Childhood Maltreatment Disrupts Brain-Mediated Pathways Between Adolescent Maternal Relationship Quality and Positive Adult Outcomes

Right frontal cingulate cortex mediates the effect of prenatal complications on youth internalizing behaviors

Prenatal and perinatal complications represent well-known risk factors for the future development of psychiatric disorders. Such influence might become manifested during childhood and adolescence, as key periods for brain and behavioral changes. Internalizing and externalizing behaviors in adolescence have been associated with the risk of psychiatric onset later in life. Both brain morphology and behavior seem to be affected by obstetric complications, but a clear link among these three aspects is missing. Here, we aimed at analyzing the association between prenatal and perinatal complications, behavioral issues, and brain volumes in a group of children and adolescents. Eighty-two children and adolescents with emotional-behavioral problems underwent clinical and 3 T brain magnetic resonance imaging (MRI) assessments. The former included information on behavior, through the Child Behavior Checklist/6-18 (CBCL/6-18), and on the occurrence of obstetric complications. The relationships between clinical and gray matter volume (GMV) measures were investigated through multiple generalized linear models and mediation models. We found a mutual link between prenatal complications, GMV alterations in the frontal gyrus, and withdrawn problems. Specifically, complications during pregnancy were associated with higher CBCL/6-18 withdrawn scores and GMV reductions in the right superior frontal gyrus and anterior cingulate cortex. Finally, a mediation effect of these GMV measures on the association between prenatal complications and the withdrawn dimension was identified. Our findings suggest a key role of obstetric complications in affecting brain structure and behavior. For the first time, a mediator role of frontal GMV in the relationship between prenatal complications and internalizing symptoms was suggested. Once replicated on independent cohorts, this evidence will have relevant implications for planning preventive interventions.

Parental Deprivation- and Threat-Based Factors Associated with Youth Emotion-Based Neurocircuitry and Externalizing Behavior: A Systematic Review

Parental factors, including negative parenting practices (e.g., family conflict, low monitoring), parental depression, and parental substance use, are associated with externalizing behaviors among youth. However, the ways in which these parental factors are associated with youth brain function and consequent externalizing behavior has been less studied. Both the dimensional and stress acceleration models provide frameworks for understanding how parental factors may be associated with frontolimbic and frontoparietal networks implicated in emotional attention and regulation processes. The current review builds upon this work by examining how deprivation- and threat-based parental factors are associated with youth neurocircuitry involved in emotional functioning and externalizing behaviors. A systematic review using PRISMA guidelines was completed and included five studies assessing parenting behaviors, six studies assessing parental depressive symptoms and/or diagnosis, and 12 studies assessing parental history of substance use. Synthesis of reviewed studies discusses support for the dimensional and stress acceleration models within the context of deprivation and threat. Further, a limited number of studies tested (i.e., six studies) and supported (i.e., three studies) youth neural structure and function as a mediator of the association between parental factors and youth externalizing behavior. Specific recommendations for future work include more deliberate planning related to sample composition, improved clarity related to parental constructs, consistency in methodology, and longitudinal study design in order to better understand associations between contextual parental influences and youth neural and behavioral functioning.

Parental stress during pregnancy and maternity

OBJECTIVE

To identify factors related to parental stress of women during pregnancy and the child's first month of life.

METHOD

Prospective longitudinal study in two stages. Analysis of home interviews with 121 participants, Gestational Stress Scale, and Parental Stress Scale. Fisher's exact test, Spearman's correlation, and linear and logistic multivariate regression were applied, with p < 0.05.

RESULTS

Most of the participants were between 18 and 35 years old, had 11 to 13 years of education, had no paid work, had a partner, usually the child's father, planned pregnancy, were multiparous, and underwent prenatal care. During pregnancy, 67.8% had stress. In the first month after the child's birth, most had low parental stress (52.1%). High parental stress correlated with some gestational stress. Planning pregnancy decreased parental stress.

CONCLUSION

Gestational and parental stress in the child's first month of life were correlated and pregnancy planning was a factor that reduced stress levels. Timely actions to reduce parental stress are essential for parenting and the child's overall health.

Estresse parental na gestação e maternidade

RESUMO Objetivo: Identificar fatores relacionados ao estresse parental de mulheres na gestação e primeiro mês de vida da criança. Método: Estudo longitudinal prospectivo em duas etapas. Análise de entrevistas em domicílio com 121 participantes, Escala de Estresse Gestacional e de Estresse Parental. Aplicados teste exato de Fisher, correlação de Spearman e regressão multivariada linear e logística, com p < 0,05. Resultados: A maior parcela das participantes tinha entre 18 e 35 anos, 11 a 13 anos de estudo, sem trabalho remunerado, com companheiro, geralmente o pai da criança, gestação planejada, multípara e realização do pré-natal. Na gestação, 67,8% apresentaram estresse. No primeiro mês após o nascimento do filho, a maioria teve baixo estresse parental (52,1%). Estresse parental alto apresentou correlação com algum estresse gestacional. Planejar a gestação diminuiu o estresse parental. Conclusão: Estresse gestacional e parental no primeiro mês de vida da criança foram correlacionados e o planejamento da gestação constituiu fator de diminuição dos níveis de estresse. Ações oportunas para reduzir o estresse parental são fundamentais para a parentalidade e saúde integral da criança.

Consequences of Inadequate Caregiving for Children's Attachment, Neurobiological Development, and Adaptive Functioning

Given that human infants are almost fully reliant on caregivers for survival, the presence of parents who provide sensitive, responsive care support infants and young children in developing the foundation for optimal biological functioning. Conversely, when parents are unavailable or insensitive, there are consequences for infants' and children's attachment and neurobiological development. In this paper, we describe effects of inadequate parenting on children's neurobiological and behavioral development, with a focus on developing capacities for executive functioning, emotion regulation, and other important cognitive-affective processes. Most prior research has examined correlational associations among these constructs. Given that interventions tested through randomized clinical trials allow for causal inferences, we review longitudinal intervention effects on children's biobehavioral and cognitive-affective outcomes. In particular, we provide an overview of the Bucharest Early Intervention Project, a study in which children were randomized to continue in orphanage care (typically the most extreme condition of privation) or were placed into the homes of trained, supported foster parents. We also discuss findings regarding Attachment and Biobehavioral Catch-up, an intervention enhancing sensitivity among high-risk parents. We conclude by suggesting future directions for research in this area.

Impact of childhood maltreatment and resilience on behavioral and neural patterns of inhibitory control during emotional distraction

Exposure to childhood maltreatment (CM) may disrupt typical development of neural systems underlying impulse control and emotion regulation. Yet resilient outcomes are observed in some individuals exposed to CM. Individual differences in adult functioning may result from variation in inhibitory control in the context of emotional distractions, underpinned by cognitive-affective brain circuits. Thirty-eight healthy adults with a history of substantiated CM and 34 nonmaltreated adults from the same longitudinal sample performed a Go/No-Go task in which task-relevant stimuli (letters) were presented at the center of task-irrelevant, negative, or neutral images, while undergoing functional magnetic resonance imaging. The comparison group, but not the maltreated group, made increased inhibitory control errors in the context of negative, but not neutral, distractor images. In addition, the comparison group had greater right inferior frontal gyrus and bilateral frontal pole activation during inhibitory control blocks with negative compared to neutral background images relative to the CM group. Across the full sample, greater adaptive functioning in everyday contexts was associated with superior inhibitory control and greater right frontal pole activation. Results suggest that resilience following early adversity is associated with enhanced attention and behavioral regulation in the context of task-irrelevant negative emotional stimuli in a laboratory setting.

Health Outcomes Following Childhood Maltreatment: An Examination of the Biopsychosocial Model

Child maltreatment constitutes a notoriously large problem within the healthcare field and is associated with significant biological, psychological, and social consequences across the lifespan. Objectives: The primary aim of this study was to examine the biopsychosocial outcomes of an adult population who reported a history of child maltreatment. Method: Data from the Midlife Development in the United States 2 Biomarker Project were used. The analytic sample in the present study included 1228 adults. AMOS 23 was used to conduct structural equation modeling and fit two separate models in order to examine the relationships between childhood maltreatment and biopsychosocial variables for both men and women. Results: Childhood maltreatment had a direct association with cortisol levels, subjective well-being, positive life events, depression, and physical symptoms and conditions for both men and women. Discussion: The present study offers unique contributions toward the examination of biopsychosocial outcomes following maltreatment. Practical implications and future directions are addressed.

Transforming the paradigm of child welfare

As a founder of the field of applied developmental psychology, Dr Edward Zigler promoted public policy that translated scientific knowledge into real-world programs to improve the outcomes of high-risk children and families. Many researchers, practitioners, and public policy proponents have sought to carry on his legacy through integration of empirical research, evidence-based prevention and intervention, and advocacy to address a range of challenges facing families with young children. To advance the field of child maltreatment, a multidisciplinary team of investigators from the Universities of Rochester and Minnesota partnered with the Eunice Kennedy Shriver National Institute of Child Health and Human Development to create the Translational Research that Adapts New Science FOR Maltreatment Prevention Center (Transform). Building on state-of-the-art research methodologies and clinical practices, Transform leverages theoretically grounded research and evidence-based interventions to optimize outcomes for individuals across the life span who have experienced, or may be at risk for, maltreatment. Inspired by the work of Dr Zigler, Transform is committed to bridging science and real-world practice. Therefore, in addition to creating new science, Transform's Community Engagement Core provides translational science to a broad audience of investigators, child-serving professionals, and parental and governmental stakeholders. This article describes Transform's purpose, theoretical framework, current activities, and future directions.

Childhood Maltreatment, Cortical and Amygdala Morphometry, Functional Connectivity, Laterality, and Psychopathology

Child maltreatment (CM) is the most important preventable risk factor for psychopathology and there is a pressing need to understand how CM gets 'under the skin' to markedly increase risk in some individuals as well as a comparable effort to identify factors associated with better than expected outcomes in other individuals. This special issue of Child Maltreatment provides a series of sophisticated studies on the neurobiological impact of CM, of which we have chosen 4 articles to comment on.The articles by Oshri et al., and Peveril, Sheridan, Busso & McLaughlin are amygdala centric and provide important new information on the impact of CM on the morphology and functional connectivity of this highly stress susceptible structure. The article by Demers et al., presents data from a longitudinal study that illustrates the potentially disruptive effects of CM on the association between maternal relationship quality, frontal cortical development and symptomatology. Finally, the De Bellis et al., study addresses the pressing question, which we have labeled the 'ecophenotype hypothesis', that postulates that maltreated and non-maltreated individuals with the same primary DSM diagnosis are clinically and neurobiologically distinct, and provides new evidence for a specific prefrontal cortical neurobiological abnormality in the maltreated subtype.

Understanding the Neurobiological Implications of Maltreatment: A Commentary on the Special Issue

A large body of evidence demonstrates the deleterious effects of childhood maltreatment that span across multiple levels of functioning and throughout development. This commentary highlights the important research in this special issue of Child Maltreatment that advances our understanding of the neural and physiological implications of maltreatment. Throughout, the commentary calls attention to critical issues in the study of maltreatment and neurobiological processes for future work in this area.