Maternal depressive symptoms, mother-child interactions, and children's executive function

[Formula: see text] Environmental predictors of children's executive functioning development

Executive functioning (EF) abilities develop through childhood, but this development can be impacted by various psychosocial environmental influences. Using longitudinal data from the Health Outcome and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort study, we examined if psychosocial environmental factors were significant predictors of EF development. Study participants comprised 271 children and their primary caregivers (98.5% mothers) followed from birth to age 12. We identified four distinct EF developmental trajectory groups comprising a consistently impaired group (13.3%), a descending impairment group (27.7%), an ascending impairment group (9.95%), and a consistently not impaired group (49.1%). Higher levels of maternal ADHD and relational frustration appear to be risk factors for increased EF difficulty over time, while higher family income may serve as a protective factor delaying predisposed EF impairment. Important intervention targets might include teaching positive and effective parenting strategies to mothers whose children are at risk for EF dysfunction.

Trajectories of maternal depressive symptoms from infancy through early childhood: The roles of perceived financial strain, social support, and intimate partner violence

Although new mothers are at risk of heightened vulnerability for depressive symptoms, there is limited understanding regarding changes in maternal depressive symptoms over the course of the postpartum and early childhood of their child's life among rural, low-income mothers from diverse racial backgrounds. This study examined distinct trajectories of depressive symptoms among rural low-income mothers during the first five years of their child's life, at 6, 15, 24, and 58 months, using data from the Family Life Project (N = 1,292). Latent class growth analysis identified four distinct trajectories of maternal depressive symptoms, including Low-decreasing (50%; n = 622), Low-increasing (26%; n = 324), Moderate-decreasing (13%; n = 156), and Moderate-increasing (11%; n = 131) trajectories. Multinomial logistic regression demonstrated that higher perceived financial strain and intimate partner violence, and lower social support predicted higher-risk trajectories (Low-increasing, Moderate-decreasing, and Moderate-increasing) relative to the Low-decreasing trajectory. Compared to the Low-decreasing trajectory, lower neighborhood safety/quietness predicted to the Low-increasing trajectory. Moreover, lower social support predicted the Moderate-increasing trajectory, the highest-risk trajectory, compared to those in Moderate-decreasing. The current analyses underscore the heterogeneity on patterns of depressive symptoms among rural, low-income mothers, and that the role of both proximal and broader contexts contributing to distinct trajectories of maternal depressive symptoms over early childhood.

Longitudinal pathways between maternal depression, parenting behaviors, and early childhood development: a mediation analysis

Maternal depression is a global public health concern with far-reaching impacts on child development, yet our understanding of mechanisms remains incomplete. This study examined whether parenting mediates the association between maternal depression and child outcomes. Participants included 841 rural Pakistani mother-child dyads (50% female). Maternal depression was measured at 12 months postpartum, parenting behaviors (warmth, stimulation, and harsh parenting) were measured at 24 months, and child outcomes (mental health, socioemotional development, and cognitive skills) were measured at 36 months. Maternal depression predicted increased harsh parenting, child mental health difficulties, and child socioemotional concerns; however, there was little evidence for parenting as a mediator between maternal depression and child outcomes. Sex-stratified results are discussed, and findings are situated in context.

Positive Parenting and Sociodemographic Factors Related to the Development of Chilean Children Born to Adolescent Mothers

The lack of economic resources has a negative effect on the maternal role of younger mothers. In Chile, the majority of adolescent pregnancies occur in socially and economically vulnerable contexts. The current study aimed to examine the relationship between demographic variables within the family context and parenting behaviors among Chilean adolescent mothers (including affection, responsiveness, encouragement, and teaching). These factors were correlated with communication, problem-solving abilities, and personal-social development in typically developing infants. The study included a sample of 79 Chilean adolescent mother-child dyads with children aged 10 to 24 months. Communication, problem-solving, and personal-social development were assessed using the Ages and Stages Questionnaire-3, along with a demographic information questionnaire. The parenting behaviors mentioned above were observed using the Spanish version of Parenting Interactions with Children: Checklist of Observations Linked to Outcomes. The findings indicated that mothers in employment and those who had not dropped out of school had children with better problem-solving skills. Additionally, children residing with their fathers and female children performed better in communication, problem-solving, and personal-social development. Maternal responsiveness was associated with communication and problem-solving, while maternal encouragement was linked to improved problem-solving skills. Maternal teaching was connected to communication, problem-solving, and personal-social development. The study emphasized the significance of parenting and sociodemographic factors among adolescent mothers and their influence on their children's development.

Teaching or learning from baby: Inducing explicit parenting goals influences caregiver intrusiveness

Caregivers' goals influence their interactions with their children. In this preregistered study, we examined whether directing parents to teach their baby versus learn from their baby influenced the extent to which they engaged in intrusive (e.g., controlling, adult-centered rather than child-centered), sensitive, warm, or cognitively stimulating caregiving behaviors. Mothers and their 6-month-old infants (N = 66; 32 female infants) from the San Francisco Bay Area participated in a 10-min "free-play" interaction, coded in 2-min epochs for degree of parental intrusiveness. Prior to the final epoch, mothers were randomly assigned to receive instructions to focus on (a) teaching something to their infant or (b) learning something from their infant. A control group of mothers received no instructions. Analyses of within-person changes in intrusive behavior from before to after receiving these instructions indicated that mothers assigned to teach their infant increased in intrusiveness whereas mothers assigned to learn from their infant and mothers in the control group did not significantly change in intrusiveness. The study provides experimental evidence that caregivers' explicit goals to teach infants result, on average, in more controlling and adult-centered caregiving behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Protocol for a randomized control trial of the Building Regulation in Dual Generations Program (BRIDGE): preventing the intergenerational transmission of mental illness in at-risk preschool children

BACKGROUND

Since the onset of the COVID-19 pandemic, the worldwide prevalence of maternal depression has risen sharply; it is now estimated that one quarter of mothers experience clinically significant depression symptoms. Exposure to maternal depression during early childhood increases the risk for the development of childhood mental illness (MI) in offspring, with altered parenting practices mediating the association between maternal depression and child outcomes. Dual-generation interventions, which aim to simultaneously treat parent and child mental health, show promise for improving outcomes for mothers with depression and their young children. The Building Regulation in Dual Generations (BRIDGE) program combines Dialectical Behavior Therapy (DBT) and parenting skills training to concurrently treat maternal depression and improve parenting practices. In pilot within-group studies, BRIDGE has led to large reductions in maternal depression and child MI symptoms. The aim of the current study is to evaluate the efficacy of BRIDGE in reducing maternal depression and child MI symptoms (primary outcomes) as well as parenting stress and harsh parenting (secondary outcomes).

METHODS

A three-armed randomized control trial with equal group sizes will be conducted to compare the efficacy of (1) BRIDGE (DBT + parenting skills), (2) DBT skills training, and (3) services-as-usual. Participants (n = 180) will be mothers of 3- to 5-year-old children who report elevated depression symptoms. Those randomized to BRIDGE or DBT skills training will complete a 16-week group therapy intervention. Assessments will be administered at pre-intervention(T1) post-intervention (T2), and 6-month follow-up (T3).

DISCUSSION

Dual-generation programs offer an innovative approach to prevent the intergenerational transmission of mental illness. The current study will add to the evidence base for BRIDGE by comparing it to a stand-alone mental health intervention and a services-as-usual group. These comparisons will provide valuable information on the relative efficacy of including parenting support in a mental health intervention for parents. The results will contribute to our understanding of how maternal depression affects children's development and how intervening at both a mental health and parenting level may affect child and family outcomes.

TRIAL REGISTRATION

Name of registry: Clinical Trials Protocol Registration and Results System; trial registration number: NCT05959538; date of registry: July 24, 2023; available: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT05959538.

Socioeconomic disadvantage and parental mood/affective problems links negative parenting and executive dysfunction in children born very preterm

Poverty increases the risk of poorer executive function (EF) in children born full-term (FT). Stressors associated with poverty, including variability in parenting behavior, may explain links between poverty and poorer EF, but this remains unclear for children born very preterm (VPT). We examine socioeconomic and parental psychosocial adversity on parenting behavior, and whether these factors independently or jointly influence EF in children born VPT. At age five years, 154 children (VPT = 88, FT = 66) completed parent-child interaction and EF tasks. Parental sensitivity, intrusiveness, cognitive stimulation, and positive and negative regard were coded with the Parent-Child Interaction Rating Scale. Socioeconomic adversity spanned maternal demographic stressors, Income-to-Needs ratio, and Area Deprivation Index. Parents completed measures of depression, anxiety, inattention/hyperactivity, parenting stress, and social-communication interaction (SCI) problems. Parental SCI problems were associated with parenting behavior in parents of children born VPT, whereas socioeconomic adversity was significant in parents of FT children. Negative parenting behaviors, but not positive parenting behaviors, were related to child EF. This association was explained by parental depression/anxiety symptoms and socioeconomic adversity. Results persisted after adjustment for parent and child IQ. Findings may inform research on dyadic interventions that embed treatment for parental mood/affective symptoms and SCI problems to improve childhood EF.

Persistent Maternal Mental Health Disorders and Toddler Neurodevelopment at 18 Months: Longitudinal Follow-up of a Low-Income South African Cohort

One of the biggest threats to early childhood development in Africa is poor maternal mental health. The present study reports on the relationships between clinical diagnoses of persistent maternal mental health disorders (at 3- and/or 6- and 18-month post-term age) and toddler neurodevelopment at 18 months of age. Eighty-three mother-toddler dyads from low socio-economic status settings in Cape Town, South Africa, were included. At the 3-, 6- and 18-month postnatal visits, clinician-administered structured diagnostic assessments were carried out according to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria. Toddler neurodevelopment at 18 months corrected age was assessed with the Bayley Scales of Infant and Toddler Development (BSID-III). No significant differences (p > 0.05) were found between toddlers with exposure to persistent mood or psychotic disorders in the different BSID-III domains compared to toddlers with no exposure. Toddlers exposed to persistent comorbid anxiety and mood disorders scored significantly higher on the cognitive (p = 0.049), motor (p = 0.013) and language (p = 0.041) domains and attained significantly higher fine motor (p = 0.043) and gross motor (p = 0.041) scaled scores compared to toddlers with no maternal mental health disorder exposure. Future investigations should focus on the role of protective factors to explain the pathways through which maternal mental health status is associated with positive toddler neurodevelopmental outcomes.

Setting the stage: Biopsychosocial predictors of early childhood externalizing behaviors

Research has indicated that biological (self-regulation), psychological (temperament), and social (maternal parenting behaviors) factors predict childhood externalizing behaviors. Few studies, however, have evaluated psychological, biological, and social factors in conjunction as predictors of childhood externalizing behaviors. Further, limited research has examined whether these biopsychosocial predictors during infancy and toddlerhood predict the onset of externalizing behaviors in early childhood. The present study aimed to examine the longitudinal relations between biopsychosocial predictors of child externalizing behaviors. Children and their mothers (n = 410) participated when children were 5, 24, and 36 months old. Child self-regulation was assessed via baseline respiratory sinus arrhythmia (RSA) at age 5 months, and child psychology was measured via maternal report of effortful control at age 24 months. Additionally, maternal intrusiveness was assessed during a mother-child interaction at age 5 months. At 36 months, mothers reported on child externalizing behaviors. Longitudinal path modeling was used to examine the direct and indirect effects of maternal intrusiveness and child effortful control on child externalizing behavior, as well as whether these effects were conditional upon child baseline RSA. Results showed a significant indirect effect of maternal intrusiveness on externalizing behavior through effortful control, and this pathway was moderated by baseline RSA after controlling for orienting regulation at age 5 months. These results suggest that early childhood externalizing behaviors are jointly affected by biological, psychological, and social factors during toddlerhood.

Maternal perinatal depression and child neurocognitive development: A relationship still to be clarified

Pregnancy frequently is associated with emotional conditions such as anxiety and depression. Perinatal depression has an incidence of around 12%. Only recently researcher put the attention on the effects of pre- and postpartum psychopathology on infant neurocognitive development. Neurobiology studies indicate that perinatal maternal depression can significantly affect the structure and function of children's prefrontal cortex and modulate the development of cognitive abilities from intrauterine life. On the topic, the scientific literature appears ambiguous, reporting mixed results. Some studies have found no significant differences in developmental outcomes between prenatal and postpartum exposure to maternal depression, others have suggested a greater burden of depression in pregnancy than in postpartum, and still others have emphasized the role of chronicity of symptoms rather than the period of onset. Few studies have examined the effects of different developmental trajectories of maternal depression on children's neurocognitive outcomes. The assessment of maternal health has for years been limited to postpartum depression often neglecting the timing of onset, the intensity of symptoms and their chronicity. These aspects have received less attention than they deserve, especially in relation to the effects on children's neurocognitive development. The aim of this Perspective was to highlight inconsistencies and gaps that need to be filled in the approach to the study of this problem. Given the wide heterogeneity of data in the current literature, further studies are needed to clarify these interactions. This Perspective provides an overview of current progress, future directions, and a presentation of the authors' views on the topic.

Profiles of early family environments and the growth of executive function: Maternal sensitivity as a protective factor

We identified family risk profiles at 6 months using socioeconomic status (SES) and maternal mental health indicators with data from the Family Life Project (N = 1,292). We related profiles to executive function (EF) at 36 months (intercept) and growth in EF between 36 and 60 months. Latent profile analysis revealed five distinct profiles, characterized by different combinations of SES and maternal mental health symptoms. Maternal sensitivity predicted faster growth in EF among children in the profile characterized by deep poverty and the absence of maternal mental health symptoms. Maternal sensitivity also predicted higher EF intercept but slower EF growth among children in the profile characterized by deep poverty and maternal mental health symptoms, and children in the near poor (low SES), mentally healthy profile. Maternal sensitivity also predicted higher EF intercept but had no effect on growth in EF in the near poor, mentally distressed profile. In contrast, maternal sensitivity did not predict the intercept or growth of EF in the privileged SES/mentally healthy profile. Our findings using a person-centered approach provide a more nuanced understanding of the role of maternal sensitivity in the growth of EF, such that maternal sensitivity may differentially affect the growth of EF in various contexts.

Exploring proximal mechanisms behind intergenerational association between maternal childhood abuse and Chinese preschool children's executive function

BACKGROUND

Maternal personal history of childhood abuse has been found to predict child social-emotional problems; however, little is known about the intergenerational associations between maternal childhood abuse and child cognitive outcomes.

OBJECTIVE

This study aims at examining the intergenerational associations of maternal childhood emotional abuse and physical abuse with child executive functions among Chinese families with preschoolers, and exploring how these associations are mediated by maternal perspective-taking skills and mother-child conflict.

METHODS

Participants were 309 preschoolers (152 boys) aged 2-6 years and their mothers. Mothers reported on their childhood abuse histories, perspective taking, and mother-child conflict at baseline (T1). Five months later (T2), child executive functions including working memory, inhibitory control, and cognitive flexibility were assessed using five computerized tasks.

RESULTS

After controlling for child gender and age, associations with child executive functions were found for maternal childhood emotional abuse, but not physical abuse. Specifically, severer childhood emotional abuse directly predicted lower levels of child cognitive flexibility. Furthermore, chained mediation paths were found from maternal childhood emotional abuse to lower levels of child working memory and inhibitory control through worse maternal perspective taking skills and then more mother-child conflicts.

CONCLUSIONS

Our findings provide evidence for less optimal executive functions among preschoolers with emotionally abused mothers. Developing strategies to resolve the long-lasting impacts of maternal childhood emotional abuse may be important for reducing the risks of being unable to fully achieve the cognitive potentials of the next generation.

The Role of Family Function and Triadic Interaction on Preterm Child Development-A Systematic Review

Preterm infants are at high risk of developmental disability/delay and are more dependent on their caregiving environment for regulation due to their neurological immaturity. A premature birth is also a major stressor to the family system that constitutes the infant's caregiving environment. The following systematic review investigates whether families with preterm children differ from families with full-term children in their interactions, and what impact the quality of family interaction has on child development. Using the Cochrane model, we conducted a systematic review of quantitative studies published in psycINFO, socINDEX, and PubMed, concerning family quality in triadic interactions in families with premature infants and children, and at least one child development outcome variable. The quality of these studies was assessed using the Newcastle-Ottawa scale assessment form for cohort studies (NOS). Eleven studies were included in the review. Quality of family interactions is either equal to or poorer in families with preterm children, compared with families with full-term children. Importantly, the link between quality of family interactions and child development outcome is stronger in preterm children compared with full-term children, regarding both positive and negative influence. Our results highlight the importance of strengthening family interactions in order to promote development in preterm children. Notably, this review provides the first systematic overview of family function and the quality of triadic interactions in preterm families. The limited number of studies with a family-system focus makes it difficult for us to draw any definitive conclusions, while underscoring the need for more observational studies, particularly post-infancy, to be able to identify specific aspects of family interactions that may be critical for preterm child development.

Maternal mental health and infant neurodevelopment at 6 months in a low-income South African cohort

Maternal mental health disorders and the adverse consequences for infant neurodevelopment have received substantial research attention in high-income countries over the past five decades. In Africa, where relatively little work has been done on this topic, researchers have largely focused on infant physical health outcomes. This longitudinal study investigated the neurodevelopment of infants at 6 months post-term with exposure to mothers with a clinical diagnosis of persistent mental health disorders residing in low-income communities in Cape Town, South Africa. Adjusted models revealed no significant differences on the Bayley Scales of Infant and Toddler Development (BSID-III) domains (cognitive, motor, language, socio-emotional, and adaptive behavior) between infants exposed to maternal mental health disorders (n = 62) and the comparison group (n = 35) at 3 and 6 months. Subgroup analyses found no significant differences on the BSID-III domains between infants with exposure to mood disorders (n = 31), as well as infants with exposure to comorbid (i.e., a combination of two or three) mental health disorders (n = 14) and the comparison group. However, infants with exposure to psychotic disorders (n = 14) scored significantly lower on the cognitive and the motor domains and the fine motor subscale. These novel data provide an important contribution to the scientific literature especially in the field of maternal psychotic disorders in Africa.

Association between maternal psychological factors and offspring executive function: analysis of African-American mother-child dyads

BACKGROUND

Executive function (EF) develops throughout childhood and adolescence; however, little is known about whether and how early life factors are associated with EF during these two stages. This secondary analysis examined the associations between maternal psychological characteristics at 2 years after childbirth and offspring EF at 6 and 18 years.

METHODS

Data were from the 18-year New Mothers' Study in Memphis, TN. Women who self-identified as African-American were included (mother-child dyads: N = 414). Maternal psychological characteristics (e.g., depressive symptoms, self-esteem) were assessed using standardized questionnaires; offspring EF at 6 (i.e., working memory, response inhibition) and 18 years (e.g., working memory, sustained attention) were assessed using age-appropriate cognitive tasks. Statistical analyses included principal component analysis (PCA) and regression models.

RESULTS

PCA reduced the correlated psychological characteristics to two factors: emotionality (depressive symptoms, emotional instability) and psychological resources (self-esteem, mastery, active coping). After controlling for maternal IQ, maternal emotionality was associated with worse working memory and response inhibition (marginally significant) at 6 years. Maternal psychological resources were marginally associated with better working memory at 6 years.

CONCLUSIONS

Maternal psychological characteristics may be associated with later EF in offspring. Future studies are needed to replicate these findings and to explore potential mediators.

IMPACT

African-American mothers' depressive symptoms and emotional instability at 2 years after childbirth were associated with offspring executive function at 6 and 18 years. African-American mothers' psychological resources at 2 years after childbirth were marginally associated with offspring working memory at 6 years. Maternal IQ attenuated all of the associations observed between maternal psychological status and offspring executive function.

Preschoolers' Intimate Partner Violence Exposure and Their Speeded Control Abilities Eight Years Later: A Longitudinal Mediation Analysis

Executive functioning (EF), or a set of related cognitive skills that facilitate goal-oriented behavior, is a critical aspect of adaptive development. Mounting research indicates that exposure to environmental threats during the preschool years jeopardizes EF; however, the extent and mechanisms through which early exposure to intimate partner violence (IPV) influences children's EF are unknown. Using data from an eight-year longitudinal investigation of mothers who had experienced IPV and their preschool-aged children (N = 120), this study examined the relative influence of recent and remote IPV exposure on speeded control-a component of EF influenced by processing speed-in late childhood. Results indicated that preschoolers' IPV exposure had a significant negative impact on their speeded control eight years later, and this relation was mediated by the remote effects of IPV on their mothers. Specifically, IPV was positively associated with maternal depression, which in turn contributed to greater use of negative parenting strategies when children were of preschool age. Children's IPV exposure during late childhood was not predictive of their concurrent speeded control. These findings lend further evidence to the notion that the preschool years are a sensitive period for the mastery of EF skills and that IPV exposure is a distinct risk factor that can have protracted effects on children's cognitive development. Further, this study points to modifiable environmental risk factors, which, through targeted prevention and intervention efforts, could promote EF across the lifespan.

Maternal sensitivity at the age of 8 months associates with local connectivity of the medial prefrontal cortex in children at 5 years of age

The quality of mother–child interaction, especially maternal sensitivity in caregiving behavior, plays an important role in a child’s later socioemotional development. Numerous studies have indicated associations between poor mother–child interaction and offspring brain structure and function, but more knowledge on how variation in the characteristics of early caregiving is associated with children’s brain structure and function is needed. We investigated whether maternal sensitivity at 8 or 30 months is associated with functional connectivity in a child’s brain at 5 years of age based on the FinnBrain Birth Cohort Study (17 and 39 mother–child dyads at 8 and 30 months, respectively, with an overlap of 13 dyads). Maternal sensitivity was assessed during a free play interaction using the Emotional Availability Scales at 8 and 30 months of the children’s age. Task-free functional magnetic resonance imaging (fMRI) was acquired at the age of 5 years in 7-min scans while watching the Inscapes movie. Regional homogeneity (ReHo) maps were created from the fMRI data, and multiple regression analysis was performed to assess the relation between maternal sensitivity and ReHo. Maternal sensitivity at the age of 8 months was positively associated with children’s ReHo values within the medial prefrontal cortex. Distal connectivity of this region showed no significant association with maternal sensitivity in a seed-based connectivity analysis. No associations were found between maternal sensitivity during toddlerhood and brain functional connectivity. Together, these results suggest that maternal sensitivity, especially in infancy, may influence offspring brain functional connectivity. However, studies with larger sample sizes are warranted.

Neural correlates of inhibitory control and associations with cognitive outcomes in Bangladeshi children exposed to early adversities

There is strong support for the view that children growing up in low-income homes typically evince poorer performance on tests of inhibitory control compared to those growing up in higher income homes. Unfortunately, the vast majority of the work documenting this association has been conducted in high-income countries. It is not yet known whether the mechanisms found to mediate this association would generalize to children in low- and middle-income countries, where the risks of exposure to extreme poverty and a wide range of both biological and psychosocial hazards may be greater. We examined relations among early adversity, neural correlates of inhibitory control, and cognitive outcomes in 154 5-year-old children living in Dhaka, Bangladesh, an area with a high prevalence of poverty. Participants completed a go/no-go task assessing inhibitory control and their behavioral and event-related potential responses were assessed. Cortical source analysis was performed. We collected measures of poverty, malnutrition, maternal mental health, psychosocial adversity, and cognitive skills. Supporting studies in high-income countries, children in this sample exhibited a longer N2 latency and higher P3 amplitude to the no-go versus go condition. Unexpectedly, children had a more pronounced N2 amplitude during go trials than no-go trials. The N2 latency was related to their behavioral accuracy on the go/no-go task. The P3 mean amplitude, behavioral accuracy, and reaction time during the task were all associated with intelligence-quotient (IQ) scores. Children who experienced higher levels of psychosocial adversity had lower accuracy on the task and lower IQ scores.

Preserved executive functioning and low stress symptoms in children treated for acute lymphoblastic leukemia

Pediatric cancer treatment can negatively impact cognitive and psychosocial development, although it has been suggested that these adverse effects may be minimized when children have higher resilience and better executive functioning. We aimed to evaluate the impact of pediatric Acute Lymphoblastic Leukemia (ALL) treatment on executive function, resilience and stress in survivors and to investigate correlations between executive functioning and resilience and between executive functioning and stress. The neuropsychological assessment was performed in 32 ALL survivors aged 7-17 years and 28 age-, sex- and socioeconomic status matched controls. Executive functioning was assessed by inhibitory control, mental flexibility and working memory tasks. Children's self-report scales were used to assess stress symptoms and resilience. Results revealed no executive function impairment nor stress symptom differences between ALL survivors and control group. In the ALL group, executive function and resilience were positively correlated, whereas executive function and stress were negatively correlated. We concluded that ALL treatment was not associated with impairment in executive functioning nor to increased stress symptoms in our sample. ALL survivors with better performance in mental flexibility and inhibition tasks reported fewer stress symptoms and more resilience, indicating a possible relationship between these variables.

Frequent occurrence of respiratory symptoms in children is associated with exposure to air pollution, land use types, and parental mental health in the Greater Taipei area

Although studies have investigated the individual effects of air pollution, land use types, and parental mental health on children's respiratory health, few studies have examined the effects of these risk factors simultaneously in children aged <2 years. We investigated the effects of exposure to air pollution, land use types surrounding residences, and parental mental health on the frequent occurrence of respiratory symptoms in children aged <2 years in the Greater Taipei area. Participants were recruited from an ongoing Taiwanese birth cohort study. We analyzed the data of the participants who had been recruited from January 2011 to April 2014 and had responded to the follow-up questionnaires at 6, 12, and 24 months. Self-administered questionnaires were used to collect participants' sociodemographic background and health, such as respiratory symptoms, and parental mental health. Pre- and postnatal pollution levels were estimated using the spatial interpolation technique (ordinary kriging) at children's residential addresses. Land use types surrounding participants' homes were evaluated by performing buffer analysis. Multiple logistic regression analyses were conducted to examine the effects of risk factors on the frequent occurrence of child respiratory symptoms in children aged 6, 12, and 24 months. We included 228, 360, and 441 children aged 6, 12, and 24 months, respectively. Our results indicated that postnatal exposure to PM_2.5 and O₃ was positively associated with children's respiratory symptoms. Traffic-related land-use types, sports facilities, and commercial land surrounding homes exerted adverse effects on children's respiratory symptoms, whereas the presence of schools in the neighborhood was beneficial. Parental mental health was also associated with children's respiratory symptoms. Postnatal exposure to air pollution and land use types surrounding residences were associated with respiratory health in children aged <2 years. The residential environment is a critical factor affecting children's respiratory health of children aged <2 years.

Maternal depressive symptoms and maternal child-directed speech: A systematic review

BACKGROUND

Up to 1 in 5 children are exposed to maternal depressive symptoms. Children exposed to maternal depressive symptoms have poorer language skills than children not exposed to maternal depressive symptoms. Due to the crucial role of children's language skills in school readiness and academic achievement, it is imperative to understand the factors that underlie the relation between maternal depressive symptoms and children's language skills. Previous reviews have examined the mechanistic role of social-pragmatic features of mother-child interactions. However, the literature on the relation between maternal depressive symptoms and data-providing aspects of mother-child interactions, including child-directed speech, has yet to be consolidated. In this systematic review, we present maternal child-directed speech as a potential pathway through which maternal depressive symptoms influence children's language skills.

METHODS

Following PRISMA guidelines, three database searches produced 546 articles related to maternal depressive symptoms, child-directed speech, and children's language skills, ten of which examined the relation between maternal depressive symptoms and child-directed speech.

RESULTS

Findings revealed that increases in maternal depressive symptoms may be associated with decreases in amount of child-directed speech but not necessarily with decreases in the complexity of child-directed speech.

LIMITATIONS

The studies in this review varied in sample size, the inclusion of important sociodemographic factors, and the operationalization of depression and child-directed speech, thereby limiting conclusions, especially about whether maternal depressive symptoms are associated with the complexity of child-directed speech.

CONCLUSIONS

This review has implications for prevention and intervention efforts aimed at optimizing children's language skills; child-directed speech is modifiable, and mothers experiencing depressive symptoms may benefit from resources encouraging rich child-directed speech.

Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy

INTRODUCTION

Perinatal depression (PD) is a cluster of clinical depressive symptoms occurring globally during pregnancy or after childbirth, with a prevalence of 11.9%. Risk factors for PD among pregnant women may include personality traits of neuroticism, low personal resilience, higher anxiety, avoidance in close relationships, as well as dysfunctional coping strategies.

METHODS

We report on descriptive findings of a screening/prevention program aimed to detect depressive symptoms and associated risk factors in a large sample of women (N = 1,664) accessing the gynecological departments of the Regione Puglia (South of Italy) from July to November 2020. Pregnant women were assessed in their third trimester of pregnancy (T0), after childbirth (T1), and those at risk for PD within 1 year from delivery (T2-T4); The Edinburgh Postnatal Depression Scale (EPDS) has been employed for the screening of PD over time as well as other standardized measures for neuroticism, resilience, coping strategies, and quality of life.

RESULTS

Of 1,664, n = 1,541 were tested at T1, and 131 scored ≥ 12 at EPDS (14.6 ± 2.95), showing a higher risk for PD. They were followed over time at 1, 6, and 12 months after childbirth (T2-T4), and 15 of them scored ≥ 12 (EPDS) at T4. Women with a higher risk of PD also reported higher levels of neuroticism, lower levels of personal resilience, more anxiety and avoidance in close relationships, higher employment of dysfunctional coping strategies (e.g., denial, self-blame, etc.), and lower quality of life (0.0008 < all p < 0.0001).

CONCLUSION

This study confirmed the benefit of screening programs for the early detection of PD among pregnant women. We may suggest a set of risk factors to be considered in the clinical assessment of PD risk as well as the promotion of similar programs to improve depressive outcomes and pathways to care for PD on the basis of a more accurate assessment and referral.

The Impact of Maternal Depression and Parent-Child Interactions on Risk of Parasitic Infections in Early Childhood: A Prospective Cohort in Benin

Objectives

Maternal depression occurs in 13–20% of women from low-income countries, which is associated with negative child health outcomes, including diarrheal disease. However, few studies have investigated its impact on child risk of infectious disease. We studied the impacts of maternal depressive symptoms and parent–child interactions, independently, on the risk of Plasmodium falciparum malaria and soil-transmitted helminth infection in Beninese children.

Methods

Our population included mothers and children enrolled in a clinical trial during pregnancy (MiPPAD) in Benin. The Edinburgh Postnatal Depression Scale (EPDS) assessed maternal depressive symptoms and the home observation measurement of the environment (HOME) assessed parent–child interactions. Blood and stool sample analyses diagnosed child malaria and helminth infection at 12, 18, and 24 months. Negative binomial and Poisson regression models with robust variance tested associations.

Results

Of the 302 mother–child pairs, 39 (12.9%) mothers had depressive symptoms. Median number of malaria episodes per child was 3 (0–14) and 29.1% children had at least one helminth infection. Higher EPDS scores were associated with lower HOME scores; relative risk (RR) 0.97 (95% confidence interval (CI) 0.95, 0.99), particularly with lower acceptance, involvement, and variety subscales; RR 0.92 (95% CI 0.85, 0.99), RR 0.82 (95% CI 0.77, 0.88), RR 0.93 (95% CI 0.88, 0.99), respectively. However, neither exposure was associated with risk of parasitic infection in children.

Conclusions for Practice

Maternal depressive symptoms are associated with poor parent–child interactions, particularly acceptance of behavior, involvement with children, and variety of interactions, but these exposures do not independently impact risk of parasitic infection in children.

Longitudinal Dyadic Interdependence in Depression Symptoms of Caregivers Living with HIV in Uganda and Their Dependent Children's Neurodevelopment and Executive Behavior Outcomes

We tested a model of dyadic interdependence in depression symptoms experienced by female caregivers living with HIV in Uganda (n = 288) and behavioral problems of their HIV-infected (n = 92) and perinatally HIV-exposed uninfected (HEU) children (n = 196). Three repeated measures of caregiver depression symptoms and child neurodevelopment and behavioral outcomes were related to their own outcomes at a previous time point (actor effects), and the outcomes of the other member of the dyad (partner effects). Caregiver depression and child behavioral problem were interdependent over the 24 months of observation. Caregiver depression at T_n predicted child's behavioral problems at T_n+1 (coefficient = 0.1220, SE = 0.0313, p < 0.01); child behavioral problems at T_n predicted maternal depression at T_n+1 (coefficient = 0.0984, SE = 0.0253, p < 0.01). Results suggest the importance of services addressing behavioral needs of affected children and mental health of their mothers.

Effects of household chaos and parental responsiveness on child executive functions: a novel, multi-method approach

Background

Executive functions can be adversely affected by contextual risks in the home environment including chaos and parenting challenges. Furthermore, household chaos negatively influences parenting practices. Few studies, however, have examined the role of parenting in the association between household chaos and child executive functions.

Methods

Using a sample of 128 school-aged children (mean = 61.9 months, SD = 2.0, range 58–68 months) and their mothers, the present study examined direct and indirect effects (via parental responsiveness) of household chaos on child executive functioning. Multi-measures were used including performance-based assessments, behavioural observations, questionnaires, and video-home tours.

Results

Household chaos had both a direct effect on child executive functions (β = − .31, 95% CI [− .58, − .04]) and an indirect effect (β = − .05, 95% [− .13, − .01]) via parental responsiveness. Further, the indirect effect was only significant for household instability.

Conclusion

These findings indicate that parental responsiveness may be compromised by household chaos, with implications for the executive functions of school-aged children. Preventative strategies are needed to improve the stability in the home and strengthen parenting practices.

Differential At-Risk Pediatric Outcomes of Parental Sensitivity Based on Hearing Status

Purpose The aim of this study was to investigate the role of parental sensitivity in language and neurocognitive outcomes in children who are deaf and/or hard of hearing (DHH). Method Sixty-two parent-child dyads of children with normal hearing (NH) and 64 of children who are DHH (3-8 years) completed parent and child measures of inhibitory control/executive functioning and child measures of sentence comprehension and vocabulary. The dyads also participated in a video-recorded, free-play interaction that was coded for parental sensitivity. Results There was no evidence of associations between parental sensitivity and inhibitory control or receptive language in children with NH. In contrast, parental sensitivity was related to children's inhibitory control and all language measures in children who are DHH. Moreover, inhibitory control significantly mediated the association between parental sensitivity and child language on the Clinical Evaluation of Language Fundamentals-Fifth Edition Following Directions subscale (6-8 years)/Clinical Evaluation of Language Fundamentals Preschool-Second Edition Concepts and Following Directions subscale (3-5 years). Follow-up analyses comparing subgroups of children who used hearing aids (n = 29) or cochlear implants (CIs; n = 35) revealed similar correlational trends, with the exception that parental sensitivity showed little relation to inhibitory control in the group of CI users. Conclusions Parental sensitivity is associated with at-risk language outcomes and disturbances in inhibitory control in young children who are DHH. Compared to children with NH, children who are DHH may be more sensitive to parental behaviors and their effects on emerging inhibitory control and spoken language. Specifically, inhibitory control, when scaffolded by positive parental behaviors, may be critically important for robust language development in children who are DHH.

Maternal perinatal depression and child executive function: A systematic review and meta-analysis

BACKGROUND

Maternal depression during the perinatal period predicts adverse developmental outcomes for children, via poorly understood mechanisms. One plausible pathway may involve child executive function, a suite of cognitive capacities associated with social, emotional and educational outcomes. Systematic review and meta-analysis are applied to evaluate evidence of association between maternal perinatal depression and child executive function.

METHODS

Medline, Embase, PubMed, PsycInfo, and SCOPUS were searched for relevant articles to August 2020, with hand-search of relevant bibliographies. Original research published in English measuring maternal depressive symptoms during pregnancy and the first year postpartum, and child executive function outcomes at any age was included. 27 studies met criteria for review. 16 studies reporting raw data of the association between depressive symptoms and executive function were used for meta-analysis.

RESULTS

Our systematic review identified inadequate assessment of maternal depression, and unreliable measures of executive function in many studies. Assessment of confounders was also inconsistent. Our meta-analysis identified a small, statistically significant relationship between perinatal depression and child executive function (effect size r = 0.07; 95% CI 0.03-0.10); equivalent to Cohen's d = 0.14.

LIMITATIONS

Variable quality of available studies leads to cautious interpretation of results.

CONCLUSIONS

This meta-analysis is consistent with the hypothesis that maternal perinatal depression does have an impact on executive function in offspring. Future studies must use robust measurement of depression and executive function, and account for the chronicity of maternal depression, and developmental context to produce meaningful results.

A systematic review of the association between perinatal depression and cognitive development in infancy in low and middle-income countries

The association between perinatal depression and infant cognitive development has been well documented in research based in high-income contexts, but the literature regarding the same relationship in low and middle-income countries (LMICs) is less developed. The aim of this study is to systematically review what is known in this area in order to inform priorities for early intervention and future research in LMICs. The review protocol was pre-registered on Prospero (CRD42018108589) and relevant electronic databases were searched using a consistent set of keywords and 1473 articles were screened against the eligibility criteria. Sixteen articles were included in the review, seven focusing on the antenatal period, eight on the postnatal period, and one which included both. Five out of eight studies found a significant association between antenatal depression (d = .21-.93) and infant cognitive development, while four out of nine studies found a significant association with postnatal depression (d = .17-.47). Although the evidence suggests that LMICs should prioritise antenatal mental health care, many of the studies did not adequately isolate the effects of depression in each period. Furthermore, very few studies explored more complex interactions that may exist between perinatal depression and other relevant factors. More high-quality studies are needed in LMIC settings, driven by current theory, that test main effects and examine moderating or mediating pathways to cognitive development.

Effects of mother–child interaction on school adaptation of children according to maternal depression

Objective

Factors influencing school adaptation of school-aged children include both executive function (EF) and parent–child interaction. This study aims to investigate the developmental trajectory of mother–child interaction longitudinally using latent growth model analysis.

Methods

A longitudinal descriptive survey study was conducted. The participants comprised of 1,614 mothers and school-aged children, who participated in the Panel Study on Korean Children (6th–8th panel surveys). A model was designed and analyzed using latent growth modeling to estimate the pattern of change over time.

Results

In the group where the maternal depression was within the normal range, only the path by which the change rate of mother–child interaction affected school adaptation of children was statistically nonsignificant (t = 1.007, p = 0.314). In the group where maternal depression was mild or higher, only the paths by which the initial value of mother–child interaction affected EF difficulty (t = −2.75, p = 0.032) and EF difficulty affected school adaptation (t = −7.876, p < 0.001) were statistically significant.

Conclusions

This study confirms the research models developed by dividing mother–child interaction into two groups according to depression levels (i.e., normal range and mild or higher-level depression). The findings provide a basis for construction of individualized interventions.

Longitudinal Links Between Media Use and Focused Attention Through Toddlerhood: A Cumulative Risk Approach

Previous studies that examined the links between media use and children's attention abilities have yielded inconclusive findings. In the current study, we aimed to move beyond the focus on isolated aspects of media use to a comprehensive assessment of both direct and indirect media use and practices in early childhood. Drawing from the cumulative risk literature, we examined whether cumulative media use is related to children's subsequent attention abilities. Participants were 199 mothers of toddlers (60% male) who completed questionnaires assessing various aspects of children's media use, as well as children's focused attention abilities at three time points: 18 months (T1), 22 months (T2), and 26 months (T3) of age. Cumulative media use scores were computed based on four indicators: (1) child average daily screen time; (2) household background television; (3) maternal use of media to regulate child distress; and (4) maternal use of mobile devices while spending time with the child. An autoregressive cross-lagged (ARCL) path model controlling for child sex, maternal education, and general parenting practices showed that cumulative media use at 18 months negatively predicted children's focused attention at 22 months. Moreover, there was a significant negative indirect effect from cumulative media use at 18 months to focused attention at 26 months via focused attention at 22 months. Finally, the cumulative media index appeared to be a better predictor of focused attention than any of the singular media use indicators. Children's focused attention did not predict subsequent cumulative media use across time, providing no evidence for bidirectional links. Findings suggest that exposure to multiple (rather than single) aspects of media use is related to decreased subsequent focused attention abilities during toddlerhood. Family media plans that designate media-free time and increase parental awareness to media use habits in the household should therefore be encouraged.

Maternal depression trajectories and child executive function over 9 years

BACKGROUND

The present study aimed to assess the relationship between maternal depression trajectories from pregnancy to 2 years after childbirth and childhood behavioral problems and executive function at 9 years.

METHODS

Data of mother-child pairs (N = 1191) extracted from the Panel Study on Korean Children (a cohort study) were used. Maternal depression was assessed using the Kessler depression scale during pregnancy and at 6 months, 1 years, and 2 years postpartum. At ages 4, 5, 6, 7, and 9 years, the children's behavioral outcomes were assessed using the Child Behavior Checklist. The children's executive function was assessed using the Executive Function Difficulty Screening Questionnaire at ages 7, 8, and 9 years. We performed a latent profile analysis to identify maternal depression trajectories and compared the children's behavioral problems and executive function among different trajectories.

RESULTS

According to maternal depression trajectory, the mother-child pairs were divided into the no symptom (n = 503), mild symptom (n = 558), and moderate symptom (n = 130) groups. Children of mothers with significant depressive symptoms had severe behavioral problems at ages 4, 5, 6, 7, and 9 years. Moreover, compared with children whose mothers were not depressed, those whose mothers had mild or moderate symptoms had impaired executive function at ages 7, 8, and 9 years.

CONCLUSIONS

Maternal depression up to 2 years after childbirth affects childhood behavior and executive function into middle childhood.

Adverse Childhood Experiences and Executive Function Difficulties in Children: A Systematic Review

BACKGROUND

The relationship between adverse childhood experiences (ACEs) and detrimental mental health outcomes has been increasingly explored within scientific literature since the original ACE study was published by Felitti et al. (1998). Given that deficits in executive functions (EF) are prominent in most forms of psychopathology across the lifespan, there is utility in considering how ACEs relate to EF outcomes.

OBJECTIVE

To consolidate the research to date on the relationship between ACEs and EF outcomes among child samples.

METHODS

A systematic review was conducted that included 16 scientific databases and 17 grey literatures.

RESULTS

Across 36 studies, many examined EF related to forms of maltreatment (e.g. abuse, neglect, and exposure to intimate partner violence) and found a strong relationship between maltreatment and EF deficits among children. Similarly, family member mental illness (maternal depression in particular) was associated with poor EF outcomes. The relationship between other ACEs and EF outcomes have not been uniquely examined, including intimate partner violence and family member incarceration.

CONCLUSIONS

This review acts as a preliminary step towards broader understanding of outcomes related to early childhood experiences through the consideration of EFs. Through documentation of such relationships, it is possible to consider how prevention and treatment approaches may be improved.

Sad Dads and Troubled Tots: Protective Factors Related to the Stability of Paternal Depression and Early Childhood Internalizing Problems

The present study tested the moderating role of interparental relationship quality and child inhibitory control on the stability of paternal depression over time and associations between paternal depression and child internalizing problems in early childhood. Participants were a subsample (n = 166) of families from the Early Steps Multisite study, a longitudinal study of low-income parents and children. Interparental relationship quality (age 2) attenuated the association between paternal depressive symptoms at age 2 and paternal depressive symptoms at age 3. Both interparental relationship quality (age 3) and child inhibitory control (age 3) attenuated the association between paternal depressive symptoms (age 3) and age 4 child internalizing problems. Results suggest that high interparental relationship quality may be a protective factor in terms of lessening the stability of paternal depressive symptoms over time, as well as the association between paternal depression and later child internalizing problems. Similarly, high levels of inhibitory control may buffer children from the negative effects of paternal depression on the development of internalizing problems.

The Mediating Effect of Self-Regulation in the Association Between Poverty and Child Weight: A Systematic Review

Deficits in self-regulation (SR) have been proposed as a potential contributor to child overweight/obesity, a public health concern that disproportionately affects children living in poverty. Although poverty is known to influence SR, SR has not been considered as a potential mechanism in the association between poverty and child obesity. The aim of the current paper was to systematically review the current literature to determine whether SR is a viable mechanism in the relationship between child exposure to poverty and later risk of overweight/obesity. We systematically review and summarize literature in three related areas with the aim of generating a developmentally informed model that accounts for the consistent association between poverty and child weight, specifically how: (1) poverty relates to child weight, (2) poverty relates to child SR, and (3) SR is associated with weight. To quantify the strength of associations for each pathway, effect sizes were collected and aggregated. Findings from the studies included suggest small but potentially meaningful associations between poverty and child SR and between SR and child weight. The conceptualization and measurement of SR, however, varied across literature studies and made it difficult to determine whether SR can feasibly connect poverty to child obesity. Although SR may be a promising potential target for obesity intervention for low-income children, additional research on how SR affects risk of obesity is crucial, especially based on the lack of success of the limited number of SR-promoting interventions for improving children's weight outcomes.

Down syndrome and parental depression: A double hit on early expressive language development

BACKGROUND AND AIMS

Down syndrome (DS) is often characterised by intellectual disability with particular difficulties in expressive language. However, large individual differences exist in expressive language across development in DS. In the general population, one of the factors associated with variability in this domain is parental depression. We investigated whether this is also the case in young children with DS.

METHODS

Thirty-eight children with DS between 8 and 48 months of age participated in this study. Their parents reported on the children's receptive and expressive vocabularies (MacArthur-Bates Communicative Development Inventory) and on parental depression. Furthermore, an experimenter-led standardized developmental assessment (Mullen Scales of Early Learning) was administered to the children to test five domains: gross motor, fine motor, visual reception, receptive language, and expressive language.

RESULTS

A cross-sectional developmental trajectories analysis demonstrated that expressive language developed at a slower rate in children with DS whose parent reported depression than in those whose parent did not. No differences between groups were found in any other domain.

CONCLUSION

Parental depression is associated with slower rate of expressive language development in young children with DS. These findings suggest that DS and parental depression may constitute a double hit leading to increased difficulties in the development of expressive language.

Maternal depressive symptoms and children's cognitive development: Does early childcare and child's sex matter?

BACKGROUND

Maternal depressive symptoms (MDS) have been associated with poorer child cognitive development. Some studies have shown that childcare attendance moderates associations between MDS and child behavior problems, but we do not know if this is the case for children's cognitive development. Furthermore, few studies have evaluated whether associations between MDS and child cognitive development differ for boys and girls at school entry.

METHODS

This study used data from a population-based cohort study (n = 1364) comprising well-validated measures of children's cognitive development including academic readiness and language development in kindergarten and reading and mathematics achievement in first grade. Information on MDS was collected repeatedly from the child's age of 5 months to 5 years and on childcare from 5 months to 4.5 years. Moderation analyses were conducted to evaluate the differential associations of MDS with children's outcomes depending on the type of childcare attended and the child's sex.

RESULTS

Childcare type or child's sex did not moderate associations between MDS and children's cognitive outcomes except for MDS being associated with lower scores on reading achievement in first grade for girls with a very small effect size (sr2 = .003). Childcare attendance was associated with higher scores for children's cognitive development, however these associations disappeared after adjusting for covariates including child, mother and family characteristics. Regardless of MDS and childcare type, boys had, even after adjusting for covariates, lower scores on academic readiness (sr2 = .029) and higher scores on mathematics achievement (sr2 = .004).

CONCLUSIONS

Children's cognitive development at school entry was more strongly associated with maternal education, children's age in kindergarten and number of months of schooling in first grade than MDS. Contrary to associations between MDS and child behavior problems, childcare attendance did not moderate associations between MDS and children's cognitive development at school entry.

Association between caregiver depression symptoms and child executive functioning. Results from an observational study carried out in four sub-Saharan countries

Depressive symptoms among HIV-positive (HIV+) women may negatively impact their health and possibly that of their young children through risk of compromised caregiving. We evaluated how depression symptoms in predominantly (97%) female caregivers relate to neurodevelopmental outcomes in their HIV affected children. Data come from the IMPAACT P1104s Study, an observational cohort across six sites in four countries: Zimbabwe, South Africa, Uganda and Malawi. Participants (n = 611) were 5-11-year-old children with HIV (HIV), HIV exposed uninfected (HEU), or HIV unexposed uninfected (HUU). Primary caregivers were assessed for depression with the Hopkins Symptom Checklist (HSCL) and children with Behavior Rating Inventory for Executive Function (BRIEF) parent-report, Kauffman Assessment Battery for Children II (KABC), Bruininks-Oseretsky Test of Motor Proficiency 2nd Ed. (BOT-2), Test of Variables of Attention (TOVA), Multiple Indicators Cluster Survey, Child Disability and Development scales (MICS-4). Caregivers with higher depression scores (>1.75 mean HSCL score) reported more executive function problems in their children, regardless of HIV status. All executive function scores were significantly (p < 0.001) associated with depressive symptomatology at baseline and across time. Caregiver depressive symptomatology was not associated with other assessed neurocognitive outcomes. These results highlight the potential impact of caregiver depression on child behavioral outcomes.

Early life predictors of attention deficit/hyperactivity disorder symptomatology profiles from early through middle childhood

This study used repeated measures data to identify developmental profiles of elevated risk for ADHD (i.e., six or more inattentive and/or hyperactive-impulsive symptoms), with an interest in the age at which ADHD risk first emerged. Risk factors that were measured across the first 3 years of life were used to predict profile membership. Participants included 1,173 children who were drawn from the Family Life Project, an ongoing longitudinal study of children's development in low-income, nonmetropolitan communities. Four heuristic profiles of ADHD risk were identified. Approximately two thirds of children never exhibited elevated risk for ADHD. The remaining children were characterized by early childhood onset and persistent risk (5%), early childhood limited risk (10%), and middle childhood onset risk (19%). Pregnancy and delivery complications and harsh-intrusive caregiving behaviors operated as general risk for all ADHD profiles. Parental history of ADHD was uniquely predictive of early onset and persistent ADHD risk, and low primary caregiver education was uniquely predictive of early childhood limited ADHD risk. Results are discussed with respect to how changes to the age of onset criterion for ADHD in DSM5 may affect etiological research and the need for developmental models of ADHD that inform ADHD symptom persistence and desistance.

A 6-year longitudinal study: Are maternal depressive symptoms and Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant treatment during pregnancy associated with everyday measures of executive function in young children?

BACKGROUND

Building on research reports that early and chronic exposure to maternal depressive symptoms (MDS) adversely affects children's developing executive function (EF), this longitudinal study examined whether exposure to MDS and Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant treatment during pregnancy predicted individual differences in EF at school age.

METHODS

In a longitudinal prospective cohort, maternal report of EF using the Behavior Rating Inventory of EF (BRIEF) was obtained from 139 children (77 females; non-exposed n = 88, SSRI exposed n = 51) at age 6 years. Clinician rated and self reports of MDS were also obtained spanning from the 2nd trimester to 6 years postpartum.

RESULTS

Higher levels of MDS, especially at 3 years, were associated with poorer maternal reports of EF skills at 6 years. Associations between prenatal SSRI exposure and EF outcomes were not significant, even when controlling for maternal education and MDS at 3 years.

CONCLUSIONS

Postnatal exposure to MDS adversely effects developing child EF, even when maternal symptoms were treated with an SSRI antidepressant.