Risk For Later Psychopathology Research Articles

Intergenerational Effects of Parenting on Children's Internalizing and Externalizing Trajectories: A Latent Growth Model Analysis.

Externalizing and internalizing problems in childhood are associated with risk for later psychopathology. It is important to identify antecedents as they may be targets for intervention. In a sample of 501 children (M = 6.07; 54.7% male; 12.4% Hispanic; 12.2% non-White), we leveraged data from a longitudinal study to examine the transmission of parenting behaviors across two generations and its effects on children's internalizing and externalizing outcomes in the subsequent generation. The results suggested transmission of parenting behaviors, confirmed the role of parenting on children's psychopathology, and provided novel evidence of a direct and indirect role of grandparent's caregiving on children's psychopathology via parenting continuity. These findings may inform interventions addressing continuity of parenting behaviors and their subsequent effects.

Neural responding during uncertain threat anticipation in pediatric anxiety.

Excessive fear responses to uncertain threat are a key feature of anxiety disorders (ADs), though most mechanistic work considers adults. As ADs onset in childhood and confer risk for later psychopathology, we sought to identify conditions of uncertain threat that distinguish 8-17-year-old youth with AD (n = 19) from those without AD (n = 33), and assess test-retest reliability of such responses in a companion sample of healthy adults across three sites (n = 19). In an adapted uncertainty of threat paradigm, visual cues parametrically signaled threat of aversive stimuli (fear faces) in 25 % increments (0 %, 25 %, 50 %, 100 %), while participants underwent functional magnetic resonance imaging (fMRI). We compared neural response elicited by cues signaling different degrees of probability regarding the subsequent delivery of fear faces. Overall, youth displayed greater engagement of bilateral inferior parietal cortex, fusiform gyrus, and lingual gyrus during uncertain threat anticipation in general. Relative to healthy youth, AD youth exhibited greater activation in ventrolateral prefrontal cortex (vlPFC)/BA47 during uncertain threat anticipation in general. Further, AD differed from healthy youth in scaling of ventral striatum/sgACC activation with threat probability and attenuated flexibility of responding during parametric uncertain threat. Complementing these results, significant, albeit modest, cross-site test-retest reliability in these regions was observed in an independent sample of healthy adults. While preliminary due to a small sample size, these findings suggest that during uncertainty of threat, AD youth engage vlPFC regions known to be involved in fear regulation, response inhibition, and cognitive control. Findings highlight the potential of isolating neural correlates of threat anticipation to guide treatment development and translational work in youth.

The Bidirectional Relationship Between Brain Features and the Dysregulation Profile: A Longitudinal, Multimodal Approach

The field of psychiatry increasingly highlights the importance of studying not only the influence of the brain on behavior, but also the long-term influences that the persistence of specific behaviors can have on the brain. A severe behavioral phenotype that puts children at risk for later psychopathology is the Child Behavior Checklist-Dysregulation Profile (CBCL-DP).1 In earlier work, Shaw et al.2 proposed a model in which the amygdala, nucleus accumbens, and orbitofrontal cortex, structures involved in the bottom-up response to emotional stimuli, are related to emotion dysregulation. Additionally, 3 key limbic white matter tracts have also been shown to be associated with CBCL-DP symptoms: the uncinate fasciculus, cingulum bundle, and forceps minor.3,4.

Latent classes of oppositional defiant disorder in adolescence and prediction to later psychopathology.

Current conceptualizations of oppositional defiant disorder (ODD) place the symptoms of this disorder within three separate but related dimensions (i.e., angry/irritable mood, argumentative/defiant behavior, vindictiveness). Variable-centered models of these dimensions have yielded discrepant findings, limiting their clinical utility. The current study utilized person-centered latent class analysis based on self and parent report of ODD symptomatology from a community-based cohort study of 521 adolescents. We tested for sex, race, and age differences in the identified classes and investigated their ability to predict later symptoms of depression and conduct disorder (CD). Diagnostic information regarding ODD, depression, and CD were collected annually from adolescents (grades 6-9; 51.9% male; 48.7% White, 28.2% Black, 18.5% Asian) and a parent. Results provided evidence for three classes of ODD (high, medium, and low endorsement of symptoms), which demonstrated important developmental differences across time. Based on self-report, Black adolescents were more likely to be in the high and medium classes, while according to parent report, White adolescents were more likely to be in the high and medium classes. Membership in the high and medium classes predicted later increases in symptoms of depression and CD, with the high class showing the greatest risk for later psychopathology.

Salivary cortisol reactivity in 6-month-old infants of mothers with severe psychiatric disorders: findings from the face-to-Face Still-Face paradigm

Background.Maternal psychopathology is associated with altered HPA axis functioning in offspring. Most studies have focused on mildly affected populations, but less is known about the effect of severe maternal psychopathology. In our explorative study we investigated in a heterogenic sample of mothers with severe and long-lasting psychiatric disorders, if a diagnosis of depression and severity of general maternal psychiatric symptomatology were associated with infant salivary cortisol reactivity to the Face-to-Face Still-Face (FFSF) paradigm at 6 months of age.Methods.A clinical sample of 36 mother-infant dyads was explored. All mothers fulfilled criteria for a severe psychiatric disorder and had psychiatric complaints for the last two consecutive years. Maternal diagnosis was established during pregnancy using a diagnostic interview and general maternal psychiatric symptom severity was established by self-report at the time of the FFSF procedure. The FFSF paradigm was used to assess infants’ response to social stress at the age of 6 months. Infant saliva samples were collected at three time points: 5 min before and 15 and 30 min after the social stressor. Cortisol reactivity was operationalized as incremental Area Under the Curve (AUCi). Potential confounders were identified and adjusted for.Results.In regression analyses, a negative relationship was found between infant cortisol reactivity (AUCi) during the FFSF paradigm at 6 months and general maternal symptom severity at time of the FFSF paradigm (unadjusted n = 36, ß = −0.331, B = −9.758, SE 4.8, p = .048; adjusted n = 36, ß = −0.335, B = −9.868, SE 4.5, p = .039) and for diagnosis of perinatal depression at trend level (unadjusted n = 36, ß = −0.293, B = −8.640, SE 4.8, p = .083; adjusted n = 36, ß = −0.317, B = −9.347, SE 4.6, p = .052). Analyses were adjusted for gestational age.Conclusions.Preliminary results on cortisol reactivity in 6-month-old infants of mothers with severe and long-lasting psychiatric disorders show a significant reduction in the group of mothers who experienced a high level of psychiatric symptoms in the post-partum period, compared to mothers with lower levels of psychiatric symptomatology. The same trend was found for mothers with and without a diagnosis of perinatal depression. Since these infants are considered to be at increased risk for later psychopathology, our study suggests that future longitudinal studies should investigate whether reduced cortisol reactivity in babies could be a marker for any adverse outcomes, besides other possible risk factors (e.g. (epi)genetic phenomena).

A video-feedback parenting intervention to prevent enduring behaviour problems in at-risk children aged 12-36 months: the Healthy Start, Happy Start RCT.

Behaviour problems emerge early in childhood and place children at risk for later psychopathology. To evaluate the clinical effectiveness and cost-effectiveness of a parenting intervention to prevent enduring behaviour problems in young children. A pragmatic, assessor-blinded, multisite, two-arm, parallel-group randomised controlled trial. Health visiting services in six NHS trusts in England. A total of 300 at-risk children aged 12-36 months and their parents/caregivers. Families were allocated in a 1 : 1 ratio to six sessions of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) plus usual care or usual care alone. The primary outcome was the Preschool Parental Account of Children's Symptoms, which is a structured interview of behaviour symptoms. Secondary outcomes included caregiver-reported total problems on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The intervention effect was estimated using linear regression. Health and social care service use was recorded using the Child and Adolescent Service Use Schedule and cost-effectiveness was explored using the Preschool Parental Account of Children's Symptoms. In total, 300 families were randomised: 151 to VIPP-SD plus usual care and 149 to usual care alone. Follow-up data were available for 286 (VIPP-SD, n = 140; usual care, n = 146) participants and 282 (VIPP-SD, n = 140; usual care, n = 142) participants at 5 and 24 months, respectively. At the post-treatment (primary outcome) follow-up, a group difference of 2.03 on Preschool Parental Account of Children's Symptoms (95% confidence interval 0.06 to 4.01; p = 0.04) indicated a positive treatment effect on behaviour problems (Cohen's d = 0.20, 95% confidence interval 0.01 to 0.40). The effect was strongest for children's conduct [1.61, 95% confidence interval 0.44 to 2.78; p = 0.007 (d = 0.30, 95% confidence interval 0.08 to 0.51)] versus attention deficit hyperactivity disorder symptoms [0.29, 95% confidence interval -1.06 to 1.65; p = 0.67 (d = 0.05, 95% confidence interval -0.17 to 0.27)]. The Child Behaviour Checklist [3.24, 95% confidence interval -0.06 to 6.54; p = 0.05 (d = 0.15, 95% confidence interval 0.00 to 0.31)] and the Strengths and Difficulties Questionnaire [0.93, 95% confidence interval -0.03 to 1.9; p = 0.06 (d = 0.18, 95% confidence interval -0.01 to 0.36)] demonstrated similar positive treatment effects to those found for the Preschool Parental Account of Children's Symptoms. At 24 months, the group difference on the Preschool Parental Account of Children's Symptoms was 1.73 [95% confidence interval -0.24 to 3.71; p = 0.08 (d = 0.17, 95% confidence interval -0.02 to 0.37)]; the effect remained strongest for conduct [1.07, 95% confidence interval -0.06 to 2.20; p = 0.06 (d = 0.20, 95% confidence interval -0.01 to 0.42)] versus attention deficit hyperactivity disorder symptoms [0.62, 95% confidence interval -0.60 to 1.84; p = 0.32 (d = 0.10, 95% confidence interval -0.10 to 0.30)], with little evidence of an effect on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The primary economic analysis showed better outcomes in the VIPP-SD group at 24 months, but also higher costs than the usual-care group (adjusted mean difference £1450, 95% confidence interval £619 to £2281). No treatment- or trial-related adverse events were reported. The probability of VIPP-SD being cost-effective compared with usual care at the 24-month follow-up increased as willingness to pay for improvements on the Preschool Parental Account of Children's Symptoms increased, with VIPP-SD having the higher probability of being cost-effective at willingness-to-pay values above £800 per 1-point improvement on the Preschool Parental Account of Children's Symptoms. The proportion of participants with graduate-level qualifications was higher than among the general public. VIPP-SD is effective in reducing behaviour problems in young children when delivered by health visiting teams. Most of the effect of VIPP-SD appears to be retained over 24 months. However, we can be less certain about its value for money. Current Controlled Trials ISRCTN58327365. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 29. See the NIHR Journals Library website for further project information.

Early tobacco smoke exposure, preschool cool/hot inhibitory control, and young adolescents' externalizing/internalizing problems.

There is a dearth of research spanning multiple developmental stages to delineate the far-reaching implications of early tobacco smoke exposure for later behavior adaptation and also elucidate the underlying psychological mechanisms. Using NICHD SECCYD data, we conducted process model analyses to address this gap. Results indicated that early tobacco smoke exposure was not only negatively associated with preschool cool and hot inhibitory control, but also positively related to externalizing and internalizing problems in early adolescence. Further, early exposure was also positively associated with externalizing problems in early adolescence via a negative link with preschool cool inhibitory control. Behavior problems in toddlerhood also served as one mechanism underlying the implications of early exposure for behavior problems in early adolescence. As compared to nonexposed children, children with both prenatal and postnatal exposure tended to have lower cool and hot inhibitory control, whereas children with only prenatal exposure displayed lower hot inhibitory control. Regardless of whether exposure was across prenatal and postnatal periods, or restricted to prenatal phase alone, exposed children displayed more behavior problems in toddlerhood, which in turn predicted more behavior problems in early adolescence. All associations emerged after considering extensive potential confounding factors and did not vary across child sex. Taken together, early tobacco smoke exposure may induce self-regulation deficits and also early onset of behavior problems and thus elevate the risk of later psychopathology. Building a smoke free environment in pregnancy and infancy likely yields long-term benefits by facilitating adaptation in early adolescence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Early childhood stress is associated with blunted development of ventral tegmental area functional connectivity

Early life stress increases risk for later psychopathology, due in part to changes in dopaminergic brain systems that support reward processing and motivation. Work in animals has shown that early life stress has a profound impact on the ventral tegmental area (VTA), which provides dopamine to regions including nucleus accumbens (NAcc), anterior hippocampus, and medial prefrontal cortex (mPFC), with cascading effects over the course of development. However, little is known about how early stress exposure shifts the developmental trajectory of mesocorticolimbic circuitry in humans. In the current study, 88 four- to nine-year-old children participated in resting-state fMRI. Parents completed questionnaires on their children's chronic stress exposure, including socioeconomic status (SES) and adverse childhood experiences (ACEs). We found an age x SES interaction on VTA connectivity, such that children from higher SES backgrounds showed a positive relationship between age and VTA-mPFC connectivity. Similarly, we found an age x ACEs exposure interaction on VTA connectivity, such that children with no ACEs exposure showed a positive relationship between age and VTA-mPFC connectivity. Our findings suggest that early stress exposure relates to the blunted maturation of VTA connectivity in young children, which may lead to disrupted reward processing later in childhood and beyond.

Reducing Adolescent Psychopathology in Socioeconomically Disadvantaged Children With a Preschool Intervention: A Randomized Controlled Trial.

Living in poverty increases exposure to adversities that undermine healthy development, impeding growth in the social-emotional and language skills that support adaptive coping and promote mental health. Evidence-based programs have the potential to improve current preschool practice and strengthen these early skills, potentially reducing risk for later psychopathology. The authors tested the hypothesis that an enrichment program in preschool would be associated with reduced levels of psychopathology symptoms at the transition from middle to secondary school. The Head Start REDI (Research-Based, Developmentally Informed) intervention was used to enrich preschool classrooms serving children from low-income families with an evidence-based social-emotional learning (SEL) program and a coordinated interactive reading program. Centers were randomly assigned to the intervention or usual practice, and 356 4-year-olds (58% White, 25% Black, 17% Latino; 54% female) were followed into early adolescence. Hierarchical linear models were used to evaluate intervention effects on teacher-rated psychopathology symptoms using the Strengths and Difficulties Questionnaire in grade 7 (ages 12-13) and grade 9 (ages 14-15), 8-10 years after the end of the intervention. Statistically significant intervention-related reductions were observed in conduct problems and emotional symptoms in the intervention group. In addition, the proportion of youths with clinically significant levels of conduct problems, emotional symptoms, and peer problems was reduced in the intervention group, with rates one-third of those in the control group. The study findings indicate that enriching preschool programs serving at-risk children with a relatively inexpensive evidence-based SEL program with interactive reading substantially improved the later benefits for adolescent emotional and behavioral health. This kind of SEL enrichment represents an approach that can leverage public investments in preschool programs to enhance public health.

Understanding practitioners’ and young people’s views of a risk calculator for future psychopathology and poor functioning in young people victimised during childhood

Background Although children who are exposed to victimisation (including abuse, neglect, domestic violence and bullying) have an increased risk of later psychopathology and functional impairment, not all go on to develop these outcomes. Risk calculators that generate individualised probabilities of a victimised child developing future psychopathology and poor functioning have the potential to help practitioners identify the most vulnerable children and efficiently target preventive interventions. Aim This study explored the views of young people and practitioners regarding the acceptability and feasibility of potentially using a risk calculator to predict victimised children’s individual risk of poor outcomes. Methods Young people (n = 6) with lived experience of childhood victimisation took part in two focus groups. Health and social care practitioners (n = 13) were interviewed individually. Focus groups and interviews were audio-recorded, transcribed and thematically analysed. Results Ten themes were identified, organised according to the three main topics of discussion: (i) identifying risk (risk factors, current practice, accuracy, implementation, response); (ii) protective factors and prevention (individual, environment, preventative intervention); and (iii) communication of research (stakeholders, methods). Conclusion Risk calculators have the potential to enhance health and social care practice in the United Kingdom, but we highlight key factors that require consideration for successful implementation.

Global deficits in executive functioning are transdiagnostic mediators between severe childhood neglect and psychopathology in adolescence.

Children reared in institutions experience profound deprivation that is associated with both heightened levels of psychopathology and deficits in executive functioning (EF). It is unclear whether deficits in EF among institutionally-reared children serve as a vulnerability factor that increases risk for later psychopathology. It is also unclear whether this putative association between EF and psychopathology is transdiagnostic (i.e. cuts across domains of psychopathology), or specific to a given syndrome. Thus, we examined whether global deficits in EF mediate the association between severe childhood neglect and general v. specific psychopathology in adolescence. The sample consisted of 188 children from the Bucharest Early Intervention Project, a longitudinal study examining the brain and behavioral development of children reared in Romanian institutions and a comparison group of never-institutionalized children. EF was assessed at age 8, 12, and 16 using a well-validated measure of neuropsychological functioning. Psychopathology was measured as general (P) and specific internalizing (INT) and externalizing (EXT) factors at age 12 and 16. Institutionally-reared children had lower global EF and higher general psychopathology (P) at all ages compared to never-institutionalized children. Longitudinal path analysis revealed that the effect of institutionalization on P at age 16 operated indirectly through poorer EF from ages 8 to 12. No indirect effects involving EF were observed for INT or EXT at age 16. We conclude that stable, global deficits in EF serve as a cognitive endophenotype that increases transdiagnostic vulnerability to psychopathology in adolescence among those who have experienced profound early neglect.

Pathways to social-emotional functioning in the preschool period: The role of child temperament and maternal anxiety in boys and girls

Individual differences in social-emotional functioning emerge early and have long-term implications for developmental adaptation and competency. Research is needed that specifies multiple early risk factors and outcomes simultaneously to demonstrate specificity. Using multigroup longitudinal path analysis in a sample of typically developing children (N = 541), we examined child temperament dimensions (surgency, negative affectivity, and regulation/effortful control) and maternal anxiety in infancy and age 2 as predictors of child externalizing, internalizing, dysregulation, and competence behaviors at age 3. Four primary patterns emerged. First, there was stability in temperament dimensions and maternal anxiety from infancy to age 3. Second, negative affectivity was implicated in internalizing problems and surgency in externalizing problems. Third, effortful control at age 2 was a potent mediator of maternal anxiety in infancy on age 3 outcomes. Fourth, there was suggestive evidence for transactional effects between maternal anxiety and child effortful control. Most pathways operated similarly for boys and girls, with some differences, particularly for surgency. These findings expand our understanding of the roles of specific temperamental domains and postnatal maternal anxiety in a range of social-emotional outcomes in the preschool period, and have implications for efforts to enhance the development of young children's social-emotional functioning and reduce risk for later psychopathology.

Effects of Parenting and Community Violence on Aggression-Related Social Goals: a Monozygotic Twin Differences Study.

Community violence exposure and harsh parenting have been linked to maladaptive outcomes, possibly via their effects on social cognition. The Social Information Processing (SIP) model has been used to study distinct socio-cognitive processes, demonstrating links between community violence exposure, harsh parenting, and maladaptive SIP. Though much of this research assumes these associations are causal, genetic confounds have made this assumption difficult to rigorously test. Comparisons of discordant monozygotic (MZ) twins provide one empirical test of possible causality, as differences between MZ twins must be environmental in origin. The present study examined effects of parenting and community violence exposure on SIP - specifically aggressive and avoidant social goals - in a sample of 426 MZ twin dyads (N = 852 twins, 48% female). Phenotypically, we found that lower positive parenting and greater harsh parenting were associated with greater endorsement of dominance and revenge goals. We also found that indirect and direct community violence exposure was associated with greater endorsement of avoidance goals. Using an MZ difference design, we found that the relationships between lower levels of positive parenting and endorsement of dominance and revenge goals were due, in part, to environmental processes. Moreover, the relationships between the impact of indirect and direct community violence exposure and avoidance goals, as well as between the impact of indirect community violence exposure and revenge goals, appeared to be due to non-shared environmental processes. Our results establish social and contextual experiences as important environmental influences on children's social goals, which may increase risk for later psychopathology.

Prenatal maternal stress, fetal programming, and mechanisms underlying later psychopathology—A global perspective

There is clear evidence that the mother's stress, anxiety, or depression during pregnancy can alter the development of her fetus and her child, with an increased risk for later psychopathology. We are starting to understand some of the underlying mechanisms including the role of the placenta, gene-environment interactions, epigenetics, and specific systems including the hypothalamic-pituitary-adrenal axis and cytokines. In this review we also consider how these effects may be different, and potentially exacerbated, in different parts of the world. There can be many reasons for elevated prenatal stress, as in communities at war. There may be raised pregnancy-specific anxiety with high levels of maternal and infant death. There can be raised interpersonal violence (in Afghanistan 90.2% of women thought that "wife beating" was justified compared with 2.0% in Argentina). There may be interactions with nutritional deficiencies or with extremes of temperature. Prenatal stress alters the microbiome, and this can differ in different countries. Genetic differences in different ethnic groups may make some more vulnerable or more resilient to the effects of prenatal stress on child neurodevelopment. Most research on these questions has been in predominantly Caucasian samples from high-income countries. It is now time to understand more about prenatal stress and psychopathology, and the role of both social and biological differences, in the rest of the world.

Commentary: Understanding the impact of domestic violence on children, recognizing strengths, and promoting resilience: reflections on Harold and Sellers (2018).

Violence and abuse in families occurs frequently with significant impact on children of all ages. However, this type of interpersonal violence is often the least disclosed or discussed. Therefore, the Harold and Sellers paper is important to bring attention to the broad range of both behavioral and neuroscience research in this area and the clinical implications for children and adolescents including risk for later psychopathology. The commentary also expands an understanding of the impact and outcomes for very young children exposed to domestic violence. The authors provide a thorough description of the many prevention and intervention programs and approaches to help children exposed to domestic violence. In conclusion, it is essential to recognize that even at times of adversity for children and families, such as when domestic violence occurs, it is important to recognize strengths and support resilience.

Perinatal hypoxia as a risk factor for psychopathology later in life: the role of dopamine and neurotrophins.

Brain development is influenced by various prenatal, intrapartum, and postnatal events which may interact with genotype to affect the neural and psychophysiological systems related to emotions, specific cognitive functions (e.g., attention, memory), and language abilities and thereby heighten the risk for psychopathology later in life. Fetal hypoxia (intrapartum oxygen deprivation), hypoxia-related obstetric complications, and hypoxia during the early neonatal period are major environmental risk factors shown to be associated with an increased risk for later psychopathology. Experimental models of perinatal hypoxia/ischemia (PHI) showed that fetal hypoxia-a consequence common to many birth complications in humans-results in selective long-term disturbances of the dopaminergic systems that persist in adulthood. On the other hand, neurotrophic signaling is critical for pre- and postnatal brain development due to its impact on the process of neuronal development and its reaction to perinatal stress. The aim of this review is (a) to summarize epidemiological data confirming an association of PHI with an increased risk of a range of psychiatric disorders from childhood through adolescence to adulthood, (b) to present immunohistochemical findings on human autopsy material indicating vulnerability of the dopaminergic neurons of the human neonate to PHI that could predispose infant survivors of PHI to dopamine-related neurological and/or cognitive deficits in adulthood, and

Oppositional defiant disorder dimensions: genetic influences and risk for later psychopathology.

This study was undertaken to determine how well two oppositional defiant disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree towhich these outcomes can be attributed to genetic influences shared with ODD dimensions. Psychopathology was assessed via diagnostic interviews of 1,225 twin pairs at ages 11 and 17. Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed that the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions.

Parental Reflective Functioning Moderates the Relationship Between Difficult Temperament in Infancy and Behavior Problems in Toddlerhood

High levels of infant negative affect are associated with behavior problems in toddlerhood, which in turn are a risk factor for chronic behavior problems throughout childhood, especially in the context of poor parenting and psychosocial risk. Studies suggest that sensitive parenting may buffer temperamental risk in infancy by supporting self-regulation and emotion regulation (Gottman, Katz, & Hooven, 1997). Parental reflective functioning (RF) (Slade, 2005) underlies sensitivity and is a target for early interventions aimed at supporting parenting and child development. In this study, we examine whether RF-that is, the capacity of a parent to put oneself in the mind of the other (child) and see the child's behaviors as driven by his/her mental state-will protect against the effects of infant negative affect on toddler behavior problems after controlling for psychosocial risk.Early Onset of Behavior ProblemsBehavior problems in early childhood may originate from temperamental risk that is exacerbated by other parenting and psychosocial risks. Behavior problems are described in two broad domains-internalizing behavior and externalizing behavior-and each type can follow different developmental trajectories. Internalizing behavior problems have been defined as behaviors directed inward toward the self. Evidence suggests that children with internalizing behavior problems are often identified as being socially withdrawn in interactions with peers and teachers (Eisenberg et al., 2001) and are at risk for later psychopathology, including depression and anxiety. Externalizing behavior problems are defined as problematic behaviors, including hyperactivity and increased levels of aggression, directed toward the external environment (Achenbach, 1992). Some children exhibit internalizing and externalizing disorders simultaneously. One typical trajectory of behavior problems peaks in toddlerhood and decreases throughout preschool (Alink et al., 2006; Hill, Degnan, Calkins, & Keane, 2006; Tremblay, 2004). Whereas some problem behaviors during this period are developmentally appropriate, as many as 25% of young children exhibit clinically significant levels of behavior problems, and a subgroup of these children struggle with chronic behavior problems (Campbell, 1995). It is important to understand factors that predict high and chronic levels of behavior problems in childhood because they are targets for early intervention. Infants with high levels of negative affect may be regarded as showing a difficult temperament and may be at risk for early-onset behavior problems.Infant Temperament and Behavior ProblemsTemperament is involved in personality and behavior (Nigg, 2006). Infant temperament has been described as a biologically engrained pattern of behavior associated with an individual's reactivity and ability to endure new situations, people, and experiences (Rothbart & Derryberry, 1981). Several studies suggest three overarching dimensions of infant and toddler temperament: extroversion-surgency, negative affect, and effortful control (Casalin, Luyten, Vliegen, & Meurs, 2012; Gartstein, Knyazev, & Slobodskaya, 2005; Gartstein & Rothbart, 2003). Casalin and colleagues (2012) found that these dimensions of temperament demonstrated stability over a 1-year period from infancy to toddlerhood. Further, dimensions of infant temperament have been linked to later personality traits and psychopathology. High levels of negative affect, in particular, have been linked to internalizing and externalizing behavior problems in childhood and more serious behavioral and emotional problems over time, including antisocial behavior throughout adulthood (Caspi, Henry, McGee, Moffitt, & Silva, 1995; Egger & Angold, 2006; Eisenberg et al., 2000; Gartstein, Putnam, & Rothbart, 2012; Morris et al., 2002; Rubin, Burgess, Dwyer, & Hastings, 2003). The negative-affect dimension includes negative emotions such as fear, anger, frustration, and sadness (Rothbart & Derryberry, 1981). …

Fetal Origins of Mental Health: The Developmental Origins of Health and Disease Hypothesis.

The quality of fetal growth and development predicts the risk for a range of noncommunicable, chronic illnesses. These observations form the basis of the "developmental origins of health and disease" hypothesis, which suggests that the intrauterine signals that compromise fetal growth also act to "program" tissue differentiation in a manner that predisposes to later illness. Fetal growth also predicts the risk for later psychopathology. These findings parallel studies showing that antenatal maternal emotional well-being likewise predicts the risk for later psychopathology. Taken together, these findings form the basis for integrative models of fetal neurodevelopment, which propose that antenatal maternal adversity operates through the biological pathways associated with fetal growth to program neurodevelopment. The authors review the literature and find little support for such integrated models. Maternal anxiety, depression, and stress all influence neurodevelopment but show modest, weak, or no associations with known stress mediators (e.g., glucocorticoids) or with fetal growth. Rather, compromised fetal development appears to establish a "meta-plastic" state that increases sensitivity to postnatal influences. There also remain serious concerns that observational studies associating either fetal growth or maternal mental health with neurodevelopmental outcomes fail to account for underlying genetic factors. Finally, while the observed relation between fetal growth and adult health has garnered considerable attention, the clinical relevance of these associations remains to be determined. There are both considerable promise and important challenges for future studies of the fetal origins of mental health.

Infant autonomic nervous system response and recovery: Associations with maternal risk status and infant emotion regulation.

This study examined whether risk status and cumulative risk were associated with autonomic nervous system reactivity and recovery, and emotion regulation in infants. The sample included 121 6-month-old infants. Classification of risk status was based on World Health Organization criteria (e.g., presence of maternal psychopathology, substance use, and social adversity). Heart rate, parasympathetic respiratory sinus arrhythmia, and sympathetic preejection period were examined at baseline and across the still face paradigm. Infant emotion regulation was coded during the still face paradigm. Infants in the high-risk group showed increased heart rate, parasympathetic withdrawal, and sympathetic activation during recovery from the still face episode. Higher levels of cumulative risk were associated with increased sympathetic nervous system activation. Moreover, increased heart rate during recovery in the high-risk group was mediated by both parasympathetic and sympathetic activity, indicating mobilization of sympathetic resources when confronted with socioemotional challenge. Distinct indirect pathways were observed from maternal risk to infant emotion regulation during the still face paradigm through parasympathetic and sympathetic regulation. These findings underline the importance of specific measures of parasympathetic and sympathetic response and recovery, and indicate that maternal risk is associated with maladaptive regulation of stress early in life reflecting increased risk for later psychopathology.