1
|
Chang O, Huh K, Savoy CD, Krzeczkowski JE, Van Lieshout RJ. Associations between maternal postpartum depression and infant temperament in treatment-seeking mothers prior to and during the COVID-19 pandemic. Dev Psychopathol 2024; 36:495-503. [PMID: 36700350 DOI: 10.1017/s0954579422001353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
It remains unclear how the COVID-19 pandemic has affected the mother-infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother-infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 (n = 392) and during the pandemic (n = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother-infant relationship. Maternal PPD was associated with more infant negative affectivity and mother-infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children.
Collapse
Affiliation(s)
- Oswin Chang
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| | - Kathryn Huh
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| | - John E Krzeczkowski
- Department of Psychology, York University, 4700 Keele St, Toronto, ONM3J 1P3, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| |
Collapse
|
2
|
Sullivan ADW, Roubinov D, Noroña-Zhou AN, Bush NR. Do dyadic interventions impact biomarkers of child health? A state-of-the-science narrative review. Psychoneuroendocrinology 2024; 162:106949. [PMID: 38295654 DOI: 10.1016/j.psyneuen.2023.106949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/22/2023] [Accepted: 12/23/2023] [Indexed: 03/04/2024]
Abstract
BACKGROUND Early life adversity is related to numerous poor health outcomes in childhood; however, dyadic interventions that promote sensitive and responsive caregiving may protect children from the negative consequences of such exposures. To date, quasi-experimental and randomized controlled trials (RCTs) have examined the impact of dyadic interventions on a range of individual biomarkers in children, which may elucidate the relation between early stress exposure and transdiagnostic risk factors for prospective poor health. However, the content of interventions, analytic strategies, and findings vary widely across studies, obscuring key themes in the science and hindering policy and research efforts. METHODS We use a narrative approach to review findings from methodologically rigorous (predominantly RCT) studies of dyadic interventions' impacts on different biomarkers in children, including indicators of the hypothalamic-pituitary-adrenal (HPA) axis, parasympathetic (PNS) and sympathetic nervous systems (SNS), brain development, inflammation, and intracellular DNA processes. We contribute to this important area of inquiry through integrating findings across biological systems and identifying contextual and mechanistic factors to depict the current state of the field. RESULTS Evidence suggests dyadic interventions improved PNS functioning and advanced brain maturation. Some studies indicated interventions reduced hair cortisol concentrations, systemic inflammation, and resulted in differences in DNA methylation patterns. Findings did not support main effect-level change in salivary measures of HPA axis activity, SNS activity, or telomere length. Importantly, reviewed studies indicated significant heterogeneity in effects across biological systems, underscoring the importance of contextual factors (e.g., adversity subtype and severity) as potential moderators of effects. Further, findings suggested enhanced parenting behaviors may be a mechanism through which dyadic interventions operate on biomarkers. CONCLUSIONS We close with future policy and research directions, emphasizing the promise of biologically-informed dyadic interventions for understanding and ameliorating the effects of early adversity on transdiagnostic biomarkers of health.
Collapse
Affiliation(s)
- Alexandra D W Sullivan
- Department of Psychiatry and Behavioral Sciences, Center for Health and Community, Weill Institute for Neurosciences, University of California, San Francisco, USA.
| | - Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, Center for Health and Community, Weill Institute for Neurosciences, University of California, San Francisco, USA; Department of Psychiatry, University of North Carolina, Chapel Hill, USA
| | - Amanda N Noroña-Zhou
- Department of Psychiatry and Behavioral Sciences, Center for Health and Community, Weill Institute for Neurosciences, University of California, San Francisco, USA; Department of Pediatrics, Division of Developmental Medicine, UCSF, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Center for Health and Community, Weill Institute for Neurosciences, University of California, San Francisco, USA; Department of Pediatrics, Division of Developmental Medicine, UCSF, USA.
| |
Collapse
|
3
|
Roubinov D, Ivins B, Frame L, Simms S, Pfiffner L. Integrating Treatment for Maternal Depression and Young Children's Behavior Problems. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2023; 8:e230011. [PMID: 38274276 PMCID: PMC10809929 DOI: 10.20900/jpbs.20230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
It is important to consider reciprocal associations between maternal and offspring mental health problems during early childhood. Existing interventions often focus narrowly on either adult or child mental health, missing the opportunity for holistic care. We describe the rationale and development of a pilot randomized clinical trial that explores their integration, combining an evidence-based parenting intervention with depression treatment to improve both maternal and child outcomes. Our approach is part of a growing field of two-generation interventions that offer a promising approach to enhance mental health support for caregivers and their young children.
Collapse
Affiliation(s)
- Danielle Roubinov
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA 94107, USA
| | - Barbara Ivins
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA 94107, USA
- Early Intervention Services, Division of Behavioral Health, UCSF Benioff Children’s Hospital Oakland, Oakland, CA 94607, USA
| | - Laura Frame
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA 94107, USA
- Early Intervention Services, Division of Behavioral Health, UCSF Benioff Children’s Hospital Oakland, Oakland, CA 94607, USA
| | - Stephanie Simms
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA 94107, USA
| | - Linda Pfiffner
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA 94107, USA
| |
Collapse
|
4
|
Chad-Friedman S, Zhang I, Donohue K, Chad-Friedman E, Rich BA. Reciprocal associations between parental depression and child cognition: Pathways to children's internalizing and externalizing symptoms. Dev Psychopathol 2023:1-11. [PMID: 37929632 DOI: 10.1017/s0954579423001372] [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: 11/07/2023]
Abstract
Parental depression is a risk factor for children's cognitive and psychological development. Literature has found reciprocal relations between parental depression and child psychopathology and effects of parental depression on children's cognition. The present study is the first to examine reciprocity among parental depression and child cognition, and pathways to child psychopathology. Structural equation models were conducted using data from the Early Head Start Research and Evaluation Project, a nationally representative sample of 3,001 economically marginalized families. Measures were collected in four waves from 14 months to 10-11 years. Reciprocal associations emerged between maternal and paternal depression at from 14 months to 5 years. Reciprocal parental depression was associated with greater psychopathology at age 10-11. Maternal depression predicted poorer child cognition, which indirectly predicted increased depression in mothers of children aged 3-5 through paternal depression, and in fathers at age 3, through earlier paternal depression. This study was unable to parse within- and between-person effects. Additionally, data for paternal depression was limited to ages 2 and 3. Findings emphasize the transactional nature of child cognition and child and parent psychopathology, supporting family focused intervention and prevention efforts that target parent psychopathology and child cognition.
Collapse
Affiliation(s)
- Simone Chad-Friedman
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Irene Zhang
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Kristyn Donohue
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | | | - Brendan A Rich
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| |
Collapse
|
5
|
Roubinov D, Don B, Blades R, Epel E. Is it me or my child? The association between maternal depression and children's behavior problems in mothers and their children with or without autism. FAMILY PROCESS 2023; 62:737-753. [PMID: 36017571 DOI: 10.1111/famp.12810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 06/08/2023]
Abstract
Bidirectional associations between maternal depression and child behavior problems have been reported in prior research, however, few studies examine these relations across varied family contexts. This study examined parenting stress and child diagnosis of autism spectrum disorder (ASD) as moderators of bidirectional associations between maternal depression and child behavior problems over time. Our sample included 86 mother-child dyads who reported maternal depressive symptoms, child behavior problems, and parenting stress at three time points over more than 1 year. Approximately half were mothers of children with ASD (n = 41) and half were mothers of neurotypical children (n = 45). We tested the bidirectional associations between maternal depressive symptoms and children's behavior problems and the potential moderating role of parental stress or child ASD diagnosis on these bidirectional associations using aggregated, lagged, and linear mixed models. Even after controlling for lagged maternal depressive symptoms, child behavior problems were associated with greater subsequent maternal depression at the between-person level, but not at the within-person level. The converse relation of prior maternal depressive symptoms on subsequent child behavior problems was not significant. Neither parenting stress nor child ASD diagnosis moderated bidirectional associations between maternal depressive symptoms and children's behavior problems. Child behavior predicted maternal depression, but the converse was not true, regardless of parenting stress levels or child's ASD diagnosis. For mothers experiencing elevated parenting stress and those with children with ASD, this may help alleviate elevated feelings of guilt related to their children's behavior problems.
Collapse
Affiliation(s)
- Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Brian Don
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Robin Blades
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Elissa Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| |
Collapse
|
6
|
Bakken NR, Hannigan LJ, Shadrin A, Hindley G, Ask H, Reichborn-Kjennerud T, Tesli M, Andreassen OA, Havdahl A. Childhood temperamental, emotional, and behavioral characteristics associated with mood and anxiety disorders in adolescence: A prospective study. Acta Psychiatr Scand 2023; 147:217-228. [PMID: 36398468 PMCID: PMC10099752 DOI: 10.1111/acps.13522] [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: 07/12/2022] [Revised: 10/22/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mood and anxiety disorders account for a large share of the global burden of disability. Some studies suggest that early signs may emerge already in childhood. However, there is a lack of well-powered, prospective studies investigating how and when childhood mental traits and trajectories relate to adolescent mood and anxiety disorders. METHODS We here examine cross-sectional and longitudinal association between maternally reported temperamental traits, emotional and behavioral problems in childhood (0.5-8 years) and clinical diagnosis of mood or anxiety ("emotional") disorders in adolescence (10-18 years), using the prospective Norwegian Mother, Father and Child Cohort Study (MoBa) of 110,367 children. RESULTS Logistic regression analyses showed consistent and increasing associations between childhood negative emotionality, behavioral and emotional problems and adolescent diagnosis of emotional disorders, present from 6 months of age (negative emotionality). Latent profile analysis incorporating latent growth models identified five developmental profiles of emotional and behavioral problems. A profile of early increasing behavioral and emotional problems with combined symptoms at 8 years (1.3% of sample) was the profile most strongly associated with emotional disorders in adolescence (OR vs. reference: 5.00, 95% CI: 3.70-6.30). CONCLUSIONS We found a consistent and increasing association between negative emotionality, behavioral and emotional problems in early to middle childhood and mood and anxiety disorders in adolescence. A developmental profile coherent with early and increasing disruptive mood dysregulation across childhood was the profile strongest associated with adolescent emotional disorders. Our results highlight the importance of early emotional dysregulation and childhood as a formative period in the development of adolescent mood and anxiety disorders, supporting potential for prevention and early intervention initiatives.
Collapse
Affiliation(s)
- Nora R Bakken
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Laurie J Hannigan
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Guy Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Martin Tesli
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Shih EW, Ahmad SI, Bush NR, Roubinov D, Tylavsky F, Graff C, Karr CJ, Sathyanarayana S, LeWinn KZ. A path model examination: maternal anxiety and parenting mediate the association between maternal adverse childhood experiences and children's internalizing behaviors. Psychol Med 2023; 53:112-122. [PMID: 34001294 PMCID: PMC9290334 DOI: 10.1017/s0033291721001203] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/28/2020] [Accepted: 03/17/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Children of mothers with adverse childhood experiences (ACEs) are at increased risk for developmental problems. However, the mechanisms through which a mother's experience of ACEs are transmitted to her offspring are understudied. The current study investigates potential modifiable mediators (maternal psychopathology and parenting) of the association between maternal ACEs and children's behavioral problems. METHODS We utilized data from a pregnancy cohort study (N = 1030; CANDLE study) to investigate longitudinal associations between maternal ACEs, postpartum anxiety, observed parenting behavior, and child internalizing behaviors (meanage = 4.31 years, s.d. age = 0.38) in a racially diverse (67% Black; 33% White/Other) sample. We used structural equation modeling to test for direct associations between maternal ACEs and children's internalizing behaviors, as well as indirect associations via two simple mediations (maternal anxiety and parenting), and one serial mediation (sequence of maternal anxiety to parenting). RESULTS Simple mediation results indicated that maternal anxiety and cognitive growth fostering behaviors independently mediated the association between maternal ACEs and child internalizing. We observed no evidence of a serial mediation from ACEs to internalizing via the effects of maternal anxiety on parenting. CONCLUSIONS This study supports and refines extant literature by confirming the intergenerational association between maternal ACEs and child internalizing behaviors in a large, diverse sample, and identifies potential modifiable mediators: maternal anxiety and parenting behaviors related to fostering cognitive development. Findings may inform interventions targeting mothers who have experienced ACEs and suggest that providing support around specific parenting behaviors and addressing maternal anxiety may reduce internalizing behaviors in children.
Collapse
Affiliation(s)
- Emily W. Shih
- University of California, San Francisco, San Francisco, CA, USA
| | - Shaikh I. Ahmad
- University of California, San Francisco, San Francisco, CA, USA
| | - Nicole R. Bush
- University of California, San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Sheela Sathyanarayana
- University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Kaja Z. LeWinn
- University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
8
|
Hendry A, Gibson SP, Davies C, McGillion M, Gonzalez-Gomez N. Toward a dimensional model of risk and protective factors influencing children's early cognitive, social, and emotional development during the COVID-19 pandemic. INFANCY 2023; 28:158-186. [PMID: 35993691 PMCID: PMC10086814 DOI: 10.1111/infa.12495] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/09/2022] [Accepted: 07/20/2022] [Indexed: 01/19/2023]
Abstract
Variation in infants' home environment is implicated in their cognitive and psycho-social development. The pandemic has intensified variations in home environments through exacerbating socioeconomic inequalities, and increasing psychological stressors for some families. This study investigates the effects of parental (predominantly maternal) mental health, enriching activities and screen use on 280 24- to 52-month-olds' executive functions, internalising and externalising problems, and pro-social behaviour; with socioeconomic status and social support as contextual factors. Our results indicate that aspects of the home environment are differentially associated with children's cognitive and psycho-social development. Parents who experienced sustained mental distress during the pandemic tended to report higher child externalising and internalising problems, and executive function difficulties at follow-up. Children who spent more time engaged in enriching activities with their parents showed stronger executive functions and social competence six months later. Screen use levels during the first year of the pandemic were not associated with outcomes. To mitigate the risk of persistent negative effects for this 'pandemic generation' of infants, our study highlights the importance of supporting parents' mental health. As our results demonstrate the impact of social support on mental health, investing in support services and interventions promoting building support networks are likely to be beneficial.
Collapse
Affiliation(s)
- Alexandra Hendry
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Catherine Davies
- School of Languages, Cultures and Societies, University of Leeds, Leeds, UK
| | | | | |
Collapse
|
9
|
Hagan MJ, Roubinov DR, Cordeiro A, Lisha N, Bush NR. Young children's traumatic stress reactions to the COVID-19 pandemic: The long reach of mothers' adverse childhood experiences. J Affect Disord 2022; 318:130-138. [PMID: 36030995 PMCID: PMC9420002 DOI: 10.1016/j.jad.2022.08.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/22/2022] [Accepted: 08/21/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has negatively impacted parental and child mental health; however, it is critical to examine this impact in the context of parental histories of adversity. We hypothesized that maternal adverse childhood experiences (ACEs) and pandemic-related negative life events would predict child traumatic stress symptoms (TSS) and tested potential mediating pathways through maternal pandemic-related TSS and/or poorer maternal sensitivity during the pandemic. METHODS Data were collected from a longitudinal sample of low-income, racially/ethnically diverse mothers and their children. Between May and November 2020, mothers (n = 111) of young children (M age = 7.42 years, SD = 0.45) completed questionnaires to assess their own and their child's pandemic-related TSS, exposure to pandemic-related negative events, and parent-child relationship quality. Maternal ACEs, maternal depression, parent-child relationship quality, and child internalizing symptoms had been assessed approximately 1-3 years prior. RESULTS Structural equation analyses revealed that pandemic negative life events were indirectly associated with child TSS via greater maternal TSS. For mothers, recent pandemic-related negative events were associated with their own TSS, whereas maternal ACEs were not. Maternal ACEs directly predicted greater child TSS, with no evidence of mediation by either maternal TSS or maternal sensitivity. LIMITATIONS All measures were parent report, and pandemic-related measures were collected at the same time point. CONCLUSIONS Findings underscore the long reach of mothers' own adverse childhood experiences, highlighting the negative consequences of these prior traumatic exposures alongside current pandemic-related maternal trauma symptoms for children's adjustment during the pandemic.
Collapse
|
10
|
Rudd KL, Cheng SS, Cordeiro A, Coccia M, Karr CJ, LeWinn KZ, Mason WA, Trasande L, Nguyen RHN, Sathyanarayana S, Swan SH, Barrett ES, Bush NR. Associations Between Maternal Stressful Life Events and Perceived Distress during Pregnancy and Child Mental Health at Age 4. Res Child Adolesc Psychopathol 2022; 50:977-986. [PMID: 35258749 PMCID: PMC9395496 DOI: 10.1007/s10802-022-00911-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 11/26/2022]
Abstract
Accumulating evidence suggests that maternal exposure to objectively stressful events and subjective distress during pregnancy may have intergenerational impacts on children's mental health, yet evidence is limited. In a multisite longitudinal cohort (N = 454), we used multi-variable linear regression models to evaluate the predictive value of exposure to stressful events and perceived distress in pregnancy for children's internalizing problems, externalizing problems, and adaptive skills at age 4. We also explored two- and three-way interactions between stressful events, distress, and child sex. Both objective and subjective maternal stress independently predicted children's behavior, with more stressful events and higher distress predicting more internalizing and externalizing problems and worse adaptability; stress types did not significantly interact. There was some evidence that more stressful events predicted higher externalizing behaviors only for girls. Three-way interactions were not significant. The current findings highlight the importance of considering the type of stress measurement being used (e.g., counts of objective event exposure or subjective perceptions), suggest prenatal stress effects may be transdiagnostic, and meet calls for rigor and reproducibility by confirming these independent main effects in a relatively large group of families across multiple U.S. regions. Results point to adversity prevention having a two-generation impact and that pre- and postnatal family-focused intervention targets may help curb the rising rates of children's mental health problems.
Collapse
Affiliation(s)
- Kristen L. Rudd
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | - Sylvia S. Cheng
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | - Alana Cordeiro
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | - Michael Coccia
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | | | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
- Weill Institute of Neuroscience, University of California San Francisco, San Francisco, CA USA
| | - W. Alex Mason
- Department of Preventative Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Langone Medical Center, New Yok, NY USA
- Departments of Population Health and Environmental Medicine, New York University, New York, NY USA
| | - Ruby H. N. Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN USA
| | | | - Shanna H. Swan
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
- Weill Institute of Neuroscience, University of California San Francisco, San Francisco, CA USA
- Department of Pediatrics, University of California San Francisco, CA San Francisco, USA
| |
Collapse
|
11
|
Browne DT, LeWinn KZ, May SS, Tylavsky F, Bush NR. Maternal early exposure to violence, psychopathology, and child adaptive functioning: pre- and postnatal programming. Pediatr Res 2022; 92:91-97. [PMID: 35250026 DOI: 10.1038/s41390-022-01954-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/26/2021] [Accepted: 11/26/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND The pre- and postnatal programming mechanisms, timing, and direction of effects linking maternal early exposure to violence (MEEV), psychopathology, and child adaptive functioning are understudied. Thus, the following hypotheses were tested: (H1) higher pre- and postnatal maternal psychopathology will predict lower adaptive functioning, (H2) lower adaptive functioning will predict higher subsequent maternal psychopathology, (H3) cumulative effects of MEEV on maternal psychopathology and adaptive functioning will be observed, and (H4) higher MEEV will predict lower adaptive functioning via maternal psychopathology both pre- and postnatally. METHODS Prospective pregnancy cohort study including 1503 mother-child dyads with associations between MEEV, psychopathology, and child adaptive functioning examined using cross-lagged panel analysis. Assessment occurred in the third trimester and annually across the first four years of life. RESULTS Higher pre- and postnatal maternal psychopathology predicted lower child adaptive functioning at 12 and 24 months, respectively. MEEV predicted maternal psychopathology cumulatively and offered a repeated prediction of adaptive functioning across the first two years of the child's life, operating predominantly through maternal psychopathology during pregnancy. Child effects on mothers were not observed. CONCLUSIONS Like in socioemotional assessment, pediatric assessment of child adaptive functioning should consider the intergenerational transmission of MEEV. IMPACT Associations between maternal early exposure to violence (MEEV), psychopathology, and child socioemotional development is well documented. Much less is known about the pre- and postnatal programming mechanisms, timing, and direction of effects between MEEV, maternal psychopathology, and child adaptive functioning. Findings suggest associations of both prenatal and postnatal maternal psychopathology with child adaptive functioning, though the effects of MEEV were more strongly operative through the prenatal pathway. Pediatric assessment and interventions surrounding adaptive functioning should consider the potential role of MEEV in shaping children's health and development, in addition to potential consequences of pre- and postnatal maternal mental health.
Collapse
Affiliation(s)
- Dillon T Browne
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada. .,Centre for Mental Health Research & Treatment, University of Waterloo, Waterloo, ON, Canada.
| | - Kaja Z LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Shealyn S May
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Fran Tylavsky
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nicole R Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.,Department of Pediatrics, University of California, San Francisco, CA, USA
| |
Collapse
|
12
|
Griffith JM, Young JF, Hankin BL. Longitudinal Coupling of Depression in Parent-Adolescent Dyads: Within- and Between-Dyad Effects Over Time. Clin Psychol Sci 2021; 9:1059-1079. [PMID: 35003905 PMCID: PMC8740952 DOI: 10.1177/2167702621998313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present work evaluated reciprocal, within-dyad associations between parent-adolescent depressive symptoms across two independent samples (N=327 and N=435 dyads, respectively; approximately 85% biological mothers) assessed every three months for two (Study 1) to three (Study 2) years. Results of random intercept cross-lagged panel models converged to support positive contemporaneous patterns of co-fluctuation in parent and adolescent depression, such that within-person deviations in parental depression were associated with same direction within-person deviations in adolescent depression at the same timepoint. In contrast, within-person fluctuations in parent depression did not predict prospective within-person fluctuations in adolescent depression, or vice versa, across the follow-up period. Results held across boys and girls, as well as dyads with and without a parental history of depressive disorder. Overall, findings advance knowledge by demonstrating that, after accounting for between-person/dyad variance, parent and adolescent depression demonstrate contemporaneous co-fluctuations, but do not demonstrate within-dyad reciprocity over time.
Collapse
Affiliation(s)
- Julianne M. Griffith
- University of Illinois-Urbana Champaign, Department of Psychology, 603 E. Daniel Street, Champaign, IL, 61820
| | - Jami F. Young
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - Benjamin L. Hankin
- University of Illinois-Urbana Champaign, Department of Psychology, 603 E. Daniel Street, Champaign, IL, 61820
| |
Collapse
|
13
|
Predictors of Early Postpartum Maternal Functioning Among Women Veterans. Matern Child Health J 2021; 26:149-155. [PMID: 34626289 DOI: 10.1007/s10995-021-03241-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The perinatal period constitutes an important window of opportunity for optimizing healthy development of offspring but is heavily influenced by maternal mental health. Maternal pregnancy-related anxiety (PrA), depression, and post-traumatic stress disorder (PTSD) have been implicated in adverse outcomes for both mother and child. The current study examined whether psychopathology during pregnancy and postpartum was associated with greater experienced parenting stress and bonding difficulties in women veterans, who may be predisposed to develop psychopathology due to heightened risk of exposure to traumatic events. METHODS Pregnant veterans (N = 28) completed self-report questionnaires regarding their PrA, depression and PTSD symptoms during pregnancy and postpartum, as well as on their experience of parenting stress and bonding with their infant. RESULTS PrA was a more robust predictor of postpartum depression (PPD) than depression during pregnancy. PPD, in turn, was significantly associated with bonding and parenting stress, such that more depressed mothers were more likely to experience greater general bonding difficulties, increased rejections and pathological anger towards their infants, greater anxiety towards their infants, and more parenting stress. CONCLUSIONS PrA might be a high-yield modifiable risk factor in the prevention of PPD for women veterans and their subsequent experiences with high parenting stress and bonding difficulties.
Collapse
|
14
|
Bidirectional and transactional relationships between parenting styles and child symptoms of ADHD, ODD, depression, and anxiety over 6 years. Dev Psychopathol 2021; 34:1400-1411. [PMID: 34103100 DOI: 10.1017/s0954579421000201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is well established that mothers' parenting impacts children's adjustment. However, much less is known about how children's psychopathology impacts their mothers' parenting and how parenting and child symptoms relate either bidirectionally (i.e., a relationship in both directions over two time points) or transactionally (i.e., a process that unfolds over time) to one another over a span of several years. In addition, relatively little research addresses the role of fathers' parenting in the development of children's symptoms and, conversely, how children may elicit certain types of parenting from fathers. In this study, data were collected from 491 families on mothers' and fathers' parenting styles (authoritarianism, authoritativeness, permissiveness, and overprotectiveness) and children's symptoms of psychopathology (attention deficit, oppositional defiant, depression, and anxiety) when children were age 3, 6, and 9 years old. Cross-lagged panel analyses revealed that parents and children affected one another in a bidirectional and transactional fashion over the course of the six years studied. Results suggest that children's symptoms may compound over time partially because they reduce exposure to adaptive and increase exposure to maladaptive parenting styles. Likewise, maladaptive parenting may persist over time due to the persistence of children's symptoms.
Collapse
|
15
|
Roubinov DS, Luecken LJ, Curci SG, Somers JA, Winstone LK. A prenatal programming perspective on the intergenerational transmission of maternal adverse childhood experiences to offspring health problems. AMERICAN PSYCHOLOGIST 2021; 76:337-349. [PMID: 33734799 PMCID: PMC7995605 DOI: 10.1037/amp0000762] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Decades of research indicate that individuals exposed to childhood adversity are at risk for poor physical and mental health across their life span. More recently, intergenerational transmission of trauma and prenatal programming frameworks suggest an even longer reach for adverse childhood experiences (ACEs), with consequences that extend to subsequent generations. Beyond the individual-level consequences typically observed by empirical studies of ACEs, mothers' experiences of early adversity may also compromise the maternal-child dyadic relationship. We propose a conceptual model whereby mothers' ACEs impact maternal-infant dyadic functioning and later biobehavioral health outcomes through heightened perinatal psychosocial risk. We provide support for the proposed paths and mechanistic processes in our model with data drawn from Las Madres Nuevas, a longitudinal study of low-income Mexican-origin families who participated in a series of home and laboratory visits from the prenatal period through early childhood. Higher ACEs exposure among Las Madres Nuevas participants was associated with numerous perinatal psychosocial risk factors, which predicted poorer mother-infant dyadic functioning. Compromised dyadic functioning during infancy was associated with later maternal mental health and child behavior problems. We conclude with discussion of prevention and treatment strategies that can buffer against proposed risk pathways, including perinatal assessment of maternal ACEs and psychosocial risk, perinatal treatment of maternal distress, and mother-infant therapy in the postpartum period. It is our hope that the proposed conceptual model will serve as a guide for future research to examine the lasting consequences of childhood adversities within and across generations among high-risk populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
16
|
Bush NR, Wakschlag LS, LeWinn KZ, Hertz-Picciotto I, Nozadi SS, Pieper S, Lewis J, Biezonski D, Blair C, Deardorff J, Neiderhiser JM, Leve LD, Elliott AJ, Duarte CS, Lugo-Candelas C, O’Shea TM, Avalos LA, Page GP, Posner J. Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward. Front Psychiatry 2020; 11:547. [PMID: 32636769 PMCID: PMC7318113 DOI: 10.3389/fpsyt.2020.00547] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and functioning, and parental substance use) and discuss how these domains influence neurodevelopment, with particular emphasis on mental health outcomes. We also highlight a new initiative launched by the National Institutes of Health, the Environmental influences on Child Health Outcomes (ECHO) program. We discuss the role that ECHO will play in advancing our understanding of the impact of the family environment on children's risk for psychiatric outcomes. Lastly, we conclude with important unanswered questions and controversies in this area of research, highlighting how ECHO will contribute to resolving these gaps in our understanding, clarifying relationships between the family environment and children's mental health.
Collapse
Affiliation(s)
- Nicole R. Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Il, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sarah Pieper
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Johnnye Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Dominik Biezonski
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Clancy Blair
- Department of Population Health, New York University, New York, NY, United States
| | - Julianna Deardorff
- Community Health Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, Penn State University, University Park, PA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Amy J. Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, United States
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Claudia Lugo-Candelas
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Grier P. Page
- Department of Biostatistics and Epidemiology, RTI, Atlanta, GA, United States
| | - Jonathan Posner
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| |
Collapse
|