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Serravalle L, Trespalacios F, Ellenbogen MA. Hypothalamic-pituitary-adrenal axis functioning in offspring of parents with a major affective disorder: a meta-analytic review. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02553-0. [PMID: 39207496 DOI: 10.1007/s00787-024-02553-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
Because the offspring of parents with an affective disorder (OAD) are at high risk for developing mental disorders, and persons with an affective disorder (AD) show dysfunctional hypothalamic-pituitary-adrenal (HPA) axis activity, changes in HPA functioning in OAD might be an etiological risk factor that precedes the development of ADs. The primary aim of the meta-analysis was to quantitatively summarize the existing data on different indices of diurnal cortisol in the OAD. The secondary aim was to explore potential moderators of this relation. Following PRISMA guidelines, we included 26 studies (3052 offspring) on diurnal cortisol in our meta-analysis after an initial screening of 3408 articles. Intercept-only and meta-regression models were computed using the robust variance estimation method. Analyses examining mean cortisol levels at discrete timepoints, total cortisol output, and the cortisol rise in response to awakening (CAR) were conducted separately. The results demonstrated that the OAD had higher mean levels of cortisol at different timepoints throughout the day compared to controls (Hedge's g = 0.21). There was evidence of publication bias in studies examining CAR, such that effect sizes were positively biased. The present findings are consistent with a meta-analysis showing elevated cortisol in youth having an AD. Notable limitations across studies include the method of cortisol measurement and assessment of ADs. Altogether, these results highlight the fact that increased cortisol levels may act as a potential neuroendocrine antecedent and/or risk factor for the development of ADs among high risk youth.
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Affiliation(s)
- Lisa Serravalle
- Department of Psychology, Centre for Research in Human Development, Concordia University, 7141 Sherbrooke W., Montréal, QC, H4B 1R6, Canada
| | - Florencia Trespalacios
- Department of Psychology, Centre for Research in Human Development, Concordia University, 7141 Sherbrooke W., Montréal, QC, H4B 1R6, Canada
| | - Mark A Ellenbogen
- Department of Psychology, Centre for Research in Human Development, Concordia University, 7141 Sherbrooke W., Montréal, QC, H4B 1R6, Canada.
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2
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Letourneau N, McManus C, Novick J, Silverstone A. Impacts of Peer Support on Coping and Cortisol Levels for Women Affected by Domestic Violence and Coercive Control. Can J Nurs Res 2024:8445621241272723. [PMID: 39149993 DOI: 10.1177/08445621241272723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024] Open
Abstract
PURPOSE Gendered domestic violence and coercive control are prevalent public heath concerns in Canada with dire consequences for survivors. Peer support groups may address and reduce negative impacts of domestic violence and coercive control on women's stress, coping, safety, and alliances with social support network members, the focus of this study. METHODS A one-group, pre-test/post-test quasi-experimental study was undertaken to evaluate the effectiveness of Growth Circle, a 14-week peer support program offered at an agency serving women affected by domestic violence in a major western Canadian city. Through convenience sampling, women 18 years and older who experienced domestic violence were recruited and provided data on stress, coping, safety-related empowerment, and social support/alliances. Thirty-five participants provided all pre-test and post-test data, with a subsample of 14 providing repeated hair samples. Hair was employed to determine stress hormone (cortisol) levels. RESULTS A significant reduction in self-reported levels of perceived stress and stress hormone levels following completion of the Growth Circle program was revealed. Participants also reported a significant increase in safety-related empowerment, and supportive alliances with group members. CONCLUSIONS The Growth Circle peer support program was demonstrated to be effective. Further implementation and research into the Growth Circle program across Canada is recommended.
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Affiliation(s)
- Nicole Letourneau
- Professor, Faculty of Nursing and Cumming School of Medicine (Pediatrics, Psychiatry, Community Health Sciences), University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Carrie McManus
- Director of Innovation and Programs, Sagesse Domestic Violence Prevention Society, Calgary, Alberta, Canada
| | - Jason Novick
- Research Assistant, Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Andrea Silverstone
- Chief Executive Officer, Sagesse Domestic Violence Prevention Society, Calgary, Alberta, Canada
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3
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Bon Bernard J, Moules N, Tough S, Tryphonopoulos P, Letourneau N. Listening to the Voices of Mothers Who Participated in a Video Feedback Intervention for Postpartum Depression. Glob Qual Nurs Res 2024; 11:23333936241245588. [PMID: 38628401 PMCID: PMC11020710 DOI: 10.1177/23333936241245588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Postpartum depression (PPD) symptoms can negatively influence mother-infant interactions. Video-Feedback Interaction Guidance for Improving Interactions Between Depressed Mothers and their Infants (VID-KIDS) is a parenting intervention that allows mothers experiencing PPD symptoms to observe and improve their interactions with their infants. VID-KIDS has also positively influenced infants' stress (cortisol) patterns. There is limited research on maternal perspectives of interventions like VID-KIDS. In this hermeneutic study, four mothers were interviewed to increase understanding of the VID-KIDS experience. Key findings included: 1) VID-KIDS provided an opportunity for mothers with PPD symptoms to positively transform their identity; 2) VID-KIDS provided a chance to witness the mother-infant relationship forming and improve maternal mental health t, and; 3) VID-KIDS provided a space for mothers to dialogue about their experience with PPD symptoms authentically. VID-KIDS promoted healing from PPD as mothers experienced a transformation in how they perceived themselves and their relationships with their infants.
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Prasad AH, Keevers Y, Kaouar S, Kimonis ER. Conception and Development of the Warmth/Affection Coding System (WACS): A Novel Hybrid Behavioral Observational Tool for Assessing Parent-to-Child Warmth. Res Child Adolesc Psychopathol 2023; 51:1357-1369. [PMID: 37079146 PMCID: PMC10474998 DOI: 10.1007/s10802-023-01055-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 04/21/2023]
Abstract
A vast body of research and theory underscores the importance of parental warmth/affection (hereby 'warmth' and 'warmth/affection' are used interchangeably) as a distinct relational process that is fundamental to core developmental processes including parent-child attachment, socialization, emotion recognition and responsivity, and empathic development. The increasing focus on parental warmth as a viable transdiagnostic and specific treatment target for Callous-Unemotional (CU) traits highlights the critical need for a reliable and valid tool for measuring this construct within clinical contexts. However, existing assessment methods have limitations in their ecological validity, clinical utility, and the comprehensiveness of their coverage of core warmth subcomponents. In response to this clinical and research need, the observational Warmth/Affection Coding System (WACS) was developed to comprehensively measure parent-to-child warmth/affection. This paper chronicles the conception and development of the WACS, which adopts a hybrid approach of utilizing both microsocial and macro-observational coding methods to capture key verbal and non-verbal subcomponents of warmth that are currently underrepresented or poorly captured by existing assessment tools. Recommendations for implementation and future directions are also discussed.
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Affiliation(s)
- Ashneeta H Prasad
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia.
| | - Yvette Keevers
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia
| | - Silvana Kaouar
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia
| | - Eva R Kimonis
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia
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5
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Mavrogiorgou P, Diop S, Turmes L, Specht C, Vanscheidt S, Seehagen S, Juckel G. Computer-based mother-infant interaction analysis and mental functioning in postpartum depression. Psychiatry Res 2022; 311:114506. [PMID: 35287041 DOI: 10.1016/j.psychres.2022.114506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Among mothers suffering from postpartum depression (PD), 10-13% additionally experience a mother-infant interaction disturbance that causes a severe mental health risk for the infant. Besides depressive symptomology, the underlying factors promoting dysfunctional maternal interaction behavior have not yet been sufficiently investigated. Therefore, we examined potential relationships between computer-based mother-infant interaction among postpartum depressed dyads and maternal mental functioning. METHODS Mother-infant interaction was video-recorded and evaluated via a computer-based micro-interaction analysis program (INTERACT). We included only 25 hospitalized mother-infant dyads that fulfilled the diagnostic criteria of PD and tested mothers on their mental functioning (empathy, theory of mind, meta-cognition and alexithymia). RESULTS Behavioral interaction analyses indicated that mothers with PD were prone to inactive maternal behavior, less positive maternal behavior along with more rejective behavior and also disengaged affect towards the infant. Distortions in mothers' mental functioning may have had an influence on the dysfunctional patterns of mother-infant dyads. CONCLUSIONS Cognitive and social functioning could be an influencing factor on dysfunctional maternal interaction behavior. Early detection of distortions of mental processing in expectant mothers might help to inhibit the clinical manifestation of dysfunctional mother-infant bonding and negative child outcome in PD.
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Affiliation(s)
- Paraskevi Mavrogiorgou
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - Shirin Diop
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - Luc Turmes
- LWL Hospital Herten of Psychiatry, Psychotherapy and Psychosomatic, Mother-Child Unit, Im Schloßpark 20, 45699 Herten, Germany
| | - Christina Specht
- LWL Hospital Herten of Psychiatry, Psychotherapy and Psychosomatic, Mother-Child Unit, Im Schloßpark 20, 45699 Herten, Germany
| | - Simon Vanscheidt
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - Sabine Seehagen
- Ruhr University Bochum, Faculty of Psychology, Department of Developmental Psychology, Universitätsstr. 150, 44801 Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany.
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6
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Rattaz V, Puglisi N, Tissot H, Favez N. Associations between parent–infant interactions, cortisol and vagal regulation in infants, and socioemotional outcomes: A systematic review. Infant Behav Dev 2022; 67:101687. [DOI: 10.1016/j.infbeh.2022.101687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/02/2021] [Accepted: 01/10/2022] [Indexed: 11/05/2022]
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Newton LE, Hageman C, Zhou C, Roberts H, Cusick RA, Needelman H. The Relationship Between Neonatal Surgery, Postpartum Depression, and Infant Clinical Course. Matern Child Health J 2022; 26:1087-1094. [PMID: 35064427 DOI: 10.1007/s10995-021-03353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Postpartum depression (PPD) affects 10-15% of mothers in the general population, and studies show increased incidence for mothers of infants with serious health conditions. This study investigates incidence of PPD in mothers of surgical patients in the neonatal intensive care unit (NICU) and characterizes these patients' clinical and neurodevelopmental outcomes. METHODS This retrospective cohort study analyzed Nebraska's Tracking Infant Progress Statewide (TIPS) database and referring hospital medical records from February 2013 to June 2018. Upon NICU discharge, children were referred to the TIPS program, with scheduled follow-up appointments at approximately 6 months corrected age. All patients seen in NICU follow-up clinic with recorded scores for maternal Edinburgh postnatal depression screen (EPDS) were eligible except infants with congenital heart disease as this cohort was previously studied. Patients were stratified into groups based on presence or absence of a general surgical procedure within the first 6 months of life and positive (≥ 10) or negative (< 10) EPDS score. Statistical analyses assessed for significant differences between groups regarding gestational age, birth weight, maternal age, length of NICU stay (LOS), number of days on a ventilator, payment method, ethnicity, developmental testing, and rate of referral for early intervention services. RESULTS Of 436 patients, 83 were surgical patients (16 with positive EPDS; 19.3% incidence), and 353 were non-surgical patients (44 with positive EPDS; 12.5% incidence). Statistical analysis showed no significant relationship between neonatal surgery and positive EPDS (χ2 = 2.6, p = 0.1). While the surgical cohort had longer LOS and days on ventilator, maternal EPDS did not predict these factors. In the surgical cohort, mothers of children not independent on oral feeding at discharge were more likely to screen positive for depression (7/14, 50% vs. 7/61, 11%; p < 0.05). CONCLUSION Mothers of surgical patients are not significantly more likely to screen positive for post-partum depression compared to other NICU mothers. This underscores the importance of routine screening for PPD in mothers of both surgical and non-surgical NICU patients in order to identify parents and children at risk.
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Affiliation(s)
- Laura E Newton
- College of Medicine, University of Nebraska Medical Center, S 42nd and Emile St., Omaha, NE, 68198, USA.,Department of General Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Clara Hageman
- College of Medicine, University of Nebraska Medical Center, S 42nd and Emile St., Omaha, NE, 68198, USA.,Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, 64108, USA
| | - Christina Zhou
- College of Medicine, University of Nebraska Medical Center, S 42nd and Emile St., Omaha, NE, 68198, USA
| | - Holly Roberts
- Department of General Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH, 03756, USA
| | - Robert A Cusick
- Division of Pediatric Surgery, Department of Surgery, University of Nebraska Medical Center, S 42nd and Emile St., Omaha, NE, 68198, USA.,Children's Hospital and Medical Center, 8200 Dodge St., Omaha, NE, 68114, USA
| | - Howard Needelman
- Munroe Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, 444 S 44th St., A8 412 South Saddle Creek, Omaha, NE, 68198-5380, USA. .,Children's Hospital and Medical Center, 8200 Dodge St., Omaha, NE, 68114, USA.
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8
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Qouta SR, Vänskä M, Diab SY, Punamäki RL. War trauma and infant motor, cognitive, and socioemotional development: Maternal mental health and dyadic interaction as explanatory processes. Infant Behav Dev 2021; 63:101532. [PMID: 33588286 DOI: 10.1016/j.infbeh.2021.101532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Taking care of infants in conditions of war is highly demanding and a few studies reveal the negative impact of war trauma on maternal and infant well-being. Yet, little is known regarding the influence of trauma on infant development and the potential explanatory mechanisms. First, the present study examines how mothers' prenatal exposure to traumatic war events is associated with infant cognitive, motor, and socioemotional development. Second, it analyses the mediating roles of maternal postpartum mental health problems, quality of dyadic mother-infant interaction, and earlier infant development (at six months) in the association between prenatal traumatic war events and infants' developmental skills at 18 months. METHOD This prospective three-wave study involved 502 Palestinian pregnant females in their first trimester during the 2014 Gaza War and participated at delivery (T1) and when the child was six (T2;N = 392) and eighteen (T3; N = 386) months of age. Mothers reported their exposure to traumatic war events (human and material losses, horrors, and threat to life) at T1 and T2, and researchers photo-documented the extent of destruction at T1. Mothers reported infants' language, fine- and gross-motor, and socioemotional skills at T2 and researchers tested infants' motor, cognitive-language and socioemotional skills using the Bayley Scales of Infant development (BSID-II) at T3. Mothers reported their mental health problems (symptoms of post-traumatic stress disorder [PTSD], depression and somatization) at T2 and T3 as well as dyadic interaction quality (the emotional availability self-report, [EA-SR] brief) at T2. RESULTS First, the structural equation model (SEM) on direct effects indicated, in contrast to our hypotheses, that maternal prenatal exposure to traumatic war events did not associate with infants' developmental skills at T2 and predicted higher level of developmental skills at T3. Second, as hypothesized, we found two negative underlying mechanisms (paths) between high exposure and low levels of motor, cognitive-language, and socioemotional skills at T3: (1) through increased maternal mental health problems at T2, which then were associated with problems at T3, and (2) through increased maternal mental health problems at T2, which then were associated with a low quality of mother-infant-interaction and low level of infant developmental skills at T2. CONCLUSION Improving maternal mental health and encouraging close and positive dyadic interaction can be critical for infant sensorimotor, cognitive, and socioemotional development in war conditions.
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Affiliation(s)
- Samir R Qouta
- Doha Institut for Graduate Studies, School of Social Sciences and Humanities, Qatar
| | - Mervi Vänskä
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Safwat Y Diab
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland
| | - Raija-Leena Punamäki
- Tampere University, Faculty of Social Sciences, Department of Psychology, Finland.
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9
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Beck CT. Mother–Infant Interaction During Postpartum Depression: A Metaphor Analysis. Can J Nurs Res 2020; 52:108-116. [DOI: 10.1177/0844562119897756] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Reported in quantitative studies is the negative impact that postpartum depression can have on mother–infant bonding. Metaphors can enhance mothers’ communication with their health-care providers that cannot be captured by medical terminology and provide mothers a different voice to explain their experiences interacting with their infants. Purpose The aim of the study was to identify the metaphorical expressions used by women to describe their interactions with their infants during postpartum depression. Methods Secondary qualitative data analysis of three primary qualitative data sets of postpartum depression was conducted. The specific type of secondary qualitative analysis used was cross validation where multiple data sets from different studies are compared to expand the results of each individual study to make a more general claim. Data analysis involved using the Metaphor Identification Procedure. Results Identified were eight metaphors used by mothers to describe their interactions with their infants during their postpartum depression: a thief, a robot, enveloping fogginess, being at the races, an actor, an erupting volcano, skin crawling, and a wall. Conclusions Being attentive to metaphors mothers use can provide a unique approach to helping nurses identify vulnerable mother–infant dyads during postpartum depression.
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Affiliation(s)
- Cheryl T. Beck
- School of Nursing, University of Connecticut, Storrs, CT, USA
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10
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Luecken LJ, Crnic KA, Gonzales NA, Winstone LK, Somers JA. Mother-infant dyadic dysregulation and postpartum depressive symptoms in low-income Mexican-origin women. Biol Psychol 2019; 147:107614. [PMID: 30391479 PMCID: PMC6497571 DOI: 10.1016/j.biopsycho.2018.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/06/2023]
Abstract
The current study evaluated a mechanistic pathway by which prenatal stress increases the risk of postpartum depressive (PPD) symptoms via observed dyadic emotional, behavioral, and attentional dysregulation and associated cortisol responses during mother-infant interactions. METHODS Participants included 322 low-income Mexican American mother-infant dyads. Depressive symptoms, economic hardship, and negative life events were assessed at a prenatal visit. Dysregulation in dyadic (mother-infant) interactions and cortisol responses to mother-infant interaction were evaluated at 12 weeks after the birth. Twenty-four weeks after the birth, PPD symptoms were predicted from prenatal stress (negative life events and economic hardship) and prenatal depressive symptoms, mediated through dyadic dysregulation and maternal and infant cortisol responses. RESULTS More negative life events in the prenatal period predicted more dyadic dysregulation at 12 weeks postpartum. Dyadic dysregulation and economic hardship predicted elevated 12-week infant cortisol total response and reactivity, and higher total infant cortisol response predicted higher maternal PPD symptoms at 24 weeks. Maternal cortisol response was not associated with dyadic dysregulation, either form of prenatal stress, or PPD symptoms. CONCLUSION The results indicate the salience of early psychosocial processes and mother-infant relationship challenges for subsequent maternal affective well-being.
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Affiliation(s)
- Linda J Luecken
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States.
| | - Keith A Crnic
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
| | - Nancy A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
| | - Laura K Winstone
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
| | - Jennifer A Somers
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
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11
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Letourneau NL, de Koning APJ, Sekhon B, Ntanda HN, Kobor M, Deane AJ, Morin AM, Dewey D, Campbell TS, Giesbrecht GF. Parenting Interacts With Plasticity Genes in Predicting Behavioral Outcomes in Preschoolers. Can J Nurs Res 2019; 52:290-307. [PMID: 31403319 DOI: 10.1177/0844562119863612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Public health and pediatric nurses typically focus on supporting parenting to reduce the likelihood of children's behavioral problems. Studies have identified interactions between early exposures to stress in caregiving and child genotype in predicting children's behavioral problems, such that certain genotypes connote greater differential susceptibility or plasticity to environmental stressors. We sought to uncover the interaction between observational measures of parent-child relationship quality and genotype in predicting early-onset behavioral problems in 24-month-olds, using prospective methods. METHODS We conducted a secondary analysis of data collected on a subsample of 176 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study. Inclusion criteria required mothers to be ≥18 years of age, English speaking and ≤22 weeks gestational age at enrollment. Genetic data were obtained from blood leukocytes and buccal epithelial cell samples, collected from infants at three months of age. For each child, the presence of plasticity alleles was determined for BDNF, CNR1, DRD2/ANKK1, DRD4, DAT1, 5-HTTLPR, and MAOA and an overall index was calculated to summarize the number of plasticity alleles present. Observational assessments of parent-child relationship quality (sensitivity, controlling, and unresponsiveness) were conducted at six months of age. Children's internalizing (e.g., emotionally reactive, anxious/depressed, somatic complaint, withdrawn) and externalizing (e.g., aggression, inattention) behaviors were assessed at 24 months of age. After extracting genetic data, a maximum likelihood method for regressions was employed with Akaike Information Criterion (AIC) for model selection. RESULTS When parents were less responsive and children possessed more plasticity alleles, children were more likely to be emotionally reactive, anxious/depressed, report somatic complaints, and withdrawn, while when parents were less responsive and children possessed fewer plasticity alleles, children were less likely to display these internalizing behaviors, in a differentially susceptible manner. Furthermore, when parents were more responsive, and children possessed more plasticity alleles, children were less likely to display internalizing behaviors (P = 0.034). Similarly, children who possessed either the CNR1-A plasticity allele (P = 0.010) or DAT1 9-repeat plasticity allele (P = 0.036) and experienced more/less parental control displayed more/fewer externalizing problems, respectively, in a differentially susceptible manner. CONCLUSIONS The plasticity index score interacted with parental unresponsiveness in predicting anxiety and depressive behavioral problems in children, while individual genetic variants interacted with parental controlling behavior in predicting aggression and inattention in children, suggestive of differential susceptibility to caregiving. Especially in the context of nursing interventions designed to support childrearing and children's development, nurses need to be aware of the interactions between child genotype and parenting in understanding how well interventions will work in promoting optimal child behavior.
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Affiliation(s)
- Nicole L Letourneau
- Faculty of Nursing, University of Calgary, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada.,Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | | | | | - Henry N Ntanda
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
| | - Michael Kobor
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Canada
| | - Andrea J Deane
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
| | - Alexander M Morin
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Canada
| | - Deborah Dewey
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
| | | | - Gerald F Giesbrecht
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
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12
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Kao K, Tuladhar CT, Meyer JS, Tarullo AR. Emotion regulation moderates the association between parent and child hair cortisol concentrations. Dev Psychobiol 2019; 61:1064-1078. [PMID: 30953366 DOI: 10.1002/dev.21850] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 12/29/2022]
Abstract
Successful emotion regulation facilitates children's coping with everyday stress. It develops rapidly in the early preschool period. However, no work has been done to investigate the potential buffering role of emotion regulation from cumulative physiological effects of stress. In this study, we examined hair cortisol concentration (HCC), an early marker of chronic physiological stress, socioeconomic status (SES), parental sensitivity, and emotion regulation and reactivity in a sample of 3.5-year-old children (N = 86). Emotion regulation and emotional reactivity were independent of child HCC. However, emotion regulation moderated the relationship between parent and child HCC. For children with better emotion regulation, there was no association between parent and child HCC, suggesting that emotion regulation skills buffered the transgenerational effects of chronic physiological stress. Emotional reactivity moderated the relationship between SES and child HCC, and attenuated the association between parental sensitivity and child HCC. Taken together, these findings demonstrate that children who were less emotionally reactive were less susceptible to their environments. Results provide support that child emotion regulation and emotional reactivity can reduce or strengthen the relationship between established risk factors and levels of chronic physiological stress in early childhood.
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Affiliation(s)
- Katie Kao
- Harvard Medical School, Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Charu T Tuladhar
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Jerrold S Meyer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Amanda R Tarullo
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
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13
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Mother–infant cortisol attunement: Associations with mother–infant attachment disorganization. Dev Psychopathol 2019; 32:43-55. [DOI: 10.1017/s0954579418001396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThis study explores the conceptualization of mother–infant cortisol attunement both theoretically and empirically, and its association with mother–infant attachment disorganization. In a community sample (N = 256), disorganization and cortisol were assessed during the Strange Situation Procedure (SSP) at infant age 17 months. Salivary cortisol was collected at baseline, and 20 and 40 min after the SSP. We utilized three statistical approaches: correlated growth modeling (probing a simultaneous conceptualization of attunement), cross-lagged modeling (probing a lagged, reciprocal conceptualization of attunement), and a multilevel model difference score analysis (to examine the pattern of discrepancies in mother–infant cortisol values). Correlated growth modeling revealed that disorganized, relative to organized, dyads had significant magnitude of change over time, such that, among disorganized dyads, as mothers had greater declines in cortisol, infants had greater increases. The difference score analysis revealed that disorganized, relative to organized, dyads had a greater divergence between maternal and infant cortisol values, such that maternal values were lower than infant values. Disorganized attachment status was not significantly associated with attunement when conceptualized as reciprocal and lagged in the cross-lagged model. Findings suggest that mother–infant dyads in disorganized attachment relationships, who are by definition behaviorally misattuned, are also misattuned in their adrenocortical responses.
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Letourneau NL, Tryphonopoulos PD, Novick J, Hart JM, Giesbrecht G, Oxford ML. Nursing Child Assessment Satellite Training Parent-Child Interaction Scales: Comparing American and Canadian Normative and High-Risk Samples. J Pediatr Nurs 2018; 40:47-57. [PMID: 29776479 DOI: 10.1016/j.pedn.2018.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE Many nurses rely on the American Nursing Child Assessment Satellite Training (NCAST) Parent-Child Interaction (PCI) Teaching and Feeding Scales to identify and target interventions for families affected by severe/chronic stressors (e.g. postpartum depression (PPD), intimate partner violence (IPV), low-income). However, the NCAST Database that provides normative data for comparisons may not apply to Canadian families. The purpose of this study was to compare NCAST PCI scores in Canadian and American samples and to assess the reliability of the NCAST PCI Scales in Canadian samples. METHODS This secondary analysis employed independent samples t-tests (p < 0.005) to compare PCI between the American NCAST Database and Canadian high-risk (families with PPD, exposure to IPV or low-income) and community samples. Cronbach's alphas were calculated for the Canadian and American samples. RESULTS In both American and Canadian samples, belonging to a high-risk population reduced parents' abilities to engage in sensitive and responsive caregiving (i.e. healthy serve and return relationships) as measured by the PCI Scales. NCAST Database mothers were more effective at executing caregiving responsibilities during PCI compared to the Canadian community sample, while infants belonging to the Canadian community sample provided clearer cues to caregivers during PCI compared to those of the NCAST Database. Internal consistency coefficients for the Canadian samples were generally acceptable. CONCLUSIONS The NCAST Database can be reliably used for assessing PCI in normative and high-risk Canadian families. PRACTICAL IMPLICATIONS Canadian nurses can be assured that the PCI Scales adequately identify risks and can help target interventions to promote optimal parent-child relationships and ultimately child development.
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Affiliation(s)
- Nicole L Letourneau
- Faculty of Nursing and Cumming School of Medicine (Pediatrics, Community Health Sciences & Psychiatry), University of Calgary, Alberta , Canada.
| | | | - Jason Novick
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta Canada
| | - J Martha Hart
- Faculty of Nursing and Cumming School of Medicine (Pediatrics, Community Health Sciences & Psychiatry), University of Calgary, Alberta , Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics and Community Health Sciences), Faculty of Arts (Psychology), University of Calgary, Alberta Canada
| | - Monica L Oxford
- Center on Human Development & Disability, School of Nursing (Family & Child Nursing), Washington University, Seattle, WA United States
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15
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Letourneau NL, Dennis CL, Cosic N, Linder J. The effect of perinatal depression treatment for mothers on parenting and child development: A systematic review. Depress Anxiety 2017; 34:928-966. [PMID: 28962068 DOI: 10.1002/da.22687] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/05/2017] [Accepted: 08/28/2017] [Indexed: 11/10/2022] Open
Abstract
Antenatal and postpartum depression are very common and have significant consequences for mothers and their children. This review examines which antenatal depression (AD) and postpartum depression (PPD) treatment interventions are most efficacious in improving parenting and/or child development. CINAHL, Scopus, Cochrane Systematic Reviews, Cochrane Controlled Trials, Medline (OVID), Embase (OVID), PsychINFO, PsycARTICLES, AMED, and reference lists were searched. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effect of AD, PPD, or both treatment interventions on parenting and/or child development were included. Meta-analysis was conducted using random effects when possible. Thirty-six trials (within 40 articles) met criteria for review. Interventions include interpersonal psychotherapy (IPT), cognitive behavioural therapy (CBT), peer support, maternal-child interaction guidance, and other interventions, such as massage. For AD, IPT, CBT, and massage produced large effects on parenting (e.g. adjustment and attention toward infant) and child development (e.g. behaviour). For PPD, maternal-child interaction guidance and psychotherapeutic group support produced large effects on parenting (e.g. sense of competence) and child development (e.g. cortisol). However, meta-analysis revealed nonsignificant effects of IPT on maternal-child attachment and CBT on parenting stress. Promising findings exist for IPT, CBT, maternal-child interaction guidance, massage, and psychotherapeutic group support for specific parenting and/or child development outcomes. Additional RCTs using measures already employed in the literature are required to conduct necessary meta-analysis and fully elucidate treatment effects.
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Affiliation(s)
- Nicole L Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Cindy-Lee Dennis
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,St. Michael's Hospital, Toronto, ON, Canada
| | - Nela Cosic
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Jordana Linder
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB, Canada
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16
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St. John AM, Kao K, Liederman J, Grieve PG, Tarullo AR. Maternal cortisol slope at 6 months predicts infant cortisol slope and EEG power at 12 months. Dev Psychobiol 2017; 59:787-801. [PMID: 28686284 PMCID: PMC6076989 DOI: 10.1002/dev.21540] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/10/2017] [Accepted: 06/10/2017] [Indexed: 01/01/2023]
Abstract
Physiological stress systems and the brain rapidly develop through infancy. While the roles of caregiving and environmental factors have been studied, implications of maternal physiological stress are unclear. We assessed maternal and infant diurnal cortisol when infants were 6 and 12 months. We measured 12-month infant electroencephalography (EEG) 6-9 Hz power during a social interaction. Steeper 6-month maternal slope predicted steeper 12-month infant slope controlling for 6-month infant slope and breastfeeding. Steeper 6-month maternal slope predicted lower 6-9 Hz power. Six-month maternal area under the cuve (AUCg) was unrelated to 12-month infant AUCg and 6-9 Hz power. Psychosocial, caregiving, and breastfeeding variables did not explain results. At 6 months, maternal and infant slopes correlated, as did maternal and infant AUCg. Twelve-month maternal and infant cortisol were unrelated. Results indicate maternal slope is an informative predictor of infant physiology and suggest the importance of maternal physiological stress in this developmental period.
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Affiliation(s)
- Ashley M. St. John
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, , , ,
| | - Katie Kao
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, , , ,
| | - Jacqueline Liederman
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, , , ,
| | - Philip G. Grieve
- Departments of Pediatrics and Biomedical Engineering, Columbia University Medical Center, New York, NY 10032,
| | - Amanda R. Tarullo
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, , , ,
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17
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Clauss NJ, Byrd-Craven J, Kennison SM, Chua KJ. The Roles of Mothers’ Partner Satisfaction and Mother-Infant Communication Duration in Mother-Infant Adrenocortical Attunement. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2017. [DOI: 10.1007/s40750-017-0078-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Letourneau NL, Kozyrskyj AL, Cosic N, Ntanda HN, Anis L, Hart MJ, Campbell TS, Giesbrecht GF. Maternal sensitivity and social support protect against childhood atopic dermatitis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2017; 13:26. [PMID: 28559916 PMCID: PMC5446757 DOI: 10.1186/s13223-017-0199-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/17/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Many studies have identified associations between qualities of maternal-child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal-infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. METHODS We conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. RESULTS Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. CONCLUSIONS Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal-infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.
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Affiliation(s)
- Nicole L. Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Anita L. Kozyrskyj
- Departments of Pediatrics, Obstetrics & Gynecology, Faculty of Medicine and Dentistry, and School of Public Health, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Nela Cosic
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Henry N. Ntanda
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Lubna Anis
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Martha J. Hart
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Tavis S. Campbell
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Gerald F. Giesbrecht
- Cumming School of Medicine, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - The APrON Team
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Departments of Pediatrics, Obstetrics & Gynecology, Faculty of Medicine and Dentistry, and School of Public Health, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
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Tarullo AR, St John AM, Meyer JS. Chronic stress in the mother-infant dyad: Maternal hair cortisol, infant salivary cortisol and interactional synchrony. Infant Behav Dev 2017; 47:92-102. [PMID: 28391126 PMCID: PMC5493894 DOI: 10.1016/j.infbeh.2017.03.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 01/06/2023]
Abstract
Stress physiology is shaped by early experience, with enduring effects on health. The relation of chronic maternal physiological stress, as indexed by hair cortisol, to infants' stress systems and to mother-infant interaction quality has not been established. We examined maternal hair and salivary cortisol, six-month-old infants' salivary cortisol, and mother-infant interaction in 121 mother-infant dyads. High maternal hair cortisol was related to higher infant average salivary cortisol concentration. Maternal hair cortisol and bedtime salivary cortisol were both uniquely related to infant bedtime salivary cortisol. Mothers with higher hair cortisol were more intrusive and had lower positive engagement synchrony with their infants. Maternal intrusiveness moderated the association of maternal hair cortisol and infant salivary cortisol, such that maternal hair and infant average salivary cortisol were related only when mothers were more intrusive. Maternal chronic physiological stress may upregulate infants' developing stress systems, particularly in the context of lower mother-infant interaction quality.
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Affiliation(s)
- Amanda R Tarullo
- Department of Psychological and Brain Sciences, Boston University, United States.
| | - Ashley Moore St John
- Department of Psychological and Brain Sciences, Boston University, United States
| | - Jerrold S Meyer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, United States
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20
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Graff JC, Bush AJ, Palmer FB, Murphy LE, Whitaker TM, Tylavsky FA. Maternal and Child Characteristics Associated With Mother-Child Interaction in One-Year-Olds. Res Nurs Health 2017; 40:323-340. [DOI: 10.1002/nur.21798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/09/2022]
Affiliation(s)
- J. Carolyn Graff
- Professor, College of Nursing, Chief of Nursing, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center 711 Jefferson Avenue; Memphis TN 38105
| | - Andrew J. Bush
- Professor Emeritus, Department of Preventive Medicine; University of Tennessee Health Science Center; Memphis TN
| | - Frederick B. Palmer
- Professor, Department of Pediatrics, Director, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center; Memphis TN
| | - Laura E. Murphy
- Professor, Department of Child Psychiatry, Chief of Psychology, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center; Memphis TN
| | - Toni M. Whitaker
- Associate Professor, Department of Pediatrics Developmental Pediatrician, Boling Center for Developmental Disabilities; University of Tennessee Health Science Center; Memphis TN
| | - Frances A. Tylavsky
- Professor, Department of Preventive Medicine; University of Tennessee Health Science Center; Memphis TN
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21
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Kozyrskyj AL, Letourneau NL, Kang LJ, Salmani M. Associations between postpartum depressive symptoms and childhood asthma diminish with child age. Clin Exp Allergy 2016; 47:324-330. [PMID: 27770463 DOI: 10.1111/cea.12837] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/16/2016] [Accepted: 09/15/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Affecting 19% of women, postpartum depression is a major concern to the immediate health of mothers and infants. In the long-term, it has been linked to the development of early-onset asthma at school entry, but only if the depression persists beyond the postnatal period. No studies have tested whether associations with postpartum depressive symptoms and early-onset asthma phenotypes persist into later school age. OBJECTIVE To determine associations between maternal postpartum depressive symptoms and childhood asthma between the ages of 5-10 by using a nested longitudinal design. METHODS Data were drawn from the 1994-2004 administrations of the Canadian National Longitudinal Survey of Children and Youth, which tracks the health of a nationally representative sample of children in Canada. Child asthma was diagnosed by a health professional, and maternal depressive symptoms were assessed by the Centre for Epidemiological Studies Depression scale. Analyses were conducted by using a multilevel modelling approach, in which longitudinal assessments of asthma in 1696 children were nested within the exposure of postpartum depression. RESULTS Postpartum depressive symptoms had a 1.5-fold significant association with childhood asthma between the ages 6-8. This was independent of male sex, maternal asthma, non-immigrant status, low household socioeconomic status, being firstborn, low birthweight, low family functioning and urban-rural residence, of which the first 4 covariates elevated the risk of asthma. Statistical significance was lost at age 8 when maternal prenatal smoking replaced urban-rural residence as a covariate. At ages 9-10, an association was no longer evident. CONCLUSIONS AND CLINICAL RELEVANCE Women affected by postpartum depressive symptoms are concerned about long-term health effects of their illness on their infants. Although postpartum depressive symptoms were associated with school-age asthma at ages 6 and 7, this association diminished later. Both home and school life stress should be considered in future studies on asthma development later in childhood.
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Affiliation(s)
- A L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.,School of Public Health, University of Alberta, Edmonton, AB, Canada.,Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
| | - N L Letourneau
- Faculty of Nursing & Cumming School of Medicine (Pediatrics & Psychiatry), University of Calgary, Calgary, AB, Canada
| | - L J Kang
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - M Salmani
- Department of Mathematics & Statistics, University of New Brunswick, Fredericton, NB, Canada
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22
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Flom M, St John AM, Meyer JS, Tarullo AR. Infant hair cortisol: associations with salivary cortisol and environmental context. Dev Psychobiol 2016; 59:26-38. [PMID: 27472986 DOI: 10.1002/dev.21449] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/06/2016] [Indexed: 11/10/2022]
Abstract
Early chronic stress has enduring implications for physical and mental health outcomes. Hair cortisol concentration (HCC) has emerged as a marker of cumulative cortisol exposure, yet HCC in infants is not well understood. We examined how infant HCC relates to widely used basal salivary cortisol measures, maternal HCC, and environmental context in 111 infants assessed at 6 and 12 months of age. Maternal HCC at 6 and 12 months was correlated with infant HCC at 12 months. At 12 months, infant HCC was positively associated with waking salivary cortisol concentration (SCC), evening SCC, and area under the curve (AUC), but was independent of diurnal slope. Breastfeeding was associated with lower HCC, whereas increased sleep disruption was related to flatter slope. Reduced nighttime sleep duration was related both to higher HCC and to flatter slope. A person-focused analysis indicated that the combination of high HCC and flattened slope was associated with more environmental risks, highlighting the importance of investigating the interplay between HCC and diurnal cortisol slope. Results support the validity of HCC as a marker of cumulative cortisol exposure in infancy, while emphasizing the value of including multiple cortisol measures assessing distinct aspects of hypothalamic-pituitary-adrenal (HPA) function.
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Affiliation(s)
- Megan Flom
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Ashley M St John
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Jerrold S Meyer
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Amanda R Tarullo
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
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Abstract
Parent education traditionally focuses on childbirth, whereas the perinatal period gets little attention despite parents' reports of feeling unprepared. Lack of education surrounding newborn behavior leads to decreased maternal confidence and ineffective responsiveness to infant cues for feeding, crying, and sleep. This can cause overfeeding, lowered breastfeeding success, and contributes to parental stress which can impact maternal-infant bonding. Lack of postpartum maternal support adds to fatigue and stress which contributes to poor maternal well-being. This article describes an innovative perinatal program, Baystate's New Beginnings, modeled after the education from the 2011 California Baby Behavior Campaign and The Secrets of Baby Behavior that combines newborn behavior education and maternal support in the first 3 months postpartum to improve maternal role transition.
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Khoury JE, Gonzalez A, Levitan R, Masellis M, Basile V, Atkinson L. MATERNAL SELF-REPORTED DEPRESSIVE SYMPTOMS AND MATERNAL CORTISOL LEVELS INTERACT TO PREDICT INFANT CORTISOL LEVELS. Infant Ment Health J 2016; 37:125-39. [DOI: 10.1002/imhj.21554] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/20/2015] [Accepted: 11/21/2015] [Indexed: 01/14/2023]
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25
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Liu CH, Snidman N, Leonard A, Meyer J, Tronick E. Intra-individual stability and developmental change in hair cortisol among postpartum mothers and infants: Implications for understanding chronic stress. Dev Psychobiol 2016; 58:509-18. [PMID: 26806857 DOI: 10.1002/dev.21394] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 12/10/2015] [Indexed: 11/06/2022]
Abstract
The study goal was to determine the intra-individual stability, developmental change, and maternal-reported correlates (socio-demographic, stress experiences, hair characteristics, and care) of hair cortisol in mothers and their infants. To assess cortisol deposition in hair during the periods of 6-to-9 months and 9-to-12 months of age, 3 cm segments of hair samples deemed to represent approximately 3 months of retrospective hair cortisol were sampled longitudinally at 9- and 12-months in 41 mothers and infants. Bivariate correlations and mean level comparisons of log-transformed hair cortisol levels at 9- (T1) and 12-months (T2) in mothers and infants were examined. Hair cortisol values were positively correlated from T1 to T2 for mothers (r = .41, p < .05) and infants (r = .39, p < .05). Hair cortisol values did not significantly differ from T1 to T2 in infants but decreased for mothers (F(1,34) = 9.2, p < .01). Maternal and infant hair cortisol was not associated with each other at either time point. Self-reported measures of stress, and hair characteristics and care were not associated with hair cortisol. This is the first study to obtain hair cortisol from more than one time point within the first year after birth in mothers and infants. The intra-individual stability of hair cortisol suggests that it may be a possible biomarker for detecting change in chronic stress experiences within the first year of life and in the postpartum period.
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Affiliation(s)
- Cindy H Liu
- Commonwealth Research Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115.
| | | | | | | | - Ed Tronick
- University of Massachusetts Boston, Boston, MA.,Department of Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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26
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Vänskä M, Punamäki RL, Lindblom J, Tolvanen A, Flykt M, Unkila-Kallio L, Tulppala M, Tiitinen A. Timing of Early Maternal Mental Health and Child Cortisol Regulation. INFANT AND CHILD DEVELOPMENT 2015. [DOI: 10.1002/icd.1948] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Mervi Vänskä
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Raija-Leena Punamäki
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Jallu Lindblom
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Asko Tolvanen
- Department of Psychology; University of Jyvaskyla; Jyvaskyla Finland
| | - Marjo Flykt
- Psychology/School of Social Sciences and Humanities; University of Tampere; Tampere Finland
| | - Leila Unkila-Kallio
- Department of Obstetrics and Gynaecology; Helsinki University Central Hospital; Helsinki Finland
- Department of Obstetrics and Gynaecology; University of Helsinki; Helsinki Finland
| | - Maija Tulppala
- Department of Obstetrics and Gynaecology; University of Helsinki; Helsinki Finland
| | - Aila Tiitinen
- Department of Obstetrics and Gynaecology; Helsinki University Central Hospital; Helsinki Finland
- Department of Obstetrics and Gynaecology; University of Helsinki; Helsinki Finland
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27
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Infant Emotion Regulation Strategy Moderates Relations between Self-Reported Maternal Depressive Symptoms and Infant HPA Activity. INFANT AND CHILD DEVELOPMENT 2015. [DOI: 10.1002/icd.1916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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28
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