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Abstract
The effects of glucocorticoids on aggression can be conceptualized based on its mechanisms of action. These hormones can affect cell function non-genomically within minutes, primarily by affecting the cell membrane. Overall, such effects are activating and promote both metabolic preparations for the fight and aggressive behavior per se. Chronic increases in glucocorticoids activate genomic mechanisms and are depressing overall, including the inhibition of aggressive behavior. Finally, excessive stressors trigger epigenetic phenomena that have a large impact on brain programming and may also induce the reprogramming of neural functions. These induce qualitative changes in aggression that are deemed abnormal in animals, and psychopathological and criminal in humans. This review aims at deciphering the roles of glucocorticoids in aggression control by taking in view the three mechanisms of action often categorized as acute, chronic, and toxic stress based on the duration and the consequences of the stress response. It is argued that the tripartite way of influencing aggression can be recognized in all three animal, psychopathological, and criminal aggression and constitute a framework of mechanisms by which aggressive behavior adapts to short-term and log-term changes in the environment.
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Enhancing diurnal cortisol regulation among young children adopted internationally: A randomized controlled trial of a parenting-based intervention. Dev Psychopathol 2021; 32:1657-1668. [PMID: 33427179 DOI: 10.1017/s0954579420001303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who have been adopted internationally commonly experience institutional care and other forms of adversity prior to adoption that can alter the functioning of the hypothalamic-pituitary-adrenal (HPA) axis. In particular, internationally adopted children tend to have blunted diurnal declines compared to children raised in their birth families. The Attachment and Biobehavioral Catch-Up (ABC) intervention was developed to enhance young children's biological and behavioral regulation by promoting sensitive parenting. The current study used a randomized controlled trial to assess whether ABC improved the diurnal functioning of the HPA axis among 85 children who had been adopted internationally when they were between the ages of 4 and 33 months (M = 16.12). Prior to the intervention, there were no significant differences in diurnal cortisol production between children whose parents were randomly assigned to receive ABC and children whose parents were randomly assigned to receive a control intervention. After the intervention, children whose parents had received the ABC intervention exhibited steeper declines in cortisol levels throughout the day than children whose parents had received the control intervention. These results indicate that the ABC intervention is effective in enhancing a healthy pattern of diurnal HPA axis regulation for young children who have been adopted internationally.
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Isenhour J, Raby KL, Dozier M. The persistent associations between early institutional care and diurnal cortisol outcomes among children adopted internationally. Dev Psychobiol 2020; 63:1156-1166. [PMID: 33354777 DOI: 10.1002/dev.22069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 08/30/2020] [Accepted: 11/16/2020] [Indexed: 11/09/2022]
Abstract
Young children in institutional care experience conditions that are incompatible with their needs for attachment relationships. As a result, early institutionalization is expected to have lasting effects on the regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. The current study tested whether early institutionalization has persistent consequences for diurnal HPA axis outcomes among 130 children who had been adopted internationally between the ages of 6 and 48 months. Daily cortisol samples were collected from children at two time points: shortly after adoption (average of 5.3 months after adoption) and approximately 3 years later (average of 39.2 months after adoption). Shortly after adoption, children who had experienced a long duration of institutional care had lower morning cortisol levels and more blunted declines in cortisol across the day than children who experienced minimal or no institutional care. Three years later, children who had experienced a long duration of institutionalization continued to exhibit low morning cortisol levels and also exhibited low bedtime cortisol levels. Altogether, these results support the idea that early adversity results in the downregulation of the HPA axis and suggest that the effects of institutionalization on HPA axis functioning may persist several years after children are adopted into highly enriched families.
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Affiliation(s)
- Jennifer Isenhour
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - K Lee Raby
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Mary Dozier
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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4
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Relation between basal cortisol and reactivity cortisol with externalizing problems: A systematic review ✰. Physiol Behav 2020; 225:113088. [PMID: 32707158 DOI: 10.1016/j.physbeh.2020.113088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 01/25/2023]
Abstract
Delinquent behavior describes one of the most severe forms of antisocial and aggressive behavior, causing the highest mental health and public expenditures of problematic behavior in adolescence. Literature suggests that different concentrations of cortisol may serve as a biological marker for a severe antisocial subgroup of adolescents, although from the environmental risk factors that play a role in the development of severe delinquent and aggressive behavior, other neurobiological factors may be important. This review aims to analyze the association of cortisol levels with the development of delinquent behavior. Studies related to the topic were obtained from multiple databases, through rigorous exclusion and inclusion criteria. Only papers with empirical and quantitative methodologies from scientific and academic publications were included. Aims, methodological aspects (sample and instruments), and main conclusions were extracted from each study. Overall, the data suggest that regardless of the literature relating low cortisol levels to conduct problems and antisocial behavior, the lack of consensus in the examined studies demonstrates that more studies are needed to reveal the role of biosocial mechanisms in this hormonal-behavior link, and how these mechanisms are involved in establishing and maintaining delinquent behavior.
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5
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Homotypic and heterotypic continuity of internalizing and externalizing symptoms from ages 3 to 12: The moderating role of diurnal cortisol. Dev Psychopathol 2018; 31:789-798. [PMID: 30249313 DOI: 10.1017/s0954579418000573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Psychological symptoms that arise in early childhood can follow a multitude of patterns into adolescence, including homotypic continuity (i.e., similar symptoms over time) and heterotypic continuity (i.e., a shift in symptoms over time). However, we know very little about the factors that distinguish homotypic vs. heterotypic continuity of early internalizing and externalizing symptoms over development. In a separate line of research, diurnal cortisol has been shown to predict later internalizing and externalizing problems. In the current study, we tested whether diurnal cortisol patterns moderated the course of internalizing and externalizing symptoms from preschool to early adolescence. 554 children (54% male) and parents participated in a longitudinal study. Parents reported on their children's internalizing and externalizing symptoms at ages 3 and 12, and children collected diurnal saliva samples at age 9. Results showed that a steeper cortisol decline at age 9 combined with high internalizing or externalizing problems at age 3 predicted higher internalizing problems at age 12. A more blunted cortisol decline combined with early internalizing or externalizing problems predicted higher externalizing problems in early adolescence. These results illustrate the moderating role of stress system functioning in homotypic and heterotypic patterns of psychopathology from preschool to early adolescence.
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6
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Ogundele MO. Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World J Clin Pediatr 2018; 7:9-26. [PMID: 29456928 PMCID: PMC5803568 DOI: 10.5409/wjcp.v7.i1.9] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/30/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023] Open
Abstract
Mental health problems in children and adolescents include several types of emotional and behavioural disorders, including disruptive, depression, anxiety and pervasive developmental (autism) disorders, characterized as either internalizing or externalizing problems. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional, defiant or conduct disorders are the commonest behavioural problems in preschool and school age children. The routine Paediatric clinic or Family Medicine/General Practitioner surgery presents with several desirable characteristics that make them ideal for providing effective mental health services to children and adolescents. DSM-5 and ICD-10 are the universally accepted standard criteria for the classification of mental and behaviour disorders in childhood and adults. The age and gender prevalence estimation of various childhood behavioural disorders are variable and difficult to compare worldwide. A review of relevant published literature was conducted, including published meta-analyses and national guidelines. We searched for articles indexed by Ovid, PubMed, PubMed Medical Central, CINAHL, EMBASE, Database of Abstracts and Reviews, and the Cochrane Database of Systematic reviews and other online sources. The searches were conducted using a combination of search expressions including "childhood", "behaviour", "disorders" or "problems". Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents.
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Affiliation(s)
- Michael O Ogundele
- Department of Community Paediatrics, NHS Fife, Glenwood Health Centre, Glenrothes KY6 1HK, United Kingdom
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7
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Fragkaki I, Cima M, Granic I. The role of trauma in the hormonal interplay of cortisol, testosterone, and oxytocin in adolescent aggression. Psychoneuroendocrinology 2018; 88:24-37. [PMID: 29156403 DOI: 10.1016/j.psyneuen.2017.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/07/2017] [Accepted: 11/10/2017] [Indexed: 01/31/2023]
Abstract
Although numerous studies have examined the neuroendocrinology of aggression, the findings are mixed and focused on cortisol and testosterone. We argue that past findings remain inconclusive partly because the key roles of oxytocin and trauma have not been systematically integrated yet. Oxytocin is associated with social behavior and interacts with cortisol and testosterone, whereas trauma is a crucial risk factor of aggression that strongly affects hormonal activity. In this review, we investigate the role of trauma in the hormonal interplay of cortisol, testosterone, and oxytocin in aggression during adolescence. We first discuss how these hormones interact with each other and how trauma influences these interactions and then we propose a model that highlights the role of trauma in the hormonal interplay in aggression. We suggest that the timing of trauma has a distinct effect on hormonal activity and it should be integrated into any comprehensive model. Current trauma is linked to different levels of oxytocin, cortisol, testosterone, and testosterone/cortisol ratio than childhood trauma, but this distinction is also influenced by gender and type of aggression. We conclude that in order to better understand the neuroendocrinology of aggression, it is crucial to incorporate the investigation of oxytocin and trauma in future research.
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Affiliation(s)
- Iro Fragkaki
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
| | - Maaike Cima
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Isabela Granic
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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8
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Bernard K, Frost A, Bennett CB, Lindhiem O. Maltreatment and diurnal cortisol regulation: A meta-analysis. Psychoneuroendocrinology 2017; 78:57-67. [PMID: 28167370 DOI: 10.1016/j.psyneuen.2017.01.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/03/2017] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
Childhood maltreatment leads to a host of negative physical and mental health outcomes, with cortisol dysregulation implicated as a possible mechanism. Given inconsistencies across in the literature regarding the direction and magnitude of the association between maltreatment and diurnal cortisol regulation, the current meta-analysis of 27 studies aimed to examine the association between maltreatment and at least one of 3 indicators of diurnal cortisol regulation: wake-up cortisol levels, the cortisol awakening response (CAR), and/or the diurnal cortisol slope. Effect sizes were calculated using Hedges' g formula and were pooled using a random effects model. For the association between maltreatment and wake-up cortisol level, the aggregate effect size was g=0.08, p=0.26. Notably, effect sizes between maltreatment and wake-up cortisol were significantly larger (Qbetween=5.18, p=0.02) for studies of agency-referred samples, g=0.24, p=0.006, than studies for which maltreatment status was based on self-report, g=0.00, p=0.97, with maltreatment associated with reduced wake-up cortisol levels. For the association between maltreatment and the CAR and diurnal cortisol slope, the aggregate effect sizes were non-significant and none of the moderator variables were significant. Although results did not indicate a large and robust association between maltreatment and various indicators of diurnal cortisol, studies with more rigorous designs (i.e., agency-referred samples) showed a small, significant association between maltreatment and blunted wake-up cortisol levels, suggesting a pattern of hypocortisolism.
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Affiliation(s)
- Kristin Bernard
- Department of Psychology, Stony Brook University, United States.
| | - Allison Frost
- Department of Psychology, Stony Brook University, United States
| | | | - Oliver Lindhiem
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States
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9
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Burkey MD, Ghimire L, Adhikari RP, Kohrt BA, Jordans MJD, Haroz E, Wissow L. Development process of an assessment tool for disruptive behavior problems in cross-cultural settings: the Disruptive Behavior International Scale - Nepal version (DBIS-N). ACTA ACUST UNITED AC 2016; 9:387-398. [PMID: 28093575 DOI: 10.1080/17542863.2016.1226372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Systematic processes are needed to develop valid measurement instruments for disruptive behavior disorders (DBDs) in cross-cultural settings. We employed a four-step process in Nepal to identify and select items for a culturally valid assessment instrument: 1) We extracted items from validated scales and local free-list interviews. 2) Parents, teachers, and peers (n=30) rated the perceived relevance and importance of behavior problems. 3) Highly rated items were piloted with children (n=60) in Nepal. 4) We evaluated internal consistency of the final scale. We identified 49 symptoms from 11 scales, and 39 behavior problems from free-list interviews (n=72). After dropping items for low ratings of relevance and severity and for poor item-test correlation, low frequency, and/or poor acceptability in pilot testing, 16 items remained for the Disruptive Behavior International Scale-Nepali version (DBIS-N). The final scale had good internal consistency (α=0.86). A 4-step systematic approach to scale development including local participation yielded an internally consistent scale that included culturally relevant behavior problems.
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Affiliation(s)
- Matthew D Burkey
- Johns Hopkins University School of Public Health, Department of Health, Behavior, and Society, 624 N. Broadway, Baltimore, MD 21205, USA. Tel 250-392-4481
| | - Lajina Ghimire
- Transcultural Psychosocial Organization (TPO) Nepal, PO Box 8974, Baluwatar, Kathmandu, Nepal. Tel +977-01-4431717
| | - Ramesh P Adhikari
- Transcultural Psychosocial Organization (TPO) Nepal, PO Box 8974, Baluwatar, Kathmandu, Nepal. Tel +977-01-4431717
| | - Brandon A Kohrt
- Duke University, Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, 213 Trent Hall, 310 Trent Drive, Duke Box #90519, Durham, NC 27008, USA. Tel (919) 681-7516
| | - Mark J D Jordans
- War Child, Helmholtzstraat 61-G, 1098 LE Amsterdam, Amsterdam, Netherlands. Tel +31-20-422-7777
| | - Emily Haroz
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N. Broadway, Baltimore, MD 21205, USA. Tel 410-955-3910
| | - Lawrence Wissow
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N. Broadway, Baltimore, MD 21205, USA. Tel 410-614-1243
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10
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Gershoff ET. Should Parents' Physical Punishment of Children Be Considered a Source of Toxic Stress That Affects Brain Development? FAMILY RELATIONS 2016; 65:151-162. [PMID: 34334857 PMCID: PMC8323998 DOI: 10.1111/fare.12177] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The notion that negative childhood experiences can be sources of toxic stress that have short-and long-term consequences for children's health and well-being has gained increasing attention in recent years. The family environment can be a key source of stress, particularly when parents inflict pain on children; when that pain rises to the level of physical abuse the stress is thought to be toxic. In this article the author considers the possibility that nonabusive physical punishment may also constitute a source of toxic stress in the lives of children that affects their brain structure and functioning. The research linking physical abuse and physical punishment to children's brain structure and functioning is summarized, and the article concludes with a discussion of implications for future research, policy, and practice.
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11
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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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12
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Zahran S, Snodgrass JG, Maranon DG, Upadhyay C, Granger DA, Bailey SM. Stress and telomere shortening among central Indian conservation refugees. Proc Natl Acad Sci U S A 2015; 112:E928-36. [PMID: 25730846 PMCID: PMC4352804 DOI: 10.1073/pnas.1411902112] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Research links psychosocial stress to premature telomere shortening and accelerated human aging; however, this association has only been demonstrated in so-called "WEIRD" societies (Western, educated, industrialized, rich, and democratic), where stress is typically lower and life expectancies longer. By contrast, we examine stress and telomere shortening in a non-Western setting among a highly stressed population with overall lower life expectancies: poor indigenous people--the Sahariya--who were displaced (between 1998 and 2002) from their ancestral homes in a central Indian wildlife sanctuary. In this setting, we examined adult populations in two representative villages, one relocated to accommodate the introduction of Asiatic lions into the sanctuary (n = 24 individuals), and the other newly isolated in the sanctuary buffer zone after their previous neighbors were moved (n = 22). Our research strategy combined physical stress measures via the salivary analytes cortisol and α-amylase with self-assessments of psychosomatic stress, ethnographic observations, and telomere length assessment [telomere-fluorescence in situ hybridization (TEL-FISH) coupled with 3D imaging of buccal cell nuclei], providing high-resolution data amenable to multilevel statistical analysis. Consistent with expectations, we found significant associations between each of our stress measures--the two salivary analytes and the psychosomatic symptom survey--and telomere length, after adjusting for relevant behavioral, health, and demographic traits. As the first study (to our knowledge) to link stress to telomere length in a non-WEIRD population, our research strengthens the case for stress-induced telomere shortening as a pancultural biomarker of compromised health and aging.
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Affiliation(s)
- Sammy Zahran
- Department of Economics, Colorado State University, Fort Collins, CO 80523-1771
| | - Jeffrey G Snodgrass
- Department of Anthropology, Colorado State University, Fort Collins, CO 80523-1787;
| | - David G Maranon
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681
| | - Chakrapani Upadhyay
- Department of Sociology, Government Postgraduate College, Pratapgarh, Rajasthan 312604, India
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, Arizona State University, Tempe, AZ 85287-1104; and School of Nursing and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205
| | - Susan M Bailey
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523-1681
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13
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Mizushima SG, Fujisawa TX, Takiguchi S, Kumazaki H, Tanaka S, Tomoda A. Effect of the Nature of Subsequent Environment on Oxytocin and Cortisol Secretion in Maltreated Children. Front Psychiatry 2015; 6:173. [PMID: 26696910 PMCID: PMC4677106 DOI: 10.3389/fpsyt.2015.00173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/26/2015] [Indexed: 01/08/2023] Open
Abstract
Childhood maltreatment (CM), including abuse and neglect, is a crucial factor that distorts child development. CM is associated with alterations in numerous brain regions, and may be associated with hormonal dysregulation. This study aimed to investigate differences in secretion patterns of cortisol (CT) and oxytocin (OT) among children who experienced CM, children living in residential care facilities and in unstable environments. Among 38 maltreated children, 23 (mean age = 12.2 years, SD = 3.0) were categorized as "Settled" and 15 (mean age = 13.1 years, SD = 2.2) as "Unsettled." Twenty-six age- and gender-matched (mean age = 12.6 years, SD = 2.1), typically developing (TD) children were also included. Clinical and psychological assessments, including IQ and trauma evaluations, were conducted for all participants. Age, gender, and full-scale IQ were used as covariates in hormone analysis. Two saliva samples were collected, one on awakening and the other at bedtime. There were significant differences in the awakening CT levels of the "Unsettled" group, and in bedtime OT levels in the "Settled" group as compared with TD children, and between CM groups. Furthermore, there was a significant difference in trauma-symptomatic depression scores between the "Settled" and "Unsettled" CM group. These results suggest that CT diurnal secretions tend to be reactive to current stress rather than previous experience. OT diurnal secretions are presumably hyper-regulated for coping with the environment to survive and thrive. By measuring salivary CT/OT diurnal patterns, hormonal dysregulation of CM children living in "Settled" environments and "Unsettled" environments was indicated.
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Affiliation(s)
- Sakae G Mizushima
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui , Fukui , Japan ; Research Center for Child Mental Development, University of Fukui , Fukui , Japan
| | - Takashi X Fujisawa
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui , Fukui , Japan ; Research Center for Child Mental Development, University of Fukui , Fukui , Japan
| | - Shinichiro Takiguchi
- Research Center for Child Mental Development, University of Fukui , Fukui , Japan
| | - Hirokazu Kumazaki
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui , Fukui , Japan ; Research Center for Child Mental Development, University of Fukui , Fukui , Japan
| | - Shiho Tanaka
- Research Center for Child Mental Development, University of Fukui , Fukui , Japan
| | - Akemi Tomoda
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui , Fukui , Japan ; Research Center for Child Mental Development, University of Fukui , Fukui , Japan
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14
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Kohrt BA, Worthman CM, Ressler KJ, Mercer KB, Upadhaya N, Koirala S, Nepal MK, Sharma VD, Binder EB. Cross-cultural gene- environment interactions in depression, post-traumatic stress disorder, and the cortisol awakening response: FKBP5 polymorphisms and childhood trauma in South Asia. Int Rev Psychiatry 2015; 27:180-96. [PMID: 26100613 PMCID: PMC4623577 DOI: 10.3109/09540261.2015.1020052] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Despite increased attention to global mental health, psychiatric genetic research has been dominated by studies in high-income countries, especially with populations of European descent. The objective of this study was to assess single nucleotide polymorphisms (SNPs) in the FKBP5 gene in a population living in South Asia. Among adults in Nepal, depression was assessed with the Beck Depression Inventory (BDI), post-traumatic stress disorder (PTSD) with the PTSD Checklist-Civilian Version (PCL-C), and childhood maltreatment with the Childhood Trauma Questionnaire (CTQ). FKBP5 SNPs were genotyped for 682 participants. Cortisol awakening response (CAR) was assessed in a subsample of 118 participants over 3 days. The FKBP5 tag-SNP rs9296158 showed a main effect on depressive symptoms (p = 0.03). Interaction of rs9296158 and childhood maltreatment predicted adult depressive symptoms (p = 0.02) but not PTSD. Childhood maltreatment associated with endocrine response in individuals homozygous for the A allele, demonstrated by a negative CAR and overall hypocortisolaemia in the rs9296158 AA genotype and childhood maltreatment group (p < 0.001). This study replicated findings related to FKBP5 and depression but not PTSD. Gene-environment studies should take differences in prevalence and cultural significance of phenotypes and exposures into account when interpreting cross-cultural findings.
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Affiliation(s)
- Brandon A. Kohrt
- Duke Global Health Institute and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, U.S.A
| | | | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; Yerkes National Primate Research Center, Atlanta, Georgia; Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Kristina B. Mercer
- Howard Hughes Medical Institute, Chevy Chase, Maryland; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Nawaraj Upadhaya
- HealthNetTPO, Amsterdam, the Netherlands and Transcultural Psychosocial Organization, Nepal, Kathmandu, Nepal
| | - Suraj Koirala
- Transcultural Psychosocial Organization, Nepal, Kathmandu, Nepal
| | - Mahendra K. Nepal
- Department of Psychiatry, Tribhuvan University Teaching Hospital/Institute of Medicine, Maharajgunj, Nepal
| | - Vidya Dev Sharma
- Department of Psychiatry, Tribhuvan University Teaching Hospital/Institute of Medicine, Maharajgunj, Nepal
| | - Elisabeth B. Binder
- Dept. of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany and Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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15
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Kohrt BA, Jordans MJD, Koirala S, Worthman CM. Designing mental health interventions informed by child development and human biology theory: a social ecology intervention for child soldiers in Nepal. Am J Hum Biol 2015; 27:27-40. [PMID: 25380194 PMCID: PMC5483323 DOI: 10.1002/ajhb.22651] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/10/2014] [Accepted: 10/18/2014] [Indexed: 01/27/2023] Open
Abstract
The anthropological study of human biology, health, and child development provides a model with potential to address the gap in population-wide mental health interventions. Four key concepts from human biology can inform public mental health interventions: life history theory and tradeoffs, redundancy and plurality of pathways, cascades and multiplier effects in biological systems, and proximate feedback systems. A public mental health intervention for former child soldiers in Nepal is used to illustrate the role of these concepts in intervention design and evaluation. Future directions and recommendations for applying human biology theory in pursuit of public mental health interventions are discussed.
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Affiliation(s)
- Brandon A Kohrt
- Department of Anthropology, Emory University, Atlanta; Transcultural Psychosocial Organization (TPO), Nepal, Kathmandu, Nepal
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