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Doyle O, Wood EK, Sullivan EL, Mackiewicz-Seghete K, Graham A, Gustafsson HC. COVID-19 pandemic-related trauma symptoms are associated with postpartum alcohol consumption. Gen Hosp Psychiatry 2023; 85:19-27. [PMID: 37729720 PMCID: PMC10841071 DOI: 10.1016/j.genhosppsych.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/02/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has led to escalations in substance use, including alcohol consumption. Of particular concern are the potential impacts during the postpartum period, a time of heightened vulnerability to stress and potential transmission of the negative sequelae of substance use to offspring. However, postpartum alcohol consumption during the COVID-19 pandemic has not been well characterized. METHOD Postpartum drinking habits and COVID-19-related stress were repeatedly assessed (every two weeks for 12 weeks, and at one-, six-, and 12-months postpartum) from N = 378 individuals during the COVID-19 pandemic. Average alcohol use trajectories as well as heterogeneity in trajectories were characterized. COVID-19-related trauma symptoms and coping were examined in relation to alcohol use over time. RESULTS Average postpartum alcohol use included an initial quadratic increase from one-to-four-months postpartum, followed by a plateau between four-to-12-months. Higher (15.08%), moderate (26.90%), and lower consumption (57.90%) subgroups were identified. Endorsement of COVID-19-related trauma symptoms and using alcohol to cope with stress predicted higher consumption. CONCLUSIONS Findings suggest a potential sensitive period in establishing postpartum alcohol use patterns from one-to-four-months postpartum. Findings further suggest that postpartum alcohol use is heterogenous and that individual response to major traumatic stressors, like the COVID-19 pandemic, may influence emerging patterns of postpartum alcohol use.
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Affiliation(s)
- Olivia Doyle
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Elizabeth K Wood
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Elinor L Sullivan
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | | | - Alice Graham
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Hanna C Gustafsson
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
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Miller M, Arnett AB, Shephard E, Charman T, Gustafsson HC, Joseph HM, Karalunas S, Nigg JT, Polanczyk GV, Sullivan EL, Jones EJH. Delineating early developmental pathways to ADHD: Setting an international research agenda. JCPP Adv 2023; 3:e12144. [PMID: 37753147 PMCID: PMC10519745 DOI: 10.1002/jcv2.12144] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/13/2023] [Indexed: 09/28/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, impairing, and highly heritable condition typically diagnosed in middle childhood. However, it is now recognized that symptoms emerge much earlier in development. Research focused on understanding-using multiple units of analysis-the cascade of early-life (i.e., prenatal-infant-toddler) developmental changes that will later emerge as ADHD has the potential to transform early identification, prevention, and intervention. To this end, we introduce the recently established Early ADHD Consortium, an international network of investigators engaged in prospective, longitudinal studies of risk for ADHD beginning early in life, conducted within a developmental framework, and which incorporate multimethod approaches. This network seeks to harmonize measures and methodological approaches to increase the potential for data sharing and subsequent impact. Methods This perspective paper highlights the importance of investigating pre-diagnostic markers of ADHD, and potential models and mechanisms of ADHD risk and development, with the long-term objective of facilitating development of preemptive interventions that will minimize the impact of ADHD symptoms on everyday functioning and maximize health and developmental outcomes. Results We selectively describe key challenges and questions for this field related to theoretical models and developmental mechanisms in ADHD and recommend next steps for the science, including methodological, measurement, and study design considerations. We then describe potential implications for preemptive intervention development. We conclude by considering other issues including ethical concerns and the critical value of incorporating stakeholder input. Conclusions It is hoped that this perspective puts forth a research agenda that will enhance collaborative efforts and accelerate progress in understanding developmental mechanisms and the early ADHD phenotype, with implications for early intervention enhancement of healthy development for infants, young children, and their families.
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Affiliation(s)
- Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND InstituteUniversity of CaliforniaDavisCaliforniaUSA
| | - Anne B. Arnett
- Division of Developmental MedicineBoston Children's HospitalBostonMassachusettsUSA
- Department of PediatricsHarvard Medical SchoolBostonMassachusettsUSA
| | - Elizabeth Shephard
- Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de São PauloSao PauloBrasil
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN)King's College LondonLondonUK
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN)King's College LondonLondonUK
| | | | - Heather M. Joseph
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Sarah Karalunas
- Department of Psychological SciencesPurdue UniversityWest LafayetteIndianaUSA
| | - Joel T. Nigg
- Department of PsychiatryOregon Health & Science UniversityPortlandOregonUSA
| | - Guilherme V. Polanczyk
- Department of PsychiatryFaculdade de Medicina FMUSPUniversidade de São PauloSao PauloBrasil
| | - Elinor L. Sullivan
- Department of PsychiatryOregon Health & Science UniversityPortlandOregonUSA
| | - Emily J. H. Jones
- Centre for Brain and Cognitive DevelopmentBirkbeck, University of LondonLondonUK
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3
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Wood EK, Stamos G, Mitchell AJ, Gonoud R, Horgan AM, Nomura O, Young A, Nigg JT, Gustafsson HC, Sullivan EL. The association between food desert severity, socioeconomic status, and metabolic state during pregnancy in a prospective longitudinal cohort. Sci Rep 2023; 13:7197. [PMID: 37137940 PMCID: PMC10156695 DOI: 10.1038/s41598-023-32783-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/02/2023] [Indexed: 05/05/2023] Open
Abstract
Poor metabolic health during pregnancy is associated with health concerns for pregnant individuals and their offspring. Lower socioeconomic status (SES) is one risk factor for poor metabolic health, and may be related to limited access to healthful and affordable foods (e.g., living in a food desert). This study evaluates the respective contributions of SES and food desert severity on metabolic health during pregnancy. The food desert severity of 302 pregnant individuals was determined using the United States Department of Agriculture Food Access Research Atlas. SES was measured using total household income adjusted for household size, years of education, and amount of reserve savings. Information about participants' glucose concentrations one hour following an oral glucose tolerance test during the second trimester was extracted from medical records and percent adiposity during the second trimester was assessed using air displacement plethysmography. Information about participants' nutritional intake during the second trimester was obtained by trained nutritionists via three unannounced 24-h dietary recalls. Structural equation models showed that lower SES predicted higher food desert severity (β = - 0.20, p = 0.008) and higher adiposity (β = - 0.27, p = 0.016) and consumption of a more pro-inflammatory diet (β = - 0.25, p = 0.003) during the second trimester of pregnancy. Higher food desert severity also predicted higher percent adiposity during the second trimester (β = 0.17, p = 0.013). Food desert severity significantly mediated the relationship between lower SES and higher percent adiposity during the second trimester (βindirect = - 0.03, 95% CI [- 0.079, - 0.004]). These findings indicate that access to healthful and affordable foods is a mechanism by which SES contributes to adiposity during pregnancy and may inform interventions intended to improve metabolic health during pregnancy.
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Affiliation(s)
- Elizabeth K Wood
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Gayle Stamos
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - A J Mitchell
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA
| | - Rose Gonoud
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Angela M Horgan
- Clinical & Translational Research Center, Oregon Health & Science University, Portland, USA
| | - Olivia Nomura
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Anna Young
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, Portland, USA.
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA.
- Division of Neuroscience, Oregon National Primate Research Center, Portland, USA.
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Dunn GA, Thompson JR, Mitchell AJ, Papadakis S, Selby M, Fair D, Gustafsson HC, Sullivan EL. Perinatal Western-style diet alters serotonergic neurons in the macaque raphe nuclei. Front Neurosci 2023; 16:1067479. [PMID: 36704012 PMCID: PMC9872117 DOI: 10.3389/fnins.2022.1067479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The neurotransmitter serotonin is a key regulator of neurotransmission, mood, and behavior and is essential in neurodevelopment. Dysfunction in this important neurotransmitter system is connected to behavioral disorders such as depression and anxiety. We have previously shown that the developing serotonin system is sensitive to perinatal exposure to Western-style diet (WSD). Methods To advance our hypothesis that perinatal WSD has a long-term impact on the serotonergic system, we designed a fluorescent immunohistochemistry experiment using antibodies against tryptophan hydroxylase 2 (TPH2) and vesicular glutamate transporter 3 (VGLUT3) to probe protein expression in the raphe subnuclei in 13-month-old Japanese macaques (Macaca fuscata; n = 22). VGLUT3 has been shown to be coexpressed in TPH2+ cells in the dorsal raphe (DR) and median raphe nucleus (MnR) of rodent raphe nuclei and may provide information about the projection site of serotonergic fibers into the forebrain. We also sought to improve scientific understanding of the heterogeneity of the serotonin production center for the central nervous system, the midbrain raphe nuclei. Results In this immunohistochemical study, we provide the most detailed characterization of the developing primate raphe to date. We utilize multi-level modeling (MLM) to simultaneously probe the contribution of WSD, offspring sex, and raphe anatomical location, to raphe neuronal measurements. Our molecular and morphological characterization revealed that the 13-month-old macaque DR is remarkably similar to that of adult macaques and humans. We demonstrate that vesicular glutamate transporter 3 (VGLUT3), which rodent studies have recently shown can distinguish raphe populations with distinct projection targets and behavioral functions, likewise contributes to the heterogeneity of the primate raphe. Discussion This study provides evidence that perinatal WSD has a long-term impact on the density of serotonin-producing neurons, potentially limiting serotonin availability throughout the brain. Due to the critical involvement of serotonin in development and behavior, these findings provide important insight into the mechanisms by which maternal nutrition and metabolic state influence offspring behavioral outcomes. Finally, these findings could inform future research focused on designing therapeutic interventions to optimize neural development and decrease a child's risk of developing a mental health disorder.
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Affiliation(s)
- Geoffrey A. Dunn
- Department of Human Physiology, University of Oregon, Eugene, OR, United States
| | | | - A J Mitchell
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States,Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Samantha Papadakis
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States,Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Matthew Selby
- Department of Human Physiology, University of Oregon, Eugene, OR, United States
| | - Damien Fair
- Masonic Institute of Child Development, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - Hanna C. Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Elinor L. Sullivan
- Department of Human Physiology, University of Oregon, Eugene, OR, United States,Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States,Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States,*Correspondence: Elinor L. Sullivan,
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Gustafsson HC, Propper CB. Developmental trajectories of toddler sleep problems: can a person-centered approach help identify children at risk? Sleep 2022; 45:zsac142. [PMID: 35768173 PMCID: PMC9453622 DOI: 10.1093/sleep/zsac142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/15/2022] [Indexed: 08/11/2023] Open
Abstract
STUDY OBJECTIVES Previous research examining toddler sleep problems has relied almost exclusively on variable-centered statistical approaches to analyze these data, which provide helpful information about the development of the average child. The current study examined whether person-centered trajectory analysis, a statistical technique that can identify subgroups of children who differ in their initial level and/or trajectory of sleep problems, has the potential to inform our understanding of toddler sleep problems and their development. METHODS Families (N = 185) were assessed at 12, 24, 30, and 36 months of child age. Latent class growth analysis was used to test for subgroups that differed in their 24-36 month sleep problems. Subgroups were compared on child 36-month externalizing, internalizing, and total problem behaviors, and on 12 month maternal mental health, inter-parental conflict, and maternal parenting behaviors. RESULTS Results support a four-class solution, with "low, stable," "low, increasing," "high, increasing," and "high decreasing" classes. The classes whose sleep problems persisted or worsened over time had worse behavioral problems than those whose symptoms improved or remained stably low. Additionally, 12 month maternal depression and global symptom severity, intimate partner violence, and maternal harsh-intrusive parenting behaviors discriminated between the classes that had similar levels of 24 month sleep disturbance but who had diverging trajectories over time. CONCLUSIONS This statistical approach appears to have the potential to increase understanding of sleep problem trajectories in the early years of life. Maternal mental health, intimate partner violence, and parenting behaviors may be clinically useful markers of risk for the persistence or development of toddler sleep problems.
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Affiliation(s)
- Hanna C Gustafsson
- Corresponding author. Hanna C. Gustafsson, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Multnomah Pavilion, Suite 1400, Mail Code: UHN-80R1, Portland, OR 97239, USA.
| | - Cathi B Propper
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Dunn GA, Mitchell AJ, Selby M, Fair DA, Gustafsson HC, Sullivan EL. Maternal diet and obesity shape offspring central and peripheral inflammatory outcomes in juvenile non-human primates. Brain Behav Immun 2022; 102:224-236. [PMID: 35217175 PMCID: PMC8995380 DOI: 10.1016/j.bbi.2022.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/21/2022] [Accepted: 02/19/2022] [Indexed: 12/30/2022] Open
Abstract
The obesity epidemic affects 40% of adults in the US, with approximately one-third of pregnant women classified as obese. Previous research suggests that children born to obese mothers are at increased risk for a number of health conditions. The mechanisms behind this increased risk are poorly understood. Increased exposure to in-utero inflammation induced by maternal obesity is proposed as an underlying mechanism for neurodevelopmental alterations in offspring. Utilizing a non-human primate model of maternal obesity, we hypothesized that maternal consumption of an obesogenic diet will predict offspring peripheral (e.g., cytokines and chemokines) and central (microglia number) inflammatory outcomes via the diet's effects on maternal adiposity and maternal inflammatory state during the third trimester. We used structural equation modeling to simultaneously examine the complex associations among maternal diet, metabolic state, adiposity, inflammation, and offspring central and peripheral inflammation. Four latent variables were created to capture maternal chemokines and pro-inflammatory cytokines, and offspring cytokine and chemokines. Model results showed that offspring microglia counts in the basolateral amygdala were associated with maternal diet (β = -0.622, p < 0.01), adiposity (β = 0.593, p < 0.01), and length of gestation (β = 0.164, p < 0.05) but not with maternal chemokines (β = 0.135, p = 0.528) or maternal pro-inflammatory cytokines (β = 0.083, p = 0.683). Additionally, we found that juvenile offspring peripheral cytokines (β = -0.389, p < 0.01) and chemokines (β = -0.298, p < 0.05) were associated with a maternal adiposity-induced decrease in maternal circulating chemokines during the third trimester (β = -0.426, p < 0.01). In summary, these data suggest that maternal diet and adiposity appear to directly predict offspring amygdala microglial counts while maternal adiposity influences offspring peripheral inflammatory outcomes via maternal inflammatory state.
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Affiliation(s)
| | - AJ Mitchell
- Oregon Health & Science University, Department of Behavioral Neuroscience,Oregon National Primate Research Center, Department of Neuroscience
| | - Matthew Selby
- University of Oregon, Department of Human Physiology
| | - Damien A Fair
- University of Minnesota School of Medicine, Masonic Institute of Child Development
| | | | - Elinor L. Sullivan
- University of Oregon, Department of Human Physiology,Oregon Health & Science University, Department of Behavioral Neuroscience,Oregon National Primate Research Center, Department of Neuroscience,Oregon Health & Science University, Department of Psychiatry
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7
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Karalunas SL, Ostlund BD, Alperin BR, Figuracion M, Gustafsson HC, Deming EM, Foti D, Antovich D, Dude J, Nigg J, Sullivan E. Electroencephalogram aperiodic power spectral slope can be reliably measured and predicts ADHD risk in early development. Dev Psychobiol 2022; 64:e22228. [PMID: 35312046 PMCID: PMC9707315 DOI: 10.1002/dev.22228] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/20/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022]
Abstract
The aperiodic exponent of the electroencephalogram (EEG) power spectrum has received growing attention as a physiological marker of neurodevelopmental psychopathology, including attention-deficit/hyperactivity disorder (ADHD). However, its use as a marker of ADHD risk across development, and particularly in very young children, is limited by unknown reliability, difficulty in aligning canonical band-based measures across development periods, and unclear effects of treatment in later development. Here, we investigate the internal consistency of the aperiodic EEG power spectrum slope and its association with ADHD risk in both infants (n = 69, 1-month-old) and adolescents (n = 262, ages 11-17 years). Results confirm good to excellent internal consistency in infancy and adolescence. In infancy, a larger aperiodic exponent was associated with greater family history of ADHD. In contrast, in adolescence, ADHD diagnosis was associated with a smaller aperiodic exponent, but only in children with ADHD who had not received stimulant medication treatment. Results suggest that disruptions in cortical development associated with ADHD risk may be detectable shortly after birth via this approach. Together, findings imply a dynamic developmental shift in which the developmentally normative flattening of the EEG power spectrum is exaggerated in ADHD, potentially reflecting imbalances in cortical excitation and inhibition that could contribute to long-lasting differences in brain connectivity.
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Affiliation(s)
| | | | | | | | | | | | - Dan Foti
- Department of Psychological Sciences, Purdue University
| | - Dylan Antovich
- Department of Psychiatry, Oregon Health and Science University
| | - Jason Dude
- Department of Psychological Sciences, Purdue University
| | - Joel Nigg
- Department of Psychiatry, Oregon Health and Science University
| | - Elinor Sullivan
- Department of Psychiatry, Oregon Health and Science University
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8
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Martel MM, Elkins AR, Eng AG, Goh PK, Bansal PS, Smith-Thomas TE, Thaxton MH, Ryabinin P, Mooney MA, Gustafsson HC, Karalunas SL, Nigg JT. Longitudinal Temperament Pathways to ADHD Between Childhood and Adolescence. Res Child Adolesc Psychopathol 2022; 50:1055-1066. [PMID: 35102487 PMCID: PMC9680910 DOI: 10.1007/s10802-022-00902-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
The current investigation extended prior cross-sectional mapping of etiological factors, transdiagnostic effortful and affective traits, and ADHD symptoms to longitudinal pathways extending from two etiological domains: polygenic and prenatal risk. Hypotheses were (1) genetic risk for ADHD would be related to inattentive ADHD symptoms in adolescence and mediated by childhood effortful control; (2) prenatal smoking would be related to hyperactive-impulsive ADHD symptoms during childhood and mediated by childhood surgency; and (3) there would be age-related variation, such that mediation of genetic risk would be larger for older than younger ages, whereas mediation of prenatal risk would be larger in earlier childhood than at later ages. Participants were 849 children drawn from the Oregon ADHD-1000 Cohort, which used a case control sample and an accelerated longitudinal design to track development from childhood (at year 1 ages 7-13) through adolescence (at year 6 ages 13-19). Results showed the mediational pathway from prenatal smoking through surgency to hyperactivity-impulsivity at Year 1 was significant (indirect effect estimate = .053, p < .01). The mediational pathway from polygenic risk through effortful control to inattention at Year 6 was also significant (indirect effect estimate = .084, p < .01). Both results were independent of the association between inattention and hyperactivity-impulsivity and control for the alternative etiological input and held across parent- and teacher-report of ADHD symptoms. In line with dual pathway models of ADHD, early prenatal risk for hyperactivity-impulsivity appears to operate through surgency, while polygenic genetic risk for inattention appears mediated by effortful control.
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Werchan DM, Hendrix CL, Ablow JC, Amstadter AB, Austin AC, Babineau V, Anne Bogat G, Cioffredi LA, Conradt E, Crowell SE, Dumitriu D, Fifer W, Firestein MR, Gao W, Gotlib IH, Graham AM, Gregory KD, Gustafsson HC, Havens KL, Howell BR, Humphreys KL, King LS, Kinser PA, Krans EE, Lenniger C, Levendosky AA, Lonstein JS, Marcus R, Monk C, Moyer S, Muzik M, Nuttall AK, Potter AS, Salisbury A, Shuffrey LC, Smith BA, Smith L, Sullivan EL, Zhou J, Thomason ME, Brito NH. Behavioral coping phenotypes and associated psychosocial outcomes of pregnant and postpartum women during the COVID-19 pandemic. Sci Rep 2022; 12:1209. [PMID: 35075202 PMCID: PMC8786860 DOI: 10.1038/s41598-022-05299-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/16/2021] [Indexed: 11/09/2022] Open
Abstract
The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (N = 2876) and postpartum women (N = 1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Dani Dumitriu
- Columbia University Irving Medical Center, New York, USA
| | - William Fifer
- Columbia University Irving Medical Center, New York, USA
| | | | - Wei Gao
- Cedars-Sinai Medical Center, Los Angeles, USA
| | | | | | | | | | | | - Brittany R Howell
- Department of Human Development and Family Science, Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Tech, Blacksburg, USA
| | | | | | | | | | | | | | | | | | - Catherine Monk
- Columbia University Irving Medical Center, New York, USA
| | - Sara Moyer
- Virginia Commonwealth University, Richmond, USA
| | | | | | | | | | | | - Beth A Smith
- University of Southern California, Los Angeles, USA
| | - Lynne Smith
- The Lundquist Institute at Harbor-UCLA, West Carson, USA
| | | | - Judy Zhou
- University of Southern California, Los Angeles, USA
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10
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Gustafsson HC, Dunn GA, Mitchell AJ, Holton KF, Loftis JM, Nigg JT, Sullivan EL. The association between heightened ADHD symptoms and cytokine and fatty acid concentrations during pregnancy. Front Psychiatry 2022; 13:855265. [PMID: 35935444 PMCID: PMC9353213 DOI: 10.3389/fpsyt.2022.855265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Previous research conducted with samples of children suggest that individuals with attention-deficit/hyperactivity disorder (ADHD) have altered fatty acid concentrations and may have increased systemic inflammation. Whether these differences are also apparent in other populations of individuals with heightened ADHD symptoms (e.g., pregnant adults) is unknown. The goal of the current study was to examine whether there are ADHD-associated differences in polyunsaturated fatty acid concentrations or pro-inflammatory cytokine concentrations during pregnancy, a developmental period when fatty acid concentrations and systemic inflammation have implications for the health of both the pregnant person and the developing child. We hypothesized that plasma levels of the ratio of omega-6s to omega-3s (n-6:n-3) and plasma inflammatory cytokine levels would be higher in individuals with heightened ADHD symptoms, consistent with previous findings in children with ADHD. METHODS Data (N = 68) came from a prospective study of pregnant community volunteers who were oversampled for ADHD symptoms. During the 3rd trimester, plasma concentrations of fatty acids and the pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were assessed. Dietary intake was examined in the 3rd trimester using three 24-h recalls conducted by trained dietitians and by examining plasma levels of conjugated linoleic acid (n-6) and α-linolenic acid (n-3), essential fatty acids that must come from dietary intake. RESULTS The group with heightened ADHD symptoms had higher n-6:n-3s (β = 0.30, p < 0.01) and higher TNF-α concentrations (β = 0.35, p < 0.001) relative to controls. There were no group differences in dietary variables, as assessed by self-report and via plasma concentrations of essential fatty acids. IL-6 was not reliably associated with ADHD status in this sample. CONCLUSION Pregnant individuals with ADHD, on average, had higher plasma n-6:n-3s and higher TNF-α concentrations relative to controls. A difference was not detected in their dietary intake of fatty acids or other relevant nutrients. Though these null findings are inconclusive, they are consistent with the hypothesis that ADHD-associated differences in plasma fatty acid concentrations are the result of ADHD-associated differences in fatty acid metabolism, rather than simply differences in dietary intake.
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Affiliation(s)
- Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Geoffrey A Dunn
- Department of Human Physiology, University of Oregon, Eugene, OR, United States
| | - A J Mitchell
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States
| | - Kathleen F Holton
- Departments of Health Studies and Neuroscience, American University, Washington, DC, United States
| | - Jennifer M Loftis
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,VA Portland Health Care System, Portland, OR, United States
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
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11
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Gustafsson HC, Young AS, Stamos G, Wilken S, Brito NH, Thomason ME, Graham A, Nigg JT, Sullivan EL. Innovative methods for remote assessment of neurobehavioral development. Dev Cogn Neurosci 2021; 52:101015. [PMID: 34601346 PMCID: PMC8483646 DOI: 10.1016/j.dcn.2021.101015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/27/2021] [Accepted: 09/19/2021] [Indexed: 12/24/2022] Open
Abstract
In response to the COVID-19 pandemic, research institutions across the globe have modified their operations in ways that have limited or eliminated the amount of permissible in-person research interaction. In order to prevent the loss of important developmentally-timed data during the pandemic, researchers have quickly pivoted and developed innovative methods for remote assessment of research participants. In this manuscript, we describe methods developed for remote assessment of a parent child cohort with a focus on examining the perinatal environment, behavioral and biological indicators of child neurobehavioral development, parent-child interaction, as well as parent and child mental and physical health. We include recommendations relevant to adapting in-laboratory assessments for remote data collection and conclude with a description of the successful dissemination of the methods to eight research sites across the United States, each of whom are involved in Phase 1 of the HEALthy Brain and Child Development (HBCD) Study. These remote methods were born out of pandemic-related necessity; however, they have much wider applicability and may offer advantages over in-laboratory neurodevelopmental assessments.
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Affiliation(s)
- Hanna C Gustafsson
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Anna S Young
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Gayle Stamos
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Sydney Wilken
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Natalie H Brito
- New York University, 426 Greene Street, New York, NY 10003, USA
| | | | - Alice Graham
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Joel T Nigg
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Elinor L Sullivan
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Oregon National Primate Research Center, 505 NW 185th Avenue, Beaverton, OR 97006, USA.
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12
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Gustafsson HC, Nolvi S, Sullivan EL, Rasmussen JM, Gyllenhammer LE, Entringer S, Wadhwa PD, O’Connor TG, Karlsson L, Karlsson H, Korja R, Buss C, Graham AM, Nigg JT. Early development of negative and positive affect: Implications for ADHD symptomatology across three birth cohorts. Dev Psychopathol 2021; 33:1837-1848. [PMID: 36238202 PMCID: PMC9555229 DOI: 10.1017/s0954579421001012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
High levels of early emotionality (of either negative or positive valence) are hypothesized to be important precursors to early psychopathology, with attention-deficit/hyperactivity disorder (ADHD) a prime early target. The positive and negative affect domains are prime examples of Research Domain Criteria (RDoC) concepts that may enrich a multilevel mechanistic map of psychopathology risk. Utilizing both variable-centered and person-centered approaches, the current study examined whether levels and trajectories of infant negative and positive emotionality, considered either in isolation or together, predicted children's ADHD symptoms at 4 to 8 years of age. In variable-centered analyses, higher levels of infant negative affect (at as early as 3 months of age) were associated with childhood ADHD symptoms. Findings for positive affect failed to reach statistical threshold. Results from person-centered trajectory analyses suggest that additional information is gained by simultaneously considering the trajectories of positive and negative emotionality. Specifically, only when exhibiting moderate, stable or low levels of positive affect did negative affect and its trajectory relate to child ADHD symptoms. These findings add to a growing literature that suggests that infant negative emotionality is a promising early life marker of future ADHD risk and suggest secondarily that moderation by positive affectivity warrants more consideration.
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Affiliation(s)
- Hanna C. Gustafsson
- Department of Psychiatry, Oregon Health and Science
University, Portland, OR, USA
| | - Saara Nolvi
- Department of Psychology and Speech-Language Pathology,
Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center,
Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Elinor L. Sullivan
- Department of Psychiatry, Oregon Health and Science
University, Portland, OR, USA
- Divisions of Neuroscience and Cardiometabolic Health,
Oregon National Primate Research Center, Beaverton, OR, USA
| | - Jerod M. Rasmussen
- Development, Health, and Disease Research Program,
University of California Irvine, Irvine, CA, USA
- Department of Pediatrics, School of Medicine, University of
California Irvine, Irvine, CA, USA
| | - Lauren E. Gyllenhammer
- Development, Health, and Disease Research Program,
University of California Irvine, Irvine, CA, USA
- Department of Pediatrics, School of Medicine, University of
California Irvine, Irvine, CA, USA
| | - Sonja Entringer
- Development, Health, and Disease Research Program,
University of California Irvine, Irvine, CA, USA
- Department of Pediatrics, School of Medicine, University of
California Irvine, Irvine, CA, USA
- Institute of Medical Psychology, Charité University,
Berlin, Germany
| | - Pathik D. Wadhwa
- Development, Health, and Disease Research Program,
University of California Irvine, Irvine, CA, USA
- Department of Pediatrics, School of Medicine, University of
California Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, School of
Medicine, University of California Irvine, Irvine, CA, USA
- Department of Obstetrics and Gynecology, School of
Medicine, University of California Irvine, Irvine, CA, USA
- Department of Epidemiology, School of Medicine,
University of California Irvine, Irvine, CA, USA
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and
Obstetrics & Gynecology, University of Rochester Medical Center, Rochester, NY,
USA
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center,
Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University
Hospital and University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku
University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center,
Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University
Hospital and University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and
University of Turku, Turku, Finland
| | - Riikka Korja
- Department of Psychology and Speech-Language Pathology,
Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center,
Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Claudia Buss
- Development, Health, and Disease Research Program,
University of California Irvine, Irvine, CA, USA
- Institute of Medical Psychology, Charité University,
Berlin, Germany
| | - Alice M. Graham
- Department of Psychiatry, Oregon Health and Science
University, Portland, OR, USA
- Department of Behavioral Neuroscience, Oregon Health and
Science University, Portland, OR, USA
| | - Joel T. Nigg
- Department of Psychiatry, Oregon Health and Science
University, Portland, OR, USA
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13
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Allen MC, Moog NK, Buss C, Yen E, Gustafsson HC, Sullivan EL, Graham AM. Co-occurrence of preconception maternal childhood adversity and opioid use during pregnancy: Implications for offspring brain development. Neurotoxicol Teratol 2021; 88:107033. [PMID: 34601061 PMCID: PMC8578395 DOI: 10.1016/j.ntt.2021.107033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022]
Abstract
Understanding of the effects of in utero opioid exposure on neurodevelopment is a priority given the recent dramatic increase in opioid use among pregnant individuals. However, opioid abuse does not occur in isolation-pregnant individuals abusing opioids often have a significant history of adverse experiences in childhood, among other co-occurring factors. Understanding the specific pathways in which these frequently co-occurring factors may interact and cumulatively influence offspring brain development in utero represents a priority for future research in this area. We highlight maternal history of childhood adversity (CA) as one such co-occurring factor that is more prevalent among individuals using opioids during pregnancy and which is increasingly shown to affect offspring neurodevelopment through mechanisms beginning in utero. Despite the high incidence of CA history in pregnant individuals using opioids, we understand very little about the effects of comorbid prenatal opioid exposure and maternal CA history on fetal brain development. Here, we first provide an overview of current knowledge regarding effects of opioid exposure and maternal CA on offspring neurodevelopment that may occur during gestation. We then outline potential mechanistic pathways through which these factors might have interactive and cumulative influences on offspring neurodevelopment as a foundation for future research in this area.
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Affiliation(s)
- Madeleine C Allen
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States
| | - Nora K Moog
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany; Development, Health and Disease Research Program, University of California, Irvine, 837 Health Sciences Drive, Irvine, California 92697, United States
| | - Elizabeth Yen
- Department of Pediatrics, Tufts Medical Center, Boston, MA 02111, United States
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, 505 NW 185(th) Ave., Beaverton, OR 97006, United States; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States
| | - Alice M Graham
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States.
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14
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Gustafsson HC, Young AS, Doyle O, Nagel BJ, Mackiewicz Seghete K, Nigg JT, Sullivan EL, Graham AM. Trajectories of perinatal depressive symptoms in the context of the COVID-19 pandemic. Child Dev 2021; 92:e749-e763. [PMID: 34448493 PMCID: PMC8652588 DOI: 10.1111/cdev.13656] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study sought to advance understanding of the potential long‐term consequences of the COVID‐19 pandemic for child development by characterizing trajectories of maternal perinatal depression, a common and significant risk factor for adverse child outcomes. Data came from 393 women (86% White, 8% Latina; mean age = 33.51 years) recruited during pregnancy (n = 247; mean gestational age = 22.94 weeks) or during the first year postpartum (n = 146; mean child age = 4.50 months; 55% female). Rates of depression appear elevated, relative to published reports and to a pre‐pandemic comparison group (N = 155). This study also provides evidence for subgroups of individuals who differ in their depressive symptom trajectories over the perinatal period. Subgroup membership was related to differences in maternal social support, but not to child birth outcomes.
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Affiliation(s)
| | - Anna S Young
- Oregon Health & Science University, Portland, Oregon, USA
| | - Olivia Doyle
- Oregon Health & Science University, Portland, Oregon, USA
| | - Bonnie J Nagel
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Joel T Nigg
- Oregon Health & Science University, Portland, Oregon, USA
| | - Elinor L Sullivan
- Oregon Health & Science University, Portland, Oregon, USA.,Oregon National Primate Research Center, Beaverton, Oregon, USA
| | - Alice M Graham
- Oregon Health & Science University, Portland, Oregon, USA
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15
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Propper CB, Gustafsson HC, Holochwost SJ, Coffman JL. Parasympathetic response to challenge in infancy moderates the effects of sociodemographic risk on academic achievement at school entry. Dev Psychobiol 2021; 63:e22170. [PMID: 34292594 DOI: 10.1002/dev.22170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/07/2022]
Abstract
Exposure to higher levels of sociodemographic risk is associated with lower levels of academic achievement among young children. However, there is variability in the strength of this association, which may be traced to individual differences in physiological processes underlying self-regulation. In the current study, we examined whether the response of the parasympathetic nervous system to challenge, indexed by change in respiratory sinus arrhythmia (RSA), moderated the association between risk and school readiness at 5 years of age in a diverse sample of young children. We found that parasympathetic response to the Still-Face Paradigm moderated the effects of risk on a measure of school readiness, such that there was no association between risk and school readiness among children who exhibited RSA decreases during challenge at 6 months of age, a purported index of self-regulation at this age. For those infants who did not exhibit RSA withdrawal during this challenge, exposure to early cumulative risk was associated with lower scores on achievement assessment. These results speak to the possibility that certain patterns of parasympathetic response can serve as a protective factor for young children growing up in disadvantaged environments.
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Affiliation(s)
- Cathi B Propper
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Steven J Holochwost
- Department of Psychology, Lehman College, City University of New York, Baltimore, Maryland, USA
| | - Jennifer L Coffman
- Department of Human Development and Family Studies, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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16
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Gustafsson HC, Sullivan EL, Battison EAJ, Holton KF, Graham AM, Karalunas SL, Fair DA, Loftis JM, Nigg JT. Evaluation of maternal inflammation as a marker of future offspring ADHD symptoms: A prospective investigation. Brain Behav Immun 2020; 89:350-356. [PMID: 32707260 PMCID: PMC7703804 DOI: 10.1016/j.bbi.2020.07.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/02/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022] Open
Abstract
Early life predictors of attention-deficit/hyperactivity disorder (ADHD) are critically needed; they could inform etiological theory and may help identify new prevention targets. The current study examined prospectively whether maternal cytokine levels during pregnancy predict offspring ADHD symptoms at age 4-6 years. Secondarily, we evaluated maternal cytokine levels as a possible common pathway through which prenatal risks exert influence on child ADHD. Data came from a sample of women recruited during the 2nd trimester of pregnancy (N = 62) and followed postnatally until children were 4-6 years old. Maternal inflammation was assessed using 3rd trimester plasma concentrations of three indicators of nuclear factor kappa B signaling: interleukin-6, tumor necrosis factor-alpha, and monocyte chemoattractant protein-1 which were combined into a latent variable. Mothers and teachers reported on child ADHD symptoms, negative affect, and externalizing behaviors at 48-72 months of age. Maternal inflammation in the 3rd trimester predicted ADHD symptoms when children were 4-6 years old (β = 0.53, 95% CI = 0.154, 0.905, p = 0.006). Further, maternal inflammation mediated the effect of prenatal distress on child ADHD (β = 0.21, 95% CI = 0.007, 0.419, p = 0.04). The inflammation effect on ADHD was not explained by concurrent child negative affect, externalizing behavior, or familial ADHD status. This is the first human study to prospectively link maternal pregnancy cytokine levels and offspring ADHD symptoms, suggesting that cytokine levels are a possible marker of ADHD risk. Results also provide new evidence that maternal prenatal inflammation may be one common pathway by which prenatal risk factors influence offspring mental health outcomes.
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Affiliation(s)
- Hanna C. Gustafsson
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA
| | - Elinor L. Sullivan
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA,Oregon National Primate Research Center, 505 NW 185th Avenue, Beaverton, OR 97006, USA,University of Oregon, 1585 E 13th Ave, Eugene, OR 97403, USA
| | | | - Kathleen F. Holton
- American University, 4400 Massachusetts Ave NW, Washington, DC 20016, USA
| | - Alice M. Graham
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA
| | - Sarah L. Karalunas
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA
| | - Damien A. Fair
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA
| | - Jennifer M. Loftis
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA,VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, USA
| | - Joel T. Nigg
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA
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17
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Nigg JT, Karalunas SL, Gustafsson HC, Bhatt P, Ryabinin P, Mooney MA, Faraone SV, Fair DA, Wilmot B. Evaluating chronic emotional dysregulation and irritability in relation to ADHD and depression genetic risk in children with ADHD. J Child Psychol Psychiatry 2020; 61:205-214. [PMID: 31605387 PMCID: PMC6980250 DOI: 10.1111/jcpp.13132] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND A central nosological problem concerns the etiological relationship of emotional dysregulation with ADHD. Molecular genetic risk scores provide a novel method for informing this question. METHODS Participants were 514 community-recruited children of Northern European descent age 7-11 defined as ADHD or non-ADHD by detailed research evaluation. Parents-rated ADHD on standardized ratings and child temperament on the Temperament in Middle Childhood Questionnaire (TMCQ) and reported on ADHD and comorbid disorders by semi-structured clinical interview. Categorical and dimensional variables were created for ADHD, emotional dysregulation (implicating disruption of regulation of both anger-irritability and of positive valence surgency-sensation seeking), and irritability alone (anger dysregulation). Genome-wide polygenic risk scores (PRS) were computed for ADHD and depression genetic liability. Structural equation models and computationally derived emotion profiles guided analysis. RESULTS The ADHD PRS was associated in variable-centered analyses with irritability (β = .179, 95% CI = 0.087-0.280; ΔR2 = .034, p < .0002), but also with surgency/sensation seeking (B = .146, 95%CI = 0.052-0.240, ΔR2 =.022, p = .002). In person-centered analysis, the ADHD PRS was elevated in the emotion dysregulation ADHD group versus other ADHD children (OR = 1.44, 95% CI = 1.03-2.20, Nagelkerke ΔR2 = .013, p = .033) but did not differentiate irritable from surgent ADHD profiles. All effects were independent of variation in ADHD severity across traits or groups. The depression PRS was related to oppositional defiant disorder but not to ADHD emotion dysregulation. CONCLUSIONS Irritability-anger and surgency-sensation seeking, as forms of negative and positively valenced dysregulated affect in ADHD populations, both relate principally to ADHD genetic risk and not mood-related genetic risk.
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Affiliation(s)
- Joel T. Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | - Sarah L. Karalunas
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | | | - Priya Bhatt
- Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Peter Ryabinin
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Michael A. Mooney
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Stephen V. Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY,Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Damien A. Fair
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | - Beth Wilmot
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
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18
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Gustafsson HC, Holton KF, Anderson AN, Nousen EK, Sullivan CA, Loftis JM, Nigg JT, Sullivan EL. Increased Maternal Prenatal Adiposity, Inflammation, and Lower Omega-3 Fatty Acid Levels Influence Child Negative Affect. Front Neurosci 2019; 13:1035. [PMID: 31632234 PMCID: PMC6779776 DOI: 10.3389/fnins.2019.01035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/12/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Increased maternal adiposity during pregnancy is associated with offspring risk for psychiatric disorders. Inflammation secondary to adiposity is believed to be an important mechanism through which this effect occurs. Although increased adiposity introduces risk, not all children of overweight mothers develop these problems. Gestational factors that modify this risk are not well-understood. If maternal increased adiposity exerts its effects on offspring outcomes by increasing inflammation in the gestational environment, then anti-inflammatory inputs such as omega-3 fatty acids may be one protective factor. The goal of this study was to investigate whether maternal pre-pregnancy body mass index (BMI) and omega-3 fatty acid levels independently and/or interactively predicted offspring infant negative affect, an early life marker of risk for psychopathology. METHODS Data came from a prospective study of women recruited during pregnancy and their 6 month old infants (N = 62; 40% female). Maternal pre-pregnancy BMI was pulled from medical charts and third trimester omega-3 fatty acid concentrations were assessed in plasma. Child negative affect was assessed using observer- and maternal-ratings at 6 months of age. Maternal inflammation was indexed by third trimester plasma levels of interleukin-6, tumor necrosis factor-alpha, and monocyte chemoattractant protein-1. RESULTS Maternal pre-pregnancy BMI was associated with increased infant negative affect whereas eicosapentaenoic acid was associated with less infant negative affect. Maternal omega-3 fatty acid levels moderated the effect of BMI on infant negative affect, such that omega-3 fatty acids buffered children against the negative consequences of increased adiposity. Supporting the role of maternal inflammation in these associations, maternal BMI and omega-3 fatty acid levels interacted to predict maternal third trimester inflammation. Further, maternal inflammation was associated with increased infant negative affect. CONCLUSION Results suggest that omega-3 supplementation during pregnancy may protect against offspring behavioral risk associated with increased maternal adiposity.
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Affiliation(s)
- Hanna C. Gustafsson
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Kathleen F. Holton
- Department of Health Studies, Center for Behavioral Neuroscience, American University, Washington, DC, United States
| | - Ashley N. Anderson
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Elizabeth K. Nousen
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Ceri A. Sullivan
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Jennifer M. Loftis
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- VA Portland Health Care System, Portland, OR, United States
| | - Joel T. Nigg
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Elinor L. Sullivan
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Department of Human Physiology, University of Oregon, Eugene, OR, United States
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19
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Alperin BR, Smith CJ, Gustafsson HC, Figuracion MT, Karalunas SL. The relationship between alpha asymmetry and ADHD depends on negative affect level and parenting practices. J Psychiatr Res 2019; 116:138-146. [PMID: 31233897 PMCID: PMC6625668 DOI: 10.1016/j.jpsychires.2019.06.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/03/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
Abstract
Atypical frontal alpha asymmetry is associated with the approach/withdrawal and affective processes implicated in many psychiatric disorders. Rightward alpha asymmetry, associated with high approach, is a putative endophenotype for attention deficit/hyperactivity disorder (ADHD). However, findings are inconsistent, likely because of a failure to consider emotional heterogeneity within the ADHD population. In addition, how this putative risk marker interacts with environmental factors known to increase symptom severity, such as parenting practices, has not been examined. The current study examined patterns of alpha asymmetry in a large sample of adolescents with and without ADHD, including the moderating role of negative affect and inconsistent discipline. Resting-state EEG was recorded from 169 well-characterized adolescents (nADHD = 79). Semi-structured clinical interviews and well-validated rating scales were used to create composites for negative affect and inconsistent discipline. The relationship between alpha asymmetry and ADHD diagnosis was moderated by negative affect. Right asymmetry was present only for those with ADHD and low levels of negative affect. In addition, greater right alpha asymmetry predicted severity of ADHD symptoms for those with the disorder, but only in the context of inconsistent parenting practices. Results confirm right alpha asymmetry is a possible endophenotype in ADHD but highlight the need to consider emotional heterogeneity and how biological risk interacts with child environment in order to fully characterize its relationship to disorder liability and severity.
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Affiliation(s)
- Brittany R. Alperin
- Department of Behavioral Neuroscience, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA
| | - Christiana J. Smith
- Department of Psychiatry, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA
| | - Hanna C. Gustafsson
- Department of Psychiatry, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA
| | - McKenzie T. Figuracion
- Department of Psychiatry, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA
| | - Sarah L. Karalunas
- Department of Behavioral Neuroscience, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA,Department of Psychiatry, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA
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Hardaway FA, Gustafsson HC, Holste K, Burchiel KJ, Raslan AM. A novel scoring system as a preoperative predictor for pain-free survival after microsurgery for trigeminal neuralgia. J Neurosurg 2019; 132:1-8. [PMID: 30684937 DOI: 10.3171/2018.9.jns181208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/26/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEPain relief following microvascular decompression (MVD) for trigeminal neuralgia (TN) may be related to pain type, degree of neurovascular conflict, arterial compression, and location of compression. The objective of this study was to construct a predictive pain-free scoring system based on clinical and radiographic factors that can be used to preoperatively prognosticate long-term outcomes for TN patients following surgical intervention (MVD or internal neurolysis [IN]). It was hypothesized that contributing factors would include pain type, presence of an artery or vein, neurovascular conflict severity, and compression location (root entry zone).METHODSAt the authors' institution 275 patients with type 1 or type 2 TN (TN1 or TN2) underwent MVD or IN following preoperative high-resolution brain MRI studies. Outcome data were obtained retrospectively by chart review and/or phone follow-up. Characteristics of neurovascular conflict were obtained from preoperative MRI studies. Factors that resulted in a probability value of < 0.05 on univariate logistic regression analyses were entered into a multivariate Cox regression analysis in a backward stepwise fashion. For the multivariate analysis, significance at the 0.15 level was used. A prognostic system was then devised with 4 possible scores (0, 1, 2, or 3) and pain-free survival analyses conducted.RESULTSUnivariate predictors of pain-free survival were pain type (p = 0.013), presence of any vessel (p = 0.042), and neurovascular compression severity (p = 0.038). Scores of 0, 1, 2, and 3 were found to be significantly different in regard to pain-free survival (log rank, p = 0.005). At 5 and 10 years there were 36%, 43%, 61%, and 69%, and 36%, 43%, 56%, and 67% pain-free survival rates in groups 0, 1, 2, and 3, respectively. While TN2 patients had worse outcomes regardless of score, a subgroup analysis of TN1 patients with higher neurovascular conflict (score of 3) had significantly better outcomes than TN1 patients without severe neurovascular conflict (score of 1) (log rank, p = 0.005). Regardless of pain type, those patients with severe neurovascular conflict were more likely to have arterial compression (99%) compared to those with low neurovascular conflict (p < 0.001).CONCLUSIONSPain-free survival was predicted by a scoring system based on preoperative clinical and radiographic findings. Higher scores predicted significantly better pain relief than lower scores. TN1 patients with severe neurovascular conflict had the best long-term pain-free outcome.
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Karalunas SL, Gustafsson HC, Fair D, Musser ED, Nigg JT. Do we need an irritable subtype of ADHD? Replication and extension of a promising temperament profile approach to ADHD subtyping. Psychol Assess 2018; 31:236-247. [PMID: 30359050 DOI: 10.1037/pas0000664] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is emblematic of unresolved heterogeneity in psychiatric disorders-the variation in biological, clinical, and psychological correlates that impedes progress on etiology. One approach to this problem is to characterize subgroups using measures rooted in biological or psychological theory, consistent with the National Institute of Mental Health's research domain criteria initiative. Within ADHD, a promising application involves using emotion trait profiles that can address the role of irritability as a complicating feature for ADHD. Here, a new sample of 186 children with ADHD was evaluated using community detection analysis to determine if meaningful subprofiles existed and if they replicated those previously identified. The new sample and a prior sample were pooled for evaluation of (a) method dependence, (b) longitudinal assessment of the stability of classifications, and (c) clinical prediction 2 years later. Three temperament profiles were confirmed within the ADHD group: one with normative emotional functioning ("mild"), one with high surgency ("surgent"), and one with high negative affect ("irritable"). Profiles were similar across statistical clustering approaches. The irritable group had the highest external validity: It was moderately stable over time and it enhanced prospective prediction of clinical outcomes beyond standard baseline indicators. The irritable group was not reducible to ADHD + oppositional defiant disorder, ADHD + disruptive mood dysregulation disorder, or other patterns of comorbidity. Among the negative affect domains studied, trait proneness to anger uniquely contributed to clinical prediction. Results extend our understanding of chronic irritability in psychiatric disorders and provide prospects for a fresh approach to assessing ADHD heterogeneity focused on the distinction between ADHD with and without anger/irritability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | - Damien Fair
- Department of Psychiatry, Oregon Health & Science University
| | - Erica D Musser
- Department of Psychology, Florida International University
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University
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22
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Gustafsson HC, Sullivan EL, Nousen EK, Sullivan CA, Huang E, Rincon M, Nigg JT, Loftis JM. Maternal prenatal depression predicts infant negative affect via maternal inflammatory cytokine levels. Brain Behav Immun 2018; 73:470-481. [PMID: 29920327 PMCID: PMC6129422 DOI: 10.1016/j.bbi.2018.06.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 06/12/2018] [Accepted: 06/15/2018] [Indexed: 12/29/2022] Open
Abstract
Maternal depressive symptoms during pregnancy are associated with risk for offspring emotional and behavioral problems, but the mechanisms by which this association occurs are not known. Infant elevated negative affect (increased crying, irritability, fearfulness, etc.) is a key risk factor for future psychopathology, so understanding its determinants has prevention and early intervention potential. An understudied yet promising hypothesis is that maternal mood affects infant mood via maternal prenatal inflammatory mechanisms, but this has not been prospectively examined in humans. Using data from a pilot study of women followed from the second trimester of pregnancy through six months postpartum (N = 68) our goal was to initiate a prospective study as to whether maternal inflammatory cytokines mediate the association between maternal depressive symptoms and infant offspring negative affect. The study sample was designed to examine a broad range of likely self-regulation and mood-regulation problems in offspring; to that end we over-selected women with a family history or their own history of elevated symptoms of attention-deficit/hyperactivity disorder. Results supported the hypothesis: maternal pro-inflammatory cytokines during the third trimester (indexed using a latent variable that included plasma interleukin-6, tumor necrosis factor-alpha and monocyte chemoattractant protein-1 concentrations as indicators) mediated the effect, such that higher maternal depressive symptoms were associated with higher maternal inflammation, and this mediated the effect on maternal report of infant negative affect (controlling for maternal affect during the infant period). This is the first human study to demonstrate that maternal inflammatory cytokines mediate the association between prenatal depression and infant outcomes, and the first to demonstrate a biological mechanism through which depressive symptoms impact infant temperament.
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Affiliation(s)
- Hanna C Gustafsson
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA.
| | - Elinor L Sullivan
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA; Oregon National Primate Research Center, 505 NW 185th Avenue, Beaverton, OR, USA; University of Oregon, 1585 E 13th Ave, Eugene, OR, USA.
| | - Elizabeth K Nousen
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA.
| | - Ceri A Sullivan
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA.
| | - Elaine Huang
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA; VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, USA.
| | - Monica Rincon
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA.
| | - Joel T Nigg
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA.
| | - Jennifer M Loftis
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, USA; VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, USA.
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Miller LL, Gustafsson HC, Tipsord J, Song M, Nousen E, Dieckmann N, Nigg JT. Is the Association of ADHD with Socio-Economic Disadvantage Explained by Child Comorbid Externalizing Problems or Parent ADHD? J Abnorm Child Psychol 2018; 46:951-963. [PMID: 29128953 PMCID: PMC5948120 DOI: 10.1007/s10802-017-0356-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
It has been unclear whether an associations of child ADHD with socio-economic disadvantage (SES) could be accounted for by (a) parental ADHD explaining both low SES and child ADHD, and/or (b) the joint overlap of ODD or CD with low SES and ADHD. Study 1 used a community-recruited case-control sample with detailed evaluation of SES indicators, child ADHD, child externalizing, and parent ADHD symptoms (n = 931 children, 521 ADHD, 577 boys, 354 girls) in a path modeling analysis with latent variables. Study 2 evaluated ADHD and externalizing behavior in a regression model using a poverty index for SES, in 70,927 children (48.2% female) aged 5-17 years from the US 2011-2012 National Survey of Children's Health (NSCH). In Study 1, lower SES was related to the ADHD latent variable, β = -.18, p < .001; 95%CI [-.25,-.12]. This effect held when parent ADHD and child ODD and CD were in the model, β = -.11, p < .01, 95% CI [-.09,-.03], equivalent to OR = 1.50, 95% CI[1.12-2.04]). In Study 2, these results replicated. Adjusting only for age and sex, children from families who were below 200% of the federal poverty line were more likely to have moderate or severe ADHD than no ADHD, versus children above that line, OR = 2.13, 95% CI[1.79,2.54], p < .001. The effect held after adjusting for disruptive/externalizing problems, OR = 1.61, p < .01, 95%CI [1.32,1.96]. The effect size for comparable models was similar across both studies, lending higher confidence to the results. It is concluded that the SES association with child ADHD is not explained by artifact and requires a mechanistic explanation.
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Affiliation(s)
- Lindsay L Miller
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Jessica Tipsord
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Minkyoung Song
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Elizabeth Nousen
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Nathan Dieckmann
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA.
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Nigg JT, Gustafsson HC, Karalunas SL, Ryabinin P, McWeeney SK, Faraone SV, Mooney MA, Fair DA, Wilmot B. Working Memory and Vigilance as Multivariate Endophenotypes Related to Common Genetic Risk for Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2018; 57:175-182. [PMID: 29496126 PMCID: PMC6547382 DOI: 10.1016/j.jaac.2017.12.013] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/19/2017] [Accepted: 01/03/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Understanding the role of endophenotypes is essential for process models of psychopathology. This study examined which candidate cognitive endophenotypes statistically mediate common variant genetic risk for attention-deficit/hyperactivity disorder (ADHD). METHOD A case-control design using community-recruited volunteer children 7 to 11 years of age (n = 656, n = 435 ADHD), of whom 514 were of homogenous European ancestry for the primary models (n = 337 ADHD, 177 non-ADHD). Children were assessed with a multi-informant, best-estimate diagnostic procedure and laboratory measures of working memory, response inhibition, executive functioning, arousal/attention, temporal information processing, and processing speed. Latent variables were created for the candidate cognitive measures and for parent- and teacher-rated ADHD dimensions. Polygenic risk scores (PGS) were computed using a discovery sample of 20,183 individuals with ADHD and 35,191 controls from the Psychiatric Genetics Consortium. Cognitive measures that survived multiple testing correction for association with the PGS were evaluated for mediation with ADHD using structural equation models. RESULTS Results were essentially identical in the homogeneous European ancestry subgroup (n = 514) and in the full sample (N = 656). For the European population, the PGS was associated with ADHD diagnosis (Nagelkerke R2 = 0.045; β = 0.233, SE = 0.053, p = .000011) and multi-indicator dimensional ADHD latent variables by parent report (β = 0.185, SE = 0.043) and teacher report (β = 0.165, SE = 0.042). The PGS effect was statistically mediated by working memory (indirect effect, β = 0.101, SE = 0.029, 95% CI = 0.05, 0.16, p = .00049, 43% of genetic effect accounted for) and arousal/alertness (indirect effect β = 0.115, 95% CI = 0.04, 0.20, SE = 0.041, p = .005, 49% of genetic effect accounted for). CONCLUSION This is the first clear demonstration from molecular genetic data that working memory and arousal regulation are promising cognitive endophenotypes for ADHD with regard to mediating genetic risk from common genetic variants.
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Affiliation(s)
- Joel T Nigg
- Oregon Health and Science University, Portland.
| | | | | | | | | | | | | | | | - Beth Wilmot
- Oregon Health and Science University, Portland
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Thompson JR, Gustafsson HC, DeCapo M, Takahashi DL, Bagley JL, Dean TA, Kievit P, Fair DA, Sullivan EL. Maternal Diet, Metabolic State, and Inflammatory Response Exert Unique and Long-Lasting Influences on Offspring Behavior in Non-Human Primates. Front Endocrinol (Lausanne) 2018; 9:161. [PMID: 29740395 PMCID: PMC5924963 DOI: 10.3389/fendo.2018.00161] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/27/2018] [Indexed: 12/15/2022] Open
Abstract
Nutritional status influences brain health and gestational exposure to metabolic disorders (e.g. obesity and diabetes) increases the risk of neuropsychiatric disorders. The aim of the present study was to further investigate the role of maternal Western-style diet (WSD), metabolic state, and inflammatory factors in the programming of Japanese macaque offspring behavior. Utilizing structural equation modeling, we investigated the relationships between maternal diet, prepregnancy adiposity, third trimester insulin response, and plasma cytokine levels on 11-month-old offspring behavior. Maternal WSD was associated with greater reactive and ritualized anxiety in offspring. Maternal adiposity and third trimester macrophage-derived chemokine (MDC) exerted opposing effects on offspring high-energy outbursts. Elevated levels of this behavior were associated with low maternal MDC and increased prepregnancy adiposity. This is the first study to show that maternal MDC levels influence offspring behavior. We found no evidence suggesting maternal peripheral inflammatory response mediated the effect of maternal diet and metabolic state on aberrant offspring behavior. Additionally, the extent of maternal metabolic impairment differentially influenced chemokine response. Elevated prepregnancy adiposity suppressed third trimester chemokines, while obesity-induced insulin resistance augmented peripheral chemokine levels. WSD also directly increased maternal interleukin-12. This is the first non-human primate study to delineate the effects of maternal diet and metabolic state on gestational inflammatory environment and subsequent offspring behavior. Our findings give insight to the complex mechanisms by which diet, metabolic state, and inflammation during pregnancy exert unique influences on offspring behavioral regulation.
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Affiliation(s)
- Jacqueline R. Thompson
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Hanna C. Gustafsson
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Madison DeCapo
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Diana L. Takahashi
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Jennifer L. Bagley
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Tyler A. Dean
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Paul Kievit
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Damien A. Fair
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Elinor L. Sullivan
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- Department of Human Physiology, University of Oregon, Eugene, OR, United States
- *Correspondence: Elinor L. Sullivan,
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Bauer BW, Gustafsson HC, Nigg J, Karalunas SL. Working memory mediates increased negative affect and suicidal ideation in childhood attention-deficit/hyperactivity disorder. J Psychopathol Behav Assess 2017; 40:180-193. [PMID: 30386005 DOI: 10.1007/s10862-017-9635-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective Children with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for suicidal ideation and suicide attempts compared to those without ADHD. Increased risk is at least partially attributable to a subset of children with ADHD and comorbid depression or disruptive behavior disorders; however, the early predictors and mechanisms driving increased risk are not well understood. Here, we investigate the contributions of two candidate mechanisms for increased suicidal ideation in children with ADHD: executive function and negative affect. Methods 623 clinically well-characterized, community-recruited children classified by research criteria as ADHD (n=388) or typically-developing controls (n=253) participated. Parent-report on the Temperament in Middle Childhood Questionnaire provided a measure of negative affectivity. Children completed laboratory tasks to measure response inhibition and working memory. Suicidal ideation was evaluated by parent report during a semi-structured interview and child responses on the Children's Depression Inventory. Results Compared to typically developing controls, children with ADHD had higher rates of suicidal ideation, more negative affect, slower stop signal reaction times, and weaker working memory. Statistical path-model analyses confirmed the hypothesis that weaker working memory in ADHD statistically mediated increased negative affect. Weaker working memory also mediated and increased suicidal ideation in these cross sectional data. Findings were not attributable to comorbid disruptive behavioral disorders. Poor response inhibition did not reliably mediate negative affect or suicidal ideation. Conclusion Impairment in working memory is an important early risk factor for suicidal ideation in children with ADHD, and may help in identifying children for prevention and early intervention efforts.
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Affiliation(s)
- Brian W Bauer
- University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406
| | - Hanna C Gustafsson
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1505, Mail Code: UHN-80R1 Portland, OR 97239
| | - Joel Nigg
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1513, Mail Code: UHN-80R1 Portland, OR 97239
| | - Sarah L Karalunas
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1513, Mail Code: UHN-80R1, Portland, OR 97239
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Bauer BW, Capron DW, Ward-Ciesielski E, Gustafsson HC, Doyle C. Extracurricular Activities are Associated with Lower Suicidality through Decreased Thwarted Belongingness in Young Adults. Arch Suicide Res 2017; 22:665-678. [PMID: 29393836 DOI: 10.1080/13811118.2018.1427162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Research has shown a negative association between extracurricular activities (ECAs) and suicidality. This study builds upon past research by using the interpersonal psychological theory of suicide to better understand the mechanisms involved in the relationship between ECAs and suicide risk. A total of 121 community and online-recruited adults ages 18 to 24-years-old participated. Self-report measures of suicidality, thwarted belongingness, and perceived burdensomeness were collected. Duration and breadth of participation in ECAs were assessed. ECA involvement was negatively associated with thwarted belongingness and perceived burdensomeness. An indirect effect of ECAs on suicidality through thwarted belongingness was statistically significant, but not for perceived burdensomeness. ECA involvement was associated with decreased suicidality through lower levels of thwarted belongingness. Interventions utilizing ECAs may be a low-cost, high-access option for decreasing suicide risk.
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Karalunas SL, Gustafsson HC, Dieckmann NF, Tipsord J, Mitchell SH, Nigg JT. Heterogeneity in development of aspects of working memory predicts longitudinal attention deficit hyperactivity disorder symptom change. J Abnorm Psychol 2017; 126:774-792. [PMID: 28782975 PMCID: PMC5657320 DOI: 10.1037/abn0000292] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The role of cognitive mechanisms in the clinical course of neurodevelopmental disorders is poorly understood. Attention Deficit Hyperactivity Disorder (ADHD) is emblematic in that numerous alterations in cognitive development are apparent, yet how they relate to changes in symptom expression with age is unclear. To resolve the role of cognitive mechanisms in ADHD, a developmental perspective that takes into account expected within-group heterogeneity is needed. METHOD The current study uses an accelerated longitudinal design and latent trajectory growth mixture models in a sample of children ages 7-13 years carefully characterized as with (n = 437) and without (n = 297) ADHD to (a) identify heterogeneous developmental trajectories for response inhibition, visual spatial working memory maintenance, and delayed reward discounting and (b) to assess the relationships between these cognitive trajectories and ADHD symptom change. RESULTS Best-fitting models indicated multiple trajectory classes in both the ADHD and typically developing samples, as well as distinct relationships between each cognitive process and ADHD symptom change. Developmental change in response inhibition and delayed reward discounting were unrelated to ADHD symptom change, while individual differences in the rate of visual spatial working memory maintenance improvement predicted symptom remission in ADHD. CONCLUSION Characterizing heterogeneity in cognitive development will be crucial for clarifying mechanisms of symptom persistence and recovery. Results here suggest working memory maintenance may be uniquely related to ADHD symptom improvement. (PsycINFO Database Record
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Affiliation(s)
- Sarah L. Karalunas
- Oregon Health & Sciences University, Department of Psychiatry
- Oregon Health & Sciences University, Department of Beahvioral Neuroscience
| | | | | | - Jessica Tipsord
- Oregon Health & Sciences University, Department of Psychiatry
| | - Suzanne H. Mitchell
- Oregon Health & Sciences University, Department of Psychiatry
- Oregon Health & Sciences University, Department of Beahvioral Neuroscience
- Oregon Institute of Occupational Health Science
| | - Joel T. Nigg
- Oregon Health & Sciences University, Department of Psychiatry
- Oregon Health & Sciences University, Department of Beahvioral Neuroscience
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Brown GL, Gustafsson HC, Mills-Koonce WR, Cox MJ. Associations between early caregiving and rural, low-SES, African-American children's representations of attachment relationships. Attach Hum Dev 2017; 19:340-363. [PMID: 28420287 PMCID: PMC10735174 DOI: 10.1080/14616734.2017.1318935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Little research has examined the legacy of early maternal care for later attachment representations among low-income and ethnic minority school-aged children. Using data from a sample of 276 rural, low-income, African-American families, this study examined associations between maternal care in infancy and children's representations of attachment figures in middle childhood. Maternal care was coded from 10-min home-based observations at 6, 15, and 24 months of age. Representations of attachment figures were assessed using the Manchester Child Attachment Story Task at 6 years of age. Sensitive maternal care in infancy was not significantly related to attachment security or episodic disorganized behaviors in children's representations. However, children exposed to more harsh-intrusive parenting during infancy displayed less secure representations of attachment figures in middle childhood and more episodic disorganized behaviors, even after controlling for numerous child and family contextual covariates. Findings inform conceptualizations of attachment formation among rural, low-income, African-American parent-child dyads.
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Affiliation(s)
- Geoffrey L Brown
- a Department of Human Development and Family Science , University of Georgia , Athens , GA , USA
| | - Hanna C Gustafsson
- b Department of Psychiatry , Oregon Health and Science University , Portland , OR , USA
| | - W Roger Mills-Koonce
- c Department of Human Development and Family Studies , University of North Carolina at Greensboro , Greensboro , NC , USA
| | - Martha J Cox
- d Department of Psychology , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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Gustafsson HC, Brown GL, Mills-Koonce WR, Cox MJ. Intimate Partner Violence and Children's Attachment Representations during Middle Childhood. J Marriage Fam 2017; 79:865-878. [PMID: 28781383 PMCID: PMC5539880 DOI: 10.1111/jomf.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite long-standing hypotheses that intimate partner violence (IPV) may undermine children's ability to form secure attachment representations, few studies have empirically investigated this association. Particularly lacking is research that examines IPV and attachment during middle childhood, a time when the way that children understand, represent, and process the behavior of others becomes particularly important. Using data from a sample of African American children living in rural, low-income communities (n = 98), the current study sought to address this gap by examining the association between physical IPV occurring early in children's lives and their attachment security during the first grade. Results indicate that, even after controlling for child- and family-level covariates, physical IPV was associated with a greater likelihood of being rated insecurely attached. This effect was above and beyond the influence of maternal parenting behaviors, demonstrating a unique effect of physical IPV on children's attachment representations during middle childhood.
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Affiliation(s)
- Hanna C Gustafsson
- Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Suite 1505, Portland, OR 97239, (503) 418-8402
| | - Geoffrey L Brown
- Human Development and Family Science, University of Georgia, 205 Family Science Center, 403 Sanford Dr., Athens, GA 30602
| | - W Roger Mills-Koonce
- Department of Human Development and Family Studies, The University of North Carolina at Greensboro, Stone Building Room 165E, PO Box 26170, Greensboro, NC 27402-6170
| | - Martha J Cox
- Department of Psychology, University of North Carolina at Chapel Hill, Campus Box 3270, 215 Davie Hall, Chapel Hill, NC 27599-3270
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Posner J, Cha J, Roy AK, Peterson BS, Bansal R, Gustafsson HC, Raffanello E, Gingrich J, Monk C. Alterations in amygdala-prefrontal circuits in infants exposed to prenatal maternal depression. Transl Psychiatry 2016; 6:e935. [PMID: 27801896 PMCID: PMC5314110 DOI: 10.1038/tp.2016.146] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/02/2016] [Indexed: 01/17/2023] Open
Abstract
Prenatal exposure to maternal depression is common and puts offspring at risk for developing a range of neuropsychiatric disorders. Despite its prevalence and adverse associations, neurobiological processes by which prenatal maternal depression (PMD) confers risk remain poorly understood. Maternal mood and fetal behavior were assessed between 34 and 37 gestational weeks. Using resting-state functional magnetic resonance imaging (fMRI) and diffusion MRI, we examined functional and structural connectivity within amygdala-prefrontal circuits in 64 infants (mean age=5.8±1.7 weeks) with (n=20) and without (n=44) in utero exposure to PMD. Resting fMRI and diffusion MRI both indicated atypical amygdala-prefrontal connectivity in PMD-exposed infants: Resting fMRI indicated increased inverse, or negative, functional connectivity between the amygdala and the dorsal prefrontal cortex (PFC), bilaterally, and diffusion MRI indicated decreased structural connectivity between the right amygdala and the right ventral PFC. Spectral dynamic causal modeling supported these findings suggesting altered amygdala-PFC effective (or directed) connectivity in PMD-exposed infants. Last, path analyses supported a mechanistic account relating PMD to a third-trimester fetal behavior: PMD alters amygdala-PFC connectivity, which in turn, is associated with an increase in fetal heart rate reactivity to in utero perturbation. These data suggest that the maturation and coordination of central and peripheral physiology are altered by prenatal exposure to maternal depression. To the best of our knowledge, this is the first study to directly associate infant MRI measures with a behavior-fetal heart rate response, and supports hypotheses that PMD-associated variations in the development of amygdala-PFC circuits are relevant for future neurobehavioral maturation.
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Affiliation(s)
- J Posner
- Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,College of Physicians and Surgeons and New York State Psychiatric Institute, Unit 74, 1051 Riverside Drive, New York, NY 10032, USA. E-mail:
| | - J Cha
- Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - A K Roy
- Department of Psychology, Fordham University, New York, NY, USA
| | - B S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles and the Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - R Bansal
- Institute for the Developing Mind, Children's Hospital Los Angeles and the Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - H C Gustafsson
- Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY, USA
| | - E Raffanello
- New York State Psychiatric Institute, New York, NY, USA
| | - J Gingrich
- Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - C Monk
- Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
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Gustafsson HC, Cox MJ. Intimate Partner Violence in Rural Low-Income Families: Correlates and Change in Prevalence Over the First 5 Years of a Child's Life. J Fam Violence 2016; 31:49-60. [PMID: 26709334 PMCID: PMC4687491 DOI: 10.1007/s10896-015-9760-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite evidence that individuals living in low-income and rural communities may be at heightened risk for intimate partner violence (IPV), little is known about the prevalence and nature of IPV occurring in these communities. The goal of the current study, therefore, was to characterize IPV occurring in a population-based sample of families living in communities characterized by rural poverty. Specifically, we examined the prevalence, severity, and chronicity of IPV occurring in this high-risk sample, as well as the demographic correlates thereof. Using data from multiple assessments across the first five years of their child's life, we also examined changes in the prevalence of IPV across this time. Results indicate that IPV was most prevalent around the birth of the target child and that the population-level prevalence of IPV decreased significantly over the subsequent five years. Although previous research suggests that children under the age of five are at heightened risk for IPV relative to older children, this is the first study to our knowledge to demonstrate that there are changes in the prevalence of IPV within this high-risk age period.
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Gustafsson HC, Kuzava SE, Werner EA, Monk C. Maternal dietary fat intake during pregnancy is associated with infant temperament. Dev Psychobiol 2015; 58:528-35. [PMID: 26709151 DOI: 10.1002/dev.21391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 12/03/2015] [Indexed: 01/03/2023]
Abstract
Research with rodents and nonhuman primates suggests that maternal prenatal dietary fat intake is associated with offspring behavioral functioning indicative of risk for psychopathology. The extent to which these findings extend to humans remains unknown. The current study administered the Automated Self-Administered 24 hr Dietary Recall Questionnaire three times in pregnancy (n = 48) to examine women's dietary fat intake in relation to infant temperament assessed using the Infant Behavior Questionnaire at 4-months old. The amount of saturated fat that the mother consumed was considered as a moderator of the association between total fat intake and child temperament. Results from a series of multiple linear regressions indicate that greater total fat intake was associated with poorer infant regulation and lower surgency. However, this second effect was moderated by maternal saturated fat intake, such that total fat intake was only related to infant surgency when mothers consumed above the daily recommended allowance of saturated fat. Under conditions of high total fat and high saturated fat, infants were rated as lower on surgency; under conditions of low total fat yet high saturated fat, infants were rated as higher on surgency. There were no associations between maternal prenatal fat intake and infant negative reactivity. These findings provide preliminary evidence that pregnant women's dietary fat intake is associated with infants' behavioral development, though future research is needed to address this report's limitations: a relatively small sample size, the use of self-report measures, and a lack of consideration of maternal and infant postnatal diet.
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Affiliation(s)
- Hanna C Gustafsson
- Department of Psychiatry/Division of Behavioral Medicine, Columbia University Medical Center, New York, NY, 10032.
| | - Sierra E Kuzava
- Department of Psychiatry/Division of Behavioral Medicine, Columbia University Medical Center, New York, NY, 10032
| | - Elizabeth A Werner
- Department of Psychiatry/Division of Behavioral Medicine, Columbia University Medical Center, New York, NY, 10032
| | - Catherine Monk
- Department of Psychiatry/Division of Behavioral Medicine, Columbia University Medical Center, New York, NY, 10032.,New York State Psychiatric Institute, New York, NY
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Gustafsson HC, Coffman JL, Cox MJ. Intimate Partner Violence, Maternal Sensitive Parenting Behaviors, and Children's Executive Functioning. Psychol Violence 2015; 5:266-274. [PMID: 26185731 PMCID: PMC4500124 DOI: 10.1037/a0037971] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Despite knowledge that intimate partner violence (IPV) can negatively affect children's socioemotional and behavioral development, less is known about the impact of IPV on children's cognitive development, including whether it influences their executive functioning (EF). The goal of the current study was to address this gap in the literature, by examining the association between IPV that occurs early in life and EF at school entry. This study also allowed for the investigation of maternal sensitive parenting behaviors as a possible mediator of this relation. METHOD Using longitudinal data from a socioeconomically and racially diverse sample of families (n = 154), we investigated the association between IPV measured when children were 24, 30, and 36 months old and their EF when they were 60 months old. We also tested whether maternal sensitive parenting behaviors (measured when children were 24, 36, and 60 months old) mediated this association. RESULTS Results indicate that, even after controlling for a number of family- and child-level covariates, IPV occurring early in children's lives was negatively associated with their EF at school entry. This relation was mediated by maternal sensitive parenting behaviors, such that higher levels of IPV were associated with lower levels of sensitive parenting behaviors, which in turn were positively associated with children's EF. CONCLUSIONS These findings add to a limited body of literature that links IPV and children's cognitive functioning, and suggest that intervention efforts aimed at improving children's EF may want to simultaneously consider IPV and maternal sensitive parenting behaviors.
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Affiliation(s)
- Hanna C Gustafsson
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University
| | - Jennifer L Coffman
- Department of Psychology, The University of North Carolina at Chapel Hill
| | - Martha J Cox
- Department of Psychology, The University of North Carolina at Chapel Hill
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Towe-Goodman NR, Willoughby M, Blair C, Gustafsson HC, Mills-Koonce WR, Cox MJ. Fathers' sensitive parenting and the development of early executive functioning. J Fam Psychol 2014; 28:867-76. [PMID: 25347539 PMCID: PMC4261022 DOI: 10.1037/a0038128] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Using data from a diverse sample of 620 families residing in rural, predominately low-income communities, this study examined longitudinal links between fathers' sensitive parenting in infancy and toddlerhood and children's early executive functioning, as well as the contribution of maternal sensitive parenting. After accounting for the quality of concurrent and prior parental care, children's early cognitive ability, and other child and family factors, fathers' and mothers' sensitive and supportive parenting during play at 24 months predicted children's executive functioning at 3 years of age. In contrast, paternal parenting quality during play at 7 months did not make an independent contribution above that of maternal care, but the links between maternal sensitive and supportive parenting and executive functioning seemed to operate in similar ways during infancy and toddlerhood. These findings add to prior work on early experience and children's executive functioning, suggesting that both fathers and mothers play a distinct and complementary role in the development of these self-regulatory skills.
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Affiliation(s)
- Nissa R Towe-Goodman
- Center for Developmental Science, The University of North Carolina at Chapel Hill
| | - Michael Willoughby
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill
| | - Clancy Blair
- Department of Applied Psychology, New York University
| | - Hanna C Gustafsson
- Department of Psychology, The University of North Carolina at Chapel Hill
| | | | - Martha J Cox
- Department of Psychology, The University of North Carolina at Chapel Hill
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Gustafsson HC, Barnett MA, Towe-Goodman NR, Mills-Koonce WR, Cox MJ. Family Violence and Children's Behavior Problems: Independent Contributions of Intimate Partner and Child-Directed Physical Aggression. J Fam Violence 2014; 29:773-781. [PMID: 25431522 PMCID: PMC4242526 DOI: 10.1007/s10896-014-9628-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Using data from a diverse sample of 581 families living in predominantly low-income, rural communities, the current study sought to investigate the longitudinal associations among father-perpetrated intimate partner violence (IPV) and child-directed physical aggression perpetrated by the mother. The unique contributions of each of these types of family violence on children's behavioral problems at school entry were also examined. Results confirm bidirectional associations between father-perpetrated IPV and maternal physical aggression directed toward the child, and indicate that both types of physical aggression contribute to child behavior problems at school entry.
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Abstract
The current study was designed to examine the relation between intimate partner violence (IPV) and children's memory and drew from a socioeconomically and racially diverse sample of children living in and around a midsized southeastern city (n = 140). Mother-reported IPV when the children were 30 months old was a significant predictor of children's short-term, working, and deliberate memory at 60 months of age, even after controlling for the children's sex and race, the families' income-to-needs ratio, the children's expressive vocabulary, and maternal harsh-intrusive parenting behaviors. These findings add to the limited extant literature that finds linkages between IPV and children's cognitive functioning and suggest that living in households in which physical violence is perpetrated among intimate partners may have a negative effect on multiple domains of children's memory development.
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Affiliation(s)
- Hanna C Gustafsson
- Department of Psychology, The University of North Carolina at Chapel Hill
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Gustafsson HC, Cox MJ. Relations Among Intimate Partner Violence, Maternal Depressive Symptoms, and Maternal Parenting Behaviors. J Marriage Fam 2012; 74:1005-1020. [PMID: 23869110 PMCID: PMC3712529 DOI: 10.1111/j.1741-3737.2012.01010.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The authors examined the relations among intimate partner violence (IPV), maternal depressive symptoms, and maternal harsh intrusive parenting. Using a cross-lagged, autoregressive path model, they sought to clarify the directionality of the relations among these 3 variables over the first 2 years of the child's life. The results indicated that, in this diverse sample of families living in predominantly low-income rural communities (N = 705), higher levels of early IPV were associated with increases in maternal depressive symptoms, which in turn were associated with increases in maternal harsh intrusive parenting behaviors. These findings suggest that interventions aimed at improving the parenting of women exposed to domestic violence may want to simultaneously target IPV and depressive symptomatology.
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Gustafsson HC, Cox MJ, Blair C. Maternal parenting as a mediator of the relationship between intimate partner violence and effortful control. J Fam Psychol 2012; 26:115-23. [PMID: 22142253 PMCID: PMC3327444 DOI: 10.1037/a0026283] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The current study examined the relationship between intimate partner violence (IPV), maternal parenting behaviors, and child effortful control in a diverse sample of 705 families living in predominantly low-income, rural communities. Using structural equation modeling, the authors simultaneously tested whether observed sensitive parenting and/or harsh-intrusive parenting over the toddler years mediated the relationship between early IPV and later effortful control. Results suggest that parenting behaviors fully mediate this relationship. Although higher levels of IPV were associated with both higher levels of harsh-intrusive parenting and lower levels of sensitive supportive parenting, only sensitive supportive parenting was associated with later effortful control when both parenting indices were considered in the same model.
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Affiliation(s)
- Hanna C Gustafsson
- Center for Developmental Science, The University of North Carolina, Chapel Hill, NC, USA.
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