The symphonic structure of childhood stress reactivity: patterns of sympathetic, parasympathetic, and adrenocortical responses to psychological challenge

Examining the relation among callous-unemotional traits and cortisol, alpha-amylase, and testosterone reactivity in legal system involved young men

Elevated callous-unemotional (CU) traits (e.g., lack of empathy, deficient guilt/remorse, and shallow affect) are associated with increased antisociality and distinct patterns of cognitive and emotional functioning. Previous investigations have suggested that deficits in physiological stress responses may underlie these associations, yet few studies simultaneously examine the multiple physiological systems responsible for mounting a stress response. To clarify how individuals with and without elevated CU traits respond to acute stress, the current study examined the association between CU traits and hormones released by three systems: cortisol from the hypothalamic-pituitary-adrenal (HPA) axis, alpha-amylase from the sympathetic nervous system (SNS), and testosterone from hypothalamic-pituitary-gonadal (HPG) axis. Specifically, we used fixed effect regression modeling to examine within-individual changes in each biomarker across the administration of a standardized laboratory stressor (Trier Social Stress Test) in a sample of 55 justice-involved young men (Mage= 22.84). Results indicated significant within-individual changes in cortisol, alpha-amylase, and testosterone following the stressor among those with low or average CU traits. However, those with high levels of CU exhibited no significant changes in their cortisol and testosterone levels. Furthermore, individuals with high CU traits exhibit an asymmetric stress response, such that alpha-amylase and testosterone levels were not associated with changes in cortisol levels. In sum, elevated CU traits were associated with blunted cortisol and testosterone reactivity and asymmetric response to stress. Additional work is needed to determine the behavioral and treatment implications of this distinct stress response.

Developmental Pathways from Prenatal Substance Exposure to Reactive Aggression

Few studies have examined etiological pathways from prenatal substance exposure to adolescent reactive aggression. We tested a conceptual model that included hypothesized pathways from prenatal substance exposure to adolescent aggression via autonomic reactivity and violence exposure from infancy to early school age and maternal harshness across early childhood. The sample included 216 families (106 boys) who primarily self-identified as Black or Mixed Race. Results supported the hypothesized path from violence exposure across early childhood and early school age to school age autonomic reactivity and early adolescent reactive aggression. There was also a significant interaction effect of sympathetic and parasympathetic reactivity on adolescent reactive aggression, with sympathetic arousal and parasympathetic suppression at early school age associated with higher reactive relational and physical aggression in adolescence. Results emphasize the importance of early experiences and autonomic nervous system changes in contributing to the cascade of risk for reactive aggression in early adolescence.

Autonomic profiles and self-regulation outcomes in early childhood

This study examined autonomic profiles in preschoolers (N = 278, age = 4.7 years) and their relations to self-regulation outcomes concurrently and one year later, in kindergarten. Children's sympathetic (preejection period [PEP]) and parasympathetic activity (respiratory sinus arrythmia [RSA]) were measured at rest and during cognitive and emotional tasks. Three self-regulatory competencies were assessed: executive functions, emotion regulation and behavioral regulation. Executive functioning was measured at ages 4 and 5 using laboratory tasks designed to assess updating/working memory, inhibitory control, and cognitive flexibility. Emotion regulation was observed during emotionally distressing tasks in the laboratory, both at ages 4 and 5. Behavioral regulation and emotional reactivity were assessed via teacher ratings in kindergarten, at age 5. Latent profile analysis yielded four autonomic profiles: moderate parasympathetic inhibition (45%), reciprocal sympathetic activation (26%), coinhibition (25%), and high sympathetic activation (7%). The reciprocal sympathetic activation group showed better executive functioning in preschool and kindergarten, particularly compared to the high sympathetic activation group. The moderate parasympathetic inhibition group showed lower emotional reactivity and better behavioral regulation in kindergarten, compared to the other three groups. Findings suggest that autonomic profiles meaningfully associate with self-regulation outcomes in early childhood, such that certain profiles relate to better self-regulation than others.

Coordination of autonomic and endocrine stress responses to the Trier Social Stress Test in adolescence

Dysregulations in autonomic and endocrine stress responses are linked to the emergence of psychopathology in adolescence. However, most studies fail to consider the interplay between these systems giving rise to conflicting findings and a gap in understanding adolescent stress response regulation. A multisystem framework-investigation of parasympathetic (PNS), sympathetic (SNS), and hypothalamic pituitary adrenal (HPA) axis components and their coordination-is necessary to understand individual differences in stress response coordination which contribute to stress vulnerabilities. As the first investigation to comprehensively evaluate these three systems in adolescence, the current study employed the Trier Social Stress Test in 72 typically developing adolescents (mean age = 13) to address how PNS, SNS, and HPA stress responses are coordinated in adolescence. Hypotheses tested key predictions of the Adaptive Calibration Model (ACM) of stress response coordination. PNS and SNS responses were assessed via heart rate variability (HRV) and salivary alpha amylase (sAA) respectively. HPA responses were indexed by salivary cortisol. Analyses utilized piecewise growth curve modeling to investigate these aims. Supporting the ACM theory, there was significant hierarchical coordination between the systems such that those with low HRV had higher sAA and cortisol reactivity and those with high HRV had low-to-moderate sAA and cortisol responsivity. Our novel results reveal the necessity of studying multisystem dynamics in an integrative fashion to uncover the true mechanisms of stress response and regulation during development. Additionally, our findings support the existence of characteristic stress response profiles as predicted by the ACM model.

Understanding personality pathology in a clinical sample of youth: study protocol for the longitudinal research project 'APOLO'

INTRODUCTION

We propose that a dimensional, multilayered perspective is well suited to study maladaptive personality development in youth. Such a perspective can help understand pathways to personality pathology and contribute to its early detection. The research project 'APOLO' (a Dutch language acronym for Adolescents and their Personality Development: a Longitudinal Study) is designed based on McAdams' integrative three-layered model of personality development and assesses the interaction between dispositional traits, characteristic adaptations, the narrative identity and functioning.

METHODS AND ANALYSIS

APOLO is a longitudinal research project that takes place in two outpatient mental healthcare centres. Participants are youth between 12 years and 23 years and their parents. Data collection is set up to build a data set for scientific research, as well as to use the data for diagnostic assessment and systematic treatment evaluation of individual patients. Measurements are conducted half-yearly for a period of 3 years and consist of self-report and informant-report questionnaires and a semistructured interview. The included constructs fit the dimensional model of personality development: maladaptive personality traits (dispositional traits), social relations, stressful life events (characteristic adaptations), a turning point (narrative identity) and functioning (eg, achievement of youth specific milestones). Primary research questions will be analysed using structural equation modelling.

ETHICS AND DISSEMINATION

The results will contribute to our understanding of (the development of) personality pathology as a complex phenomenon in which both structural personality characteristics as well as unique individual adaptations and experiences play a role. Furthermore, results will give directions for early detection and timely interventions. This study has been approved by the ethical review committee of the Utrecht University Faculty for Social and Behavioural Sciences (FETC17-092). Data distribution will be anonymous and results will be disseminated via communication canals appropriate for diverse audiences. This includes both clinical and scientific conferences, papers published in national and international peer-reviewed journals and (social) media platforms.

Vocal communication is tied to interpersonal arousal coupling in caregiver-infant dyads

It has been argued that a necessary condition for the emergence of speech in humans is the ability to vocalise irrespective of underlying affective states, but when and how this happens during development remains unclear. To examine this, we used wearable microphones and autonomic sensors to collect multimodal naturalistic datasets from 12-month-olds and their caregivers. We observed that, across the day, clusters of vocalisations occur during elevated infant and caregiver arousal. This relationship is stronger in infants than caregivers: caregivers vocalisations show greater decoupling with their own states of arousal, and their vocal production is more influenced by the infant's arousal than their own. Different types of vocalisation elicit different patterns of change across the dyad. Cries occur following reduced infant arousal stability and lead to increased child-caregiver arousal coupling, and decreased infant arousal. Speech-like vocalisations also occur at elevated arousal, but lead to longer-lasting increases in arousal, and elicit more parental verbal responses. Our results suggest that: 12-month-old infants' vocalisations are strongly contingent on their arousal state (for both cries and speech-like vocalisations), whereas adults' vocalisations are more flexibly tied to their own arousal; that cries and speech-like vocalisations alter the intra-dyadic dynamics of arousal in different ways, which may be an important factor driving speech development; and that this selection mechanism which drives vocal development is anchored in our stress physiology.

Adolescent cortisol and DHEA responses to stress as prospective predictors of emotional and behavioral difficulties: A person-centered approach

BACKGROUND

Well-orchestrated cortisol and DHEA stress responsivity is thought to support efficacious stressor management (i.e., coping) and reduce risk for psychopathology during adolescence. Evidence of these relations, however, is lacking empirically. This longitudinal investigation had three aims: 1) to identify within-adolescent profiles of joint cortisol-DHEA responsivity, 2) examine profiles as prospective predictors of adolescents' later emotional and behavioral difficulties, and 3) examine whether distraction coping helped buffer such prospective risk in each profile.

METHOD

At Time 1, boys (n = 110) and girls (n = 105) between 11 and 16 years of age with varied levels of risk for psychopathology completed a lab-based socio-evaluative stressor and questionnaires (e.g., coping, internalizing and externalizing problems). Emotional and behavioral adjustment was assessed again at Time 2 (2 years later).

RESULTS

Multi-trajectory modeling of adolescents' cortisol and DHEA within the context of the stressor revealed three groups: Normative (n = 107; 49.8%), Hyperresponsive (n = 64; 29.8%), Hyporesponsive (n = 44; 20.5%). Relative to Normative, Hyperresponsive and Hyporesponsive adolescents were more and less advanced in pubertal status, respectively. Hyperresponsive adolescents, but not Hyporesponsive, reported greater emotional and behavioral problems at Time 2, relative to Normative adolescents. Links between distraction coping and Time 2 adjustment varied across the groups. Specifically, distraction coping was associated with fewer Time 2 emotional and behavioral problems for Normative adolescents. However, the converse was true for Hyporesponsive adolescents, with distraction associated with greater Time 2 emotional and behavioral problems. Distraction was not associated with Time 2 emotional and behavioral problems for Hyperresponsive adolescents (i.e., elevated levels irrespective of distraction coping utilization).

CONCLUSION

Our results strengthen inference about the role neuroendocrine coordination plays in risk for psychopathology. Findings also help to clarify inconsistent distraction coping-psychopathology linkages, illustrating different patterns of cortisol-DHEA responsivity that support as well as thwart the use of this potentially efficacious strategy.

The differential calibration of the HPA axis as a function of trauma versus adversity: A systematic review and p-curve meta-analyses

Although there is an abundance of evidence linking the function of the hypothalamic-pituitary-adrenal (HPA) axis to adverse early-life experiences, the precise nature of the association remains unclear. Some evidence suggests early-life adversity leads to cortisol hyper-reactivity, while other evidence suggests adversity leads to cortisol hypo-reactivity. Here, we distinguish between trauma and adversity, and use p-curves to interrogate the conflicting literature. In Study 1, trauma was operationalized according to DSM-5 criteria; the p-curve analysis included 68 articles and revealed that the literature reporting associations between trauma and blunted cortisol reactivity contains evidential value. Study 2 examined the relationship between adversity and cortisol reactivity. Thirty articles were included in the analysis, and p-curve demonstrated that adversity is related to heightened cortisol reactivity. These results support an inverted U-shaped function relating severity of adversity and cortisol reactivity, and underscore the importance of distinguishing between "trauma" and "adversity".

Individual Differences in Cross-System Physiological Activity at Rest and in Response to Acute Social Stress

OBJECTIVE

Individual differences in long-term cardiovascular disease risk are related to physiological responses to psychological stress. However, little is known about specific physiological response profiles in young adults that may set the stage for long-term increased cardiovascular disease risk. We investigated individual differences in profiles of resting cardiovascular physiology and stress reactivity, combining parasympathetic, sympathetic, and hemodynamic measures.

METHODS

Participants (n = 744, 71% women, mean [standard deviation] age = 20.1 [2.4] years) underwent the Trier Social Stress Test, while blood pressure (systolic blood pressure, diastolic blood pressure), electrocardiograms (interbeat interval), and impedance cardiograms (preejection period, left ventricular ejection time) were recorded. Respiratory sinus arrhythmia was derived from the combination of the electrocardiogram and the impedance cardiogram. A three-step latent profile analysis (LPA) was performed on resting and reactivity values to derive clusters of individual physiological profiles. We also explored demographic and health behavioral correlates of the observed latent clusters.

RESULTS

For resting physiology, LPA revealed five different resting physiology profiles, which were related to sex, usual physical activity levels, and body mass index. Five cardiovascular stress reactivity profiles were identified: a reciprocal/moderate stress response (Cr1; 29%), and clusters characterized by high blood pressure reactivity (Cr2: 22%), high vagal withdrawal (Cr3; 22%), autonomic coactivation (parasympathetic nervous system and sympathetic nervous system; Cr4; 13%), and overall high reactivity (Cr5; 12%). Men were more likely to belong to the high reactivity (Cr5) cluster, whereas women were more likely to have autonomic coactivation (Cr4).

CONCLUSIONS

We identified five cardiovascular physiological reactivity profiles, with individuals displaying generalized hyperreactivity, predominant vagal withdrawal, autonomic coactivation, or blood pressure-specific hyperreactivity. Longitudinal studies are needed to determine whether these profiles are useful in early detection of individuals at high risk for cardiovascular disease.

Externalizing and Internalizing Problems: Associations with Family Adversity and Young Children's Adrenocortical and Autonomic Functioning

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.

Associations between multisystem stress reactivity and peer nominated aggression in early childhood vary by sex

There is emerging evidence that the development of problematic aggression in childhood may be associated with specific physiological stress response patterns, with both biological overactivation and underactivation implicated. This study tested associations between sex-specific patterns of stress responses across the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis and peer nominations of aggression among 271 kindergarten children (Mean age = 5.32 years; 52% Female; 44% White). Upon entry to kindergarten, children participated in a multidomain standardized stress paradigm. Changes in pre-ejection period (PEP) and salivary cortisol were assessed. On a separate day, children provided peer ratings of physical and relational aggression in a standardized interview. As expected, there was a significant three-way interaction between PEP, cortisol reactivity, and sex, but only for physical aggression. Among boys, cortisol reactivity was positively associated with physical aggression only for those with higher SNS reactivity. Findings suggest that for boys, asymmetrical and symmetrical HPA/SNS reactivity may be associated with lower and higher risk for peer-directed physical aggression, respectively. Understanding the complex associations between multisystem physiology, child sex and peer-directed aggression in early childhood may offer insight into individual differences underlying the emergence of behavioral dysregulation in early peer contexts.

Biological sensitivity to context: A test of the hypothesized U-shaped relation between early adversity and stress responsivity

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.

Towards an understanding of neurophysiological self-regulation in early childhood: A heuristic and a new approach

Self-regulation in early childhood encompasses both "top down," volitional processes, as well as the "bottom up" activity of three neurophysiological systems: the parasympathetic nervous system (PNS), the sympathetic nervous system (SNS), and the hypothalamic-pituitary-adrenal (HPA) axis. In this paper we briefly review the structure, function, and early development of each of these systems and then explain why neurophysiological self-regulation is most accurately defined as a function of their joint activity. We note that while there are a number of predictive models that employ this definition, the field would benefit from a straightforward heuristic and aligned methods of visualization and analysis. We then present one such heuristic, which we call neurophysiological space, and outline how it may facilitate a new, collaborative approach to building a better understanding of self-regulation in early childhood. We conclude with a presentation of early education as one setting in which our heuristic and methods could be applied.

In infancy, it's the extremes of arousal that are 'sticky': Naturalistic data challenge purely homeostatic approaches to studying self-regulation

Most theoretical models of arousal/regulatory function emphasise the maintenance of homeostasis; consistent with this, most previous research into arousal has concentrated on examining individuals' recovery following the administration of experimentally administered stressors. Here, we take a different approach: we recorded day-long spontaneous fluctuations in autonomic arousal (indexed via electrocardiogram, heart rate variability and actigraphy) in a cohort of 82 typically developing 12-month-old infants while they were at home and awake. Based on the aforementioned models, we hypothesised that extreme high or low arousal states might be more short-lived than intermediate arousal states. Our results suggested that, contrary to this, both low- and high-arousal states were more persistent than intermediate arousal states. The same pattern was present when the data were viewed over multiple epoch sizes from 1 s to 5 min; over 10-15-minute time-scales, high-arousal states were more persistent than low- and intermediate states. One possible explanation for these findings is that extreme arousal states have intrinsically greater hysteresis; another is that, through 'metastatic' processes, small initial increases and decreases in arousal can become progressively amplified over time. Rather than exclusively using experimental paradigms to study recovery, we argue that future research should also use naturalistic data to study the mechanisms through which states can be maintained or amplified over time.

Charting the physiological time course of help-seeking during late childhood: Patterns of individual difference

In this study, we explored whether variability in children's physiological reactivity-respiratory sinus arrhythmia and electrodermal activity-predict concurrent and subsequent levels of children's observed help-seeking (HS) from their mothers during a failure task. In addition, we tested whether children's perceptions of maternal positivity pre-task (CPMP) and children's fearful temperament moderate these effects. In a community sample of 101 mother-child dyads, children (8-12 years of age) underwent a repeated failure task while their respiratory sinus arrythmia and electrodermal activity were monitored; their HS behaviors were later coded. Multilevel path analyses indicated that high-fearful children increased their HS at the same time as and following increased physiological reactivity regardless of CPMP pre-task. Low-fearful children showed increases in HS at the same time as and following increased physiological reactivity only when they perceived their mothers' affect to be positive. This study demonstrates children's individual differences in the physiological underpinning of time-linked HS behaviors.

Effects of varying intensities of heat stress on neuropeptide Y and proopiomelanocortin mRNA expression in rats

The aim of the present study was to investigate the effects of varying intensities of heat stress on the mRNA expression levels of neuropeptide Y (NPY), proopiomelanocortin (POMC) and stress hormones in rats. To establish a rat model of heat stress, the temperature and time were adjusted in a specialized heating chamber. Sprague-Dawley (SD) rats were randomly divided into four groups; control (CN; temperature, 24±1˚C); moderate strength 6 h (MS6; temperature, 32±1˚C time, 6 h), moderate strength 24 h (MS24; temperature, 32±1˚C; time, 24 h) and high strength 6 h (HS6; temperature, 38±1˚C; time, 6 h) groups. SD rats were exposed to heat for 14 consecutive days. The levels of heat stress-related factors, including corticotropin-releasing hormone (CRH), cortisol (COR), epinephrine (EPI) and heat shock protein 70 (HSP70), were measured in the rat blood using ELISA. In addition, the weight of the spleen, thymus, hypophysis and hypothalamus were determined. The mRNA expressions levels of NPY and POMC were detected using quantitative PCR. The results showed that the CRH, COR and HSP70 levels were increased in the three heat stress groups compared with the CN group. Notably, the levels of CRH, EPI and HSP70 were increased in the HS6 group compared with the CN and MS6 groups (P<0.05). Furthermore, the weights of the hypophysis and hypothalamus in the HS6 group were significantly lower compared with the CN group (P<0.05). In addition, NPY and POMC expression levels were downregulated in the MS24 group compared with the CN group. The mRNA expression levels of NPY and POMC were altered in response to different intensities of heat stress. Therefore, their levels were downregulated and upregulated following long-time and moderate-time heat exposure, respectively. The results of the present study suggested that the reduced mRNA expression levels of NPY may be partially responsible for the heat-induced injuries in rats following long-time heat exposure.

A latent change score approach to understanding dynamic autonomic coordination

Children's self-regulation is a core adaptive system in child development. Physiological indices of regulation, particularly the autonomic nervous system (ANS), have garnered increased attention as an informative level of analysis in regulation research. Cardiography supports the simultaneous examination of both ANS branches via measures of pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) as indicators of sympathetic and parasympathetic activity, respectively. However, despite their heavily intertwined functions, research examining autonomic coordination across sympathetic and parasympathetic systems is scarce. Moreover, extant efforts have favored static, mean level reactivity analyses, despite the dynamic nature of ANS regulation and the availability of analytic tools that can model these processes across time. This study drew on a sample of 198 six-year-old children from a diverse community sample (49.5% female, 43.9% Latinx) to examine dynamic autonomic coordination using bivariate latent change score modeling to evaluate bidirectional influences of sympathetic and parasympathetic activity over the course of a challenging puzzle completion task. Results indicated that children evidenced reciprocal sympathetic activation (i.e., PEP attenuation and RSA withdrawal) across the challenge task, and these regulatory responses were characterized by a temporally leading influence of PEP on lagging changes in RSA. The current findings contribute to our understanding of children's autonomic coordination while illustrating a novel analytic technique to advance ongoing efforts to understand the etiology and developmental significance of children's physiological self-regulation.

Disaster-related prenatal maternal stress predicts HPA reactivity and psychopathology in adolescent offspring: Project Ice Storm

BACKGROUND

Prenatal stress has been associated with adverse outcomes in offspring, including elevated risk of psychopathology. Fetal programming of the hypothalamic-pituitary-adrenal (HPA) axis has been posited as a biological mechanism underlying such consequences. The present study aimed to examine whether dysregulation of the offspring HPA axis mediates the relationship between prenatal stress exposure and adolescent psychopathology.

METHODS

Five months after the Quebec ice storm of 1998, women who had been pregnant at the time of the storm completed questionnaires about their objective hardship and subjective distress from the disaster. A total of 45 of their children, exposed to the ice storm in utero, participated at 13 years of age. Adolescents completed the Trier Social Stress Test while providing salivary samples to measure circulating cortisol levels. Maternal report of adolescent behaviors was assessed with the Child Behavior Checklist.

RESULTS

Results from the study found that greater objective hardship was associated with elevated offspring cortisol reactivity at 13 years of age. Furthermore, greater subjective distress was associated with greater externalizing behaviors. While lower cortisol reactivity predicted greater externalizing behaviors, it did not mediate the association between maternal objective hardship or subjective distress and offspring externalizing or internalizing behaviors.

CONCLUSIONS

Findings suggest that objective hardship in pregnancy has long-term implications for offspring HPA axis functioning, which is also associated with externalizing behaviors. While dysregulation of the offspring HPA axis did not mediate the association between prenatal stress and offspring psychopathological symptoms, further research is warranted to investigate programming of alternative biological systems.

Evidence for discrete profiles of children's physiological activity across three neurobiological system and their transitions over time

The conceptualization of stress-responsive physiological systems as operating in an integrated manner is evident in several theoretical models of cross-system functioning. However, limited empirical research has modeled the complexity of multisystem activity. Moreover few studies have explored developmentally regulated changes in multisystem activity during early childhood when plasticity is particularly pronounced. The current study used latent profile analysis (LPA) to evaluate multisystem activity during fall and spring of children's transition to kindergarten in three biological systems: the parasympathetic nervous system (PNS), sympathetic nervous system (SNS), and hypothalamic pituitary adrenal (HPA) axis. Latent transition analysis (LTA) was then used to examine the stability of profile classification across time. Across both timepoints, three distinct profiles of multisystem activity emerged. One profile was characterized by heightened HPA axis activity (HPA Axis Responders), a second profile was characterized by moderate, typically adaptive patterns across the PNS, SNS, and HPA axis (Active Copers/Mobilizers), and a third profile was characterized by heightened baseline activity, particularly in the PNS and SNS (Anticipatory Arousal/ANS Responders). LTA of fall-to-spring profile classifications indicated higher probabilities that children remained in the same profile over time compared to probabilities of profile changes, suggesting stability in certain patterns of cross-system responsivity. Patterns of profile stability and change were associated with socioemotional outcomes at the end of the school year. Findings highlight the utility of LPA and LTA to detect meaningful patterns of complex multisystem physiological activity across three systems and their associations with early adjustment during an important developmental transition.

Pathways from early adversity to later adjustment: Tests of the additive and bidirectional effects of executive control and diurnal cortisol in early childhood

Additive and bidirectional effects of executive control and hypothalamic-pituitary-adrenal (HPA) axis regulation on children's adjustment were examined, along with the effects of low income and cumulative risk on executive control and the HPA axis. The study utilized longitudinal data from a community sample of preschool age children (N = 306, 36-39 months at Time 1) whose families were recruited to overrepresent low-income contexts. We tested the effects of low income and cumulative risk on levels and growth of executive control and HPA axis regulation (diurnal cortisol level), the bidirectional effects of executive control and the HPA axis on each other, and their additive effects on children's adjustment problems, social competence and academic readiness. Low income predicted lower Time 4 executive control, and cumulative risk predicted lower Time 4 diurnal cortisol level. There was little evidence of bidirectional effects of executive control and diurnal cortisol. However, both executive control and diurnal cortisol predicted Time 4 adjustment, suggesting additive effects. There were indirect effects of income on all three adjustment outcomes through executive control, and of cumulative risk on adjustment problems and social competence through diurnal cortisol. The results provide evidence that executive control and diurnal cortisol additively predict children's adjustment and partially account for the effects of income and cumulative risk on adjustment.

Diverse Autonomic Nervous System Stress Response Patterns in Childhood Sensory Modulation

The specific role of the autonomic nervous system (ANS) in emotional and behavioral regulation—particularly in relation to automatic processes—has gained increased attention in the sensory modulation literature. This mini-review article summarizes current knowledge about the role of the ANS in sensory modulation, with a focus on the integrated functions of the ANS and the hypothalamic-pituitary-adrenal (HPA) axis and their measurement. Research from the past decade illustrates that sympathetic and parasympathetic interactions are more complex than previously assumed. Patterns of ANS activation vary across individuals, with distinct physiological response profiles influencing the reactivity underlying automatic behavioral responses. This review article advances a deeper understanding of stress and the complex stress patterns within the ANS and HPA axis that contribute to allostatic load (AL). We argue that using multiple physiological measurements to capture individual ANS response variation is critical for effectively treating children with sensory modulation disorder (SMD) and sensory differences. We consider the relative contributions of automatic vs. deliberately controlled processes across large-scale neural networks in the development of sensorimotor function and their associated links with arousal patterns and sensory over- and under-responsivity.

Cortical and affective regulation of autonomic coordination

Although anatomical research clearly demonstrates the ability of the sympathetic and parasympathetic branches of the autonomic nervous system to independently influence cardiac function, little research has examined whether coordinated activation is typical or whether the extent of autonomic coordination is situationally dependent. This study examines the extent of coordination between sympathetic (cardiac pre-ejection period: PEP) and parasympathetic (respiratory sinus arrhythmia: RSA) influences on the cardiac function to determine whether coordination is a trait-like between-person characteristic or a state-varying within-person phenomenon, and if so, whether variability in autonomic coordination is modulated by cognitive (P3b amplitude) or affective state. Kindergarten-aged children (n = 257) completed a go/no-go task administered in blocks designed to induce affective states through the delivery of reward (Blocks 1 and 3) and frustration (Block 2). Results from multilevel models that allowed for the simultaneous examination of between-person and within-person associations in the repeated measures data suggested that (a) children with higher overall RSA also tended to have higher overall PEP; (b) at within-person level, RSA and PEP tended to be reciprocally coordinated; but that (c) when frustration invokes cognitive disengagement, coordination between parasympathetic and sympathetic systems demonstrate compensatory coordination. These findings highlight the extent to which the coordination of autonomic systems is a dynamic state-like phenomenon rather than a trait-like individual differences characteristic.

Parents Mimic and Influence Their Infant's Autonomic State through Dynamic Affective State Matching

When we see someone experiencing an emotion, and when we experience it ourselves, common neurophysiological activity occurs [1, 2]. But although inter-dyadic synchrony, concurrent and sequential [3], has been identified, its functional significance remains inadequately understood. Specifically, how do influences of partner A on partner B reciprocally influence partner A? For example, if I am experiencing an affective state and someone matches their physiological state to mine, what influence does this have on me-the person experiencing the emotion? Here, we investigated this using infant-parent dyads. We developed miniaturized microphones to record spontaneous vocalizations and wireless autonomic monitors to record heart rate, heart rate variability, and movement in infants and parents concurrently in naturalistic settings. Overall, we found that infant-parent autonomic activity did not covary across the day-but that "high points" of infant arousal led to autonomic changes in the parent and that instances where the adult showed greater autonomic responsivity were associated with faster infant quieting. Parental responsivity was higher following peaks in infant negative affect than in positive affect. Overall, parents responded to increases in their child's arousal by increasing their own. However, when the overall arousal level of the dyad was high, parents responded to elevated child arousal by decreasing their own arousal. Our findings suggest that autonomic state matching has a direct effect on the person experiencing the affective state and that parental co-regulation may involve both connecting and disconnecting their own arousal state from that of the child contingent on context.

Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children

BACKGROUND

The negative effect of perceived stress on health has become a cultural epidemic. Despite many health implications, the clinical impact of stress on the nervous system is not well understood. This case series describes the symptom profiles of 80 children with nervous system dysregulation attributed to maladaptive neuroendocrine responses to stress.

METHODS

We reviewed of 80 children with nervous system dysregulation identified from a single, tertiary care pediatric neurology clinic. Included patients were between five and 17 years of age, with unexplained medical symptoms lasting three months or longer affecting at least four of six neurological domains: (1) somatization, (2) executive function, (3) autonomic function, (4) digestion, (5) sleep, and (6) emotional regulation. Medical symptoms, diagnoses, and detailed social histories were collected.

RESULTS

Of 80 children, 57 were female (71%), 57 were Caucasian (71%), with median age of 14 years. Symptoms had a mean duration of 32 months, and included: 100% somatic symptoms, 100% emotional dysregulation, 92.5% disrupted sleep, 82.5% autonomic dysregulation, 75% executive dysfunction, and 66% digestive problems. Overall, 94% reported chronic or traumatic stressors; adverse childhood experiences were present in 65%.

CONCLUSIONS

Perceived stress impacts many functions of the neuroendocrine system through experience-dependent plasticity, resulting in a constellation of symptoms and functional impairments we describe as nervous system dysregulation. The pathophysiology of these symptoms involves dysregulation of subcortical, hormonal, and autonomic circuits, which remain largely untested. Recognition and understanding of maladaptive neurophysiology in stress-related symptoms has important implications for diagnosis, treatment, and advances in health research.

Autonomic nervous system functioning assessed during the Still-Face Paradigm: A meta-analysis and systematic review of methods, approach and findings

Animal and human research suggests that the development of the autonomic nervous system (ANS) is particularly sensitive to early parenting experiences. The Still-Face Paradigm (SFP), one of the most widely used measures to assess infant reactivity and emotional competence, evokes infant self-regulatory responses to parental interaction and disengagement. This systematic review of 33 peer-reviewed studies identifies patterns of parasympathetic (PNS) and sympathetic (SNS) nervous system activity demonstrated by infants under one year of age during the SFP and describes findings within the context of sample demographic characteristics, study methodologies, and analyses conducted. A meta-analysis of a subset of 14 studies with sufficient available respiratory sinus arrhythmia (RSA) data examined whether the SFP reliably elicited PNS withdrawal (RSA decrease) during parental disengagement or PNS recovery (RSA increase) during reunion, and whether results differed by socioeconomic status (SES). Across SES, the meta-analysis confirmed that RSA decreased during the still-face episode and increased during reunion. When studies were stratified by SES, low-SES or high-risk groups also showed RSA decreases during the still face episode but failed to show an increase in RSA during reunion. Few studies have examined SNS activity during the SFP to date, preventing conclusions in that domain. The review also identified multiple qualifications to patterns of SFP ANS findings, including those that differed by ethnicity, infant sex, parental sensitivity, and genetics. Strengths and weaknesses in the extant research that may explain some of the variation in findings across the literature are also discussed, and suggestions for strengthening future research are provided.

An Autonomic Network: Synchrony Between Slow Rhythms of Pulse and Brain Resting State Is Associated with Personality and Emotions

The sympathetic system's role in modulating vasculature and its influence on emotions and personality led us to test the hypothesis that interactions between brain resting-state networks (RSNs) and pulse amplitude (indexing sympathetic activity) would be associated with emotions and personality. In 203 participants, we characterized RSN spatiotemporal characteristics, and phase-amplitude associations of RSN fluctuations with pulse and respiratory recordings. We found that RSNs are spatially reproducible within participants and were temporally associated with low frequencies (LFs < 0.1 Hz) in physiological signals. LF fluctuations in pulse amplitude were not related to cardiac electrical activity and preceded LF fluctuations in RSNs, while LF respiratory amplitude fluctuations followed LF fluctuations in RSNs. LF phase dispersion (PD) (lack of synchrony) between RSNs and pulse (PDpulse) (not respiratory) correlated with the common variability in measures of personality and emotions, with more synchrony being associated with more positive temperamental characteristics. Voxel-level PDpulse mapping revealed an "autonomic brain network," including sensory cortices and dorsal attention stream, with significant interactions with peripheral signals. Here, we uncover associations between pulse signal amplitude (presumably of sympathetic origin) and brain resting state, suggesting that interactions between central and autonomic nervous systems are important for characterizing personality and emotions.

Annual Research Review: Early adversity, the hypothalamic-pituitary-adrenocortical axis, and child psychopathology

BACKGROUND

Research on early adversity, stress biology, and child development has grown exponentially in recent years.

FINDINGS

We review the current evidence for the hypothalamic-pituitary-adrenocortical (HPA) axis as a stress-mediating mechanism between various forms of childhood adversity and psychopathology. We begin with a review of the neurobiology of the axis and evidence for relations between early adversity-HPA axis activity and HPA axis activity-psychopathology, as well as discuss the role of regulatory mechanisms and sensitive periods in development.

CONCLUSIONS

We call attention to critical gaps in the literature to highlight next steps in this research including focus on developmental timing, sex differences, stress buffering, and epigenetic regulation. A better understanding of individual differences in the adversity-HPA axis-psychopathology associations will require continued work addressing how multiple biological and behavioral systems work in concert to shape development.

Person-centered examination of salivary cortisol and alpha-amylase responses to psychosocial stress: Links to preadolescent behavioral functioning and coping

This study adopted a person-centered approach to identify preadolescent salivary cortisol (sC) and alpha-amylase (sAA) co-activation response patterns and examine links to behavioral functioning and coping. Children (N = 151, 51.7% male) were exposed to the Trier Social Stress Test (TSST) and one of two randomly-assigned, post-TSST coping conditions: distraction or avoidance. Multi-trajectory modeling yielded four child subgroups. Child internalizing and externalizing positively predicted High sC-High sAA relative to Low sC-Low sAA and Low sC-High sAA relative to High sC-Low sAA subgroup membership, respectively. Low sC-Low sAA children demonstrated more efficient sC recovery when primed with distraction and more protracted sC recovery when primed with avoidance. For High sC-High sAA, internalizing children, the opposite was true. Findings illustrate adjustment-linked variability in preadolescent sC-sAA co-activation response patterns that further articulates for whom effortful coping works to effectively manage stressor-induced neuroendocrine activation.

Family environments and leukocyte transcriptome indicators of a proinflammatory phenotype in children and parents

High conflict and low warmth in families may contribute to immune cells developing a tendency to respond to threats with exaggerated inflammation that is insensitive to inhibitory signaling. We tested associations between family environments and expression of genes bearing response elements for transcription factors that regulate inflammation: nuclear factor kappa B (NF-κB) and glucocorticoid receptor. The overall sample (47 families) completed interviews, questionnaires, and 8-week daily diary assessments of conflict and warmth, which were used to create composite family conflict and warmth scores. The diaries assessed upper respiratory infection (URI) symptoms, and URI episodes were clinically verified. Leukocyte RNA was extracted from whole blood samples provided by a subsample of 42 children (8-13 years of age) and 73 parents. In children, higher conflict and lower warmth were related to greater expression of genes bearing response elements for the proinflammatory transcription factor NF-κB, and more severe URI symptoms. In parents, higher conflict and lower warmth were also related to greater NF-κB-associated gene expression. Monocytes and dendritic cells were implicated as primary cellular sources of differential gene expression in the sample. Consistent with existing conceptual frameworks, stressful family environments were related to a proinflammatory phenotype at the level of the circulating leukocyte transcriptome.

Sensitive periods of substance abuse: Early risk for the transition to dependence

•

Early substance use dramatically increases the risk of substance use disorder (SUD).

•

Although many try drugs, only a small percentage transition to SUD.

•

High reactivity of reward, habit, and stress systems increase risk.

•

Identification of early risk enables targeted, preventative interventions for SUD.

•

Prevention must start before the sensitive adolescent period to maximize resilience.

Early adolescent substance use dramatically increases the risk of lifelong substance use disorder (SUD). An adolescent sensitive period evolved to allow the development of risk-taking traits that aid in survival; today these may manifest as a vulnerability to drugs of abuse. Early substance use interferes with ongoing neurodevelopment to induce neurobiological changes that further augment SUD risk. Although many individuals use drugs recreationally, only a small percentage transition to SUD. Current theories on the etiology of addiction can lend insights into the risk factors that increase vulnerability from early recreational use to addiction. Building on the work of others, we suggest individual risk for SUD emerges from an immature PFC combined with hyper-reactivity of reward salience, habit, and stress systems. Early identification of risk factors is critical to reducing the occurrence of SUD. We suggest preventative interventions for SUD that can be either tailored to individual risk profiles and/or implemented broadly, prior to the sensitive adolescent period, to maximize resilience to developing substance dependence. Recommendations for future research include a focus on the juvenile and adolescent periods as well as on sex differences to better understand early risk and identify the most efficacious preventions for SUD.

The adaptive calibration model of stress responsivity: An empirical test in the Tracking Adolescents' Individual Lives Survey study

The adaptive calibration model (ACM) is a theory of developmental programing focusing on calibration of stress response systems and associated life history strategies to local environmental conditions. In this article, we tested some key predictions of the ACM in a longitudinal study of Dutch adolescent males (11-16 years old; N = 351). Measures of sympathetic, parasympathetic, and adrenocortical activation, reactivity to, and recovery from social-evaluative stress validated the four-pattern taxonomy of the ACM via latent profile analysis, though with some deviations from expected patterns. The physiological profiles generally showed predicted associations with antecedent measures of familial and ecological conditions and life stress; as expected, high- and low-responsivity patterns were found under both low-stress and high-stress family conditions. The four patterns were also differentially associated with aggressive/rule-breaking behavior and withdrawn/depressed behavior. This study provides measured support for key predictions of the ACM and highlights important empirical issues and methodological challenges for future research.

Sleep Moderates the Association Between Response Inhibition and Self-Regulation in Early Childhood

Early childhood is a time of rapid developmental changes in sleep, cognitive control processes, and the regulation of emotion and behavior. This experimental study examined sleep-dependent effects on response inhibition and self-regulation, as well as whether acute sleep restriction moderated the association between these processes. Preschool children (N = 19; 45.6 ± 2.2 months; 11 female) followed a strict sleep schedule for at least 3 days before each of 2 morning behavior assessments: baseline (habitual nap/night sleep) and sleep restriction (missed nap/delayed bedtime). Response inhibition was evaluated via a go/no-go task. Twelve self-regulation strategies were coded from videotapes of children while attempting an unsolvable puzzle. We then created composite variables representing adaptive and maladaptive self-regulation strategies. Although we found no sleep-dependent effects on response inhibition or self-regulation measures, linear mixed-effects regression showed that acute sleep restriction moderated the relationship between these processes. At baseline, children with better response inhibition were more likely to use adaptive self-regulation strategies (e.g., self-talk, alternate strategies), and those with poorer response inhibition showed increased use of maladaptive self-regulation strategies (e.g., perseveration, fidgeting); however, response inhibition was not related to self-regulation strategies following sleep restriction. Our results showing a sleep-dependent effect on the associations between response inhibition and self-regulation strategies indicate that adequate sleep facilitates synergy between processes supporting optimal social-emotional functioning in early childhood. Although replication studies are needed, findings suggest that sleep may alter connections between maturing emotional and cognitive systems, which have important implications for understanding risk for or resilience to developmental psychopathology.

[Child maltreatment and new morbidity in pediatrics : Consequences for early child support and child protective interventions]

The effects of child maltreatment on children's chronic health conditions have become more visible during recent years. This is true for mental health problems as well as some chronic physical conditions, both summarized as new morbidity within pediatrics. As several Bradford Hill criteria (criteria from epidemiology for the determination of the causal nature of a statistical association) are met, the likely causal nature of underlying associations is discussed. Early family support may have the potential to modify such associations, although empirical evidence is lacking. At least for attachment-based interventions with foster carerers after child maltreatment, positive effects on child HPA axis dysregulation have been demonstrated.

Stress Physiology in Infancy and Early Childhood: Cortisol Flexibility, Attunement and Coordination

Research on stress physiology in infancy has assumed increasing importance due to its lifelong implications. In this review, we focus on measurement of hypothalamic-pituitary-adrenal (HPA) function, in particular, and on complementary autonomic processes. We suggest that the measure of HPA function has been overly exclusive, focusing on individual reactivity to single, pragmatically selected laboratory challenges. We advocate use of multiple, strategically chosen challenges and within-subject designs. By administering one challenge that typically does not provoke reactivity and another that does, it is possible to represent allostatic load in terms of "flexibility," the capacity to titrate response to challenge. We also recommend assessing infant reactivity in the context of the primary caregiver's physiological function. Infant-mother "attunement" is central to developmental psychology, permeating diverse developmental domains with varied consequences. A review of adrenocortical attunement suggests that attunement is a reliable process, manifest across varied populations. However, attunement appears stronger in the context of more highly stressful circumstances, such that administration of multiple, selected challenges may help evaluate the degree to which individuals titrate attunement to challenge and determine the correlates of this differential attunement. Finally, we advocate studying the "coordination" of HPA function with other aspects of stress physiology and variation in the degree of this coordination. The use of multiple stressors is important here because each stress system is differentially sensitive to different types of challenge. Therefore, use of single stressors in between-subject designs impedes full recognition of the role played by each system. Overall, we recommend measure of flexibility, attunement, and coordination in the context of multiple challenges to capture allostasis in environmental and physiological context. The simultaneous use of such inclusive and integrative metrics may yield more reliable findings than has hitherto been the case. The interrelation of these metrics can be understood in the context of the adaptive calibration model..

Childhood socioeconomic status and cardiovascular reactivity and recovery among Black and White men: Mitigating effects of psychological resources

OBJECTIVE

To evaluate a possible physiological mechanism underlying links between low childhood socioeconomic status (SES) and poor adult health by (a) testing whether childhood SES is prospectively related to cardiovascular responses to laboratory stress in adulthood, and (b) by determining whether psychological resources buffer cardiovascular reactivity and promote better recovery from stress.

METHOD

Participants (n = 246; 55% Black; mean age = 32 years) were from a population-based sample of men in Pittsburgh, PA. Childhood SES was measured through the Hollingshead index (parental education and occupation) across 10 waves between the ages of 6 and 16. In adulthood, cardiovascular measures, including systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and high-frequency heart rate variability (HF-HRV), were taken during and following standardized laboratory psychological stressors. Participants completed measures of optimism, purpose in life, self-esteem, positive affect, and self-mastery, which were combined into a psychological resource factor.

RESULTS

Lower childhood SES predicted higher HR and SBP at recovery, independent of age, race, body mass index, current smoking, task demand, and current SES. Psychological resources moderated the association between childhood SES and SBP. Lower childhood SES predicted SBP recovery only among men with fewer psychological resources.

CONCLUSIONS

Psychological resources may buffer the relation between low childhood SES and cardiovascular recovery from stress. This buffering may improve adult health to the extent that cardiovascular recovery contributes to the risk of low childhood SES for subsequent disease. (PsycINFO Database Record

Differential Susceptibility of the Developing Brain to Contextual Adversity and Stress

A swiftly growing volume of literature, comprising both human and animal studies and employing both observational and experimental designs, has documented striking individual differences in neurobiological sensitivities to environmental circumstances within subgroups of study samples. This differential susceptibility to social and physical environments operates bidirectionally, in both adverse and beneficial contexts, and results in a minority subpopulation with remarkably poor or unusually positive trajectories of health and development, contingent upon the character of environmental conditions. Differences in contextual susceptibility appear to emerge in early development, as the interactive and adaptive product of genetic and environmental attributes. This paper surveys what is currently known of the mechanisms or mediators of differential susceptibility, at the levels of temperament and behavior, physiological systems, brain circuitry and neuronal function, and genetic and epigenetic variation. It concludes with the assertion that differential susceptibility is inherently grounded within processes of biological moderation, the complexities of which are at present only partially understood.

Relational victimization and proactive versus reactive relational aggression: The moderating effects of respiratory sinus arrhythmia and skin conductance

This research examined the moderating effect of the autonomic nervous system (ANS) on the associations between relational victimization and reactive and proactive relational aggression. Both branches of the ANS, the parasympathetic nervous system (indexed by respiratory sinus arrhythmia reactivity; RSA-Reactivity) and the sympathetic nervous system (indexed by skin conductance level reactivity; SCL-Reactivity), were examined. Emerging adults (N = 168) self-reported on relational victimization and proactive and reactive relational aggression; RSA-Reactivity and SCL-Reactivity were assessed in response to a laboratory stressor. Relational victimization predicted heightened reactive relational aggression given RSA augmentation/high SCL-Reactivity (i.e., coactivation) and RSA withdrawal/low SCL-Reactivity (i.e., coinhibition). In addition, relational victimization predicted heightened reactive relational aggression given RSA augmentation/low SCL-Reactivity (i.e., reciprocal parasympathetic activation). This study extends previous research on relational victimization and provides novel evidence that (a) exposure to relational victimization is associated with reactive relational aggression, but not proactive relational aggression, and (b) parasympathetic and sympathetic nervous system reactivity jointly moderate the link between relational victimization and reactive relational aggression.

Respiratory sinus arrhythmia and heart period in infancy as correlates of later oppositional defiant and callous-unemotional behaviors

Extant literature suggests that oppositional defiant (ODD) and callous-unemotional (CU) behaviors in childhood and adolescence are associated with distinct patterns of psychophysiological functioning and that individual differences in these patterns have implications for developmental pathways to disorder. Very little is known about the associations between psychophysiological functioning in infancy and later ODD and CU behaviors. This study examined associations between basal autonomic nervous system (ANS) functioning in infancy and ODD and CU behaviors in later childhood. Using longitudinal heart period (HP) and respiratory sinus arrhythmia (RSA) data from the Durham Child Health and Development Study (N = 206), the current study tested associations, within a structural equation modeling framework, between continuous measures of HP and RSA across the first two years of life and later ODD and CU behaviors at first grade. Results indicate that ODD and CU behaviors in childhood are associated with lower baseline RSA, but not HP, across infancy. The implications of these findings for developmental models of ODD and CU behaviors are discussed.