Infant adrenocortical reactivity and behavioral functioning: relation to early exposure to maternal intimate partner violence

A Preliminary Investigation of Associations Between Traumatic Events Experienced During Pregnancy and Salivary Diurnal Cortisol Levels of Brazilian Adolescent Mothers and Infants

INTRODUCTION

Interpersonal violence against women is a major global health problem that may have intergenerational effects. This study investigated associations between maternal experiences of interpersonal violence and other traumatic events and maternal and infant salivary diurnal cortisol in a cohort of adolescent mothers in São Paulo, Brazil.

METHOD

Adolescent mothers (14-19 years) participating in a home-visiting intervention were interviewed retrospectively about lifetime and pregnancy violence and trauma exposure. Mothers collected saliva at waking and before bedtime from themselves (n = 23) and their infants (n = 32) at 12 months postpartum. Multivariable regression models were used to examine associations between trauma history variables and salivary diurnal cortisol.

RESULTS

Adjusting for the intervention group, infant sex, maternal age, non-supplement medication use, and sample collection time, we found that higher-than-average lifetime trauma exposure was associated with maternal evening cortisol (b = 0.472, p-value = 0.028). Lifetime assaultive violence exposure was also associated with maternal evening cortisol (b = 0.196, p-value = 0.02). Maternal exposure to traumatic events in pregnancy was positively associated with bedtime cortisol levels of infants (b = 0.21, p = 0.01). Trauma variables were not associated with maternal or infant morning cortisol levels.

CONCLUSION

Results suggest that maternal trauma history influences both maternal and infant postnatal cortisol regulation as indexed by evening cortisol levels. These results are consistent with models of fetal programming; however, future studies should investigate potential postnatal psychobiological pathways. Lifetime trauma exposure may also become embedded in the maternal hypothalamic-adrenal-pituitary axis regulation. Future studies are needed to consider other biological pathways in the intergenerational transmission of trauma.

Adrenocortical deviations and adverse clinical outcomes in children and adolescents exposed to interparental intimate partner violence: A systematic review

Childhood exposure to interparental intimate partner violence (i-IPV) is a pervasive form of child maltreatment, posing major public health concerns and elevating risks for enduring adverse clinical and developmental consequences. However, assessing the full spectrum of clinical effects is challenging, potentially leading to inconsistent identification of children in need of early intervention. This systematic review aimed to identify hypothalamic-pituitary-adrenocortical axis dysfunction following i-IPV exposure, elucidating the underlying biopsychobehavioural mechanisms and predicting adverse outcomes. We searched Embase, MEDLINE, and PsycINFO for peer-reviewed studies from infancy through adolescence, screened reference lists and conducted forward searches. Analysis of 23 publications (N = 1848) revealed associations between i-IPV and altered adrenocortical function from early childhood, influenced by FKBP5 haplotype, parental caregiving and offspring emotional insecurity. Results showed that the adrenocortical stress response may predict internalising and externalising problems, childhood asthma, impaired executive function and poor academic performance. Nonetheless, inconsistencies in findings between studies suggest methodological heterogeneity and potential bias. Identifying biomarkers such as cortisol can enhance prediction and mechanism-based intervention efforts but long-term studies with a common theoretical and methodological framework are needed for comprehensive understanding. Integrating biological, emotional, and behavioural assessments could potentiate trauma services and research, ultimately improving outcomes for affected children.

Patterns of intimate partner violence exposure across the first 10 years of life and children's emotional-behavioural outcomes at 10 years

BACKGROUND

Childhood exposure to intimate partner violence (IPV) is associated with emotional-behavioural problems. However, little is known about children's emotional-behavioural outcomes following exposure to different long-term patterns of IPV.

OBJECTIVE

The current study aimed to investigate the emotional-behavioural functioning of children at 10 years of age following exposure to different patterns of IPV across the first 10 years of life.

PARTICIPANTS AND SETTING

Data for this study was drawn from the Mothers' and Young People's Study- a longitudinal study of 1507 first time mothers and their first born child.

METHODS

Women were recruited during pregnancy from six public hospitals in Victoria, Australia. Data was collected during pregnancy, and at one, four and ten years postpartum. Four patterns of IPV exposure were previously identified: (a) minimal IPV exposure; (b) early IPV; (c) Increasing IPV; and (d) persistent IPV. Logistic regression was used to assess associations between IPV exposure and emotional-behavioural outcomes.

RESULTS

Exposure to early, increasing, or persistent IPV was associated with increased odds of experiencing emotional-behavioural difficulties (OR 2.15-2.97). Children exposed to a persistent pattern of IPV experienced over 6 times the odds of conduct problems (OR = 6.15 CI = 2.3-16.44).

CONCLUSIONS

Children exposed to early, increasing, or persistent IPV experienced increased odds of emotional-behavioural problems at age 10, regardless of the duration or type of violence they were exposed to. However, children exposed to persistent IPV across childhood appeared to experience the highest odds of emotional-behavioural difficulties.

Prenatal Exposure to Intimate Partner Violence and Child Developmental Outcomes: A Scoping Review Study

Pregnant women face an increased risk of intimate partner violence (IPV). In addition to the risk of violence faced by women, there is a dual concern for risk of harm to the fetus. Expanding knowledge on childbirth outcomes, other domains of children's development have been examined in recent literature. Yet, there is limited comprehensive knowledge in the area. This scoping review study, informed by ecobiodevelopmental theory, mapped evidence associating prenatal IPV exposure and children's development. We searched eight databases, including PubMed, CINAHL, and ERIC. Thirty-one empirical studies published in English that associated prenatal IPV exposure and children's development were eligible for our review. Included studies were published between 2006 and 2022, with 39% published in the most recent 5 years. Eighteen studies had sample sizes smaller than 500, and 21 were atheoretical; six failed to consider covariates. Reviewed studies showed adverse effects of prenatal IPV exposure on psychological, behavioral, physical health, and physiological outcomes, either directly or indirectly via mechanisms such as maternal behavioral health. Due to inconsistency in results and a lack of empirical evidence, however, social and cognitive outcomes were identified as needing further research to enhance our understanding of the global and domain-specific effects of prenatal IPV exposure. Prospective longitudinal studies, driven by theories of causal mechanisms, which adjust for empirically qualified confounders, will be critical to inform practice and policy to promote healthy development of prenatally IPV-exposed children. Incorporating strengths/asset-focused outcomes and examining contextual factors and sex/gender specific effects may advance the knowledge in this area.

Could children exposed to intimate partner violence against their mother have more functional gastrointestinal disorders?

OBJECTIVE

To analyze the association between child exposure to intimate partner violence (CEIPV) committed against their mother and functional gastrointestinal disorders (FGIDs) in school-age children.

METHODS

A prospective cohort study was carried out that evaluated 626 mother-child pairs living in a poor urban area in the Northeast of Brazil. The mothers were asked about their children's exposure to intimate partner violence. Holden's classification was used, which investigates ten types of CEIPV from prenatal care. The number of exposures, age of onset, and the perpetrator of the exposure were also verified. The FGIDs in children were identified from the mother's responses to the questionnaire about pediatric gastrointestinal symptoms, Roma III version parent-report, translated and cross-culturally adapted into Brazilian Portuguese.

RESULTS

FGIDs were more frequent among children exposed to violence than those not exposed (OR: 1.64; 95% CI: 1.04-2.58; p = 0.03). Likewise, in children who suffered four or more types of exposure (OR: 1.81; 95% CI: 1.10-2.96; p  = 0.01), in which the exposure started in the first two years of life (OR: 1.93; 95% CI: 1.08-3.47; p = 0.02) and in those whose biological father was the perpetrator of the violence (OR; 1.62; 95% CI: 1, 05-2.48; p = 0.02).

CONCLUSION

Corroborating the proposal of the biopsychosocial model, CEIPV increases the chance of occurrence of FGIDs in school-age children. Therefore, early identification and proposals for appropriate interventions are suggested both for the prevention of CEIPV and for the prevention and follow-up of FGIDs.

Preliminary findings of emotion regulation in 12-month-old infants of mothers enrolled in a randomized controlled trial assessing a nutrition + exercise intervention

Improved offspring emotion regulation (ER) has been associated with maternal intake of single nutrients or exercise during pregnancy but has not been examined in randomized trials. We investigated the impact of a maternal nutrition + exercise intervention during pregnancy on offspring ER at 12 months of age. Mothers in the Be Healthy In Pregnancy randomized controlled trial were randomly assigned to an individualized nutrition + exercise intervention plus usual care (UC) or UC alone (control group). A multimethod assessment of infant ER using parasympathetic nervous system function (high frequency heart rate variability [HF-HRV] and root mean square of successive differences [RMSSD]) as well as maternal reports of infant temperament (Infant Behavior Questionnaire- Revised short form) was completed with a subsample of infants of enrolled mothers (intervention = 9, control = 8). The trial was registered at www.clinicaltrials.gov (NCT01689961). We observed greater HF-HRV (M = 4.63, SD = 0.50, p = .04, ƞ² _p  = .25) and RMSSD (M = 24.25, SD = 6.15, p = .04, ƞ² _p  = .25) in infants of mothers in the intervention versus control group. Intervention group infants also had higher maternally rated surgency/extraversion (M = 5.54, SD = 0.38, p = .00, ƞ² _p  = .65) and regulation/orienting (M = 5.46, SD = 0.52, p = .02, ƞ² _p  = .81), and lower negative affectivity (M = 2.70, SD = 0.91, p = .03, ƞ² _p  = .52). These preliminary results suggest that pregnancy nutrition + exercise interventions could improve infant ER but these findings require replication in larger, more diverse samples.

Glucocorticoids and Aggression: A Tripartite Interaction

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.

Externalizing behavior in preschool children in a South African birth cohort: Predictive pathways in a high-risk context

Mental health problems often begin in early childhood. However, the associations of various individual and contextual risk factors with mental health in the preschool period are incompletely understood, particularly in low- to middle-income countries (LMICs) where multiple risk factors co-exist. To address this gap, we prospectively followed 981 children in a South African birth cohort, the Drakenstein Child Health Study, assessing pre-and postnatal exposures and risk factors. The predictive value of these factors for child mental health (assessed by the Child Behavior Checklist) was modeled using structural equation modeling. We identified two key pathways to greater externalizing behavior: (1) prenatal exposure to substances (alcohol and smoking) directly predicted increased externalizing behavior (β = 0.24, p < 0.001); this relationship was partially mediated by an aspect of infant temperament (negative emotionality; β = 0.05, p = 0.016); (2) lower socioeconomic status and associated maternal prenatal depression predicted more coercive parenting, which in turn predicted increased externalizing behavior (β = 0.18, p = 0.001). Findings in this high-risk LMIC cohort cohere with research from higher income contexts, and indicate the need to introduce integrated screening and intervention strategies for maternal prenatal substance use and depression, and promoting positive parenting across the preschool period.

Depression in childhood: The role of children's exposure to intimate partner violence and maternal mental disorders

BACKGROUND

Intimate partner violence (IPV) is a global problem with high prevalence rates, and is linked to maternal mental disorders (MMD). Children's exposure to IPV (CEIPV) can have impacts on their physical and mental health, including depression.

OBJECTIVE

To analyze the associations between exposure to both CEIPV and MMD and depression in schoolchildren.

PARTICIPANTS AND SETTING

630 mother-child pairs were evaluated in a poor urban district in Recife, Northeast Brazil.

METHODS

A cohort study investigated the effects of IPV during pregnancy, postpartum and six to nine years after delivery. Women were asked about their experience of IPV, their own mental health, and the exposure of their child to violence. The child's mood was reported by the mother, using the Short Mood and Feelings Questionnaire (SMFQ). Ten types of CEIPV, and the age of onset of exposure, were compared with the child's subsequent risk of depression.

RESULTS

IPV was associated with MMD in 31.9% of the women at some period of time. Depressive symptoms were reported in 15.7% of school-age children. All types of CEIPV were associated with depression at school age. Multivariable analyses of exposure to IPV and MMD at different ages showed that exposure to both IPV and MMD in the first year of life had the strongest association with childhood depression (OR = 9.1; 95% CI: 2.4-33.9).

CONCLUSIONS

The frequency of CEIPV and MMD, and the high prevalence of depression at school age, shows the importance of assessing MMD and identifying exposure to IPV in pregnancy and the early years.

Parenting Mediates Associations Between Intimate Partner Violence at Different Life Stages and Toddler Social-Emotional Problems

BACKGROUND

Researchers have linked parent experiences of intimate partner violence (IPV) to engagement in more negative and less positive parenting behaviors with their own children. This parenting behavior is associated with more negative child social-emotional outcomes. There is little research examining the impact of exposure to IPV during childhood on subsequent parenting and child outcomes in the next generation. This study aimed to better understand the complex relationship between IPV, parenting, and child social-emotional development among mothers of toddler-aged children, using both mothers' self-reported and observed parenting.

METHOD

This study utilized longitudinal data from an economically disadvantaged, racially diverse sample of 120 women who participated in data collection across the perinatal period, until children were 2 years of age. Measures included self-reported and observed parenting, mother-reported IPV history, and mother-report of toddler social-emotional difficulties.

RESULTS

Childhood exposure to IPV predicted observed parenting problems, which in turn predicted greater toddler social-emotional problems. Conversely, adult experiences of IPV predicted self-reported parenting difficulties, which predicted greater toddler social-emotional problems.

SUMMARY

Findings suggest that exposure to IPV at different time points may influence parenting in different ways, representing unique pathways between maternal IPV experiences and child social-emotional difficulties.

Mothers' Experience of Intimate Partner Violence and Subsequent Offspring Attachment Security Ages 1-5 Years: A Meta-Analysis

Attachment status in early childhood is a key yet modifiable contributor to the development of social-emotional competence. The security and organization of the infant-mother attachment bond is particularly susceptible to stressors in the caregiving environment. While the impacts of normative interparental conflict on infant attachment are increasingly understood, the potentially unique place of intimate partner violence (IPV) in this pathway has been under-researched. This study surveyed all empirical work in this area, including unpublished literature (k = 6, N = 3,394), to examine meta-analytic associations between maternal experiences of IPV and offspring attachment security (ages 1-5 years) measured at least 6 months post-IPV exposure. Mothers' reports of IPV from pregnancy onward were inversely associated with offspring attachment security, r = -.23, CI [-0.42, -0.04], p = .02. Sample risk characteristics (e.g., clinical vs. community) moderated this association; child's age at attachment measurement and method of assessing child attachment (e.g., observational, representational, parent report) also moderated at a trend level. Implications for early screening, intervention, and future research are discussed.

Longitudinal prospective study examining the effects of the timing of prenatal stress on infant and child regulatory functioning: the Michigan Prenatal Stress Study protocol

INTRODUCTION

A considerable literature implicates prenatal stress as a critical determinant of poor psychological functioning in childhood and beyond. However, knowledge about whether the timing of prenatal stress differentially influences the development of child outcomes, including psychopathology, is virtually unknown. The primary aim of our study is to examine how the timing of prenatal stress differentially affects early childhood regulatory functioning as a marker of psychopathology. Our second aim is to examine the mediating effects of maternal physiological and psychological factors during pregnancy. Our third aim is to examine the moderating effects of postnatal factors on child regulatory functioning. Our project is the first longitudinal, prospective, multimethod study addressing these questions.

METHODS AND ANALYSIS

Our ongoing study recruits pregnant women, oversampled for intimate partner violence (a common event-based stressor allowing examination of timing effects), with data collection starting at pregnancy week 15 and concluding 4 years post partum. We aim to have n=335 mother-child dyads. We conduct a granular assessment of pregnancy stress (measured weekly by maternal report) in order to reveal sensitive periods during fetal life when stress particularly derails later functioning. Pattern-based statistical analyses will be used to identify subgroups of women who differ in the timing of their stress during pregnancy and then test whether these patterns of stress differentially predict early childhood self-regulatory outcomes.

ETHICS AND DISSEMINATION

Due to the high-risk nature of our sample, care is taken to ensure protection of their well-being, including a safety plan for suicidal ideation and a safety mechanism (exit button in the online weekly survey) to protect participant data privacy. This study was approved by Michigan State University Institutional Review Board. Dissemination will be handled by data sharing through National Institute of Child Health and Human Development Data and Specimen Hub (DASH), as well as through publishing the findings in journals spanning behavioural neuroendocrinology to clinical and developmental psychology.

Why achieving gender equality is of fundamental importance to improve the health and well-being of future generations: a DOHaD perspective

Despite progress in gender equality, women continue to be disadvantaged compared with men. Worldwide, women are more often confronted with poverty, violence, and mental health problems, and they have less access to food and education. All these factors do not only affect women themselves, but also have a negative impact on the child's early environment and impair its early development, thereby reducing the health and well-being of future generations. Framing gender equality as a women's issue fails to highlight the importance of gender equality for the health and well-being of the next generation. As a scientific community investigating early human development and health, we have failed to fully recognize and underscore the importance of gender equality in achieving the best possible start for every child. If women and men had equal rights and opportunities, their children would be more likely to reach their full potential which would improve the health and well-being of future generations. Our studies and interventions have not fully taken into account the complexity of gender inequality and women's disadvantaged positions in society. We need better insight into the complex adaptive interactions between various societal and human factors contributing to gender inequality and find approaches that take this complexity into account. If we want DOHaD science to have societal impact, we should strive beyond gender equality for gender equity and help women achieve equal rights and opportunities. We need to work with public health professionals, human rights activists, and policymakers to gauge the importance of gender equality. After all, gender equality is not only a fundamental human right, but also a necessary foundation for healthier future generations.

Maternal exposure to violence and offspring neurodevelopment: A systematic review

BACKGROUND

Stress during pregnancy is known to affect fetal neurodevelopment. It seems likely therefore that intimate partner violence (IPV) and domestic violence (DV) as extreme stressors will have a similarly adverse effect.

OBJECTIVES

A systematic review was conducted to assess the association between prenatal exposure to violence for mothers and developmental difficulties in their children.

DATA SOURCES

PubMed, PsycInfo, CINAHL, ERIC, Science Direct, SCOPUS, PsyARTICLES, Networked Digital Library of Theses and Dissertations, Women's Studies International and Gender Studies Database were all searched using the agreed search terms.

STUDY SELECTION AND DATA EXTRACTION

We include studies of women who have experienced any violence, fear of violence or aggression while pregnant, including emotional, psychological, physical or sexual violence in the context of IPV or DV. Studies were excluded if the neurodevelopmental outcomes of the offspring were not assessed. Studies from all countries were included, in English or translated to English, and search dates were not restricted. We included all years from inception of the database until the search date.

SYNTHESIS

Study design and biases, assessment tools, management of confounding, results and overall quality were assessed.

RESULTS

We identified 11 papers reporting on observational studies. Almost three quarters of the studies found a relationship between prenatal exposure to violence and developmental difficulties in the offspring. Differing assessment tools were used with a range of data collected and not all adjusted their findings for the same confounders.

CONCLUSIONS

Current evidence on the relationship between prenatal violence exposure, as IPV or DV, and consequent child developmental disorders remains limited. Future research using comprehensive study designs, larger samples and longitudinal follow-up of the offspring could clarify this association. While maternal trauma resulting from exposure to violence may play an important role in childhood development disorders, additional intervening factors on the pathway need further explored.

Mental health of children exposed to intimate partner violence against their mother: A longitudinal study from Brazil

BACKGROUND

Exposure to intimate partner violence (IPV) is an important adverse childhood experience, but there are few longitudinal studies in low and middle-income countries.

OBJECTIVE

To investigate the consequences of exposure to IPV for a child's mental health.

PARTICIPANTS AND SETTING

614 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil.

METHODS

Women were interviewed in pregnancy, postpartum and six to nine years after delivery, and asked about their experience of IPV, and the exposure of their child to violence. The Strengths and Difficulties Questionnaire (SDQ) was completed by child's mother and teacher. Ten types of child experience of IPV and the age of onset of exposure were compared with the child's behavioral profile at school age.

RESULTS

The mothers reported that 372/614 (60.6%) children had been exposed to IPV. The commonest types of child exposure to IPV were "prenatally", "overheard", "eyewitnessed", and 10.0% of children were physically or verbally involved in the IPV. Mothers reported high SDQ Total Difficulties scores in 71.7% of all children exposed to IPV and teachers in 59.8%. Multivariate logistic regression analysis demonstrated the strongest association with behavioral difficulties was with exposure to IPV in the age group 1-2 years (OR 2.5 [95% CI: 1.3-4.8]).

CONCLUSION

Young children are sensitive to the age of first exposure to IPV and to the type of IPV. Interventions to reduce IPV should be targeted on vulnerable women from poor urban communities during their pregnancies and in the first two years of their child's life.

Socioeconomic risk moderates the association between caregiver cortisol levels and infant cortisol reactivity to emotion induction at 24 months

Relations between maternal baseline cortisol and infant cortisol reactivity to an emotion induction procedure at child ages 7, 15, and 24 months were analyzed using data from the Family Life Project (N = 1,292). The emotion induction consisted of a series of standardized and validated tasks, including an arm restraint, toy removal, and mask presentation, intended to elicit responses of fear and frustration. Results revealed that at 7 and 15 months, maternal baseline cortisol was negatively related to child cortisol reactivity, such that children of mothers with lower cortisol exhibited steeper cortisol increases in response to the emotion induction. At 24 months, the association between mother and infant cortisol was moderated by socioeconomic risk, such that maternal baseline cortisol was associated with child cortisol reactivity only in dyads characterized by low socioeconomic risk. Furthermore, at 24 months, children of mothers with low baseline cortisol and low socioeconomic risk exhibited decreasing cortisol responses, whereas children of mothers with low baseline cortisol but high risk exhibited flat cortisol responses. Children in dyads characterized by high baseline maternal cortisol also exhibited flat cortisol responses regardless of socioeconomic risk. The role of caregiver physiology in the regulation of the child's stress response in the context of adversity is discussed.

Breastfeeding continuation at 6 weeks postpartum remediates the negative effects of prenatal intimate partner violence on infant temperament

Very little work has examined potential moderating effects in the link between prenatal intimate partner violence (IPV) and infant adjustment, especially in the first critical weeks following delivery. The current study evaluated the protective role of breastfeeding in the relationship between prenatal IPV and infant temperament at 4 months. Pregnant women (n = 82) were interviewed during pregnancy and at 6 weeks and 4 months postpartum. It was hypothesized that (a) prenatal IPV would predict infant temperament outcomes at the 4-month postpartum visit, and (b) breastfeeding continuation at 6 weeks acts as a protective factor such that breastfed infants will be less affected by the risk posed by prenatal IPV. Results indicated direct and negative effects of prenatal IPV on positive affectivity/surgency and orienting/regulatory capacity at 4 months. A significant moderating effect of breastfeeding at 6 weeks postpartum was identified. Mothers who were not breastfeeding at 6 weeks postpartum demonstrated the expected negative relationship between prenatal IPV exposure and infant adjustment, but if mothers were breastfeeding at 6 weeks postpartum, the relationship between IPV exposure and infant positive affectivity/surgency and orienting/regulatory capacity was not significantly different from zero. Results indicate a significant protective effect of breastfeeding in the intergenerational transmission of risk for infants born to mothers exposed to IPV.

Stress reactivity in preschool-aged children: Evaluation of a social stress paradigm and investigation of the impact of prenatal maternal stress

Prenatal maternal stress is an established risk factor for somatic and psychological health of the offspring. A dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in offspring has been suggested as an important mechanism. However, the impact of prenatal stress on stress reactivity in preschool-aged children is not yet well understood. This is partly due to the fact that for this age group there is no stress test as well established as for older children and adults. In the present work a previously published stress test (Kryski et al., 2011) was evaluated in a large sample of 45-month-old children (n = 339). Furthermore, the relation between measures of prenatal maternal stress and cortisol reactivity was investigated. Prenatal stress was defined as psychopathology (self-report available for n = 339; expert-rating available for a subsample of n = 246) and perceived stress (n = 244) during pregnancy. The stress paradigm elicited significant increases in salivary cortisol 30 and 40 min after the test, and 60.8% of the children were classified as responders. Lower cortisol levels after the stress test were observed in the group of children with prenatal stress defined as maternal psychopathology (both self-reported and expert-rated). Maternal perceived stress as a continuous measure was not significantly associated with cortisol levels. However, when comparing children in the highest quartile of maternal perceived stress to all other children, significantly lower cortisol values were observed in the prenatally stressed group. The present study confirms the paradigm by Kryski et al. as an effective stress test for preschool-aged children. Moreover, it provides further evidence that prenatal stress impacts HPA axis reactivity. Future studies should target the timing, nature, and intensity of prenatal stressors and their effect on the stress response in offspring at different developmental stages.

Maternal witness to intimate partner violence during childhood and prenatal family functioning alter newborn cortisol reactivity

Witnessing intimate partner violence (IPV) during childhood is a risk factor for mental health problems across the lifespan. Less is known about the intergenerational consequences of witnessing IPV, and if the current family climate buffers intergenerational effects of witnessing violence. The mother's experience of witnessing IPV against her own mother during childhood, prenatal family dysfunction, and prenatal perceived stress were examined as predictors of offspring cortisol in the first month of life (N = 218 mother-infant dyads). Mothers reported on witnessing IPV in their childhoods, prenatal family dysfunction, and prenatal perceived stress in pregnancy. At 2 days and again at 1 month postpartum, infants engaged in a neurobehavioral exam to assess infant cortisol reactivity. Infants whose mothers witnessed IPV in childhood exhibited alterations in their baseline cortisol and their cortisol reactivity at 1 month of age, whereas family dysfunction during pregnancy was associated with baseline cortisol and cortisol reactivity at 2 days of age. Prenatal perceived stress was not associated with infant cortisol at 2 days or 1 month. Prenatal family dysfunction and perceived stress did not moderate effects of the mother's experience of witnessing IPV. Results support the view that maternal experiences in childhood and during pregnancy exert intergenerational effects on the HPA stress response system.

Neuroendocrine and immune pathways from pre- and perinatal stress to substance abuse

Early life adversity is a documented risk factor for substance abuse and addiction. The pre- and perinatal period (i.e., from implantation, through pregnancy, to 6 months of age) is a critical period marked by high biological plasticity and vulnerability, making perinatal stress a particularly robust form of adversity. The neuroendocrine and immune systems are key mechanisms implicated in the transmission of addiction risk. We review animal and human studies that provide preliminary evidence for links between perinatal stress, neuroendocrine and immune dysregulation, and risk for substance abuse and addiction. A translational neuroscience perspective is employed to elucidate pre- and perinatally-induced biological mechanisms linked to addiction and discuss implications for prevention and intervention efforts. Significant evidence supports associations between pre- and perinatal stress and dysregulation of the hypothalamic-pituitary-adrenal axis and immune systems as well as links between neuroendocrine/immune functioning and addiction risk. More work is needed to explicitly examine the interplay between pre- and perinatal stress and neuroendocrine/immune disruptions that together heighten substance abuse risk. Future work is needed to fully understand how pre- and perinatal stress induces biological alterations to predispose individuals to higher risk for addiction. Such knowledge will strengthen theoretically-driven and empirically-supported prevention efforts for substance abuse and addiction.

Prenatal intimate partner violence exposure predicts infant biobehavioral regulation: Moderation by the brain-derived neurotrophic factor (BDNF) gene

The ability to regulate stress is a critical developmental milestone of early childhood that involves a set of interconnected behavioral and physiological processes and is influenced by genetic and environmental stimuli. Prenatal exposure to traumatic stress and trauma, including intimate partner violence (IPV), increases risk for offspring biobehavioral regulation problems during childhood and adolescence. Although individual differences in susceptibility to prenatal stress have been largely unexplored, a handful of studies suggest children with specific genetic characteristics are most vulnerable to prenatal stress. We evaluated the brain-derived neurotrophic factor Val66Met gene (BDNF) as a moderator of the effect of prenatal IPV exposure on infant temperamental and cortisol regulation in response to a psychosocial challenge. Ninety-nine mother–infant dyads recruited from the community were assessed when infants (51% female) were 11 to 14 months. Maternal reports of IPV during pregnancy and infant temperament were obtained, and infant saliva was collected for genotyping and to assess cortisol reactivity (before and after the Strange Situation Task). Significant genetic moderation effects were found. Among infants with the BDNF Met allele, prenatal IPV predicted worse temperamental regulation and mobilization of the cortisol response, while controlling for infant postnatal exposure to IPV, other maternal traumatic experiences, and infant sex. However, prenatal IPV exposure was not associated with temperamental or cortisol outcomes among infant carriers of the Val/Val genotype. Findings are discussed in relation to prenatal programming and biological susceptibility to stress.

Annual Research Review: Early adversity, the hypothalamic-pituitary-adrenocortical axis, and child psychopathology

BACKGROUND

Research on early adversity, stress biology, and child development has grown exponentially in recent years.

FINDINGS

We review the current evidence for the hypothalamic-pituitary-adrenocortical (HPA) axis as a stress-mediating mechanism between various forms of childhood adversity and psychopathology. We begin with a review of the neurobiology of the axis and evidence for relations between early adversity-HPA axis activity and HPA axis activity-psychopathology, as well as discuss the role of regulatory mechanisms and sensitive periods in development.

CONCLUSIONS

We call attention to critical gaps in the literature to highlight next steps in this research including focus on developmental timing, sex differences, stress buffering, and epigenetic regulation. A better understanding of individual differences in the adversity-HPA axis-psychopathology associations will require continued work addressing how multiple biological and behavioral systems work in concert to shape development.

Stress and cortisol responses in men: differences according to facial symmetry

Stress response is associated with increased activity in the hypothalamic-pituitary-adrenocortical axis. Chronic stress-induced elevation in cortisol may alter its own negative regulation with multiple long-term consequences for physical and psychological health. One of the most reliable physical traits associated with mental, apparent physical health, and competitiveness is the degree of facial fluctuating asymmetry. However, to our knowledge there are no studies regarding the relationship between cortisol levels, facial symmetry and male competitiveness, and how cortisol changes after a stressful test depending on these traits. Here, a group of 100 college men were photographed to obtain their facial asymmetry levels. They then, answered the perceived stress scale and the intrasexual competition test and donated two saliva samples (pre-and post-test sample) to measure the change in their cortisol levels after a stressful test. We found that basal cortisol levels were positively correlated with both perceived stress and competitiveness, but not with facial fluctuating asymmetry. Cortisol levels increased in most symmetrical men after a short stressful test, but it decreased in most asymmetrical men. The results suggest differences in endocrine responses according to facial fluctuating asymmetry in men and how these responses could be related to the maintenance of social status.

Prematurity and perinatal adversity effects hypothalamic-pituitary-adrenal axis reactivity to social evaluative threat in adulthood

This study examined the long-term effects of prematurity and perinatal adversity on individual differences in stress-related reactivity and regulation of the HPA axis. A prospective sample of 155 infants born preterm and healthy (n = 20), medical illness (n = 48), neurological illness (n = 26), and small for gestational age (n = 24) and full-term (n = 37) were recruited between 1985 and 1989. At age 23 years, multiple saliva samples were collected before and after participation in the Trier Social Stress Test and later assayed for cortisol. Results reveal that at age 23 years, infants born premature with neurological complications showed higher cortisol reactivity to social evaluative threat compared to either their full-term, small for gestation age, medically ill, or healthy preterm peers. Findings are discussed in terms of implications for contemporary theories that propose effects of early adversity on biological sensitivities and susceptibilities, which translate experience into developmental outcomes related to poor health and risk for disease.

Exposure to intimate partner violence in utero and infant internalizing behaviors: Moderation by salivary cortisol-alpha amylase asymmetry

Guided by the main tenets of contemporary models of the developmental origins of health and disease, this study evaluated whether individual differences in reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and Sympathetic Nervous System (SNS) moderate the effect of prenatal exposure to trauma on internalizing and externalizing behaviors during infancy. Participants were a community sample of 182 mothers (M age=25years, 43% Caucasian, 33% Black/African American, 24% Biracial/Other) and their infants (59% girls; M age=11.8months). Each mother completed questionnaires that assessed IPV experienced during pregnancy and also reported on her infant's behavior problems. Infant saliva samples (later assayed for cortisol and sAA) were collected before and after a frustrating task (i.e., arm restraint). Results revealed that the association between in utero IPV and infant internalizing behaviors was most pronounced for infants with asymmetrical HPA-SNS (i.e., high-cortisol and low-sAA) reactivity to frustration, and least pronounced for infants with symmetrical HPA-SNS (i.e., low-cortisol and low-sAA or high-cortisol and high-sAA) reactivity to frustration. Higher levels of externalizing behavior, in contrast, were associated with higher levels of prenatal IPV but unrelated to either cortisol or sAA reactivity to stress. Findings replicate documented associations between maternal IPV exposure during pregnancy and offspring risk. Moreover, findings advance our understanding of individual differences in the developmental origins of health and disease and provide additional evidence that assessing multiple stress biomarkers contributes to a more comprehensive understanding of individual vulnerability to adversity.

Family influences on the development of aggression and violence

Recent research confirms that many of the most salient risk and protective factors for the development of aggression and violence reside in the family system. Family-based risks begin before birth, encompassing genetic and epigenetic processes. Contextual stressors (e.g., poverty, conflict) may impact development directly or indirectly through disrupted parenting behavior, including high negativity, low warmth, harshness, and exposure to violence. The family can also serve as a powerful adaptive system counteracting the risk of aggression and violence. Parents can promote healthy behavioral development through warmth, structure, and prosocial values, as well as by fostering adaptive resources in the child and community. Successful interventions often reduce aggression and violence by supporting parents and families. Recent insights and future directions for research and practice are discussed.

Transcending as a driver of development

This paper draws from three different bodies of research to discuss the hypothesis that age-appropriate experiences enhance brain and cognitive development throughout the life span. These age-appropriate experiences could be considered as the drivers of development at each age, including drivers to foster development beyond adult abstract thinking, as described in Piaget's formal operational stage. We explore how a nurturing caregiver is the driver in the first 2 years of life, how language learning is the driver from 3 to 10 years, and how problem solving is the driver in the teenage years. To develop beyond adult rational thinking, we suggest that the driver is transcending thought, which can result when practicing meditations in the automatic self-transcending category, such as Transcendental Meditation.