Children, stress, and context: integrating basic, clinical, and experimental prevention research

Relationships among caregiving, stress, and self-regulation in toddlers living in poverty

PURPOSE

The Developmental Psychobiological Model of Experiential Canalization (DPMEC) proposes that conditions of poverty-related adversity influence child self-regulation through parental caregiving, stress hormones, and the child's genetics. However, empirical findings investigating these relationships with prolonged stress hormones are mixed. Further, the relationships among conditions of adversity with prolonged stress hormones have seldom been investigated in toddlers living in poverty. Guided by the DPMEC, we examined the relationships among maternal caregiving, prolonged stress, and self-regulation in toddlers living in poverty in the United States, to include examining whether toddler prolonged stress mediated relations between maternal caregiving and child self-regulation.

DESIGN AND METHODS

Participants were mothers and toddlers (20 to 24 months of age) living in poverty, who provided hair samples to measure four months of average cortisol concentration to estimate prolonged stress. We used observational measures to examine maternal caregiving and indirect report to measure children's self-regulation.

RESULTS

Findings did not support the role of toddler prolonged stress in mediating the relationship between maternal caregiving and toddler self-regulation. However, multiple linear regression models showed that higher levels of maternal emotionally supportive caregiving significantly predicted better toddler soothability (b = 0.90; p = .03; 95% CI [0.10, 1.69]; partial correlation = 0.26).

CONCLUSIONS

This study adds partial support for the DPMEC to represent associations between maternal caregiving and toddler self-regulation for mothers and toddlers experiencing poverty.

PRACTICE IMPLICATIONS

While these data come from an observational study, pediatric nurses may consider assessing maternal supportive caregiving upon reports of poor toddler soothability.

Childhood abuse and social anxiety symptoms among young adults: Moderating role of respiratory sinus arrhythmia suppression to social stress

BACKGROUND

Childhood abuse (CA) has been considered as an environmental risk factor for the development of social anxiety symptoms. Respiratory sinus arrhythmia (RSA) is a biomarker that has been found to interact with environmental stressors to affect psychopathological symptoms. However, little is known whether RSA moderates the relationship between CA and social anxiety symptoms.

OBJECTIVE

The current study aimed to examine the relationships between CA and two forms of social anxiety symptoms including social performance anxiety symptoms (SPAS) and social interaction anxiety symptoms (SIAS), and the moderating role of baseline RSA and/or RSA suppression to a social-evaluative stress in these links.

PARTICIPANTS AND SETTING

A total of 157 Chinese undergraduate students (Mage = 18.96, SD = 0.85, 85 % females) participated in this study.

METHOD

Participants completed the short form of Childhood Trauma Questionnaire, Social Phobia Scale and Social Interaction Anxiety Scale to assess CA, SPAS and SIAS, and then underwent a social stress protocol (a public speech task) during which their baseline RSA and stress induced RSA were obtained.

RESULTS

CA was positively correlated with SPAS but was not correlated with SIAS. RSA suppression to social stress moderated the associations between CA and two forms of social anxiety symptoms, such that CA was positively associated with SPAS and SIAS among individuals with blunted RSA suppression, but not among those with greater RSA suppression.

CONCLUSIONS

Greater social stress RSA suppression as a better physiological regulation marker might ameliorate the negative effect of CA on social anxiety symptoms.

Exploring Factors That Helped Adolescents Adjust and Continue With Life After the Death of a Parent

The aim of this study was to explore factors that helped adolescents to adjust and continue with life after the death of a parent. A qualitative research design was utilized, in which 12 participants participated in semistructured interviews. Data were analyzed according to thematic analysis. The following categories and themes emerged from the data: family support-supportive remaining parent, parent has a supportive partner and supportive extended family; social support-child has supportive friends and supportive community; religion--religion as a coping mechanism and religion as means of communicating with the deceased parent; and a strong personal sense of coherence (the ability to relate to and make sense of the world) as an intrapersonal coping mechanism. In addition, the following themes also emerged: exercising, allowing time to prepare for the death of a terminally ill parent, tangible reminders of the deceased, and journal writing. The findings can be used to design interventions for adolescents whose parent has passed away.

A Pilot Study of Stress System Activation in Children Enrolled in a Targeted Prevention Program: Implications for Personalization

Empirically validated interventions addressing childhood psychological problems are now readily available, but success likely depends in part on accurately identifying which children will benefit from which intervention. This pilot study examined the stress activation and response system, first as a way to differentiate high versus low-risk children, and second to explore indicators of the stress system associated with favorable intervention response. Method. Participants (N = 43, 58% male) were school-aged children who qualified for inclusion in the Early Risers “Skills for Success” Prevention Program based on their elevated levels of aggressive and/or socially withdrawn behavior and a normally developing comparison group. Compared to the normally developing group, children who were participants in the intervention exhibited a more blunted cortisol response to the stress paradigm. However, for the children in the intervention group, elevated cortisol levels at the start of the stress paradigm were concurrently associated with internalizing problems and predictive of improvement in internalizing problems over time. These findings provide preliminary evidence that hypothalamic pituitary adrenal (HPA) axis biological variables may be helpful tools for identifying children who would benefit from intervention and personalizing interventions.

Parenting stressors and young adolescents' depressive symptoms: Does high vagal suppression offer protection?

Grounded in a dual-risk, biosocial perspective of developmental psychopathology, this study examined the role of higher vagal suppression in providing young adolescents protection from four parenting stressors. It was expected that lower vagal suppression would increase youth vulnerability to the deleterious effects of these parenting stressors. Depressive symptoms were examined as a central marker of socioemotional difficulties during early adolescence. The four parenting stressors examined were interparental hostility, maternal use of harsh discipline, maternal inconsistent discipline, and maternal psychological control. Participants were 68 young adolescents (Grade 6) and their mothers. Greater vagal suppression provided protection (i.e., lower depressive symptoms) from interparental hostility, harsh discipline, and maternal psychological control for boys but not for girls.

Holding parents so they can hold their children: grief work with surviving spouses to support parentally bereaved children

A child's adjustment to the death of a parent is greatly influenced by the surviving parent's ability to attend to his or her own grief-related needs, to create and sustain a consistent and nurturing environment, and to encourage the child to express distressing or conflicting thoughts, feelings, and fantasies about the loss. Yet, the surviving parent's grief often compromises their ability to parent consistently and empathically. This article will illustrate how, by providing a holding environment for whole families, clinicians can help parents to facilitate children's grief reactions and, thus, mitigate long-term adverse mental health outcomes. Family Matters programs, designed and implemented in a community agency, use a holistic approach to family support and treatment in a milieu setting. Combining therapeutic work with surviving spouses and bereaved children supports children's grief while facilitating newly single parents as they adapt the structure of family life. When clinical work with families begins before the ill parent dies, the clinicians may build a relationship with the dying parent, prepare the child and surviving spouse for life after loss, and support continuity in family culture. We introduce a curriculum for simultaneously supporting bereaved children and parents, present a series of common challenges faced by surviving parents, and suggest avenues for intervention research.

Child development in the context of adversity: experiential canalization of brain and behavior

The authors examine the effects of poverty-related adversity on child development, drawing upon psychobiological principles of experiential canalization and the biological embedding of experience. They integrate findings from research on stress physiology, neurocognitive function, and self-regulation to consider adaptive processes in response to adversity as an aspect of children's development. Recent research on early caregiving is paired with research in prevention science to provide a reorientation of thinking about the ways in which psychosocial and economic adversity are related to continuity in human development.

Growing up with grief: revisiting the death of a parent over the life course

In the era of managed care, evidence-based practice, and short term, solution focused interventions, clinicians in agency based settings generally do not have the luxury of long-term contact with bereaved children. Although a substantial, yet controversial, literature argues that children cannot fully resolve early loss until adulthood, limited attention is given to how children's understandings of early loss shift as their cognitive capacities mature. This article argues the emotional experience of grief shifts: 1) as children grapple with both normative life changes and the tasks of mourning, and 2) as their cognitive and emotional development allow them to understand and question aspects of their deceased parent's life and death in new ways. This article will present an overview of longitudinal and cross-sectional research on the long-term impact of childhood grief. We then suggest the ways bereaved children and adolescents revisit and reintegrate the loss of a parent as their emotional, moral, and cognitive capacities mature and as normative ego-centrism and magical thinking decline. To demonstrate these ideas, we draw on the case of a parentally bereaved boy and his family presenting across agency-based and private-practice work over the course of 14 years. This case suggests the need for coordinated care for children who are moving beyond the initial trauma of parental loss into various stages of grief and reintegration. While the loss of a parent is permanent and unchanging, the process is not: it is part of the child's ongoing experience. (Worden, 1996, p. 16).

First-Year Maternal Employment and Child Development in the First Seven Years

Using data from the first 2 phases of the NICHD Study of Early Child Care, we examine the links between maternal employment in the first 12 months of life and cognitive, social, and emotional outcomes for children at age 3, age 4½, and first grade. Drawing on theory and prior research from developmental psychology as well as economics and sociology, we address three main questions. First, what associations exist between first-year maternal employment and cognitive, social, and emotional outcomes for children over the first seven years of life? Second, to what extent do any such associations vary by the child's gender and temperament, or the mother's occupation? Third, to what extent do mother's earnings, the home environment (maternal depressive symptoms, sensitivity, and HOME scores), and the type and quality of child care mediate or offset any associations between first-year employment and child outcomes, and what is the net effect of first-year maternal employment once these factors are taken into account? We compare families in which mothers worked full time (55%), part time (23%), or did not work (22%) in the first year for non-Hispanic white children (N=900) and for African-American children (N=113). Comparisons are also made taking into account the timing of mothers' employment within the first year. A rich set of control variables are included. OLS and SEM analyses are constructed. With regard to cognitive outcomes, first, we find that full-time maternal employment in the first 12 months of life (but not part-time employment) is associated with significantly lower scores on some, but not all, measures of cognitive development at age 3, 4 ½, and first grade for non-Hispanic white children, but with no significant associations for the small sample of African-American children Part-time employment in the first year is associated with higher scores than full-time employment for some measures. Employment in the second and third year of life is not associated with the cognitive outcomes. Second, we examine the role of the child's gender and temperament and the mother's occupation in moderating the associations between first-year maternal employment and cognitive outcomes, but find few significant interactions for either child characteristics or mother's occupation. Third, we examine the role of an extensive set of potential mediators - the mother's earnings, the home environment, and the type and quality of child care. We find that mothers who worked full time have higher income in the first year of life and thereafter, that mothers who worked part time have higher HOME and maternal sensitivity scores than mothers who did not work or worked full time, and that mothers who worked either full time or part time were more likely to place their children in high-quality child care by age 3 and 4 ½ and their children spent more time in center-based care by age 4 ½ than in families where mothers did not work in the first year of life. However, we also find some links between first-year maternal employment and elevated levels of maternal depressive symptoms thereafter. Turning to results from structural equation modeling, we find that the overall effects of first-year maternal employment on the cognitive outcomes are neutral. This occurs because significantly negative direct effects of full-time first-year employment are offset by significantly positive indirect effects working through more use of center-based care and greater maternal sensitivity by age 4 ½. Regarding social and emotional outcomes, several findings, again limited to non-Hispanic white children, stand out. First, we find no significant associations between first-year maternal employment and later social and emotional outcomes (including attachment security) when comparing children whose mothers worked full-time or part-time in the first year with the reference group of children whose mothers did not work in the first year, although in models that take the timing of employment within the first year into account, we find some significant associations between full-time maternal employment in the first year and higher levels of caregiver- or teacher-reported externalizing problems at age 4 ½ and first grade. Second, part-time maternal employment by 12 months tends to be associated with fewer externalizing problems at age 4 ½ and first grade than full time maternal employment by 12 months. These results are unchanged when we allow for the possibility of moderation by child characteristics or maternal occupation. Third, the results from SEM models indicate that, while neither full-time nor part-time first-year employment has significant total effects on children's externalizing behavior problems at age 4 ½ or first grade, part-time first-year employment has indirect positive effects, working primarily through differences in the home environment and maternal sensitivity. Another important finding from the SEM models is that center-based care, which is often associated with maternal employment, is not significantly associated with elevated levels of child behavior problems. Taken together, our findings provide new insight as to the net effects of first-year maternal employment as well as the potential pathways through which associations between first-year maternal employment and later child outcomes, where present, come about. Our SEM results indicate that, on average, the associations between first-year maternal employment and later cognitive, social, and emotional outcomes are neutral, because negative effects, where present, are offset by positive effects. These results confirm that maternal employment in the first year of life may confer both advantages and disadvantages and that for the average non-Hispanic white child, those effects balance each other.

First-Year Maternal Employment and Child Development in the First Seven Years

Using data from the first 2 phases of the NICHD Study of Early Child Care, we examine the links between maternal employment in the first 12 months of life and cognitive, social, and emotional outcomes for children at age 3, age 4½, and first grade. Drawing on theory and prior research from developmental psychology as well as economics and sociology, we address three main questions. First, what associations exist between first-year maternal employment and cognitive, social, and emotional outcomes for children over the first seven years of life? Second, to what extent do any such associations vary by the child's gender and temperament, or the mother's occupation? Third, to what extent do mother's earnings, the home environment (maternal depressive symptoms, sensitivity, and HOME scores), and the type and quality of child care mediate or offset any associations between first-year employment and child outcomes, and what is the net effect of first-year maternal employment once these factors are taken into account? We compare families in which mothers worked full time (55%), part time (23%), or did not work (22%) in the first year for non-Hispanic white children (N=900) and for African-American children (N=113). Comparisons are also made taking into account the timing of mothers' employment within the first year. A rich set of control variables are included. OLS and SEM analyses are constructed. With regard to cognitive outcomes, first, we find that full-time maternal employment in the first 12 months of life (but not part-time employment) is associated with significantly lower scores on some, but not all, measures of cognitive development at age 3, 4 ½, and first grade for non-Hispanic white children, but with no significant associations for the small sample of African-American children Part-time employment in the first year is associated with higher scores than full-time employment for some measures. Employment in the second and third year of life is not associated with the cognitive outcomes. Second, we examine the role of the child's gender and temperament and the mother's occupation in moderating the associations between first-year maternal employment and cognitive outcomes, but find few significant interactions for either child characteristics or mother's occupation. Third, we examine the role of an extensive set of potential mediators - the mother's earnings, the home environment, and the type and quality of child care. We find that mothers who worked full time have higher income in the first year of life and thereafter, that mothers who worked part time have higher HOME and maternal sensitivity scores than mothers who did not work or worked full time, and that mothers who worked either full time or part time were more likely to place their children in high-quality child care by age 3 and 4 ½ and their children spent more time in center-based care by age 4 ½ than in families where mothers did not work in the first year of life. However, we also find some links between first-year maternal employment and elevated levels of maternal depressive symptoms thereafter. Turning to results from structural equation modeling, we find that the overall effects of first-year maternal employment on the cognitive outcomes are neutral. This occurs because significantly negative direct effects of full-time first-year employment are offset by significantly positive indirect effects working through more use of center-based care and greater maternal sensitivity by age 4 ½. Regarding social and emotional outcomes, several findings, again limited to non-Hispanic white children, stand out. First, we find no significant associations between first-year maternal employment and later social and emotional outcomes (including attachment security) when comparing children whose mothers worked full-time or part-time in the first year with the reference group of children whose mothers did not work in the first year, although in models that take the timing of employment within the first year into account, we find some significant associations between full-time maternal employment in the first year and higher levels of caregiver- or teacher-reported externalizing problems at age 4 ½ and first grade. Second, part-time maternal employment by 12 months tends to be associated with fewer externalizing problems at age 4 ½ and first grade than full time maternal employment by 12 months. These results are unchanged when we allow for the possibility of moderation by child characteristics or maternal occupation. Third, the results from SEM models indicate that, while neither full-time nor part-time first-year employment has significant total effects on children's externalizing behavior problems at age 4 ½ or first grade, part-time first-year employment has indirect positive effects, working primarily through differences in the home environment and maternal sensitivity. Another important finding from the SEM models is that center-based care, which is often associated with maternal employment, is not significantly associated with elevated levels of child behavior problems. Taken together, our findings provide new insight as to the net effects of first-year maternal employment as well as the potential pathways through which associations between first-year maternal employment and later child outcomes, where present, come about. Our SEM results indicate that, on average, the associations between first-year maternal employment and later cognitive, social, and emotional outcomes are neutral, because negative effects, where present, are offset by positive effects. These results confirm that maternal employment in the first year of life may confer both advantages and disadvantages and that for the average non-Hispanic white child, those effects balance each other.

Probing the neural correlates of anticipated peer evaluation in adolescence

Neural correlates of social-cognition were assessed in 9- to- 17-year-olds (N = 34) using functional magnetic resonance imaging. Participants appraised how unfamiliar peers they had previously identified as being of high or low interest would evaluate them for an anticipated online chat session. Differential age- and sex-related activation patterns emerged in several regions previously implicated in affective processing. These included the ventral striatum, hippocampus, hypothalamus, and insula. In general, activation patterns shifted with age in older relative to younger females but showed no association with age in males. Relating these neural response patterns to changes in adolescent social-cognition enriches theories of adolescent social development through enhanced neurobiological understanding of social behavior.

Adolescent self-regulation as resilience: resistance to antisocial behavior within the deviant peer context

This study tests the hypothesis that self-regulation serves as a resiliency factor in buffering youth from negative influences of peer deviance in middle to late adolescence. The interactive effects between peer deviance and self-regulation were investigated on change in antisocial behavior from age 17 to 19 years in an ethnically diverse sample of adolescents. A multi-agent construct was created using adolescent, parent, and teacher reports of self-regulation and peer deviance. Results indicated that self-regulation shows convergent validity and covaries as expected with developmental patterns of adolescent antisocial behavior. Self-regulation moderated the association of peer deviance with later self-reported adolescent antisocial behavior after controlling for prior levels of antisocial behavior. The implications of these findings for models for the development of antisocial behaviors and for intervention science are discussed.

Child outcome measures in the study of child care quality

This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review by Vandell and Wolfe (2000) as the starting point. Serious methodological problems were not pervasive for child outcome measures. However, methodological concerns were most prevalent among measures of socioemotional development. Furthermore, psychometric information on outcome measures was often missing from published reports, and health outcomes and approaches to learning were infrequently studied. Future research should address alignment issues between aspects of quality and the specific child outcomes chosen for study.

Children's cortisol levels and quality of child care provision

BACKGROUND

Cortisol levels are increasingly being used as an indicator of stress levels. Research suggests that children who attend child care demonstrate higher cortisol levels than children in their homes, suggesting that child care acts as a risk factor for poor child outcomes. However, it is also suggested that quality influences outcomes.

METHODS

Cortisol levels were measured through samples of saliva taken from children (3-5 years of age) attending long-day care centres in Perth, Western Australia. Quality of the programme was measured using industry national quality assurance indicators designed for child care centres. The analysis employed a 2 (time of collection: average am cortisol, average pm cortisol) by 3 (centre quality: high, satisfactory, unsatisfactory) split plot ANOVA with repeated measures on the time factor.

RESULTS

Cortisol levels of children attending high-quality programmes demonstrated a decline across the child care day. Levels in children attending unsatisfactory programmes demonstrated an increase across the day.

CONCLUSIONS

Although we do not yet know how high, and for how long, cortisol levels need to be elevated for risk of undesirable outcomes to increase, this research signals the importance of emphasizing the need for high-quality care for young children.

Environmental Control, Social Context, and Individual Differences in Behavioral and Cortisol Responses to Novelty in Infant Rhesus Monkeys

The effects of appetitive controllability on behavioral and cortisol reactivity to novelty in 12 infant rhesus monkeys were studied. Surrogate-peer-reared infants had homecage access to food treats contingently via lever pressing ("master") or noncontingently ("yoked") for 12 weeks from postnatal month 2. Masters lever-pressed more, but did not differ in baseline cortisol. At month 5, infants were exposed to a novel environment in social groups and individually. Masters were significantly more active and exhibited significantly lower cortisol reactivity to the novel environment, but only in the individual context. Also, individual differences in operant behavior were positively correlated with behavioral activity and negatively correlated with cortisol reactivity to the novel environment. The results reveal context-specific benefits of contingent stimulation in infancy.

Placing Emotional Self-Regulation in Sociocultural and Socioeconomic Contexts

In their review, Cole, Martin, and Dennis (this issue) relied on a valuable set of empirical examples of emotion regulation in infancy, toddlerhood, and the preschool period to make their case. These examples can be extended to include an emergent body of published research examining normative emotional regulatory processes among low-income and ethnic minority children using similar experimental methods. The following article considers emotion regulation across differing income, risk, and sociocultural contexts. Review of this literature points to ways these broader contexts are likely to influence children's development of emotional self-regulation. This review also points to innovative analytic approaches that might be useful in inferring causal mechanisms in emotion regulation research.

Child care research: an editorial perspective

The goals of Child Development's new From Another Perspective format are discussed, and an overview of the content of the inaugural From Another Perspective collection on child care effects is provided. The two lead articles suggest, respectively, that long hours in child care are related to children's later behavior problems and that child care may be physiologically challenging for young children. Commentaries focus on the need to examine a range of additional factors before drawing definitive conclusions about cause and effect. Among the issues discussed in the commentaries are the need to account for context, individual differences among children, and methodological challenges. The introductory editorial also overviews policy implications and directions for future research.