academic Center-Braga (2CA), Hospital de Braga, Lugar de Sete Fontes, S. Victor, 4710-243 Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, R. da Universidade, 4710-057 Braga, Portugal
| | - E Juulia Paavonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00029 Helsinki, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychology, University of Turku and Turku University Hospital, Assistentinkatu 7, 20014 Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520 Turku, Finland; Department of Clinical Medicine, Unit of Public Health, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520 Turku, Finland
| |
Collapse
|
2
|
Tu EN, Manley H, Saunders KEA, Creswell C. Systematic Review and Meta-Analysis: Risks of Anxiety Disorders in Offspring of Parents With Mood Disorders. J Am Acad Child Adolesc Psychiatry 2024; 63:407-421. [PMID: 37453607 DOI: 10.1016/j.jaac.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To examine the risk of anxiety disorders in offspring of parents with mood disorders. METHOD We conducted a systematic review and meta-analysis. We searched 4 electronic databases (Medline, Embase, PsycINFO, and Web of Science [core collection]) to identify cross-sectional and cohort studies that examined the association between parental mood disorders (including bipolar disorder and unipolar depression) and risk of anxiety disorders in offspring. Pooled risk ratios (RRs) of overall and specific anxiety disorders were synthesized using a random effects model. Subgroup analyses and meta-regression were performed to identify moderation factors. RESULTS A total of 35 studies were included in the final analysis. Our results showed higher risks of all types of anxiety disorders in the offspring of parents with mood disorders (any anxiety disorder, RR = 1.82, 95% CI = 1.47-2.26), except for agoraphobia (RR = 1.08, 95% CI = 0.56-2.08), and with an especially elevated risk of panic disorder (RR = 3.07, 95% CI = 2.19-4.32). Subgroup analysis demonstrated no significant difference between the risks of anxiety disorders across the offspring of parents with bipolar disorder as opposed to unipolar depression. The absence of anxiety disorders in control parents, younger offspring age, and specific parent/offspring sex were associated with higher RRs for some anxiety disorders in offspring of parents with mood disorders. CONCLUSION Our findings suggest a robust relationship between parental mood disorders and offspring anxiety disorders, and highlight the potential value of prevention and early intervention for anxiety disorders in this context. DIVERSITY & INCLUSION STATEMENT We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. STUDY PREREGISTRATION INFORMATION Anxiety Disorders in Offspring of Parents with Mood Disorders: A Systematic Review; https://www.crd.york.ac.uk/prospero/; CRD42021215058.
Collapse
Affiliation(s)
- En-Nien Tu
- University of Oxford, United Kingdom; Chang Gung Memorial Hospital, Keelung, Taiwan, and Chang Gung University, Taiwan
| | | | - Kate E A Saunders
- University of Oxford, United Kingdom; Queen's University, Kingston, Canada, and Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | | |
Collapse
|
3
|
Graf S, Schechter DS. The Impact of Maternal Interpersonal Violent Trauma and Related Psychopathology on Child Outcomes and Intergenerational Transmission. Curr Psychiatry Rep 2024; 26:166-175. [PMID: 38427205 PMCID: PMC10978628 DOI: 10.1007/s11920-024-01491-7] [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] [Accepted: 01/26/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE OF REVIEW This review aims to outline some consequences that maternal history of trauma with and without related psychopathology, such as posttraumatic stress symptoms (PTSS), can have on their children's development and functioning. It then addresses mechanisms through which intergenerational transmission of interpersonal violence (IPV) and related psychopathology may occur. RECENT FINDINGS Findings include the effects of maternal IPV experience and related psychopathology on child social-emotional and biologically-based outcomes. This includes increased developmental disturbances and child psychopathology, as well as physiological factors. Secondly, the review focuses on psychobiological mechanisms by which maternal experience of IPV and related psychopathology likely trigger intergenerational effects. Maternal IPV and related psychopathology can have a negative impact on several areas of their child's life including development, interactive behavior, psychopathology, and physiology. This transmission may partially be due to fetal and perinatal processes, genetic and epigenetic effects, and interactions with their parents.
Collapse
Affiliation(s)
- Shannen Graf
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), SUPEA-Unité de recherche, Avenue d'Echallens 9, 1004, Lausanne, Switzerland.
- Department of Psychiatry, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
| | - Daniel S Schechter
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), SUPEA-Unité de recherche, Avenue d'Echallens 9, 1004, Lausanne, Switzerland
- Department of Psychiatry, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
4
|
Airikka A, Lahti-Pulkkinen M, Tuovinen S, Heinonen K, Lahti J, Girchenko P, Lähdepuro A, Pyhälä R, Czamara D, Villa P, Laivuori H, Kajantie E, Binder EB, Räikkönen K. Maternal exposure to childhood maltreatment and mental and behavioral disorders in children. Eur Child Adolesc Psychiatry 2023; 32:2463-2475. [PMID: 36181574 PMCID: PMC10682113 DOI: 10.1007/s00787-022-02090-8] [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: 03/16/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022]
Abstract
Exposure to maltreatment in childhood is associated with lifelong risk of mental and behavioral disorders. Whether the effects extend to the next generation remains unclear. We examined whether maternal exposure to childhood abuse and neglect in her own childhood were associated with mental and behavioral disorders and psychiatric symptoms in her children, and whether maternal lifetime mental and behavioral disorders or lower education level mediated or added to the effects. Mothers (n = 2252) of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction cohort study completed the Childhood Trauma Questionnaire and reported on their education and their 7.0-12.1-year-old children's psychiatric symptoms using the Strengths and Difficulties Questionnaire. We identified lifetime mental and behavioral disorder diagnoses for the mothers and diagnoses for their children from birth (2006-2010) until 8.4-12.8 years (12/31/2018) from Care Register for Health Care. We found that maternal exposure to childhood abuse, but not neglect, was associated with higher hazards of mental and behavioral disorders (hazard ratio 1.20, 95% confidence interval 1.06-1.37) in children. These associations were partially mediated by maternal mental and behavioral disorders and education (proportion of effect size mediated: 23.8% and 15.1%, respectively), which together with maternal exposure to childhood abuse added to the hazard of mental and behavioral disorders in children. Similar associations were found for maternal exposure to childhood abuse and neglect with psychiatric symptoms in children. To conclude, maternal exposure to childhood maltreatment is associated with mental and behavioral disorders and psychiatric symptoms in children. Our findings call for interventions to prevent intergenerational transmission.
Collapse
Affiliation(s)
- Aino Airikka
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland.
- The Finnish Institute for Health and Welfare, Helsinki, Finland.
- University of Edinburgh, Edinburgh, UK.
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Anna Lähdepuro
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Riikka Pyhälä
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Pia Villa
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
- Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Center for Child, Adolescent and Maternal Health Research, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eero Kajantie
- The Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| |
Collapse
|
5
|
Galbally M, Watson SJ, van IJzendoorn MH, Tharner A, Luijk M, de Kloet ER, van Rossum EFC, Lewis AJ. Prenatal predictors of childhood anxiety disorders: An exploratory study of the role of attachment organization. Dev Psychopathol 2023; 35:1296-1307. [PMID: 34911592 DOI: 10.1017/s0954579421001206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood anxiety disorders (CAD) are a common childhood mental disorder and understanding early developmental pathways is key to prevention and early intervention. What is not understood is whether early life stress predictors of CAD might be both mediated by infant cortisol reactivity and moderated by infant attachment status. To address this question, this exploratory study draws on 190 women recruited in early pregnancy and followed together with their children until 4 years of age. Early life stress is operationalized as maternal depression measured using the Structured Clinical Interview for the DSM, Childhood Trauma Questionnaire, Parenting Stress Index, and antenatal maternal hair cortisol concentrations. Infant cortisol reactivity was measured at 12 months together with the Strange Situation Procedure and CAD assessed at 4 years of age using the Preschool Age Psychiatric Assessment. There was no direct association between attachment classification and CAD. Furthermore, infant cortisol reactivity neither mediated nor attachment moderated the association of early life stress predictors and CAD. However, only for infants with organized attachment classifications, higher maternal antenatal depression, and hair cortisol were associated with a higher risk of CAD.
Collapse
Affiliation(s)
- Megan Galbally
- Psychology, Murdoch University, Murdoch, Australia
- School of Medicine, University of Notre Dame, Australia
- King Edward Memorial Hospital, Subiaco, Perth, WA, Australia
| | - Stuart J Watson
- Psychology, Murdoch University, Murdoch, Australia
- School of Medicine, University of Notre Dame, Australia
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, UCL, UK
| | - Anne Tharner
- Department of Educational and Family Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje Luijk
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - E Ron de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | |
Collapse
|
6
|
Uy JP, Tan AP, Broeckman BBFP, Gluckman PD, Chong YS, Chen H, Fortier MV, Meaney MJ, Callaghan BL. Effects of maternal childhood trauma on child emotional health: maternal mental health and frontoamygdala pathways. J Child Psychol Psychiatry 2023; 64:426-436. [PMID: 36331294 DOI: 10.1111/jcpp.13721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Experiences of early life adversity pose significant psychological and physical health risks to exposed individuals. Emerging evidence suggests that these health risks can be transmitted across generations; however, the mechanisms underlying the intergenerational impacts of maternal early-life trauma on child health remain unknown. METHODS The current study used a prospective longitudinal design to determine the unique and joint contributions of maternal childhood trauma (neglect and abuse) and maternal prenatal and postnatal mental health (anxiety and depressive symptoms) (N = 541) to children's resting frontoamygdala functional connectivity at 6 years (N = 89) and emotional health at 7-8 years, as indexed by parent-reported internalizing problems and child self-reported anxiety and depressive symptoms (N = 268-418). RESULTS Greater maternal childhood neglect was indirectly associated with greater internalizing problems serially through a pathway of worse maternal prenatal and postnatal mental health (greater maternal anxiety and depressive symptoms). Worse maternal postnatal mental health was also uniquely associated with more negative child frontoamygdala resting-state functional connectivity, over and above maternal childhood trauma (both neglect and abuse) and prenatal mental health. More negative frontoamygdala functional connectivity was, in turn, associated with poorer child emotional health outcomes. CONCLUSIONS Findings from the current study provide support for the existence of intergenerational influences of parental exposure to childhood trauma on childhood risk for psychopathology in the next generation and point to the importance of maternal factors proximal to the second generation (maternal prenatal and postnatal mental health) in determining the intergenerational impact of maternal early experiences.
Collapse
Affiliation(s)
- Jessica P Uy
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research in Singapore, Singapore City, Singapore
| | - Birit B F P Broeckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research in Singapore, Singapore City, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research in Singapore, Singapore City, Singapore.,Liggins Institute, University of Auckland, Grafton, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research in Singapore, Singapore City, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.,Department of Obstetrics and Gynaecology, National University Health System, Singapore City, Singapore
| | - Helen Chen
- Psychiatry and Radiology, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research in Singapore, Singapore City, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research in Singapore, Singapore City, Singapore.,Liggins Institute, University of Auckland, Grafton, Auckland, New Zealand.,Department of Psychiatry, Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada
| | - Bridget L Callaghan
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
7
|
Khoury JE, Giles L, Kaur H, Johnson D, Gonzalez A, Atkinson L. Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: A meta-analysis. Psychoneuroendocrinology 2023; 147:105969. [PMID: 36335755 DOI: 10.1016/j.psyneuen.2022.105969] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Pregnancy and the early postpartum signify a period of high stress. Perinatal stress can include psychological distress (PD), such as anxiety, depression, and stress, as well as neuroendocrine stress, indexed by activation of the hypothalamic-pituitary-adrenal (HPA) axis and the production of the hormone cortisol. Elevated PD and cortisol levels during the perinatal period can have long-term implications for the mother and child. Methodological advances have enabled the sampling of cortisol from hair, to provide a retrospective marker of HPA axis activity over several months. Despite knowing that maternal PD and HPA activity during the perinatal period independently impact health and development, research to date is unclear as to the association between maternal PD and hair cortisol. The present meta-analysis included 29 studies to assess the strength of the relation between maternal PD and hair cortisol levels during pregnancy and the early postpartum period. Several sample and methodological factors were assessed as moderators of this effect. Analyses were conducted using multilevel meta-analysis. Results of the multilevel meta-analysis indicated that the overall effect size between PD and HCC was small but not significant z = 0.039, 95% CI [- 0.001, 0.079]. Moderator analyses indicated that the strength of the association between PD and hair cortisol was moderated by pregnancy status (i.e., effects were stronger in pregnant compared to postpartum samples), timing of HCC and PD measurements (i.e., effects were larger when PD was measured before HCC) and geographic location (i.e., effects were larger in North American studies). The findings advance our understanding of the link between PD and HPA activity during the perinatal period, a time of critical impact to child development.
Collapse
Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada.
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada
| | - Hargun Kaur
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Dylan Johnson
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON Canada
| |
Collapse
|
8
|
Galbally M, Watson SJ, Lewis AJ, van IJzendoorn MH. Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID-19 pandemic. J Paediatr Child Health 2022; 58:2051-2057. [PMID: 36371627 PMCID: PMC9537807 DOI: 10.1111/jpc.16155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/27/2022] [Accepted: 07/24/2022] [Indexed: 11/30/2022]
Abstract
AIM This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia - a city exposed to one of the longest lockdowns world-wide in response to the pandemic. METHODS This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3-4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic. RESULTS When compared to mothers followed up at 3-4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. CONCLUSIONS Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient.
Collapse
Affiliation(s)
- Megan Galbally
- School of Clinical SciencesMonash UniversityMelbourneVictoriaAustralia,Health Futures Institute, Murdoch UniversityPerthWestern AustraliaAustralia,School of MedicineUniversity of Notre DameFremantleWestern AustraliaAustralia
| | - Stuart J Watson
- School of Clinical SciencesMonash UniversityMelbourneVictoriaAustralia,Health Futures Institute, Murdoch UniversityPerthWestern AustraliaAustralia,School of MedicineUniversity of Notre DameFremantleWestern AustraliaAustralia
| | - Andrew J Lewis
- Institute of Health and WellbeingFederation UniversityBallaratVictoriaAustralia
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamthe Netherlands,Department of Clinical, Educational and Health Psychology, Faculty of Brain SciencesUCLLondonUnited Kingdom
| |
Collapse
|
9
|
Daskalakis NP, Meijer OC, de Kloet ER. Mineralocorticoid receptor and glucocorticoid receptor work alone and together in cell-type-specific manner: Implications for resilience prediction and targeted therapy. Neurobiol Stress 2022; 18:100455. [PMID: 35601687 PMCID: PMC9118500 DOI: 10.1016/j.ynstr.2022.100455] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/30/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022] Open
Abstract
'You can't roll the clock back and reverse the effects of experiences' Bruce McEwen used to say when explaining how allostasis labels the adaptive process. Here we will for once roll the clock back to the times that the science of the glucocorticoid hormone was honored with a Nobel prize and highlight the discovery of their receptors in the hippocampus as inroad to its current status as master regulator in control of stress coping and adaptation. Glucocorticoids operate in concert with numerous neurotransmitters, neuropeptides, and other hormones with the aim to facilitate processing of information in the neurocircuitry of stress, from anticipation and perception of a novel experience to behavioral adaptation and memory storage. This action, exerted by the glucocorticoids, is guided by two complementary receptor systems, mineralocorticoid receptors (MR) and glucocorticoid receptors (GR), that need to be balanced for a healthy stress response pattern. Here we discuss the cellular, neuroendocrine, and behavioral studies underlying the MR:GR balance concept, highlight the relevance of hypothalamic-pituitary-adrenal (HPA) -axis patterns and note the limited understanding yet of sexual dimorphism in glucocorticoid actions. We conclude with the prospect that (i) genetically and epigenetically regulated receptor variants dictate cell-type-specific transcriptome signatures of stress-related neuropsychiatric symptoms and (ii) selective receptor modulators are becoming available for more targeted treatment. These two new developments may help to 'restart the clock' with the prospect to support resilience.
Collapse
Affiliation(s)
| | - Onno C. Meijer
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - E. Ron de Kloet
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
10
|
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.
Collapse
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
| | | |
Collapse
|