Testing the effectiveness of the culturally adapted skills training START NOW to reduce mental health problems in adolescent refugees: study protocol for a randomized controlled trial.

Background: Adolescent refugees are particularly vulnerable to mental health problems, as they experience many risk factors associated with their resettlement at crucial stages of their physical and emotional development. However, despite having a greater healthcare needs than others, they face significant barriers to accessing healthcare services. Therefore, this study aims to test the effectiveness of a low-threshold, culturally adapted version of the skills training START NOW - START NOW Adapted - in reducing mental health problems among adolescent refugees. Methods: We will recruit 80 adolescent refugees (15-18 years) with symptoms of anxiety and depression or high perceived stress in Northwestern Switzerland. They will be randomly assigned to one of two study groups: an intervention group, receiving START NOW Adapted, and a control group, receiving treatment as usual (TAU). The intervention will last 10 weeks and will consist of one-hour sessions per week provided by a trained facilitator with the same cultural background, in the respective language. Assessments to collect depressive and anxious symptoms, perceived stress, social-ecological resilience, and emotion recognition abilities will be conducted pre-intervention, post-intervention (11 weeks later) and at the 3-month follow-up. Multilevel models will be computed with primary and secondary outcome measures as dependent variables. An effect of at least moderate size will be considered clinically relevant. Discussion: This randomized controlled trial aims to investigate the effectiveness of a culturally adapted version of START NOW, providing valuable insights to improve current health promotion for adolescent refugees in Switzerland (or rather lack thereof). Ultimately, the effects of START NOW may facilitate integration and promote healthy development while decreasing costs associated with treating migration- or conflict-related trauma.Clinical trial registration: ClinicalTrials.gov, identifier: NCT06324864.

The effect of cognitive reappraisal and early-life maternal care on neuroendocrine stress responses.

Early-life adversity (ELA) is related to profound dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, reflected in both, blunted or exaggerated cortisol stress responses in adulthood. Emotion regulation strategies such as cognitive reappraisal might contribute to this inconsistent finding. Here, we investigate an interaction of early-life maternal care (MC), where low MC represents a form of ELA, and instructed emotion regulation on cortisol responses to acute stress. Ninety-three healthy young women were assigned to a low (n = 33) or high (n = 60) MC group, based on self-reported early-life MC. In the laboratory, participants received regulation instructions, asking to cognitively reappraise (reappraisal group, n = 45) or to focus on senses (control group, n = 48) during subsequent stress exposure, induced by the Trier Social Stress Test. Salivary cortisol and subjective stress levels were measured repeatedly throughout the experiment. Multilevel model analyses confirmed a MC by emotion regulation interaction effect on cortisol trajectories, while controlling for hormonal status. Individuals with low MC in the control compared with the reappraisal group showed increased cortisol responses; individuals with high MC did not differ. These results highlight the significance of emotion regulation for HPA axis stress regulation following ELA exposure. They provide methodological and health implications, indicating emotion regulation as a promising target of treatment interventions for individuals with a history of ELA.

START NOW: a cognitive behavioral skills training for adolescent girls with conduct or oppositional defiant disorder - a randomized clinical trial.

BACKGROUND: Conduct disorder (CD) and oppositional defiant disorder (ODD) both convey a high risk for maladjustment later in life and are understudied in girls. Here, we aimed at confirming the efficacy of START NOW, a cognitive-behavioral, dialectical behavior therapy-oriented skills training program aiming to enhance emotion regulation skills, interpersonal and psychosocial adjustment, adapted for female adolescents with CD or ODD. METHODS: A total of 127 girls were included in this prospective, cluster randomized, multi-center, parallel group, quasi-randomized, controlled phase III trial, which tested the efficacy of START NOW (n = 72) compared with standard care (treatment as usual, TAU, n = 55). All female adolescents had a clinical diagnosis of CD or ODD, were 15.6 (±1.5) years on average (range: 12-20 years), and were institutionalized in youth welfare institutions. The two primary endpoints were the change in number of CD/ODD symptoms between (1) baseline (T1) and post-treatment (T3), and (2) between T1 and 12-week follow-up (T4). RESULTS: Both treatment groups showed reduced CD/ODD symptoms at T3 compared with T1 (95% CI: START NOW = -4.87, -2.49; TAU = -4.94, -2.30). There was no significant mean difference in CD/ODD symptom reduction from T1 to T3 between START NOW and TAU (-0.056; 95% CI = -1.860, 1.749; Hedge's g = -0.011). However, the START NOW group showed greater mean symptom reduction from T1 to T4 (-2.326; 95% CI = -4.274, -0.378; Hedge's g = -0.563). Additionally, secondary endpoint results revealed a reduction in staff reported aggression and parent-reported irritability at post assessment. CONCLUSIONS: Although START NOW did not result in greater symptom reduction from baseline to post-treatment compared with TAU, the START NOW group showed greater symptom reduction from baseline to follow-up with a medium effect size, which indicates a clinically meaningful delayed treatment effect.

Interplay between stress, sleep, and BDNF in a high-risk sample of young adults.

Children in institutional care have a high risk to experience childhood adversities (CAs), with consequences for physical and mental well-being. The long-term effects of CAs on the brain, including consequences for neuronal plasticity and sleep, are poorly understood. This study examined the interplay between stress (including CAs), sleep, and brain-derived neurotrophic factor (BDNF), a prominent marker for neuronal plasticity. Participants (N = 131, mean age = 26.3±3.4 years, 40 females) with residential youth-care history completed questionnaires measuring CAs (Childhood Trauma Questionnaire, CTQ), psychological well-being (World Health Organization-Five Well-Being Index, WHO-5), and sleep disturbances (Pittsburgh Sleep Quality Inventory, PSQI). Hair cortisol and serum BDNF concentration were measured using enzyme-linked immunosorbent assays. The analyses were conducted by using bootstrap regression models. There was no association of stress parameters or sleep with BDNF concentration. However, we found a significant association of CAs and well-being with sleep disturbances. Last, we found an association between CAs and BDNF in sleep-healthy but not sleep-disturbed participants. Our findings indicated a role of sleep disturbance in the association between stress and BDNF. Still, further studies are warranted using vulnerable groups at-risk to understand long-term effects on mental health and sleep.

Estimation of antibody levels after COVID-19 vaccinations: Preliminary evidence for immune interoception.

To date, 72 % of the world's population has received at least one COVID-19 vaccination. The number of antibodies produced by some individuals is exponentially higher than in others, for various mostly unknown reasons. This variation causes great diversity in the future susceptibility to infection by the original or variants of the SARS-CoV-2 virus. The following study investigated whether individuals were able to estimate the strength of their antibody response after their COVID-19 vaccinations. 166 recently vaccinated participants provided a blood sample for determination of antibody titers. Participants were asked to estimate how many antibodies they thought they had produced, and were further asked how protected they felt from COVID-19 due to vaccination. Both self-rated antibody levels, and feelings of protection against COVID-19 were significantly related to their actual IgG spike antibody titers, after controlling for age, days since vaccination, BMI and cross vaccination. These results suggest that individuals may have a form of "immune interoception" which relates to their response to their COVID-19 vaccination.

The role of parenting practices in parent and child mental health over time.

BACKGROUND: Parent and child mental health has suffered during the pandemic and transition phase. Structured and shared parenting may be intervention targets beneficial to families who are struggling with parent or child mental health challenges. AIMS: First, we investigated associations between structured and shared parenting and parent depression symptoms. Second, we investigated associations between structured and shared parenting and depression, hyperactivity/inattention and irritability symptoms in children. METHOD: A total of 1027 parents in two-parent households (4797 observations total; 85.1% mothers) completed online surveys about themselves and their children (aged 2-18 years) from April 2020 to July 2022. Structured parenting and shared parenting responsibilities were assessed from April 2020 to November 2021. Symptoms of parent depression, child depression, child hyperactivity and inattention, child irritability, and child emotional and conduct problems were assessed repeatedly (one to 14 times; median of four times) from April 2020 to July 2022. RESULTS: Parents who reported higher levels of shared parenting responsibilities had lower depression symptoms (ß = -0.09 to -0.32, all P < 0.01) longitudinally. Parents who reported higher levels of shared parenting responsibilities had children with fewer emotional problems (ages 2-5 years; ß = -0.07, P < 0.05), fewer conduct problems (ages 2-5 years; ß = -0.09, P < 0.01) and less irritability (ages 13-18 years; ß = -0.27, P < 0.001) longitudinally. Structured parenting was associated with fewer conduct problems (ages 2-5 years; ß = -0.05, P < 0.05). CONCLUSIONS: Shared parenting is beneficial for parent and child mental health, even under chaotic or inflexible life conditions. Structured parenting is beneficial for younger children.

Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder.

Aims: Heart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala. Methods: Respiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9-18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest. Results: There were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects. Conclusion: RSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula's role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those.

Increased empathic distress in adults is associated with higher levels of childhood maltreatment.

While many studies investigated basic facets of empathy, less is known about the association with early life adversity (ELA). To investigate a possible association of empathy with ELA, we assessed self-reported ELA, using the Childhood Trauma Questionnaire (CTQ), the Parental Bonding Instrument (PBI) for mother and father, and empathy, using the Interpersonal Reactivity Index (IRI), in a sample of N = 228 (83% female, agemean = 30.51 ± 9.88 years, agerange = 18-60). Further, we measured willingness to donate a certain percentage of study compensation to a charity as an index of prosocial behavior. In line with our hypotheses that stated a positive association of empathy with ELA, increased levels of emotional, physical, and sexual abuse, and emotional and physical neglect were positively correlated with personal distress in response to others' suffering. Likewise, higher parental overprotection and lower parental care were related to higher personal distress. Furthermore, while participants with higher levels of ELA tended to donate more money on a merely descriptive level, only higher levels of sexual abuse were significantly related to larger donations after correction for multiple statistical tests. Other facets of the IRI (empathic concern, perspective taking and fantasy) were not related to any other ELA measure. This suggests ELA only affects levels of personal distress.

Patterns of parent screen use, child screen time, and child socio-emotional problems at 5 years.

Digital media screens have become an essential part of our family life. However, we have insufficient knowledge about parental screen use patterns and how these affect children's socio-emotional development. In total, 867 Canadian parents of 5-year-old children from the TARGet Kids! Cohort (73.1% mothers, mean ± SD age = 38.88 ± 4.45 years) participated in this study from 2014 to the end of 2019. Parents reported parental and child time on television (TV) and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis identified six latent profiles of parent screen use: low handheld users (P1, reference; n = 323), more TV than handheld (P2; n = 261), equal TV and handheld (P3; n = 177), more handheld than TV (P4; n = 57), high TV and handheld (P5; n = 38), and extremely high TV and handheld (P6; n = 11). Parents that were more likely to belong to P6 were also more likely to be living in single-parent households compared to P1 (estimate = -1.49 ± 0.70), p = .03). High membership probability for P2 (estimate = -0.67 ± 0.32, p = .04) and P4 (estimate = -1.42 ± 0.40, p < 0.001) was associated with lower household income compared to P1. Children of parents with higher P4 (χ2  = 12.32, p < 0.001) or P5 (χ2  = 9.54, p = .002) membership probability had higher total screen time compared to P1. Finally, a higher likelihood to belong to P6 (χ2  = 6.82, p = .009) was associated with a higher SDQ Total Difficulties Score compared to P1. Thus, patterns of parent screen use were associated with child screen use and child socio-emotional problems. The emerging link between parental screen use profiles and child behaviors suggests the need for more research on parent screen time.

Validation of an online version of the trier social stress test in adult men and women.

The Trier Social Stress Test (TSST) is a reliable and efficient protocol to induce acute psychosocial stress in the laboratory. If circumstances do not allow in-person assessments, an online version of the TSST could create more flexible research opportunities. To date, studies have confirmed subjective and autonomic stress responses to online TSST protocols. In this preregistered study (https://osf.io/u57aj), we focused on the effect of a TSST online for adults (TSST-OA) on cortisol and alpha amylase levels, and pleasure and arousal ratings. As cortisol stress reactivity is mediated by sex, we further compared men and women. We hypothesized significant increases in cortisol, alpha amylase and arousal, and a decrease in pleasure in response to the TSST-OA. Also, we expected stronger cortisol responses in males as compared with females, as in the laboratory TSST. N = 48 adults (56% female, meanage=23.02 years, SD=3.19) participated in the study. Saliva sampling devices were sent to participants' home before testing sessions, during which the experimenter, a mixed-sex panel, and the participant joined a video call. Participants underwent the TSST-OA and overall provided five saliva samples for cortisol and alpha amylase detection. Pleasure and arousal ratings and psychometric questionnaires were also completed online. As hypothesized, the TSST-OA significantly increased cortisol, alpha amylase, and arousal levels, while it decreased pleasure. Moreover, cortisol responses were significantly stronger in males as compared to females. 64% of subjects were classified as responders (cortisol rise>1.5nmol/l). The TSST-OA successfully induced psychophysiological stress in adults. Our protocol offers new possibilities to study stress outside of the laboratory.

Nature-Based Relaxation Videos and Their Effect on Heart Rate Variability.

Growing evidence suggests that natural environments - whether in outdoor or indoor settings - foster psychological health and physiological relaxation, indicated by increased wellbeing, reduced stress levels, and increased parasympathetic activity. Greater insight into differential psychological aspects modulating psychophysiological responses to nature-based relaxation videos could help understand modes of action and develop personalized relaxation interventions. We investigated heart rate variability (HRV) as an indicator of autonomic regulation, specifically parasympathetic activity, in response to a 10-min video intervention in two consecutive studies as well as heart rate (HR). We hypothesized that a nature-based relaxation video elicits HRV increase and HR decrease, with response magnitude being affected by aspects of early life adversity (conceptualized as low parental care and high overprotection/constraint) and trait mindfulness. In Study 1, N = 60 participants (52% female, age mean = 23.92 ± 3.13 years, age range = 18-34 years) watched a relaxation video intervention depicting different natural scenery. We analyzed changes in HR and respiratory sinus arrhythmia (RSA) as a standard HRV measure, both based on 3-min segments from the experimental session, in multiple growth curve models. We found a decrease in HR and increase of RSA during the video intervention. Higher paternal care and lower trait mindfulness observing skills (assessed via questionnaires) were associated with higher RSA values before but not during video exposure. In Study 2, N = 90 participants (50% female, age mean = 22.63 ± 4.57 years, age range = 18-49 years) were assigned to three video conditions: natural scenery from Study 1, meditation video, or short clip from "The Lord of the Rings." Again, HR decreased, and RSA increased during video segments, yet without expected group differences across different video types. We found higher parental care and lower parental overprotection to predict higher RSA at different times during the experiment. Interestingly, lower paternal overprotection predicted overall higher RSA. These results suggest a generic relaxation effect of video interventions on autonomic regulation that we discuss in light of different theories mapping restorative effects of natural environments. Further, psychological characteristics like aspects of early life adversity and trait mindfulness could contribute to individual differences in autonomic regulation. This study contributes to a better understanding of autonomic and psychological responses to relaxation videos.

[Psychometric Properties of a German Translation of the Parental Bonding Instrument]. / Psychometrische Kennwerte einer deutschen Übersetzung des Parental Bonding Instrument.

Parenting behavior affects a child's development as well as the etiology and treatment of mental disorders. The Parental Bonding Instrument (PBI; Parker, Tupling & Brown, 1979) is a well-known measurement tool to retrospectively assess parenting styles. Yet, no sufficiently validated German version exists to date. Therefore, we developed an updated translation of the German PBI version (PBI-dt) and analyzed its psychometric properties in an online survey based on a sample of n=791 German-speaking participants with a focus on item and reliability characteristics, construct and criterion validity as well as factorial structure of the PBI-dt.Our results indicated good item characteristics and reliability (α=0.86-0.95). Correlations between PBI and CTQ-SF (Childhood Trauma Questionnaire Short Form) scales were in line with the literature. Significant differences in the reported parenting style were found between people with and without mental illness as well as between normal-weight and overweight people. These results indicated the presence of good construct and criterion validity. Confirmatory factor analyses indicated an acceptable model fit for all fit indices in the original 2-factor model of Parker et al. (1979) as well as in the 3-factor model with the scales CareCareCareCareCareCare, Discouragement of behavioral freedomDiscouragement of behavioral freedomDiscouragement of behavioral freedomDiscouragement of behavioral freedomDiscouragement of behavioral freedomDiscouragement of behavioral freedom and Denial of psychological autonomyDenial of psychological autonomyDenial of psychological autonomyDenial of psychological autonomyDenial of psychological autonomyDenial of psychological autonomy. A 3-factor structure provided additional information, e. g., a better differentiation between normal and overweight people. Hence, this German translation of the PBI has good psychometric properties and is a reliable measuring instrument.

Effects of psychological, sensory, and metabolic energy prime manipulation on the acute endocrine stress response in fasted women.

The stress response supports survival through energy mobilization. Paradoxically, a low blood glucose level dampens the endocrine stress response, and sugar consumption prior to stress restores it. Thus, energy availability may play a causal role in the endocrine stress response. Yet, it has never been tested whether sweet taste or expectations towards a drink content modulate the stress response. We investigated the potential role of sweetness, energy load and expectations towards energy load of a drink consumed prior to stress in restoring stress reactivity after fasting. N = 152 women (meanage=21.53, sdage=2.61) participated in the Trier Social Stress Test for groups in the morning after an overnight fast. Prior to stress induction, participants consumed a drink containing saccharose (sugar, n = 51), an equally sweet drink containing non-caloric sweetener (sweetener, n = 46), or water (n = 56). Additionally, participants in the sugar and sweetener group (n = 97) were informed whether or not their drink contained any calories (energy prime), which was deceptive in 50% of the cases. Eight salivary cortisol (-30, -20, -10, 0, +12, +25, +35, +45 min) and three blood glucose samples (-30, 0, +25 min) were assessed throughout the experiment. The effects of the experimental manipulations on cortisol trajectories were tested using multilevel mixed models. We found that compared with water, sugar and sweetener both significantly increased cortisol stress reactivity and with comparable intensity. However, our sensitivity analysis revealed a significant effect of sugar on cortisol trajectories compared to water and to sweetener. Drink-induced changes in blood glucose concentration were not associated with increases in cortisol. The energy prime did not affect the stress response. Overall, we could replicate the boosting effect of sugar consumption in a female sample after 8 h of fasting. The specific contribution of sweet taste and metabolic hormones to this boosting effect should be tested more rigorously in sex-balanced designs in the future.

Influence of stress on physiological synchrony in a stressful versus non-stressful group setting.

Physiological synchrony (PS) is defined as the co-occurrence and interdependence of physiological activity between interaction partners. Previous research has uncovered numerous influences on the extent of PS, such as relationship type or individual characteristics. Here, we investigate the influence of acute stress on PS. We do so in a setting in which PS was not promoted, but contact between group members was explicitly minimized. We reanalyzed cortisol, alpha-amylase, and subjective stress data from 138 participants (mean age = [Formula: see text], 47.1% female) who previously underwent the Trier Social Stress Test for groups (TSST-G) or a non-stressful control task together, collected as part of a larger project by Popovic et al. (Sci Rep 10: 7845, 2020). Using a stability and influence model, an established method to test for synchrony, we tested whether individuals' cortisol and alpha-amylase concentrations could be predicted by group members' levels. We found cortisol PS in participants who were in the same group, the extent of which was stronger in the non-stressful control condition. For alpha-amylase, participants were synchronized as well; furthermore, there was an interaction between previous stress levels and PS. This suggests that while synchrony of both stress markers can occur in group settings even with spurious interaction, stressor exposure might attenuate its extent. We argue that if PS occurs in a sample where interaction was minimal, the phenomenon might be more widespread than previously thought. Furthermore, stressor exposure might influence whether a situation allows for PS. We conclude that PS should be investigated within group settings with various degrees of social interaction to further expose mechanisms of and influence on PS.

The impact of maternal care and blood glucose availability on the cortisol stress response in fasted women.

Individuals with a history of low maternal care (MC) frequently present a blunted, yet sometimes also show an increased cortisol stress response. Fasted individuals with low blood glucose levels who are exposed to acute stress typically show an attenuated response pattern in this endocrine marker. Despite well-documented metabolic dysregulations after low MC, a possible interaction of both factors has not been investigated yet. Here, we examined the effects of MC and blood glucose concentration on various aspects of the stress response. Fasted women (N = 122, meanage = 22.12, sdage = 2.56) who experienced either very high, high, or low MC (based on the Parental Bonding Instrument) were randomly assigned to consume grape juice (condition sugar), or water (condition water) prior to being exposed to the Trier-Social-Stress-Test for groups. Salivary cortisol and alpha amylase, blood glucose, and mood ratings were assessed repeatedly. Using multilevel mixed models, we replicated the boosting effect of glucose on the cortisol stress response. While we found neither an effect of MC, nor an interaction between MC and blood glucose availability on the cortisol stress response, we observed an effect of MC on the amylase stress response. We discuss the results in the light of links between various stress/energy systems that possibly mediate health-related MC effects.

Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial.

Health and disease are strongly linked to psychophysiological states. While stress research strongly benefits from standardized stressors, no established protocol focuses on the induction of psychophysiological relaxation. To maintain health, functioning regenerative systems are however likely as important as functioning stress systems. Thus, the identification of validated relaxation paradigms is needed. Here, we investigated whether standardized massages are capable of reliably inducing physiological and psychological states of relaxation. Relaxation was indicated by changes in high frequency heart rate variability (HF-HRV), a vagally-mediated heart rate variability component, and repeated ratings of subjective relaxation, and stress levels. Sixty healthy women were randomly assigned to a vagus nerve massage (n = 19), a soft shoulder massage (n = 22), or a resting control group (n = 19). During the intervention, HF-HRV and subjective relaxation increased, while subjective stress decreased significantly in all groups. Both massage interventions elicited significantly higher HF-HRV compared to the control group. Accordingly, both massage protocols increased psychophysiological relaxation, and may serve as useful tools in future research. However, future work will have to determine which of several protocols might be used as a gold standard to induce a psychophysiological state of relaxation in the laboratory.

The Opposite of Stress.

Cognition is affected by psychophysiological states. While the influence of stress on cognition has been investigated intensively, less studies have addressed how the opposite of stress, a state of relaxation, affects cognition. We investigated whether the extent of parasympathetic activation is positively related to divergent thinking. Sixty healthy female participants were randomly allocated to a standardized vagus nerve massage (n = 19), a standardized soft shoulder massage (n = 22), or a resting control group (n = 19). Subsequently, participants completed the Alternative Uses Test (AUT), a measure of divergent thinking. Respiratory sinus arrhythmia (RSA), a vagally mediated heart rate variability component, was monitored throughout the experiment. The area under the curve with respect to the increase was calculated for RSA trajectories as an indicator of vagal tone during the relaxing intervention. Regressions tested the effect of vagal tone on AUT outcomes. We found an association between vagal tone and subsequent AUT outcomes. Yet, this association was no longer significant when controlling for the effect of the creative potential of an individual, which was strongly related to AUT outcomes. Being exploratory, we found a positive association between creative potential and vagal tone. These results imply that creative potential might be related to the capacity to relax.

Maternal symptoms of depression and sensitivity mediate the relation between maternal history of early adversity and her child temperament: The inheritance of circumstance.

We examined maternal depression and maternal sensitivity as mediators of the association between maternal childhood adversity and her child's temperament in 239 mother-child dyads from a longitudinal, birth cohort study. We used an integrated measure of maternal childhood adversity that included the Childhood Trauma Questionnaire and the Parental Bonding Index. Maternal depression was assessed with the Edinburgh Postnatal Depression Scale at 6 months postpartum. Maternal sensitivity was assessed with the Ainsworth maternal sensitivity scales at 6 months. A measure of "negative emotionality/behavioral dysregulation" was derived from the Early Childhood Behaviour Questionnaire administered at 36 months. Bootstrapping-based mediation analyses revealed that maternal depression mediated the effect of maternal childhood adversity on offspring negative emotionality/behavioral dysregulation (95% confidence interval [0.026, 0.144]). We also found a serial, indirect effect of maternal childhood adversity on child negative emotionality/behavioral mediated first by maternal depression and then by maternal sensitivity (95% confidence interval [0.031, 0.156]). Results suggest the intergenerational transmission of the effects of maternal childhood adversity to the offspring occurs through a two-step, serial pathway, involving maternal depression and maternal sensitivity.

The PedBE clock accurately estimates DNA methylation age in pediatric buccal cells.

The development of biological markers of aging has primarily focused on adult samples. Epigenetic clocks are a promising tool for measuring biological age that show impressive accuracy across most tissues and age ranges. In adults, deviations from the DNA methylation (DNAm) age prediction are correlated with several age-related phenotypes, such as mortality and frailty. In children, however, fewer such associations have been made, possibly because DNAm changes are more dynamic in pediatric populations as compared to adults. To address this gap, we aimed to develop a highly accurate, noninvasive, biological measure of age specific to pediatric samples using buccal epithelial cell DNAm. We gathered 1,721 genome-wide DNAm profiles from 11 different cohorts of typically developing individuals aged 0 to 20 y old. Elastic net penalized regression was used to select 94 CpG sites from a training dataset (n = 1,032), with performance assessed in a separate test dataset (n = 689). DNAm at these 94 CpG sites was highly predictive of age in the test cohort (median absolute error = 0.35 y). The Pediatric-Buccal-Epigenetic (PedBE) clock was characterized in additional cohorts, showcasing the accuracy in longitudinal data, the performance in nonbuccal tissues and adult age ranges, and the association with obstetric outcomes. The PedBE tool for measuring biological age in children might help in understanding the environmental and contextual factors that shape the DNA methylome during child development, and how it, in turn, might relate to child health and disease.

Effects of a mindfulness based childbirth and parenting program on pregnant women's perceived stress and risk of perinatal depression-Results from a randomized controlled trial.

OBJECTIVES: The aim of this study was to test the efficacy of a Mindfulness-Based Childbirth and Parenting Program (MBCP) in reducing pregnant women's perceived stress and preventing perinatal depression compared to an active control condition. METHOD: First time pregnant women (n = 197) at risk of perinatal depression were randomized to MBCP or an active control treatment, which consisted of a Lamaze childbirth class. At baseline and post-intervention, participants filled out questionnaires on perceived stress, depressive symptoms, positive states of mind, and five facets of mindfulness. RESULTS: Compared to the active control treatment, MBCP significantly reduced perceived stress (p = 0.038, d = 0.30) and depressive symptoms (p = 0.004, d = 0.42), and increased positive states of mind (p = 0.005, d = 0.41) and self-reported mindfulness (p = 0.039, d = 0.30). Moreover, change in mindfulness possibly mediated the treatment effects of MBCP on stress, depression symptoms, and positive states of mind. The subscales "non-reactivity to inner experience" and "non-judging of experience" seemed to have the strongest mediating effects. LIMITATIONS: The outcomes were self-report questionnaires, the participants were not blinded to treatment condition and the condition was confounded by number of sessions. CONCLUSIONS: Our results suggest that MBCP is more effective in decreasing perceived stress and risk of perinatal depression compared to a Lamaze childbirth class. The results also contribute to our understanding of the underlying psychological mechanisms through which the reduction of stress and depression symptoms may operate. Thus, this study increases our knowledge about efficient intervention strategies to prevent perinatal depression and promote mental wellbeing among pregnant women.