Interactive effects of early and recent exposure to stressful contexts on cortisol reactivity in middle childhood

Feasibility of an Online Acute Stressor in Preschool Children of Mothers with Depression

Maternal depression is a risk factor for future mental health problems in offspring, with stress-system function as a candidate vulnerability factor. Here we present initial validation of an online matching-task (MT) paradigm in young children exposed to maternal depression (N = 40), a first in stressor-paradigm research for this age group. Investigations of stress-system reactivity that can be conducted online are an innovative assessment approach, accelerated by the COVID-19 pandemic. Results indicate high feasibility, with a >75% data collection success rate across measures, similar-to or better-than in-person success rates in young children. Overall, the online MT elicited significant heart rate but not cortisol reactivity. Individual differences in child mental health symptoms were a moderator of reactivity to the stressor such that children with lower, but not higher, behavioral problems exhibited the typical pattern of cortisol reactivity to the online MT. Results are aligned with allostatic load models, which suggest downregulation of stress-system reactivity as a result of experiencing adversity and mental health vulnerability. Consistent with in-person research, this suggests that an early phenotype for the emergence of behavior problems may be linked to altered stress-system reactivity. Results hold potential clinical implications for intervention development and the future of online stress-system research. Trial Registration: Clinical Trial Registration: NCT04639557; (Building Regulation in Dual Generations-Telehealth Model [BRIDGE]).

Daily COVID-19 Stressor Effects on Children's Mental Health Depend on Pre-pandemic Peer Victimization and Resting Respiratory Sinus Arrhythmia

Children's risk of poorer mental health due to the COVID-19 pandemic may depend on risk and protective factors heading into the pandemic. This study examined same-day associations between COVID-19 stressors and children's mental health using a daily diary design across 14 days, and considered the moderating roles of pre-pandemic peer victimization experiences and resting respiratory sinus arrhythmia (RSA; an indicator of cardiac regulatory capacity). Forty-nine Canadian children aged 8-13 years (Mage = 10.69, 29 girls) participated in the final wave of a longitudinal study just prior to the pandemic and a daily diary extension during the pandemic (N = 686 pandemic measurement occasions). Multilevel modeling indicated that children had poorer mental health on days when they experienced a COVID-19 stressor (e.g., virtual academic difficulties, social isolation). A three-way interaction indicated that this association was stronger for those with higher pre-pandemic peer victimization experiences and lower pre-pandemic resting RSA; however, highly victimized children with higher resting RSA did not experience poorer mental health on days with COVID-19 stressors. Findings offer preliminary insights into the preceding risk and protective factors for children's mental health amidst major subsequent stress.

Child abuse and pubertal timing: what is the role of child sex and identity of the perpetrator?

BACKGROUND

This study investigated the association between child abuse [child neglect (CN), emotional (CEA) and physical abuse (CPA)] and early puberty with special regard to sex-specific effects concerning child and parental perpetrator.

METHODS

Data assessment took place within the framework of the LIFE Child Depression study, a longitudinal study on the development of depressive symptoms and disorders between child- and adulthood in Leipzig, Germany. A sample of 709 children (8-14 years) was recruited from the general population and via psychiatric hospitals. Data on pubertal status were assessed using an instrument for self-assessment of tanner stages (scales of physical pubertal development). Information on menarche was provided by parents. The Parent-Child Conflict Tactics Scales (CTS-PC) served for data on child abuse.

RESULTS

Regarding physical puberty markers, significant correlations were found, especially with child neglect (CN) and child emotional abuse (CEA). Regression analyses, controlling for Body-Mass-Index (BMI) and Socioeconomic Status (SES), revealed that children affected by child neglect perpetrated by mother (CNm) and child emotional abuse (CEA) parent-non-specifically enter puberty significantly earlier. Sex-specific analyses identified child neglect perpetrated by mother (CNm) to be associated with early puberty in girls and child emotional abuse perpetrated by father (CEAf) with early puberty in boys. Concerning the onset of menstruation, there was a significant positive correlation between early menarche and parent-specific and non-specific child neglect (CN), as well as between early menarche and child emotional abuse perpetrated by the mother (CEAm). In regression models that controlled for Body-Mass-Index (BMI) and Socioeconomic Status (SES) no significant associations were maintained. Child physical abuse (CPA) was not associated with early puberty.

CONCLUSION

Results outlined child neglect (CN) and child emotional abuse (CEA) to be sex- and perpetrator-specific risk factors for early pubertal development. Knowledge of sex- and perpetrator-specific effects could help clinicians to specify their diagnostic process and to define differential prevention and treatment goals for children with experiences of CN and CEA. Further research on the sex-specific impact of parental CN and CEA on girls' and boys' puberty is needed.

Experiences of adversity in childhood and adolescence and cortisol in late adolescence

Early life adversity influences the diurnal cortisol rhythm, yet the relative influence of different characteristics of adversity remains unknown. In this study, we examine how developmental timing (childhood vs. adolescence), severity (major vs. minor), and domain of early life adversity relate to diurnal cortisol rhythms in late adolescence. We assessed adversity retrospectively in early adulthood in a subsample of 236 participants from a longitudinal study of a diverse community sample of suburban adolescents oversampled for high neuroticism. We used multilevel modeling to assess associations between our adversity measures and the diurnal cortisol rhythm (waking and bedtime cortisol, awakening response, slope, and average cortisol). Major childhood adversities were associated with flatter daily slope, and minor adolescent adversities were associated with greater average daily cortisol. Examining domains of childhood adversities, major neglect and sexual abuse were associated with flatter slope and lower waking cortisol, with sexual abuse also associated with higher cortisol awakening response. Major physical abuse was associated with higher waking cortisol. Among adolescent adversities domains, minor neglect, emotional abuse, and witnessing violence were associated with greater average cortisol. These results suggest severity, developmental timing, and domain of adversity influence the association of early life adversity with stress response system functioning.

Prenatal substance exposure, early-life adversity, and parenting: Associations with adolescent stress response

We tested a conceptual model examining associations between prenatal substance exposure and adolescent cortisol reactivity profiles in response to an acute social evaluative stressor. We included cortisol reactivity in infancy, and direct and interactive effects of early-life adversity and parenting behaviors (sensitivity, harshness) from infancy to early school age on adolescent cortisol reactivity profiles in model testing. Participants were 216 families (51% female children; 116 cocaine-exposed) recruited at birth, oversampled for prenatal substance exposure, and assessed from infancy to early adolescence (EA). Majority of participants self-identified as Black (72% mothers, 57.2% adolescents), and caregivers were primarily from low-income families (76%), were single (86%), and had high school or below education (70%) at recruitment. Latent profile analyses identified three cortisol reactivity patterns including elevated (20.4%), moderate (63.1%), and blunted (16.5%) reactivity groups. Prenatal tobacco exposure was associated with higher likelihood of membership in the elevated reactivity compared to the moderate reactivity group. Higher caregiver sensitivity in early life was associated with lower likelihood of membership in the elevated reactivity group. Prenatal cocaine exposure was associated with higher maternal harshness. Interaction effects among early-life adversity and parenting indicated that caregiver sensitivity buffered, and harshness exacerbated, the likelihood that high early adversity would be associated with the elevated and blunted reactivity groups. Results highlight the potential importance of prenatal alcohol and tobacco exposure for cortisol reactivity and the role of parenting as exacerbating or buffering the impact of early-life adversity on adolescent stress response.

Parent-child relationship quality and adolescent health: Testing the differential susceptibility and diathesis-stress hypotheses in African American youths

This study tested two competing models of differential susceptibility and diathesis-stress in a prospective longitudinal study of African American youths (N = 935). It examined whether individual variations in the functioning of the hypothalamic-pituitary-adrenocortical axis at age 11 interact with middle childhood parent-child relationship quality to predict mental and physical health problems in adolescence (ages 11-15 years old). Adolescent boys with lower levels of cortisol reactivity to laboratory challenges had the highest levels of internalizing problems if they experienced a high conflictual relationship with their parents. Equally low-reactive boys, however, reported the lowest number of physical illnesses if their relationship with their parents was characterized by high levels of intimacy and support.

Getting under the skin: Physiological stress and witnessing paternal arrest in young children with incarcerated fathers

U.S. jails see nearly 11 million annual admissions, rates that disproportionately affect men of color-more than half of whom are fathers. An estimated 7% of U.S. children experience the incarceration of a parent, increasing their risk for poor developmental and health outcomes. Although stress processes are often suggested as an underlying mechanism linking paternal incarceration to child well-being, few studies have examined such links. To study how witnessing a father's arrest prior to incarceration in jail relates to children's stress processes, we collected data on 123 individuals from 41 families with young children whose father was in jail, including collecting hair from 41 children, and analyzed their cumulative stress hormones, cortisol, and cortisone. Results indicate that children had higher cumulative stress hormone concentrations when they witnessed their father's arrest. Moreover, there was evidence of a blunted stress reaction in children who witnessed the arrest and who also had high levels of ongoing behavioral stress symptoms, similar to findings in Post-Traumatic Stress Disorder studies. Long-term exposure to stress can have deleterious effects on children's brain development, further increasing risk for developmental psychopathology. Findings have implications for criminal justice approaches that safeguard children during parental arrest.

Adrenocortical Activity and Aggressive Behavior in Children: A Longitudinal Study on Risk and Protective Effects

Most research on aggression and delinquency concentrates on risk factors. There has been less attention for protective factors and mechanisms, in particular with regard to biosocial influences. Based on theories of autonomous arousal and stress reactance the present study addresses the influence of adrenocortical activity as a risk and/or protective factor in the development of antisocial behavior in children. We also investigated relations to anxiousness and family stressors. In a prospective longitudinal study of 150 German boys, the first measurement took place at preschool age and contained an assessment of cortisol after waking up and 30 min later. Aggressiveness and anxiousness of the children were assessed by the kindergarten teachers with the Social Behavior Questionnaire. After 6 years, the children's behavior was rated by the teachers in middle school. Variable-oriented data analyses revealed a significant correlation between the total amount of cortisol after waking up and 30 min later (AUC _G ) and anxiousness both cross-sectionally and longitudinally, but not with aggressiveness. A family stress index correlated positively with aggressiveness but neither with cortisol nor with anxiousness. There were significant correlations between aggressiveness and anxiousness at kindergarten age and the respective behavior problems 6 years later. In a linear regression analysis on aggression only family stress had a significant effect but anxiousness not. Moderator analyses on aggressiveness with anxiousness and AUC _G or on AUC _G with anxiousness and aggressiveness did not show any significant interactions. Longitudinally, only aggression significantly predicted aggression 6 years later in a linear regression. In addition to variable-oriented analyses, we also applied a person-oriented approach to investigate specific patterns of behavior. Children who were high in both aggressiveness and anxiousness had the highest cortisol level and those with low anxiousness and high aggressiveness the lowest. The groups with different patterns of externalizing and internalizing problems at preschool age showed significant differences in aggression 6 years later. Our results underline the need for complex pattern analyses on cortisol, aggression, and anxiousness in children and for a differentiated consideration of emotional reactive aggression and unemotional instrumental aggression.

The differential calibration of the HPA axis as a function of trauma versus adversity: A systematic review and p-curve meta-analyses

Although there is an abundance of evidence linking the function of the hypothalamic-pituitary-adrenal (HPA) axis to adverse early-life experiences, the precise nature of the association remains unclear. Some evidence suggests early-life adversity leads to cortisol hyper-reactivity, while other evidence suggests adversity leads to cortisol hypo-reactivity. Here, we distinguish between trauma and adversity, and use p-curves to interrogate the conflicting literature. In Study 1, trauma was operationalized according to DSM-5 criteria; the p-curve analysis included 68 articles and revealed that the literature reporting associations between trauma and blunted cortisol reactivity contains evidential value. Study 2 examined the relationship between adversity and cortisol reactivity. Thirty articles were included in the analysis, and p-curve demonstrated that adversity is related to heightened cortisol reactivity. These results support an inverted U-shaped function relating severity of adversity and cortisol reactivity, and underscore the importance of distinguishing between "trauma" and "adversity".

A Study on the Effect of Change Management on Organizational Innovation: Focusing on the Mediating Effect of Members’ Innovative Behavior

This study is an empirical study on the impact of change management on organizational innovation through innovative behavior in the public sector. The independent variables are the four elements of change management (organizational goal, transformational leadership, participation and communication, education and training), the dependent variable is organizational innovation, and the mediating variable is the innovative behavior of members. The data used for the analysis is the Public Service Recognition Survey 2018 by KIPA (the Korea Institute of Public Administration). Hayes’ Process Macro analysis (Model 4) was performed to verify the mediating variable. As a result of the analysis, it was found that change management factors have a positive effect on innovative behavior and organizational innovation. In addition, public officials’ innovative behavior played a mediating role between change management and organizational innovation. It was confirmed that the innovative behavior of organizational members is essential to achieve organizational innovation. Among the factors of change management, participation and communication had the highest influence on innovative behavior and organizational innovation.

Life stress and cortisol reactivity: An exploratory analysis of the effects of stress exposure across life on HPA-axis functioning

Stressful experiences affect biological stress systems, such as the hypothalamic-pituitary-adrenal (HPA) axis. Life stress can potentially alter regulation of the HPA axis and has been associated with poorer physical and mental health. Little, however, is known about the relative influence of stressors that are encountered at different developmental periods on acute stress reactions in adulthood. In this study, we explored three models of the influence of stress exposure on cortisol reactivity to a modified version of the Trier Social Stress Test (TSST) by leveraging 37 years of longitudinal data in a high-risk birth cohort (N = 112). The cumulative stress model suggests that accumulated stress across the lifespan leads to dysregulated reactivity, whereas the biological embedding model implicates early childhood as a critical period. The sensitization model assumes that dysregulation should only occur when stress is high in both early childhood and concurrently. All of the models predicted altered reactivity, but do not anticipate its exact form. We found support for both cumulative and biological embedding effects. However, when pitted against each other, early life stress predicted more blunted cortisol responses at age 37 over and above cumulative life stress. Additional analyses revealed that stress exposure in middle childhood also predicted more blunted cortisol reactivity.

Environmental determinants of physiological reactivity to stress: The interacting effects of early life deprivation, caregiving quality, and stressful life events

Children who spend their early lives in institutions experience profound psychosocial deprivation that is associated with altered stress response system development. Here, we used data from a longitudinal randomized controlled trial of foster care for institutionally reared children to examine whether caregiving quality and stressful life events (SLEs) in early adolescence (age 12) influence patterns of hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) reactivity. Controlling for the effect of institutional care, higher caregiving quality at age 12 was associated with heightened cortisol and SNS reactivity. However, moderation analysis revealed that the latter effect was only observed among never-institutionalized children, whereas ever-institutionalized children demonstrated a persistently blunted SNS response regardless of recent caregiving quality. Among institutionally reared children, SLEs interacted with prior random assignment to foster care, such that those placed in foster care early in development had a SNS response that approximated never-institutionalized children when SLEs at age 12 were low. In contrast, SNS reactivity was persistently blunted among those with prolonged deprivation, regardless of recent SLEs. Early-life deprivation is associated with persistent blunting of stress response systems, but normalization may be achievable if SLEs are limited following placement into enriched family-based care.

Hair cortisol moderates the association between obstetric complications and child wellbeing

Obstetric complications (OC) may have implications for later health outcomes. However, there is a lack of research examining the association between OC and behavior problems or quality of life (HRQoL). We aimed to close this gap and further investigate functioning of the hypothalamus-pituitary-adrenal (HPA)-axis as a potential physiological vulnerability moderating the association between OC and behavior problems and HRQoL. We investigated 232 mothers and their five to 12-year-old children. Presence of OC during the pre-, peri-, and postnatal phases was determined by interviewing mothers. Children's behavior problems (CBCL, TRF) and HRQoL (Kidscreen rated by mothers and children) were assessed. Children gave 3 cm strands of hair for analysis of hair cortisol (HC). Structural equation modeling analyses with a latent variable of child outcome ("distress"), OC as predictor and HC as a potential moderator were conducted. OC significantly predicted distress (β = .33, p < .01). The model showed a good fit to the data: χ2(14)=15.66, p < .33, CFI=.99, TLI=.99, RMSEA=.02, 90 %CI [.00, .06], SRMR=.04. In addition, HC moderated the association between OC and distress (β=-.32, p < .01). The moderation model also showed a good fit: χ2(14) =7.13, p = .93, CFI=1.00, TLI=1.06, RMSEA=.00, 90 %CI [.00, .02], SRMR=.03. Results indicated that the association between OC and distress was significant only when children had low HC-levels. This was also the case for both externalizing and internalizing behavior problems. Our results underline the notion of OC as a risk factor for child behavior problems and wellbeing and point to an important role of the children's physiological set-up such as HPA-functioning.

Biological aging in childhood and adolescence following experiences of threat and deprivation: A systematic review and meta-analysis

Life history theory argues that exposure to early life adversity (ELA) accelerates development, although existing evidence for this varies. We present a meta-analysis and systematic review testing the hypothesis that ELA involving threat (e.g., violence exposure) will be associated with accelerated biological aging across multiple metrics, whereas exposure to deprivation (e.g., neglect, institutional rearing) and low-socioeconomic status (SES) will not. We meta-analyze 54 studies (n = 116,010) examining associations of ELA with pubertal timing and cellular aging (telomere length and DNA methylation age), systematically review 25 studies (n = 3,253) examining ELA and neural markers of accelerated development (cortical thickness and amygdala-prefrontal cortex functional connectivity) and evaluate whether associations of ELA with biological aging vary according to the nature of adversity experienced. ELA overall was associated with accelerated pubertal timing (d = -0.10) and cellular aging (d = -0.21), but these associations varied by adversity type. Moderator analysis revealed that ELA characterized by threat was associated with accelerated pubertal development (d = -0.26) and accelerated cellular aging (d = -0.43), but deprivation and SES were unrelated to accelerated development. Systematic review revealed associations between ELA and accelerated cortical thinning, with threat-related ELA consistently associated with thinning in ventromedial prefrontal cortex, and deprivation and SES associated with thinning in frontoparietal, default, and visual networks. There was no consistent association of ELA with amygdala-PFC connectivity. These findings suggest specificity in the types of early environmental experiences associated with accelerated biological aging and highlight the importance of evaluating how accelerated aging contributes to health disparities and whether this process can be mitigated through early intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Dyslexia as an adaptation to cortico-limbic stress system reactivity

A new school of thought in evolutionary developmental biology, combined with research in the neurobiology of stress, suggest that early exposure to stressful circumstances may be a cause of dyslexia. A balance between epigenetic, stress-induced and cognitive-growth genetic programs modulates the brain's cellular, regional, and network homeostasis. This balance is essential for adaptability to the normative range of everyday stress. However, even mild chronic stress exposition may overactivate the hypothalmic-pituitary-adrenal stress axis, upsetting the homeostatic balance between these programs, and exposing the brain to harmful levels of stress hormones. A protective strategy to sustained disequilibrium precociously advances maturation at the cost of neuroplasticity, which blunts stress axis reactivity but also compromises learning potential in the prefrontal cortex and networks associated with dyslexia. Stress exceeding an individual's range of resilience: (1) reduces levels of TFEB and BDNF, gene regulatory factors prolonging maturation and neuroplasticity; (2) interferes with the insular cortex, amygdala and hippocampus in coordinating afferent visceral signals with cognitive performance; (3) over-recruits the brain's Default Mode network; and (4) amplifies release from the Locus coeruleus/norepinephrine system which impairs the entrainment of oscillations in the lower phonological frequencies of speech. Evidence supporting a stress-growth imbalance is preliminary, but holds promise for reconceptualizing the neurobiology of dyslexia and reducing its prevalence.

Stress Response in Suicide Attempters with Borderline Personality Disorder: The Role of Behavioral Problems in Childhood

Objective: Suicidal individuals are a heterogeneous population and may differ in systematic ways in their responsiveness to stress. The primary aim of the present study was to identify whether a different pattern of physiological stress response exists among adult suicide attempters with a history of behavioral problems during childhood and adolescence, which earlier studies have related to both decreased activity of the HPA axis and to suicidal behaviors. Method: Seventy-eight participants with Borderline Personality Disorder were assessed using the SCID-II, and completed self-report measures assessing their history of suicide attempts, history of aggressive behaviors, depressive symptoms, history of lifetime abuse and demographics. Participants' cortisol reactivity was assessed using the Trier Social Stress Test. Results: Analyses indicated that suicide attempters with a history of behavioral problems in youth (n = 30) had a significantly lower response to stress than both suicide attempters without such a history (n = 26) and non-attempters (n = 22), when controlling for lifetime history of abuse. The groups did not differ in basal cortisol. Conclusions: These findings suggest a unique subtype of suicide attempter among those with Borderline Personality Disorder, characterized by a blunted physiological stress response.

Cognitively-Based Compassion Training for parents reduces cortisol in infants and young children

This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The intervention group was compared to a waitlist control group. Thirty-nine parents and their children, who ranged in age from 4 months to 5 years, were evaluated at pre- and postintervention (n = 25 intervention, n = 14 waitlist control) on hair cortisol concentration. Parents also completed self-administered questionnaires at both time points regarding demographics, physical symptoms of stress, parenting stress, self-compassion, and mindfulness. Children of parents in the CBCT group experienced significant decreases in cortisol at the postintervention assessment, as compared with the control group. However, parent cortisol and self-report measures did not significantly change other than a small effect on clinical levels of parenting stress. CBCT may be a positive new way to intervene with parents to lower infants' and young children's cumulative physiological stress.

Maternal stress and adolescent brain structure and function

INTRODUCTION

Adolescence is a time of heightened sensitivity in biological stress systems and the emergence of stress-related psychopathology. Thus, understanding environmental factors in adolescence that might be associated with adolescents'' stress systems is important. Maternal stress levels may be involved. However, the relationship between maternal stress and the adolescent brain is unknown.

METHOD

The present study examined the association between mothers' self-reported stress levels and mothers' cortisol stress reactivity and their early adolescents' brain structure and functional activation to stressful negative emotional images. Participants included 66 mothers and their 12- to 14-year old adolescents. Mother's perceived stress and salivary cortisol reactivity to a stressful task were collected. Then, adolescents' brain structure and function were assessed in a magnetic resonance imaging session.

RESULTS

Functional whole-brain analyses revealed that mothers' higher reported perceived stress, but not cortisol reactivity, predicted adolescents' higher responses in the medial prefrontal cortex (mPFC) to stressful negative emotional stimuli. There were no statistically significant associations for structural analyses.

CONCLUSIONS

Given the finding of maternal stress reactivity related to adolescent mPFC function-an integral structure related to stress responses-parent stress may play a role in the development of neural stress systems in adolescence, with potential implications for development of psychopathology.

Early life stress predicts cortisol response to psychosocial stress in healthy young adults

Repeated exposure to stress during early life has a lifetime impact on physical and psychological functions. Our study investigated the long-term effects of early life stress (ELS; measured retrospectively) on the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system functions under psychosocial stress among healthy adults. Fifty healthy volunteers (33 male, 17 female, mean age 22.6 ± 1.8 years) underwent a standardized psychosocial stress protocol (the Trier Social Stress Test), with the collection of salivary cortisol, heart rates, and positive and negative affect. The results showed increases in cortisol, heart rate, and negative affect after the stress inducement. More importantly, a significant negative correlation was found between the severity of ELS and the increase of cortisol to the stress. The severity of stress in one's early life predicted his/her cortisol reactivity to the stress in adulthood. Neither the heart rate reactivity nor the affective reactivity shows significant association with ELS. The blunted cortisol reactivity reflects the alteration of the HPA axis, which may confer the risk for certain stress-related disorders.

Effects of psychosocial stress on the hormonal and affective response in children with dyslexia

INTRODUCTION

Research on stress and dyslexia has mainly focused on chronic and contextual stress caused by the school environment. Our goal was to test individual differences in the hypothalamic-pituitary-adrenal (HPA) axis reactivity of dyslexic and non-dyslexic children and the related emotional manifestations associated with exposure to a psychosocial stressor.

METHODS

Eighty-one children (11-14 years old; 38 dyslexic) were exposed to the Trier Social Stress Test adapted to children or to a control condition. The salivary cortisol response, anxiety, and mood were measured before and after the stress.

RESULTS

Dyslexic children did not show the expected cortisol response, as the highest percentage of children who were non-reactive to stress was found in this group. Cortisol reactivity to stress was related to higher levels of anxiety and lower positive affect in the non-dyslexic children.

CONCLUSION

These results suggest a pattern of hypo-activation of the HPA axis to psychosocial stress in children with dyslexia.

Obesogenic food consumption among young children: the role of maltreatment

OBJECTIVE

To determine whether children exposed to a greater variety of acts of parent-to-child physical and psychological maltreatment will be at greater risk of consuming obesogenic foods at a higher frequency.

DESIGN

Survey research using a longitudinal panel design.

SETTING

In-home interviews with primary caregivers in twenty large US cities.ParticipantsA national sample of at-risk children and their families who participated in the Fragile Families and Child Wellbeing Study (FFCWS).

RESULTS

Child maltreatment emerged as a statistically significant (P&lt;0·01) and robust predictor of obesogenic food consumption, in both cross-sectional and longitudinal analyses. Child maltreatment also consistently emerged as one of the strongest predictors of obesogenic food consumption in these models. Ancillary analyses indicated that physical maltreatment plays a particularly important role in these associations.

CONCLUSIONS

A major implication of the present study is that child maltreatment prevention efforts should be reflected in interventions that seek to diminish unhealthy eating practices among children. Multi-professional teams can work together on obesity prevention not only via education but also by considering the interconnectedness of obesogenic food consumption and experiences of maltreatment.

Developmental influences on stress response systems: Implications for psychopathology vulnerability in adolescence

The adolescent transition is marked by increases in stress exposure and significant maturation of neural and hormonal stress processing systems. Variability in the development of these systems during adolescence may influence the risk for stress-related psychopathology. This paper aims to review the developmental maturation of the HPA axis and related stress regulation systems, and demonstrate how interference in this adaptive developmental process may increase the risk for negative outcomes. We argue that the developmental maturation of the HPA axis aims to improve the regulatory capacity of the axis in order to more adaptively respond to these increases in stress reactivity. Additionally, we review evidence that sex differences in the development of the HPA and related axes may contribute to sex differences in the risk for stress-related psychopathology. Finally, we discuss how contextual factors, such as early trauma and obesity may alter the development of HPA axis during the adolescence transition and how alterations of normative development increase the risk for stress-related disorders.

Extending the developmental origins of disease model: Impact of preconception stress exposure on offspring neurodevelopment

The concept of the developmental origins of health and disease via prenatal programming has informed many etiologic models of health and development. Extensive experimental research in non-human animal models has revealed the impact of in utero exposure to stress on fetal development and neurodevelopment later in life. Stress exposure, however, is unlikely to occur de novo following conception, and pregnancy health is not independent of the health of the system prior to conception. For these reasons, the preconception period is emerging as an important new focus for research on adverse birth outcomes and offspring neurodevelopment. In this review, we summarize the existing evidence for the role of preconception stress exposure on pregnancy health and offspring neurodevelopment across species and discuss the implications of this model for addressing health disparities in obstetrics and offspring outcomes.

Link between children's hair cortisol and psychopathology or quality of life moderated by childhood adversity risk

The hypothalamus-pituitary-adrenal axis (HPAA) and its end product, the glucocorticoid cortisol, has been shown to be associated with psychopathology. Determining cortisol concentrations in hair (HCC) allows the investigation of long-term HPAA-activity. There is a significant scarcity of studies investigating the link between HCC and psychopathology and quality of life in child and adolescent samples. In addition, as the HPAA constitutes a feedback system enabling adaption to environmental demands, it is important to consider the socio-environmental context that the children grow up in. We therefore investigated the associations between child HCC and psychopathology/quality of life and compared these links in two groups of five to 12-year-olds: children living with mothers who report experiences of early life maltreatment (ELM) (high-risk group) and children whose mothers did not report any ELM (low-risk group). We expected that, under conditions of a high-risk environment, elevated HPAA-functioning would be associated with low levels of psychopathology and high levels of quality of life in children. Under low-risk conditions, elevated HPAA-functioning would be associated with high levels of psychopathology and low levels of quality of life in children. For the complete sample of N = 130 children, three-months HCC did not significantly predict child psychopathology or quality of life. However, there was a significant moderating effect of group membership: In the high-risk group, high levels of HCC were significantly associated with high levels of self-reported quality of life. In the low-risk group, there was no association between HCC and self-reported quality of life. For child psychopathology, in the low-risk group, high levels of HCC were significantly associated with high levels of teacher reported behavior problems, whereas in the high-risk group, the association did not reach significance. Our results underline the importance of accounting for the social environment children grow up in when investigating the link between HCC and child psychopathology and quality of life.

Adversity-driven changes in hypothalamic-pituitary-adrenal axis functioning during adolescence. The trails study

The hypothalamic-pituitary-adrenal (HPA) axis has been proposed to be a key mechanism underlying the link between adversity and mental health, but longitudinal studies on adversity and HPA-axis functioning are scarce. Here, we studied adversity-driven changes in HPA-axis functioning during adolescence (N=141). HPA-axis functioning (basal cortisol, cortisol awakening response, anticipation of, reaction to and recovery after a stress task) was measured twice, at age 16 and 19. Adversity (i.e., social defeat and loss/illness) since age 16 was measured extensively with the Life Stress Interview at age 19. Adolescents who reported being exposed to social defeat showed increases in basal cortisol (ɳ²=0.029) and decreases in reaction to the stress task (ɳ²=0.030) from age 16-19, compared to their peers in the loss/illness and no stress group. The current study provides unique longitudinal data on the role of adversity in HPA-axis functioning. Evidence is provided that adversity can affect the body's neuroendocrine response to stress, dependent on the nature of both the HPA-measures and adverse events under study.

Endocrinological and subjective stress responses in children with depressive, anxiety, or externalizing disorders

In this study, we used a stress test to investigate endocrinological and subjective stress responses of 8- to 14-year-old children with internalizing or externalizing disorders and healthy controls. The sample (N = 170) consisted of clinical and community children. Parents were given a diagnostic interview to diagnose their children's psychiatric condition. We measured saliva cortisol and subjectively experienced arousal in children before and after the Trier Social Stress Test for Children. Children also rated their performance immediately after the stress test, and 1 hr later they rated their positive and negative thoughts about this stressful event. Children with internalizing or externalizing disorders exhibited a blunted cortisol response compared to healthy controls. Depressed children rated their test performance lower and reported more negative thoughts after the test in comparison to healthy controls, anxious children reported more arousal before and after the task, and children with externalizing disorders reported more positive thoughts. In regression analyses, cortisol and subjective stress responses were both predictive of psychiatric disorders. The study extends previous work on the relation between psychiatric disorders and children's stress responses to an experimentally induced stress task by including a broad range of psychiatric disorders and by integrating endocrinological and subjective stress responses.

Reduced hair cortisol after maltreatment mediates externalizing symptoms in middle childhood and adolescence

BACKGROUND

The enduring impact of childhood maltreatment on biological systems and ensuing psychopathology remains incompletely understood. Long-term effects of stress may be reflected in cumulative cortisol secretion over several months, which is now quantifiable via hair cortisol concentrations (HCC). We conducted a first comprehensive investigation utilizing the potential of hair cortisol analysis in a large sample of maltreated and nonmaltreated children and adolescents.

METHOD

Participants included 537 children and adolescents (3-16 years; 272 females) with maltreatment (n = 245) or without maltreatment histories (n = 292). Maltreated subjects were recruited from child protection services (CPS; n = 95), youth psychiatric services (n = 56), and the community (n = 94). Maltreatment was coded using the Maltreatment Classification System drawing on caregiver interviews and complemented with CPS records. Caregivers and teachers reported on child mental health. HCC were assessed in the first 3 cm hair segment.

RESULTS

Analyses uniformly supported that maltreatment coincides with a gradual and dose-dependent reduction in HCC from 9 to 10 years onwards relative to nonmaltreated controls. This pattern emerged consistently from both group comparisons between maltreated and nonmaltreated subjects (27.6% HCC reduction in maltreated 9-16-year-olds) and dimensional analyses within maltreated subjects, with lower HCC related to greater maltreatment chronicity and number of subtypes. Moreover, both group comparisons and dimensional analyses within maltreated youth revealed that relative HCC reduction mediates the effect of maltreatment on externalizing symptoms.

CONCLUSIONS

From middle childhood onwards, maltreatment coincides with a relative reduction in cortisol secretion, which, in turn, may predispose to externalizing symptoms.

Stress through the mind of the beholder: preliminary differences in child and maternal perceptions of child stress in relation to child cortisol and cardiovascular activity

The present study examined associations among parent and child reports of youth's stressful life events (SLEs), perceived stress, and biological measures of stress activity (i.e. cortisol and cardiovascular activity). Examining these aspects of youth stress presents several challenges. Unlike adult studies of individual differences in which information regarding SLEs, perceptions of events, and biological activity are gathered from one individual, assessment of individual differences among children usually involves other informants (e.g. parent). However, parent and child reports of SLEs and the child's psychological response to such events are often discordant. Moreover, examinations of youth perception of stress are hampered by limitations of child cognitive processes, as well as parents' limited knowledge of their child's perception of stress. In a preliminary effort to unscramble the complex effects of youth SLEs and perceived stress in relation to biological response to acute stressors, this study examined 51 boys and girls aged 7-16, with no history of psychopathology or medical concerns. Contrary to hypotheses, findings revealed that compared to actual experiences of stress, perceived stress has greater associations with both cortisol and cardiovascular activity. That is, perceived stress is more biologically salient relative to actual stress. Results also suggest that informant differences may explain some previous inconsistent findings in studies of youth's stress reactivity. The current findings mirror the adult studies that show appraisal and perception of traumatic and stressful events may be more predictive of negative health and mental health outcomes than the severity of the events. Further studies are needed to understand the impact of youth's perceptions of stress on their biological stress reactions and later health outcomes such as clinical disorders.

Emotion socialization as a predictor of physiological and psychological responses to stress

Reactivity patterns to acute stress are important indicators of physical and mental health. However, the relationships between emotion socialization and stress responses are not well understood. This study aimed to examine whether parental responses to negative emotions predicted physiological and psychological responses to acute stress in late adolescence and emerging adulthood, and whether these relationships varied by gender and ethnicity. Participants were 973 individuals (mean age=19.20years; 50% male; 63% African American, 34% European American) who reported on parental emotion socialization. Participants completed a standardized social stress test (the Trier Social Stress Test; TSST). Heart rate, blood pressure and salivary samples were assessed from baseline throughout the task and during recovery period. Psychological responses to stress were measured immediately after the TSST. Unsupportive parental responses to children's negative emotions were associated with blunted cortisol reactivity and greater negative emotions to a psychosocial stress task in females and African American youth, whereas supportive parental responses predicted greater cortisol reactivity and lower negative emotions to stress in European American youth, as well as less negative emotions in males. However, parental responses to negative emotions did not predict heart rate or SBP reactivity to the TSST. Findings suggest that parental emotion socialization may be an important factor influencing HPA axis reactivity and psychological responses to stress, with important differences across gender and ethnic youth subgroups.

Patterns of cortisol and alpha-amylase reactivity to psychosocial stress in maltreated women

BACKGROUND

Childhood maltreatment can trigger enduring changes in major stress response systems, particularly in the context of major depressive disorder (MDD). However, the relative impact of maltreatment versus MDD on hypothalamic-pituitary-adrenal axis and sympathetic-adrenal-medullary system stress reactivity is not well understood.

METHOD

This study examined salivary cortisol and alpha-amylase responses to the Trier Social Stress Test (TSST) in 26 maltreated (15 with current MDD) and 26 non-maltreated (17 with current MDD) women.

RESULTS

Maltreated women showed greater anticipatory cortisol reactivity during the TSST protocol compared to non-maltreated women. Maltreated women also showed rapid deceleration in cortisol levels. Whereas non-maltreated women showed initial declines in alpha-amylase levels but rapidly increasing alpha-amylase levels during the TSST protocol, maltreated women did not exhibit changes in alpha-amylase levels during the TSST protocol. Contrary to expectation, MDD did not impact cortisol or alpha-amylase responses.

LIMITATIONS

The present study is limited by retrospective report of childhood maltreatment, cross-sectional design, and modest sample sizes.

CONCLUSIONS

These findings suggest that childhood maltreatment plays a greater role driving alterations in cortisol and alpha-amylase stress reactivity than MDD. Understanding the biological embedding of maltreatment is critical for elucidating mechanisms linking these experiences to risk for negative mental and physical health outcomes.

The endocrinology of human caregiving and its intergenerational transmission

Variation in the quality of parental care has a tremendous impact on a child's social–emotional development. Research investigating the predictors of this variability in human caregiving behavior has mostly focused on learning mechanisms. Evidence is currently accumulating for the complementary underlying role of steroid hormones and neuropeptides. An overview is provided of the hormones and neuropeptides relevant for human caregiving behavior. Then the developmental factors are described that stimulate variability in sensitivity to these hormones and neuropeptides, which may result in variability in the behavioral repertoire of caregiving. The role of genetic variation in neuropeptide and steroid receptors, the role of testosterone and oxytocin during fetal development and parturition, and the impact of experienced caregiving in childhood on functioning of the neuroendocrine stress and oxytocin system are discussed. Besides providing a heuristic framework for further research on the ontogenetic development of human caregiving, a neuroendocrine model is also presented for the intergenerational transmission of caregiving practices. Insight into the underlying biological mechanisms that bring about maladaptive caregiving behavior, such as neglect and insensitive parenting, will hopefully result in more efficient approaches to reduce the high prevalence of such behavior and to minimize the impact on those affected.

Biological sensitivity to context: Cortisol awakening response moderates the effects of neighbourhood density on the development of adolescent externalizing problem behaviours

This four-year longitudinal study attempted to test person-environment interaction theory and biological sensitivity theory by assessing whether individuals' biological stress activity CARAUCg (Cortisol Awakening Response Area Under the Curve with respect to ground) moderates the effects of neighbourhood density on the development of adolescent externalizing problem behaviours. Participants were 358 Dutch adolescents with a mean age of 15 years at the first measurement. Our analyses showed that CARAUCg moderated the effects of neighbourhood density on the level of parent-reported delinquency and aggression and adolescent self-reported delinquency. More specifically, for adolescents with high CARAUCg, higher neighbourhood density significantly predicted higher levels of parent-reported and adolescent self-reported delinquency and aggression, whereas the association was reversed or non-significant for adolescents with low CARAUCg. Our findings suggest that adolescents with different levels of CARAUCg respond differentially to the density of the neighbourhood they live in, supporting for person-environment interaction perspectives and biological sensitivity theory.

Take your mind off it: Coping style, serotonin transporter linked polymorphic region genotype (5-HTTLPR), and children's internalizing and externalizing problems

Individuals with the short variant of the serotonin transporter linked polymorphic region gene are more susceptible than individuals homozygous for the long allele to the effects of stressful life events on risk for internalizing and externalizing problems. We tested whether individual differences in coping style explained this increased risk for problem behavior among youth who were at both genetic and environmental risk. Participants included 279 children, ages 8-11, from the Children's Experiences and Development Study. Caregivers and teachers reported on children's internalizing and externalizing symptoms, and caregivers and children on children's exposure to harsh parenting and parental warmth in middle childhood, and traumatic events. Children reported how frequently they used various coping strategies. Results revealed that short/short homozygotes had higher levels of internalizing problems compared with long allele carriers and that short allele carriers had higher levels of externalizing problems compared with long/long homozygotes under conditions of high cumulative risk. Moreover, among children who were homozygous for the short allele, those who had more cumulative risk indicators less frequently used distraction coping strategies, which partly explained why they had higher levels of internalizing problems. Coping strategies did not significantly mediate Gene × Environment effects on externalizing symptoms.

Multidimensional assessment of neuroendocrine and psychopathological profiles in maltreated youth

It has been debated whether children who have experienced early life stress (ELS), such as early caregiver separation show elevated risk for stress-related psychiatric disorders and a multi-symptom psychopathological profile that is not fully reflected in categorical assessments. In this study, we investigated dimensional measures of stress-related psychopathology in children in permanent out-of-home care, taking into account potential neuroendocrine interactions. In the current study, 25 children who had been placed in permanent out-of-home care before age 3 (years) and 26 controls (aged 10.6 ± 1.75 years) were investigated with categorical (DSM-IV) and dimensional assessments (CBCL) of psychopathology and diurnal salivary cortisol levels were assessed. Semi-structured interviews (K-DIPS) revealed no significant group differences in full-scale psychiatric diagnoses, whereas dimensional assessment (CBCL) revealed significant group differences in externalizing and total problem behaviours within the clinical range for children with ELS. Only children with ELS showed a combined symptom profile of clinical-range internalizing and externalizing problems. Lower morning cortisol values and subsequent flatter decline was found in subjects with ELS children compared to controls, showing group differences in diurnal cortisol secretion. Lower morning cortisol values were associated with more problem behaviour in the ELS group. Results show that ELS children exhibited increased psychopathological symptom severity and complexity associated with lower morning cortisol levels, which was not fully reflected in categorical assessments. This highlights the importance of incorporating dimensional assessments and neurobiological factors into psychopathological evaluations of children in out-of-home care in order to facilitate early identification of children at high risk for stress-related disorders.

Depression from childhood through adolescence: Risk mechanisms across multiple systems and levels of analysis

This paper selectively reviews recent research, especially in the last two years (2012-2014) in preschool, child, and adolescent depression. In particular, attention is paid to developmental epidemiology as well as risk factors and processes that contribute to depression trajectories over time. Emphasis is placed on a developmental psychopathology perspective in which risks are instantiated across multiple systems and levels of analysis, including genetics, stress contexts and processes, biological stress mechanisms, temperament, emotion, reward, cognitive factors and processes, and interpersonal influences. These risks dynamically transact over time, as they emerge and stabilize into relatively trait-like vulnerabilities that confer risk for the increasing rates of depression observed in adolescence. Overall, this summary illustrates that considerable progress has been made recently in understanding the complex developmental processes contributing to depression. Finally, a few gaps are highlighted as opportunities for future research.