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Mullin LJ, Rutsohn J, Gross JL, Caravella KE, Grzadzinski RL, Weisenfeld LA, Flake L, Botteron KN, Dager SR, Estes AM, Pandey J, Schultz RT, St John T, Wolff JJ, Shen MD, Piven J, Hazlett HC, Girault JB. Differential cognitive and behavioral development from 6 to 24 months in autism and fragile X syndrome. J Neurodev Disord 2024; 16:12. [PMID: 38509470 PMCID: PMC10953146 DOI: 10.1186/s11689-024-09519-y] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Specifying early developmental differences among neurodevelopmental disorders with distinct etiologies is critical to improving early identification and tailored intervention during the first years of life. Recent studies have uncovered important differences between infants with fragile X syndrome (FXS) and infants with familial history of autism spectrum disorder who go on to develop autism themselves (FH-ASD), including differences in brain development and behavior. Thus far, there have been no studies longitudinally investigating differential developmental skill profiles in FXS and FH-ASD infants. METHODS The current study contrasted longitudinal trajectories of verbal (expressive and receptive language) and nonverbal (gross and fine motor, visual reception) skills in FXS and FH-ASD infants, compared to FH infants who did not develop ASD (FH-nonASD) and typically developing controls. RESULTS Infants with FXS showed delays on a nonverbal composite compared to FH-ASD (as well as FH-nonASD and control) infants as early as 6 months of age. By 12 months an ordinal pattern of scores was established between groups on all domains tested, such that controls > FH-nonASD > FH-ASD > FXS. This pattern persisted through 24 months. Cognitive level differentially influenced developmental trajectories for FXS and FH-ASD. CONCLUSIONS Our results demonstrate detectable group differences by 6 months between FXS and FH-ASD as well as differential trajectories on each domain throughout infancy. This work further highlights an earlier onset of global cognitive delays in FXS and, conversely, a protracted period of more slowly emerging delays in FH-ASD. Divergent neural and cognitive development in infancy between FXS and FH-ASD contributes to our understanding of important distinctions in the development and behavioral phenotype of these two groups.
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Affiliation(s)
- Lindsay J Mullin
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Joshua Rutsohn
- Department of Biostatistics, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Julia L Gross
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kelly E Caravella
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Rebecca L Grzadzinski
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Leigh Anne Weisenfeld
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Lisa Flake
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, USA
- Center On Human Development and Disability, University of Washington, Seattle, USA
| | - Annette M Estes
- Center On Human Development and Disability, University of Washington, Seattle, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, USA
| | - Juhi Pandey
- The Children's Hospital of Philadelphia and University of Pennsylvania, Center for Autism Research, Philadelphia, USA
| | - Robert T Schultz
- The Children's Hospital of Philadelphia and University of Pennsylvania, Center for Autism Research, Philadelphia, USA
| | - Tanya St John
- Center On Human Development and Disability, University of Washington, Seattle, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities, the University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
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2
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McFayden TC, Rutsohn J, Cetin G, Forsen E, Swanson MR, Meera SS, Wolff JJ, Elison JT, Shen MD, Botteron K, Dager SR, Estes A, Gerig G, McKinstry RC, Pandey J, Schultz R, St John T, Styner M, Truong Y, Zwaigenbaum L, Hazlett HC, Piven J, Girault JB. White matter development and language abilities during infancy in autism spectrum disorder. Mol Psychiatry 2024:10.1038/s41380-024-02470-3. [PMID: 38383768 DOI: 10.1038/s41380-024-02470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/23/2024]
Abstract
White matter (WM) fiber tract differences are present in autism spectrum disorder (ASD) and could be important markers of behavior. One of the earliest phenotypic differences in ASD are language atypicalities. Although language has been linked to WM in typical development, no work has evaluated this association in early ASD. Participants came from the Infant Brain Imaging Study and included 321 infant siblings of children with ASD at high likelihood (HL) for developing ASD; 70 HL infants were later diagnosed with ASD (HL-ASD), and 251 HL infants were not diagnosed with ASD (HL-Neg). A control sample of 140 low likelihood infants not diagnosed with ASD (LL-Neg) were also included. Infants contributed expressive language, receptive language, and diffusion tensor imaging data at 6-, 12-, and 24 months. Mixed effects regression models were conducted to evaluate associations between WM and language trajectories. Trajectories of microstructural changes in the right arcuate fasciculus were associated with expressive language development. HL-ASD infants demonstrated a different developmental pattern compared to the HL-Neg and LL-Neg groups, wherein the HL-ASD group exhibited a positive association between WM fractional anisotropy and language whereas HL-Neg and LL-Neg groups showed weak or no association. No other fiber tracts demonstrated significant associations with language. In conclusion, results indicated arcuate fasciculus WM is linked to language in early toddlerhood for autistic toddlers, with the strongest associations emerging around 24 months. To our knowledge, this is the first study to evaluate associations between language and WM development during the pre-symptomatic period in ASD.
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Affiliation(s)
- Tyler C McFayden
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA.
| | - Joshua Rutsohn
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gizem Cetin
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Elizabeth Forsen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Meghan R Swanson
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Shoba S Meera
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Kelly Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, Seattle, WA, USA
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
| | - Annette Estes
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, New York, NY, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Juhi Pandey
- Center for Autism Research, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Schultz
- Center for Autism Research, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - Tanya St John
- Institute on Human Development and Disability, University of Washington, Seattle, WA, USA
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Young Truong
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Carrboro, NC, USA
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3
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Burrows CA, Lasch C, Gross J, Girault JB, Rutsohn J, Wolff JJ, Swanson MR, Lee CM, Dager SR, Cornea E, Stephens R, Styner M, John TS, Pandey J, Deva M, Botteron KN, Estes AM, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Gilmore JH, Shen MD, Piven J, Elison JT. Associations between early trajectories of amygdala development and later school-age anxiety in two longitudinal samples. Dev Cogn Neurosci 2024; 65:101333. [PMID: 38154378 PMCID: PMC10792190 DOI: 10.1016/j.dcn.2023.101333] [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: 06/13/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
Amygdala function is implicated in the pathogenesis of autism spectrum disorder (ASD) and anxiety. We investigated associations between early trajectories of amygdala growth and anxiety and ASD outcomes at school age in two longitudinal studies: high- and low-familial likelihood for ASD, Infant Brain Imaging Study (IBIS, n = 257) and typically developing (TD) community sample, Early Brain Development Study (EBDS, n = 158). Infants underwent MRI scanning at up to 3 timepoints from neonate to 24 months. Anxiety was assessed at 6-12 years. Linear multilevel modeling tested whether amygdala volume growth was associated with anxiety symptoms at school age. In the IBIS sample, children with higher anxiety showed accelerated amygdala growth from 6 to 24 months. ASD diagnosis and ASD familial likelihood were not significant predictors. In the EBDS sample, amygdala growth from birth to 24 months was associated with anxiety. More anxious children had smaller amygdala volume and slower rates of amygdala growth. We explore reasons for the contrasting results between high-familial likelihood for ASD and TD samples, grounding results in the broader literature of variable associations between early amygdala volume and later anxiety. Results have the potential to identify mechanisms linking early amygdala growth to later anxiety in certain groups.
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Affiliation(s)
| | - Carolyn Lasch
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Julia Gross
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jessica B Girault
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joshua Rutsohn
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Meghan R Swanson
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Chimei M Lee
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Stephen R Dager
- Deptartment of Radiology, University of Washington Medical Center, Seattle, WA, USA
| | - Emil Cornea
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca Stephens
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Tanya St John
- University of Washington Autism Center, University of Washington, Seattle, WA, USA
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Meera Deva
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Annette M Estes
- University of Washington Autism Center, University of Washington, Seattle, WA, USA; Deptartment of Speech and Hearing Science, University of Washington, Seattle, WA, USA
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities and Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Jed T Elison
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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4
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Garic D, McKinstry RC, Rutsohn J, Slomowitz R, Wolff J, MacIntyre LC, Weisenfeld LAH, Kim SH, Pandey J, St. John T, Estes AM, Schultz RT, Hazlett HC, Dager SR, Botteron KN, Styner M, Piven J, Shen MD. Enlarged Perivascular Spaces in Infancy and Autism Diagnosis, Cerebrospinal Fluid Volume, and Later Sleep Problems. JAMA Netw Open 2023; 6:e2348341. [PMID: 38113043 PMCID: PMC10731509 DOI: 10.1001/jamanetworkopen.2023.48341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/03/2023] [Indexed: 12/21/2023] Open
Abstract
Importance Perivascular spaces (PVS) and cerebrospinal fluid (CSF) are essential components of the glymphatic system, regulating brain homeostasis and clearing neural waste throughout the lifespan. Enlarged PVS have been implicated in neurological disorders and sleep problems in adults, and excessive CSF volume has been reported in infants who develop autism. Enlarged PVS have not been sufficiently studied longitudinally in infancy or in relation to autism outcomes or CSF volume. Objective To examine whether enlarged PVS are more prevalent in infants who develop autism compared with controls and whether they are associated with trajectories of extra-axial CSF volume (EA-CSF) and sleep problems in later childhood. Design, Setting, and Participants This prospective, longitudinal cohort study used data from the Infant Brain Imaging Study. Magnetic resonance images were acquired at ages 6, 12, and 24 months (2007-2017), with sleep questionnaires performed between ages 7 and 12 years (starting in 2018). Data were collected at 4 sites in North Carolina, Missouri, Pennsylvania, and Washington. Data were analyzed from March 2021 through August 2022. Exposure PVS (ie, fluid-filled channels that surround blood vessels in the brain) that are enlarged (ie, visible on magnetic resonance imaging). Main Outcomes and Measures Outcomes of interest were enlarged PVS and EA-CSF volume from 6 to 24 months, autism diagnosis at 24 months, sleep problems between ages 7 and 12 years. Results A total of 311 infants (197 [63.3%] male) were included: 47 infants at high familial likelihood for autism (ie, having an older sibling with autism) who were diagnosed with autism at age 24 months, 180 high likelihood infants not diagnosed with autism, and 84 low likelihood control infants not diagnosed with autism. Sleep measures at school-age were available for 109 participants. Of infants who developed autism, 21 (44.7%) had enlarged PVS at 24 months compared with 48 infants (26.7%) in the high likelihood but no autism diagnosis group (P = .02) and 22 infants in the control group (26.2%) (P = .03). Across all groups, enlarged PVS at 24 months was associated with greater EA-CSF volume from ages 6 to 24 months (β = 4.64; 95% CI, 0.58-8.72; P = .002) and more frequent night wakings at school-age (F = 7.76; η2 = 0.08; P = .006). Conclusions and Relevance These findings suggest that enlarged PVS emerged between ages 12 and 24 months in infants who developed autism. These results add to a growing body of evidence that, along with excessive CSF volume and sleep dysfunction, the glymphatic system could be dysregulated in infants who develop autism.
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Affiliation(s)
- Dea Garic
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Joshua Rutsohn
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Jason Wolff
- Department of Educational Psychology, University of Minnesota Twin Cities College of Education and Human Development, Minneapolis
| | - Leigh C. MacIntyre
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
| | - Leigh Anne H. Weisenfeld
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Sun Hyung Kim
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Tanya St. John
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Annette M. Estes
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Robert T. Schultz
- University of Washington Autism Center, University of Washington, Seattle
| | - Heather C. Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Stephen R. Dager
- Department of Radiology, University of Washington Medical Center, Seattle
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Mark D. Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
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5
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Burrows CA, Grzadzinski RL, Donovan K, Stallworthy IC, Rutsohn J, St John T, Marrus N, Parish-Morris J, MacIntyre L, Hampton J, Pandey J, Shen MD, Botteron KN, Estes AM, Dager SR, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Truong KN, Piven J, Elison JT. A Data-Driven Approach in an Unbiased Sample Reveals Equivalent Sex Ratio of Autism Spectrum Disorder-Associated Impairment in Early Childhood. Biol Psychiatry 2022; 92:654-662. [PMID: 35965107 PMCID: PMC10062179 DOI: 10.1016/j.biopsych.2022.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/12/2022] [Accepted: 05/30/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Sex differences in the prevalence of neurodevelopmental disorders are particularly evident in autism spectrum disorder (ASD). Heterogeneous symptom presentation and the potential of measurement bias hinder early ASD detection in females and may contribute to discrepant prevalence estimates. We examined trajectories of social communication (SC) and restricted and repetitive behaviors (RRBs) in a sample of infant siblings of children with ASD, adjusting for age- and sex-based measurement bias. We hypothesized that leveraging a prospective elevated familial likelihood sample, deriving data-driven behavioral constructs, and accounting for measurement bias would reveal less discrepant sex ratios than are typically seen in ASD. METHODS We conducted direct assessments of ASD symptoms at 6 to 9, 12 to 15, 24, and 36 to 60 months of age (total nobservations = 1254) with infant siblings of children with ASD (n = 377) and a lower ASD-familial-likelihood comparison group (n = 168; nobservations = 527). We established measurement invariance across age and sex for separate models of SC and RRB. We then conducted latent class growth mixture modeling with the longitudinal data and evaluated for sex differences in trajectory membership. RESULTS We identified 2 latent classes in the SC and RRB models with equal sex ratios in the high-concern cluster for both SC and RRB. Sex differences were also observed in the SC high-concern cluster, indicating that girls classified as having elevated social concerns demonstrated milder symptoms than boys in this group. CONCLUSIONS This novel approach for characterizing ASD symptom progression highlights the utility of assessing and adjusting for sex-related measurement bias and identifying sex-specific patterns of symptom emergence.
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Affiliation(s)
- Catherine A Burrows
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota.
| | - Rebecca L Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kevin Donovan
- Department of Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Isabella C Stallworthy
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
| | - Joshua Rutsohn
- Department of Biostatistics, Gillings School of Global PubLic Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tanya St John
- UW Autism Center, Center on Human Development & Disability, University of Washington, Seattle, Washington
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Julia Parish-Morris
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Leigh MacIntyre
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Jacqueline Hampton
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Neuroscience Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelly N Botteron
- Department of Radiology, University of Washington Medical Center, Seattle, Washington; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Annette M Estes
- UW Autism Center, Center on Human Development & Disability, University of Washington, Seattle, Washington; Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
| | - Stephen R Dager
- Department of Radiology, University of Washington Medical Center, Seattle, Washington
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Alberta, Canada
| | - Kinh N Truong
- Department of Biostatistics, Gillings School of Global PubLic Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jed T Elison
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota; Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
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Abstract
Father involvement has been associated with positive child social, emotional, psychological, developmental, and health outcomes. However, tools for measuring father involvement have not kept pace with the expanding understanding of the roles of fathers, and in the area of child health, are blunt. The purpose of this study was to develop and validate a self-report measure of father involvement in preschooler's health, the Father Involvement in Health-Pre-School (FIH-PS). In phase 1 item generation, 47 items were developed based on previous qualitative work and vetted through cognitive interviews with 21 fathers of children ages 3-5 (preschool). In phase 2 psychometric validation, 560 fathers of 3-5 year olds (n=392 resident, n=168 non-resident) completed the FIH-PS item bank. Participants were predominantly white (64%), had private health insurance (53%), had a mean age of 33 years, and half were married. Item Response Theory was used to determine measurement scoring. The FIH-PS scale was reduced from a 47-item bank to a total of 20 items supporting a 4-factor scale made up of Acute Illness, General Well-being, Emotional Health, and Role Modeling. Following exploratory (n=280) and confirmatory factor (n=280) analyses, the scale followed a bifactor structure, was internally consistent (Cronbach's α=0.953), and discriminated among fathers with lower involvement. A sum-to-T-score crosswalk table was produced to standardize the scores along a normal distribution (mean=50, S=10, range 10.8-71.3). Future research and clinical applications of the FIH-PS are discussed.
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Affiliation(s)
- Craig F Garfield
- Northwestern University Feinberg School of Medicine, Chicago, IL
- Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Sheehan D Fisher
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - David Barretto
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joshua Rutsohn
- Northwestern University Feinberg School of Medicine, Chicago, IL
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7
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Garfield CF, Abbott C, Rutsohn J, Penedo F. Hispanic Young Males' Mental Health From Adolescence Through the Transition to Fatherhood. Am J Mens Health 2018; 12:1226-1234. [PMID: 29577835 PMCID: PMC6142135 DOI: 10.1177/1557988318765890] [Citation(s) in RCA: 4] [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] [Received: 10/27/2017] [Revised: 01/23/2018] [Accepted: 01/30/2018] [Indexed: 11/30/2022] Open
Abstract
The objective of the current study was to examine the associations between the transition to fatherhood and depressive symptoms scores among Hispanic men. Using the sample of Hispanic men included in the National Longitudinal Study of Adolescent to Adult Health, depressive symptom scores were examined from 1994 to 2008. A "fatherhood-year" data set was created that included the men's Center for Epidemiologic Studies Depression Scale (CES-D) scores as well as residency status with the child. By regressing age-adjusted standardized depressive symptom scores, associations between mental health scores of Hispanic men and their transition to fatherhood were identified. Among the 1,715 Hispanic men, resident ( n = 502) and nonresident ( n = 99) Hispanic fathers reported an increase in depressive symptom scores (CES-D) during the first 5 years after entrance into fatherhood (β = 0.150, 95% CI [0.062, 0.239] and β = 0.153, 95% CI [0.034, 0.271], respectively) compared to non-fathers ( n = 1,114), representing an increase of 10% for resident fathers and a 15% for nonresident fathers. Hispanic non-fathers reported a decrease in depressive symptom scores (CES-D) during parallel ages. Hispanic fathers, regardless of residency status, reported increased depressive symptoms in the first 5 years after the transition into fatherhood, a period critical in child development.
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Affiliation(s)
- Craig F. Garfield
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Collin Abbott
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joshua Rutsohn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank Penedo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Kaat AJ, Schalet BD, Rutsohn J, Jensen RE, Cella D. Physical function metric over measure: An illustration with the Patient-Reported Outcomes Measurement Information System (PROMIS) and the Functional Assessment of Cancer Therapy (FACT). Cancer 2017; 124:153-160. [PMID: 28885707 DOI: 10.1002/cncr.30981] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 02/01/2017] [Revised: 06/19/2017] [Accepted: 08/02/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Measuring patient-reported outcomes (PROs) is becoming an integral component of quality improvement initiatives, clinical care, and research studies in cancer, including comparative effectiveness research. However, the number of PROs limits comparability across studies. Herein, the authors attempted to link the Functional Assessment of Cancer Therapy-General Physical Well-Being (FACT-G PWB) subscale with the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) calibrated item bank. The also sought to augment a subset of the conceptually most similar FACT-G PWB items with PROMIS PF items to improve the linking. METHODS Baseline data from 5506 participants in the Measuring Your Health (MY-Health) study were used to identify the optimal items for linking FACT-G PWB with PROMIS PF. A mixed methods approach identified the optimal items for creating the 5-item FACT/PROMIS-PF5 scale. Both the linked and augmented relationships were cross-validated using the follow-up MY-Health data. RESULTS A 5-item FACT-G PWB item subset was found to be optimal for linking with PROMIS PF. In addition, a 2-item subset, including only items that were conceptually very similar to the PROMIS item bank content, were augmented with 3 PROMIS PF items. This new FACT/PROMIS-PF5 provided superior score recovery. CONCLUSIONS The PROMIS PF metric allows for the evaluation of the extent to which similar questionnaires can be linked and therefore expressed on the same metric. These results allow for the aggregation of existing data and provide an optimal measure for future studies wishing to use the FACT yet also report on the PROMIS PF metric. Cancer 2018;124:153-60. © 2017 American Cancer Society.
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Affiliation(s)
- Aaron J Kaat
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Benjamin D Schalet
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Joshua Rutsohn
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Roxanne E Jensen
- Cancer Center and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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Garfield CF, Duncan G, Peters S, Rutsohn J, McDade TW, Adam EK, Coley RL, Chase-Lansdale PL. Adolescent Reproductive Knowledge, Attitudes, and Beliefs and Future Fatherhood. J Adolesc Health 2016; 58:497-503. [PMID: 26896211 PMCID: PMC5052073 DOI: 10.1016/j.jadohealth.2015.12.010] [Citation(s) in RCA: 18] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 12/19/2015] [Accepted: 12/21/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE With a growing focus on the importance of men's reproductive health, including preconception health, the ways in which young men's knowledge, attitudes, and beliefs (KAB) predict their reproductive paths are understudied. To determine if reproductive KAB predicts fatherhood status, timing and residency (living with child or not). METHODS Reproductive KAB and fatherhood outcomes were analyzed from the National Longitudinal Study of Adolescent Health, a 20-year, nationally representative study of individuals from adolescence into adulthood. Four measures of reproductive KAB were assessed during adolescence in waves I and II. A generalized linear latent and mixed model predicted future fatherhood status (nonfather, resident/nonresident father, adolescent father) and timing while controlling for other socio-demographic variables. RESULTS Of the 10,253 men, 3,425 were fathers (686 nonresident/2,739 resident) by wave IV. Higher risky sexual behavior scores significantly increased the odds of becoming nonresident father (odds ratio [OR], 1.30; p < .0001), resident father (OR, 1.07; p = .007), and adolescent father (OR, 1.71; p < .0001); higher pregnancy attitudes scores significantly increased the odds of becoming a nonresident father (OR, 1.20; p < .0001) and resident father (OR, 1.11; p < .0001); higher birth control self-efficacy scores significantly decreased the odds of becoming a nonresident father (OR, .72; p < .0001) and adolescent father (OR, .56; p = .01). CONCLUSIONS Young men's KAB in adolescence predicts their future fatherhood and residency status. Strategies that address adolescent males' reproductive KAB are needed in the prevention of unintended reproductive consequences such as early and nonresident fatherhood.
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Affiliation(s)
- Craig F Garfield
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Institute for Policy Research, Northwestern University, Evanston, Illinois.
| | - Greg Duncan
- School of Education, University of California-Irvine, Irvine, California
| | - Sarah Peters
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joshua Rutsohn
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Thomas W McDade
- Institute for Policy Research, Northwestern University, Evanston, Illinois; Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Emma K Adam
- Institute for Policy Research, Northwestern University, Evanston, Illinois; School of Education and Social Policy, Northwestern University, Evanston, Illinois
| | | | - Patricia Lindsay Chase-Lansdale
- Institute for Policy Research, Northwestern University, Evanston, Illinois; School of Education and Social Policy, Northwestern University, Evanston, Illinois
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Garfield CF, Lee YS, Kim HN, Rutsohn J, Kahn JY, Mustanski B, Mohr DC. Supporting Parents of Premature Infants Transitioning from the NICU to Home: A Pilot Randomized Control Trial of a Smartphone Application. Internet Interv 2016; 4:131-137. [PMID: 27990350 PMCID: PMC5156477 DOI: 10.1016/j.invent.2016.05.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [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: 03/14/2016] [Revised: 05/23/2016] [Accepted: 05/24/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine whether parents of Very Low Birth Weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU) transitioning home with the NICU-2-Home smartphone application have greater parenting self-efficacy, are better prepared for discharge and have shorter length of stay (LOS) than control parents. METHODS A four-week pilot randomized controlled trial during the transition home with 90 VLBW parents randomized to usual care (n=44) or usual care plus NICU-2-Home (n=46), a smartphone application designed for VLBW parents. Parenting Sense of Competence Scale (PSOC) was assessed at baseline, day after discharge, and two weeks post-discharge. Preparedness for discharge and length of stay (LOS) were secondary outcomes. Analyses by usage were also included. RESULTS While parents of VLBW infants in the intervention group did not show an improvement in PSOC during the transition when compared directly to controls, after accounting for actual mean app usage, PSOC improved 7% (2.71 points/time greater; 95%CI = 1.45, 6.27) for intervention versus controls. Compared to controls, above-average users increased their PSOC score by 14% (6.84 points/time; 95%CL = 5.02, 8.67), average users by 11% (4.58 points/time; 95%CL = 2.89, 6.27) and below-average users by 6% (2.41 points/time; 95%CL = 0.04, 4.79). Moderate evidence showed LOS was shorter for above-average users compared to the control group (β = 12.2. SE = 6.9, p = 0.085). CONCLUSION A smartphone application used by parents of VLBW infants during the transition home from the NICU can improve parenting self-efficacy, discharge preparedness, and LOS with improved benefits based on usage.
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Affiliation(s)
- Craig F. Garfield
- Northwestern University Feinberg School of Medicine, Department of Pediatrics, United States
- Ann & Robert H. Lurie Children's Hospital of Chicago, United States
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, United States
| | - Young Seok Lee
- Northwestern University Feinberg School of Medicine, Department of Pediatrics, United States
| | - Hyung Nam Kim
- Northwestern University Feinberg School of Medicine, Department of Pediatrics, United States
| | - Joshua Rutsohn
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, United States
| | - Janine Yasmin Kahn
- Northwestern University Feinberg School of Medicine, Department of Pediatrics, United States
- Ann & Robert H. Lurie Children's Hospital of Chicago, United States
| | - Brian Mustanski
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, United States
| | - David C. Mohr
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine-Behavioral Medicine, United States
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Garfield CF, Duncan G, Gutina A, Rutsohn J, McDade TW, Adam EK, Coley RL, Chase-Lansdale PL. Longitudinal Study of Body Mass Index in Young Males and the Transition to Fatherhood. Am J Mens Health 2015. [PMID: 26198724 DOI: 10.1177/1557988315596224] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Despite a growing understanding that the social determinants of health have an impact on body mass index (BMI), the role of fatherhood on young men's BMI is understudied. This longitudinal study examines BMI in young men over time as they transition from adolescence into fatherhood in a nationally representative sample. Data from all four waves of the National Longitudinal Study of Adolescent Health supported a 20-year longitudinal analysis of 10,253 men beginning in 1994. A "fatherhood-year" data set was created and changes in BMI were examined based on fatherhood status (nonfather, nonresident father, resident father), fatherhood years, and covariates. Though age is positively associated with BMI over all years for all men, comparing nonresident and resident fathers with nonfathers reveals different trajectories based on fatherhood status. Entrance into fatherhood is associated with an increase in BMI trajectory for both nonresident and resident fathers, while nonfathers exhibit a decrease over the same period. In this longitudinal, population-based study, fatherhood and residence status play a role in men's BMI. Designing obesity prevention interventions for young men that begin in adolescence and carry through young adulthood should target the distinctive needs of these populations, potentially improving their health outcomes.
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Affiliation(s)
- Craig F Garfield
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA Northwestern University, Evanston, IL, USA
| | | | - Anna Gutina
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joshua Rutsohn
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Garfield CF, Duncan G, Rutsohn J, McDade TW, Adam EK, Coley RL, Chase-Lansdale PL. A longitudinal study of paternal mental health during transition to fatherhood as young adults. Pediatrics 2014; 133:836-43. [PMID: 24733877 PMCID: PMC4006439 DOI: 10.1542/peds.2013-3262] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [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] [Accepted: 01/27/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Rates of paternal depression range from 5% to 10% with a growing body of literature describing the harm to fathers, children, and families. Changes in depression symptoms over the life course, and the role of social factors, are not well known. This study examines associations with changes in depression symptoms during the transition to fatherhood for young fathers and whether this association differed by key social factors. METHODS We combined all 4 waves of the National Longitudinal Study of Adolescent Health to support a 23-year longitudinal analysis of 10 623 men and then created a "fatherhood-year" data set, regressing age-adjusted standardized depressive symptoms scores on fatherhood status (nonresidence/residence), fatherhood-years, and covariates to determine associations between Center for Epidemiologic Studies Depression Scale scores and fatherhood life course intervals. RESULTS Depressive symptom scores reported at the entry into fatherhood are higher for nonresident fathers than nonfathers, which in turn are higher than those of resident fathers. Resident fathers have a significant decrease in scores during late adolescence (β = -0.035, P = .023), but a significant increase in scores during early fatherhood (β = 0.023, P = .041). From entrance into fatherhood to the end of early fatherhood (+5 years), the depressive symptoms score for resident fathers increases on average by 68%. CONCLUSIONS In our longitudinal, population-based study, resident fathers show increasing depressive symptom scores during children's key attachment years of 0-5. Identifying at-risk fathers based on social factors and designing effective interventions may ultimately improve health outcomes for the entire family.
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Affiliation(s)
- Craig F Garfield
- Northwestern University Feinberg School of Medicine, Departments of Pediatrics and Medical Social Sciences, Chicago, Illinois; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Institute for Policy Research, Northwestern University, Evanston, Illinois;
| | - Greg Duncan
- School of Education, University of California-Irvine, Irvine, California
| | - Joshua Rutsohn
- Northwestern University Feinberg School of Medicine, Departments of Pediatrics and Medical Social Sciences, Chicago, Illinois
| | - Thomas W McDade
- Institute for Policy Research, Northwestern University, Evanston, Illinois; Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Emma K Adam
- Institute for Policy Research, Northwestern University, Evanston, Illinois; School of Education and Social Policy, Northwestern University
| | | | - P Lindsay Chase-Lansdale
- Institute for Policy Research, Northwestern University, Evanston, Illinois; School of Education and Social Policy, Northwestern University
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