Neural and Physiological Correlates of Prosocial Behavior: Temporoparietal Junction Activity in 3-year-old Children.

Although the development of prosocial behavior has been widely studied from the behavioral aspect, the neural mechanisms underlying prosocial behavior in the early stages of development remain unclear. Therefore, this study investigated the neural mechanisms underlying the emergence of prosocial behavior in 3-year-old children. Brain activity in the medial pFC and right TPJ (rTPJ) and facial expression activity, which are related to the ability to infer others' mental states (mentalizing), during the observation of prosocial and antisocial scenes were measured using functional near-infrared spectroscopy and electromyography, respectively. Subsequently, the children's helping and comforting behaviors toward an experimenter were assessed to examine prosocial behavioral tendencies. A correlation analysis revealed that the children who showed stronger activity levels in the rTPJ while observing prosocial scenes had more immediate helping behaviors toward others than those who did not show stronger response levels. Moreover, the amount of facial expression activity correlated with prosocial behavior, including both helping and comforting behaviors. These results suggest that the development of mentalizing ability and the social evaluation of others' actions, mediated by the rTPJ, contribute to the emergence of prosocial behavior.

Dynamic transient brain states in preschoolers mirror parental report of behavior and emotion regulation.

The temporal dynamics of resting-state networks may represent an intrinsic functional repertoire supporting cognitive control performance across the lifespan. However, little is known about brain dynamics during the preschool period, which is a sensitive time window for cognitive control development. The fast timescale of synchronization and switching characterizing cortical network functional organization gives rise to quasi-stable patterns (i.e., brain states) that recur over time. These can be inferred at the whole-brain level using hidden Markov models (HMMs), an unsupervised machine learning technique that allows the identification of rapid oscillatory patterns at the macroscale of cortical networks. The present study used an HMM technique to investigate dynamic neural reconfigurations and their associations with behavioral (i.e., parental questionnaires) and cognitive (i.e., neuropsychological tests) measures in typically developing preschoolers (4-6 years old). We used high-density EEG to better capture the fast reconfiguration patterns of the HMM-derived metrics (i.e., switching rates, entropy rates, transition probabilities and fractional occupancies). Our results revealed that the HMM-derived metrics were reliable indices of individual neural variability and differed between boys and girls. However, only brain state transition patterns toward prefrontal and default-mode brain states, predicted differences on parental-report questionnaire scores. Overall, these findings support the importance of resting-state brain dynamics as functional scaffolds for behavior and cognition. Brain state transitions may be crucial markers of individual differences in cognitive control development in preschoolers.

The intersection between alexithymia, testosterone reactivity, and coparenting in fathers predicts child's prosocial behavior.

The development of prosocial skills in children is a key predictor of long-term social, cognitive, and emotional functioning. However, the role of fathers' psychological characteristics in fostering prosocial development, including during the prenatal period, and the mechanisms underlying their influence, remain relatively unexplored. This study aimed to examine whether a higher tendency of alexithymia, a difficulty to identify and verbalize emotions, in expectant fathers predicts prosocial behavior of two-year-old toddlers through the quality of coparenting and whether greater testosterone increase during a stressful parenting task moderates this indirect effect. A sample of 105 couples and their children was tracked longitudinally starting from the third trimester of pregnancy (T1), at three months (T2), and at two years postnatally (T3). Using self-report questionnaires, fathers reported on alexithymia (T1) and mothers and fathers reported on coparenting quality (T2). Additionally, fathers provided saliva samples before and after engaging in a stressful parenting task (the Inconsolable Doll Task) to measure testosterone reactivity (T1). Children's prosocial behavior was observed during an out-of-reach task (T3). A moderated mediation analysis using structural equation modeling showed that higher levels of alexithymia pre-birth predicted lower coparenting quality three months after birth, which in turn predicted lower prosocial behavior of two-year-old children, but only among fathers with mean or high testosterone increases. This study illuminates a potential mechanism by which fathers' alexithymia and testosterone reactivity forecast their toddlers' prosocial behavior.

Mapping the duration and severity of preschool-aged children's depressive moods and behaviors.

BACKGROUND: Depressive moods and behaviors are developmentally normative, yet potentially impairing, in preschool-aged children. In addition to frequency, duration of behavior is an important parameter to consider when characterizing risk for worsening mood dysregulation. The goal of this study was to identify the duration and severity of depressive moods and behaviors and associations with impairment in a large community sample of preschool-aged children using an online parent-report daily diary. METHODS: Primary caregivers (N = 900) of 3-5-year-old children reported the daily duration of each instance of seven depressive moods and behaviors for 14 days. We used item response theory analyses to examine duration item characteristics. RESULTS: Moods and behaviors occurred at specific durations to be considered psychometrically severe/rare; for example, instances of sadness had to last an average total of 32 min per day or more, irritability at least 38 min, tantrums at least 30 min, and tearfulness/sensitivity at least 35 min. Longer durations of mood and behavior were associated with daily impairment, as well as older child age and less parental education. CONCLUSIONS: To our knowledge, this is the first study to delineate specific duration ranges for depressive moods and behaviors in preschool-aged children. These data, coupled with information about the frequency of mood-related behaviors, can assist child practitioners in differentiating normative patterns from less normative mood problems to evaluate which children may be at risk. Future work should identify the duration of depressive moods and behaviors in early childhood that predict clinically significant psychopathology over time.

Parent-child coregulation as a dynamic system: a commentary on Wass et al. (2024).

In this commentary, I argue that including and operationalizing allostatic processes will become increasingly important in future research on parent-child biobehavioral coregulation. In particular, the conceptualization and modeling of dyadic oscillatory rhythms that align in expected ways with the child's developmental stage and that distinguish typical and atypical development will be useful in future work. Despite the inherent asymmetry characteristic of parent-child relationships, we should not forget to consider the child's effects on the parent within and across time, the additional environmental demands upon parents that shape parent-child coregulation, and variations in parent-child asymmetry by parental risk factors. Studying risk factors that are dyadic in nature, such as child maltreatment, may be particularly informative in gaining a deeper understanding of how parent-child coregulation interfaces with developmental psychopathology. To best model parent-child coregulation as a dynamic system, it will be critical to employ more nonlinear analytic models and better represent the multiple hierarchical domains of coregulation and their interactions, including affect, cognition, behavior, and biology. Finally, in future research, a deeper application of existing dyadic and dynamic theories, as well as the generation of new dyadic developmental theories, will aid us in obtaining a stronger understanding of the developmental function and intervention implications of parent-child biobehavioral coregulation.

Large-scale proteomics in the first trimester of pregnancy predict psychopathology and temperament in preschool children: an exploratory study.

BACKGROUND: Understanding the prenatal origins of children's psychopathology is a fundamental goal in developmental and clinical science. Recent research suggests that inflammation during pregnancy can trigger a cascade of fetal programming changes that contribute to vulnerability for the emergence of psychopathology. Most studies, however, have focused on a handful of proinflammatory cytokines and have not explored a range of prenatal biological pathways that may be involved in increasing postnatal risk for emotional and behavioral difficulties. METHODS: Using extreme gradient boosted machine learning models, we explored large-scale proteomics, considering over 1,000 proteins from first trimester blood samples, to predict behavior in early childhood. Mothers reported on their 3- to 5-year-old children's (N = 89, 51% female) temperament (Child Behavior Questionnaire) and psychopathology (Child Behavior Checklist). RESULTS: We found that machine learning models of prenatal proteomics predict 5%-10% of the variance in children's sadness, perceptual sensitivity, attention problems, and emotional reactivity. Enrichment analyses identified immune function, nervous system development, and cell signaling pathways as being particularly important in predicting children's outcomes. CONCLUSIONS: Our findings, though exploratory, suggest processes in early pregnancy that are related to functioning in early childhood. Predictive features included far more proteins than have been considered in prior work. Specifically, proteins implicated in inflammation, in the development of the central nervous system, and in key cell-signaling pathways were enriched in relation to child temperament and psychopathology measures.

A network approach to the investigation of childhood irritability: probing frustration using social stimuli.

BACKGROUND: Self-regulation in early childhood develops within a social context. Variations in such development can be attributed to inter-individual behavioral differences, which can be captured both as facets of temperament and across a normal:abnormal dimensional spectrum. With increasing emphasis on irritability as a robust early-life transdiagnostic indicator of broad psychopathological risk, linkage to neural mechanisms is imperative. Currently, there is inconsistency in the identification of neural circuits that underlie irritability in children, especially in social contexts. This study aimed to address this gap by utilizing a functional magnetic resonance imaging (fMRI) paradigm to investigate pediatric anger/frustration using social stimuli. METHODS: Seventy-three children (M = 6 years, SD = 0.565) were recruited from a larger longitudinal study on irritability development. Caregivers completed questionnaires assessing irritable temperament and clinical symptoms of irritability. Children participated in a frustration task during fMRI scanning that was designed to induce frustration through loss of a desired prize to an animated character. Data were analyzed using both general linear modeling (GLM) and independent components analysis (ICA) and examined from the temperament and clinical perspectives. RESULTS: ICA results uncovered an overarching network structure above and beyond what was revealed by traditional GLM analyses. Results showed that greater temperamental irritability was associated with significantly diminished spatial extent of activation and low-frequency power in a network comprised of the posterior superior temporal sulcus (pSTS) and the precuneus (p < .05, FDR-corrected). However, greater severity along the spectrum of clinical expression of irritability was associated with significantly increased extent and intensity of spatial activation as well as low- and high-frequency neural signal power in the right caudate (p < .05, FDR-corrected). CONCLUSIONS: Our findings point to specific neural circuitry underlying pediatric irritability in the context of frustration using social stimuli. Results suggest that a deliberate focus on the construction of network-based neurodevelopmental profiles and social interaction along the normal:abnormal irritability spectrum is warranted to further identify comprehensive transdiagnostic substrates of the irritability.

High consistency of cheating and honesty in early childhood.

Three preregistered studies examined whether 5-year-old children cheat consistently or remain honest across multiple math tests. We observed high consistency in both honesty and cheating. All children who cheated on the first test continued cheating on subsequent tests, with shorter cheating latencies over time. In contrast, 77% of initially honest children maintained honesty despite repeated failure to complete the tests successfully. A brief integrity intervention helped initially honest children remain honest but failed to dissuade initially cheating children from cheating. These findings demonstrate that cheating emerges early and persists strongly in young children, underscoring the importance of early prevention efforts. They also suggest that bolstering honesty from the start may be more effective than attempting to remedy cheating after it has occurred. RESEARCH HIGHLIGHTS: Our research examines whether 5-year-old children, once they have started cheating, will continue to do so consistently. We also investigate whether 5-year-old children who are initially honest will continue to be honest subsequently. We discovered high consistency in both honesty and cheating among 5-year-old children. Almost all the children who initially cheated continued this behavior, while those who were honest stayed honest. A brief integrity-boosting intervention successfully helped 5-year-old children maintain their honesty. However, the same intervention failed to deter cheaters from cheating again. These findings underscore the importance of implementing integrity intervention as early as possible, potentially before children have had their first experience of cheating.

A dyadic investigation of shy children's behavioral and affective responses to delivering a speech.

Shyness is typically associated with avoidant social behavior and restricted affect in new social situations. However, we know considerably less about how one child's shyness influences another child's behavior and affect in new social situations. Children's shyness was parent-reported when children were age 3 (N = 105, 52 girls, Mage = 3.50 years), and children were tested approximately 1 year later (Mage = 4.76 years) in same-gender dyads where they were asked to give an impromptu speech about their most recent birthday in front of an experimenter and the other member of the dyad. We examined whether children's shyness and speech order influenced their own and their social partner's observed behavior and affect during the speech. Regardless of speech order, children's own shyness was positively associated with their own avoidant social behavior and gaze aversion. Regardless of shyness, children who gave their speech second averted their gaze more than children who gave their speech first. We also found that children who gave their speech second displayed less positive affect if their social partner who they watched give the speech first was shyer. We speculate that some 4-year-old children may be sensitive to the avoidant behaviors of their shy peers and, in turn, respond with less animation when it is their turn to participate in the same activity. RESEARCH HIGHLIGHTS: We examined whether preschool children's shyness and speech order influenced their own and their social partner's observed behavior and affect during a dyadic speech task Children's own shyness was positively associated with their own avoidant social behavior and gaze aversion Children who gave their speech second averted their gaze more than children who gave their speech first. Children who gave their speech second displayed less positive affect if their social partner who they watched give a speech first was shyer These findings suggest that preschool-aged children are sensitive to learning about their environment indirectly through social observation.

The relationship between attachment representations and minimal intergroup bias in preschool-aged children.

Attachment theory proposes that young children's experiences with their caregivers has a tremendous influence on how children navigate their social relationships. By the end of early childhood, intergroup contexts play an important role in their social life and children build strong ties to their ingroups. Although both domains relate to the same psychological processes-children's affective ties to others-surprisingly very little research has addressed how children's attachment relates to their intergroup attitudes and behavior. In this study, we investigate the link. For that purpose, 5-year-old children (n = 100) first underwent the German Attachment Story Completion Task (GEV-B). Then we allocated children into minimal groups based on T-Shirt color and assessed their intergroup attitudes and intergroup behavior. Results showed that while most children showed a strong and robust ingroup bias in their attitudes and behavior, children with an insecure-ambivalent attachment representation treated in- and outgroup similarly. Overall, this study provides novel perspectives on the relationship between children's attachment representation and their interactions in the social world. RESEARCH HIGHLIGHTS: This study provides novel insights into the relationship between children's attachment security and the development of intergroup bias in a minimal group context Children with secure, insecure-avoidant and disorganized attachment representation showed a strong intergroup bias in explicit attitudes and behavior Children with insecure-ambivalent attachment representation displayed no intergroup bias Insecure-ambivalent attachment representations might be detrimental to the formation of ingroup attachment.

Sensitivity to psychosocial influences at age 3 predicts mental health in middle childhood.

Children vary in how sensitive they are to experiences, with consequences for their developmental outcomes. In the current study, we investigated how behavioral sensitivity at age 3 years predicts mental health in middle childhood. Using a novel repeated measures design, we calculated child sensitivity to multiple psychological and social influences: parent praise, parent stress, child mood, and child sleep. We conceptualized sensitivity as the strength and direction of the relationship between psychosocial influences and child behavior, operationalized as toothbrushing time, at age 3 years. When children were 5-7 years old (n = 60), parents reported on children's internalizing and externalizing problems. Children who were more sensitive to their parents' praise at age 3 had fewer internalizing (r = -0.37, p = 0.016, pFDR = 0.042) and externalizing (r = -0.35, p = 0.021, pFDR = 0.042) problems in middle childhood. Higher average parent praise also marginally predicted fewer externalizing problems (r = -0.33, p = 0.006, pFDR = 0.057). Child sensitivity to mood predicted fewer internalizing (r = -0.32, p = 0.013, pFDR = 0.042) and externalizing (r = -0.38, p = 0.003, pFDR = 0.026) problems. By capturing variability in how children respond to daily fluctuations in their environment, we can contribute to the early prediction of mental health problems and improve access to early intervention services for children and families who need them most. RESEARCH HIGHLIGHTS: Children differ in how strongly their behavior depends on psychosocial factors including parent praise, child mood, child sleep, and parent stress. Children who are more sensitive to their parents' praise at age 3 have fewer internalizing and externalizing problems at age 5-7 years. Child sensitivity to mood also predicts fewer internalizing and externalizing problems.

Do reflection prompts promote children's conflict monitoring and revision of misconceptions?

We tested whether reflection prompts enhance conflict monitoring and facilitate the revision of misconceptions. German children (N = 97, Mage = 7.20, 56% female) were assigned to a prediction or a prediction with reflection condition that included reflection prompts. Children in the prediction with reflection condition (1) showed greater error-related response times and pupil dilation responses, indicating better conflict monitoring, and (2) performed closer to an optimal Bayesian learner, indicating better monitoring-based control. However, by the end of the study, all children had similar levels of misconception revision. Thus, reflection prompts can enhance learning from anomalous evidence by improving conflict monitoring, but they may need to be repeated often to sustain their beneficial effects.

Children's distinct drive to reproduce costly rituals.

Costly rituals are ubiquitous and adaptive. Yet, little is known about how children develop to acquire them. The current study examined children's imitation of costly rituals. Ninety-three 4-6 year olds (47 girls, 45% Oceanians, tested in 2022) were shown how to place tokens into a tube to earn stickers, using either a ritualistic or non-ritualistic costly action sequence. Children shown the ritualistic actions imitated faithfully at the expense of gaining stickers; conversely, those shown the non-ritualistic actions ignored them and obtained maximum reward. This highlights how preschool children are adept at and motivated to learn rituals, despite significant material cost. This study provides insights into the early development of cultural learning and the adaptive value of rituals in group cognition.

Specialized and versatile antisocial behavioral profiles in preschoolers: Associations with persistent behavioral problems.

This study investigated specialized and versatile antisocial patterns in preschoolers and examined the link between these patterns and the risk of developing chronic antisocial behaviors throughout childhood. A total of 556 children (50.6% boys, 88% White) participated in this three-wave longitudinal study at 3-5, 6-8, and 10-12 years old. A latent transition analysis revealed that most preschoolers (89.5%) who adopt several subtypes of antisocial behaviors simultaneously exhibit stable and severe antisocial behaviors throughout childhood. In contrast, most preschoolers (60%) who favor one specific subtype of antisocial behaviors desist from such behaviors between preschool and preadolescence. Importantly, aggression accompanied by other subtypes of antisocial behaviors predicted chronicity better than aggression alone, casting doubt on the notion that aggression is the strongest predictor of chronicity.

Interparental conflict dimensions and children's psychological problems: Emotion recognition as a mediator.

This study tested children's emotion recognition as a mediator of associations between their exposure to hostile and cooperative interparental conflict and their internalizing and externalizing symptoms. From 2018 to 2022, 238 mothers, their partners, and preschool children (Mage = 4.38, 52% female; 68% White; 18% Black; 14% Multiracial or another race; and 16% Latinx) participated in three annual measurement occasions. Path analyses indicated that Wave 1 observations of hostile interparental conflict predicted residualized increases in children's emotion recognition accuracy (i.e., angry, sad, and happy) at Wave 2 (ß = .27). Wave 2 emotion recognition, in turn, predicted residualized decreases in children's internalizing symptoms at Wave 3 (ß = -.22). Mediational findings were partly attributable to children's accuracy in identifying angry and high-intensity expressions.

Comparison of emotional and behavioral regulation between metopic and sagittal synostosis.

PURPOSE: Children with surgically corrected nonsyndromic craniosynostosis have been previously found to have neurocognitive and behavioral difficulties. Children with metopic synostosis have been described to have more difficulties than children with sagittal synostosis. This study aims to characterize the behavioral differences between children with metopic and sagittal synostosis. METHODS: Children with metopic and sagittal synostosis were recruited at school age. Parents completed four separated behavioral assessments: Conners-3 (evaluation of ADHD), Social Responsiveness Scale-2 (SRS-2: evaluation of autism), Behavior Rating Inventory of Executive Function-2 (BRIEF-2: evaluation of executive function), and Child Behavior Checklist (CBCL: evaluation of overall behavioral problems). Children underwent intelligence quotient (IQ) testing using the Wechsler Abbreviated Scale of Intelligence (WASI-II). RESULTS: There were 91 children (45 with metopic and 46 with sagittal synostosis). More children with metopic synostosis reported requiring supportive services (57.7% vs 34.7%, p = 0.02) and more reached or exceeded borderline clinical levels of two executive function subscales of the BRIEF-2 (emotion regulation index: 33.3% vs 17.4%, p = 0.05; global executive composite: 33.3% vs 17.4%, p = 0.05). Children with sagittal synostosis had higher scores on the rule-breaking and externalizing problem subscales of the CBCL. Increasing age at surgery was associated with worse executive function scores. CONCLUSIONS: A relationship between suture subtype and behavioral outcomes exists at school age. More children with metopic synostosis required social services indicating more overall difficulties. Children with metopic synostosis have more specific problems with executive function, while children with sagittal synostosis had more difficulties with externalizing behaviors.

Assessing Children's Autonomic Nervous System Activity During Structured Tasks: A Feasibility and Reliability Study in Ghana.

The significance of physiological regulation in relation to behavioral and emotional regulation is well documented, but primarily in economically advantaged contexts. Few studies have been conducted in low- and middle-income countries. We investigated the feasibility and reliability of measuring autonomic nervous system (ANS) activity and behavior during challenge tasks in 30 children aged 8-10 years in Ghana during two visits, 1 week apart. Completeness of ANS data ranged from 80% to 100% across all tasks. There was low-to-moderate test-retest reliability of video mood induction (VMI) emotion ratings and balloon analog risk task (BART) pumps (r = 0.34-0.52). VMI elicited higher targeted emotion ratings in Visit 2 than Visit 1. Respiratory sinus arrhythmia (RSA) was higher, and pre-ejection period (PEP) was longer at Visit 2 than Visit 1 for baseline and both tasks. RSA was higher at baseline than during the VMI anger scene at Visit 1, whereas PEP was shorter at baseline than during all VMI emotion scenes at Visit 2. RSA was higher at baseline than during BART at both visits. In conclusion, ANS data collection within evocative and arousing challenge tasks was feasible in Ghana, and the tasks were generally reliable and effective in eliciting target emotions and risk-taking behavior in this sample.

Cognitive Control Moderates Associations Between Domains of Temperamental Reactivity and Preschoolers' Social Behaviors.

Temperamental characteristics and emerging cognitive control are meaningful predictors of children's development of adaptive and maladaptive social behaviors during the preschool period. However, knowledge of the interplay of these pathways, when examined concurrently to highlight their individual contributions, is limited. Using a cross-sectional sample of 3-year-old children, we examined parent-reported discrete traits of negative (anger, fear, sadness, and shyness) and positive (low- and high-intensity pleasure) temperamental reactivity as predictors of children's prosociality and physical aggression. Further, we tested whether the effects of discrete temperament were moderated by cognitive control, as indexed by the N2 event-related potential, during a go/no-go task. Analyses focus on a subsample of children with an observable N2 (n = 66). When controlling for other relative temperament traits, several significant main effects emerged. Moreover, at low cognitive control (smaller N2), fear was negatively associated with aggression, whereas at high cognitive control, sadness was positively associated with aggression. Heightened anger was linked to reduced prosocial behavior when cognitive control was low but linked to greater prosocial behavior when cognitive control was high. The results highlight that discrete temperament traits predict individual differences in child outcomes but that associations depend on concurrent levels of cognitive control.

Temperament in Early Childhood Is Associated With Gut Microbiota Composition and Diversity.

Temperament is a key predictor of human mental health and cognitive and emotional development. Although human fear behavior is reportedly associated with gut microbiome in infancy, infant gut microbiota changes dramatically during the first 5 years, when the diversity and composition of gut microbiome are established. This period is crucial for the development of the prefrontal cortex, which is involved in emotion regulation. Therefore, this study investigated the relationship between temperament and gut microbiota in 284 preschool children aged 3-4 years. Child temperament was assessed by maternal reports of the Children's Behavior Questionnaire. Gut microbiota (alpha/beta diversity and genera abundance) was evaluated using 16S rRNA sequencing of stool samples. A low abundance of anti-inflammatory bacteria (e.g., Faecalibacterium) and a high abundance of pro-inflammatory bacteria (e.g., Eggerthella, Flavonifractor) were associated with higher negative emotionality and stress response (i.e., negative affectivity, ß = -0.17, p = 0.004) and lower positive emotionality and reward-seeking (i.e., surgency/extraversion, ß = 0.15, p = 0.013). Additionally, gut microbiota diversity was associated with speed of response initiation (i.e., impulsivity, a specific aspect of surgency/extraversion, ß = 0.16, p = 0.008). This study provides insight into the biological mechanisms of temperament and takes important steps toward identifying predictive markers of psychological/emotional risk.

Early Life Surgency, but not Effortful Control or Negative Affectivity, Is a Mediating Variable Between Maternal Pre-Pregnancy Body Mass Index and Childhood Obesity Risk.

Maternal gestational obesity is related to risk of obesity in the child. This risk may be in part mediated by altered child temperament, which can affect mother-child interactions, including feeding and soothing behaviors that affect obesity risk. Our objective was to examine the association between maternal pre-pregnancy BMI and child zBMI and determine if child temperament, specifically positive Affectivity/Surgency, mediates this association. Using conditional process modeling, we analyzed data from 408 mother-child dyads enrolled in the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Child temperament was assessed at 3 years of age via a parent report measure, the Child Behavior Questionnaire (CBQ), and child zBMI was calculated from in-person measurements of child height and weight at 4-5 years of age. Bivariate correlations showed that there was a significant positive correlation between zBMI and Surgency (r = 0.11, p = 0.03), and zBMI was also correlated with maternal pre-pregnancy BMI (r = 0.12, p = 0.02). Multivariable regression revealed that maternal pre-pregnancy BMI (adjusted ß = 0.15, 95% confidence interval [CI]; 0.00-0.05, p = 0.02) and Surgency scores (adjusted ß = 0.14, 95% CI; 0.02-0.28, p = 0.03) were associated with higher child zBMI at 4-5 years of age. Mediation analysis showed that Surgency mediated the association between pre-pregnancy BMI and child zBMI. Our models controlled for maternal gestational weight gain, gestational diabetes, socioeconomic status, maternal anxiety and depression, and gestational age at birth. Overall, maternal pre-pregnancy BMI was positively associated with child zBMI, and this association was mediated by higher child Surgency scores.